Dr. Gellner: When kids get sick, it's not uncommon for parents to panic about all the possible things that could go wrong with their child. I'll review some myths and facts about when panicking is warranted and when you can relax. On today's Scope, I'm Dr. Cindy Gellner.
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Dr. Gellner: I'll admit it, I've done it. I've worried that my child has some weird, exotic disease when he just has a cold. Although a few common symptoms are really bad, it's hard for moms and dads to not be anxious. Pediatricians spend a lot of time reassuring parents. For example, if your child has a stomach ache, your first thought is, "It might be appendicitis." Well, stomach aches are by far one of the most common reasons parents bring their kids to the doctor.
The majority of the time, the stomach pain has just a handful of causes, including a stomach virus, indigestion, constipation, and stress, including school phobia. Your child's pediatrician can help you figure out which of these is the cause and help give you a plan on how to help the stomach issues resolve. Appendicitis has other symptoms that go along with it, usually severe, lower right-sided abdominal pain, to the point where your child can't even walk upright. That's an emergency.
What about when your child complains of neck pain? It might be meningitis, right? Probably not. A stiff neck is much more likely to be that they slept on their neck wrong, just how we adults do sometimes. Kids with meningitis look really sick. They can't move their neck at all without severe pain, and often they'll vomit.
Kids with stiff necks who aren't sick are having painful muscle spasms, kind of like a charley horse we get in our legs. The neck kind is called torticollis, and it can be very uncomfortable and make their heads tilt. But some heat and ibuprofen will go a long way to make them feel better in a few days.
Finally, what about when your child gets recurrent headaches? That means they might have a brain tumor, right? Luckily, while headaches in kids are extremely common, so much so that most of us pediatricians talk about headaches with parents on a daily basis, brain tumors are not common. In fact, studies have shown that by the time children reach 15 years old, as many as 82% have had headaches.
The most common causes of headaches in kids are viral illnesses and stress. Believe it or not, kids who chew gum all the time are more prone to headaches. Drinking a lot of caffeine can also cause headaches in kids, another good reason to cut out soda. Many kids who have recurrent headaches actually have migraines, and they account for 44% of all chronic headaches in children.
Migraine headaches, usually one-sided, pounding, and often associated with vomiting, have been estimated to affect almost 10% of the pediatric population by the age of 15. Migraines run in families, so parents often know when their child has a migraine. Muscle tension-type headaches, the stress-related ones, account for 30% of children's headaches. These headaches feel like pressure at the forehead and the lower back of the head.
Brain tumors certainly do cause headaches, but these headaches are different. They cause severe headaches that will often wake a child up in the night. They'll vomit. And there will be other signs too, like they'll have balance problems, parts of their bodies won't work like they used to, they'll have problems walking or using their hands, or their eyes might even shake back and forth. That's called nystagmus.
These children look very ill. If your child starts to develop these symptoms, take them right to the ER as they will need to have an urgent CT scan or an MRI of their brain. And if the worst-case diagnosis is there, they will need specialists on-board right away.
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