Surviving a Life-Threatening Diagnosis — 12,000 Miles From Home

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Oren and Cassandra had a fun moment on the northernmost point of the Emerald Isle in Ireland. (Photo: Cassandra Kramer)

Who: Oren Liebermann (31) and Cassandra Kramer (29)

How did you meet?

We were both local television news reporters at WBOC in Delaware. Cassie and I didn’t hit it off right away, but after we met for drinks to discuss contacts, sparks started to fly. After dating for five years, we got married on Sept. 9, 2012.

Why did you plan your trip around the world?

Travel was an addiction for Cassie. She fell in love with traveling during college after spending a summer teaching English in rural Ecuador. Luckily, I had a similar interest in travel, although I had never really traveled internationally before. For a year, we saved as much money as we could, and whatever we didn’t sell, we stuffed into a 7½ x 10 ft. storage space. A few days after our first year anniversary, we quit our jobs (Both of our employers were supportive.) and embarked on our budget backpacker voyage, staying in hostels, guesthouses, and dorm rooms and couch-surfing our way around the world. And even more surprising? Cassie was able to fit all of her belongings for one year in one 50 liter backpack!

Where did you start and end?

Our trip started on Sept. 15, 2013, in Italy and finished on Aug. 9, 2014 in Iceland.

Related: #RealTravel: I Told My Boss I Bought a One-Way Ticket to Kenya and Wasn’t Coming Back

The two globe-trekkers celebrate as they reach Annapurna Base Camp at nearly 14,000 feet after five days of hiking in the Himalayas. (Photo: Cassandra Kramer)

How many countries did you visit?

We visited 30 countries across five continents (in order): Italy, France, Monaco, Spain, Ireland, Northern Ireland (U.K.), Hungary, Slovakia, Poland, Czech Republic, Austria, Ethiopia, Kenya, Tanzania, Israel, Jordan, Nepal, Thailand, United Arab Emirates, Laos, Cambodia, Vietnam, China, Japan, United States, El Salvador, Peru, Chile, Argentina, and Iceland.

There was a bump — a health scare — on the road. How did Oren find out he had diabetes?

Unbeknownst to us, I was diabetic for about eight weeks around the winter of 2013. I lost about 45 pounds and felt generally weak and incredibly thirsty, but I never felt like I was in danger until the last week before my diagnosis. A doctor in Nepal thought it was simply malnutrition, so he recommended fruits and juices to get more vitamins. The excess sugar spiked my blood sugar even more, causing a sharp downhill turn. The official diagnosis as type 1 diabetes and subsequent hospitalization in Pokhara came on Valentine’s Day. After four nights, we decided the treatment wasn’t adequate enough and flew to Kathmandu and spent two more nights at a Western clinic that offered better services. More than a week later, we were cleared to fly home.

What was the scariest moment?

The diagnosis itself was terrifying at first, but the scariest moment actually came a few weeks earlier, during a hike in the Himalayas near the Annapurna Base Camp at about 14,000 feet. We woke up early in the morning to make the final push to the top. Unbeknownst to us, my blood sugar had bottomed out. At that point, if I had passed out from hypoglycemia, I probably would have died. We were very far away from medical help.

Cassie: It’s a really scary thing to watch your husband’s health literally disintegrate before your eyes. If you are in a normal routine at home and something seems wrong, you seek treatment. But when you’re traveling, every variable is new. There are no constants, so it’s very difficult to recognize the warning signs. Even though Oren had classic symptoms, he still felt “fine.”

Related: #RealTravel: I Quit My Job to Visit All 50 States in 365 Days

Oren and Cassandra spent Valentine’s Day 2014 in the hospital in Pokhara, Nepal. (Photo: Cassandra Kramer)

How did you make the decision to go home?

We knew we had to get home as soon as possible and actually booked tickets for Valentine’s Day, but I felt too weak to make the flight. Hanging out in a Nepali hospital definitely wasn’t my idea of an awesome date. We eventually caught a flight back home.

Tell us why you decided to get back on the road?

Once we realized that I was going to be just fine with some medical treatment, we didn’t want to quit the journey of a lifetime. More importantly, if I backed down from doing something because of the diabetes, I would be setting a dangerous precedent for the rest of my life. After about a month at home, we picked up our trip in Thailand. It felt incredible to be back on the road.

How did travel and eating abroad change for you going forward?

No desserts! And I avoided eating too much rice or too many potatoes or big bowls of pasta, but almost everything else was fair game. It took a while to learn to manage blood sugar on the road, but everything worked out great in the end. It certainly helped that we were very active. We hiked along the Great Wall and the Inca Trail.

Post-diagnosis, the couple went to Thailand, where they posed in front of the White Temple. (Photo: Cassandra Kramer)

What are some other tips for traveling with this medical condition?

It’s all about preparation. You need extra supplies in case you run out of insulin (or someone steals your insulin, which happened in Phnom Penh, Cambodia!). When we got back on the road, we tested my blood sugar all the time, almost 10 times a day if not more. Once we got into a bit of a routine — eating certain foods, avoiding sugary drinks and smoothies — it became very easy to travel with diabetes. The hardest part is the mental block. You have to believe you can do it safely so that you can take that first step out your front door. It also helps to travel with someone you trust who can double check your health and decisions at all times. If you’re going somewhere that doesn’t have Western medicine, make sure to look up organizations that treat diabetes, and find out who can tell you where to get reinforcements.

How else do you keep your wellness a priority now?

My diagnosis was a complete lifestyle change for me. Now I eat better, exercise more, and am in the best shape of my life. I allow myself dessert once every two weeks, and even then, it’s completely measured out so I know how much insulin to take. Diabetes didn’t stop me from doing anything on our trip, and it won’t stop me from doing anything in the future.

After about a year abroad, Cassie and Oren took their final picture together on their trip in Iceland. (Photo: Cassandra Kramer)

What have you learned from being a couple on the road?

Traveling together is the ultimate test of a relationship. We were with each other 24/7 for nearly a full year, and it brought us closer together than ever. We try to encourage others to travel (especially diabetics!). You don’t have to be rich. There are budget options almost everywhere. Just get out there, and go explore!

(As told to writer Ko Im)

You can read more about Oren and Cassie’s global travel adventures — all the ups and downs in multimedia — on their blog 42nd Class.

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