4th year has been fun so far! In a previous post, I mentioned how exciting it is to choose electives. Well, one of the elective I chose is Pediatric Diabetic Camp and Endocrinology.
This is a 2-week elective, which consists of 1 week of Diabetic Camp at Camp Conrad-Chinnock in Angelus Oaks (near Big Bear) and 1 week of Outpatient Pediatric Endocrinology at LLUCH Subspecialty Clinics in San Bernardino (a mile from LLU). Though I was at camp on an elective, you do not need to be a 4th year LLU medical student to volunteer.
I was part of the medical staff at Camp Conrad-Chinnock, and it was a blast. I recommend this experience to medical students of all levels, premed students, doctors, PAs, nurses, and anybody else who wants to learn about diabetes and/or chronic diseases while having fun with the kids.
Although I am going into Adult Neurology, I found my camp experience to be relevant to my future career because I will be working with patients living with chronic diseases. Besides, I want to take full advantage of gaining broad medical knowledge while I am still a medical student.
You can learn more about Camp Conrad-Chinnock here: http://campconradchinnock.weebly.com/ Mark your calendars for next year!
This past week, I had an amazing time in the San Bernardino Mountains learning how to manage Type 1 Diabetes while enjoying camp life. The week I attended, Session 4, had approximately seventy type 1 diabetic campers between the ages of 7 to 12 years old. Some were diagnosed only 3 months ago, while others had already been living with diabetes as infants or toddlers. Because diabetes does not discriminate, there was a diverse group of children with diabetes. The majority of the program staff and counselors had diabetes too, and many were also past campers, which showed me how valuable camp is to these diabetic kids.
While at Camp Conrad-Chinnock, I was assigned a cabin with ten campers to follow and manage for the session I attended, with the supervision of excellent physicians. Before meals and snacks, I would help them figure out how much insulin they needed to administer, adjusting for carb intake and their glucose corrections. I also made sure they received their daily medications and drew up injections. Many children, however, had insulin pumps, which are attached to areas with subcutaneous fat on their bodies. It is a device that resembles a pager where the user can enter in how much insulin will be delivered. It is connected to tubing that attaches to the user’s body. The insulin pumps remind me of IV’s because they are always attached. Of course, the tubing and pager part can be taken out for showering and swimming. I thought they were a convenient way of administering insulin. Rather than getting 4 injections each day, those with an insulin pump just needed to change their infusion site every 3 days. One of the days at camp, a representative from Medtronic, an insulin pump manufacturer, came to teach some of the kids about the insulin pump. Those that did not have the pump got to try what it feels like to have the pump infusion set placed on their bodies. Although I do not have diabetes, the Medtronic representative let me try too. I had the infusion set placed on my abdomen. Before I came to camp, I did not know how to calculate insulin dosing, and I did not know that insulin pumps exist. What a difference a week makes.
In addition to helping campers figure out insulin dosages before meals and snacks, medical volunteers were assigned shifts, in which we staffed the infirmary. Campers would come to the infirmary for high or low blood glucose readings, in addition to treatment for common medical problems, such as headaches, injuries, and more. Doctors, PAs, nurses, and other students volunteer as medical staff. Honestly, being a medical member of Camp Conrad-Chinnock was a lot of work, but it was also a lot of fun. During free time, I could enjoy camp activities (arts & crafts, rifles, archery, swimming, nature, sports, etc.) or take a hike in Angelus Oaks.
