Thank You Mary for making the very valid observation that we need to be confident in our Endo and the drug of choice that they work with.

As we know HCT is no less able to control CAH as any other corticosteroid.  It is only the same as DEX and in the wrong hands is as useless at control as DEX can be.  

It IS every bit about the individual Doctors ability to control with that particular drug, and I think even yourself and Carol would agree that had you Doctors controlling children on HCT of done a better job, it would have been just as effective.  I think the convenience of dosing once a day is wonderful, especially if it achieves the same as HCT dosed three times per day, but if I am not mistaken Carol’s Doctor treating with HCT had her dosing Nick twice per day--12 hourly apart--or some such nonsens.  THIS is the kid of treatment of CAH that gets one particular corticosteroid a bad reputation actually.  It IS possible to emulate one a day dex dose but it is considerably more bothersome with three doses and means having to rise in the early morining that is all.  

I think Doctors need more training with the biological half life of various drugs and a better understanding of exactly what they are prescribing and what they expect it to achieve.  or exapmle dosing 12 hourly (twice a day) it seems to me that a Doctor rather has unrealistic expectations of what HCT can achieve given that it is excreted within 6-8 hours on average.  

Cheers

Anne-Marie