My Diagnosis in Iceland
When I moved to Iceland in January 2016 to coach figure skating, I knew I was moving to one of the world’s safest and healthiest countries. With a population of only 330,000 in Iceland, it is common to see children alone on public buses and napping babies intentionally left outside coffee shops in their strollers. I had moved to the safest and healthiest country in the world, yet it was my own body that held the danger.
When I look back, I wonder when exactly type 1 diabetes developed. When exactly did my immune system decide to start attacking my insulin-producing beta cells? Did I have it a month prior to my diagnosis when I went to a remote part of England’s Lake District to track down an inn owned by an ancestor?
At the start of September, I noticed that literally overnight both ankles were painfully swollen. I sprained my right ankle and developed a bone contusion several times during my years as a competitive figure skater and I once sprained my left ankle after falling down a hostel stairwell in Prague, but it was strange for them to both be swollen at once. I was tired all of the time, no matter how much coffee I drank or how much sleep I got. Each morning, I would set eight alarms, encouraging me to wake up and do something productive. I always turned off all of the alarms, except on the days when I had to leave my house at 6 a.m.. I would walk half an hour to the rink with my painful ankles, getting slower and slower each day.
One night, I came home from work in the evening, fell asleep at 6 p.m. and didn’t wake up until 11 a.m.. I couldn’t ever remember sleeping that long. I was also excessively thirsty. I planned out my day based on going to juice bars and drinking water. Thinking I had a kidney infection, I went to the American import store to buy cranberry juice and stopped myself from drinking entire gallon in one sitting. When I stepped on the scale, I saw I was down eleven pounds, at a weight I had not been since my hardcore training in figure skating. For a week, I would wake up every morning and feel overcome with nausea and dizziness. Even though I was losing weight, I noticed increased hunger and was eating more than normal. I would go to Laugavegur, the busiest street in Iceland, for meals because I lived alone and was worried that I would pass out.
By this point, I knew something was wrong and tried contacting my employers about health insurance and how to see a doctor. No one replied. I told my family that I felt sick, but they thought it was just anxiety. I can’t remember exactly when I self-diagnosed myself with diabetes, but it was pretty early on. I finally found someone to take me to a doctor, but the doctor didn’t take me seriously. He said, “Your ankles are probably just swollen from standing so much in your ice skates. You are young and healthy and fine.” At my request, he signed for bloodwork but it was late on a Friday night so I had to wait until Monday morning. A medical student told me I should take comfort in the fact that my lifestyle didn’t make me a top candidate for type 2 and that at 23 I was too old to be diagnosed with type 1. I started to feel a bit better too and diabetes no longer seemed likely. I went through with the bloodwork anyway.
On Tuesday, I decided I needed to do something about what I thought was a kidney infection. As I was waiting to see a doctor, I got a phone call that my blood sugar was too high and that I should go to the ER immediately. Since I was already at the doctor’s, he called me in and looked at my bloodwork results. My A1C was 9.5 and my fasting blood glucose was 342 mg/dL19 mmol/L.
I had no idea what those numbers meant, but I knew that high blood sugar confirmed my suspicions of diabetes. I was given medication for type 2 and sent on my way. The next day, I got called back to the doctor’s office, where he told me he had spent the night consulting with other doctors and that they all thought I actually had type 1. I was sent to the diabetes center where they showed me how to check my blood sugar. I looked at the meter and saw the number said 360 mg/dL20 mmol/L. Then, they told me that normal was 72-108 mg/dL4-6 mmol/L! English was not their first language so they looked up information for me from Australia, the UK, Canada and America. Because almost everything in Iceland is imported, my insulin pens were in Danish, my meter in German and my logbook in Icelandic!
The diabetes center in Iceland was great. They called me in every few days to consult with doctors and a nutritionist. At first, I recorded every number and sent it to a nurse. In Iceland, health insurance is a dream. I could go to any pharmacy in the country, provide my Icelandic social security number and get as many test strips, lancets, needles as I needed for free and the prescribed amount of insulin for a small amount of money. Many Americans warned me not to return to my home country to deal with the expensive healthcare, but it was time for me to return home and I was not going to let diabetes force me into exile. However, I look back with gratitude that I was diagnosed in a country where the health insurance is nearly free and the healthcare is top notch.
Read Travels with New Diabetes by Gretchen Otte.
