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From CHOC patient to CHOC donor: Katrina’s story

When Katrina, now age 28, was a teenager, she knew about type 1 diabetes because her friend had it – she just never expected to be diagnosed herself.

Katrina’s journey to a diagnosis started after she experienced typical signs and symptoms of type 1 diabetes – weight loss and extreme thirst, among others.

During a cheerleading practice, she mentioned she felt thirsty “all the time” and her mom’s ears perked up. This prompted a trip to her pediatrician, who tested her blood sugar levels. They were 707, and a typical 13-year-old’s levels should have been around 100.

“Being diagnosed with type 1 diabetes at age 13 was life-changing,” Katrina says. “But having my best friend and her brother with type 1 and their mom being a nurse helped me navigate the early days of it and not go in blind.”

She adds that the support she received from her CHOC team in the early days of her diagnosis also made the transition into her “new life” much easier.

“The care that I received at CHOC was above and beyond,” Katrina says. “That time in a girl’s life can be the hardest of all – the stress of high school, hormones and sports to name a few – but it was definitely so much easier with the help of Dr. Clark.”

Her primary pediatric endocrinologist was Dr. Susan Clark, a longtime CHOC physician and nationally-recognized expert in diabetes and endocrinology who passed away in 2017.

“Dr. Clark was the reason I became so successful in managing diabetes. She always had a positive outlook,” Katrina says.

As counting carbs and taking daily insulin injections became her norm, Katrina also began quarterly checkups with the endocrinology team at CHOC.

“I always came to appointments with so many questions. I’m a sweet tooth, and no matter what food I asked my team about eating, they would always come from a place of, ‘Yes you can have anything you want. We will help you figure things out safely,” Katrina recalls. “I was in high school at the time, and if my friends were going to 7-Eleven to get ICEEs, I didn’t want to feel held back; I just wanted to be able to enjoy my adolescence.”

Also notable about her frequent appointments, Katrina says, is that Dr. Clark and her team took the time to truly partner with her and allow her to take an active role in her own care.

“Dr. Clark would address me first – not my mom or dad. She asked her questions to me. ‘How are things going? What do you want to change?’” Katrina recalls. “It’s easy to feel belittled at that age, but Dr. Clark always treated me like an adult and made me feel empowered.”

For those reasons, Katrina considered her CHOC visits not a chore, but “like going to see an old friend.”

Although Dr. Clark primarily managed her care, Katrina became familiar with other endocrinologists and staff at CHOC during her frequent appointments – including Dr. Mark Daniels, medical director of pediatric endocrinology at CHOC.

Dr. Mark Daniels
Dr. Mark Daniels, medical director of pediatric endocrinology at CHOC

CHOC experience inspired her career

Katrina’s career interests were ultimately impacted by her CHOC experience. After college, she joined CHOC as an intern, working on with the research team for CHOC’s endocrinology program.

“My experiences at CHOC were so positive that my career interests flipped to the medical field. Having the chance to work with the endocrinology team that diagnosed and took care of me was like a dream,” Katrina says. “Interning at CHOC confirmed in my mind that if you have a child and something happens – diabetes or anything else – CHOC is the best place you can find. Everyone genuinely cares about the patients and employees.”

As part of her internship, she shadowed Dr. Daniels.

“His rapport with patients and the rest of the medical team was amazing. He knows how to talk to anyone and make them feel empowered, and like what they have to say is important,” Katrina recalls. “He was always so much fun to have a conversation with because I would always learn something new.”

Transitioning to adult care

Katrina’s care was transitioned at age 21 out of CHOC to an adult doctor, which she has found to be a much different experience than the one she had growing up.

“When I was at CHOC, all my appointments felt like open conversations; they never used an accusatory tone. I was empowered to make safe, health decisions. I was part of the solution,” she says. “At my adult doctor, sometimes I think, ‘You don’t have diabetes. You don’t get it.’ But when I was at CHOC, my walls were always down.”

Around that time, she met her now-husband Jake at a fundraiser for PADRE Foundation (Pediatric Adolescent Diabetes Research & Education) – a non-profit that serves thousands of Southern California families living with type 1 diabetes through free education classes taught by CHOC educators and a variety of youth and family programs.

