The Hell?

Patrick's pediatrician is sending him to a neurologist following the fourth of what we are now calling his episodes in a little over a week. The episodes vary a little but for the most part they involve blinding headache pain followed by projectile vomiting. The first time was after the split lip and it seemed reasonable to classify it as being related to a mild concussion. The second time occurred a week later after he was running around. Then two days after that he woke up screaming in the middle of the night and threw up all over the bed. Tuesday morning he woke up with a headache that didn't seem so bad but halfway through breakfast he ran to the bathroom and dry heaved. In between these bouts he feels fine, normal, ok, great but he has taken to carrying a large silver bowl around with him just in case he suddenly shoots vomit out his nose (I was unfamiliar with just what projectile vomiting is - now I know and I wish I didn't.) We call the bowl his bucket and it struck me how not ok Patrick is, really, when I was picking up the living room last night and said to myself, oh I'd better bring Patrick his bucket in much the same way I remember to put the book he is reading next to his bed.

So we don't know what is going on and for the those of you (see dopey but harmless comment on last post) for whom I need to spell this out: I AM VERY WORRIED ABOUT HIM AND I AM SEEKING NEAR-DAILY MEDICAL INPUT.

Seriously, what the hell? Migraines? Post-concussion whatsit? Allergies? Right now the neurologist cannot see him until May 2nd (GOD) but our ped has promised to try to get that moved up. In the meantime I'd like to pursue all the possibilities we can collectively imagine. You always have such good insights into things. 

My poor baby. I drove him to swimming yesterday and when we got to the parking lot he said, "I'm sorry but I think I'm too nauseous to do this today." I just drove him home again.

But, like I said, most of the time he feels totally normal.

He's on this team at school that is doing some kind of creativity competition that involves... I don't understand it, actually. There is a building challenge and they've written a script and there are some other parts to it as well (it's Destination Imagination, if that means more to you than it does to me.) Last week I picked him up after their meeting and he cheerfully told me that he had invited his team of seven to our house where they were all going to make their own pants for the tournament. I thought this sounded overly ambitious but the competition makes parents sign a blood oath saying they will not help assist input or intervene in any way whatsoever so I just smiled with my teeth clenched and said Mmmmmmhmmmm?

Patrick made a list of what he needed, solicited color preferences from his teammates and then I drove him to Jo-ann where he picked out notions and fabrics and told the woman at the sewing counter how many yards he wanted of each. She kept looking over his head at me until I threw up my hands and said, "I don't sew. This isn't my project. I just drive."

As it happened we got almost a foot and a half of snow over the weekend and we (the other parents and I) decided it was not worth it to have the kids over when the roads still weren't plowed. This left Patrick to make seven pairs of pants by himself on Monday. It took eleven hours and to his credit he did them all but he bitched incessantly as he worked and he kept asking if I felt sorry for him.

I didn't and I asked him if he felt sorry for his teammate who was busy typing up the scripts or the ones who built the prototype thingy while we were in Arizona. He admitted he did not. So I said, "See? It's part of being a team. You are all working. Now buck up and get back to those straight pins unless you want me to tell you about working conditions for child laborers in 19th century woolen mills?"

He got back to work but at the end of the day he called my mom:

"Nana, I made seven pairs of pants and it took me all day long and I didn't get to do anything else today that was fun, like play, AT ALL and my mom and dad didn't feel sorry for me."

My mom said, "Oh sweetie pie you poor thing! That's terrible."

Patrick purred. I just rolled my eyes.

The pants looked pretty good, though.

Our new babysitter worked out beautifully. She was great with the kids and after they went to bed she cleaned the kitchen; she even neatly labeled the leftovers she put away. I expect any second she will be stolen from me but until that happens I am clinging to her with both hands and booking her solid, so we're going out to dinner this weekend and getting her to help with the twins during Patrick's tournament the week after that.

It's such a nice feeling to know - however briefly - that we have help when we want it. In retrospect (although I love Minnesota) I don't know if I would have moved so far away from our families. It sort of sucks to be so isolated when the kids are little.

Anyway, I went upstairs to say goodbye to Patrick before we left on Saturday and found him working with a box of old letter stickers he had found. He told me he was doing a letter recognition sheet for the babies and I said great, have fun with that.

