How to tell when its a genuine pain

[justine1]

Hi

 

Sam(9,ASD) told me last night that he had pain in his knee,I assumed its just bruised as he was playing and jumping around as usual and other than mentioning it once he did not carry on about it much.

 

This morning he woke up and as he got down from bed(bunk) he again said his knee is really hurting.I don't really like him missing school unless its very serious,on the occassions he has missed school he has slept most of the day so it has been genuine. I insisted he gets ready for school,first thing he done was to hide his school trousers(two) before he went for a bath.I told him I would look for them whilst he bathed,then I heard him muttering in the bathroom saying the toothpaste was nearly out and then I heard his toothbrush been thrown only to find it in the toilet. He went to get dressed and whilst in his room sat on the bed moaning about everything and saying we never give him food and that it is child abuse(this from a child who eats non-stop!) He did'nt get completely dressed but went downstairs and took his shirt with him,when downstairs he began playing with his younger brother. I told him sternly to stop playing(it was 8am and his taxi comes around 8.05am) as he still was'nt ready,he then said it was his brothers fault and slapped him. I told him off and said he will lose time on xbox when he gets back. He got ready and went to school. I quickly wrote in his diary about the refusal and mentioned the knee pain they spoke to him and called me saying they will let me know how he got on through the day.

 

What I want to know is how do we know when the pain is that bad that he should be at home? He mentions pain but not expressive enough for me to tell how serious it is.It happened just under three years ago when at mainstream,he told me his eye hurt and I sent him to school only to get a call an hour later saying he punched his TA,I took him to the GP and he had a severe eye infection and got antibiotics. If I knew it was that bad I would'nt have sent him in. He does kick off more when he is unwell or in pain,and I believe thats the reason for the outburst. He is generally very good when getting ready and on time for school. The school even mentioned how he rarely complains about any type of pain and he usually has 100% attendence. I really want to understand when he is in pain so I don't send him in when he is hurting and should be seen by a doctor.

[oxgirl]

Yes, this is difficult. When our lad was young, we had a opposite problem, any tiny ache or a scratch would send him hysterical to the point where we didn't know if we just needed to rub it better or call an ambulance. I've taken him to casualty twice when he was younger because he was making such an extreme fuss about a pain I thought he'd actually broken something, we never did know if it was just a mild ache or if he actually was in genuine agony! He would also over-react at the slightest spot or paper cut or scuff, he would spend the rest of the day or week hiding the offending injury, so if he had a tiny spot on his hand he would hold it behind his back or cover it with his jumper and avoid looking at it or using it. He did grow out of it eventually though.

 

Not sure how you should react when your lad is not reacting to injuries though. I guess it's just about observing him and if he can walk okay and isn't limping or is using his arm okay you can pretty much assume it isn't a serious injury. Sorry, not much help, I'm sure.

 

~ Mel ~

[justine1]

Thanks oxgirl. The funny thing is I to have a very high pain threshold,or I am just stubborn. I broke my arm age 13 and did not go to see a doctor until three months after it happened,I had to have surgery and a cast put on. Again when I was 15 I injured my knee playing basketball and did'nt see anybody for a month,I severly damaged cartilage and again had to have surgery and 6 weeks of physio.

 

I have also had 5 children naturally,no pain relief(had gas and air once but made me sick) no stitches and very quick easy births. So I guess he may just have an equally high pain threshold. However I do think its more down to him not being able to express himself.He rarely cries when injured,I recall when he was 4 yrs old he fell on a lightbulb which cut his knee he was not bothered by the pain more facinated by the amount of blood. He made more of a fuss when we took him to the hospital as he did'nt want anyone touching him. Sometimes he looks like he is in pain or discomfort, like when he has a cold, he goes very quiet and not his usual jumpy self. As my partner said it would not surprise him if Sam has injured his knee as he constantly jumps,runs and climbs.

[LancsLad]

One thing I will throw in from personal experience is that I have a very high pain threshold, this might well be an autistic trait. I have for example had a triple fracture of my face in the first minute of a rugby match and played through 60 minutes of the game. I can honestly say it didn't feel 'that' bad or at least not to go off. I underwent surgery within a few days of the accident to put things back in their right place and was told by the surgeon i was lucky not to loose my eyesight.

 

I think you need to make a call to either go one way or the other and see if things run true. I know for example if I feel pain and think something might be wrong it means it is and this has been the case throughtout my life.

 

My son in contrast makes a fuss about anything and everything and so I will look at what it is and keep checking every hour to see what is changing looking for signs. If he complains and is very quiet I know it is possibly something which needs investigating. For many years I was the first aider and first port of call in large secondary schools. For most kids when they are quiet and concerned then that is a good sign that something is wrong. When they are making a big fuss it is often something a lot more superficial rather it is an emotional release.

 

If he does have a very high pain threshold like myself and others I would develop skills of compare and contrast. For example what does this area feel like compared to another one and use a scale 1-10. Or what is it like compared to the time..... This is the only way I can make sense of some of my own issues a lot of the time.

[karmadestiny]

Hi Justine,

 

My son at the age of 5 climbed our metal fence, inour back garden, he slipped and severely grazed his neck all the way down from under his chin...without us knowing he crept back into the bathroom tried to clean up the blood with wet tissues...he went passed me as I was working in the kitchen at that time and went upstairs with blood smearing all over the walls in all the rooms as he tried to find something to stop the blood flow...not finding anything he returned went back into the bathroom...As he took time, I knocked on the door to find out if he was ok, and why he was spending so much time in there...he had locked the door from inside and wouldn't open the door...I got really worried and begged him to open the door, the more anxious I became the more he wouldn't open the door, worried that he would be in trouble...On begging him to open the door and promising he won't get into trouble he opened the door...what I saw shook me to my bones...he was standing there calmly we wet tissues placed all over his neck and I could see that he was bleeding...it took a little coersing to get him to remove the tissues to see how bad he was...I told my husband to drop everything and we got him to casaulty as fast as we could...luckily he had surface grazing bad but not fatal...

 

What really amazed me was how he didn't seem to feel much pain...the only time he cried was when he saw the panic in my face and voice...up until a couple of years ago, now his 11, he had legs full of large bumps all over the place, when asked what happened he had no idea...the only thing that really scared me was what if he has an injury (like Lancslad) and he doesn't seek help, thinking nothing of it and ending up with life threatening situation...I talked to specilaists but as far as they were concerened its just one of the Aspergers symptoms... So I've stopped worrying and have tried to make him aware of knowing when he needs help...Try not to worry too much, as a mum I think you will know when his really not well...have faith in your own intuition, it won't let you down:)

Edited October 20, 2012 by karmadestiny

[Isobel]

when I broke my humerus falling off a horse, I did feel pain, but TBH the shock overtook my body so quickly my brain became foggy (to the point that I was almost fainting) and then after that once my arm was in a sling I didn't feel a lot of pain. Probably the adrenaline going through my body was an effective pain killer as I only needed oral morphine once and then I was on codeine for the next few days but only needed it about once a day. I couldn't eat the meal my mum made me that night as the shock was still present in my body and obviously my stomach wasn't ready to take a lot of food.

[trekster]

I was diagnosed last year with EDS/HMS. This means I dislocate either partially or fully my joints randomly. I am also really bad at expressing pain I end up being angry at others instead of saying "I'm in agony" even when I do people find it hard to believe or understand just how much pain I am in or how it saps my strength. In the past I was bullied out of saying "I am in pain" by a former abuser. I wasn't able to express pain in the conventional way until the gluten and dairy were fully out of my system (which was a few months ago as I hadn't realised tea bags have gluten in them).