Hi Sue, I can really appreciate your desire for both parents to be able to get to your daughter quickly in a time of need. As a single (never been married) mom (kids joined family through adoption), one thing that I very quickly had to learn was that I can’t be there all of the time and do everything. I have also learned that there are almost always other folks who are willing to help -- they just need to be made aware of the need and my desire for help. (For me, the second part is hard since I tend to be too independent.) I really liked what Judy had to say, We have never let CAH rule our decisions.  It certainly plays a part in the decision but it has never been the ruling factor in them. My Olivia (now 5) was always in a day care that was close to my work -- 5 to 10 minute drive depending on the stop lights.  I always "felt" in control. Last November I had to change day care settings because the first day care was not taking appropriate care of my girls. The new day care is less than 1 mile from my house, two blocks from the elementary school and 30 minutes on a good day from work. Olivia will be starting kindergarten at the elementary school in July. Things that I have done to make sure Olivia will always have the care she needs include: First, I approach the subject of CAH in a very calm manner so those in charge will know that I believe that they will handle any situation correctly. I remember when I first learned Olivia had CAH -- I didn’t think that I would be able to care for her. My guess is that teachers might feel the same way. I really want them to know that they can do it and that it isn’t hard. I don’t want to overwhelm them. At day care I had to work with the main office because they initially said that they didn’t want her injectable and syringes left at school. There is no one at day care trained to give her an injection. This turned out to be a simple phone call explaining the importance of it being there for me or for the EMS. The local director was also very concerned that she wouldn’t "know" when Olivia would need a stress dose. "Fortunately" Olivia spiked a fever the second week in the school and the director saw that it is easy to determine. I really do trust my day care, but I still check the medicine sheet every week to see when she got her meds. I have talked with the head of our local EMS. Our paramedics have the maximum amount of training available (I can’t remember their classification) and they are allowed to give injections. They know about Olivia. And they know that the injectable and doctor’s orders will be at the day care when they arrive. I have made the rule that if day care (and school) feels that they need to call 911, then an injection is to be given (no one has to make any judgment calls) and Olivia is to be transported. There is a very limited amount of time that I can’t be reached at work, so day care or school shouldn’t have to even make a judgment call about calling 911. School is still somewhat of an unknown. The school nurse knows that Olivia is on daily meds and she has the doctor’s orders for an injection. The nurse has also stated, and the phys ed teachers agree that Olivia is to wear her MedicAlert bracelet at all times. A week or so before school starts I will go in to meet with her teacher, the nurse, the phys ed teacher and the principal so they understand her situation and that we all understand what will happen if Olivia needs either an oral stress dose or an injection.  I will also give them some CAH handouts so that they can read all about CAH. I don’t know if this is helpful. But please know that what ever you decide, it will work because you will have made the appropriate preparations. Warm regards, Janet