Meeting the growth specialist
At this point, your pediatrician (or family doctor) has referred you to a growth specialist. GHD and growth disorders are generally identified by a pediatric endocrinologist – a doctor who specializes in assessing, treating and managing hormone-related conditions.
Pediatric endocrinologists are experienced in dealing with hormone disorders through every stage of childhood. They work closely with a network of other healthcare professionals – including psychologists, nurses, nutritionists and disease educators – to ensure children with GHD and growth disorders are receiving the best possible care.
Like most specialists, pediatric endocrinologists are in high demand. You may wait anywhere from several weeks to a few months for an appointment and your priority may be based on the urgency of your child’s condition.
Identifying a GHD or growth disorder
Your pediatric endocrinology team may start by taking a complete patient history for your child, which includes birth history, medical history and family history.Specific questions your doctor may ask you…
This information will help in determining the nature of your child’s slow growth. If your pediatric endocrinologist suspects a GHD or growth disorder, he/she will proceed with a series of examinations and tests.
Exams and tests
While testing practices vary between growth disorders, some common steps for identifying/assessing GHD include:
- Physical exam: examining the body and organs as well as measuring height, weight and body proportions can help the doctor establish whether a child’s growth is on track, delayed or advanced
- Hand x-ray: a quick x-ray of the left wrist, hand and fingers can help verify if the size and shape of a child’s bones are following a normal growth pattern
- Blood tests: measuring hormone and protein levels can help determine if the pituitary gland is working normally or not
- Growth Hormone (GH) stimulation test: children are given substances that should increase growth hormone; a small amount of blood is taken at timed intervals to see if the pituitary is producing enough growth hormone
- MRI of the head: a medical scan used to view the pituitary gland and hypothalamus to detect any possible causes of GHD (e.g., growths or tumours)
Not all testing procedures are necessary – your pediatric endocrinologist will decide what is most appropriate for your child.
How long will GH testing and assessment take?
There is no clear-cut timeline when it comes to assessing GHD. If initial exams and bloodwork suggest a growth problem, there will likely be further testing to determine the extent, cause and most appropriate treatment plan.
YOU are your child’s biggest advocate and YOU have an important role – getting to and from appointments, tracking test results, making follow-up calls and supporting your child throughout the process.
Your pediatric endocrinology team may monitor your child’s growth for a few months prior to performing a GH stimulation test, which is a highly involved process that can be draining, especially for a young person.
While this period of testing may be scary and emotional for both you and your child, it is important to remain patient and calm. Your child needs your strength and comfort during this confusing time.
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