Jake, a firefighter, has been living with type 1 diabetes since he was diagnosed at age 3.

Giving back

Given Katrina’s diagnosis and her family’s philanthropic spirit, raising funds to find a cure was a natural way for the family to give back to CHOC. Starting in 2009, the family of runners organized yearly charity races, dubbed Katrina Kures, to raise money for CHOC researchers who are studying diabetes. To date, the family has raised nearly $200,000.

Katrina speaks at Katrina Kures fundraiser
Katrina addresses the crowd at a Katrina Kures fundraiser

“Part of why we give back to CHOC is that we’ve had such a positive experience there as a family. If we had had a negative experience, we wouldn’t do what we do for CHOC,” says David, Katrina’s dad. “CHOC takes as much of an interest in research as we do. Every time we go to CHOC, you can tell they’re doing something amazing. You can see how CHOC is helping the most vulnerable and the most innocent. We want the money to go toward research for a cure. I hope the cure for diabetes will happen in my lifetime. It’s getting closer.”

Dr. Daniels and his team oversee the funds raised and donated annually by Katrina’s family.

“Dr. Daniels is at the top of his game for research. Whatever he thinks will have the most impact on finding a cure, we’re all in,” says Beth, Katrina’s mom.

The high opinion the Jewell family has of Dr. Daniels goes both ways.

“The Jewell family’s continued dedication to making a better future for people living with type 1 diabetes is truly inspiring. Every time I am around Dave, Beth, their son Jesse, Katrina and Jake, I feel the passion that they have for this cause, and it motivates me and everyone in their presence to work harder, be better and strive for a permanent solution to diabetes. They are my heroes,” Dr. Daniels says.

check presentation
Dave and Beth present a fundraising check from Katrina Kures to Winnie Tran, CHOC Foundation’s director of community engagement, and Dr. Daniels

Finding a cure is especially important to Katrina, as she and her husband will soon expand their family.

“Having the money go toward finding a cure is huge, not just for us, but especially as we’re expecting our first child, it makes the cause so much bigger,” she says. “We’re very proud to be partnered with CHOC and excited about what’s to come.”

Advice to others with diabetes

Living with diabetes for nearly two decades has given Katrina a unique perspective on the disease. She hopes to give other people living with diabetes a message of inspiration.

“Consider what you can control and what you can’t control. Everyone goes through difficult times in life. Your outlook affects the way diabetes affects you,” she says. “Diabetes is a huge hand to be dealt. If I went into it with a negative mindset, I wouldn’t want to do injections, which would affect my blood sugar levels.”

Katrina and Jake hope to show others living with diabetes all that is possible, despite their disease.

“A lot of people’s preconceptions about diabetes come from knowing someone with type 2 diabetes,” Katrina says. “I want people to know that people with type 1 diabetes are just as free with food as you are; there’s just an algorithm running in our minds when we see a plate of food, and we’re making different calculations and decisions than you have to.”

As a paramedic and firefighter, Jake’s job is grueling and physically demanding. Many people didn’t think such a career was possible for him.

“In my paramedic program, we were learning about different medical conditions and they basically said that people with diabetes can’t exercise more than 30 minutes at a time and if they miss a meal they will become hypoglycemic, which isn’t necessarily true,” he recalls. “Diabetes is something that I live with and work with, but it doesn’t run my life.”

Katrina adds that having a strong team around you is essential to maintaining proper health and a positive attitude.

“Because I had a great support system, and the medical care I received at CHOC was so amazing, I was able to live a full life growing up,” she says. “I could do cheer team, earned above a 4.0 GPA in high school, go away to college and manage my diabetes on my own, go on runs and do half marathons. All of these are particularly big accomplishments for someone living with diabetes.”

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How to safely celebrate Thanksgiving during COVID-19

As the holiday season approaches, and the community makes plans to observe traditions in a way that may look different from years past, CHOC experts provide the following recommendations for how to celebrate Thanksgiving safely amid COVID-19.

