Well, the saga continues.  It seems that any and every strange thing happens to Kristin.  She is 14 and a simple virilizer.  She had arthroscopic surgery to her right knee on 5/9/02 and subsequently developed RSD in that leg.  RSD is a problem with the sympathetic nerve system.  It causes extreme pain - so much so that even the touch of the lightest, softest fabric is extremely painful.  Kristin is not able to use her leg properly.  She is walking with a limp and in contant pain.  Last week she had her first nerve block to see if that will help.  While we were at the hospital, the doctor administering the block and the nurses were all alarmed at her blood pressure.  When we first arrived it was 150/95.  After being sedated during the procedure it got as high as 170/103.  It was still very elevated 150-160/95-105 after the procedure when she was still sedated.  The endo thought she was "just nervous and upset" about the hospital and nerve block procedure.  I told her that was not the case.  A few days later at the endo’s office the reading was 142/93.  I am getting similar readings at home.  Now, here is what I believe is happening.  At her last endo visit, her 17 OHP reading was 1700+ (down from something like 2300, but still way too high).  Androgens were not elevated.  Not knowing why the 17 OHP was so high and in an effort to bring it down, the endo increased Kristin’s florinef from one 0.1 mg tablet at night to one in the morning and one at night. Her reasoning was that Kristin was on one florinef daily to help the hydrocortone work better, so two would help even more without increasing her steroids and having issued from too high a dose of hydrocortone.  Not being a salt waster, I tend to believe that the florinef may be what caused it to go up so high.   I spoke with Dr. Migeon of Johns Hopkins as he is an expert in the field of CAH and he warned th at she may develop high bp from too much florinef.  As of Friday, we went back to just one florinef a day.  Does anyone have any experience with high blood pressure being the result of too high a dose of florinef?  If so, how long did it take the bp to go back to more normal levels?  This is perplexing to me.  I would also add that Kristin takes a multitude of other meds, but I am told none of these should cause the bp problem.  They are elavil, neurontin, vioxx, acifex - taking them for her leg and for reflux.  Sorry this is so long.  It just gets so frustrating - and you guys seem to have such a wealth of knowledge that I am hoping someone knows something about this.  Thanks, everyone.