When we got home I found this certificate on Caroline's door

I said, awwwwww.

Then I checked Edward and found this.

Feel free to click on that link for the punchline. I'll wait. Somehow I don't think that tutoring session went as well, do you?

I like to ask the twins to show me different emotions, partly because it makes me feel like Fellini and partly because it is sort of boring to spent lots and lots and lots of time with post-toddlers.

Edward as Angry.

Two interpretations of Thoughtful

Worried

And Caroline nails Coy

I know there is other stuff going on but I cannot seem to think of any of it right now, maybe because I'm perserverating on Patrick. I am really worried about him.

Comments

[~Sacha]

COncussions can take months and months to heal. If you check CBC One in Canada (our NPR) they just recently devoted a whole day to concussions and children. Swimming is not that important. Put it off.

[Lindsey]

I'm going with migraines. My husband had them so bad for a while that he projectile vomited at least a couple of times a week. That was a fun time. I seem to remember you getting migraines now and again, yes? Migraines are definitely genetic so I wouldn't be surprised if that's it. I'm sorry you're in limbo on this, that feeling sucks.

[QoB]

I am sniggering with laughter over here at that picture. Holy god.

I'm sure we will all be worrying along with you.

[martha]

Your post-toddlers are gorgeous - Caroline's coy is my favorite. I'll be thinking of Patrick, my husband went through a period of debilitating migraines at age 12 (no projectile vomiting) and it was quite difficult to diagnose. His mother's theory was dust/forced air. He still gets a migraine every two months or so. You could pull a Samantha from Sex and the City and sit in the waiting room until they agree to see Patrick!

[Kate]

I was Patrick. It was migraines. They were awful but they did eventually go away. I am sorry you're so stressed and worried but I also think that worrying is pretty normal.

[beadlady]

Sending prayers your way for Patrick. On a side note, Caroline is going to be SO MUCH fun as a teenager! She's what my sister in law calls her daughter, 'Spicy'!

[scantee]

Sure sounds like a migraine. Do children get migraines? Dr. Google says yes and that blinding pain and vomiting are common symptoms.

I'm not sure if migraines are familial but if they are and you get them that might provide a clue as to what is going on. I would definitely push hard to have him seen asap as it is wrong for a child to have to wait months to see a doctor when they are this sick.

So sorry for Patrick. Hang in there.

[Ginger]

I'll keep Patrick and you in my thoughts. I'm sure everything will be ok.

Living close to family doesn't always have good points. We live really really close to the grandparents. The bad thing is they are all having midlife crisis in their 60's and don't want to be grandparents. They refuse to keep kids because, and I quote "it makes them look old." Um ok, well don't bitch when your grandkids don't want anything to do with you.

[Lisa S,]

I'm no MD but it sounds like migraines to me. I had them when I was in 4th grade just about every week. Always accompanied by vomiting. is he sensitive to light?

The good news is I outgrew it within that year. Also they gave me some horse-sized pills that are probably not so huge anymore (modern medicine, yay) that if I took at the very beginning of the headache, it never progressed to a migraine state.

Also - caffeine and advil (in the absence of RX meds) taken at the very, very beginning of the headache works like a charm.

[Alison]

You want to hear something odd? Although I'm so sorry Patrick isn't well, and it sounds super stressful, reading between the lines YOU sound so much better than you did 6 months ago. I assume it's the zoloft or whatever. But when you say, "you know, it kind of sucks to live so far from family" I think "yup, it does!" How honest! And in my mind being able to say that one thing sucks means, well, not everything sucks, and you know that. Does that make sense?

Anyway, I tend to agree that Patrick sounds migraine-ish, or post-concussion-ish, and very scary all around, and I hope it settles down quickly!

[tree town gal]

no insight but worried with you. thanks for the update... although truly had hoped for better news. pics were worth the wait, of course.

i took my daugher to see that gnomeo and juliet movie... caroline completely reminded me of juliet in the best way...

and that clueless commentor, i'm sure, flunked reading comprehension during the formative years...

[Kirsten]

Holy Moly, those certificates in juxtaposition are PRICELESS!~ I understand your worries about Patrick, I would want that neuro appt bumped up too....hang in there!

