Last night, Collin started back on growth hormone after almost a full week of being happy and retch-free.
This week, I spoke with his endocrinologist, who was shocked to hear that Collin had reacted, since he is not on any medicines that would conflict. He explained that Collin's symptoms could have been from the HGH rapidly increasing protein synthesis and fluid levels in the body - too rapidly for the body to manage and reabsorb it, thus allowing it to build up in areas like the brain, which could result in crippling headaches and consequent nausea. But then, as we were putting together our titration plan to get back up to Collin's dose, he said something along the lines of, "Now that we're talking about it, I do remember a handful of adults who were treated with growth hormone complaining of nausea and general malaise when they started treatment. We eventually figured out that it was a sensitivity to the preservative in the HGH shot." I admit that I did make bug eyes out of frustration at first, but I do understand that treating adults and children with HGH are two very different things. And it made me thankful that we have at least another option to try if this titration doesn't work, since preservative-free HGH is available, even though it is slightly more complicated to draw up and a larger volume to inject.
So, our plan for now is to start Collin back at one sixth of his original dose. We'll try that for two weeks and if we don't see any adverse effects, we'll add another sixth, and so on. If he starts reacting in any way, we will stop immediately and start the process to get preservative-free HGH.
Well, that is the technical plan. The actual plan, influenced by parental spidey-sense and our observation of Collin's obvious hypersensitivity two weeks ago, is to add a transition week between each of those dose increases. So this week, we will only give him a shot every other day before moving up to the sixth dose every day. Then in three weeks, if things are fine, we will do one third every other day and one sixth on the days in between before moving up to one third every day. You get the picture. If Collin reacts while on a plan like that, we will know it has to be preservative sensitivity rather than intercranial fluid buildup, because we'll be giving his body ample time to adjust to fluid levels.
So now, even though we're not sure what we're dealing with, we just have to move forward with our next plan and try not to worry too much. Hm. That sounds like the story of the last two years.