pain medication - headaches

[Kjs]

I am just so frustrated. I hope you are not getting sick of my posts. difficult child is very fearful of a bad headache returning.

Medication instructions from ER doctor:

difficult child may take up to 3 advil at a time.
difficult child may take up to 2 Excedrin Migraine at a time
difficult child may take 2 tylenol #3's at a time.

Advil and Excedrin must be 4 - 6 hours apart.
Tylenol #3 may be given one hour after either Advil or Excedrin but must wait 4 - 6 hour for more tylenol #3.

Suggested we try Excedrin first because caffeine is good for headaches.
(we always did Advil first followed by Excedrin)

Two hours after we returned home from ER he took Advil, afraid that his headache was returning.

That early evening he took tylenol #3. Head was hurting and he was terrified it would get as bad as it was that morning. (I was sleeping when he took this)

Just before I left for work husband went to get Excedrin Migraine for him as we were out.

Friday morning difficult child calls to tell me easy child is over and asks if he can go to his house. (easy child also lives with two other guys) I tell him sure.
About an hour later difficult child calls me and asks if he can take two Excedrin Migraine his head was hurting and it was starting to get bad.
I asked him if he took it with him over there and he says yes. I asked if he had taken any medication prior in the day. he says no. OK.

difficult child calls me an hour after this. He says "mom, easy child had this powder and it took my headache away in like five minutes!!" he was so excited. MY heart skipped a few beats.
Me...what kind of powder?
difficult child...I don't know, powder.
me..let me speak to easy child please.
easy child..hello....
me...WHAT POWDER..
easy child..it's called BC. It has aspirin and caffiene in it. Same as excedrin.
Me..are you sure that is all.
easy child..says ages 12 and older.
Me...ok. bye

So I am all worried. I googled it. Still I am worried. Too much medication. AND the fact that someone can say it will help your headache and he just does it.

difficult child is usually so social, over at peoples houses and doing things. He has not left the house in about two weeks. Shaky - scared of a bad headache.

 

[smallworld]

Kjs, I wrote in your other thread about the type of medications your difficult child needs to deal with migraines ONCE diagnostic tests are run to rule out other physical causes for the headache. I agree that he's on too many pain medications, which actually could be causing rebound headaches.

 

[Kjs]

we Have seen a pediatric neurologist. We have done MRI, MRA, EEG, CT. Seems as if we do this once a year. Always comes back normal. I am reluctant to do all these again. Hasn't been a year since last test.

He tried topomax to prevent the headaches and that did not do anything. He was on that atleast a yearor more. He was on Lamictal for three years and still had headaches. I do think this past year has been the worst. (he has been off Lamictal a little over a year)

It is just so frustrating. For ME, i have also had all those tests done. I am at the point with my headaches to just take pain medications when they are bad and deal with it. But he is so young. And SO much pain.

I wonder if it is hormones, but that wouldn't explain the past many years of headaches.

 

[smallworld]

Our neuro says that migraines for boys typically improve AFTER puberty. For girls, they get worse after puberty (related to hormones). Anxiety can make migraines worse.

You should see a new pediatrician neruo and bring a copy of your difficult child's past medical records. Ask about preventive medications like Propranolol and Nortriptyline. I don't believe heavy-duty pain medications are the long-term answer in this case.

 

[susiestar]

It is well owrth trying the medications that smallworld and I have suggested. Staying on the pin medications is likely CAUSING some of these headaches. It is also quite likely that anxiety is contributing to them (there must be a lot of anxiety about the coach of the other team, in my opinion).

While caffeine MAY be helpful in treating a migraine OCCASIONALLY it is NOT a good idea to have it daily, esp for a child. It can help a migraine in a couple of ways. ONE way is that if you are used to caffeine and don't get it - this can CAUSE a migraine. Caffeine also makes many pain medications work better.

Most ER docs will tell you that what they prescribe is for treatment of occasional problems - NOT for prevention or for long term treatment of problems.

It is important to know what classes of pain relievers exist. You should not take 2 medications of a similar type with-o specific doctor advice. For these migraines you should be seeing a pediatrician neuro. If the pediatrician neuro you saw did not get the problem under control, it may be time to seek out another one.

Tylenol (acetaminophen) is one type of pain reliever. NSAIDS are another (ibuprofen, naproxen, aspirin). Caffeine is another. Taking tylenol with-in a few hours of excedrin is not safe. Neither is taking aspirin and ibuprofen with-in a few hours. Each of these has a specific dosing interval.

You may want to discuss the way he is using these medications with a pharmacist to clarify this.

