Down East Diabetology

A camp counselor shares snacks with a child

ECU nursing student and Camp Needles counselor in training Trey Hasty helps Matthew Kurzontkowski prick his finger in order to check his blood sugar levels during arts and crafts Wednesday morning. Camp Needles is a one week residential camp for children with type 1 diabetes ages 8 to 14 years.
(Rhett Butler/The Daily Reflector)

BLOUNTS CREEK — Corn dogs for breakfast and French toast for dinner may sound like a pretty mixed-up menu, especially at a camp for kids with diabetes. But it was a fitting fare for Camp Needles in the Pines’ "Upside Down and Backwards Day," a rather odd occasion that inspired some campers to wear their clothes inside out and others to back their way into the dining hall.

The celebration, though certainly silly, also was strangely symbolic of steps taken forward in the management of type 1 diabetes. In the three decades since Camp Needles was founded, advances in treatment and understanding have given children living with the disease the freedom to have fun.

For nearly every summer since 1984, children with type 1 diabetes have been invited to spend a week at Camp Boddie, an 800-acre Boy Scout camp on the banks of the Pamlico River. Here, as many as 75 campers ages 8-14 do the same things that any other campers might do. They take turns tubing and try tie-dying, they compete in cornhole and conquer the climbing wall, they swim in a pool and sleep in a tent.

"We don’t discourage anybody from doing anything," said Dr. Jennifer Sutter, a pediatric endocrinologist and medical director for Camp Needles. "We want them to play football, play basketball, swim…dance."

Such a philosophy is hardly in tune with advice given to type 1 diabetes patients a generation ago. Back then, a diagnosis often was accompanied by a prescription for a regimented and restricted life.

Camp Needles co-founder Pam Hardy remembers the first time she and other area diabetes educators decided to test the waters by hosting a weekend camp at the coast for children with type 1 diabetes, a condition in which the body does not produce the insulin needed to convert sugar, starches and other food to energy. Hardy saw patients who had grown up a little more than an hour’s drive from the beach but had never seen the ocean or felt the sand between their toes.

"They were never allowed to do these things," said Hardy, a retired nurse practitioner who served as camp coordinator at Camp Needles for more than two decades. "Kids (with type 1 diabetes) didn’t do things like that. (The philosophy was) ‘You shouldn’t do this. You shouldn’t do that.’ "

Ashley Mangum of New Bern came to Camp Needles to get away from all that. Mangum was diagnosed with type 1 diabetes, estimated to affect 1.25 million Americans (200,000 of them children and youth), when he was 11. He had just started to play baseball.

"The doctors, at the time, they had me quit," Mangum, now 34, said. "Now I think that sort of thing is unheard of…. But I think camps like this helped."

Coming to Camp Needles helped Amy Lee deal with the type 1 diabetes diagnosis she received shortly before her ninth birthday. With it came more information about "food exchanges" than a child her age could hope to digest, along with a ban on ketchup.

"I was told that I couldn’t even have ketchup because ketchup had sugar in it," Lee, now 32 and a counselor at Camp Needles, recalled. "Back then they served french fries with everything in the cafeteria, and kids put ketchup on everything. So you’re going to tell a 9-year-old you can’t have ketchup?"

It was at Camp Needles where Lee learned to give herself injections. It also was here that she learned that having type 1 diabetes meant more than "no" and "don’t."

Camp Needles aimed to give campers a different experience, one that included often forbidden pleasures such as archery and ice cream. Camp Director Lynne Braxton, a registered nurse who was one of the original counselors at Camp Needles, isn’t sure whether the idea simply was ahead of its time or slightly crazy. ("I think a little bit of both," she said.)

"Some families are very regimented at home about food choices, so here they get to try new food choices," Braxton said. "And certainly there are a lot of the activities they’ve never done."

Braxton, a certified diabetes educator, said the fact that the camp is staffed by medical professionals gives peace of mind to parents, who often are hesitant to let children with type 1 diabetes leave home for an extended stay due to the level of care they require. These doctors, nurses and nutritionists, along with many counselors who also have type 1 diabetes, spend time at camp teaching kids the skills they need to manage their disease in order to become more independent.

"Parents tell me after camp that their children are so different," Braxton said. "They’ve come here and they have never given a shot or they wear an insulin pump, and mom always has done the insertion site. Now the kids can do it."

About half the children at the camp rely on an insulin pump, a computerized device that delivers insulin through a catheter placed under the skin. The pump works nonstop, releasing small doses of insulin designed to keep blood sugar in the patient’s target range.

