Growth Hormone Treatment

Growth Hormone Treatment is a medical therapy used to support the healthy development of children and adolescents with growth hormone deficiency or related conditions. It involves regular injections of synthetic growth hormone to help simulate growth in height, support bone and muscle development, and improve overall well-being. The treatment is carefully monitored by healthcare professionals and tailored to each patient’s individual needs.

Growth Hormone Treatment

Growth Hormone Treatment is a medical therapy used to support the healthy development of children and adolescents with growth hormone deficiency or related conditions. It involves regular injections of synthetic growth hormone to help simulate growth in height, support bone and muscle development, and improve overall well-being. The treatment is carefully monitored by healthcare professionals and tailored to each patient’s individual needs.

  • What is growth hormone?

    Growth hormone is a proteine produced in the pituitary gland. It works as a messenger and stimulates the growth of bones and other tissues. It influences the energy balance by regulating the way carbohydrates, proteins and fat are controlled in the body. This proteine is now synthetically produced in order to treat people with growth hormone insufficiency and children with growth disorders. Growth hormone is a proteine that cannot be given in tablet because it will be destroyed in the stomach and intestines before it could get into the bloodstream. Therfor, growth hormone is injected under the skin (subcutaneously) where it is slowly absorbed into the bloodstream. The natural release of growth hormone by the pituitary gland is the highest at night, so the administration of growth hormone happens preferably in the evening, before bedtime. Growth hormone should be given regularly (daily or weekly, according to the formula used)  to optimise the growth.

     

  • Follow up and guidance

     

    • Medical follow up

    During growth hormone treatment, regular check ups by the paediatric endocrinologist are important. The doctor evaluates the growth and growth velocity, performs regular blood examinations to determine the optimal growth hormone dose, ensures the correct function of the different organs (kidney, liver, pancreas…) and evaluates possible adverse events. Sometimes X Rays of the left hand are taken  to evalautes the bone age progression (equal, slower or faster than chronological age) to ensure the expected adult height.

    • Psychological care

    Some children really struggle with being shorter dan their peers. This can influence their self image and emotional wellbeing. It can be usefull, if the child agrees, to seek psychological support. Sometimes, a condition can be diagnosed during the examinations for short stature, and child and parents are faced with a lot of information. For some families, psychological help to deal with this recently diagnosed  condition can be helpfull.

    If your child remains very anxious for getting injections, a psychologist may help to face this fear. Often, peadiatric endocrinology services have experienced psychologists in the team.

    • Patient associations

    When confronted with the diagnosis of a rare condition, talking to other parents and families who went through the same proces might help. There are several patient associations offering contact and support on difficult moments. The contact details can be found on this website under the topic ‘organisations’

    https://belendo.be/organisations/

     

    • School

    Sometimes it can be usefull to inform the school about the recently diagnosed condition. This happens preferably in collaboration with the child, and it can be interesting fort he child to give a presentation or a talk in the class.

    During multiple day outings with the class, it can be usefull that the classmates now why the child gets a shot to grow. In collaboration with the child an teacher, it can be discussed if en what information is spread

     

  • How to engage my child in the growth hormone treatment

     

    Start at the begining : see for yourself how you would feel about having to start a medical treatment. You would probably appreciate to be informed about what is going to happen and how the proces will be organised. That is also the case for your child.

    It is important to be honest and positive. Explain quietly and on a comprehensible way what the treatment involves, why it is necessary and how the daily administrations will happen. Adapt your explication to the age and development of your child, so he/she can understand and cope with the information.

    A lot of children feel anxious or uncertain in the beginning. That is normal, a growth hormone treatment is new and unknown, and after several hospital visits the idea of day growth hormone injections may not be appealing. Listen to your child, observe the reactions and be attentive for signs that indicate what is experienced as comfortable or not. Show compassion for the anxiety and émotions your child may experience and allow your child to ask questions.

    Do not make promises that you cannot keep. Do not say the the injection will never hurt if you are not sure. You can explain that most children get used to the injections after a while and the there exist techniques to make the injection more comfortable.

    Engage, if possible, other family members like brothers and sisters. Older brothers and sisters can be a great support and help motivate and comfort your child. Their encouragement can be more effective than that of the parents.

