The girl refuses to grow.

Such is the nature of the disease and the prednisone, which pounds her adrenals

and consequently, her growth hormones.

She has been 94 cm for a good while now.

Noah, on the other hand, has sprouted from 96 cm to 108 cm in just under a year.

Her shoe size sits somewhere between the 6 1/2 to 7 and has for as long as I can remember.

I think that is the equivalent of a 2 year old, or a small 3 year old.

She is the only girl I know who doesn’t outgrow her shoes before they fall apart.

It’s okay though.

Petite is the new black, at least, that is what I’m telling myself

and I save a small fortune in clothing costs.

As my Mum always says, good things come in small packages

but this August we sat across from the immunologist

who suggested that we talk with the paediatrician about Ivy’s need for growth hormone.

Her arguing point was that the lack of growth was putting strain on her bones and on her heart

and so I did talk to the paed,

who, in an email, told me that he would organise things,

not to worry myself over it

and I said wait!

Wait because I don’t know if I want the little girl to go through another test, when I don’t know anything about it.

I need to be informed before I consent.

Wait because I would like to know that the benefits are going to outweigh the risks – it is after all a daily injection of synthetic hormone

and wait

because if she does ‘qualify’ for it, then we will be treating a complication of one medication, with another medication

and I want the world to just stop

and let me breathe

and take it all in.

So instead, he organized the endocrinologist to come today,

to explain that I was a stress head

and not being sensible about it

and silly to worry

but the only way to gain government approval for the growth hormone,

which, by the way,

she believes will be of benenfit to not only Ivy’s height

but improve her immunological system,

her bone density,

and her risk of heart disease,

is to prove it

with the growth hormone stimulation test.

You see, growth hormone is only measurable in ‘bursts’ every ninety minutes or so

and if you measure at any given time of the day, chances are that your child will get a low reading,

even if they do not have any issues with their hgh.

So, they infuse a medication called arginine, which is an enzyme, into the blood stream

and this tricks the body into releasing the hormone.

If the hgh measures above 10 then there is enough being released

and the government sees that as their cut off point, anything below and Ivy will then be moved onto the next test.

Lather, rinse, repeat.

If both tests show she has low hormone levels then she will be allowed to have the medication.

Confused?

Me too.

It kind of feels like the IVIG all over again.

The endocrinologist fully believes that this could be a good thing for the girl,

who can’t quite reach the lock on the toilet door, at her soon to be school

and can reach the taps but not the soap dispenser, to wash her hands.

Not only will she grow in height but other parts of her anatomy will grow and change too, like her pesky ear canals, for example.

We know Ivy isn’t growing

but unless she falls on or below the 1st centile on the growth chart (she is currently just under the 3rd)

or she peaks below that magical 10, she won’t qualify.

The quirky thing is, she may be producing enough but because of the adrenal suppression, the body doesn’t know what to do with the growth hormone

and that is cause enough for concern for the endocrinologist

but evidently not for the men in ivory towers.

So, we are going to start with the testing, it seems.

For better or for worse.

She told me reactions are rare.

I didn’t tell her that Ivy enjoyed a challenge.

I just weighed all of the information up

and hoped that my choice was the right one.