[Genevieve]

Migraines or post-concussion would be my guess as well. Things that can help pinpoint diagnosis of migraines: keeping a headache diary. It's likely one of the first things a neurologist would ask you to do, so if you do it ahead of time, you'll be way ahead of things and that much able to move on to the next diagnostic. Some different kinds are here:
http://www.headaches.org/pdf/How_Keep_Headache_Diary.pdf
http://www.achenet.org/tools/diaries/index.asp
http://uhs.berkeley.edu/home/healthtopics/pdf/diary.pdf
http://www.fairmountpediatrics.com/documents/HeadacheDiary.pdf

Things that can help with migraines (many of which will be mentioned in the headache diary info): try eliminating potential food triggers (mine are cheddar cheese [it has a particular natural chemical that other cheeses don't] and wine, and chocolate only if I already have a headache, I gave it up for 2 months to see if it cut down on headaches and it didn't - I think for some people nuts, MSG, other triggers.). Pay attention to whether they're affected by getting enough sleep. See if he has other symptoms such as photophobia (light sensitivity) or sound sensitivity. Regular meals/snacks -- being hungry is a major trigger for me, so I usually have a granola bar or some almonds in my bag. Any vision changes, like an aura, squiggles, etc. - very common in the prodrome (run-up) to a migraine, then when they go away, the headache starts to get bad. Mine are kind of like this:
http://www.migraine-aura.org/content/e27891/e27265/e26585/index_en.html

[Kristi]

Really interesting that concussions take months and months to heal. I wouldn't have thought that.

Migrains, most definitely.

I am so sorry those b*st*rds at the crazy high medical offices take FOREVER.

[Clarabella]

Poor Patrick! Poor you! I hope they get that appointment moved up for all of your sakes!
I just wanted to thank you for "post-toddler." I have been trying to figure out what to call my almost-4-year-old for months, other than that, obv.
Take care!

[Lise]

Poor Patrick, and poor you. I'm sending many good wishes for a speedy recovery from. . . migraines? Post-concussion syndrome?

I love the posters and the pants. Even under the cloud of unpredictable projectile vomiting and blinding pain, he's an amazing kiddo.

[llcsis]

I am a devout Advil/Motrin advocate, since Tylenol, etc never seemed to do anything for me. However I could take twice my normal amount of Advil and it wouldn't even touch a migraine. Finally I was desperate enough to try Excedrin for Migraines (has caffeine) and holy @&#* does it work. 15 min later, gone - vs 8 hours of agony. So uh.. since it's over the counter and May is far away, I'd probably try it for poor Patrick.

[Kendra]

Concussions are weird. My bet is concussion.

I took a tumble sledding on MLK day, had no symptoms at the time, developed headaches, nausea, and light sensitivity throughout the following week, and now have been off work for a month. Probably not going back any time soon. Everybody says, it will heal, but it takes time and you can't speed up the process.

That said, if he is concussed, he should be getting lots of physical and mental rest. NOT going swimming. NOT going to school. NOT thinking about stuff.

If the neurologist can't get you in sooner, check with a sports medicine place. There are some in the cities that have concussion specialty clinics. Feel free to email me if you want more info.

[Alyssa]

Ask about cluster headaches - basically a neverending migraine. I've seen them called "suicide headaches" which is not an exaggeration. Mine lasted for a month and it was the most miserable time of my life. Eventually I was put on beta blockers which were a miracle cure. I took them for about a year and since then (knock on wood) have not had another migraine.

[Sarah]

My neighbor's son has pediatric migraines that certainly sound very similar to these episodes. She herself has had migraines since early adulthood but never with vomiting , so she didn't make the connection at all. Their neurologist said vomiting is very frequent in pediatric migraines. They have gotten some real help, and though he still has some, knowing what it is has made all the difference. Hoping that you all soon have some answers and solutions.

[Sara Neyer]

Laughing out loud in an empty house at the "Biter" pic has caused my dog to obsessively look around for another human. She is certain that there must be someone who has made me giggle and is growing fretful...

So sorry about the worry. I hope things look better soon. And, please, throw that bowl away when all this goes away!

[Ree]

I have migraines with food triggers. I don't know if kids do, though. But one thing people don't often say about food diaries is that there is often a lag time between the offending food and the migraine. For me, it's about 12 hours. That's why it took me a long time to figure out what food caused migraines. For several years we blamed my in-laws, not the red wine. Now I know when it's just the in-laws.

