Volume 20 Issue 16 | Aug. 31 - Sept. 6, 2007

Downtown Express photos by David Gibbons

Corey Greenblatt, 15, takes a rip for the Downtown Blue Jays this season. He has an insulin pump connected to his arm, which is visible on the bench with his teammates. He says friends would wince when he used to inject himself before meals.

Teen athlete takes diabetes in stride

By David Gibbons

In the early fall of 2006, Corey Greenblatt, a strapping multi-sport athlete and Downtown resident since birth, began to exhibit some curious symptoms. He had worked himself into the best shape of his life for his first season of high school football. And yet, over the course of less than two months, he lost more than 30 pounds. He was almost constantly thirsty and had to make frequent trips to the bathroom, even in the middle of the night. He was extremely tired and lethargic, especially after meals.

At a muscular 160-plus pounds, Corey had been wearing one of his father’s suits for special occasions; now it hung on him like the proverbial bag of bones. Even his bar mitzvah suit, from two years earlier, was too big. At one of his football games, his parents noticed, every time he squatted into the lineman’s down position before a play, he had to reach back and hike up his uniform pants.

Corey’s mom, Elizabeth Beskin, had a hunch having to do with another member of the family: their cat, Cooper. “I knew nothing about diabetes,” she said. “I had never even met anyone who had it. But I did know that when Cooper starting peeing like that, he was diagnosed with it.

“[Corey] went to football camp, they were doing the two-a-day practices and he just started melting away. He was super-skinny. He said, ‘Oh, Mom, don’t be ridiculous. My body’s changing, I’m growing. Maybe I’m not going to be chubby anymore when I get older.’ Neither of them wanted to go to the doctor. Michael [Corey’s father] was saying, ‘He’s a healthy, normal boy. My metabolism changed when I was a teenager.’”

“I credit his mother for saving his life,” said Michael. “She pushed us to go to the doctor and get him tested a little sooner.” Corey’s pediatrician found excess sugar in his urine and, within minutes, he and Michael were headed Uptown to the Mount Sinai Hospital emergency room. A diagnosis of Type I (formerly called juvenile or insulin-dependent) diabetes was confirmed and the staff there worked quickly to establish a regimen of blood-testing and insulin shots. Corey’s blood sugar level was five and a half times normal; his keytones, however, indicative of high blood acidity and the potential for permanent damage, were not yet elevated.

“I was surprised,” recalled Corey, who turned 15 last February and is entering his sophomore year at Brooklyn’s Poly Prep Country Day upper school this September. “Even my doctor was shocked because most of the time when people are first diagnosed, they’re in shock or in a coma. I was as healthy as could be.”

Very early on, the Greenblatts adapted a staunch approach of taking things in stride. Of course, they knew Corey’s condition was serious, even life-threatening. After all, Michael joked later, what else could drag them that far Uptown? The answer was nothing, except perhaps baseball games with their beloved Downtown Blue Jays. For the past three years, Michael has been the manager and Corey one of the anchors — at catcher — of this championship Little League Senior Division team, which often plays in Central Park’s North Meadow, at the same latitude as Mt. Sinai.

“On the way up to the hospital,” said Corey, “my dad and I looked at each other and the one thing we said was, ‘Hey, at least it’s not cancer.’ We thought of hundreds of other ways it could have been worse. The only way it could have been better is if I never got diagnosed.

“I’ve never really thought of it as something that can kill me. I’ve only thought about it as a new lifestyle. That’s how I’ve got to take it. All my doctors say, ‘It’s not a disease, it’s a condition.’ Basically, that’s what I’ve been living on.”

Type I diabetes, which is much less common than Type II, is a disorder of the body’s immune system in which it destroys the pancreas’ ability to produce insulin, the key substance in processing sugars, which are ingested via sweet and other carbohydrate-laden foods. Chronic high blood sugar levels eventually lead to various serious and potentially fatal complications, including kidney failure; retinal damage, eventually causing blindness; cardiovascular disease; nerve damage; and wounds, particularly of the feet, that do not heal properly and may lead to gangrene, necessitating amputation. People afflicted with diabetes must test their blood sugar levels regularly and adjust them to within a target range by taking synthetic insulin.

“All I kept thinking about was he was going to get his legs amputated,” said Beskin. “I started imagining all these horrible scenarios. Luckily, diabetes is a lot more manageable than it used to be. So we feel really blessed by that. Corey has, miraculously, handled this really maturely. Ever since he was diagnosed, his attitude has been, ‘This is what my body needs.’”

Never a big fan of getting shots when he went to the doctor, Corey suddenly found himself having to give himself five a day. He graduated to wearing an insulin pump in the form of a small, lightweight pod that attaches to his upper arm and delivers the insulin via a tiny subcutaneous tube called a cannula. “Eventually [giving myself shots] became habit,” he says, “but one reason I switched to a pump was because when I went out with friends, they would always cringe and look away when I injected myself.” The pump — called an OminPod and manufactured by the Insulet Corporation — is waterproof so Corey can shower and swim with it. It is also lightweight and shockproof, which comes in very handy indeed at both his principle sports positions — defensive end and catcher — where collisions are inevitable.

