OT - Has anyone gone to pediatric endocrinologist?

[cmaee]

My 7 year old had his well-child check-up today. He turned 7 yesterday. He weighs 50 pounds and is 44 3/4" tall. He measured on the growth chart to show he is in the 50th percentile in weight and 5th percentile for height. He has been declining in the height percentiles since he was 4. Last year, he only grew 1 3/4" between his 5th and 6th birthdays. I asked the nurse practioner (that is who sees kids for well-child visits at our doctor) and she said that was considered normal. This year he grew 1 3/4" again, but I asked her about it again because his younger brother is taller than he is and he is only 5. He is about the same size as the Kindergardens and that is starting to affect him at school. He is pretty upset that he is the smallest kid in his class...a great deal shorter than everyone else. Anyway, when I asked the NP about it she felt that it would be a good idea to refer him to a pediatric endocrinologist. I don't know how long it will be before he will be seen, but what should we expect to happen when he sees the pediatric endocrinologist?

 

[CJ's Mommy]

I don't have any advice for you, but I am interested to see what other Dis'ers may say. I feel like I may be in your shoes in a couple of years. My younger DS is VERY small for his age. He is 19 months old and weighs 20 lbs 12oz, and is a little more than 30 inches tall.

To the OP, my older DS is almost 5 (Oct) and he is 44 1/4 inches tall, and weighs around 40 lbs, so you are definitely right to be concerned. Good luck at the Dr. and let us know what happens.

My mom has a cousin who's son needed Growth Hormone because he was also very small.

 

[stefplus3]

This reply is a tad random (seeing that it wasn't my child) but I figured I'd share anyways. My friend's son (she has 2) was tiny. He is 9 and his little brother is 8 and the 8yr old towers over the older one. The pedi that they see had some type of special x-ray (sorry about the vagueness, lol) done on his bones to look for growth plates/ problems.

I know this probably dosen't help, but I figured I'd mention it just in case!

 

[stitchlovestink]

younger DD has been to 2 different pediatric endocrins, not related to short sature though. I took her to one at Johns Hopkins hospital. That one took about 2 mo to get an appt and that was with a newer Dr. To get the very experienced ones was at least a 6 mo wait for a new patient visit. The other endocrin was about a 6 to 8 week wait and that DR was thru a children's hospital here in Balto. Did NOT like the one from the children's hospital. I really don't feel like she listened to me at all. I was very frustrated and disappointed at the cost and time wasted at that appt.
I wish you luck. I can't share about what will happen as our visit was not due to growth problems. But I would say plan on it taking a month or two to get an appt. Best of Luck!

 

[dis-happy]

My baby saw a ped. endo at Duke Univ. and it took a couple of months to get the appt...and that was with my ped's office calling to get him in. His stats were very similar to CJ's mommy.

What they did: (may be different for a baby than a 7 y/o though)

full assessment and overview of all records since birth

measure him really well (the height/length box they used was better than any I'd ever seen plus they measure him 3 times and took an average of all the measurements)

blood work: re-ran a bunch of tests and added a bunch of new ones that hadn't been run yet, including endocrine specific ones


Results:
Except for a couple of results that we'd had been watching (not endocrine related) his other tests came back within normal limits, including growth hormone. The next step right now is wait and watch and remeasure in a few months---the endocrinologist had a special term for this, but that's what it came down to. Plus my ped is re-running some basic bloodwork again this month. Our happy news is that our toddler actually grew a bit at the beginning of summer and made it onto the charts. I credit all the Pediasure supplements we've been giving him.


Wishing you the best in all this.

 

[Maiya]

My youngest son is really little, so I'm kind of interested in this too. He turns 7 the first part of October and is only 44" tall and weighs only about 41 lbs. He's only starting 1st grade, but was littlest in his kindergarten class.

His doctor says he's just a slow grower. so we've not looked into any specialist or anything.

 

[amberg@eastlink.ca]

the xray is called a bone age scan....they xray the hand to see if it's measuring where it should age wise.

dd went to an endocrinologist...but sadly i wasn't there- hubby had to take her. i knwo they did test upon test upon test. including drawing blood, putting something in it waitign a few hrs, reinjectiing it and see if there was any reaction of any kind.

i also took her for blood work as well.

my little guy whos 2 is jsut that little....i mean insanly short, hes 32 inches at 2 yrs almost 4 months. i've been told a its okay and b it's on my side of the family! lol that part comes from relatives tho!

