Migraines and "faking"
Moms View Message Board: Parenting Discussion: Archive July-December 2004:
Migraines and "faking"
My youngest DS has undiagnosed (by a doctor) migraine headaches. I had them severely as a child from age 2-14 about once a month and very occasionally in highschool. Mine must have been hormonally related b/c the last one I had was when I was 19.
DS gets severe pain with crying and nausea. His first one was at his favorite Mexican restaurant and he begged to go home before we even got our food and then threw up as soon as we got home. He's had a few since then and I have discussed it with our ped. I KNOW that they are migraines, but the ped. wants to do an MRI to rule out other stuff (i.e., tumors) to cover himself before he gives us any migraine prescriptions. DH and I don't want DS to have an MRI because (1) We think it's unnecessary and I hate that the practice of medicine includes tests just for the doctor's liability and (2)DS has reflux and has had so many invasive tests (2 endoscopies with IVs and a pH probe) that he freaks out with needles and in hospitals and we don't want to put him through that unnecessary stress. At this point his migraines can be controlled with a nap in a dark, cool room, Motrin, and a cold pack on his head.
Here's the dilemma. Since Saturday he has had three "bad headaches." One on Saturday and he missed his football game, yesterday and DH checked him out of school, and then one today and his teacher told him he couldn't check out. I do think (know) that he really gets an occasional migraine. However, DS is also a homebody and while he likes school okay he is always up for an excuse to stay home. He did sleep for 2 hours yesterday when DH checked him out, but he has always needed a lot of sleep. We are thinking that he has been faking these last 3 headaches or that he has had a mild "buck up and get on with life" type of headache, but enjoys getting to check out of activities for the day. He's always fine after a nap (which I was too when I had a migraine), but it's so hard to tell if he just wants to miss school or some activity (he loves football and wants to play, but he's realized that pick up games are more fun than organized where he has to only play offense or defense, not both).
I don't want to not allow him to check out or get suck it up and deal with it if he has a real migraine, but by the same token I don't want him to use it as an excuse. It's just so hard to tell. If it's a really bad one, then it's obvious, but migraines are relieved much more quickly if you catch them before they get too bad and that's the tricky part. I'm thinking about taking him to a pediatric neurologist (and we will have to do the MRI I guess) and hoping she'll have some insight into the real thing vs. faking issue. Any advice for me?
No advice, but I agree with taking him to the ped. neuro. Would he have to have an MRI with contrast?? Because otherwise, there would be no needles involved. However, every MRI I've ever had was LOUD.
I've had migraines since I was a child too, but I never faked having a headache. Like you said, if it's bad, it's obvious, and I think you are in a position where you have to give him the benefit of the doubt.
HOWEVER - you might try a *pep* talk and tell him how important it is not to miss school, activities, etc., and that if he REALLY has a migraine, it's OK, but otherwise it's not.
It's hard to tell someone with a migraine to tough it out as long as they can because once you've gotten past a certain point, you are ILL.
I hope you get some answers. Keep us posted.
Pam, I have had the same dilemma with my ds. If you figure how to tell if they are really "faking", please let me in on the secret. 
I accused him of faking one time to get out of his homework and he threw up all over the table. ick!
I am a long time occasional migraine sufferer. As long as I get Motrin on board fast enough i can usually fend them off. If this works for him could you send him to school w/ some motrin to be held at the office for in case he feels one coming on and write a note saying he can take them if he feels it is necessary. Also you may want to check his diet. Nitrates are really what does it for me. So I can eat one piece of cheddar not 2, one hot dog, not two, ect. It may be a diet related problem. Anything processed is a no no for me, you may want to try a no processed meat diet for a while and see what happens.
I would have the MRI done.
I'd have the MRI done, also. When you weigh the long term benefits of having the migraines diagnosed and the short term trauma of the MRI process, the benefits seem to win out. As far as the faking goes, I'd love to know any secrets you discover, too.
A coworker's son has migraines, and it is a "rule out" diagnosis. I would definitely have the MRI done, and maybe allergy tests as Kristen suggests. I suggest he should be seen by a pediatric neurologist. My coworker's son had a number of tests, including MRIs with and without contrast, but it is essentially a rule out diagnosis where the doctor checks the symptoms and does tests to rule out everything else. One of the classic symptoms of migraines, as you probably know, is tunnel vision or a loss of peripheral vision - you may come up with some way to test his peripheral vision to see if he is faking.
As far as the teacher saying he can't leave, see what your doctor says. My friend's son's doctor wrote a letter to the school both about excusing him from class and giving medication immediately, and this has helped.
