Point, Click And Play
Big Green Players Persevere Against Huge Health Odds
Dartmouth College safety Steve Dazzo, right, sits on the bench during the Big Green's Oct. 5 contest against Pennsylvania in Philadelphia. Dazzo has Type 1 diabetes and carefully monitors his blood sugar during games. Valley News - Tris Wykes Purchase photo reprints »
Dartmouth College running back Jacob Siwicki squeezes his left index finger while preparing to test his blood sugar level prior to the Big Green's Oct. 10 practice at Memorial Field. The freshman has Type 1 diabetes and tests himself eight to 10 times during most practices. Valley News - Tris Wykes Purchase photo reprints »
Hanover — Various equipment is scattered around Dartmouth College’s Memorial Field when the Big Green football team practices. There are blocking sleds and hand-held pads and wheeled water carts and medicine balls for the linemen to toss. The most important piece of gear, however, lies under an aluminum bench on the west sideline near midfield. It’s a silvery bag the size of a small backpack and it belongs to freshman Jacob Siwicki.
About eight or nine times per practice, the reserve running back trots out of drills and takes a seat on the bench. He loosens the bag’s drawstring and removes a zippered, glucose testing kit a little larger than an iPhone. With practiced hands born of more than 50,000 repetitions, he holds one of his fingertips to a spring-loaded lancing device that resembles a fat pen. There’s a sharp click as it punches a hole in the skin and Siwicki squeezes the digit as a droplet of blood blooms against the callused flesh.
He touches the blood to a paper testing strip in a hand-held glucose meter and a digital display pops up. Before Thursday’s practice, it read his blood sugar at 94, a little low perhaps, but good enough. There’s no need at the moment for Siwicki to hook the tubing of his portable insulin pump, which bears resemblance to a pager, into the small, circular port on his left hip.
An hour later, however, Siwicki’s reading was 182, so he connected the pump and sent 2.5 units of insulin into his system during the next two minutes. Then it was back into the fray.
“Trying to get the perfect blood sugar is like being blindfolded in a dark room, spun around a bunch of times and then taking a bow and arrow and trying to hit a target,” said Siwicki, whose team hosts Yale today in a game that could be crucial to the Big Green’s season.
Siwicki and teammate Steve Dazzo, Dartmouth’s starting strong safety, were each diagnosed with Type 1 diabetes around the time they started elementary school. They and their parents have had to be vigilant ever since, because the consequences of forgetfulness or inattention can be deadly in certain situations.
Type 1 diabetes is a chronic condition usually diagnosed during childhood that impairs the utilization of insulin, which in turn regulates a person’s conversion of sugars and other carbohydrates to energy. The cells that produce insulin in the pancreas are destroyed by the body’s own immune system, a slow process which often plays out after diagnosis, making attempts to keep the child’s blood sugar in a safe range increasingly difficult over time.
“It’s a lifestyle change for your whole family,” said Siwicki’s father, J.R., who has four other children with his wife, Michelle, and whose family lives on Long Island, N.Y. “You never buy food without looking at your carbohydrate chart.
“I remember that Jacob could have 14 cherries for breakfast per one unit of insulin and milk was another unit. Now, he can just look at a banana or a piece of chicken and calculate in his head what he needs.”
If blood sugar is too high, people with diabetes can become fatigued, thirsty and suffer blurred vision. They need insulin for a lowering affect. If blood sugar is too low, the person may quickly experience sweating, shaking and confusion. In that case, they need to promptly consume sugar or carbohydrate-rich food or liquids to boost their blood sugar.
“Being too low is like you just did the hardest workout ever, times two, and you have cold sweats,” said Dazzo. “When you’re high, your legs feel dead and you have to pee all the time.”
If the blood sugar is high for a long period of time, the condition can cause blindness, heart disease or kidney failure. If it sinks too low during sleep, the person can suffer convulsions and fall into a coma. Another possible consequence of in Type 1 diabetes is diabetic ketoacidosis, where the body, left without sufficient insulin, burns fatty acids and produces a poisonous type of acid called ketones. Nick Keatts, a varsity cheerleader at James Madison (Va.) University, died of that condition in 2011.
According to the American Diabetes Association, Type 2 diabetes accounts for roughly 90 percent of the 27 million diabetes cases in the U.S. It tends to be diagnosed more often in adults and overweight people and occurs when the body becomes resistant to the insulin created by the pancreas. A healthy diet and exercise can help lower blood sugar and medication can help the body better accept insulin and prevent one’s liver and muscles from secreting stored sugars.
“I feel like Type 1 and Type 2 diabetes are pretty much different diseases,” said Jacob Siwicki, who uses his insulin pump throughout the day and may need to give himself a shot once or twice a week if the tubing gets twisted or develops air bubbles inside it. “People with Type 1, we’re not looking for attention, but at the same time, people don’t understand our situation.”
