Migraines

[MrNurse(x2), ADN]

I have a student this year with brain CA. I know he wants to test us and see how we respond, but he comes in almost every day. He says he has a migraine, meanwhile he wants the glaring lights on and his mouth is going like a duck's tail feathers. I realize chronic conditions present different than acute, but these things don't coincide with what I expect. I don't want to blow off his symptoms, but he get Mountain Dews and GatorAde when he has a headache.

[WineRN]

In his defense, a few of my chronic migraine kids have caffeinated drinks in their bags just in case. I'm still mixed on how I feel about it but for some of them it helps.

I would touch base with the parents to see how he acts when he has a migraine at home to see if things are lining up.

[Supernrse01, BSN]

I would consider speaking with the parents on this one, explaining to them that you don't want to discount his symptoms but you are seeing him on a pretty consistent schedule and you just want to get a good handle on what he experiences outside of school, how frequently, patterns. etc... This is a tough one, I agree.

[NutmeggeRN, BSN]

Ugh...That sucks, I have had several kids with brain cancer, what type? I would guess the lights are not going to make a bit of difference. The pain is from the cancer. What is the rationale for the Mountain Dew, caffeine? Has he had surgery chemo and radiation? I think some latitude is ok...but at some poiint, I think it is OK to have a heart to heart with a kid and their parent as necessary.

Acknowledging you will do what ever needs to be done, but...Try to ferret out of he just needs to touch base? Maybe mom and dad are not as available as they could or should be, but they are dealing with their own stuff. He may just need someon who tell him no! I bet he gets all kinds of latitude at home and may need some reigning in.

Just some random thoughts.

I hope he has a good outcome!

[MrNurse(x2), ADN]

Thanks for the input, I really value your opinions. I totally understand that the soda is for the caffeine, I'm OK with it, really, but that gives him one more positive consequence to being in my office. He has a slow growing low grade Astrocytoma. He talks a lot from the victim standpoint where he has endured a lot. I don't discredit that viewpoint, but I believe one can get further by not staying there. Had a 5 minute conversation with mom and dad, so hard to gauge where they are with this. My principal thinks a meeting with mom and dad is in order.

[kidzcare]

Could you recommend caffeine pills instead? Take the tasty drink out of the equation?

[MrNurse(x2), ADN]

Could you recommend caffeine pills instead? Take the tasty drink out of the equation?

Despite his history, he is unable to swallow pills. He is the most polite of children, but he has that manipulative edge that most chronic disease processes produce. Would love to ask for Shasta instead, but the caffeine content is about half.

[kidzcare]

Despite his history, he is unable to swallow pills. He is the most polite of children, but he has that manipulative edge that most chronic disease processes produce. Would love to ask for Shasta instead, but the caffeine content is about half.

Ah, yes. I am familiar with the manipulative mindset that you mention. Pills can be crushed and put in applesauce. If it tastes terrible, then that is what it is.

[MrNurse(x2), ADN]

I love the devious little smile that you were making typing it, I had the same one reading it.

[OldDude]

I certainly agree a more in depth meeting with the parents to make a game plan would be in order. Compare how many headaches he has at home versus how many he has at school, especially weekends, compare his behavior at home when he complains of a headache to parents versus what you are seeing, and try to get a sense of where the parents are in regard to him and the legitimacy of his complaints. If they say, "oh yea, he can have a terrible headache but still bounce around and chat everyone up non-stop because he has such a high pain tolerance...the battle is lost so just go with it until he moves on.

I like kidz idea...there is chewable and liquid caffeine.

[kidzcare]

there is chewable and liquid caffeine.

Which can both be taken faster than drinking a soft drink. So it can start working faster and there will less lost class time.

[WineRN]

Which can both be taken faster than drinking a soft drink. So it can start working faster and there will less lost class time.

This is why I love this board. I have never even thought about suggesting chewable/liquid/non soda caffeine options!! And that would be effective quicker and so much better than drinking a soda!