My daughter's neuro says that caffeine is far more likely to cause migraines than to treat them - especially if you are taking it more than 1 time per week.

does difficult child have a therapist who can help him learn biofeedback and other ways to handle the headaches with-o medicine?

You are quite right to be worried that he is taking medications just because someone else (not a doctor or a parent) says they will help.

A physical therapist may also be able to help with exercises to prevent and to treat migraines.

A food diary is one of the best tools to help you prevent migraines. If you are not addressing dietary triggers you are likely to not get migraines under control. You should also be tracking what pain relievers he is taking for migraines and other headaches, when he is taking them, and if he is taking them for other reasons.

 

[TerryJ2]

Hi Kjs, I agree, that he may be having rebound headaches. Plus, his anxiety about the headaches may be stressing him out and bringing on headaches.
The caffeine mixed with-medications is supposed to speed up the delivery of the drug into the system. At his age, I wouldn't put too much stock in caffeine by itself.
Have you considered massage and chiropractic? And an elimination diet to rule out allergies? (All very time consuming, I know.)
Also, if he is getting migraines, you need ice, not heat. Heat is good for tight muscles.
So many things to consider.
I wish you luck with-your future testing.
I feel for you both. (Especially since I get headaches, too.)

 

[Andy]

You post whenever you need to - we want to help you through this.

I am not good in the medicine realm so will address the non-medication realm. Has the doctor discussed any sleep and food issues with difficult child?

therapist told us yesterday that kids with anxiety need 11 hours of sleep (yep, we have same problem - how to do this with a preteen?) but something to thrive for.

Maybe if you can sit down with difficult child and draw up a health plan for him to focus on it may take some attention away from the headaches. He may feel his is actually doing something:

therapist also told us he learned this last week that the kinds of food eaten at breakfast is important. Kids should have protien (eggs) for breakfast - that will give them steady energy for a longer time - stays until lunch time. The carbohydrates are good in the evening because the energy they give is short lived - will drop energy levels mid morning.

Fruits and veggies are much better than chips and cookies. If he can plan his snacks at a certain time each day and have a banana or some carrots.

Also, does he have any exercises to reduce stress? Like breathing to calm down? These can be done on a regular basis - don't wait until you feel you need them.

Water and Gaterade - stay away from sugar and caffene drinks. Especially no caffene (unless it is at the medication time for getting rid of a headache). I had headaches big time from caffene withdrawals when I gave up caffene for my 2nd pregnancy (not for my 1st though).

Let him know that eating, sleeping, relaxing is healthy and although they may not solve the headache problems, they will help while you continue looking for the medical reason.

Ask him to just try it for one month. If he has a timeline to know it is not for forever, it may get him going. Once the month is over, continue the healthy habits but allow more of the favorites and see what happens.

My difficult child says he can now tell that he feels better after eating a banana.

 

[Sara PA]

BC Powders contain 650 mg of aspirin, 33.3 mg of caffeine, and 195 mg of Salicylamide.

Excedrine contains acetaminophen, aspirin and therapeutically active caffeine.

They aren't the same.

I would use the BC Powders for this "coming on" or "getting worse" headaches, now that he's sure they work. Even having BC Powders on hand might cut his anxiety, at least as long as he's sure they will work.

 

[susiestar]

One thing you iwll want to run past whatever doctor you choose to treat him: aspirin and Reyes Syndrome. Our docs have stressed that people under the age of 18 should NOT take any medication containing aspirin because the risk of Reyes Syndrome. Here is a link explaining what it is and how aspirin is linked to it.

http://www.reyessyndrome.org/aspirin.html

 

[svengandhi]

I often get bad headaches which are not migraines. I have found that after much trial and error that Advil liqui-gel caps work the best. THey seem to get into the system quicker than regular Advil. Since I began using them, I have not had to take a Tylenol 3 or a Percocet, as I sometimes would have to before that. If you want a little caffeine in him, have him take the pill with Coke or Mountain Dew.

Also, if he is able to do this, it helps. If he can lie down after taking the pills in a dark room (migraine treatment) and just breathe deeply for about 10 minutes, he will likely fall asleep and the headache will be gone when he awakes. If it comforts him, sit with him and hold his hand or rub his shoulders. One of my sons always comes and sits with me till I fall asleep and has been doing it since he was 5.

 

[KTMom91]

Miss KT has developed headaches within the last six months or so. Her doctor has her taking Relpax, since Advil etc. wasn't working. Don't know how often she's taking it, though.

 

[TerryJ2]

I didn't know aspirin was bad for anyone under 18. I thought it was 12.
Good thing I saw this!