The journey behind her final run

Camille Izlar will never forget that third-grade boy named Stephen who chased her around the playground yelling "Diabetic, diabetic,diabetic."

Thirty-three years later, Izlar is still running, but no longer running to hide.

Next month, Izlar will run a marathon with "Team Diabetes" to raise $5,000 for the American Diabetes Association (ADA). Over the past three years, she has raised $12,000 by running in two half marathons and one full marathon.

She ran her first 26-mile marathon in Rome a year ago. The first 13 miles of the run were over cobblestone roads, and because of the bumps she developed blisters on nearly every toe. A teammate, who also has diabetes, developed an upset stomach and didn't have her blood sugar meter with her. The teammate was forced to make frequent stops, and each time Izlar stayed with her. Seven hours after they started, they both wobbled across the finish line.

"I would never quit," Izlar said. "People with diabetes never quit. It beats you up sometimes, but you keep on trying."

This year's marathon will be held Oct. 28 in Dublin, Ireland, and Izlar has dedicated her run and fund-raising effort to a woman named Lori Davis and her 6-year-old son Jacob. Davis has had diabetes for 17 years. Jacob was diagnosed when he was 3.

Izlar met Davis in April when she taught Davis how to use an insulin pump. Davis, like Izlar, must check her blood sugar at least 10 times every day. And Davis must check Jacob's blood sugar that many times as well.

"Diabetes is demanding enough for yourself, but when your child has it as well it is especially challenging," Izlar said. "Lori and her family's never-give-up attitude inspired me to make this commitment to run one more time."

Having diabetes, of course, is a marathon of a different kind, with miseries measured not in miles but years. It's not a race you decide to enter, but a treadmill that never stops.

'You are too sweet'
That treadmill for Izlar began as she neared the end of second grade.

As a diabetes educator at UNC Hospitals and clinical instructor in the School of Medicine, the symptoms are easily recognizable to her now. She was tired all the time. She drank too much and peed too much and weighed too little. When she went to see her family doctor, she was 8 years old and weighed no more than 40 pounds. She spent the next day in the hospital for further tests. She will never forget the words her doctor used to tell her what those tests revealed. "You are too sweet," he said.

She remained in the hospital for the next two-and-a-half weeks. She learned about disposable needles. She learned how to give herself insulin shots by practicing on an orange. She learned how to test her urine with a kit that included a test tube, a dropper and pills.

She was the youngest of five children. Her father was a cardiologist in Durham. Her mother was a nurse who quit to raise her family.

She went back home to that family, equipped with her supply of needles and insulin and test kits and with a heavy dose of attitude that her life could go on the same as it had before.

And by most outward appearances, it did.

Except for her favorite brown sugar and cinnamon Pop Tarts that disappeared from the breakfast table, replaced by toast and eggs. Except for lunch. When the other kids munched cookies, she nibbled graham crackers.

And except for those private chemistry experiments in the bathroom testing her blood sugar. Executing the formula became as routine as brushing her teeth: put two drops of urine into the tube with 10 drops of water; drop in a pill; and watch as the mixture burst in color.

Blue was always good, orange always bad.

As Izlar got older, she came to believe there was nothing that diabetes could stop her from doing. She rode horses. She ran track. In high school, she was a cheerleader.

Except she always tried to do everything better. Then, and only then, would she talk about having diabetes.

"When I was growing up I tried to hide it because I didn't want anybody to think I was different," Izlar said. "I was determined to do anything that anybody else did." The disease, for her, became a prod, not a crutch.

The pretender
It's one thing to pretend around other people, quite another to kid yourself. That's the mistake Izlar made after she went off to college at the University of Virginia.

She developed a taste for beer and reacquainted herself with foods she would have had to sneak out of her mother's kitchen. At the cafeteria she gorged on big salads and feasted on cookies "as big as my face."

Like other teenagers, she was rebelling, but Izlar was rebelling not against her parents but her disease. She stopped conducting those chemistry experiments in the bathroom. "I definitely wasn't going to check my urine in a dorm filled with 22 women. I hid it. Nobody in my sorority knew I had diabetes."

She majored in psychology and figured she would end up going to medical school like her dad.

During a stint as a counselor at a summer camp in Brevard, deep in the Pisgah National Forest, she stumbled upon a different path.

The camp happened to be for children with diabetes; the cabin she supervised was filled with girls who happened to all be 8, the age she was when she found out she had the disease.

As a little girl, she used to ask the question "Why me?" out of shame and anger. Inside that cabin, she began to think about the same question a different way. And in the faces of those little girls, the answer to that question -- and her life -- began to emerge.

She was 19, and it was the first time since she knew she had diabetes that it occurred to her that maybe she wasn't as different from everybody as she thought she was. And no longer did she feel she was alone.

After graduating from Virginia, Izlar went on to earn a master's degree in nutrition at UNC-Greensboro in 1985. Her training included a six-month internship at UNC Hospitals and from 1985 to 1987 she stayed on at UNC Hospital as a clinical dietician. She spent two more years working as a clinical dietician, then in 1989 she began her career as a diabetes educator at Bowman Gray School of Medicine, which is now Wake Forest University Hospitals. She returned to UNC Hospitals to continue her work as a diabetes educator in 1995. Over the years, she has come to believe there is a reason why things happen, and she has built her life -- and career -- around that idea.

