Here is the background for our Diabetes Challenge Question of the Day.

We had several family members of former diabetes campers on the medical staff this week. Several were siblings of persons with type 1 diabetes. Chances are very good that a child with type 1 diabetes has a non- diabetic brother or sister (over several). I saw lots of siblings waiting around at check in. I’m sure I’ll see more today at check out.

Non-diabetic siblings often experience a wide range of feelings surrounding their diabetic brother or sister. Some may state (like my sister did at one point), that I got all the attention and special privileges she never did. Some sibs may live in fear that they might develop diabetes too. Often, the only persons explaining anything to the siblings are the parents. And if the parents don’t have the necessary training, the information that they do share may be inconsistent or sometimes simply incorrect.

Some older siblings may get placed in the position of acting as a “junior parent” to their younger diabetic sibling. This might include giving or watching insulin injections and blood sugar checks, preparing proper meals, or even making self care choices for their diabetic brother or sister.

Over time, a chronic family focus on the diabetic child may make the non-diabetic sibs angry or even resentful. Many sibs may be severely conflicted by these feelings.

So, today’s Diabetes Challenge Question is the following: How did growing up with a diabetic sibling affect you as a child and later as an adult? Did it permanently affect your adult relationship with your diabetic brother or sister? If you overcame this challenge, what do you think contributed most to your success? Feel free to be specific in your comment below.

Dance Night

The dance was a big success as always. Campers were made up and dressed up as well as one could at camp. I have several great photos below. If you are looking for the youngest campers, they were on camp out so the Rec Hall was less crowded than usual, but nonetheless just as active. Our med staff BG check table saw steady business all evening.

Last Day of Camp

Friday is the last day of camp. It’s been a privilege to have the opportunity to provide a safe and enjoyable camping experience for 215 children from across the state of Texas. My staff has also enjoyed this challenge and all are prepared to hand over campers to their parents on Friday night (or Saturday morning at 8AM for the 42 campers staying over). I will not be able to meet with the parents of campers discharged on Saturday morning since I will be occupied with orienting incoming new medical staff for Session 2, which starts at 1PM on Sunday July 26th 2009.

Free Photo/Video DVD

We shot over 2000 photos and 1 hour of video (Night Court). Mike Koch is working to create complimentary DVD’s in time for check out. These have great music tracks as well. This is Mike’s 8th year volunteering his time for the diabetic camping sessions. He was also involved with the organization of the Webinar the other evening (and this coming Wednesday evening too).

Texas Lions Camp

My medical team is very appreciative of the Lions Club and the Texas Lions Camp. The people who established this camp had their diabetes camping program vision almost 40 years ago. I’ve been lucky to be part of it each year since 1981. I encourage families to consider making donation to the camp. Every donation is appreciated and put to good use to serve the children and families of Texans with diabetes. The medical staff applauds Mr. Stephen Mabry, the camp’s CEO, for the quality team of individuals who operate every facet of the camp and effectively interface with my volunteer medical staff. The camp’s website is http://www.lionscamp.com. Photos of campers from this session can be purchased on the Lions Camp site.

Webinar

We have corrected the sound feedback problem for next week’s Parent’s Day Webinar so there will be no “echo chamber” effect. Updated links are posted to the webinar site. Attendees from last Wednesday night are invited to rejoin the webinar next week if you had to leave early. Also, the twitter site http://twitter.com/Dr_Steve_Ponder and this blog site form part of the alternative approach I’ve tried to develop to replace the former 2 hour Parents Day program in the Rec Hall we used to have. I will also have the pleasure of visiting with parents over dinner on Friday evening July 24th at 5:15 PM. If you have any questions or comments about camp, please let me know anytime by sending me an email at Stephen.Ponder@dchstx.org.

Diabetes Housecall

About 2 years ago I created a revolutionary new approach to diabetes care for children. It’s called Diabetes HouseCall. I currently have patients with diabetes in this modern version of my practice who have been seen as far away as Iowa. Texas patients as far away as 600 miles are seen just as easily as if they were in town. I encourage you to check out my practice website for HouseCall that explains how this innovative care program operates (http://www.diabeteshousecall.com ) to allow me to see you in the comfort of your own home, also while having access to all your relevant diabetes self care information. The rules of participation in this exciting program are explained on the site. I received some exciting news today that Blue Cross Blue Shield of Texas is embracing this program as a covered service starting around the end of September 2009. This would be a first for home based telemedicine care for children with diabetes in Texas. Advantages of HouseCall include 30 minutes or more of direct face to face time with the diabetes specialist. No waiting rooms, no long car rides, no time out of work or school, to see the diabetes doctor. Does this sound pretty good to you? Let me know if you need more info or would like to talk to one of the families already enrolled in my HouseCall practice. There is also an online community forming around HouseCall at glucoKIDZ.com and I know at least one of our families there would be more than happy to tell you more about their experience.

