Children and Headache

who you have headaches as a child who has a child with headaches but so hopefully this will be useful for you so that you go to the doctor the doctor has to try to figure out how to fly an appendix this is something that every doctor should have at their office because okay fit into one of the four categories and that helps because you just have all this like best ability to memorize a list like this but there are just specific categories – 3ds so this is one category where you have no headed this here is that this is time measured of the day so ya know I had a really bad day I could go back to normal what’s that gonna be like man this may be my train in tax reform if somebody has all the time Georgia’s big plan that’s what gets admitted to the hospital all the time and they did my veins in between this is the terrible before and if it’s worse than or suppose that’s going to be progressive as for people that’s going to be it okay there’s some people never had a head and they bully gonna pay for the first time there’s a question mark for those are patients to be somewhere right and raggedly but if you think that that tanks in those categories I leave this in the way people check off what category they have that’s pretty simple so kids do the same thing for kids the BIOS thing I just got this one it’s nobody has my hand read ahead of this one not for distillation at this one unfortunately some of the children and teenagers that we see our place had my main floor so kids getting migraines – as we said earlier boys and girls need for changing about the same for the first one if you had your first one 14 30 50 percent of the time after view into adulthood if unfortunately the penny was after puberty the girl most likely that girl so the reason I studied this one is this is the classic time and this one you see that the person has Finnick only on one side right you also see that it says it’s nausea light and sound sensitivity the problem is that we stick to this very strict criteria you will miss most of the kiss with his kids and I love that more than 80% of the time like kids may have pain under their eyes where their slice default science a kid’s gonna have pain in their neck outside so location and location of location is a blue real estate rule it’s a bad rule in treating children and adolescents nothing is a desolate teenager to describe your pain that the state works like Robbie Davis it works so if you rely on descriptive words the kids won’t give it to me so is use that road map I showed you at the beginning if you have that right pattern there you in enormities or if you notice this poor person has these wavy lines that go all the way to the outside that’s a migraine war unfortunately children and adolescents who might be only 10 percent so tonight understand I had 10 people kids despite that kids will tell you no I should have known it was gonna be a library bed the day before I was gone I was tired and I had a little sleep maybe

one irritable feeling of dread so after a while some of the teenagers say I don’t like this story so it’s that pattern of the pattern I showed you it’s severe somebody with a migraine alone I cannot exercise cannot read now if you can’t exercise we can’t read what else came to do those school won’t be successful in school because all kissed in school every 45 minutes is my life the stairs to the next class and it required to be reading so you have a lot of my grants you’re gonna have a lot of school nurses the location doesn’t matter most kids don’t have are divided – symptoms is nausea vomiting light sound sensitivity say that I say it one where you have nausea vomiting leg and SAS Institute so here the right character nausea vomiting like sound sensitivity that’s right – Teresa asked the question George showed you earlier that 50% of adults don’t know that they apply so if you ask the question to somebody is there a family history of mind in your family the better question is is there anybody in your family has a lot of headed yeah please describe if they tell me most about me like the South sets of to show you this long as I want you to focus on this poor child pulling his hair out that’s the reason why I showed you this one is that treating migrating it’s a race to prevent your hair hurting here with migraines get scalped anticipated goes too far okay this is a visit doctor word for that it’s called a towel did you Valentinian something her special characters smell gets in your head has progressed to the point when your scalp gets sore that’s going ahead much harder to treat the usual good drugs in the culture and don’t work so well once you had Aladeen it’s a little kids treating the kids is a race so pretty defend alligators I’m accessible so you got that pattern if you have to that could be arranged I have to tell you that every single patient that comes to see me is convinced they have a range that’s right there be convinced that they don’t have a great so it’s very important to tell people many times during the visit if you don’t think it’s a great tune so if the pattern is the migraine Adams not going to think unfortunately if someone does that the rest of the cabinet was straight up what L suppose would range it’s aligned with your band we have voted it’s worse than caucuses why is that that’s why we all have pressure in that ring in between legs and hands the pressure is not felt people cost these they do things that might increase the pressure a little bit never reaches symptomatic if you have an increased pressure that’s what that Academy that keep it happens with viruses some way it’s a skin infection though they get blood infection then each is that’s thinking that was huge head that’s not hard to see which must act on you guys there’s one QA as a medical emergency somebody gets back maybe should make the divers quick somebody never had it happen before they’ve had a headache before and just their headaches fall to the floor that’s all right that is very very different than all the others so I’ll get a lot of people who come to be safe and the Tilda unfortunately died from enemies and then my child has headaches possibly could

that be a way that the spread would happen to him until she was minding her own business she felt so that’s gonna be was path over time doesn’t show up in the picture is that there are migrating spikes in between that’s gonna be called right Michael the whole point of getting here migraines treated when we were young is to prevent this from happening so here’s a general advice for your treating belt take the time carefully people it’s not it’s not fair out and we had a patient has their story to be heard before today everybody needs a chance to serve their aunt airplane mechanic nation deserves the right diagnosis if you go home wrong diagnosis and continue so this sometimes weeks months or years we the lines have you made the right treatments everybody you don’t have that locked so they do that physicians to me assessing disability helping physicians figure out how intention-to-treat if someone’s not going to work anymore at school anymore they tell you they’re about to lose their job because they’re hanging good that somebody needs a lot more and someone says you know I’m worried but I get these days maybe two three times a year it’s inaccessible so how do you assess disability I call the absenteeism and presenteeism absent is no means how many days you absolutely for school because you’re headed that’s easily measure presidencies is the more common nowadays to go to work or school that you’re not functioning at under percent that’s a very important document because presenteeism was would lose you lose your job you get FMLA if you need to be protected absenteeism president easily means you have two people sitting in working side to side and your colleagues gotta pick up your work all the days you have my grant you come to work because your duty for trying their best but it’s just not work that gets laid off or fired in – so when describing disability is pacifism and presenteeism and when you’re getting better – green dots and radicals that means you have a but you’re okay the red dot means it’s a bad day because another doctor days into impressment unaccounted for at work and if you fall let’s see which your absolute easement precedent to use as god damn is what meaning the last position is to work for those needles in the haystack these are the worst lies that us about us used to figure out who’s got some morrow so the first was Hispanic settlers if you got a woman in her twenties misses her period that makes for work as well if a child stops brother that makes me worried that there’s neurological symptoms are obvious someone has a new neurologic finding their game changes is abrupt we talked about slowness falls down right away that’s where I saw my parents 15 years old when they start getting my friends we were because these days it’s change okay it’s very central row that’s migraine that means 3 and 10 people lot

