I am so sorry to hear how lousy you are feeling Steve.  Have they actually diagnosed you as having CAH or something else?  Have the doctors actually explained exactly what the imbalance is?  It must be terrible to live like that.  If they do not advise you to take pred regularly, I just wonder what they actually expect you to do. How is your b/p? Does the fludro cause this to go high? Sorry, I am just quite cynical where the medical profession are  concerned sometimes and think if they don’t know what to do they procrastinate and do nothing but let the patient suffer. I expect you have had several opinions!