HANFORD — Every pregame routine for a basketball player is different. For some it involves prayer, others listen to music and some just suit up and get ready to play.
Kalea Bush, a member of the Sierra Pacific girls basketball team, has one different than all of those. It usually starts at a teammate’s house where the team has a meal not too long before tipoff. Bush’s routine specifically involves eating foods with carbohydrates, and although she’s not too picky, she does have her favorites.
“Well, I mean I eat anything,” Bush said before briefly pausing for a moment to think. “Pasta, especially spaghetti. Spaghetti’s good.”
Bush almost always carbs up before a game and no, it’s not a crazy superstition or a result of basketball milieu. It’s not even necessarily by choice.
Before she eats the Italian favorite, or whatever meal she’s decided on, she’ll prick her finger. Just a small prick will do since the instrument she uses will read the data that a globule of blood has to offer.
After a moment, a number comes back. That number is her blood sugar and dictates the next step. Before getting into the rest of her pregame routine, it’s important to note that Bush is unlike so many others.
On the outside, she’s an athletic five-foot-nine-inch power forward and center who’s been balling nearly her whole life. On the inside, she’s a Type 1 diabetic.
According to the American Diabetes Association, approximately 1.25 million Americans have Type 1 diabetes and an estimated 40,000 new cases will be diagnosed this year. The cause of Type 1 diabetes is still unclear, but it makes up about 5 to 10 percent of all diabetes cases.
Bush became part of that percentage when she was 5 years old.
“I was next door at my cousin’s house, and I drank 26 cups of water and I kept going to the bathroom,” Bush said.
Feeling thirsty and frequent trips to the bathroom are two symptoms of Type 1 diabetes. She also began to drastically lose weight — a third symptom — noted her mom, Amy Bush.
“You start to see different signs and losing that much weight so quickly was scary,” Amy said. “From the time we took her in, she was rushed immediately to [Valley] Children’s Hospital and that’s when we stayed a couple days there.”
Bush weighed 38 pounds when she was brought to the hospital and her pancreas was in the honeymoon phase: Just able to produce enough insulin to help regulate her blood sugar, but beginning to wane. This is the ultimate issue with Type 1 diabetics, the pancreas stops producing insulin — a hormone which regulates the glucose (or sugar) in the blood. Unchecked, one faces the consequences of hyperglycemia, which can lead to diabetic ketoacidosis, a diabetic coma or other life-threatening issues if they’re not treated immediately.
“We spent 4 days of learning what was going on and how to take care of her,” Amy said. “But still, driving away from there once you have your kid in the car and now you’re in charge, it’s terrifying.”
The new reality was a scary one, but they managed and Bush, now 17 years old, reads her meter after pricking her finger. If her blood sugar is at 200 or over, she knows she can play. She’ll count the carbs in front of her and give herself insulin accordingly. If she’s below 200, she’ll adjust and probably drink a small bottled juice to get herself to her magic number.
Normally she tries to stick between 80 and 150, but when playing sports she needs to be at a higher level because her blood sugar will drop throughout the game. At first, Amy, also her high school coach of three years, admits it was much more of a guessing game. Trying to figure out where Bush could find a happy medium took years to do.
Now it’s a lot simpler and once she’s made the determination of how much insulin she needs, it’s placed into an insulin set. The one she currently has is its own inserter with a needle in it. It’s placed on her stomach and the insulin runs through a tube, which then delivers it into her bloodstream. Bush keeps it on her stomach so she can avoid having it ripped out during basketball, which has happened before when it’s been on her arm or back.
The activity of athletics makes such a big difference that when she was younger, Bush would go through three or four juices trying to get her blood sugar up to get back on the court. Take into account anxiety levels from a game, active insulin from food she ate and all this plays into one giant equation. To further add to the complexity, all carbs are not created equal. A slice of pizza and spaghetti are both carbs, but each will give Bush different results.
After she determines all this, Bush’s pregame routine is over and she’ll finally deem herself ready to play. Except, her routine continues throughout the game, after the game and so on. It’s a never-ending routine actually.
If her blood sugar is low during a game, she’ll know. The sensation of feeling dizzy will creep in, her face will become pale or her hands will start to shake, so she’ll take herself out of the game.
“I’ll sit at the end of the bench. I’ll check my blood,” Bush said. “Just to make sure I’m ok I’ll drink a juice … and then I’ll be ready.”