Physical exercise is particularly important for diabetics because it helps burn carbohydrates and also flush one’s system of excess sugars. Consequently, being an athlete can be a plus; on the other hand, the physical demands of competition can create additional stresses and extra-careful management of the blood sugar level.

“In some ways [being an athlete] makes it easier because when I’m active, my blood sugar lowers, which makes it easier to stay in my target range,” says Corey. “But in a way it’s hard because I have to always remember to eat something before I do any activity because that will raise my blood sugar before it starts to lower from the activity itself.”

Corey uses a blood glucose meter to monitor his sugar levels; this involves pricking his finger with a small needle and then squeezing a drop of blood onto a strip, which gives a reading. Michael recalls doctors stressing that feelings, hunches, notions don’t necessarily indicate the actual blood sugar level; it’s important to take a scientific approach and always test immediately before, as well as two hours after, every meal. Meals must be carefully planned and monitored, and the insulin level adjusted to deal with the anticipated carbohydrate intake. Corey’s OmniPod has a wireless P.D.A.-like control device, with which his basal rate of insulin delivery can be set and then increased, as needed, at mealtimes.

Various substances ingested can have different effects; for example, Corey discovered that drinking Gatorade during games could extend his sugar highs up to four hours after the end of a contest. “This is where the whole idea that it’s more of an art than a science comes in,” said Michael. “You’re constantly adjusting.”

Each person experiences diabetes somewhat differently; there are, however, stark indications when sugar levels go awry. “There’s no one real indication that will tell me if my sugar level is high,” said Corey, “except if it’s extremely high I’ll start getting very thirsty, I’ll go to the bathroom a lot and I’ll get very tired.

“When it gets too low, I start losing my motor functions. My hands will start to shake, my knees give out and it really hurts to walk. Eventually, I’ll get light-headed to the point where if I don’t bring [my blood sugar] up in time I could pass out. I’ve shaken a lot, I’ve had my knees give out, but I only got light-headed once.” He was tossing the football around with friends at a tailgate party in the parking lot of Giants Stadium on a chilly November day. When he checked his blood-sugar level, it had plummeted to 29, dangerously below his target range of between 70 and 150 milligrams per deciliter, and low enough to make some diabetics pass out. It was still “early days,” Corey may not have been entirely familiar with the symptoms and, in any case, the cold weather probably masked them.

“Honestly — and I told my dad this — it’s the worst feeling to get, but the rewards…,” said Corey, looking at the bright side. “I’m not going to turn them down, because that’s the one time I can eat basically whatever I want, whatever’s around the house.” The first food that comes to mind is an apple. What parent wouldn’t dream of their husky teenager lusting after such a healthy snack?

Kids in general — and 14- and 15-year-old boys in particular — do not enjoy a reputation for organizational thinking, advanced planning and executive functioning. Not to be too cavalier or cynical about it, but there’s nothing like a life-threatening illness to spur an adolescent on to mature, independent behavior.

“What I was most worried about was, as a 15-year-old, how he would react to us being so intrusive in his life?” said Michael. “Luckily for us, he was able to exhibit a maturity level in dealing with it very quickly. We’re not quite a year into it and we don’t really have all that much to do with it. He knows what to do. If he has questions, he asks us. Other than that, he manages his diabetes.

“At one point, within a couple of weeks [of the diagnosis], Elizabeth was fretting over him — I think this really sums it up — and he looked at her and said, ‘Mom, this is what I have to deal with. Don’t worry about it. I understand it; I can deal with it.’”

Asked whether this was surprising, Michael replied, “I like to think of it more as rewarding. You want to believe you’ve done an O.K. job raising your kid. Then something like this happens and you’re able to say, yes, we did alright, we prepared him at least to handle this fairly well. He responded and that’s what I keep thinking — how proud we are of how he’s dealt with this.”

Crises management is a large part of dealing with the condition. Beskin recalls one incident this summer wherein Corey’s Personal Diabetes Manager, the wireless unit that controls his insulin-delivery pod, broke down while she was out. By the time she returned home, he had gone through various procedures of trying to re-set it, had called his nurse at Mount Sinai, gotten in touch with the manufacturer and arranged to have a replacement sent by overnight delivery to their beach house in Fire Island. Insulin shots, self-administered with a pre-filled syringe-type device called a pen, are the ever-present fallback. On another recent vacation, Corey’s entire stash of OminPods — each one lasts a few days — got left out of his suitcase so he had to revert temporarily to giving himself shots.

“Those are the instances you fear to some degree,” said Michael, “but as we’ve gone through them and as he’s handled each one himself you realize that he understands what needs to be done. That once again comes back to how proud we are of him.”

David Gibbons is a Community Media L.L.C. freelance reporter and his son is Corey Greenblatt’s teammate on the Downtown Blue Jays.

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