 

[cmaee]

Thanks for the replys. I am hoping that he can be seen soon. I hope they can see him earlier than months from now. I am really irritated with myself tonight. I wish I had pushed the issue harder last year. I really hope that if there is a problem, that we didn't lose a whole year in correcting it or not being able to correct it because we didn't catch it soon enough. My DH is not as worried about it as I am. He keeps reminding me that to have percentiles you have to have people who are tall and who are short to make percentiles. I completly get that. My DH isn't tall by any stretch of the imagination...5' 8" and I am 5' 5". I never thought my kids would be centers on the basketball team, but I also thought they would be around their dad's height, not shorter than me. I really don't care about what their adult height is going to be...my concern is that it doens't appear that he is growing at a healthy rate. He has been falling in the percentiles. When he was 3, he was 36" - right about 25%; at 4, he was 39" - right about 25%; at 5 - 41.25" - about 12%; at 6 - 43" - right about 10%; at 7 - 44.75" - around 5%. That is what is concerning me. I just want him to be healthy. I suppose that it is just going to be wait and see thing. I won't know anything until he sees the doctor, so I need to chill out or I will be an emotional wreck by the time his appt. comes around. Thanks for listening...

 

[ireland_nicole]

Don't worry; there's nothing that could have been done for his height before now, anyway. Both of my kids see a pediatric Endocrinologist; my DD every 4 months, my son every 6. I also have two half brothers with pituitary dwarfism.
I will say that we were initially referred to a different endo, but were extremely uncomfortable, and felt like she blew us off (plus she read the bone age wrong) so we immediately asked our neuro and geneticist if they could help us get an earlier appt, and they were very helpful, we saw our current endocrinologist within two months of the other visit.

It's a pretty sure thing that you'll get a bone age xray. It's painless, and very simple; just an xray of the wrist. The endo will carefully view this and look at different measurements; not just the growth plate in the wrist, but the fingers, etc. as well.

Yes, there will probably be blood work, but usually there is a lab tech in or affiliated with the office who is very used to kids. They're very gentle.

They will take detailed measurements of your son, and do a full physical exam.
They will also take a very detailed history; both of your son and of the two of you.

If there are any issues, they'll talk to you, or refer you to a specialist as needed.

I know it sounds trite, but try not to worry too much. Just because "most" kids do something,doesn't mean that all kids do, or that they're not "normal" or ok. Although seeing the specialist is a good idea, at this age a lot of it is precautionary, particularly re: height.

If you're wondering,
DD is 9 1/2, 48" and 50 lb.
DS is 7, 44" and 44 lb.

 

[eeyore3847]

my son sees one. His first visit was 7 weeks old! we got in within days the first time. he was born with a rare congenital problem so it was critical for us to go within days.
I am sure when you get in you will get the care you need. try to go preparred with as much info and write it all down before you go to be preparred.


Lori

 

[carone0318]

I agree with PPs, it sounds like they will do a bone age scan. My dd has had a couple. After the 1st one, the endo said she is healthy, but petite and to focus on her self-esteem to make sure her size "doesn't get her down." That really isn't a problem because her size is a positive for her since she is a competitive gymnast. Now that she is about to turn 13 though I find clothes to be an issue. She wants to wear what her friends wear, but she is so tiny in the waist (I just bought her size 10 jeans) and for shoes she still wears a size 2/3, so it is slim pickens - at least she has her Uggs!

I opted out of doing the bloodwork because she didn't want it done. She is healthy, but very petite. I waited for the results of the bone age scan and decided if the results were wonky, then I might force her to have the bloodwork done, but everything was basically as I suspected.

When the results of the bone age are read you want the true bone age (the scan) to be less than what their actual age is. At the time that my dd had her last bone age, it read that of a 9.5 yr old when she actually was about to turn 12 two months later. This is good, it means that she has time to catch up to her actual age.

I know how you feel about the way it affect the kids in school and such, my dd has been there, but quiet honestly, if your child is for the most part healthy there isn't much to worry about. Genetic short stature is not the end of the world.

The endo will also go over the growth charts for you too. I don't know how they really work for a boy, but now that I understand how they work for girls, I understand more with my dd. With girls, most have their pre-pubescent growth spurt around the age of 10-11 and that is why all of dd's friends tower over her. When dd was 12, her body was that of a 9.5 yr old and she hadn't hit that growth spurt. Now I think this past yr I think she did have her pre-pubescent growth spurt, she grew 3 inches in a yr. In the past few yrs, she had grown .5" each yr.

As I said above, dd will be turning 13 in September - entering 8th. She is 4'6" tall and weighs 72#, but remember she is all muscle because she is in the gym 20 hrs a week.

Go see what the Endo has to say, but do the testing that you feel comfortable with. The bone age scan is non-evasive, but provides a ton of info for th Endo.