There is even a way to link glucose monitors to smartphones so parents can keep a watch on their children’s blood sugars throughout the day.

"Even just in the past 10 years, the whole diabetes technology has changed," said Sutter, who has two daughters with type 1 diabetes. "They can eat when they want, play when they want. We more adjust the insulin to them than adjusting them to the insulin, so it is a different world."

In Coy Terrell’s world, kids who have type 1 diabetes have never been sidelined from sports. Coy, 12, who was diagnosed at age 6, uses an insulin pump. He plays soccer, rugby and basketball and has recently taken up baseball.

The Charlotte native has traveled with his family and lived in places as far away as Hawaii and South Africa. But he never had a chance to go to an overnight camp until he came to Camp Needles for the first time last year.

"It’s a great camp," said Coy, who listed petting snakes as his favorite camp activity. "It’s really fun, like just awesome."

Camp Needles also is a first for Lindsey Halliday, who was diagnosed with type 1 diabetes at age 9.

"This is my first camp of any kind," said Lindsey, 12, whose father shares her condition.

Back home in Forest City, Lindsey likes to play volleyball, go caving, whitewater rafting and even zip lining. But she almost never has a chance to meet anyone her age who has type 1 diabetes.

Mangum, who teaches digital media at Havelock High School, said children with type 1 diabetes may not know anyone outside of camp who has the disease. That is one reason the staff at Camp Needles became like a second family to him.

"I remember as a kid spending the first half of the week with one of our counselors and then finding out he was diabetic, and that stuck with me," said Mangum, who has been to camp for 16 of the last 23 years, most of them as a counselor.

"I know it’s a huge impact we’re making on these kids’ lives," he said. "Not all of us are doctors telling them what to do. We’re people that are doing it…teaching them what to do."

Nutritionist Mary Bea Kolbe has been teaching kids at Camp Needles since she was a graduate student at the University of North Carolina at Chapel Hill in 1996. She has watched campers like Lee and Mangum grow up to be counselors.

"I still haven’t gotten one of them to eat his vegetables," she said, laughing. "But I’ll never quit trying."

Down East Diabetology web site featured in a newspaper

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InTandem recently designed a website for Down East Diabetology (www.downeastdiabetology.com), which opened June 22 at 845 Johns Hopkins Drive, Suite B.

As the agency of record for Down East Diabetology, InTandem also designed and created the practice logotype and all ancillary materials for the opening of the medical practice.

Down East Diabetology, founded by Dr. Amy Howell, is the only diabetes specialist in eastern North Carolina that is 100-percent devoted to the care of children, young adults and pregnant women. The mission of Down East Diabetology is to educate and provide patients with tools to help manage their diabetes.

“Eastern North Carolina is a medically underserved area and a lot of people with diabetes do not have access to the care they need,” Howell said “My goal is to provide a medical office that specializes in complete diabetes care offering expertise in glucose monitoring, insulin pumps, diabetes self-management education, medical nutrition support, medical family therapy and diabetic medications,” states Dr. Amy Howell.

During Howell’s career, which includes five years as a pediatrician, she developed a clinical interest in nutrition and obesity, as well as chronic disease management and community outreach and service. Howell’s interests eventually led to specialty training through a Diabetes and Metabolism Fellowship at the Brody School of Medicine under the mentorship of Dr. Robert Tanenberg.

During her fellowship, Howell’s training focused on diabetes in all age groups, including for women during pregnancy.

The practice website was designed to provide detailed descriptions and statistics about pediatric, young adulthood and gestational diabetes. Additionally, there is information regarding screening procedures and diagnosis, as well as highlighting diabetes specialty services available at Down East Diabetology including diabetes self-management education, medical nutrition support and medical family therapy.

The website informs visitors about the practice’s history, its providers and services offered, and there is a special section with advice for patients on handling their “sick days.” The site also has a Patient Portal where patients and providers are able to access a referral form to expedite the referral process. A News and Events section provides updates involving the practice and upcoming diabetes events within the region.

“Working with Dr. Howell to develop branding for her new practice has been a pleasure for us. It was evident at our first meeting how dedicated she is to her mission of providing diabetes care and education to the area,” said Bridgette Williamson, InTandem vice president and director of communications. “We wish her much success in this new endeavor.”

InTandem specializes in branding, website design, public relations and photography. For more information, call 321-1111 or visit www.intandeminc.com.

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