Athletes with Type 1 diabetes have become increasingly common throughout high-level college and professional sports. Deceased baseball stars Ty Cobb, Ron Santo and Catfish Hunter, onetime NHL player Bobby Clarke and several current NFL and Major League Baseball players, including Chicago Bears quarterback Jay Cutler, have dealt with the disease.
Beth Dazzo, Steve’s mother, recalls being devastated when her son was diagnosed at age 6. Like Siwicki, he initially spent a week in the hospital, and he had to be tested every few hours once he returned to the family home in suburban Chicago.
“You go back to bed, but you worry,” Beth Dazzo said. “I don’t think I really slept soundly or for an extended period of time for the first four years. The sorrow, it changes you. I wouldn’t wish it on anyone.”
J.R. Siwicki recalls sprinting up the stairs to Jacob’s bedroom after falling asleep in a downstairs chair and not hearing an alarm he had set. “You’re wondering if your son has died and knowing that if he has, it’s your fault,” he said.
The Siwickis and Dazzos both experienced difficulties as their sons grew up. The Siwickis’ local school was so small it didn’t have a nurse, and J.R. Siwicki said its administrators didn’t hire one until pressured by the district superintendent. Beth Dazzo recalls asking to see the diabetes protocol for her son’s elementary school and being given a photocopy from 1974 that said diabetic children should consume a candy bar if they seemed disoriented.
“I told the principal that the kid with the speech impediment had more resources than my son,” she said. “Steve came out of school one day and his teacher said he was doing fine, but I could tell he wasn’t. His blood sugar turned out to be 37, which is very close to the point where he was going to collapse.”
Beth Dazzo also remembers having to challenge the local park district so that youth baseball umpires wouldn’t try to make Steve remove a bracelet intended to alert medical personnel to his condition.
Siwicki said football referees have made similar demands of him, and that a coach at one of the four high schools at which he played made disparaging comments about the disease after Siwicki missed part of a practice because his blood sugar wasn’t balanced.
Despite their conditions, Siwicki and Dazzo were both star athletes. Siwicki ran for 1,500 yards as a junior at Upper St. Clair High in suburban Pittsburgh, a traditional western Pennsylvania powerhouse, before earning All-League honors at DeMatha Catholic in Baltimore, another nationally known program. Dazzo, a standout youth hockey and baseball player growing up, declined offers to play quarterback at Indiana State and Columbia to come to Dartmouth, where he was second in tackles last season and is one of the defense’s best performers this fall.
Greg Smith, a running back on Dartmouth’s undefeated 1996 team, suffers from diabetes and Big Green coach Buddy Teevens became familiar with it when he coached a Tulane player with the condition during the 1990s. Foley Schmidt, the Big Green’s former standout kicker and a 2012 graduate, also had the disease.
Teevens said Siwicki and Dazzo both brought up their conditions while being recruited, but that the condition isn’t a red flag as long as prospects demonstrate that they’re responsible.
“Our two guys are well-educated and prepared, as are our (medical) trainers,’’ the coach said. Siwicki and Dazzo “pop out of practice (to test themselves) and we don’t even blink. They don’t miss anything we do. They’re just more aware of their bodies than some other guys.”
Sitting together in a Floren Varsity House lounge and discussing their disease, the pair agreed that Siwicki has a more volatile form in terms of up-and-down blood sugar levels, but they emphasize that every person with diabetes is different, as is the way they cope.
“I only test once a practice usually, and sometimes not at all,” said Dazzo, who injects a long-lasting form of insulin upon waking in the morning, then gives himself shots of a shorter-lasting form after every meal and snack, about half a dozen per day total.
“It’s a pain and an inconvenience, but you try not to let it identify you as a person.”
Early this season, during a hot and humid practice, Siwicki tested himself 19 times in less than three hours. He said the weather and the excitement and stress from being in a new situation and wanting to excel caused unusual instability in his blood sugar levels. Mood, adrenaline level and health are factors that can affect the condition of people with diabetes. Dazzo said a tense fourth quarter at Butler during the season opener exacerbated a cramping issue. Dazzo also said that his blood sugar levels alert him to when he’s coming down with a cold or flu before the other symptoms surface.
“When did you last eat and what did you eat? What exercise have you gotten and are you about to get?” Dazzo said. “Sure, you take a shot when you’re high and eat when you’re low, but there are so many variables, and that’s why this is such a tough disease.”
Both said they go out of their way to talk to youngsters who share their condition. Siwicki is looking forward to meeting the diabetic daughter of his bible study group leader and Dazzo was able to calm and reassure a teenager at Dartmouth’s summer football camp who was embarrassed after having to sit out because of low blood sugar.
“I told him don’t worry about it,” Dazzo said. “People out there have no idea what you’re going through and most of them couldn’t do what you’re doing.”
He would know.
Tris Wykes can be reached at firstname.lastname@example.org or 603-727-3227.