    Try to see the growth hormone treatment as a family project in which your child feels supported. By keeping an open and comprehensive attitude, you help your child getting confident with the new routine.

  • I have an appointment to start with the growth hormone treatment

    What will happen?

      The appointment takes about 1-1.5 houres and you will receive all the necessary explications and accompaniment to start the new routine with confidence.
    • Explication on the injection pen
      You will receive a complete demonstration about the working of the injection pen and how to administer the injections correctly. We take the time to get trough all the procedures and to answer all your questions.
    • Exercise with the demo pen
      You will get enough time to practise with the demo-pen on an injections cushion. This helps to get used to the actions, so you are more confident to administer the first injection. Only when you feel confident enough, we do the first injection together.
    • Measurements for the evaluation of growth
      In order to evaluate the growht hormone treatment, several measurements are taken at the start of the treatment. We measure the height and weight, but also the circumference of the head, neck, arm, belly and hips. The length of the forearm and hand are also measured. Additonal, some skin fold measurements are taken, to hel determine the body fatt composition.

               Good to know : this is completely painless and often experienced as playfull and pleasant by the children.

    • Practical information
      You will also receive information about continuing the treatment in different situations like going on holiday or on camp. We also discuss the best moment for the administration and other practical issues.

     

    Questions
    If you have questions before the appointment, write them down and bring them with you to the appointment. We will be able to answer your questions and reduce your worries and hesitations. Together, we will ensure that the start of the growth hormone treatment is smooth and comfortable as possible for you and your child.

    If you have questions after the start of the treatment, you can always contact your doctor or contact person at the hospital

    What to bring with me?
    As soon as you have the approvement for the growth hormone treatment, the doctor will place the prescription for the growth hormone on the identity card of your child. With the identity card of your child, you can get the growth hormone at the pharmacy.

    At the pharmacy
    Depending on the brand of the prescribed growth hormone, you will receive either a pre filled pen or an ampoulle. Do not worry if you only get 1 ampoulle. This is a precaution to prevent that other ampoulles will be destroyed by not being kept in the refrigerator

    Important : get the growth hormone just before the appointment and bring it with you in cooled condition (F.E. small coolbag with cooling element)

    Do not forget your needles !

    Needles are not given routinely together with growth hormone. Ask alsof or subcutaneous needles 4 mm at the pharmacy, these are used for small children. You do not have to take them with you to the appointment, but if you have them fort he first injection at home, you do not have to go tot he pharmacy again.

    Participation in the BELGROW registry
    During the appointment to start with growth hormone treatment, you will be asked to participate in the registry for growth hormone treated patients of the BELSPEED. Your nurse will explain the purpose of this registry during the start up of the treatment. This is completely without obligation, you are free to decide.

    Since 1986, the BELSPEED collects data of all children treated with growth hormone who agreed to particpate in the registry after approval of the parents and child.

    This enables the pediatric endocrinologists to

    • perform scientific studies
    • improve the growth hormone treatment,
    • monitor adverse events
    • study long term effects.

    The registry keeps growth data, lab results and other medical parameters. This is completely anonymous and only happens with your permission. Your child does not need any complementary examinations and you can decide to stop the data collection at any moment.

    Nevertheless, the registry is an important tool to improve future treatments and garantee the best care. We will certainly answer all the questions you may have during the start up visit, or you can ask your pediatric endocrinologist.

     

     

  • Frequently asked question on growth hormone treatment
    •  I forgat an injection

    I you are treated with daily injections, no need to worry. You do not have to do an extra injection. Just continue the next day with you prescribed dose ar the usual time. Note down the number of injections you have forgotten, and discuss this at the next follow up visit with you doctor.

    With weekly injections, you can give your injection during 1 of the following 3 days. If you usually give an injection on tuesday for example, you ca nprogress to wednesday, thursday or friday. If you have forgotten to give your injectionby friday, you have to wait for the next week, on tuesday to inject. If you have questions, you can contact your nurse. Inform your doctor or nurse that you have changed your injction day.