of great history so listen carefully make sure your Doc’s wasn’t genetic histories changed that’s all things grow so that smells the worst so the doctor text history and doesn’t support that if there’s no red flags catalyst right there’s autonomic symptoms it’s my grant there’s no need for a test but if you sue so what do you do so I think the biggest a that’s done doctors under treatment doesn’t have to drive so he may need more passes to go in for a little bit to trickle through make sense so these drugs across I shouldn’t change that not as proper toast is nice higher doses some pediatricians to refer they get so use higher doses between those oral treatments pre- tans come as pills as nasal sprays and kind of shots shots you have to worry about your stomach it means a spray if done properly you don’t have to worry about your stuff shots give you more site that contains a spray and these are spray gives you more side effects than pills but pills are not as reliable because if your stomach isn’t empty and you wait too long so that’s the time to discuss with your physician attacks and knowledge and analytics are lots of bad guys either another biggest a misstep doctors prescribed these for the treatment of migraine and forget about these pageants they are not the primary so someone’s very anxious with the nightmare they cancel it but they also need insurance so just subscribe Nastya cries that’s bad this is the stuffing every speaker so far thought about it’s really true teenagers as well and also you know and they change their sleep habits a wild weekends so Friday night the mostly Val till 4:00 in the morning and sleep very bad your head teenagers went out of the house the only breakfast they just don’t drink enough water and they’re not allowed to get water out their desk I didn’t know to almost everyone on my teenagers that says he or she can carry water a school keep it on their desk exercise exercise of exercise 45 to 60 minutes now it’s different about teenagers and adults is that walking the dog maybe the first thing that 40 year olds ever done for exercise the teenagers do they should be stressed I say they have to be the most stressed kids say they have that’s the toughest and you turn to their parents talk about how many activities two teams and the debating team and they travel against rocky etcetra etcetra etcetra sometimes the place are just too full yeah the kids have to have permission to throw something that’s all goodbye but the stress has gone home many questions is bullying the bully is having trouble learning the younger kids with tags back comes much high schools are miserable blessed to be learning

and I say this people with migraines have are more sensitive to internal cues or externally that’s not be nice to mr. irritating so you can say everyone has a threshold threshold is let’s say you don’t have my rangers threshold is very high so we can tell our external stimuli we really have to be strongly to go ahead if you’re online or your jeans put your stress rational lower so that those things of you and part of the treatment is to raise repression and that’s where the exercises you first that’s my principles of treatment yeah somebody has a bee sting allergy but you can’t recommend you wait until you’re in anaphylactic shock to use it same thing with Mike we’ve got a carrier medicine with you first twenty new my grandma’s you guys before your stomach shuts again excess that means for school-age kids they gotta have MS and that’s cool keep it on ourselves well that’s where the nurse has to have it and the nurse has to know that Susie comes in to see you with your mind with her migraine you don’t say lighthouse swings for half an hour give them their medicine immediately it’s an emergency need the taxa first wins it’s a very important and I said before tree attacks with high dose of next to drugs need to be at their highest level not their lows with my grandpa George said before yeah why your headaches if you remind me more to take out to my therapist no way that’s when you search warrants a vibrator just like that your hair hurts so don’t wait until your Schwartzman’s your migraine medicine this to work for the school educator the high school you got to get a small person to teach you to buy don’t have the school nurse when they teach her buy anything so you go over the school night not to say my child has migrant my child tells you she has a headache she’s not faking she needs to be so if your trigger is avoidable on the way figure out how people come there are coping skills some bad code 14 year old girls them going to bed with no parents at my command protocol assessment skills are in place this one just shows you that not everything is the same the same person that this young woman has some types of pay and it doesn’t to be acknowledged somebody wakes up with a full-blown library at 4 o’clock in the morning they shouldn’t be taking their ibuprofen because they have expounded in raging Washington see that person’s permission to whether this is wrong for us right away so these are some preventative approaches that are beautiful apparently feedback United States versus acupuncture that’s all five of these is they require a lifetime so the principle for prevention medicine

is trying to take one that will kill two birds with one stone so songs can feel that my medicine every day there’s something today if somebody has sleep problems we do the medicine also so it’s depressed you don’t want that picking those drugs really some combinations so make the right diagnosis I think is pretty easy you have a graphic assess that severity and define what people want the comorbidities are stuff like depression anxiety and just those are the three main ones that we see okay so some has trouble falling asleep and needs to be done there’s depressed or anxious it is a partnership I gave every one of my patients email address it allows for small city planning this is watching my little boy that’s somebody getting depressed I think the diagnosis is stratified care means if somebody wakes up early in the morning really sick they have permission to mr. longer that they don’t always have to march down the same plan stratified carry means you have the choice of what to use