Hi, Suzanne.  I am the US - we live in Virginia.  My 12 yr old daughter has CAH and is not a salt waster.  When she was 3 her boneage was 7-1/2.  Now at 12, her bone age is only 13.  She is currently just under 5 ft tall which is good - she has two short parents!  You need to be sure your child's CAH is being well managed - under-suppression will result in abnormally short stature because the growth plates will close too quickly.  I have heard that some doctors are using growth hormone to increase potential height, but I think it may be experimental.  Precocious puberty is sometimes secondary to CAH.  That can also result in the rapid progression of bone age.  That is treated with a drug called Lupron.  My daughter has been  treated with it since she was 5.  Before treatment begins, testing must be done to determine that the child is in puberty.  The way I understand it, without being technical, is the Lupron blocks hormones that stimulate the production of the pubertal hormones.  It is given by injection and my daughter takes the monthly type.  We used to go to the doctor for the shot, but now I administer the shot at home each month.  It is a very expensive medication, but my insurance covers most of the cost.  Since she is 12, we will probably stop the Lupron soon and allow her to start puberty.

One other thing, while Kristin is NOT a salt waster, she does take Florinef, which is the drug normally given to salt wasters.  She has been doing this for years (since she was about 4).  The reason she takes it is that it makes the hydrocortone work more effectively.  It immediately gave us better results in controlling the advancement of her bone age. 

As far as the temperature, that is a factor of whatever illness you child is experiencing at the moment - not the CAH.  If the temperature goes up, you will want to increase the medication, but also if he is showing other signs of being seriously ill.  Remember, you will not harm your child be increasing the dose if he is ill.  It is better to be safe and give extra during times of illness.

Please discuss these treatment options with your endocrinologist.  If he/she won't work with you, please try to find another.  There is more at stake here than just growth.  For your child's health, you need to be sure you have good control.  When you have that, the growth should follow.  Please keep me posted.  Good luck.

 

Kay