The year was 1957. School was in session for Carpinteria fourth graders. The kids followed the rules: get to class on time, pay attention, raise your hand if you would like to speak, no bathroom breaks until recess. It was a time for learning new things and making new friends. Students were having an exciting and joyful day. Except for one little girl who was uncontrollably wetting her pants at her school desk…again. Though it had yet to be diagnosed, nine-year-old Linda had type 1 diabetes.
“I tried to hide my accidents, drying it with my sweater because the shame and humiliation of frequently losing bladder control at that age was crushing,” Linda Silvestri recalls. “But I think it is important to share those unpleasant memories now because it may help parents and teachers recognize the early signs of this disease in children.”
Early detection and treatment of diabetes can decrease the risk of developing the complications of diabetes. The seventy-two year-old Santa Barbara great-grandmother remembers other symptoms from her childhood. She was constantly sleepy and took naps often. Her body felt fatigued. Along with fatigue and frequent urination, common symptoms of new-onset type 1 diabetes in children can include increased hunger and thirst, blurry vision, and weight loss.
One day as her mother was helping her get dressed, young Linda keeled over and went into a coma. An ambulance took her to Santa Barbara County General Hospital where tests revealed she had type 1 diabetes. She was transferred to Cottage Hospital where she stayed for a month. “It was really hard for me,” she says. “I was the only patient in the pediatric ward. It was so lonely.”
Thanks to more than sixty years of ongoing treatment and care from Sansum Clinic medical professionals for her disease, Ms. Silvestri has enjoyed a fulfilling and productive life. She worked for the Santa Barbara News-Press for 34 years as a linotype operator and retail ad builder. She is now retired and lives independently, staying active with daily walks and occasional Pilates classes. “I am so grateful for the care I have received from the people at Sansum Clinic over my entire life,” she says. “I credit them for the quality of life right here and now that I am living.”
Comprehensive Professional Care Provides Decades of Wellbeing
Previously known as juvenile diabetes, type 1 diabetes is a condition where the pancreas produces very little or no insulin. Insulin is a hormone required for the body to use blood sugar for energy. Without insulin, blood sugar (also known as blood glucose) builds up in the bloodstream where it is causes damaging symptoms and complications. It is usually diagnosed in children, teens and young adults, but it can develop at any age. Approximately five to ten percent of people with diabetes have type 1. The cause is believed to involve a combination of genetic and environmental factors. Treatment with insulin, usually given by injection, is required for survival.
When Ms. Silvestri was a child undergoing treatment for the disease, her doctor was Percy Grey, who had previously worked with William Sansum, MD. Dr. Sansum pioneered research to formulate artificial insulin, along with Canadian physician Sir Frederick Grant Banting and others. When Dr. Sansum moved to Santa Barbara in 1920 as a specialist in diabetes, it was a fatal disease. He founded Sansum Medical Clinic in 1921. In 1922 Dr. Sansum administered the first doses of insulin produced in the United States. Today 7.4 million Americans, including Linda Silvestri, rely on insulin to sustain their lives.
For the past twenty years, Ms. Silvestri has received treatment from Rosanna Petronella, PA-C, CDE. Ms. Petronella joined the Sansum Clinic staff in 1983. She is a certified physician assistant and certified diabetes educator who trained at University of Texas Medical Branch in Galveston. “I love Rosanna and I trust her completely,” Silvestri says. “I call her Saint Rosanna. She is compassionate, caring, and professional. She analyzes the numbers that represent my blood sugar levels and guides me on exactly how much insulin I need. She is so kind, and that is very important to me.”
Ms. Silvestri’s appointments with Ms. Petronella occur every three months and include analysis of blood tests that are performed at Pacific Diagnostic Laboratories in Santa Barbara, as well as evaluation of readings from a medical sensor that Linda wears on her arm. The sensor, called the FreeStyle Libre, measures the glucose concentration in her interstitial fluid, which is a thin layer of fluid that surrounds the body’s cells. Close monitoring of glucose levels is critical for diabetes patients. Dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma, as Linda experienced as a young child.
“Previously, I had to prick my finger many times a day to draw blood for a home test of my blood sugar levels,” Silvestri explains. “The test results help me determine how much insulin I should inject. My fingertips were always in bad shape because of constantly pricking them with needles to get blood. I love the Libre sensor because it frees me from that painful procedure and makes it so much easier to test my blood glucose levels throughout the day. I wear a small disc on my arm that I change every two weeks. Any time I want to know my blood sugar levels, I hold the Libre sensor up to the disc.” Ms. Petronella developed a scale that helps Ms. Silvestri accurately calculate how much insulin she should take, based on analysis of metrics from the Libre sensor and Linda’s personal medical history.
Ms. Silvestri explains that when she was younger, diabetic patients only had their blood sugar levels tested when they went to a medical lab. “With the arrival of home tests, patients like me can see how our blood sugar fluctuates,” she says. “Because of the variability, I take a combination of long-acting insulin and quick insulin. Long-acting therapies mimic the insulin levels that a typical healthy body has. A normal body produces additional insulin when a person eats carbohydrates. But mine doesn’t. So I give myself quick insulin to cover the meal.”
Gerri French, MS, RDN, CDCES also provides care for Ms. Silvestri. Ms. French is a clinical dietitian, culinary nutritionist, diabetes educator, and cooking instructor. She has worked with Sansum Clinic since 2002. “There is a link between diet and diabetes,” Silvestri says. “I see Gerri French as a patient and I also attend her nutrition education classes. She is very practical and realistic in the way she provides information about what our bodies need. Gerri teaches us about eating whole, real foods that are not processed. She helps us understand how to count our carbohydrates, which is important for diabetic patients because carbs break down into sugar, which enters the blood. And Gerri doesn’t merely tell people about a healthy diet. She lives what she teaches.”
Linda believes one of the reasons Sansum Clinic functions so well is collaboration among caregivers. “Gerri French, Rosanna Petronella and other medical experts can easily share information about patients like me to get a complete picture of our condition, our history, medications, and more,” she says. “Various specialists can access my records as well as the notes from other professionals so pertinent information is always in the right hands. I also appreciate the after-visit summary I receive. When I get home after a medical visit, it is so helpful to have a written description of what transpired at the appointment.”
Ms. Silvestri values the medical services she has received from Sansum Clinic over the course of her life. She shares some advice. “Sansum Clinic provides something vital in our community that we can be a part of if we choose,” she says. “Everyone should have a physician that they have a close relationship with. People may think they won’t need it. But if you have a crisis, you can call your physician and be confident that they know your medical history so they can provide the help you need. The professionals at Sansum Clinic have saved my life more than once. And so I’m still here. I am medically stable, capable of living independently, and able to enjoy fulfilling activities with family and friends. Sansum Clinic has everything to help us with our lives, if we want to take the help.”
Linda Silvestri is a native of Santa Barbara. She enjoys walks downtown and spending time with her daughter, granddaughter and great-grandson.