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Not limited by diabetes

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Camp Hickory Hill captions

Nathan Heide, 8, leads his cabin mates to the cafeteria for afternoon snack. Camp Hickory Hill schedules three daily snacks in addition to regular meals.

Ethan Fish, 8, administers his own insulin injection before breakfast. Many campers learn to give themselves shots for the first time at Camp Hickory Hill.

Children are more physically active at Camp Hickory Hill than at home, requiring them to monitor their blood glucose levels every few hours. Prompted by a dangerously low blood-sugar reading during a softball game, counselor-in-training Justin Balk, 15, right, of Jefferson City, Mo., eats sugar and saltine crackers.

Campers file into the “Blood Shed” to check their glucose levels.

Campers have designated lockers in the Blood Shed for their glucometer test kits and other supplies.

After eating glucose tablets to bring his blood-sugar level up, Ethan Fish, 8, shows University Hospital nurse Amber Bettis a test strip that shows his insulin is at a healthy level, allowing him to continue playing.

Campers adhere to strict meal plans and learn to weigh every morsel of food in an effort to maintain constant blood glucose levels.

Campers’ meal plans tell them how many exchanges they can eat of meats, starches, fruits, vegetables, fats and milk products.

As part of the camp’s educational mission, Jason Holman, a fourth-year resident in pediatric internal medicine, quizzes teams of children on their diabetes knowledge.

The team that won celebrates answering the most questions correctly.

Daily activities include fishing.

Songs and circles are a regular part of the day at Camp Hickory Hill.

Camp Hickory Hill slide show: Hover mouse pointer over images to read captions.

Camp Hickory Hill, a wooded 77-acre spread five miles northwest of Columbia, contains both a cave with nesting bats and a building called the “Blood Shed.”

But the facility is not a training ground for budding vampires. Instead, it is one of the few camps in the nation dedicated to helping children with type 1 diabetes learn how to manage their disease in an environment where for one week a year they are completely average. “Every day is a fun day,” says fifth grader Ethan Phillips of Columbia.

Like any summer camp, Hickory Hill features cabins, archery, lanyards, hokey songs, campfires and nature trails. These kids also jab themselves six times a day to monitor their blood-sugar levels, since extreme highs and lows could send them into a coma or kill them within minutes.

Camp Hickory Hill

Columbia doctor and diabetic Ronald James, MS '64, MD '65, founded Camp Hickory Hill in 1972 and served as its medical director until his death in March 2006. The non-profit, residential camp seeks to educate diabetic children and teens ages 8-17 how to manage and control their type 1 diabetes to minimize complications and live longer.

James devoted his life to helping diabetic children. He once wrote that he was motivated by the diabetes-related death of his older sister before he was born, and by the difficulties he faced after his own diagnosis at the age of 11.

At Camp Hickory Hill, children learn self-care, such as how to measure their blood glucose levels and administer their own insulin shots. Counselors also provide vigorous recreational activities to prove that diabetics can safely engage in sports.

In 1995, James founded a similar camp in the Republic of Georgia in partnership with the Columbia-based humanitarian aid organization A Call to Serve (ACTS) International. He had been horrified to learn that, lacking education and medical supplies, the life expectancy for diabetics in Georgia was just 10 years from diagnosis. "He said, 'We can't let that happen,' " remembers his widow, Elizabeth James, MD '65, professor of child health, who says campers from the first sessions have now grown up and are raising children of their own. "He did a lot for diabetics all over the world," says James, who is currently helping ACTS raise money to build a dining hall at the Georgian camp, now renamed in her late husband's honor.

Campers learn how to give themselves insulin shots, measure their blood sugar levels and weigh their food, all in an effort to manage their disease. They spend an hour each morning learning about medical issues such as foot care and diabetic complications.

But campers learn 24 hours a day, largely from each other and the camp’s counselors-in-training, teenage diabetics who serve as role models. One is Justin Balk, 15, of Jefferson City, Mo. Balk, who has attended the camp for four years, knows only one other diabetic kid at his school. At camp, “I feel more accepted,” he says.

Camp organizers aim to show kids that having diabetes does’t have to limit their lives. A performance by a diabetic stunt pilot and spelunking were highlights of the first week of camp, June 10-17, populated by teenagers. The second week, June 24-30, for children aged 8-12, also contained a dizzying range of activities that kept campers hopping alongside their slightly bedraggled adult companions.

Although many campers use insulin pumps to deliver consistent dosages, they are much more active than usual at camp, which throws dosages off. To deal with the resulting highs and lows, the adults tote “reaction kits” to every activity. Brightly patterned lunch sacks hold insulin testers, film cans full of sugar, glucose tablets and packets of saltine crackers.

The camp also has at least one licensed physician on site 24 hours a day.

At the camp, Mizzou medical students Laura Gonzalez and Jason Holman got a crash course in diabetes management. Both fourth-year residents in pediatric internal medicine, Gonzalez and Holman had only limited experience with the disease until they arrived at camp.

Sitting on the step outside the clinic, Gonzalez watched campers helping each other with their insulin shots, a breakthrough of modern medicine. “Two hundred years ago,” she says, “these kids wouldn’t have been here.”

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