Hi Carol,

You’re right. I think the ACTH is more for me than for the doctor. At first the doctor wrote up a letter for me to give my ob that said  that I was expecting a baby boy whose prenatal testing showed similar genetics to Jackson. This would imply that  the baby would have CAH, SV form. HOWEVER, she went on to say that since Jackson required florinef in addition to the cortef in the first few months and since we can’t predict the phenotype from the genotype she recommended:

close monitoring; checking glucose before discharge  from hospital; cover with solucortef for emergencies;start hydrocortisone and florinef within the first week of life;make arrangements for ACTH stim test by day 3 of life; make sure electrolytes are checked within the appropriate time for the development of hyponatremia.

Then.....I got another letter from her saying that my baby is due at the end of Nov and has the same genetics as Jackson and she feels that the ACTH test might not give us additional information therefore she would recommend to proceed with baseline 17ohp, plasma renin and D4 Androstenendione and start treatment with Hydrocortisone and follow lytes closely. She went on to say that the ACTH test is appropriate but less informative when we know the genetics.

So...I think I’m just going to pretend I didn’t get the second letter and push for the ACTH. Of course if the baby is in trouble, I would just start the meds and forget about the ACTH. I guess I’m hoping that this one reacts the same as Jackson did. I guess all we can do is wait and see.

I am feeling really good. I have gained more weight with this one than I did with my other three pregnancies but then again I had a feeling I would considering I gained lots  the short time I was on the dex. Oh well, it’s for a good cause and since this is my last one I can focus on getting my body back! I’ll let everyone know when the little one arrives. I must admit I’m nervous about his birth but I can’t control it all so I’ll have to just wait and see!

Thanks,

SAndra