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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CHOC recognized as one of nation’s best children’s hospitals

best-childrens-hospitals-7specialtiesCHOC Children’s is one of a select number of pediatric facilities nationwide to have been ranked today as a best children’s hospital by U.S. News & World Report.

The following CHOC specialties are honored in the 2020-21 Best Children’s Hospitals rankings: neonatology; cancer; diabetes and endocrinology; neurology and neurosurgery; orthopaedics; pulmonology; and urology. Both orthopaedics and diabetes and endocrinology earned a “Top 20” spot. 

“At CHOC, we are committed to the highest standards of care, safety and service – and this honor reflects that unwavering dedication,” said Dr. James Cappon, CHOC’s vice president, chief quality and patient safety officer and interim chief medical officer. “Not only does this recognition of our excellence in these subspecialties, including two on the top 20 lists, validate our efforts, but it also offers our patients and families additional assurance of our commitment to their health and safety.”

The Best Children’s Hospitals rankings were introduced by U.S. News in 2007 to help families of children with rare or life-threatening diseases find the best medical care available. Only the nation’s top 50 pediatric facilities are distinguished in 10 pediatric specialties, based on survival rates, nurse staffing, procedure and patient volumes, reputation and additional outcomes data. The availability of clinical resources, infection rates and compliance with best practices are also factored into the rankings.

The U.S. News Best Children’s Hospitals rankings rely on clinical data and on an annual survey of pediatric specialists. The rankings methodology factors in patient outcomes, such as mortality and infection rates, as well as available clinical resources and compliance with best practices.

Learn more about Best Children’s Hospitals rankings.

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8 ways to protect children with diabetes from COVID-19

We know how frightening the spread of the 2019 novel Coronavirus (COVID-19) may be for parents – especially parents of children with diabetes.

The good news is that for children with diabetes, there is no evidence this virus will be any different than most other viral respiratory illnesses. As always, an illness will require increased glucose monitoring, possible ketone testing, and increased attention to insulin and carbohydrate intake.

If any person with diabetes gets sick — from any cause— CHOC Children’s endocrinology department recommends the following:

  1. If you are using a glucose meter, check your glucose more often, every two to three hours at minimum.
  2. If you are using a continuous glucose monitoring, or CGM, device such as DexCom or Libre, review the data from your continuous glucose every one to three hours to monitor for trends and adjust your insulin/food intake.
  3. If you are on injections, always take your long-acting insulin (such as Lantus, Levemir, Tresiba or Basaglar), even if you are eating less. If you are experiencing overnight lows, you can decrease your dose by 10%. For example, if you use 20 units nightly, then decrease down to 18 units, but if you need to decrease further for continued low blood glucose values, please contact your provider.
  4. If you are using an insulin pump, continue to wear the pump for basal insulin.
  5. Continue to stay hydrated by drinking lots of fluids.
  6. Check for ketones if glucose readings are higher than 300 for more than three hours.
  7. If you have moderate or large ketones, especially if you are vomiting, contact your provider.
  8. Ensure you have your diabetes supplies, and that you are not close to running out.

For type 1 diabetes–specific topics related to COVID-19, please visit JDRF.org/coronavirus.

CHOC’s endocrinology department continues to offer on-site office visits, but if you or your child is sick, please stay home and notify us that you will not be attending the visit. Our team will work with your family on alternative arrangements if you cannot make it to your scheduled visit.

CHOC endocrinology can be reached during daytime hours at 714-509-8634. During evenings and weekends, call 714-765-7679.

Get more information on Coronavirus (COVID-19)

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CHOC recognized as one of nation’s best children’s hospitals

CHOC Children’s is one of only 50 pediatric facilities in the nation to earn recognition as a best children’s hospital by U.S. News & World Report. The following CHOC specialties are honored in the 2019-20 Best Children’s Hospitals rankings: diabetes/endocrinology, cancer, neonatology, neurology/neurosurgery, pulmonology and urology. Cancer ranked in the “top 20.”

“The national recognition for CHOC’s cancer program is well-deserved. There’s nowhere else I’d rather have gone through treatment than CHOC,” says 17-year-old Sydney Sigafus, CHOC patient and cancer survivor. “Everyone who works at CHOC cares about you as a person, not just a patient. I was included in every decision and conversation about my care.”

The Best Children’s Hospitals rankings were introduced by U.S. News in 2007 to help families of children with rare or life-threatening diseases find the best medical care available. Only the nation’s top 50 pediatric facilities are distinguished in 10 pediatric specialties, based on survival rates, nurse staffing, procedure and patient volumes, reputation and additional outcomes data. The availability of clinical resources, infection rates and compliance with best practices are also factored into the rankings.

us-news-best-childrens-hospitals-6specialties

“We understand how scary it can be for parents whose children are dealing with life-threatening illnesses or injuries. That’s why we are committed to the highest standards of care, safety and service,” says Dr. James Cappon, CHOC’s chief quality officer. “While we are proud of our accolades, including being named a best children’s hospital, we remain focused on preserving the magic of childhood for all kids, whether they are seriously ill or healthy, or somewhere in between.”

Learn more about the Best Children’s Hospitals rankings.

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CHOC Included Among Nation’s Best Children’s Hospitals in U.S. News Survey

CHOC Children’s has been named one of the nation’s best children’s hospitals by U.S. News & World Report in its 2017-18 Best Children’s Hospitals rankings.

CHOC ranked in seven specialties: cancer, diabetes/endocrinology, neonatology, neurology/neurosurgery, orthopedics, pulmonology and urology, which earned a top 20 spot on the coveted list.

According to U.S. News, the Best Children’s Hospitals rankings were introduced in 2007 to help families of children with rare or life-threatening illnesses find the best medical care available.

The 11th annual rankings recognize the top 50 pediatric facilities across the United States in 10 pediatric specialties.

The U.S. News Best Children’s Hospitals rankings rely on clinical data and on an annual survey of pediatric specialists. The rankings methodology considers clinical outcomes, such as mortality and infection rates, efficiency and coordination of care delivery and compliance with “best practices.”

“At CHOC Children’s, we are steadfastly committed to delivering high-quality, safe and reliable health care to our patients,” said Dr. James Cappon, CHOC’s chief quality officer. “Recognition from U.S. News of our excellence in these seven subspecialties validates our efforts, but also provides our patients and families with even more assurance of our commitment to excelling in all areas of care.”

“The pediatric centers we rank in Best Children’s Hospitals deliver exceptionally high-quality care and deserve to be recognized for their commitment,” U.S. News Health Rankings Editor Avery Comarow said. “Children with life-threatening illnesses or rare conditions need the state-of-the-art services and expertise these hospitals provide every day.”

Learn more about survival rates, adequacy of nurse staffing, procedure and patient volume, availability of programs for particular illnesses and conditions and more. 

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