Wishing your son the best and hoping you can get him seen sooner.

[Genevieve]

Also note whether barometric pressure seems to be a trigger for him, i.e. is he getting headaches as there's a rain-or-thunderstorm approaching. Predicting storms via head throbbing is kind of my superpower.

My best discovery for me (though my kiddo didn't like them the time he head a headache): Wellpatch Migraine. A non-drug way to help combat them (I take meds as well, but these help for smaller migraines where I might not need meds - they help me keep from using the meds then - and when I have worse migraines these plus the meds are a big help). They stick on the back of the neck or the forehead, they smell like Vick's, they are like wearing a coldpack right on the sensitive point.
http://www.amazon.com/WellPatch-Cooling-Migraine-0-18-Ounce-2-Patches/dp/B0024NLF82/ref=sr_1_2?ie=UTF8&qid=1298573516&sr=8-2

Oh, and avoid heat on the back of the neck - I wash my hair in cold water, I don't use those relaxing heating pillows on my neck, etc. It's a very reliable trigger - heat on those nerves makes them swell, or something. An icepack on the back of the neck (when you can be sedentary) is the first line of action for a migraine. But Wellpatches let you walk around but feel like you have an icepack on. Some people prefer the forehead, but my irritated nerves are almost always on the back of the neck.

If feeling at all pre-headachy, avoid computer pages with things that move and bounce and change. I shrink pages so I only see the text part.

Having an appointment on May 2 stinks horribly (though hopefully your pediatrician will succeed in getting it moved up). But there are things you can do ahead of time that will save time and effort at that appointment and move the doctor closer to getting a diagnosis and solution. It always helps me to have something concrete to do!

Good luck. I feel for you. So incredibly frustrating not to know and to have to wait.

Also, Patrick's tournament sounds exactly like what we have here, called Odyssey of the Mind. Our kiddo has been doing it for years and loves it. The no-outside-feedback-on-pain-of-death part makes it tricky, but it does make them very self-reliant and they learn tons and have huge amounts of fun.

Caroline's "thoughtful" and Edward's "angry" crack me up. As does Patrick's sign for Edward.

[Andrea]

I'm on Team Migraine, if you're looking for guesses based on reading and hearing people's stories. But I would be really worried, too.

[Patricia]

Although their parents may not recognize the condition, I think many children suffer from migraines, especially if there is a genetic predisposition. Because the headaches do not present in the same way in each person, the parent may not put two and two together even if he/she experiences migraines also. Our toddler daughter called them "eye aches." Hope you find the source of Patrick's symptoms, and he is on his way to good health soon.

You have great kids, but you don't need anyone to tell you that.

[Kelli]

Hum... Sounds like migraines.... But, you've heard that already.

On another note, my 7 year old daughter is on a Destination Imagination team. We compete next weekend. I'm team captain and still don't know what the hell is going on. I feel your pain ;)

[sheilah]

I can send my husband your way. If someone he cares about is sick he will bull his way into that neurologist's office straight away. He is a great advocate in medical situations...altho' the medical professionals will come to hate him, your loved one will get seen.

I've got everything crossed for Patrick...I am amazed that they can't get a child in before May.

[Genevieve]

Last thing for now - someone mentioned caffeine and Advil at the start of a headache. Yes, definitely, but with a major caveat -- you can get rebound headaches from too much reliance on caffeine (and advil, but that seems less likely). Not such a worry since he's probably not a coffee-drinker yet, but I was told to cut waaay back on my caffeine, to help the migraines. The advantage there is because I drink very little of it now (usually one soda in the morning, ew, I know), then when I have a headache it's more effective because I'm not used to it. But you've got to be careful not to overdo and then get caffeine-withdrawal headaches too.

[Lawmommy]

Sounds like migraines. Gabriel gets these occasionally (although without the projectile vomiting, at least so far, knock a gigantic piece of wood) - does Patrick have a period of bizarre or strange behavior before the headaches start? Like, maybe, overly emotional, or strangely fixated on something, or sense of being dizzy or seeing spots? We have started heading the migraine off by giving our son 400 mg of ibruprofen + caffeine (usually Coke) when he becomes aware of the pre-migraine sensation, followed by sending him to bed. More often than not this avoids this skully splitting pain and screaming. We then continue with 200 mg of ibuprofen every 6 hours for the next day. (Obviously, the dose of ibuprofen is dependent upon the weight of the child, ask your doctor, I didn't go to med school, etc etc.)

