Migraines

Specialties School

Published

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.

Specializes in School nursing.
I understand where that could be the interpretation. I was told at the beginning of the year that this is considered "benign" as it is slow growing and curable per the parents. I am an advocate for my students and patients in my other role. This is my primary career choice, chosen at age 12 when society viewed all male nurses as gay. Sometimes I see nurses make these accusations of lack of compassion as a bullying tactic and truly, I am asking you to contemplate this when you choose to make these assumptions. AN is full of nasty nurses, let's try to make it a little nicer.

I love this response and it is why I adore this forum and find my fellow school nurse colleagues to be some of the very best folks ever - even when we've never met face-to-face.

Part of working in the schools means we will work with student with chronic illness and diagnoses that most people will just aww at because they aren't great, nor or some outcomes for them great.

But...

Our job is to help students stay in school and have as normal a school day as they can get. While it may seem less compassionate to some, some kids with chronic conditions will learn how to manipulate accommodations they receive for said illness. It is a balancing act to separate the two sometimes, which is what Mr. Nurse is asking for advice on.

I've had to go a bit tough love on a few students with chronic illness in order to get them a productive and close as normal as possible school day. I've had parent blessing to do and involved them in this, of course.

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Specializes in kids.
He has Maxalt. Motrin and Tylenol for pharmaceutical treatment, but I prefer non med treatment, which seem to be adequate.

I would offer that it is not about our preference, or what makes us feels better

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Specializes in IMC, school nursing.
I would offer that it is not about our preference, or what makes us feels better

Again, missing material. Mom said to offer caffeine and electrolytes first. Maxalt is a twice in 48 hour issue, so going down the med rabbit hole severely protracts management options.

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If the child has been determined well enough to be in school, then he/she is treated as all the other students are. Sick kids belong at home and healthy kids belong in class.

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Specializes in Neuro ICU and Med Surg.
I'm not a cancer expert, but I thought astrocytoma is the worst form of brain cancers and most victims die within a couple years. Isn't this the cancer that Senator McCain is currently struggling with? You sound cold and unsyGlmpathetic that he has a victim mentality. How is he supposed to deal with a almost assuredly fatal cancer diagnosis! I'm offended just reading your comments!

Glioblastoma is the worst one. I also see no offense to the comments here. The OP is trying to figure out if this kid is manipulating or not. Legit concern. I wish my shcool has any one of these nurses here helping kids with chronic conditions in our school. In SE MI we have no in school nurses. My district has a nurse consultant which is shared with the whole county mostly. That is a ton of kids. My son is a T1D and a student advocate helps manage his insulin at lunch time. I would absolutely be much more comfortable with a nurse in the building.

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Specializes in IMC, school nursing.
No need for pardon...other observations, thoughts, and opinions are always welcome. Thank You.

Boston FNP, OD stated it perfectly. I value your knowledge on your side of the fence.

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Specializes in Critical Care; Cardiac; Professional Development.
I understand where that could be the interpretation. I was told at the beginning of the year that this is considered "benign" as it is slow growing and curable per the parents. I am an advocate for my students and patients in my other role. This is my primary career choice, chosen at age 12 when society viewed all male nurses as gay. Sometimes I see nurses make these accusations of lack of compassion as a bullying tactic and truly, I am asking you to contemplate this when you choose to make these assumptions. AN is full of nasty nurses, let's try to make it a little nicer.

I just want to jump in for a sec, as a parent of a kiddo with a benign brain tumor (craniopharyngioma) removed at age 5. It has resulted in a life-long sentence of medical treatment. He is 19 now and doing well, but the impact from his "benign" tumor has been devastating on a number of levels.

Inside the brain, the benign nature of the tumor doesn't weigh in as much as it would in other parts of the body. All the benign means is that it cannot spread outside of the brain/spinal column area. In fact, some benign brain tumors have fewer treatment options than some of the malignant ones and the treatments that ARE available impact the growth and maturing of the brain itself dramatically (ie: radiation and/or gross resection) as well as the rest of the body parts controlled by whatever part of the brain the tumor is in. Even a benign tumor, in the head, can and does do massive destruction. Please do not see the term "benign" when it comes to a brain tumor as meaning "less serious". It is not accurate.

The location of the tumor may be impacting the child's impulse control. I agree with assessing how things are at home outside of school versus how they are at school. I would also ask the teacher what kinds of behaviors are happening in the classroom and make sure the child is getting the psychosocial support needed for a child who is diagnosed with a serious medical condition. This impacts all the way around, not just in terms of pain. There are lots of reasons a child may want to get out of class, such as bullying, struggling to comprehend material, sensory issues, etc. It seems a meeting with all team members involved in the child's well being at school would be warranted.

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Specializes in IMC, school nursing.

Thanks for all the input. Mom is a teacher (not here) and stopped by after dropping him off after therapy. She was very receptive to what I observed and feels his migraines may be pressure related, and I can see where that may be the case. He is headed for a second opinion tomorrow. Mom's desire is for him to only see me at recess (2 per day) and lunch. I consulted the teacher, a newbie, but really good, to send him if he seems really uncomfortable. Love the good outcomes.

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Specializes in Cardiology, School Nursing, General.

I would talk to the parent and ask them what is his symptoms for migranes, and if he doesn't have them when you see him then, he's fine. If he keeps coming in for soda, explain this to his parents that while you do want to care for his needs, you feel he's taking advantage of the free soda and you don't want to run low on it and he's losing precious instructional time, leaving class and staying in your room when he's fine. If they get defensive, talk to your admin about this issue, because you don't want this kid to miss class and end up failing his grade for trying to get out of class.

I don't have a similar symptom child, but I have a student with a prosthetic leg and she does whatever she can to seem the victim and come see me to gossip, I put a stop on it. I told her that if she's fine and all, she doesn't need to come to my office. I talked to her parents, and it was controlled now.

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