What I Did This Summer: Camp Needlepoint Dietetic Intern

Originally posted 9/2/18

Hello!

Welcome back to another episode of "What I Did This Summer"!

Today's topic? What I Did This Summer: Camp Needlepoint Nutrition Intern

What is Camp Needlepoint?

Camp Needlepoint is a summer camp run by the American Diabetes Association. Children ages 8-16 with Type 1 Diabetes can come and attend overnight camp, enjoying all kinds of exciting camp activities and meeting new friends while being supervised by a medical staff to help them manage their diabetes. There is also a day-camp version of Needlepoint called Camp Daypoint, for younger campers who aren't ready to be away from home at night.

What is Type 1 Diabetes? 

In a healthy person, carbohydrates (breads, starches, sugars, fruits, vegetables) are broken down into glucose molecules, which circulate in the blood (blood glucose) and are carried into cells by insulin, a hormone produced in the pancreas, an organ. Our cells need glucose to function.

In a person with Type 1 Diabetes, their pancreas no longer produces insulin. They need to give themselves insulin in order to make sure this process happens. If they give themselves too much or too little insulin, their blood glucose level (blood sugar level) can be too low or too high, which can make them sick, or even kill them. To prevent this, Type 1 Diabetics check their blood sugar levels multiple times a day and count the number of carbohydrates they are eating, to make sure their blood sugar stays within a healthy range.

Several factors can affect blood sugar levels: stress, exercise, illness, puberty, the type of carbohydrate (a vegetable versus a sugar packet), and what the carbohydrate is served with. Anecdotally, some people with Type 1 Diabetes find that pizza, with all of the fat and protein from the cheese and toppings, tends to throw off their blood sugar.

What was my role? 

Carol Brunzell, the lead dietitian for the camp, organizes a team of dietetics and nutrition students in their junior or senior year of college to come and intern at camp while learning about Type 1 Diabetes. The Nutrition Interns assist with carbohydrate counting at meals, serve the campers with Celiac Disease, a disease that requires them to be gluten-free, prepare and serve snack for the entire camp, and attend educational sessions with the Dietitians and medical staff.

What did I do? 

A typical camp day looks something like this:

6:30am: Wake up, get ready for the day.

7:00am: Shadow the med staff for morning rounds. Every day, the campers check their blood sugar first thing decide how many carbs they want to eat for breakfast, something I helped a lot of younger campers with. They meet with their medical staff member, a doctor or a nurse, and decide how much insulin they need to give themselves to cover breakfast and correct for their morning blood sugar level.

7:45am: Head to the dining hall and prepare plates for my 3 celiac campers.

8:00am: Breakfast for all!

9:00am: The interns prepared afternoon snack for the entire camp. We put snacks into bags with labels for each cabin and placed them on a cart to be grabbed by counselors later in the day.

10:00am: We'd either do an education session with the RDs and Med Staff, or we would be given the morning off. One morning I joined several campers in making friendship bracelets, another morning I drove into Hudson, WI, to walk along the river.

12:15pm: Return for lunch prep. Depending on the meal, we occasionally had to count out individual pretzels or potato chips, to ensure that we were giving campers the number of carbohydrates that they were dosing insulin for. This was tedious but necessary.

12:30pm: Lunch time!

1:30pm: Another educational session with the RDs and Med Staff.

2:30pm: We were given the afternoons off. One afternoon, I was able to go horseback riding! Another afternoon, all of us interns went into Hudson, walked around downtown, and got coffee together.

5:15pm: Dinner prep! At 15 minutes before every meal, the dinner bell would ring. This allowed cabins to gather with their medical staff, check their blood sugars, and dose their insulin for dinner. The camp's schedule is designed to allow campers to do this as a way to help them form good habits and make it easier for med staff to keep track of their campers.

5:30pm: Dinner time!

6:30pm: We usually had a bit of free time after dinner, where we could choose to join in the camp evening activity, usually a big game such as Capture the Flag.

[caption id="attachment_1808" align="alignnone" width="300"] Playing volleyball with one of my fellow interns, Emily.[/caption]

7:45pm: Return to the kitchen to prepare evening snack for the entire camp. We'd dish up the snacks and arrange them on trays, prepare the cereal and milk station, and make large coolers full of sugar-free lemonade, or "bug juice".

8:30pm: Snack time!

9:00pm: Clean up the dining hall from snack. Wipe down the counters, wrap up leftover snacks, sweep the floors, etc.

10:00pm: Head back to the cabins and get ready for bed!

What did I learn? 

I learned SO MUCH about Type 1 Diabetes during my week at Camp Needlepoint!

At the beginning of the week, the RDs assigned each of us an Insulin-to-Carbohydrate ratio and a Correction dosage. We counted our carbs at every meal, just like the campers do. While we interns ate our meals, the RDs would give us a blood sugar, and we would have to calculate the insulin dose we'd need to correct the blood sugar and cover the carbs we'd eaten.

On our first morning at camp, all of the interns learned how to check our own blood sugars using "one-timer" sharps and a glucose meter. Though I have 5 piercings and a tattoo, I was very nervous about this experience! It was very easy to check my own blood sugar. A quick, tiny little poke with the one-timer and the meter read me my blood glucose level in about 5 seconds.

The interns got to ask questions of the doctors and dietitians about Type 1 Diabetes, and they were all really receptive to us and had great answers and experiences. I had many conversations throughout the week and I'm grateful for the opportunity to learn from all of them.

On my last afternoon at camp, I got to try out the Omnipod Insulin Pump with help from a nurse. I filled the pump with "insulin" (sterile saline) and cleaned the back of my upper arm with an alcohol wipe. The Omnipod can go wherever there is enough subcutaneous fat: the hips, thighs, stomach, and lower back are good places as well. Then, I programmed the PDM, which controls the pump, and then placed the pump into my arm! I was also nervous about this, but when the tiny (tiny) plastic catheter went in, it was pretty non-painful.

The Onmipod can stay in for about 3 days, or until it runs out of insulin, so I left mine in from Thursday afternoon through Saturday morning, to get an idea of what it's like for someone with Type 1 Diabetes who has to wear one constantly. It didn't hurt at all, and I would forget that I was wearing it most of the time until my hand brushed it or I leaned against it. Showering with it was easy and the water didn't loosen the adhesive at all. The adhesive was very sticky, so when I peeled it off on Saturday I used some vegetable oil to loosen it.

I have a much greater appreciation and understanding of Type 1 Diabetes now that camp is over. It made me realize that Type 1, like any disease, is complex and unique to each individual who has it. I'll always have more to learn when it comes to dietetics, and I can't wait to dive into my Medical Nutrition Therapy class in the fall. I enjoyed staying curious and open to new ideas while at camp, and, schedule permitting, I would love to come back in the future and work the camp again!

Stay tuned! Another episode of "What I Did This Summer" is coming soon to a blog near you.