[Clarity]

BEST.PUNCHLINE.EVER!!! OMG how I did snort. That boy is not right!
The headache/heaving thing is terrifying, I'll be anxiously awaiting updates :(

[Missie]

My husband is a neurologist, for big people, not little ones, but it sounds like migraines which are often accompanied by projectile vomiting in kids. In fact, some kids only get "referred pain" in their stomachs rather than actual headaches. A headache journal is a great tool to have BEFORE Patrick's appointment. It takes forever to see a neurologist anywhere in the country- there's actually a shortage. Hope the docs can get this sorted out- Patrck sounds like he's being a trooper!

[Jan]

Nothing to offer about Patrick except an empathetic ... Scary! :( I'd be worried, too. Maybe take the May 2nd appointment as a good sign -- if the Medical Professional Types were worried about anything truly scary, they'd see him sooner.

BUT. I get migraines and I'm learning all kinds of awesome things from your commenters. So, you know, great news for me. It IS all about me, right?

[Genevieve]

Oh, yes, what lawmommy said about the behaviour before the headaches start!! I absolutely have that at times -- I get like a chemical drive to be unreasonable (and I know I'm being unreasonable), agitated over small things, anxious, talking really fast and upset, etc. It's gotten so my husband and even my son can often say "Are you maybe getting a headache?" and then I know it's time to go eat something/take a little caffeine/take my meds (which can keep the headache from escalating), depending on the intensity. Emotional behavior is part of the prodrome.

[Leandra]

I know this sounds really weird, but I've found that if I feel a migraine coming on, if I rub my hands together under warm water for several minutes (vigorously rubbing!), then usually a full blown migraine will not develop. See if that might help ward them off? if that's what it is? I can't imagine how worried you must be.

Edward's sign made me laugh out loud.

[bethany actually]

Oh, I hope it's something non-serious and easily treatable! How worrying. But that stack of pants speaks volumes to Patrick's skills and perseverance. I don't know ANY other boys his age who could make 7 pairs of pants in a day. Tell him I said the day of not playing was worth it.

"I'm a biter." I'm still snickering.

[Alexis]

I had migraines as a kid. Often I didn't even notice the headache until I started to throw up. Mine were triggered by the heat and light(in Phoenix, mandatory outdoor recess, bleh!) The barfing is actually your bodies way to relieve the pressure in your head(Migraines are a blood vessel expanding thing, unlike a regular headache)and it pulls the blood down to your stomach away from the head. I've since read that some people get relief by soaking their feet in VERY hot water because it works the same minus the vomit. Wishing Patrick well!

[Julie]

So, ummm, (nervous cough)....what did you say was the name of that babysitter again?

[Sarah]

Yikes - poor Patrick. Does he have any symptoms in his eyes before it gets bad? I'd guess concussion / migraines, but I can imagine it is scary. I little regular coke if he gets the eye symptoms might be worth a shot.

My son has a bucket he carries around too. He's had it for a year and a half (he's two), and you get used to it eventually. And learn to love it for the laundry it saves! (He has a cleft in his larynx that makes him aspirate easily, and when he coughs, it often makes him projectile vomit. Fun fun!)

I LOVE the Biter sign - too funny. That babysitter is a keeper. :)

Good luck! I'll be sending cancellation vibes to your Neuro so you get in earlier. ;)

[Lisame]

When did Caroline's hair become a Pantene commercial?

[Bookshop Becky]

I have had cluster migraines since age 12, and it sounds familiar - I have a year when I'm fine, then 3 months of excrutiating headaches every day, with vomiting, even in the night. Also, they can come and go and come back again within a day.

It's worth asking whether the pain is localised around one area (mine is a circle around my left eye) because that's a migraine red flag.

I agree with the person who said make a diary, because they will sometimes send you away to make one before agreeing to medicate.

[Bookshop Becky]

I have had cluster migraines since age 12, and it sounds familiar - I have a year when I'm fine, then 3 months of excrutiating headaches every day, with vomiting, even in the night. Also, they can come and go and come back again within a day.