“Family traditions during the holiday season are a treasured part of childhood, and we want all families to enjoy this special season, but it’s important to do so in a safe way,” says Melanie Patterson, CHOC’s vice president of patient care services and chief nursing officer. “After months of living through the COVID-19 pandemic, people may be inclined to make exceptions to the safety precautions we’ve all been encouraged to follow, but during this season we must remain vigilant in doing our part to curb the spread of COVID-19.”

These recommendations are meant to supplement, rather than replace, any local or statewide regulations.

Celebrate with your household

The safest way to celebrate Thanksgiving this year is to celebrate with people in your own household.

Watch Thanksgiving Day parades, sports and movies at home.

If getting a head start on holiday shopping is typically part of your Thanksgiving weekend plans, opt for online sales or use contactless pickup options.

Celebrate virtually with others

Use technology such as FaceTime, Zoom or Skype to enjoy a Thanksgiving meal with loved ones who don’t live in your household. Consider sharing recipes between family members and friends ahead of time, and cooking each of your meals together over video chat.

Children can also use video chat to do a festive craft project with cousins and friends outside their household.

Or, have a virtual, interactive watch party for your favorite holiday movie using Netflix Party or Disney+’s GroupWatch. These services allow you to synchronize your show or movie with friends and family, and chat while you’re watching.

Virtual celebrations can include gratitude activities, such as making lists of what you’re grateful for, and sharing them with friends and family.

Celebrating virtually is especially important if you are celebrating with family members over the age of 65, or those who are immunocompromised and have underlying conditions that put them at greater risk of complications from COVID-19.

Festive outdoor celebrations

As temperatures begin to dip in Southern California, be sure to dress warmly before engaging in any physically distant outdoor activities. Consider a nature scavenger hunt, apple picking, hiking or taking a drive through a neighborhood near you that may have gotten a jump-start on holiday décor.

Thanksgiving travel

Traveling can increase your chance of getting or spreading COVID-19. Staying home is the best way to protect yourself and your family.

The California Department of Public Health issued a travel advisory Nov. 13, urging visitors to California or residents returning home from non-essential travel to self-quarantine for 14 days and limit their interactions to their immediate household, in order to slow the spread of COVID-19.

If you travel this holiday, follow these guidelines:

  • Check travel restrictions for your destination before you go. Some states require visitors from certain parts of the country to quarantine upon arrival.
  • Get a flu shot before you travel. This year more than ever, it is important to get a flu shot to offer as much protection as possible from influenza.
  • Wear a face covering in public
  • Practice physical distancing
  • Wash your hands often or use hand sanitizer
  • Bring extra supplies, including masks and hand sanitizer
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Tips for involving your child with ASD in the kitchen

Cooking as a family this Thanksgiving can be an enjoyable experience for all parents and children, including those with challenges related to autism spectrum disorder (ASD) such as food aversions or sensory issues. With a bit of planning, the experience can be fun, and help strengthen important skills. The Thompson Autism Center at CHOC offers these tips for involving children with ASD in the kitchen.

Safety first

Talk to your child about the importance of food safety and hygiene. Take the time to explain the danger of sharp knives and hot stoves. Demonstrate hand-washing and have your child practice good hand-washing side-by-side with you before handling any food.

Prepare in advance

Before the cooking begins, spend some time explaining new or unfamiliar words that may be used in the kitchen, like the ingredients and tools you’ll be using. Understanding the vocabulary can make the cooking experience more enjoyable for your child.

Avoid sensory overload

Cooking engages all the senses, which may be overwhelming for children with ASD. Try to avoid using noisy appliances or cooking with strong-smelling ingredients. Allow your child to wear food-safe gloves if they are uncomfortable touching foods with different textures. Try to expose your child to one new physical texture, such as gooey pie dough, and make a game of it.

Choose a favorite dish

Children with ASD are more likely to have food aversions. Involving your child in the kitchen is one step toward tasting new foods. Start by cooking something your child loves to eat. This could be as simple as a sandwich or pizza. If your child wants to eat what they are cooking, they are more likely to be engaged in the preparation.

Keep it simple

Try a recipe that is on the simpler side without a lot of steps. If visual supports are helpful for your child, — like they are for many children with ASD, — use pictures to show the steps of the recipe. Avoid too many activities with complex steps or motor tasks if those are challenging areas for your child. Chopping is a simple activity to try, and it’s a good way to improve fine motor skills. To help your child chop, put your hand over your child’s hand to help them maneuver items.

