I am about to send off for the paper written regarding the treatment of a group of I think 150 Addison patients in Holland and I am pretty sure it only involves adults.  Patches and implants are not being used on kids because the type of hydrocortisone used is the long lasting form.  I understand that the longer lasting forms are not used during the growing period because  there use does not provide a uniform and optimal growth pattern in kids.

As far as I am aware the patches and implants used at the moment release a steady flow of medication(could be anything, nicotine, oestrogen.....) and the output is not regulated by the blood chemistry of the patient.  However, medical technology is miniturizing very quickly and I believe we will see technology of this type used for patients needing any form of replacement therapy.  I see no reason why a miniture pump(1 square mm or lees) controlled by a tiny micro processor analysing specific blood chemistry unique to a given patient is not a realistic possibilty in the next 10-15 years.

Engineers have great imaginations and there are any number of medical conditions and self induced medical problems  for this kind of devise to make someone a great deal of money.   Given the latter it is almost certain that more than one enterprise is on the case.

That is probably for the future, but I do no see any reason why we could not give our kids  take their normal dose in the morning with the lunch time dose that is coated and releases the hydrocortisone 6hrs(?) later.  The technology is used for other medication so why not hydrocortisone.

We all individually have a wonderful amount of experience dealing with CAH and as a group this is far more powerful.  I completely agree with your sentiment that this board as a resourse is not being used by the professionals dealing with CAH.  This may be unfair but my experience of the many endocrinologists I have dealt with is that they are fine with everything related to CAH dealt with in their office(Blood tests, growth etc...). However, ask any question relating to care outside the surgery and you will get conflicting advise.  Realistically, we can expect nothing else because this information is outside their realm of experience.

 However, a well structured questionaire given to all or anyone interested on this board could gather an incredible amount of relevant information that would be a godsend to parents just starting out with CAH.  Why should every parent reinvent the wheel time after time.  TO me it seems completely unneccessary.  As the tragedy  of last week shows us this is completely unacceptable to me as a parent of a son I could not bear to lose to a CAH related situation. I ramble as usual........

ShaunP.