Below is roughly how I spent each day:
- 6:30am= wake up, shower, stock supplies, get campers’ meds ready, check overnight events
- 7:30am= record campers’ blood sugars before breakfast, calculate insulin dosing, prepare insulin injections, check insulin pumps
- 8:30am= eat breakfast
- 9:15am= camp staff meeting
- 10:00am= free time or staffing the infirmary
- 12:15pm= stock supplies, get campers’ meds ready, check morning events
- 12:30pm= record campers’ blood sugars before lunch, calculate insulin dosing, prepare insulin injections, check insulin pumps
- 1:15pm= lunch
- 2:00pm= free time or staffing the infirmary
- 5:15pm= stock supplies, get campers’ meds ready, check afternoon events
- 5:30pm= record campers’ blood sugars before dinner, calculate insulin dosing, prepare insulin injections, check insulin pumps
- 6:15pm= dinner
- 7:00pm= medical staff meeting
- 7:30pm= free time or staffing the infirmary
- 9:15pm= stock supplies, get campers’ meds ready, check evening events
- 9:30pm = record campers’ blood sugars before bedtime snack, calculate insulin dosing, prepare insulin injections, check insulin pumps
- 10:00pm= bedtime snack
- 10:30pm= prepare list of campers for midnight rounds, stock supplies
- 12:00am= midnight rounds or bedtime
- 3:00am= 3am rounds or bedtime
Camp was an intensive introduction to living with Type 1 Diabetes. Every other day, I had to do midnight rounds, which consisted of bringing lancets (aka pokers) and glucose meters to my assigned cabins and testing certain campers’ blood sugar levels. A group of us medical staff would bring the supplies to each cabin and use flashlights to find the campers that needed to be tested. Since most of the children were already sleeping, I would usually just grab their hands, poke their fingers, and drop their blood on a glucose meter. This would get a bit complicated when testing the children on the top bunk beds. What was funny is that most of the campers did not even wake up when I tested them. However, we did need to wake up the kids whose sugar readings were below 100 or above 300. These campers were given juice or a snack if their readings were low, or asked to test for urine ketones if their readings were high. Getting them out of bed was sometimes a challenge. For one night during the week, I was also assigned to do 3am rounds on the children who had concerning glucose levels at midnight. Although some days were busy, it was a wonderful learning experience, and everyone seemed to have a good time.
The most valuable thing I learned from Diabetic Camp is what life is like living with a chronic disease. As a diabetic, there are definitely challenges. Blood glucose levels change with different activities and different types of foods. Sometimes, it can be a struggle to determine the appropriate carbohydrate to insulin ratio and basal rates of each child. Each person is also unique in their responses to insulin dosages and responses to changes in activity and diet. It was certainly very interesting to witness how the various campers responded to their insulin regimens at this camp, which was at high altitudes in the mountains. At times, I would find myself frustrated when my campers’ blood glucose readings were fluctuating. Luckily, there were no campers during Session 4 who had sugar readings that were too high or too low to the point of going into diabetic ketoacidosis or having seizures. Overall, our medical staff did a good job of managing the campers’ insulin regimens. The children, obviously, also did an excellent job of counting carbs and reporting when they over-ate or felt that something was wrong. I was very impressed with how much knowledge these young children had of managing their diabetes on their own, especially at the young age of 7 to 12 years old. I could tell the campers also had a lot of fun.
Although living with diabetes can be challenging, I have seen that it is not limiting. Having diabetes, or any chronic disease for that matter, does not necessarily mean that the person must cease all activity. At Camp Conrad-Chinnock, each day was packed with various activities for the campers to do. These included: swimming, shooting rifles, doing archery, climbing an adventure wall, playing sports, and more. There were also water fights and dances. One of the days, the whole camp hiked to Jenks Lake, and we went canoeing. This was exciting for me because it was my first time riding in a canoe. With careful management, having diabetes is not restrictive. Working at camp showed me that people with diabetes can do activities and eat food just like everybody else as long as they are aware of their bodies’ changes in glucose levels.
Ultimately, I enjoyed my experience managing children with diabetes at Camp Conrad-Chinnock. Since I do not have diabetes or any other chronic disease myself, I feel a greater appreciation of my own health. I feel fortunate that I can eat whatever I want or do whatever activity I desire without having to worry how my glucose-insulin balance will be affected. At the same time, I believe I have also become more aware of the needs of others living with diabetes or other chronic diseases. This experience has been very valuable to my medical education and future career as a neurologist. As a neurologist, I will certainly deal with patients who have chronic medical issues. I would recommend this rotation to anyone looking for a unique, hands-on experience learning about diabetes and living with a chronic disease. This is truly an amazing elective, and Camp Conrad-Chinnock even provides housing and food for medical volunteers. I also got to shoot a rifle for the first time. What more can I ask for? Can you believe I actually get elective credit for having fun at camp?