just for kids

march 2000

It's February in Oklahoma, and it's so cold and windy out that my 55 pound dog and I almost got blown away this morning on our early morning walk, but it's also time to begin research on summer camps for your children. Residential and day camps for children with diabetes can provide an unmatched opportunity for learning and fun. As an eye witness to the camp our local ADA sponsors, I saw the joy, ease, learning, camaraderie and caring that campers and staff evidenced during our sessions. It was a lot of work for us, as members of the board to do, but the results were certainly worth while. Surrounded by counselors and other kids with diabetes, campers are freed from the feelings of being different and are able to enjoy one of childhood's great pleasures, summer camp. Since Leonard F.C. Wendt, MD opened the doors of the first diabetes camp in Michigan in 1923, the concept of specialized residential and day camps for children with diabetes has become widespread in the US and many other parts of the world. It is estimated that worldwide camps serve 15,000-20,000 campers each summer. The mission of camps specialized for children and adolescents with diabetes is to allow for a camping experience in a safe environment. An equally important goal is to enable children with diabetes to meet and share their experiences with one another while they learn to be more personally responsible for their disease. For this to occur, a skilled medical and camping staff must be available to ensure optimal safety and an integrated camping/educational experience. Let's look at the general recommendations for diabetes management for the camp you select for your child. Why is it important that you have all of the correct information? We went to the web site for camps for diabetic children at the American Camping Association, http://search.acacamps.org/search.htm and found 84 camps listed with specialties for children with diabetes. They range from residential to day camps and from religious to secular. There are camps from North Dakota to Texas, and from California to Florida, so you have to start early and make informed decisions. When you interview staff you will want to know: How do they balance activity with insulin dosage and food intake to keep children safe from hypoglycemia and hyperglycemia? Do they expect each camper to have a detailed medical history, immunization record, and diabetes regime as well as any psychological history that is relevant before camp begins? Do they expect home insulin dosages, type of insulin given and H1Ac records for camp staff ? During camp does staff keep a daily record of each child's progress? Does this include insulin doses and blood glucose levels? Is it used to review insulin doses and change them as well as food intake and activity levels? If significant changes in insulin are needed, such as change in type of insulin or extra injections, are there professionals to discuss this with the child and parents? When camp is over and more normal activity is resumed how will this transition be handled? Meals and snacks should be at the same time daily. Are the carbohydrate component of food, exchange value and/or calorie count taught to children and adolescents according to their developmental levels? For younger children is the staff trained to make sure that they get enough calories and nutrition for the insulin that they take? Does the camp have a relationship with a nearby hospital just in case of an emergency? Are universal precautions taken by staff when blood is drawn? Are there places to dispose of sharps in appropriate places around the camp? Is there a medical director who has a history of knowing how to care for both children and type 1 diabetics? This person will have to preside over staff for daily care, but also for any emergencies that occur. Are there staff nurses and diabetes educators available for care and teaching? Is there a well stocked infirmary, not just stocked for diabetes? Have all staff been trained and educated about diabetes and the daily routines that campers will need to tend to during the day? Does each staff member know how to help a child at the appropriate developmental level? Do they know when to get help from medical staff? Diabetes Education and Psychological Issues at Camp-Camp is an ideal place for teaching diabetes self-management skills. Here is a list of issues that you may want to have in the back of your mind when you read about what is included in the camp you select: insulin injection techniques blood glucose monitoring recognition and management of hypoglycemia insulin dosage adjustment based on nutrition and activity schedules carbohydrate counting disease complications importance of diabetes control new therapies problem solving skills for caring for diabetes at home Now let us share with you some tips for your child who is going off to camp and for you as a parent. These are tips I would give to any parent of a child going off to camp. Tips for parents: Mail is very important. Begin the week before camp and start to send mail to your child. For younger children or for that older child who is going off for the first time, or for the child who has qualms about leaving home, write each day. As your child feels more secure, a letter every other day is fine. Send a "Care package" with some special things your child likes: baseball cards, plating cards, magazines, sugar free mints, a new pony tail holder, a new T-shirt, etc. Add something for each bunk mate, small but fun. Camp doctors routinely decrease insulin doses, under the assumption that activity levels at camps are greater than at home. If your child is one of those very active children who are always on the go, let the camp doctor know this. Work with the doctor to determine the appropriate dosage while you child is at camp. Make sure you know what the dosages are while your child is at camp. You don't want your child to return home and have very high blood glucose levels when they continue those doses and have stopped exercising 5 hours a day. Send disposable cameras with your child, but be ready for the first 2 rolls to be taken in the bunk house the first day. Don't call the camp the first day to see how your child is doing. If there is a problem, you'll get a call. It's tough to let go, but that's one of the reasons your child is at camp. Don't feel gully when you take a vacation from your child's diabetes. They are taking a vacation from home (and their family too). Tips for campers: Don't pack anything for camp that you don't want to lose. That means special things that you love such as special stuffed animals. Camp means dirt, dust, rain and bugs. That's part of the fun of camp. Leave all of your jewelry at home. If you have pierced ears, wear your simple posts. Take lots of extra underwear and socks-especially socks. Take extra shoes so that you never have to wear wet shoes. Bring sun screen and use it. Bring paperback books and a deck of cards, just in case it rains. Older children may want to bring a dairy or journal. Be prepared for blood tests and insulin injections. If you give yourself shots at home, be prepared for somewhat different amounts at camps. Be prepared to help others in your bunk house. Go off to camp with a positive attitude. This is fun, not a chore. Be prepared to help the staff, but most of all be prepared to learn new skills, to learn new sports, and to gather new information about diabetes. Lastly here is the web address for lists of camps for children with diabetes once more in case you missed it: http://search.acacamps.org/search.htm Once you get to the site, fill in the blanks for camps for diabetic children and you'll get the same 84 camps we got. You need information and you know your child best, so get started, and this summer your child will enjoy a camping experience to end all camping experiences.