Karen,

I know you didn't take it as such anyway, but I didn't mean my comment about bone age interpretation to be just a throw-away "dis" on an HMO doctor. By its very nature, an xray is a picture, and pictures are subjective. If you put the same xray in front of two different doctors---no matter how good---they would probably give you two slightly different numbers. Hopefully, if both doctors are well-trained, the differences will be minimal, off by a few months, rather than years.

Being able to accurately read bone ages is also dependent on experience, how many the doctor or radiologist has seen in his/her career. I know you are somewhat limited in your choices---I would only suggest that you get the most experienced person you have treating Reily to take a look at her film. If it has been her regular pediatrician, so far, I would guess that he has not seen many in his career. Reily's endocrinologist should have more specialized training, and I would make sure she takes a look at the actual xray, rather than rely solely on someone else's report (especially if that someone may not be as experienced, as she.)

It's good that Reily's bone age hasn't advanced much since the spring. I believe that that is often common, shortly after treatment. Bone age does not necessarily grow at a constant pace, however, and it can also apparently "lag behind" what is actually going on in the body, so it will also be important to get new readings every six months or so to monitor Reily's progress.

Again, I think it's really important to get the doctors to give you a CLEAR picture of Reily's diagnosis, especially this late into the game, be it with bone age or renin. The renin issue, especially, and whether or not she is actually a mild salt-waster, has much more serious implications for her health, and I would try to pin them down, if you can, as quickly as possible, to be sure Reily is getting properly treated.

Hope you are hanging in there.