Big City Hospital - Big Hopes

April 12, 2007

It broke my heart to step into the children's hospital and see so many sick children. I had to stop and thank God that the reason we were here with Kyle was not a life-threatening situation. On our way to the Endocrinology unit, we passed kids being wheeled around in wagons; some without hair, some crying, some content at looking at the bright colors a children's hospital displays. We saw parents with tears in their eyes as they sat comforting their sick little one. My heart truely goes out to parents who have a child with a life-threatening disease.

We got comfortable in the waiting room and I began to fill out the necessary paperwork. After just a short time, Kyle's name was called, so he, his father and I went to join the nurse as she led us into the unknown. "First things first." she said. "Take off your shoes and jump on the scale." Kyle weighed in at 76 pounds. "Okay, sweetie, let's get your height". Kyle was 4'8". Kyle was within one week of turning 14 years old.

We sat in our room waiting for the doctor, who eventually joined us and began by asking a ton of questions about family history, what types of diseases run in the family, etc. Mother's height is 5'3". Father's height is 5'8". Child's pulse is good, blood pressure is good, pupils are good, ears are a little dirty, but good. Neck is supple, Oropharynx is clear, Tympanic membranes are clear, Respiratory: Clear. Cardiavascular: Regular rate and rhythm without murmurs. Abdomen is soft and nontender and nondistended. Neurological: Nonfocal. No scholiosis. Very early signs of puberty. His bone age was concurrent with his actual age, thus ruling out a constitutional delay of growth.

The doctor spent some time reading over the test results and reviewing the growth records. She was extremely grateful that Kyle's doctor had done all those preliminary tests and was glad we brought the results and the growth charts with us. According to the test results, Kyle's IGF-1 revealed a low-normal which is suspicious for growth hormone deficiency. She wanted to schedule him for a growth hormone stimulation test to rule out a growth hormone deficiency. She explained how the window of growth opportunity would soon begin to close, so treatment, if necessary needed to begin immediately. She also mentioned that she would have liked to have seen Kyle 5 years earlier, but it's a little late to worry about that.

In addition to the growth hormone stimulation test, she ordered a tTGA and ESR to rule out celiac disease and chronic illnesses that would impede his growth.

Preliminary diagnosis: His height is -2.53 standard deviations which would actually qualify him for idiopathic short stature if his growth hormone stimulation test is normal.

We were given a pamphlet which included the instructions on how to prepare for the Growth Hormone Stimulation Test, as in do not eat or drink (except water) after midnight the night before the test. We scheduled the appointment for April 17th...