This really surprises me, Sherry!! We saw Dr. Couch when he was still at BC Children’s Hospital ... of course, that was back in 1989 ... and at that time they DID NOT routinely recommend having the IM shots. Our SW son died of adrenal crisis is 1991 (age 23 mo) and we since have another daughter with SW CAH, born in ’97. Since the IM hydrocortisone is so prevalent now with our daughter, I assumed that they had changed treatment throughout Canada, and that it was just standard procedure. In fact, we were led to believe that CAH treatment was pretty standarized throughout Canada. Our endo when we lived in Winnipeg (who, I believe was head of Pediatric Endocrinology in Western Canada at the time - Dr. Heather Dean) knew - and seemed to approve of - Dr. Couch, but she was also VERY adamant about having the IM shots with us. I would be interested to know - and would probably question Dr. Couch (and yes! he is a very nice man!) - about his "lasse faire" approach to the shots, especially when there is SO much information out there (BC Children’s booklet, booklets from CARES foundation, Johns’ Hopkins, Rick Warren in Australia, etc.) that says the complete opposite!! I guess as long as he’ll give you the prescription, his opinion is not really important ... but I’d also wonder how his recommendations for illness are different that (it seems) most other endos in western Canada: for example - we are told to give shots for a broken bone ... what does he recommend?? Adrenal crisis can happen LONG before you could get seen in the ER ... take it from someone who’s been there ...

In any case, sorry to ramble!! I’m just very surprised at this, and very glad that you "know better"!! Please let us know how it goes! Blessings,

Wendy-Lee