Gary... your questions are well thought out! I certainly hope more than one med student interested in CAH research is paying attention to your last three questions! We have been told that generally this type of stress should not be of concern but I would beg to differ. I have watched the toll it takes on my daughter compared to others when she competes. Both the physical as well as mental. We certainly don't force her to any of it...she just likes sports. Also the academic stresses have increased over the years now that she is 15. She is a very bright young girl and more than once has asked to take part in speech as well as music competitions. On the good side, she has learned that being well prepared reduces the stress immensely, but I have never felt hands as ice cold as hers during stressful times. On rare occasions, I have given her an extra dose or cortisone and it seems to help. Maybe Dr. New could update us on current thought in regards to this.