All she needs is 15 to 20 minutes and she’ll check her blood again. Bush likes to see her number at a minimum of 160 to come back into the game. If not, she’ll drink two more juices and wait a little bit again before stepping back on the court.
It’s not as often that she has to sit out parts of a game these days since she’s got a better hold on her diabetes, but it is another challenge to be constantly aware and monitoring herself. But Bush is responsible and understands her situation.
After the game, it’s back to checking her blood sugar. She has to make sure she’s not too low because she drives as well. Once she likes what she sees, it’s off to get more food.
“We go home, everybody goes home, but we go home to needing more carbohydrates, more juice,” Amy said.
“Eating a second dinner,” Bush chimes in.
All of this just to get through a basketball game and that doesn’t include the daily management of her diabetes, yet never does Bush become dour. There’s never an excuse that she can’t do something because of her diabetes. It’s simply a matter of figuring out how they’re going to do it.
It also helps to have a great supporting cast that Bush has had from when she was young. Her teammates, many of whom Bush has played with since the third grade, absolutely get it. They know what Bush deals with and some have even come to be able to read her. They’ll ask her if she’s feeling OK or if she’s low, when a pale look comes over her.
“I would say that’s probably one of the best parts about your teammates because there are times in practice where she does have to step off and has to be on the sideline and they understand,” Amy said.
When Bush was younger, all the parents would ask the same questions whether it was at basketball games or during sleepovers. Parents would riffle through their bags to look for candy bars or anything that could bring Bush’s blood sugar up when she was low. Any way they could help, they would.
Nowadays, things are much more regular for Bush. It’s more of a “routine” as she put it since she deals with it every day. Bush doesn’t even look at her diabetes as a disability. She insists that it’s simply part of her.
“In a heartbeat I would be diabetic for her,” Amy said with a tone only a mother’s love could have. “I tell her that all the time. I would much rather take that on than watch your kid take it on. I think just being able to balance everything altogether and deal with a disability, which nobody can really see or knows that you have, then…”
Amy trailed off, unable to finish her sentence, but clearly in awe of the superstar her daughter is. For Amy, Bush is a testament as to what you can do.
That same drive is the one, which Amy believes will help her this summer. In January, Bush was hired as a full-time paid counselor at Bearskin Meadow Camp. Bearskin Meadow, located on the outskirts of Kings Canyon National Park, is run by the Diabetes Youth Foundation. Their mission is to “improve the quality of life for children, teens and families affected by diabetes.”
This summer will be Bush’s fourth time returning to the camp. She previously went when she was eight, 11 and last summer. All three times she was sponsored by Pi Alpha, a chapter of Theta Tau Theta, a non-profit organization that has been affiliated with the Diabetes Youth Foundation for 60 years.
While, there the kids — who are all Type 1 diabetics — take part in different activities such as hiking, swimming and campfires, but one of the big priorities is diabetes education. Bush’s most recent experience last summer lasted two weeks and gave her the tools to be a counselor this upcoming summer.
She took part in the Leaders in Training Program during her first week, which consisted of team-building exercises and different scenarios of kids at camp. Her second week was working with the Family Camp where they looked after the children, while their parents were educated on diabetes.
For Bush, not only is this a way for her to give back to the camp which helped her when she was younger, but it’s also a stepping stone toward her ultimate goal of becoming a first-grade teacher.
She’ll start in June and it’ll last for approximately five to six weeks during which she’ll take part in the buddy, kid and family camp. Each one will focus on something different.
“I’m looking forward to just helping out different age groups,” Bush said.
It’s been over a decade now that diabetes has been a part of Bush’s life. With no cure yet, although medical advancements every year provide hope that one day that will be a reality, Amy is just happy that her daughter is able to do what she wants without it holding her back.
“When she was five, it’s scary because you want your kid to be perfect,” Amy said. “You want them to be healthy. You want them not to have to have any major challenges like that because life is going to give you so many challenges and to start off at five with this kind of challenge — and to watch your child go through that daily — it’s heartbreaking. To see her now and how she is and who she is and how strong she is, is amazing. She’s my hero.”
And for Bush? Well, she’s just another girl who happens to live a little differently than many.
“I would tell [people] I don’t see it as a disability,” Bush said. “I see it as it’s part of me. I’ve had it for so long it kind of just grows on you. It’s a daily thing. It doesn’t change who I am.”