Wednesday, April 28, 2010

How Small is Too Small?

Maybe her growth over the last four months is "unimpressive," but have you seen this girl do pull-ups? Now that's impressive. Does it really matter if she's short--even tiny? She's been tiny since the day she was born, but she's also entirely healthy and unbelievably strong.

If I'm understanding it all correctly, it's not so much that Alyssa is tiny (which in and of itself is odd because neither of her parents could be described as such) but that she's actually gotten tinier when compared with others her age.

When we took Alyssa in for her well child check back in November, her pediatrician was concerned that she had fallen off her growth curve. A bone age test proved deviant enough to warrant a referral to a pediatric endocrinologist. She was subjected to extensive blood work which came back mostly clear. Then we waited four months before doing a remeasurement of her stats.

Evidently, 48 inches and 50 lbs. for a nine-year old is not big enough. And the growth from her last appointment was "unimpressive."

So unimpressive, in fact, that the doctor recommends performing a growth hormone stimulation test. It's a test that involves spending a morning in the hospital with an IV, a couple of medications and multiple blood draws.

All of that because she's short? Is short such a bad thing? I'm OK with her stature and so is she. But I'm not sure I'm OK with daily injections just to make her taller. Or is it more than that? Are there other possible complications involved?

I was full of questions but the doctor didn't want us "getting ahead of ourselves." This test would just be the next step to finding out more. He explained that the worst case scenario would be a brain tumor (I'm not at all worried about that one) but at the very least her stature could have social stigmas such as not being able to drive a car or finding clothes that fit. Are you kidding me? Too short to drive? That seems like an altogether too dramatic prediction to me.

So what do I do? Do I put my baby girl through this lengthy, uncomfortable and likely expensive test? Is this doctor just being overly precautious or am I just a mom in denial?

This Alyssa and her dear friend, Abigail, who is 14 months younger.
Some kids are tall, some are short. Alyssa just happens to be short. And good things come in small packages, right?

What would you do?


Michelle said...

That's a tough one, Tara! Obviously, you don't want to ignore the fact that something "could" be wrong, especially if it's correctable/fixable. But, it seems that so far, they can't find any real "red flags" or causes for concern from the previous testing they've done... so my question would be, what do they think this specific test will accomplish? To me, it seems like an awful lot to put her through. I've already shared with you that at age 9, I was actually slightly smaller then she is. (granted my parents were 5'10 and 5'4, not quite as tall as you and Jon). Obviously being short hasn't prevented me from doing anything, and I'm considerably shorter then everyone in my immediate family. When I was 9 years 4 months I was 47 3/4 inches, and at age 10 was 49 inches. I wonder if they would put her through all this testing if she were my daughter? I'm guessing not...

Amy Jones said...

So, I wish I had some fabulous advice to give you. My nephew had some testing done a couple years ago (when he was 5). He's still on the short quite a bit. And, although the doctors were nonplussed, they didn't really recommend anything further at the time. His parents aren't really worried about his health either.

I'm sure if I were in your shoes I'd balk at the thought of putting my daughter through something that may not be necessary. I think Michelle has a point...what do they hope to accomplish with the test? Some answers would be nice before submitting to a procedure just because she doesn't fit into someone else's measure of "normal".

Pray a LOT. That's what I'd do. I'll be thinking of you. xoxo

Holly said...

I wish I could tell you what road is best, but it sounds like nobody really knows. I guess I'm the type that wouldn't feel totally at peace unless I went through with the testing, just to rule out anything serious and make sure I wasn't missing something that might be helpful. I'd talk to Alyssa about it and if she feels up for it than I'd probably do it. Good luck!

Lucy said...

Hmmmmm....I think I'd get a second opinion. You're right, she's so healthy and strong and smart and capable. Just...teeny. Considering her talents and skills, that may actually be a really good thing.

Good luck to you and Jon in making your decision. I'm sure you'll do what's best for Alyssa.

Erin said...

Don't they think that if there was something major going on that they would have found some other evidence somewhere? It sounds to me like they just want to figure out some way to explain it just to make themselves feel better.

I personally feel that if you were small to begin with and are working out that much, and eat as little as she does, you're not going to get much bigger! All of your kids are super skinny, Alyssa just happens to be short along with it.

That being said, I do understand why they would want to figure this out. You don't want to find out when she's 16 or 18 and not going through puberty that there is something hormonally wrong.

I agree with Amy...Pray, pray, pray. And we'll be praying too!

Chad said...

I say hold off on needles and such! Pray for guidance and enjoy our perfect Alyssa Rose! She is great at any height!

Tammy said...

Normality is relative. I don't know of many people who think they or their children are "normal." The grass is always greener and we often want what we don't have.

I've always wanted to be thinner--I mean naturally thinner--not the "I-have-to-work-to-get-it-off-thinner." Heavenly Father has given us the bodies and/or challenges He knows we need to help us grow spiritually.

If people Alyssa's age make fun of her, it's probably because they're jealous. I think Alyssa is perfect the size she is!

On the other end of the spectrum, whenever Rachel observes that she's the tallest girl in her class and worries about it, I tell her she's just fine. Ironically, one of the reasons she quit gymnastics was because she was self-conscious of her size.

Good luck with everything! Alyssa's amazing--she'll be fine short or tall!!! By the way, they make car extension pedals for people who can't reach the pedals.

Craythorn Family said...

I have a friend who has a little girl who the Dr.'s want to do the same thing. My opinion, unless she looks like a dwarf and isn't gaining any weight or growing at all, she is probably fine. All of my kids are shorter and smaller than everyone their age. Logan is in the 5th percentile for his weight...he just barely got on the chart and he's 2 1/2. Some kids are just small. Another little girl in our ward is super tiny. She has been through every test. Conclusion, she is just naturally small...her tests all came back normal. It's a tough decision.

Jenny said...

I am with Lucy a second opinion is a good idea. Jared is short like Alyssa and often looks like a midget compared to his friends (like the recent baseball photo). Good luck with your decision. Hang in there!

lynne said...

Tara--if you or Jon want to talk give me a call, you might want to do it and I still know how to talk in English rather than doctor talk

Steve (209) 832-2638: