E-needle, needle and alcohol sterilization tablets used for Xin Yi’s injection
After the introduction of genetically recombinant human growth hormone as a drug to treat diseases of short stature in children, height is no longer a natural result that is difficult to interfere with. In order to grow taller, some parents began to give their children growth hormone injections, one shot per day, costing tens of thousands of dollars a year. In addition to the injections, these children have to go to bed early, jump rope, drink milk, race against time and play with reality. This has also given rise to height anxiety and the potential for substance abuse.
Can’t wait any longer
“Look at what you’re smoking for me. “
Xin Yi, 8, rolled up her sleeves, revealing two bruised, thin arms, and complained to the doctor. This morning, she has had more than 10 tubes of blood drawn to test whether her body is producing growth hormone properly.
This was just the beginning of her dealings with needles.
The doctor smiled after hearing Xin Yi’s words, “You are very brave, my child. All I ask of you is that you learn to give yourself a shot, one shot a day, starting today, okay? “
Xin Yi looked a little scared, but still nodded: “Yes! “After coming out of the clinic, she jumped and went to the nurse’s station to learn how to give injections.
Looking at her daughter’s thin and small figure, Xin Yi’s mother was not feeling well.
At the end of last year, Xin Yi’s mother asked her daughter’s teacher for advice on how to learn, and the teacher reminded her that after a year of teaching, children who were taller when they enrolled in school had scaled up, but Xin Yi’s size had not grown.
Xin Yi was born two weeks earlier than her due date, and has been growing petite since she was a child. Xin Yi’s mother waited for her daughter to catch up on her own as she grew up. When she reached the age of 5, she took Xin Yi to a tertiary care hospital in Beijing to see a doctor, who advised her to go back and observe, and if she could grow 5 cm a year, she would try not to give her child any injections.
But anxiety clung to her daughter’s shortened pant legs, hiding in a closet flooded with clothes. Other children’s clothes bought in the spring were short in the fall, but Xin Yi’s clothes were not short even after three years of wear. After the epidemic took a few months off last year, Xin Yi’s mother heard from other parents that her child’s pants had become “7-point pants” and she was envious from the bottom of her heart. She was so envious that she couldn’t wear all the clothes in her closet.
The teacher reminded her that she had to face this matter.
When she came back to the hospital three years later, the doctor read the test results and announced that it was not advisable to wait any longer because Xin Yi’s height was not enough even if she was behind in her bone age.
It is likely that Xin Yi has a growth hormone deficiency and is unable to produce enough growth hormone on her own. If she does not intervene with growth hormone injections, it will be too late to intervene to normal height once the epiphysis closes.
After the introduction of recombinant human growth hormone (rhGH) in 1985, it was rapidly used in the treatment of children with short stature. According to the “Recommendations for the Clinical Standardization of the Application of Recombinant Human Growth Hormone in Pediatrics”, in addition to growth hormone deficiency, the endocrine genetic diseases that cause short stature, such as idiopathic dwarfism and Turner syndrome, which are common in domestic pediatrics, can all be treated with growth hormone injections.
Tingting, who is 9 and a half years old, is not deficient in growth hormone and is also taking the injections.
Last year in July and August, Tingting said her breasts hurt a bit and her mother thought Tingting was developing a bit. After going to the hospital for a checkup, she found that her bone age was 2 years older, which meant that her bone age was going in overdrive.
Tingting was diagnosed with precocious puberty, a premature acceleration of physical growth and early epiphyseal fusion influenced by sex hormones in the body, which can make the final adult height lower than that of a normal child of the same age. Tingting is relatively tall for her age, but she is already 12 cm behind the average height based on her bone age.
The doctor predicted that Ting’s final height would be 150cm at the highest and 148cm at a conservative level, which was unacceptable to Ting’s mother. According to her experience, her height will be affected by her future job search and finding a date. She had hoped that her daughter would break through her genetic heritage and grow to at least 155cm – Tingting’s mother is 154cm tall and her father 158cm tall, and they knew all too well what their daughter would encounter when she entered society.
Because Tingting’s short stature was caused by precocious puberty, she needed to take growth hormone injections along with inhibitory injections to suppress her sexual development, and the two injections together cost more than 4,000 yuan a month for the cheapest powder, two-thirds of Tingting’s family income. The two injections together, the cheapest powder, cost more than 4,000 yuan a month, two-thirds of Ting’s family’s income. She didn’t dare to tell the elderly in her family.
Tingting’s family is located in a small fourth-tier town in the southwest. Her mother works full-time at home with the children, and the family’s income depends on Tingting’s father, who is a hard worker in steel. The injections are a constant battle, she joked, a month to get a cell phone, a year to get a car. But without the intervention, Tingting will not grow to 150cm, and Tingting’s mother thinks that her child’s future mental health is more important than money.
Needless to say later, Xin Yi’s mother now notices the troubles her height brings to Xin Yi: she doesn’t want to play with the children around her because “the ones younger than me are taller than me “; her classmates took turns being the day student every day to serve lunch to everyone at noon, but the teacher wouldn’t let her do it because she couldn’t reach the bottom of the lunch bucket.
Xin Yi’s mother was heartbroken. Her daughter had tried so hard. Xin Yi’s blood vessels were so thin that she had to be stabbed three times before she could find a blood vessel for the test, and she had to rely on the nurse to squeeze by hand before she could pump blood. But the next time she had a test, she would say, “Mom, don’t worry about me, I’ll go in and let the aunt draw blood myself.
Xin Yi’s mother had heard many questions about growth hormone: her pediatrician friends thought that the application time of growth hormone was still too short and they were not sure about the long-term effects on the human body; the old people at home also did not understand, “Children grow early and grow late, how can you give them injections every day? “; there are also netizens who say that parents nowadays are simply sick and have no place to spend their money.
She decided to ignore all this. What’s the reason not to think about the child? In Xin Yi’s mother’s opinion, children’s world many times more obey the law of the jungle, tall children will be dominant inside the group, strong and strength will feed character, so they become confident and have an innate sense of superiority; and petite, short people, will have a sense of vulnerability and fear in strength, in the group is easy to be bullied, or feel powerless, which is now many mothers are focusing on the physical exercise of children This is why many mothers are now focusing on physical exercise for their children.
Moreover, for Xin Yi, who was already lacking in growth hormone, injections were the last resort.
A 200% effort
At 8:00 pm, Xin Yi’s mother carefully took the needle out of the refrigerator and rewarmed it in advance. Xin Yi played a short-acting water, a small 30 units, can be used for 10 days, electronic pen, the needle is very small, almost invisible.
But this is the first time to inject themselves, Xin Yi some fear, although learned from the nurse, but still afraid to tie, closed his eyes and hold his mother’s hand. Xin Yi’s mother set the dosage, sterilized, exhausted the air, and quickly stuck the needle into Xin Yi’s soft tummy, waiting for the measurement on the screen of the electronic pen to reach 0.
For the first few weeks, Xin Yi would say it hurt, but then she gradually got used to it and now remembers to give herself a shot every day, and she is more skilled than her mother.
In addition to the injection, she also needs to adjust her living habits. She has to pay attention to the nutrition of three meals a day, control her sugar intake, drink at least 500 ml of milk every day, jump 1000-1500 ropes, go home at 8 pm sharp for her injection, and go to bed before 10 pm.
Xin Yi tried hard to cooperate with all this. She is lactose intolerant, before she did not drink a sip of milk, but after she started the injection, she drank three boxes of milk by herself every day; when she first jumped rope, she could not jump thirty to fifty times, but now she can jump more than 1000 times. When she opened a box of cookies for Christmas, she sighed and said to herself, “Santa doesn’t know I can’t eat sugar yet. After all, she is only an 8-year-old, and sometimes she can’t help but see the cream on the cake. After some pleading, she finally ate three bites, and she and her mother agreed to eat sweets only once a week.
Occasionally, when she and her children were having fun downstairs at night and her father called her home for a shot or to jump rope, Xin Yi would ask, “Why can they not go home, but I have to go home? “
Xin Yi’s mother always felt sad when she heard this. Growing taller is as natural as breathing for others, but her daughter needs to work 200% harder to achieve it.
The injections have been given, but Xin Yi’s mother feels that the results are not good. Her daughter did not grow a centimeter a month like other children. Xin Yi’s mother measured her daughter’s height every now and then, with her back feet and small buttocks and the back of her head at three points on the wall, taking a thick cardboard book and pressing it down at right angles. But each time the error is very large, the first day jumped up, the next day to the hospital to measure and down, the measurement of Xin Yi’s mother more and more discouraged.
Xin Yi also became more and more annoyed, she would ask: “Mom are you satisfied with the growth of my height? “Worried that anxiety will affect the child’s growth, Xin Yi’s mother reassured: “You have worked very hard, let’s just look at the process. “
But no one cares about the results. Height and bone age race, do not know how much time left for the child to grow taller. When she was just one month into the injection, Xin Yi’s mother would ask everyone, “Do you see how tall my child is growing? After four or five months of injections, someone finally looked at Xin Yi and said, “Why is she growing so fast this year? Xin Yi’s mother began to believe that the injections were working.
The latest relief came from a pair of running shoes that Xin Yi didn’t want to wear anymore. Not long after she bought them, she heard her daughter say that she couldn’t wear them on her feet – a good sign of growth.
