I can see all of the side to this debate. But, I cannot see letting your decisions be motivated by fear.

My son also has CAH.  Our family lives in a small community. We love it and have excellent medical care.

We drive 3 hours to the endo and I don’t feel that is that bad.

I am 5 minutes away from the hospital here and if my son has a problem his doctor thinks he needs a higher level of care he will be life flighted to the children hospital were his endo is.

The only thing I would not do is live more than 30 minutes from the hospital (Even if it only had 4 or 5 beds they would have a hela-pad) . Lets be honest if you live in a big city it may take you more than 30 minutes to get to a hospital with traffic and lights.

Solu-Cortef gives us a 6 hour window.  That is a good amount of time.

Jenni- I would give it a trial. Interview the doctors in the area. You would be surprised the good doctors that practice in small town America because it is a good place to live and raise families. (We have 5 in Winslow, AZ). I know that is cannot be an easy decision for you and your family. Good luck in doing what is best for your family.