S
samuel82873747
Iron
- Joined
- May 31, 2025
- Posts
- 32
- Reputation
- 7
Samuel’s dad , booked an appointment for him to be seen in my clinic, there was no referral letter or past info received other than that was verbally discussed at the consult. However, patient/carer were happy for my letter to be sent to you for records.
I was informed that Samuel was diagnosed with Crohn’s disease at the age of about 12 years and treated with Pentasa and oral steroids till the age of 15; he has taken himself odd the steroids for last 18 months and thankfully the Crohn’s seems to not have flared up. The reason for consulting me today was due to him feeling he has not grown as tall as he’d have expected and that in the last 2 years his height growth curve has plateaued off, his younger brother who is 13 is already about 2 to 3 inches taller than him, as is his mum, although he is roughly the same height as his dad.
He’s been working out at the gym and consuming a healthy diet, and managed to develop a good muscular physique, however, would like to rule out growth hormone deficiency, and if so supplement to potentially gain height if his growth plates haven’t yet closed. Upon his request I have arranged bilateral wrist x-rays to evaluate this. We also arranged a bone profile, full pituitary hormone profile including testosterone and 9 am Cortisol, along with an MRI Pituitary with contrast and US testes to rule out other potential causes.
We discussed that it is possible that there may not be any growth hormone deficiency found, however, worth a check. Commonly boys are expected to achieve a mid-parental height + 7 cm, however, there can be a lot of physiological variation of upto +/- 10 cm. We know that for Samuel, the long-term oral steroid use may not have helped his height gain and as per his request are evaluating him with some simple investigations to start off. At this stage, I have not recommended any dynamic hormonal tests considering the risk benefits.
No known drug allergies, on symbicort inhaler for asthma, but not on any other regular medication.
He is sexually active, gets early morning erections and denies any problems with his testis / penis. He wasn’t keen for me to examine his genitalia ( so this examination was not performed), however he confirmed that he has normal pubic hair and hair on his legs but a slight paucity of hair in his arm-pits.
O/E (Dad Chaperoned) Height 162.3 cn, Weight 63.2 Kg (musucular), BP 135/67 and HR 63 bpm. No pallor, icterus, clubbing, cyanosis, lymphadenopathy or pedal oedema. Chest clear, Heart sounds normal, abdomen soft, non-tender, present bowel sounds. No evidence of goitre, abnormal striae, tremors, sweaty palms or eye-signs in relation to potential thyroidal diseases. No gynaecomastia or excess fat-pad on the nape of neck.
Agreed plan: MRI Pituitary with contrast, US testes, bloods including bone/pituitary profile/PTH, X-ray both wrists and review in clinic in a couple of weeks with results to plan further course of action.
The patient and carer were happy with the consultation and had no further questions at this stage.
Please do not hesitate to contact me should you have any queries in the interim.
Bro someone just fucking help me grow taller or I’m going to deadass kill myself
I was informed that Samuel was diagnosed with Crohn’s disease at the age of about 12 years and treated with Pentasa and oral steroids till the age of 15; he has taken himself odd the steroids for last 18 months and thankfully the Crohn’s seems to not have flared up. The reason for consulting me today was due to him feeling he has not grown as tall as he’d have expected and that in the last 2 years his height growth curve has plateaued off, his younger brother who is 13 is already about 2 to 3 inches taller than him, as is his mum, although he is roughly the same height as his dad.
He’s been working out at the gym and consuming a healthy diet, and managed to develop a good muscular physique, however, would like to rule out growth hormone deficiency, and if so supplement to potentially gain height if his growth plates haven’t yet closed. Upon his request I have arranged bilateral wrist x-rays to evaluate this. We also arranged a bone profile, full pituitary hormone profile including testosterone and 9 am Cortisol, along with an MRI Pituitary with contrast and US testes to rule out other potential causes.
We discussed that it is possible that there may not be any growth hormone deficiency found, however, worth a check. Commonly boys are expected to achieve a mid-parental height + 7 cm, however, there can be a lot of physiological variation of upto +/- 10 cm. We know that for Samuel, the long-term oral steroid use may not have helped his height gain and as per his request are evaluating him with some simple investigations to start off. At this stage, I have not recommended any dynamic hormonal tests considering the risk benefits.
No known drug allergies, on symbicort inhaler for asthma, but not on any other regular medication.
He is sexually active, gets early morning erections and denies any problems with his testis / penis. He wasn’t keen for me to examine his genitalia ( so this examination was not performed), however he confirmed that he has normal pubic hair and hair on his legs but a slight paucity of hair in his arm-pits.
O/E (Dad Chaperoned) Height 162.3 cn, Weight 63.2 Kg (musucular), BP 135/67 and HR 63 bpm. No pallor, icterus, clubbing, cyanosis, lymphadenopathy or pedal oedema. Chest clear, Heart sounds normal, abdomen soft, non-tender, present bowel sounds. No evidence of goitre, abnormal striae, tremors, sweaty palms or eye-signs in relation to potential thyroidal diseases. No gynaecomastia or excess fat-pad on the nape of neck.
Agreed plan: MRI Pituitary with contrast, US testes, bloods including bone/pituitary profile/PTH, X-ray both wrists and review in clinic in a couple of weeks with results to plan further course of action.
The patient and carer were happy with the consultation and had no further questions at this stage.
Please do not hesitate to contact me should you have any queries in the interim.
Bro someone just fucking help me grow taller or I’m going to deadass kill myself
100% start with aromasin or Arimidex if you doc won’t give u anything