It's worth asking whether the pain is localised around one area (mine is a circle around my left eye) because that's a migraine red flag.

I agree with the person who said make a diary, because they will sometimes send you away to make one before agreeing to medicate.

[Chelsea]

I one billionth the vote for migraines. I've had them since I was 5 and that's pretty much what they looked like until I was 10. Then I started getting auras which are a very handy reminder to get myself somewhere quiet and dark, tout suite!

I hope Patrick skips my experience of vomiting in the middle of a packed church service...

[Katherine]

My first thought was also migraines. And if you're going to keep a diary (great suggestion!) also note what he ate/drank/how much he slept etc. Those things helped me identify my triggers (too little sleep, bright lights, both too much and too little caffeine, and no I am not kidding about that...)

Oh, and I love the sign!

[anon]

Maybe push for an immediate MRI?

[Elizabeth]

Edward's sign made me think of David Copperfield.

I think a headache/illness diary is a good idea. I started getting migraines when I hit puberty, but it took me months to figure out that I only got a migraine the day before my period. (Of course this isn't Patrick's problem, but there might be another pattern that seems obvious in hindsight.) One Imitrex shot and I haven't had one since. But even if it isn't migraines, the diary might help the neurologist anyways.

[Sarah R]

Yet another "sounds like migraines" post here. My daughter had 'em, as did I. I never actually threw up with them so it scared me when she did. Then I realized that really, as soon as she threw up she felt better. Then I sort of envied her.

Poor ole Patrick though. They are miserable things. And poor you. Hoping you get some answers (and some good answers) soon!

Awesome pants, too.

[Jennifer Greene]

I seriously have to stop reading your blog at work. "I'm a biter" had me giggling very loudly at my desk.

I have no words of wisdom about Patrick's illness ... just hoping that you find an answer and he starts feeling better very soon.

[Flyover Belle]

I never jump in, but... Concussions are a thing for me. I taught a session on them last semester, and now I swear, they are following me around. All head 'things' are scary - and of course, you are worried. I wondered a few things:

1. Did your ped actually see Patrick, and evaluate him for concussion (mild traumatic brain injury)? There are tools that can be used - even after the initial injury.

2. Headache diary AND food diary would be helpful. Given my husband's symptoms (and others' in this thread), I would also keep track, if you can, of the weather. Changes in barometric pressure absolutely can bring on migraines. And, if you can make note of any times when Patrick doesn't seem like himself - e.g., he's sleeping in and he never does that, or he refuses to eat x and it's his favorite food ever - that might also be helpful. I know it sounds like you'd be writing down everything that happens everyday, and that's not reasonable. But any information you can record over time will likely be helpful. Also, because things tend to blur together, it's a good thing to try to record them close to the time they occur.

3. Concussions can take months to heal, which I know no one wants to hear. But rest is so important for that healing. It may be worth considering keeping him out of activities for 2 weeks or so to see if that helps. Otherwise, you're jostling around an already-injured brain. As an example, I was completely freaked out that Lindsay Vonn (the skier) was being allowed to ski while still post-concussive.

I'm not sure whether the peds office or you called the neurologist, but... if you didn't call before, you might want to try calling to, um, emphasize the severity of the symptoms (because they ARE severe if they are interfering with his life and yours) and request an earlier appt. And, also - what someone said above about sports medicine. They are now seeing LOTS of kids for sports-related concussion. Since that seems to have come first, it's certainly a logical option.

I'll stop with the assvice now. Please don't apologize for being worried. He's your kid. Something is going on, and you want to find out what it is. I don't know who on earth would tell you NOT to worry, but please ignore them.

[Shandra]

If searching for migraine triggers mine are MSG and aspartame.

But my son had something like this and it was due to a concussion. We just had to wait it out for healing. Then he started vomiting again and it was appendicitis (so not related to Patrick, but I had to get my whine in).

Was he tested for Lyme disease when he had the rash? Because that can trigger migraines, rashes, and fever.

[Jenn]

Concussions can take an athlete down for weeks and weeks, so it's likely that if he had a concussion, it could be from that. Or maybe migraines? Either way, the thought of waiting until May 2 for an appointment makes want to go hide in a closet and curl up in the fetal position.