Review time at the hospital was a healing moment for Xin Yi’s mother. She sat in on parents talking to doctors in the clinic and found parents similar to her struggling with their child’s height. The children who came to the review 1000 jump rope every day is the basis, basketball, running, swimming, badminton, can think of all the sports arrangements, and even a parent let the boy run 3000 meters every morning, jump 2000 rope in the afternoon, and then play basketball in the evening for an hour, was told by the doctor to stop: in case of injury, can not move for months, the loss is not worth it.
Parents also built their own group, which has thousands of new messages every day, we encourage each other and monitor each other: “Today’s physical examination, the growth of 3.5 cm. ” “My daughter recently lazy, jump rope themselves reduced by half. “Also worried about the side effects of injections:” last month’s checkup myopia deepened a lot, both can not its beauty. ” “The day before yesterday went to the third injection, do not like to eat, so annoying …… “
Of course the most common question exchanged in the group, or “how many centimeters your child has grown now? “
Six months after the injection, Xin Yi is now 116.5cm tall, a growth of 4cm, but the doctor looked at it and still said it was not ideal, and compared to his peers still 10cm short. The doctor suggested adding slow walking or brisk running to jumping rope every day, eating some plain yogurt and probiotics to aid digestion, and upping the dosage of the injection.
An extra centimeter of growth is worth it?
Normally speaking, there are treatment standards for height intervention with growth hormone and other drugs. For example, according to the Ministry of Health’s “Guidelines for the Treatment of Precocious Puberty (for Trial Implementation)”, the standard for predicting significant impairment of adult height is less than 160cm for boys and less than 150cm for girls, and children who exceed this standard do not need injections for intervention. But some parents have more than that as a mental standard.
Nini from Sichuan started taking growth hormone injections at the age of 10 and has been doing so for over two years, now growing to over 150cm. Nini’s father is relatively satisfied with the results of the injections. He intends to let his daughter continue the injections and preferably grow up to 160cm.
Nini is not deficient in growth hormone and is of idiopathic short stature. The company’s main business is to provide a wide range of products and services to the public. In the eyes of Nini’s father, girls are at least 1 meter 55, and boys should reach 1 meter 67.
Children’s height is taller than one generation, and now there is the possibility of human intervention, and parents’ standards rise with it. Nini’s father feels that the injection is a bit like the private schools nowadays, where children in private schools do better, and everyone is not willing to lag behind and go to private schools, which raises the cost of reading for the whole society; just like some children were just short, but if children with similar conditions are given growth hormone injections, the children who don’t will “Shorter”.
One parent recorded in her social media that she had seen two special parents in the hospital: one whose child had grown to 174cm through injections and wanted to continue, but was rejected by the doctor; and another whose child was of normal height, but whose parents wanted him to grow taller, but was also rejected by the doctor. Parents call this “cosmetic height increase” – the child’s height no longer belongs to the category of short, but still want to be taller. But they still want to be taller.
Similar accounts are not uncommon on social media. Many parents like to share their experiences of taking their children to the hospital for injections. One parent said that her child was only 3 years and 3 months old and had 10 tubes of blood drawn without crying the whole time – according to the recommendations of the Chinese Medical Association, the starting age for treatment should be 5 years old for idiopathic dwarfism without growth hormone deficiency.
Someone soon replied below: “How high are you 3 years old, my family is also 3.5 years old, 94cm, 25 pounds, always hesitant to check, and afraid that the child can not stand it, how did you decide to go? “
Some parents have posted a few posts about their children’s injections to grow taller, and then they keep getting private messages from other parents asking for the latest results. One parent whose child was diagnosed with precocious puberty said she also ran into her child’s classmates when she went to the hospital, and their group of parents who get shots has new people joining every now and then.
According to the Chinese Medical Association, the prevalence of childhood dwarfism in China is about 3 percent, and the natural incidence of dwarfism has not increased significantly in the past decade. But Changchun High-Tech, the leading company producing growth hormone needles, has seen its stock and turnover increase exponentially in the past few years, and is known by parents as the drug Mao Tai. In the first quarter of this year, the two main producers of growth hormone, Kinsey Pharmaceuticals (a holding subsidiary of Changchun High-Tech) and Anker Bio, both saw their results rise sharply.
A beauty blogger recalled his own experience with injections as a child on Weibo. He took the shots for more than a year before his epiphysis closed, costing him $200,000 to $300,000. The doctor previously predicted that without intervention, his adult height would be around 170cm, and now he claims to be 179cm tall. he’s not sure if the injections are to blame, as adequate exercise, nutrition and sleep may have played a role.