"I used to say, `Why me, why me?' I just think God has a plan and part of his plan is that I do have diabetes and that I use that to help other people with diabetes."

Not just a job
Izlar has been a diabetes counselor for 13 years, and the work is now a part of her. It not only defines who she is but gives her a chance to help other people with diabetes to redefine themselves.

"One guy about made me cry when he called me up and said, `I'm glad I talked to you. You made me feel so much better,'" she said.

What made him so happy? When Izlar told him it was all right to eat a hamburger and French fries, provided he take the proper amount of insulin for the carbohydrates.

"Sometimes, when you have diabetes, you feel like everything is taken away from you," Izlar said. "I want them to know they can have some things back."

Izlar doesn't so much dispense information as she does display what she believes is the attitude. Both have to be correct, she is convinced, for either to work.

"I tell people diabetes is no day at the beach, but the good news is there are ways to manage it. Learn to do that, and you can still go."

That message is credible to her patients, Izlar believes, because they know she lives with diabetes just as they do -- and follows the same demanding advice that she dishes out.

In June, for instance, right before she started training in earnestfor this year's marathon, a friend invited her on a horseback-riding excursion in the Nevada desert. The night before the ride, she found herself awake in a top bunk bed, her face inches from the ceiling, her blood sugar level four times normal and her nose bleeding. A few hours later, she was astride her horse just like everybody else, except for the fanny pack around her waist filled with food, water, her blood sugar meter and her insulin pump.

The point of that experience is that having diabetes makes leading a full life harder, but it does not put it out of reach.

Another bump in the road
There will be bumps in the road, she tells her patients, but don't turn them turn into mountains. Don't let anything get in your way. But recently, Izlar ran into a bump that could have become too big to get around.

For years, she has had diabetic retinopathy, a disease that affects the retina, the transparent membrane that lines the inside back wall of the eye.

Think of the retina as a movie screen onto which light entering the eye is projected and then converted into the electrical signals that are processed and transmitted by the optic nerve to the brain.

Think of diabetes as an invisible knife that can rip that screen apart.

That was what began happening to Izlar's eyes in 1987. She would wake up with blurry vision, but it would clear by noon. Then one morning in 1990 she went to work, and she had the sensation that someone had pulled a curtain over her left eye. She didn't know it then, but it was a curtain of blood.

Doctors repaired the eye with a vitrectomy, a surgical procedure in which the blood and other fluids were suctioned out through tiny slits in the eyeball, and a laser was used to cauterize damaged blood vessels to prevent further leaking.

She spent six weeks at home recuperating. Her first day back at work, though, blood vessels burst in her right eye, and she went through the same ordeal again.

Both operations were successful, and she had no more problems with her eyes until Aug. 30, when she went to see her ophthalmologist for what was supposed to be a routine checkup. "He was looking at my right eye, and he kept looking at it and kept looking at it," Izlar said. "He saw tears in my retina that hadn't been there six weeks before."

He gave her two choices. He could perform laser surgery that day, a procedure he equated to sticking a finger in a dike, or he could schedule her for a more invasive, complicated procedure, called a scleral buckle, that could prove to be a permanent fix.

She went for the fix.

The operation was performed on Sept. 4. A friend drove her home the same day, her eye pounding with pain. For the next three days, she lay in bed on her left side and was not allowed to get up for more than 10 minutes each hour. Staying in this position was necessary for the repaired retina to heal properly.

Four days after the operation, she went outdoors for the first time.

Six days later, she went back to see the doctor. "It's fixed," he told her. "You can run."

On Sept. 12, eight days after the operation, she did.

She was afraid to do it, but even more afraid to put it off, she said. She put in six miles that morning, all the while thinking about the bigger race ahead. And a voice inside her kept asking, "Do you really want to do this? Do you really want to run 26 miles?"

But she already knew the answer.

On Sept. 14, a Saturday, she ran 12 miles.

On Sept. 16, on a Monday morning before work, she ran four. The following day she ran three miles, and nine miles the day after that, and five miles the day after that. On Sept. 21, another Saturday, she ran 18.

In the month she has left to train, she will spend two weeks building up to a 20-mile run, then taper off in the two weeks leading up to the marathon. That day, she will run exactly 26.2 miles, in whatever time it takes.

Having diabetes has made life harder in some ways, but rewarding in ways she could not have imagined as a little girl running away from a mean little boy on the playground.

Back then, she was running away from the fact that she had the disease. Now she runs to prove the disease can't stop her. And pushing her forward this one last race will be a mother, and another little boy named Jacob.

Make a Difference

Team Diabetes is affiliated with the American Diabetes Association. Almost 80 cents of every dollar raised goes to fund activities to prevent and cure diabetes and to improve the lives of all people affected by the disease. To make a contribution in support of Camille Izlar's marathon run, make your check payable to the American Diabetes Association and send it to Izlar at 4112 Settlement Drive, Durham, NC 27713.

University Gazette