I just want to add here also that when my child first started school I gave them information about CAH and the booklet by Garry Warne.  I gave them a bottle of hydrocortisone tablets and a letter with my permission to give one should Jared complain of nausea.  These are held in the school office. He has been at school for 5 - 6 years now and on every occasion he has felt sick they have rung me at home or on my  mobile to ask me to collect him.  I simply ask them to give him one of the tablets with water and to let him lie down in sick bay until I get there.  I do this because sometimes, it may save him getting to the vomiting stage, where I would be unable to get such down anyway.  All the salty snacks and gatorade drinks in the world are not going to help if cortisol levels are low in my humble opinion, if a child's cortisol levels and aldosterone levels are low because of sickness.  Anything they drink will not be absorbed and just excreted in their urine.  They can only retain the above when they receive the correct doses of their medication, and often teachers as I say here are relcutant to even give tablets unless you insist over the phone.  Even when you leave a letter with your express permission and go into great depth about the urgency of such.  Taking that into consideration, I therefore just concentrate on them ringing me now as soon as he complains, as they are far more willing to administer such when I have verbalized over the phone his needs. A child having an excess of snacks and such drinks during the day also concerns me, because I was always told my child didn't need a special diet.  That they would get the salt they need from their normal diet.  Giving it in excess seems to me like we might be just putting a strain on the kidneys as like I said, the body will only absorb the amount of electrolytes dictated by the doses of cortisol and florinef your child receives and after that the rest would have to be excreted.

You are right with your comment about the 'adrenal insufficiency when taking medicines' part Carol.  It would need to be re worded there perhaps to read that the child has a condition that can lead to such rapidly in the event of shock due to physical injury or illness,fever etc. However, apart from that, I felt that the letter itself was informative where it would count, in the hands of emergency services.  Another thing I would like to say is that I recently discussed the idea of having a nurse go into the school to talk to teachers there about such situations as I live in a rural area and we rely on helicopters in emergency. My doctor is now going to put together a kit with solu cortef as our Principal used to work in the emergency services---maybe some teachers at childrens schools are familiar with giving shots due to diabetes being more of a popular condition and it is therefore worth while asking around sometimes about this.  Especially if you live in the 'out back' or some where rural.  Just a thought to ponder on. 

 

JH