But, “there is only one chance to grow taller naturally in a lifetime, so if you miss it, you’re gone, and even if you only grow 1 cm more, I think it’s worth it. Think about how abusive it is to break bones to increase height. “He finally wrote this.
At the bottom is the reply of netizens: “Can you still fight now? ” “My daughter’s classmates are also playing. ” “I hope the children can all be high. “
Misdiagnosis
The desire to grow an extra centimeter pushes parents to choose to use injections to gamble a probability of growing taller, which requires money, persistence and luck, as well as facing more unknowns.
Doduo’s mother was not the one who was favored by luck. During the consultation, she noticed something unusual about the doctors.
A year ago, Duoduo was diagnosed with precocious puberty. According to doctors at a tertiary care hospital in Zhejiang, she is now 10 years old and 144cm tall, and will only grow to 153cm if no intervention is made.
In order to get growth hormone, Duoduo’s mother went to three tertiary hospitals in Zhejiang within a week. The three consultations were simple and quick, and without exception, Doudou was advised to get a growth hormone shot as soon as possible, and the medication list was crisp and clear.
“Does this shot have any side effects? ” asked DouDou’s mother when she saw the second doctor.
She remembers the doctor almost jumping up and down: “What is this shot? It’s a needle from the world-famous Kinsey Pharmaceuticals! “
In another hospital, the doctor said here can not take drugs, will take up the doctor’s quota, after recommending a pharmacy next door, where there are two kinds of needles, the more expensive one now has 75% discount activities, can be a one-time tun on three months, tun half a year can, “5000 yuan needle said like In the canton cabbage. “
The mother thought it was a bit strange that such words as discount were coming from the doctor’s mouth. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The assistant showed the payment code with a shot of growth hormone and an appointment for the next checkup at the end of July, without saying a word.
When she got home, the more Doduo’s mom thought about it, the more upset she became. The other doctors I had seen before were busy and had some compassion or sympathy for their patients, but the doctors I met this week in the area of growth hormone injections all had a look of excitement in their eyes when they heard that the parents wanted to give their child the shot.
Out of caution, Doudou’s mother spent several hundred dollars to consult online with pediatric endocrinologists in Beijing and Nanjing. The two doctors unanimously replied that Doudou’s precocious puberty was a misdiagnosis.
Doudou’s mother was in disbelief. She planned to go to Nanjing for a face-to-face consultation and asked for leave from Doudou’s teacher, who advised Doudou’s mother not to take the injection, as she had heard many parents talk about similar experiences, “growth and development is a pit. “
The actual doctor in Nanjing’s tertiary care hospital did not think that DouDou had met the criteria for precocious puberty and did not need injections. The actual fact is that you can find a lot of people who have been in the business for a year, so you can’t stop and continue to play, and the inhibition needle has inhibited the growth, and now you have to match the growth hormone needle, otherwise the previous needle is all for nothing.
What else can I do? I have to continue the injections. After returning home, Doduo’s mother went to the clinic designated by her doctor to prescribe follow-up growth hormone injections, which was located in a somewhat remote area.
On May 21, Changchun High-Tech disclosed to the public that roughly 30% or less of its recombinant growth hormone was sold in public hospitals, and more than 70% was sold in other cooperative medical institutions. In Doduo’s mother’s experience, doctors at tertiary hospitals are also equipped with “height managers” to recommend pharmacies and hospitals for parents to buy needles.
The Pediatrics Branch of the Chinese Medical Association states in its “Recommendations for the Clinical Standardization of the Application of Recombinant Human Growth Hormone in Pediatrics” that while monitoring the effects of treatment, attention should be paid to checking whether adverse reactions occur. The adverse reactions associated with growth hormone therapy are currently reported to include benign cranial hypertension, effects on glucose metabolism, hypothyroidism, slipped femoral head, scoliosis, the possibility of inducing tumors, pigmented nevi, and enlargement of hands and feet.
Summer vacation is coming, and Xin Yi is still drinking milk and skipping rope every day, as her doctor told her to do, and has recently added running, hoping to catch up with her peers soon, as she hopes to start school again without having to stand at the head of the line. Xin Yi’s mother is also learning to stay away from anxiety, reducing the frequency of height measurements to once a month and no longer trying to compare.
The child is like a sapling sent by God, I do not know what seedling is in hand, if you raise a creeper, do not care about anything, they will climb up, but if you raise a grape, do not give it a shelf, certainly will not climb up. “Xin Yi’s mother lamented, do not bother other parents that their children easily grew 12 centimeters a year, know that seedlings are not the same, they spell on the good.
“And people may also this aspect is not good, on the other hand good, Messi is not also playing this needle well, he finally hit and hit not much higher, it seems to be 170cm, but it does not prevent him from being a very good ball player, right? “
(The characters in the article are pseudonyms)
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