    •  I administered growth hormone twice on the same day

    you do not have to do anything special. Just note this down and repaort this at you next follow up visit with your doctor. If unusal complaints appear, like serious headache, you should contact your doctor

    •  I see a drop of blood or liquid after the injection

    A small drop of blood or fluid on the skin or at the needle is normal.

    If different drops come out of the needle or lay on the skin after the injection, you probably retracted the needle too early. The complete dose of medication is probably not administered. Count to 10 after pushing the injection button has been pressed, and keep the needle stright in the skin. Remove the needle after counting to 10.

    • A bruise

    it can happen that a bruise appears after an injection. This is because a very small blood vessel has been touched. This is ennoying, but not painfull and not dangerous. If you have bruises frequently, contact your nurse or report this at you next follow up visit with you doctor

    • Why do I have to change injection sites?

    Your skin needs to heal after each injection. That is why it is better to use different injection zones. Your nurse will show you the places that are the softest to use : you tummy, the upper leggs, the buttocks. Change the zone regularly. If you inject at the same place all the time, hard spots will occur, where the reosrption of growht hormone into the blood becomes more difficult.

    • My pen is broken

    If you have problems with your pen, if you lost your pen or if it is broken, …contact you nurse.

    Pens get worn out with intensive use, and should be replaced after some years.

    Even if you use prefilled pens, a problem may occur. Your nurse will cenrtainly help you with this.

    It is possible that you will not be able to give the injection for some days while you wait for your new pen. If you used to give your injections regularly before, this will not compromise your treatment.

    •  How to store my pen?

    Keep you pen in the refrigerator, betwoon 2 and 8°C

    Use a cooling bage with a colling element when travveling.

    Be sure that your pen or vials DO NOT FREEZE. Never lay a vial directly against a cooling element and never put a pen or vial in the freezer. Growth hormone that has been frozen losses its function and cannot be used anymore.

    • I did not store my pen correctly

    Did you forget to put your pen in the refrigerator? Look carefully at the fluid in the pen or vial. The fluid has be be clear and may not be milky or cloudy. Every change of the fluid (milky, cloudy,..) indicates that the product is no longer usable and you will have to replace it. If you hesitate, you ca ncontact your nurse.

    • There are air bubbles in my pen

    During the preparation of the pen, air bubbles can occur. Read the instructions carefully how th remove them correctly. If there remain small air bubbles visible, these will rise during the injection and will have no influence on the treatment.

    • Use of a vial

    As soon as you start using a new vial, this will have a duration of 28 day maximum. Keep this date on a calender. You have to replace the vial after 28 days, even if it is not completely empty.

    • I need a prescription or document

    The doctor prescribes suffifient growht hormone untill the next appointment. In case of an unexpected problem, or need for travel document, contact your doctor or nurse. Be prepared when you have an appoitment and ask for the necessary documents, so you or your doctor have no extra worries.

    • I go on holiday

    By air plane

    Ask your nurse or doctor for a medical certificate (flying certificate) at the beginning of the growth hormone treatment

    Always keep your pen, extra vials and needles in your handluggage and use a thermic bag with a cooling element

    Report to the Customs that you transport medication and show your certificate

    In case of a long flight (>7 hours) contact the airway society to request space in the refrigerator on board. Inform about the need to keep medication cool. Hand over your medication in the cooling bag, with your personal contact information on it,  to the flight attendant at boarding.

    Why can the growth hormone not in the luggage compartement?

    In the luggage compartement, the temperature can become too low, and the growth hormone can freeze

    Time difference

    If you travel far into a different time zone, try to adjust to the local time as soon as possible. If you inject at home at 20 h in de evening, do so at 20h in de evening local time. When you get back home, you resume the injections at 20h in the evening like before.

    • Sport competition

    Growth hormone is on the list of forbidden products for competition sporters. Because you require growth hormone for medical reasons, an exeption can be made. Discuss this with your doctor, he or she will give the necessary ecplanation and documents if required. Even for some amateur sporters, a medical certificate can be required.

    •  Who can I contact with questions regarding growth hormone administration? 

    You can contact the nurse who explained the treatment at the start or you can contact the BELSPEED nurse. They are ready to help.

    Sara Neyrinck
    📞 0478/77 13 22
    📧 sara.neyrinck@belspeed.org