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Control = freedom: dancing diabetics can rely now on the insulin pump.

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Suchu Dance member Lindsey Sarah Thompson moves easily through the relentless pace of Jennifer Wood's choreography. Often singled out for her fluidity and stage presence, Thompson has been dancing in Houston's leading contemporary companies since 2004. She also navigates the unpredictable terrain of being a dancing diabetic.

With Type I Diabetes, which affects some 23.6 million people in the U.S., the pancreas cannot produce enough insulin to control blood sugar. Insulin moves glucose into cells, where it is stored and used for energy. Low blood sugar can be lethal to a diabetic, while high blood sugar takes its toll on the body's organs over time.

Advances in medicine like the insulin pump have made a life in dance more feasible. The pump, widely available for the last decade, replaces the need for repeated injections. It delivers insulin throughout the day by a catheter attached to the abdomen, so a diabetic's blood sugar stays within normal levels.

"The pump continually monitors and delivers insulin, removing the guesswork," says Dr. Rebecca Clearman, MD, a former dancer who works with Houston artists. It still takes training to learn to use. Diabetics work closely with their endocrinologists to set their pumps to the correct calculations. And they must be alert when their dancing might have an effect on those calculations so they can recalibrate their pumps.

Serious concerns still remain. Skin wounds, a frequent issue for dancers, need constant care. "Glucose affects all the body's chemical processes, so the immune system and healing can be compromised," says Clearman. She urges dancers to meticulously examine their feet for splits between toes or any other lesions. Even minor cuts should get a thorough soap-and-water washing, complete drying, and a gel Band-Aid.

For Thompson, the good news is that dancing lowers blood sugar. The less than good news is that the sometimes intense life of a dancer produces stress hormones, like cortisol, which can wreak havoc on blood sugar. Adrenaline, produced during performance, also drives blood sugar up. Thompson adjusts her pump accordingly. "Initially I can correct modestly with my pump to prevent it from climbing too high," she says. "Once I've gotten through a couple of shows I can create a pattern on my pump with adjusted basal levels."

Diagnosed at the age of 12, Thompson has been on the pump since she was 15. She removes it while dancing. She has learned the warning signs of high blood sugar. "I get a headache, nausea, and my eyes burn," she says. With low blood sugar, which is even more dangerous, come other symptoms. "My chest will get tight, cognition gets blurred, and I feel a primal urge to eat. It comes on quickly and I need to treat it immediately." There's a delicate balance between informing those around her about her condition (for her own safety) and being considered a normal member of the company. "I want to be a voice for diabetes so people understand what I am dealing with," Thompson says. "Yet I don't want people to worry about me or think I am less capable."

Thompson is not the only dancer who has juggled diabetes and a professional career. Infected underarm sores brought New York City Ballet dancer Zippora Karz to the doctor's office some two decades ago. It took years before doctors got her diabetes under control. She remembers suffering through symptoms like frequent urination, thirst, hunger, dizziness, and fatigue. Karz, who performed when the main solution for diabetes was insulin injections, finally found a way to live and dance. She managed a remarkable 16-year career at NYCB, reaching the rank of soloist and performing leading roles in works by Balanchine, Martins, and Robbins.

Karz and Thompson are eager to share their stories to help the next generation of diabetic dancers. Karz has written a memoir that was published last year, The Sugarless Plum: A Ballerina's Triumph Over Diabetes. "I hear from people all over the world," she says. "That's why I wrote the book; I wanted people to feel like they can talk about this disease." Today, Karz teaches and serves as a repetiteur for the George Balanchine Trust.

Preliminary research on the generation of diabetics who use the pump indicates that it does a better job of controlling blood sugar, leading to less longterm damage to the body. "The pump has made an athletic life possible," says Clearman. However, dancers who use it must remain vigilant. "It takes a lot of discipline. Luckily, dancers excel at that."

Both Thompson and Karz refuse to be defined by a disease. Karz adds, "I want to be seen as a dancer who has diabetes, not a diabetic who was dancing."

Nancy Wozny writes about the arts and health from Houston.
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Title Annotation:your body; Lindsey Sarah Thompson and Zippora Karz
Author:Wozny, Nancy
Publication:Dance Magazine
Geographic Code:1USA
Date:Sep 1, 2010
Words:791
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