Monroe girl lives life with, beyond diabetes

Imagine having to give yourself a shot every time you wanted to have something to eat, whether a meal, a small snack or even just a blended smoothie. Imagine not being able to grab a cookie or a handful of chips without carefully computing the number of carbohydrates and then translating that into how much insulin your body will need.

Imagine if the stomach flu could be fatal. -á

It would be a lot to handle GÇô even for the strongest adult. But for 8-year-old Harli Carswell, it's "no biggie.GÇ¥

Harli was diagnosed with insulin-dependent diabetes, also known as Type 1 or juvenile diabetes, when she was just 5 years old. Currently in the third grade, Harli lives in Monroe with her parents, Chrissy and Jake, and her three siblings.-á

Although there are significant challenges that come with navigating her condition, Harli takes it all in stride and doesn't let the disease slow her down.

"She's the strongest little 8-year-old I've ever met in my entire life. I cannot even imagine what she goes through,GÇ¥ Chrissy said. "She just amazes me every single day.GÇ¥-á

Chrissy, a dance instructor at Platinum Dance Center in Monroe, and Jake, an officer with the Monroe Police Department, went from zero to 60 when Harli was diagnosed in 2011, having had no prior experience with the condition. They just knew that that their daughter was constantly going to the bathroom, drinking a lot of water and wasn't acting quite normal.-á

Initially, Chrissy and Jake suspected that she might have a bladder infection, so Jake took her to the doctor. After a test indicated that Harli's blood sugar was well above the normal range, they were advised to take her to Seattle Children's hospital immediately.-á

They spent a whirlwind three days in classes given by doctors, nutritionists and other instructors, learning about Harli's condition and how to manage it. They were given a crash course on how to give shots, learned how to count carbs and learned the math involved in translating carbs into insulin.-á

"Everything GÇô carb ratio versus what she needs GÇô is based on mathematics,GÇ¥ Jake said. -á

"It was so overwhelming,GÇ¥ Chrissy said.-á

If the transition was abrupt for Chrissy and Jake, it was even more so for Harli, who went from feeling a bit under the weather, to needing a shot every single time she wanted to have something to eat. There have been days when Harli has had up to nine or 10 shots.

Only 5 percent of people diagnosed with diabetes have Type 1. The more common form of diabetes is known as Type 2, which occurs when the body's pancreas no longer produces a sufficient amount of insulin. Patients with Type 2 diabetes sometimes require oral medication or insulin but can often positively influence the disease via a healthy diet and adequate exercise.-á -á

In Harli's case, her pancreas has ceased to produce any insulin at all. Without insulin, Harli's blood sugar level gets too high, since her glucose isn't being transported to her cells to be used for energy. Sustained levels of high blood sugar can adversely affect almost every part of the body, causing kidney disease, heart attacks, vision loss or blindness, nerve damage and poor circulation.-á

Proper insulin administration and diet management are both critical for Harli, who enjoys an active and healthy lifestyle. She loves to dance and spends two hours per week in classes studying lyrical-style dance, which is a combination of ballet and jazz.-á

Until a cure is found, Harli will need to manage her condition through insulin therapy, which helps to keep her blood sugar at an appropriate level. Healthy blood sugar numbers can range from 80 to 120, a tight range that can be difficult for someone with Type 1 diabetes to attain. In order to achieve a healthy blood sugar level, Harli must take insulin every time she eats carbohydrates.-á

When her blood sugar gets too high, she needs to use insulin. When it gets too low, she has to eat GÇô whether she wants to or not.-á -á -á

"Her body, right now, is on kind of a roller coaster because she's growing,GÇ¥ Chrissy said. "She's growing, and then every single diabetic is different GÇô how their body responds to adrenaline or stress.-á All these factors play into what her blood sugar's going to do.GÇ¥-á

Harli has also experienced frightening lows. Low blood sugar can cause lapses in memory, erratic behavior, moodiness, coma, unconsciousness and brain damage.

While there were some difficult moments in the beginning, for the most part, Harli adjusted to her condition with ease.

"There are a lot of people that are terrified of needles, and thank goodness, she is not,GÇ¥ Chrissy said. "She just took it in strideGǪ She just sort of went, "OK, I've got to do this now. It's not a big deal.'GÇ¥-á

But there was an adjustment period for Harli, who had to accept the fact that her condition didn't come with an expiration date. Chrissy remembered when they got home from their initial stay in the hospital and Harli's first question to her was, "OK, so, when am I done with this?GÇ¥-á

"Sometimes I get very sad, and I want to have whatever I want,GÇ¥ Harli said. "Like sometimes, I see in my classroom, everybody's eating something with sugar in it GÇô like bread or something GÇô and I always feel like I want to have that again.GÇ¥

Technically, Harli's diet is unrestricted, but until recently, every 10 grams of carbs came with a price tag GÇô an injection of insulin administered approximately 15 minutes prior to eating. The amount of insulin she needs is based on numerous factors, including her current blood sugar level and what she is about to eat, which brings up another complication of Type 1 diabetes: Harli must finish her meal in its entirety, or the insulin amount will no longer be appropriate, causing her blood sugar to plummet too low.

"That's the other thing,GÇ¥ Chrissy said. "We have to finish our food because if she doesn't, she'll go low.GÇ¥

Low blood sugar levels are a significant hazard on their own, but even more so during episodes of the flu. The only way to combat low blood sugar is by eating food, which has been problematic during times that Harli has been nauseated or had the flu.-á

"With diabetes, it's pretty life-threatening,GÇ¥ Chrissy said. "It can be fatal.GÇ¥-á

"The last two years when she's had the flu, like everyone has, she's ended up in the hospital,GÇ¥ Jake said.-á

Since her diagnosis, Harli has learned to perform the necessary mathematics involved in her insulin management and learned to give her own injections. In January, Harli was able to transition from multiple daily injections to an insulin pump, which she wears in a soft belt around her waist. The pump, which works via a tiny tube that gets inserted into her leg or her stomach, stays in place, giving her insulin continuously.-á

"We leave it hooked up at night because it's constantly dripping,GÇ¥ Chrissy said. "It's like an IV, kind of, so it's constantly giving her insulin throughout the day.GÇ¥

The small tube is attached to a computerized insulin pump that supplys insulin at a steady rate. In the past, Chrissy and Jake have had to wake Harli up in the middle of the night to either force her to eat or give her a shot.

Chrissy has tried to make the midnight meals fun, creating tiny sandwiches for their middle-of-the-night "tea parties.GÇ¥-á

"She has to go to school the next day, and she has a full day of activities after school,GÇ¥ Chrissy said. "How she does it blows my mind GÇô it's just amazing. She's so brave.GÇ¥

Harli is monitored by a diabetes specialist in Everett and returns to Children's Hospital every year for additional blood tests. She doesn't love the blood draws, but is hopeful that one day she'll be able to meet Seahawks quarterback Russell Wilson, who is an ambassador for the CR3 Diabetes Association.-á

Harli wants people to know that having diabetes is only one tiny aspect of her life. She's a smart, articulate and social girl who loves to dance and spend time with her friends and family. She's also a talented artist.

For Harli, coming to terms with her condition hasn't always been easy. Thinking about diabetes in a positive way, rather than dwelling on the negative aspects, has helped her develop the attitude that it's all just "no biggie.GÇ¥-á

And she has a message for other kids with the condition: "You'll get used to it, and the math comes really easy after you've done it for a while,GÇ¥ she said. "You have to think of diabetes as a friend.GÇ¥