At age 86, a petite Phyllis Gray guides her walker carefully but at a surprisingly pace through the halls of her North London retirement home. Bubbly and unassuming, it's not readily apparent is that this delicate, sweet senior is actually a fearless warrior.
The evidence is tucked just under her blouse, clipped to her slacks. Phyllis is believed to be Canada's longest user of an insulin pump - her success at managing her diabetes having forged new ground for countless others. The octogenarian is a diabetes pioneer.
Diagnosed in 1957 at age 30, Phyllis hasn't been married long and was a young mom. She didn't know anyone else with diabetes and was told to expect her lifespan to be 30 per cent less than someone without the condition. "I felt alone but had so much to live for. Having young children I knew I had to do everything I could to manage my condition the best I could."
When the opportunity arose in the late 1970s to take part in Canada's first trials of insulin pumps, Phyllis didn't hesitate. "It was an opportunity to be part in something new that could be good for me and where I could learn more."
Leading Phyllis' trial was the trailblazing endocrinologist Dr. Wilson Rodger, who came to St. Joseph's Hospital in 1967. Under his guidance and that of Dr. John Dupre at University Hospital, London had the first insulin pump patients in the world outside the United Kingdom. Phyllis was among them.
Earlier - in 1973 - Dr. Rodger and his St. Joseph's colleague Dr. Gerald Tevaarwerk led the creation of one of Canada's first diabetes education centres recognizing the value of education to help patients manage their condition. Before then, "patients learned what they could from their family doctor, did what they were told and hoped for the best," recalls Dr. Rodger.
When Phyllis was diagnosed and put on insulin - which required a week-long stay in hospital - she remembers being given a book. "One book. I felt that was all there was to know, and I managed."
With the creation St. Joseph's Diabetes Education Centre (DEC), knowledge became readily available. In November, to coincide with World Diabetes Day, the DEC celebrates 40 years of achievement in helping patients become skilled partners in their care. For individuals with type 1, type 2 and gestational diabetes, the DEC is where good management begins - where patients learn they are not alone and discover all they need to know to stay healthy.
Tucked in Phyllis' book shelf are remnants of her early days with diabetes - nutritional values of food from the Canadian Diabetes Association dated 1962 entitled "Food for Diabetics - A word of caution". Also in her collection is a book written by Dorothy Gibson, the DEC's coordinator when it opened and a pioneer in her own right as a diabetes nurse educator and the first person with insulin-dependent diabetes to be accepted into nursing.
"I always followed the rules," says Phyllis, who remembers that her mother was afraid to have her for dinner in case she made the wrong thing. "It was a controlled health. I had to be very aware. I didn't go out to eat often. It was easier to be at home."
Phyllis remembers the last piece of pie she ever ate. It was Thanksgiving 1957 - pumpkin pie - just before her diagnosis. Despite being a baker who kept the cookie jar filled with oatmeal cookies for her children and would cook meat pies by the dozen for her church's food program, Phyllis never strayed from her very careful diet. Life was organized around her diabetes.
"It just became part of me. I didn't have any choice. Having young children - they needed me. I couldn't get sick."
The first pumps, recalled Phyllis, were clunky gadgets measuring 6" by 4" and as thick as a wallet. She devised and sewed a case for it with loops so it could hang from her bra, which she modified to accommodate the case. "This way the pump sat on my rib cage and no one could tell I was wearing it under my blouse."
In the trial, which required frequent trips to the hospital for testing, Phyllis spent time on the pump and then switched back to traditional insulin injections so the two methods could be compared. The trial showed she had better blood sugar control on the pump. "I then had a choice to go back on the pump or not," said Phyllis.
The decision had significant financial ramifications. Back on the trial pump, support for the program would eventually no longer covered by Dr. Rodger's funding. Subsequent pumps had to be purchased. Phyllis' next two pumps cost $4,000 to $5,000 each, a staggering amount that the Health Ministry would, years later, cover for all qualified patients with type 1 diabetes.
With the opening of the DEC, the tools to manage became much more accessible. For those starting on insulin or pumps, for example, classes became available and hospital stays a thing of the past.
Even today, Phyllis is a regular at the DEC, still learning, still doing all she can to live life to the fullest. Her good health is a testament to her diligence. "There's always something new for me to learn."