Here is Daniel with a picture of his bones. Don’t you dare call them cute or beautiful. They are tough boy bones. That is all.
Now why is my son holding an x-ray of his left hand and wrist? Did he fall from the monkey bars at school? Or perhaps he got a little too aggressive with his Tae Kwon Do punches. No worries. No bumps, no bruises, no sprains and no broken bones. He just had a referral from his pediatrician for a little extra lab work and an x-ray of his left wrist to determine his bone age. After an all around normal annual checkup, Dr. B. revisited the fact that Daniel is remarkably small for his age…
off the charts small for his age…
waa-aay off the charts small for his age.
Here we go again.
Our conversation continues as I remind her that of course he is small for his age. He was born 16 weeks too soon. He weighed only 1lb6oz at birth. He was a classic BPD-er or ex preemie with chronic lung disease. He was tube fed for four years of his life living with severe reflux disease. He never caught up in growth during the most critical “catch up” phase between the ages of two and four. His biological parents were both, well, they both were not as tall as me and I am not that tall. Okay, I’m 5’7½”…I’m tall but not that tall, really. Odds are my boy is not going to tower over me and I am okay with that. All the anecdotal tales offered of preemies you know who are now 6’9″ tall really mean nothing to me. Whatever height Daniel finally reaches is okay with me because obviously that is the height that the good Lord intended him to be.
Still Dr. B. is concerned. She is aware that Daniel was followed by endocrinology for over three years before she took over as his primary pediatrician. His growth hormone levels were on the low side of normal and there was much debate and discussion over whether or not he would benefit from daily injections of human growth hormone well into puberty. There was also a lot of blood drawn during those three years. Daniel’s blood. As if my little man was tortured enough in his young life. Finally I grew tired of long, long drives over to Packard Children’s, the anxiety of weighing and measuring and plotting my son’s miniscule growth and the blood draws every three months. I hated the drawing of his blood. His veins were scarred and twisted and tortuous like a heroin addict and it always proved to be a sweaty, teary, exhausting endeavor to draw a couple teaspoons worth of his blood. Finally I confronted the endocrinology team with the ultimatum of either we start the HGH therapy or we agree that he won’t benefit from it and move on. Let him be the size he is meant to be. So then Daniel was released from their services. One less specialist we had to see then.
He has grown a lot since then. A lot. But he remains head and shoulders below his peers at 3’7″ and Dr. B. is curious. Perhaps there is something going on. Perhaps endocrinology shouldn’t have been so conservative. Perhaps there still is a crack in the window for some catch up growth. So she orders some blood work…YEAH!…and a bone age study, an x-ray of his left wrist.
Hormone levels are on the low end of normal range just like they were over 5 years ago. And his bones? How old are his bones? Well, he doesn’t have the bones of an 8 year old boy. No, his bones are younger.
But they remain tough boy bones.
Well, Dr. B. and we will have to talk that over. We shall see.
In the meantime Daniel has this awesome picture of his tough bones.
How lucky can one boy get?