Is there an increase in headaches among junior high students in New york?

valk · Feb 15, 2003

I work in a Pre-K to 8th Grade school in N.Y.

In my experience I am seeing very few headaches in the upper grades, most are in conjunction with flu like symptoms or in students who refuse or forget to wear their glasses.

In the schools where I have practiced, the 2nd grade students are the ones with the most frequent c/o headaches.

No otc's here without a 504.

bergren · Feb 16, 2003

I have personally met two school nurses who diagnosed brain tumors in children with chronic headaches. Migraines related to homones frequently start in middle school with puberty and end when it is over. I could not find it in the literature reveiw, but I did hear of a school nurse research study that directly related headaches with lack of breakfast. That habit most often starts in middle school.

If you are a member of the National Association of School Nurses you can have full text access to theJournal of School Nurisng articles: http://www.nasn.org

Go to members only section and click on the journal link

Kolar, K.R., Fisher, W, & Gordon, V. (2001). "Nurse, my head hurts": a review of childhood headaches. Journal of School Nursing 17(3), 120 - 125.

Rhee, H. (2001). Risk factors for and sequelae of headaches in schoolchildren with clinical implications from a psychosocial perspective. Journal of Pediatric Nursing. 16(6), 392-401.

Schneider MB, Friedman SB, Fisher M. (1995). Stated and unstated reasons for visiting a high school nurse's office.

J Adolesc Health. 16(1), 35-40.

DiMario FJ (1992). Childhood headaches: a school nurse perspective. Clinical Pediatrics, 31(5), 279 - 282.

valk · Feb 16, 2003

Originally posted by bergren
I could not find it in the literature reveiw, but I did hear of a school nurse research study that directly related headaches with lack of breakfast. That habit most often starts in middle school.

Absolutely, it's a classic, they usually come in @ 10:30 with the no breakfast headache. It's not just middle school students who skip breakfast.

debRNo1 · Feb 16, 2003

Originally posted by dherb
Any ideas? Thanks for your help!

I live in NY and my son is an 8th grader who last year complained continually of "headaches and stomach" aches. Pedi MD gave him a clean bill of health-medically and the complaints continued as his grades plummeted. He spent the summer in school passing by the skin of his teeth. He seemed to have a sad look but was he sad because his grades were bad or did the saddness make him get the bad grades ??

I decided to have a psych consult to R/O depression. He has been on an antidepressant now for about 8 weeks and he seems to be a little more outgoing/more talkative and a little less "sad" looking. Im hoping that the grades will improve pretty soon.

So my point is that maybe the headaches you are seeing could be a something other than an excuse to leave the classroom or a meal not eaten ?????

deb

bergren · Feb 16, 2003

Deb is right

even if the most OFTEN cause of a headache is breakfast missed, that does not preclude doing an assessment, which is why a nurse is best suited to man a health office.

Many of the kids coming to the health office may be depressed. Others may be in a difficult home situation, others, the object of bullies.

Even though we should try to keep the kids in class, there may be a very good reason kids are coming to a caring adult in the school.

debRNo1 · Feb 16, 2003

Originally posted by bergren
bullies

Another good point I over looked :confused:

They better not be picking on my baby boy :crying2:

Ill talk to him about that

thanks...

deb

Mrs.B · Feb 17, 2003

The no breakfast thing can be tricky. I would say the majority of my students c/o H/A in the late morning hours haven't had breakfast or anything to drink for that matter! I have noticed that it tends to be the 7th and 8th graders most often c/o the no-breakfast headache. My 9-12th graders have usually figured out on their own that no food = feeling lousy and go to the cafeteria before coming to me. Anyway, I have one student with chronic H/A that has an OTC script. He is recieving in-school couseling for the first time this year. As soon as he started counseling, the headaches miraculously disappeared! Like Bergren said, I would always fully assess a student esp if it's their first c/o h/a. If it's a frequent flyer, I would speak with the parents and seriously recommend a medical if not psychiatric work up.

I'm glad NY requires MD script and parental approval to give out OTC meds. I'm not sure it reduces visits to the nurses office though. Not at my school at least!

dherb · Feb 17, 2003

Thanks for the input. I do see no breakfast headaches as well as legitimate migraines. I am interested in any more follow uop on MD prescriptiions for OTC meds. It is about time that the private MD's realize how many meds their patients take at home! They do not seem to listen to the school nurse... I have seen many of the NASN articles on h/a's. They are being used for my BS project! I have not read the article entitled"Childhood headaches: a school nurse perspective" Thank you for the article!

dherb · Feb 20, 2003

Originally posted by valk
I work in a Pre-K to 8th Grade school in N.Y.
In my experience I am seeing very few headaches in the upper grades, most are in conjunction with flu like symptoms or in students who refuse or forget to wear their glasses.
In the schools where I have practiced, the 2nd grade students are the ones with the most frequent c/o headaches.
No otc's here without a 504.

Thanks for your response! I can't believe you need to do a 504 for any OTC meds. I have at least 100 students out of a total of 650 that have MD orders for Advil and Tylenol! I have noticed a big reduction in visits to my office since the newSED regulations. Going back to school and working full time is for the birds! I'm glad I am about to get my BSN because my new knowledge for caring for the kids! Thanks!

dherb · Feb 20, 2003

Originally posted by debRNo1
I live in NY and my son is an 8th grader who last year complained continually of "headaches and stomach" aches. Pedi MD gave him a clean bill of health-medically and the complaints continued as his grades plummeted. He spent the summer in school passing by the skin of his teeth. He seemed to have a sad look but was he sad because his grades were bad or did the saddness make him get the bad grades ??

I decided to have a psych consult to R/O depression. He has been on an antidepressant now for about 8 weeks and he seems to be a little more outgoing/more talkative and a little less "sad" looking. Im hoping that the grades will improve pretty soon.

So my point is that maybe the headaches you are seeing could be a something other than an excuse to leave the classroom or a meal not eaten ?????

deb

Deb- thanks for your response, I appreciate the thoughts. It is our job to investigate the various causes for all the frequent visits to the nurse. I work closely with the counselors in the next office to clue them into my "frequent flyer" list as well as bring these kids up to our special services team for discussion as well. I think these students are very lucky to have caring school nurses. I wish the administration thought we were more important. Our district is the third from the bottom for low salary positions...

Flynurse · Feb 20, 2003

My take on this would be the REGENTS EXAMS they have to study for and take on what seems to be a monthly basis. If I had that much studying to do in Junior HS I would have claimed HA's all of the time.