Complementary tasks

Give your child tasks that complement their strengths. For example, if your child is good at measuring, have them start by measuring ingredients. By mastering the easier skills and gaining confidence, accomplishing the harder task will be a much more enjoyable process.

“Cooking is a skill that can help a child with ASD gain independence as they get older,” says Dr. Tom Megerian, pediatric neurologist and medical director of the Thompson Autism Center. “It offers a chance for social interaction, lets children feel pride in their work and also may help broaden the range of foods they are willing to eat, as they taste their work. But even more, it is a way for you and your child to connect.”

Explore the Thompson Autism Center at CHOC Children's

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I’m a pediatrician. Here’s what I want you to know about vaccines.

By Dr. Katherine Williamson, a CHOC Children’s pediatrician

dr-katherine-williamson
Dr. Katherine Williamson, a CHOC Children’s pediatrician

Proper vaccination is important for all people, but especially infants and babies. When children follow the recommended immunization schedule outlined by the American Academy of Pediatrics (AAP), they are better protected against potentially life-threatening diseases.

During the COVID-19 pandemic, your CHOC pediatrician’s office is a safe, physically distant environment to keep your child and family safe while still delivering high quality preventive care.

As a pediatrician during COVID-19, I get a lot of questions about baby vaccination and vaccines for children. Here are the most common questions I’ve gotten about vaccines during COVID-19– and why maintaining your child’s immunization schedule is more important than ever.

Can I delay my child’s vaccines during COVID19?

Getting vaccinated on time is important because even though we have the threat of COVID-19 to contend with, all the diseases that we can prevent easily with vaccines are still a threat. These diseases — such as whooping cough and measles — are ready to emerge at any time that we don’t have the majority of our kids vaccinated.

Recent data released by the World Health Organization and the Centers for Disease Control and Prevention showed that measles deaths worldwide reached the highest level in 23 years last year. Although no measles deaths were reported in the U.S., the number of measles cases nationwide were at their highest point since 1992. Public health experts have linked the increases in measles cases to insufficient vaccine coverage.

If we don’t keep our kids protected against measles and other fatal diseases, the risk for further emergence is going to be very high. While we are waiting for a COVID-19 vaccine to stop the pandemic, it is up to us to keep our kids safe and prevent any future epidemics by using the tools we already have to prevent disease.

Do I really need a flu shot every year?

It’s important that each member of your family get their flu shot every year. This is especially true this year, amid the COVID-19 pandemic. Since both influenza and COVID-19 can have overlapping symptoms, it may be difficult for doctors to determine which virus is behind your symptoms based on a clinical exam alone, according to pediatric infectious disease experts at CHOC.

These overlapping symptoms may include, but are not limited to:

  • Fever or chills
  • Cough
  • Shortness of breath
  • Fatigue
  • Sore throat
  • Runny or stuffy nose
  • Muscle pain or body aches
  • Headache

Learn more about why getting a flu shot is more important than ever this year.

Are vaccines safe?

Vaccines are one of the most important things we can do to help protect our children’s health. Vaccines and proper handwashing, more so than all other interventions, have proven to be the most safe and effective ways to prevent disease.

What is the proper vaccine schedule?

The current immunization schedule outlined by the AAP and Centers for Disease Control & Prevention has been researched and proven to be the most effective and safest way for children to be vaccinated against potentially fatal diseases. It’s important to know that no alternative schedule has been shown to be as safe and effective.

Is it better to do multiple vaccines at one time or space them out?

The safest way to keep your child safe from vaccine-preventable diseases is to get all their vaccines on time. There is no advantage to spacing them out, and instead the longer you wait, you increase the risk of them catching one of the preventable diseases before you protect them.

The amount of antigen (protein) in each vaccine is so tiny that your immune system can process multiple vaccines at one time and build an antibody “army” to protect your child for each of those potentially fatal diseases. In fact, the amount of antigen (protein) in each vaccine is 100,000 times less than if your child has a common cold, so there’s no concern about overwhelming their immune system when they get their vaccines.

What can I do to make my child more comfortable while receiving a vaccination?

