Yesterday marked the end of Emily's first month on growth hormone. We had her checkup with the endocrinologist today, and found out that, this past month, she's gained 4 pounds and 1.5cm. Which is wonderful, but also scary. It means that this stuff that we inject into her every day really is having a substantial impact on her. I just pray that it is just as the endo keeps assuring us : that injecting her with the growth hormone is only giving her what's missing, not adding anything new, so there shouldn't be any adverse long-term effects.

Ems had initially thought that she'd like to administer the injections herself, but when it came to the point (sorry) she couldn't bring herself to do it. So Bobby had to take care of them all the time I was away, and I usually do it now that I'm back. Emily sets everything up : she washes her hands, gets the "pen" device out, gets the needle out, wipes everything down with an alcohol wipe, puts the needle on, dials the correct dose (the injection device has a little LCD display; you turn a button to get to the correct dose, which goes up in 0.1mg increments.) Em's current dose is 1mg each night. You can see the pen here, if you're so inclined. The medicine has to be stored in the fridge. Injecting cold medicine feels yucky though, so Emily takes it out of the fridge and puts it ready on the table before she goes to bath. By the time she's out of the bath, the medicine has reached room temperature. The injection is given subcutaneously, and it's important not to give it in the same area all the time. She can use her upper thighs, her tummy, the backs of her arms (this doesn't work for her, as there's no flesh there to pinch up), or what she refers to us her "lower hips" but what anyone else would term her butt. She pinches up the area that's been chosen for that night, and then Bobby or I give the shot. Using the pen device means that you don't actually see the needle go in, thank goodness. Once the needle's in, you need to push down the top of the pen to inject the medicine. Here's where the person doing the injection has to be careful : you have to push quite hard, so you need to hold the pen very steady so as not to push the needle further into poor Emily. Hold it down for five seconds, and then you're done. After she's had the shot, Emily disposes of the needle (we were given a small bio-hazard box for this) and puts everything back in the fridge.

Emily is very brave about this whole process. No moaning, no complaining ... she really is a trooper. She has an m&m right afterwards; when Bobby does the shot, he gets two. (He says it's more stressful for the person giving the shot than the person receiving it. Ems disagrees.) Generally, the injection doesn't hurt much - just a prick, Emily says - but occasionally it feels horrible. A couple of times she's bled a bit after the shot. The nurses said this is normal - sometimes you just hit a little blood vessel. And a couple of times she's had a little bruise the next day.

I hate the whole injection process. It makes me feel sick to my stomach to hurt her every evening. (Ems does not know that I feel this way; she has a very positive attitude about the whole thing). I'm glad we endured all that testing. At least this way, I know with absolute certainty that she's not making growth hormone on her own and would end up classified as a dwarf without it. I wouldn't have been able to go through with this if we'd just been going on a doctor's gut feel (which is all you need for a growth hormone prescription in some parts of the country, apparently).