Lisa, if your ENT is affiliated with a children's hospital that has an accredited cf clinic (or for that matter, ANY hospital as long as it has an accredited cf clinic), request that your ENT order a sweat test ASAP. They're easy, relatively painless and cheap (less than $100). You can usually get the answers back the same day, or at the latest, the following day. And, I would think as long as the HMO were in network, as cheap as a sweat test is, it wouldn't have to have prior authorization. How old is your ds?
Also, just because he has symptoms does NOT mean he has cf either. DEFINITELY get him tested but try not to stress too much. My ds is 6-1/2. He has asthma, allergies, severe chronic sinusitis, silent reflux, and is very small for his age but does NOT have cf. DS was near the top of the growth charts and relatively healthy for the first couple of months of his life but when he started daycare, we started the endless cycle of wheezing, ear infections, sinus infections, pink eye, pneumonias/lung infections, and non-stop coughing. He quickly fell down on the growth chart and did not recover even when we removed him from daycare a few months later. At birth, he was 90% for weight, now he's barely on the chart between 3 & 5%. By his second b-day, he was on albuterol in the nebulizer more days than not, and had already had 23 rounds of antibiotics for various lung/ear/sinus infections. At 3, our ex pediatrician (do NOT ask me why I stayed with the man for so long!), anyway, he referred him to an allergist who immediately diagnosed him with chronic sinusitis, asthma, and sent him for a sweat test which thankfully, came back negative. After a year of trying to figure out WHY his sinuses were so bad and HOW to fix them medically, he finally gave up and referred us to an ENT who removed his tonsils, adenoids, and did sinus surgery to clean them out & widen the natural openings so they would drain better. At the time, he said ds's sinuses were filled with thick "glue-like" mucous. When a few months later, despite aggressive prophylactic treatment, ds's sinuses were in the same shape as before, our ENT requested that we have ds tested genetically for cf. Our ENT is the main ENT that the local cf clinic refers their patients to so he has extensive experience with cf patients and felt like there was a good chance that ds's sweat test could have been wrong. By this time we had changed pediatricians and our new family doctor had referred ds to a pediatric pulmonary clinic that also happens to be an accredited cf clinic. The pedi-pulmo agreed that we should have ds tested further. The genetic test was negative & ds is not even considered a carrier. They did NOT do the AMBRY panel so there's a part of me that still occasionally worries about cf (why I still lurk here I guess). Despite my paranoia (for lack of a better term), all of his current drs consider him cf-free and he is doing somewhat better on advair 500, nasonex, nasal washes, zyrtec, prevacid, singulair, and allergy shots. Anyway, I shared my story because I remember how scary it was waiting for the results both times, especially since the drs seemed so sure that ds had cf. Our lab said they sweat test 200+ children every year and only a very small fraction come back positive. Definitely get him tested but try not to worry too much. I hope that helps.
Oh, and one more thing, did the ENT mention nasal polyps? According to our pedi-pulmo, children with nasal polyps are more likely to have cf than children with chronic sinusitis that do NOT have nasal polyps. Would you mind sharing your ds's story?
Noel