Studies have shown that preparing your child for vaccinations should ideally include three components: explaining what will happen, how it will feel, and strategies for coping with any related stress or discomfort. Here’s more tips on how to make shots less stressful.

This article was updated on Nov. 16, 2020.

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How to help kids cope with social isolation during the COVID-19 pandemic

By Dr. Hannah Greenbaum, neuropsychology postdoctoral fellow at CHOC and Dr. Melanie Fox, pediatric psychologist at CHOC

As we have taken important steps to practice physical distancing throughout the COVID-19 pandemic, virtually all children and teens have had much less interaction with their peers than they typically would.

Peer support is a very important part of childhood and adolescence, as friendships provide support, mitigate feelings of loneliness and boredom, help build a sense of belonging, and encourage identity development. As caregivers, it is important that we promote resilience and help children cope with not being around their peers during this time. For any caregivers who are struggling with how to help children cope with social isolation, there are many things you can do to help:

Encourage creative ways to connect with others:

Help your child come up with creative methods of spending time with their friends. The safest way for your child to talk or play with people outside their household during this time is through video chats or phone calls. One way is to encourage a weekly video chat with a friend or family member. Older children and teens may prefer texting or playing online games with friends. This might require temporarily loosening rules about daily screen time. Children might also enjoy writing letters to their friends. Here’s a few more ideas:

  • Schedule “social time” each day, so your child can look forward to it.
  • Scavenger hunt walk in the neighborhood
  • Create arts and crafts together with friends. Choose a project and supplies in advance and make the same craft as friends over video chat.
  • Video chat with other family members and friends.
  • Set up calls or video chats to allow your child to spend time with extended family and other people important to him or her. You might ask a relative to read a story to your child over the phone or on a video chat. Or, invite family members or friends to a video chat party.

Seek daily purpose:

Kids and teenagers often thrive on daily purpose. Spending time doing activities they care about or value can give your child’s day meaning and help them cope with social isolation. Your child might find meaning through reading, biking, creating music, making movies, baking, dressing up, drawing, writing, planting a garden or building something.

Encourage your child’s unique creativity. To motivate them, consider organizing a family reward board, where for example, by doing something like riding their bike they can earn a sticker working toward movie night.

Older kids might enjoy researching a topic that they’re passionate about and sharing what they’ve learned with friends.

Children and teens often feel rewarded when they help others. Consider encouraging them to find ways to connect with their larger community, like making crafts for the local senior facility, picking up litter around the neighborhood, doing yard work for a neighbor, or finding a safe way to volunteer.

Talk about feelings:

Your child might feel sad about missing an important social event, such as a birthday party. Acknowledge your child’s loss, ask about his or her feelings, and validate them by showing that you understand. Allow your child to lead the discussion, rather than making assumptions about how he or she thinks and feels.

You also might consider giving your child an age-appropriate book that deals with loneliness. This can give your child words to describe his or her feelings. Or, have your child write down what they miss about certain people, places or events as a way to cope. Also, explore different ways he or she might cope with these kinds of losses, such as having a different kind of birthday celebration or planning something for when social distancing is no longer needed. Here’s more tips for talking to kids about disappointment and celebrating special events in a creative way.

Your wise mind vs. your emotion mind

Your wise mind can take in new information, be flexible considering alternatives, and be creative in thinking of solutions. Your emotion mind will urge you to give up, act impulsively or rage. Wait for your wise mind to lead, and make decisions and problem solve with your wise mind.

We cannot control the pandemic, but we can control what we do with it. Your child cannot control the current need for social distancing, but they can control how they choose to deal with the circumstances.

By encouraging your child to connect with others, share his or her feelings, and find daily purpose, you’ll help him or her cope with inevitable challenges associated with this pandemic. Working through this challenge also might contribute to your child’s personal growth and better prepare him or her to deal with future obstacles.

We know children and teenagers will continue to struggle being separated from friends as the pandemic continues. Given the importance of peer support, try to acknowledge the loss your children are experiencing, and work in your wise mind to problem-solve and find ways to continue to find peer support. After all, as the Beatles so eloquently stated, “I get by with a little help from my friends.”

Get more information on Coronavirus (COVID-19)

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