Five Feet Tall

June 16, 2020

Gabbi Krachenfels had the biggest ear to ear smile as everyone in the endocrinologist’s office congratulated her. Gabbi did not receive some sort of trophy or medal for anything. What she had done was reach five feet – a great, if not, life-changing accomplishment for her. 

This seems like a minute accomplishment to many as it’s fairly common to reach five feet at a young age. But Gabbi was never the type of person to be able to reach the top shelf. Often at amusement parks, she could not enjoy the rides she wanted to. 

Simply, Gabbi was short. 

“Are you a dwarf of something?” classmates would curiously ask Gabbi.

“Oh – you’re in fifth grade! I’m sorry – you just look younger,” a surprised lunch lady told Gabbi, consequently leaving Gabbi red cheeks as her classmates watched. 

“I mean – it’s a first-world problem,” Gabbi said. “I guess most of the time I was just annoyed at people’s reactions to my height. And I guess it was an insecurity growing up.”

Gabbi has always been the shortest among her peers, but the cause of Gabbi’s short stature and weight was a somewhat different case compared to others. She wasn’t just short as other people were – Gabbi was diagnosed with growth hormone deficiency at nine years old – a condition where the body does not adequately produce enough growth hormones. 

Growth Hormone Deficiency does not secrete enough growth hormones due to a malfunction in the pituitary gland, which is nicknamed “the master gland.” Although a shorter height is the primary cause of growth hormone deficiency, many other symptoms come with growth hormone deficiency, such as anxiety, depression, sluggish hair growth, heart problems, and dry and thick skin. 

“Growth Hormone comes from a stimulus in the pituitary gland. We need it for exactly what it sounds like – to help us grow cells, bones, and every organ in the body. It’s found that sometimes it causes other problems such as overall not feeling so great, low energy levels, and difficulty gaining weight, “ Dr. Yana Garger explains. Dr. Garger is primarily an adult endocrinologist in Ho-Ho-Kus and has been working for thirteen years. 

It’s hard to decipher what qualifies as “short” or “growth hormone deficiency short” just from plain sight. It’s like how every square is a rectangle, but not every rectangle is a square. If you were to walk into an elementary school, there would most definitely be short kids. However, it’s not definite to theorize that these kids have growth hormone deficiency. In fact, growth hormone deficiency is a somewhat rare condition. 

“The incidence of specifically short stature with growth hormone deficiency is estimated to be one in four thousand to one in ten thousand,” Dr. Garger explained. 

To put this occurrence in perspective, the probability of developing breast cancer is a one in eight chance or about 12%.

Gabbi was never fond of her short height. Most of the time, people ignorantly commented on her height. Gabbi always knew not to take these comments too seriously, but somehow these comments still dented her self-esteem. 

At yearly checkups at the doctors, Gabbi was found to be not growing to her expected growth projection. 

“Usually, there’s a predicted curve. If you’re going along that curve and suddenly you fall off, that’s when we start looking into what is the problem,” Dr. Garger explains. 

Gabbi’s parents, Michael and Stephanie Krachenfels also grew slightly concerned as the doctor explained how Gabbi was not growing to her expected growth projection. 

Short height is completely normal but with the combined small chance of growth hormone deficiency and the tendency of being short, Michael and Stephanie decided that Gabbi should get tested for growth hormone deficiency in the third grade. 

To find out if you have growth hormone deficiency, a patient must go through a blood test, called a Growth Hormone Stimulation Test. Here, the doctor will determine whether the pituitary gland, a gland that secretes hormones, produces a sufficient amount of growth hormone to grow regularly. 

Now, there are several different ways to get tested for Growth Hormone Deficiency. 

“The one I was trained on sort of fell out of favor because now, there is what is called Macimorellin, “ Dr. Garger said. 

Macimorellin is an oral drug that patients can take. Macimorellin works as a stimulus. measures growth hormone and different time points after you take it. Yo

“In Endocrinology, there are two types of problems, you either have too much or too little of something, “ Dr. Garger explains. 

With this knowledge, Growth Hormone Deficiency is known varies from patient to patient. As there could be a large range in the production of growth hormone, the severity varies. When testing for it, it attempts to stimulate the growth hormone to see if there is an appropriate response. 

Although Macimorellin is a more common test used now, Gabbi went through a different test that was essentially a blood test. 

