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Tuesday, July 31, 2018

Taking diabetes by storm: Hurricane Harvey 2017

As the one year anniversary of Hurricane Harvey rapidly approaches I am filled with a confetti stream of different emotions that come in waves. Watching the city of my birth fill with water. Seeing the destruction and devastation from Lumberton down to Rockport. Realizing that hundreds of insulin requiring diabetics were now being left in predicaments where their physician offices, pharmacies and local ERs were shut down and without power or filled with water. And knowing that if I didn’t help these people, some....many, would die.

Not long after landfall, the social media posts and texts were already being sent my way. Children and young adults away from their insulin and pump supplies, or entire coolers of insulin being exposed to the brutal Texas heat and humidity, now rendered useless. I began stockpiling insulin and supplies at my home in The Woodlands, a township located 20 miles northwest of downtown Houston. I took items from my clinic and accepted donations from local type 1 families.

I began posting on social media asking for more donations to be utilized in the community, even though I was subscribing to the “no plan, plan”. It wasn’t long before I joined forces with a man that is well recognized by many type 1s, Dr. Stephen Ponder, a pediatric endocrinologist, fellow Aggie and type 1, based in Temple, TX, which is 3 hours North and West of Houston. We both had our spidey senses activated, and knew we were being called to action.

It was also around this time that I was contacted by a representative for both the ADA and AADE in the Houston area, for those not in the know, that’s the American Diabetes Association and American Association of Diabetes Educators. I was asked to promise not to hand out insulin or pump supplies, as this could go against my nursing scope of practice without a current prescription or physician orders to go off of. I was asked to only supply meters and education for using glucose meters when asked to help. As though persons that have gone without insulin for days are concerned with learning how to “properly” use a brand new meter. As though the thousands of people that filled the city shelters wanted me to sashay in there to teach the diabetics how to use meters. It would have been like using a spray bottle of water to put out a bonfire. I frankly was angered and annoyed that I was even asked to ignore such a large call to action by the community. I was sharply warned and reminded that FEMA and the Red Cross had emergent medical needs covered and that it wasn’t my concern.

Later, we would find out that the initial shipment of insulin from Red Cross and supplies from FEMA didn’t arrive until day 9 post landfall. Would you or your child survive 9 days without insulin? I know I wouldn’t. There were pharmacies and clinics and physician offices that stayed closed either permanently or the entire 9 days. Shipments from mail order pharmacies and pump companies were significantly delayed, as the area was shut down to incoming mail. Houston was in a medical crisis. Enter: the DOC. The diabetes online community.

Dr. Ponder, myself and a small group of local type 1 advocates joined forces to make up Type One Team Texas: Diabetes Disaster Relief. We organized one of the largest scale social media swarm that our small diabetes community has ever seen. Remember: Type 1 diabetes accounts for less than 5% of all diabetics. We are essentially the unicorns of the diabetes world. So if you know one of us, we likely know 500 others that we are connected to through JDRF social gatherings and online support groups.

Donations of supplies, insulin and money began pouring in to my clinic. From Alaska, Canada, the UK and even Australia. 37 states were represented by donations, and we had items like contact lens solution, and even a DNA paternity test placed in packages. Lancets. Don’t forget the lancets. So. So many. I am now utterly convinced that the entire DOC hoards these tiny daggers for rainy days like Hurricane Harvey, because about 7,897,345 of them ended up on my front porch.

A detailed Excel spread sheet was created by Anne Imber, one of our team’s integral members, and a T1 D-mom. Our intake form was widely distributed, and once specific needs were ascertained, we would package up shipments to go out with our volunteer “runners”. Many would drive 30 min to deliver supplies, such as insulin, meters and pump and CGM sensors, some even as far as 2-3 hours away. We had packages being delivered to National Guard helicopters, Game Warden command centers and the large city shelters set up around Houston, including the George R Brown convention center, Lakewood Church, NRG stadium and complex and the Toyota Center. Texas Children’s hospital system and their satellite hospitals and clinics relied on our insulin supply and extensive inventory of pump and CGM items to begin seeing patients in their diabetes clinics again. Without the huge shipments of insulin delivered by Insulin For Life in Florida, many of these deliveries would not have been possible.

JDRF Houston/Gulf Coast (juvenile diabetes research foundation) did what they could within their legal scope. They spread the word about our cause and pointed lost families in our direction. Every shipment that went out of mine, Anne’s and Michelle Kallensen’s homes was inside of a JDRF donated bag. Thank you, JDRF Houston. Y’all were there when many were not, or refused to be.

The city of Houston as a diabetic community was unprepared for a natural disaster like Harvey. It caught MANY families off guard. We reached dozens of Type 1s as they entered into DKA (diabetic ketoacidosis), after not having had insulin for 24 hours or more. Not having an exit strategy for something like this for either yourself or your child is, simply put, playing with Fire. Had any of you relied on the government (FEMA, ADA, Red Cross), you would not be with us any longer. Be your own advocate. Keep extra insulin on hand. Have multiple exit routes planned, know where gas stations and family members live along the way. Have a cooler designated for the trip that is both sturdy and reliable against the harsh Texas weather. Pack enough supplies for 2 weeks and then double that when evacuating your home. Double bag everything in brand name Ziplocks, as I saw MANY H-E-B and Kroger generic baggies disintegrate during our work. Know what to do if you or your child experiences a low low or a high high during a time where you can’t reach your endocrinologist. Some people had no access to their cell phones, as they were lost in the rising water. Expect the best, prepare for the worst.

And thank you to the COUNTLESS members of the DOC that made Type One Team Texas a reality. We received over $1.5 million in donated supplies and insulin within the two weeks following Harvey’s land fall. The DOC saved lives.

And special thanks to the companies that donated supplies and time:
Insulin For Life
Pump Peelz
Insulet OmniPod
Tandem Diabetes
NovoNordisk specialty diabetes division
Lions Club - Temple & Conroe chapters

The countless volunteers, runners and organizers that made our operation a successful one.

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