This post will be a little on the other end of the spectrum from many others. We are generally a little more conservative about doubling and tripling the hydrocortisone - probably due to the varying degrees of severity of CAH and the differences in every child. Also, my son has been on the oversuppressed side for quite some time so I am reluctant to frequently give him even more hydrocortisone.

We double if fever is over 101.  We have never had to triple. Just prior to vaccinations (my son is 2 1/2) I give him some tylenol. This has worked well to keep the fever from ever starting. We have never had to double or triple for vaccinations. The times he has had bad colds we have doubled for 24 to 48 hours and he has pulled out of them fine. He has had low fevers a couple of times and we have alternated tylenol and advil. Ask your dr. about that one. It works well. I think you give one every 6 hours?, the other every 4 hours? Even the time he had the stomach flu and was vomitting, we gave an injection of solu-cortef then doubled for 24 hours and he was fine.

Again, I don't want to dispute anyone else's findings with their children. I just want to let you know there is a spectrum out there and your dr., or your child, could be on either end.

As far as the bracelet goes - I highly recommend the Medic Alert Bracelets. They are engraved and include a toll free number emergency personnel can call for further information. Based on some research I did about our local ambulance companies (we are in the US in a large metro area) I discovered the e.m.t.s won't give an injection (even if you provide the solucortef) without a dr.'s orders. With the medic alert bracelt the emt can call the 1-800 number, get the ped endo's number, and confirm injection in just matter of moments. Additional perks - they will replace bracelets for loss or growth for free, and you can update the information (dr.s, emo contacts, insurance info etc) at any time for no additional cost. There is an annual fee, but I think you more than get it back in their services. Check them out. Oh, we have "adrenal insufficiency, hydrocortisone dependent" on my son's bracelet.