Gabbi’s stomach was practically in fisherman’s knots as she drove along Maple Road to the Valley Hospital. In the back of her head, Gabbi knew this was nothing to be that worried about. It was just a test – plenty of people have had much worse hardships compared to her. Still, she couldn’t help herself from being consumed with anxiety. 

Looking around the hospital room, Gabbi finally took a seat on the hospital bed and exhaled. She waited patiently while her mind raced until the nurse entered the room. 

Naturally, the nurse greeted her and proceeded to start the Growth Hormone Stimulation Test. 

“Do you want anything while you wait?” the nurse questioned. “Maybe a book?”

If she had to stay here and get tested, Gabbi might as well enjoy this situation. 

“Sure,” she replied as the nurse brought the book and left the room. 

Soon enough, Gabbi was feeling calmer and was browsing through the newest edition of Diary of a Wimpy Kid. That relief soon left once the nurse returned. Gabbi stared at her arm while the nurse prepared to insert an IV. It wasn’t so bad – still, it wasn’t her most desirable situation. 

“Overall, it wasn’t the best experience, “ Gabbi explains. 

Not a lot of third-graders enjoy having any type of needle in them and Gabbi belonged to this boat of people. It especially did not help when four tries were needed to insert an IV into Gabbi’s arm. 

Along with this blood test, the doctors gave Gabbi sleeping medication. While asleep for three hours, the doctors would monitor the amount of growth hormone Gabbi secretes. Gabbi groggily closed her eyes, relaxed, and was put to sleep. She hoped for good results as the sound and sight around her faded. 

Gabbi slowly arose from her sleep, opening her eyes. 

Three hours passed by relatively quickly, and Gabbi had woken up. Slightly dazed, Gabbi spotted the doctor and her parents in the room. 

“We’ll have the results in about a week,” Gabbi heard the doctor say. 

On her way out, Gabbi picked up a small butterfly sticker from the front desk. With a sticker in hand, Gabbi felt relieved that the test was over, but the results were still to come. 

As suspected, a week later, the results were quickly relayed to Gabbi’s parents. 

Often, the severity of growth hormone deficiency can be understood on a scale of 1 – 10. In this case, 1 would be the best, meaning that the patient secretes enough growth hormone deficiency. 10 would be the worst-case possible, indicating not enough growth hormone being produced. 

In Gabbi’s case, hers was somewhat moderate compared to others. Still, in terms of the scale, she was at a 9. At this point, there was a decision to be made – should Gabbi begin growth hormone deficiency treatment now, or later in her life? 

Ultimately, Gabbi’s parents decided to wait and start Growth Hormone Deficiency treatment later as it wasn’t a severe case. Once Gabbi was in sixth grade, she started treatment. 

At this point in Gabbi’s life, she was incredibly shorter than her classmates. Evident in almost any picture of her and peers, Gabbi was significantly the shortest. To her parents, it seemed like the right time to start the treatment. As she grew up, Gabbi also felt more insecure about her height as everyone around her grew taller. 

Treatment for growth hormone deficiency involves injecting yourself with growth hormones. 

“Growth Hormone replacement is an everyday treatment. It’s based on the patient’s weight and history. It is subcutaneously injected with needles,” Dr. Garger said. 

Every day, Gabbi has injected herself with growth hormones for treatment. It has worked amply over the past four years, as Gabbi has finally reached five feet. Reaching five feet was nothing less than a big accomplishment for Gabbi, especially for a person who had a projected height of around 4’8”. 

Relief was the word Gabbi sought for and she finally achieved it – Gabbi was finally a “normal” height. No longer was it possible for people to question Gabbi’s short stature. No longer could people comment ignorantly and call her a “dwarf,” as five feet is relatively common. 

But as Gabbi grew older, this mindset began to change. Gabbi finally realized something vital – no one cared that much. 

“I don’t think people really cared that much except for Gabbi,” says Hannah Yang, a close friend of Gabbi.

Really, the issue of Gabbi being short wasn’t a hardship for her – it was overcoming insecurities fueled by comments from others. It’s almost guaranteed that people will always poke at insecurities. It took a while but ultimately, Gabbi learned to love herself for who she was, before growth hormone treatment and after. Most would agree, even Gabbi as well, that being short is somewhat of a first-world problem and many others have gone through harsher struggles. Even today, though Gabbi remains one of the shortest among her peers, it’s a fact she can accept without even batting an eye. 

Although she’s grown just a couple of inches over the past years, Gabbi grew more mature over these years. 

Through the journey of having growth hormone deficiency, Gabbi learned to love herself for who she was, even the distinct traits. 

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