I actually think that a short dose at the early onset ---as sson as they complain of something like that is the best thing to do because as you say, it helps to shorten the life of whatever it is. It has always helped us anyway, and shortens the life of any cold or flu or illness. Normally I only double for a day at the most and he comes right again! Whereas if you wait for the illness to do it's worst you are looking at anti-biotics on top of stress dosing for longer. I actually think these kids are quite advantaged dosed like that as the life of any infection seems to be halved compared to us or the other kids we have here that do not have CAH. Another thing that concerns me is in the past when I have waited before I double, it has always affected any blood tests we had shortly after if I had not acted speedily as the 17 OHP results have come back higher. I literally have pured over his notes since I got copies and they have noted any vomiting episodes that we had before the tests and you can see how they affected the blood results. So all around a short sharp quick jolt with the HCT (doubling up for at the most a day) when you KNOW theyare coming down with something nasty is more effective I found and they are back to their normal selves the day after.