This is a common problem with the NV-4500 5 speed transmissions. Basically, the nut holding the 5th gear in place loosens up and falls off into the transmission case. That's in most of the cases. In a small percentage, it falls into something expensive and completely ruins the transmission. The problem is a design shortcut. Only half of the bore of the gear (and the corresponding part of the shaft) is splined. The other half is just a press fit.
Getting a rebuilt transmission with the retrofit 5th gear shaft and gear that are both fully splined, and with a better nut. There are variations. The shaft, gear and nut are available separately and can be used to replace just those parts into an otherwise good transmission. I believe that Standard Transmission in Ft. Worth is the site-recognized expert on this matter. Both of these otions are going to be a lot less expensive than a 6th gear retrofit. (I certainly appreciate the desire to go to a 6 speed; every time I have to shift from 3rd to 4th on an upgrade.)
This has not ever happened to me, but it has to people I know. I seldom use 5th gear, and when I do, I use 5th gear at a high enough RPM to prevent the high-torque banging on the assembly that'll loosen the nut.