See you at Parent’s Night!!!

(Alternate Title for Trekkies - Captain’s Log: T+204 hours…hey this is camp)

First, here is the Diabetes Challenge Question of the Day and some background.

Over 80 years ago, Elliot P. Joslin, the father of modern diabetes care and education, made a conscious choice to keep children with diabetes separated by gender when they attended diabetes camp. This practice persists to this day. His rationale was simple: if two diabetics married back then, the risk of death or disability to the young diabetic woman from the complications of pregnancy were very high. The risk of death of an infant of a diabetic mother was also very high. These are both still very real risks, but we have better knowledge and tools to address these problems. But there was more to this separation simply based on medical risk: including undertones of trying to prevent the growth of a presumed genetic condition (diabetes) by encouraging two known juvenile diabetics to form a relationship that might result someday in marriage and children that would expand the number of persons with diabetes.

We have married medical staff where both spouses have type 1 diabetes. They made their choices with full knowledge of the potential medical consequences. But how many of us have considered the emotional challenges of living with a diabetic?

Today, relationships between persons with diabetes are a choice any one can make for themselves. We have the big dance tonight in the Rec Hall and already dates have been locked in for days and the anticipation is high for tonight, especially in the older camper cabins. Girls are fretting that some did not bring “the right shoes”! Adolescence rears its head!

Divorce rates in persons with diabetes are higher than the norm. While much has been done address discrimination against diabetics in the workplace or education, the last frontier for many persons with diabetes falls into a much more personal level: the relationships we have with friends and loved ones.

I get e-mails from readers everywhere telling me about how diabetes and its consequences have damaged or even prevented a serious personal relationship. It’s not just the long term complications of diabetes that can affect intimacy (male or female), but living day to day with a chronic illness that not only demands your time and attention to properly manage, but sometimes may steal away your personality (as in low blood sugar).

So, today’s Diabetes Challenge Question is the following: Explain how diabetes (type 1 or type 2) or its management has impacted a personal relationship you have had, or wished to have had. Has the impact been positive or negative…or not at all? Has low blood sugar changed your personality often enough that you reached a point where an important relationship with someone you love or have loved has been threatened or lost?

Webinar

The webinar hosted over 50 participants last night. We have corrected the sound feedback problem for next week so there will be no “echo chamber” effect. Updated links will be posted to the http://lionscamp.com/webinar site. Attendees from last night are invited to rejoin the webinar next week if you had to leave early. The twitter site http://twitter.com/Dr_Steve_Ponder and this blog site have served as alternatives to the traditional Parent’s Day program we lost by discharging campers on Friday evening. I will also have the chance to visit with parents over dinner on Friday evening. If you find this approach acceptable, please let me know at Stephen.Ponder@dchstx.org

Camp Photos

The Price is Right:

Night Court Action: Penalty Phase!

Counselors from Clean Cabin winners have to eat Weet-Bix (an Australian cereal) and then try to whistle!

At snack time, horsing around.

After pool time, insulin pump sites get changed out for many campers. It gets crazy!

Who would have thought I’d get ice cream sandwiches at Diabetes Camp!

Counselor “Moose” gets dressed up for morning flag-raising on Wednesday.

Keep up with camp on line. I’m tweeting frequently at http://twitter.com/Dr_Steve_Ponder

Check out the camp’s website at http://www.lionscamp.com. Photos of campers can be purchased on the Lions Camp site.

A free DVD of all photos will be provided at check out, plus 1 hour of Night Court video. You are not able to save or print from the DVD, so if you find photos you like, they can be found at the camp’s website.

For many of you, I’ll see you Friday at the Parent’s Dinner. Be there by 5:15 at the dining hall. The entire family is invited. Awards ceremony will follow. Check out is scheduled for 8:45 PM in the Rec Hall.

I first started using the GlucoPALS term to describe a certain protocol of using our system to connect peers inside of patient-centric teams back in 2005 while working closely with a teen who was then using the second generation GlucoMON. It seems that this model of self-care is taking hold with large care delivery systems both here in Texas and another one primarily located in California.

Now 4 years seems like a very long time but I read an article a few months ago that said it takes about 17 years for anything new to catch on in the practice of medicine. Only 13 years to go.