Tuesday, November 24th, 2009

I had an early appointment this morning with my endocrinologist. Mommy is becoming a fan of being the first appointment of the day - usually a lot less waiting! We had to do the standard height, weight and head circumference checks which I sobbed through as usual. Fully clothed I weighed in at 23 pounds. When Dr Long came in to see me he let Mommy know that since my last appointment I had a little growth spurt. In fact, he doesn't see any reason to keep following me since I am consistently staying on my growth curve - it's just my growth curve is not comparable to most kids my age. That brought up an interesting discussion around the term "failure to thrive". One of my night nurses has told the agency that I am failing to thrive. Since Mommy has never had one single doctor of mine use that term she was a little surprised to hear it. As she talked to Dr Long she found there are several definitions of failure to thrive.

One Mommy found on line said: "Failure to thrive (FTT) is used to describe a delay in a child's growth or development. It is usually applied to infants and children up to two years of age who do not gain or maintain weight as they should. Failure to thrive is not a specific disease, but rather a cluster of symptoms which may come from a variety of sources."

As Dr Long explained it some may choose to classify me as failure to thrive due to the mere fact that I am smaller than most children my age. From his standpoint, though, I do not qualify as failure to thrive because although my growth curve is well below the average it is predictable and I am gaining weight. As with other labels sometimes it works to someone's advantage to be "diagnosed" to qualify for additional resources. So that got Mommy thinking - would a little person be considered failure to thrive? Dr Long said because being smaller than average is part of the syndrome that wouldn't be the case. Since there are so few cases of Nager it isn't always clear what symptoms are considered part of the syndrome and which aren't. However, many online sources list short stature as universal to Nager cases. Based on my current growth curve Dr Long expects me to be somewhere around 5' tall. Since Mommy is only 5' 1'' it's hard to say if my short stature may be me taking after Mommy or part of Nager or a combination of the two. Since only 5% of the female population are 5' or smaller Mommy might have been considered failure to thrive based on current definitions! So as far as the endocrinologist and my gastroenterologist are concerned I am growing just fine thank you - I'm just on the petite side!

Peyton Nicole Smith