My son gets yearly MRI's since having a brain tumor removed. He has to have contrast, therefore a needle, but with an initial one, they may not even need to use contrast. We have ours done at a Children's Hospital, so they make it as least traumatic as possible. My ds can listen to any CD he wants (they even have story ones to choose from), or the radio. This last time, he was even able to watch a video! He has earphones on, so the noise doesn't bother him, and I sit in the room with him, with earplugs in. For us, it's really not a big deal. I don't have any advice on the faking, though! That's a tough one.
I have had migraines since age 11. Since age 30, I have had several per week (and I'm now 46) - not all are severe, but they are migraines. Migraines is a default diagnosis - that is, they are usually diagnosed after everything else is ruled out.
As for the interference of peripheral vision/tunnel vision - this is not always a symptom...classic, yes, as in widely publicized, but not necessarily a normal symptom. I rarely experience nausea with mine, even though it's a 'classic symptom'.
I am so grateful to have a neurologist who thinks outside the box regarding migraines and expands his knowledge to include the 'not-so-usual' aspects.
Update:
The day after I posted, Noah had another headache "so bad" that he needed to be checked out of school, so I took him to the ped. The ped. did a basic neuro eval and we discussed doing the MRI again, so DH and I finally agreed to do it. After much questioning Noah also admitted that a boy has been picking on him at daycamp (after school care). He only has to go to daycamp on Tues. and Thurs. b/c those are the days I work all day and those are the days he just happened to get headaches bad enough to warrant checking out of school. We've resolved the daycamp bully issue and he has an appt for an MRI tomorrow.
It will not be a fun day. We've decided he will do better sedated, so that means a needle---not good for this little guy. Also we are supposed to keep him up late tonight and wake him up early in the morning so that the sedative will work better. And...he can't have anything to eat or drink after 6 am, but his test isn't until 1:00 pm. It will be a long day for all of us. I'll pass on the results when we know them.
Oh, poor thing! If he's being tormented by a bully, his anxiety could so easily come out as physical ailments. I'm glad you found out about it - I hope everything comes out okay.
Poor little guy. Hope it went okay.
{{{{{Pam}}}}}} I'm sure everything will go fine, but I know that doesn't help with the *anticipation*. Keep us posted.
Lots of hugs,Pam! It's so hard to see our children hurting in any way. I'll be keeping you and your ds in my thoughts tomorrow. Please let us know as soon as you can.
{{{{Pam}}}} I will be thinking of you and your ds today. It sounds like a very long day. I am hoping you get through it as easily as possible. Keep us updated on his results.
Hope all went well.
My migranes are alergic reactions (mold, meldew, and most perfumes), so I would certainly consider alergy tests as well.
Thanks for the well wishes and prayers. The MRI ended up being pretty uneventful. Noah was very worried about possibly needing a shot or IV, but was even more concerned that he would have to take his clothes off and wear a hospital gown. Thankfully neither happened. We tried without sedation and he did wonderfully, even though that machine made LOUD noises. One of us was able to keep a hand on his leg to remind him that we were there, so we elected DH since Noah is such a Daddy's boy. Afterward, we all went out for pizza! We'll have the results in a couple of days.
Re: allergy tests. Noah has already had a comprehensive evaluation by an allergist due to his reflux issues. He was allergic to milk, but has since outgrown that allergy, so we are in the clear there. His primary trigger seems to be lack of sleep. He's like his mama and needs his sleep. If he gets less than 10-11 hrs of sleep we can pretty much guarantee a migraine. It's an understood rule that if he goes to a sleepover he WILL have to take a nap the next day or he will surely have a migraine.
It was a long day. I'm skipping class tonight b/c I'm sick with a cold. My 10 y/o DS cooked supper for us and we're about to eat and go to bed. DH had a youth event tonight, so I'm the only (tired, sick) parent here. DH had to go to the doc today for a sinus infection and left with 3 prescriptions and a steroid shot in the butt. We are a sorry lot--LOL
Glad to hear that the MRI went so well and he didn't even have to be sedated! WTG Noah!! Hope everyone starts feeling better really soon.
Christy
I'm glad it went well. Hope you all sleep well tonight.
((((Pam)))) I hope you are *all* feeling better soon!! Keep us posted on how things turn out with Noah.
I'm glad it went as well as it could have. Let us know the results! Take care.
{{{Hugs}}} Hope today is going better for you! Also glad the MRI was uneventful. Keep us posted.
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