Читать книгу Confessions of a School Nurse - Michael Alexander - Страница 15

I could no longer just take patients at their word, especially when all their symptoms were so subjective. And I clearly still had a lot to learn.

‘I have a migraine.’

‘Are you sure?’

‘I have a migraine – a headache.’

‘There’s a difference between a migraine and a headache, do you have any symptoms?’

Chrissy sighed and rolled her eyes as if speaking to a simpleton. ‘My … head … is … sore.’

The ‘migraine’ sufferers are the easiest to catch. A real migraine sufferer looks absolutely miserable, and just wants to lie down with a pillow over their head and a bucket beside them. Not only did Chrissy look fine, she also had the energy to be sarcastic and roll her eyes. But knowing someone’s lying doesn’t necessarily make it easier to catch them out.

‘How do you know it’s a migraine?’ I asked.

‘Mum has them, and she said I do as well.’ So many people have no idea of any of the symptoms of a true migraine. But perhaps Chrissy had the beginnings of one.

‘Do you feel like vomiting?’ She nodded her head.

‘Visual disturbance?’ Another nod.

‘Dizziness?’ Of course.

I naïvely asked her to rate her pain on a scale of 1 to 10, with 10 being the worst pain she could ever imagine.

‘Nine or ten.’

She seemed prepared to say yes to every symptom I described. She should be curled up on the floor, her arms wrapped over her head, pleading for us to put her out of her misery.

‘It sounds like a real bad one, you’ve probably got some diarrhoea as well.’ Chrissy thought over her response, unsure if I was testing her (which I was) before suggesting that things had seemed a little ‘looser’ than normal that morning. I gave up. Two 500mg tablets of paracetamol, one hour rest, and she went back to class, symptom free. I found out later that she had missed her Maths test because she was resting in the health centre.

What did I learn? I learnt to keep my mouth shut, which is quite different to what I’d do in an emergency room. When you’ve got a forty-year-old man with chest pain, you question their symptoms because it helps define the problem, and may just save their life. Questions like ‘Does the pain go down your left arm?’ or ‘Do you have pain in the jaw?’ are absolutely vital.

But at the school, I didn’t want to ask them if they had any visual disturbance, nausea, vomiting, aura, pins and needles, as the moment I gave them some symptoms to choose from, they usually chose the lot. Without fail, those who have real migraines know their symptoms and do not hesitate to let me know.