Carol, I love your posts. I learn so much everytime I read one.

I can't remember if I have asked you this yet - what do you think Nick's levels are doing now? Do they seem stablized, or are you expecting undersuppression with the next set of levels? You mentioned you "have had very subtle dose incresaes, and (we) have stomped". I would love to hear more about that . I am assuming the "subtle" includes the recent dose reductions. When did you guys try the stomping? How did it work?

I am also interested in your findings about growth during the first two years. I have asked myself the same question many times  - knowing both under and oversupppression are not desirable, is there one side we should lean to? I have read similiar research suggesting the first two years are absolutely critical for growth.

If I understand you correctly, from what you read . . . because the first two years of growth are very critical, the newborn diagnosed and treated from infancy should be cautious of oversuppression especially during those critical growth years. Assuming I follow you on that point, I am struggling trying to apply that to Jack. He was pretty oversuppressed between 18 months and 2 1/2 years, yet he stayed fairly close to the 50% height curve, and, his 2 and 3 year bone ages were interpreted as very close to chronological age. This leads me to wonder (1) Did we just get lucky so far with height? or (2) Do kids have different growth spurts regardless of the "curve" and did we oversuppress, hence miss, one of his?  (3) Could his bone age interpretations have been incorrect (although advanced bone age wouldn't be consistent with oversuppression - I don't think?) (4) Does his system maybe do better slightly oversuppressed since his height wasn't as affected as may be typical? I would love to hear your analysis.

Your "newest idea" is definitely something to ponder. Do you know more about why shorter lasting is advocated? I guess I have heard the conclusion "it doesn't negatively impact growth like longer acting steroids", but never the reasoning.