My son is 9 1/2 yrs. old and salt-wasting. Naturally, in all these years, he has had a few stomache viruses. I usually triple dose immediately upon finding a temp., even a low-grade one if I feel he is going to get really sick-you know, mothers instinct! He has had 2 really difficult times, the first was at age 3. Vommited off and on for 2 days, yet never near his med time and kept in touch with endo's. Never gave injection and he was fine in 2 days. The other episode was worse. He had just turned 5. He developed a nasty stomach bug that lasted almost a week. Never had to give an injection even though even vomitted, literally off and on for about 5 days. I kept in constant touch with his endo and because I felt he was fine and my descriptions of his condition didn't alarm the doctor , we both felt he was actually absorbing his meds. Although he was slightly weak ( who wouldn't be after beign sick for so long) I would not have said he exhibited signs of dehydration or shock. On the 6th day, I told the doctor I was getting nervous, only because he had been sick so long, he said to go to the ER to have him checked out. All the blood work came back fine, they said they said he was not dehydrated and his electolytes were great!! I demanded they give him fluids anyway, because I couldn't believe it! He went on to vomit one more time later that evening, triple dosed again and then he was fine! Go figure - one would think that should have just done him in, but he did great with no injection! Now, when he was 2 we had an episode that we had to call 911. He had always been a great sleeper ( basically came home from the hospital sleeping through the night, and never changed!) and never woke until morning. There was this night , 2 days after his 2nd birthday, during the morning hours , he came into our bedroom a couple of times and seemed kind of odd, but I naturally assumed he was 1/2 asleep. He really just seemed like he had had a nightmare and just needed to be guided back to bed. When my husband woke at 6 am to give him his am meds, he came to me and said that Ben just didn't look right to him. I immediately knew something was wrong and ran to his bedroom where what I found was so frighteniing. He looked exactly like he did when he was diagnosed. His eyes were sunken, he was pale, cool to the touch and almost unresponsive. He would open his eyes and look at me and then go right back to sleep. I called the endo and said I couln't even get a "normal" temp rectally etc. , he said to inject and immediately call 911. I DID NOT inject first, because I had never done it before and I paniced. I called 911 first then, threw some clothes on and then ran downstairs to get his solu-cortef. By the time my husband brought him downstairs and I was getting ready for the injection, the ambulance was here (later found out it was just 6 min.). They asked what I was doing etc and we all decided to just put him in the ambulance and get him to the ER. In hindsight, I now know what a big mistake that was. However, being the first crisis, I admit I paniced. Anyway, he was in adrenal shock, and we NEVER found it what caused it. He had had his meds on time, he was not ill. We still don't know. Just thought I would mention it, as here is a case of when he wasn't ill, he had an adrenal crisis and yet he has mustered through a couple of horrific stomach bugs without solu-cortef. I think this is such a case-by-case situation. No one knows your child like you do and you do on instinct. What one parent may do for their child during illness, does not necessarily mean that that course of action may be the right thing for your child. Lets pray for a healthy winter season for all!

Valerie