How a chronic illness bankrupted a 27-year-old from Ohio

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A series of different diseases attacked his colon while another clogged the arteries in Kolton Chapman’s brain.

Derailing his semesters at Columbus State Community College and saddling Chapman, now 29, with $45,000 in debt he would never pay back was just collateral damage.

“I had been hounded by creditors, all of that, my credit score was obnoxiously low, and I got to the point where I was able to put together enough of everything, added it all up, and realized my only way out was bankruptcy.” he said.

Chapman, of Pickerington, has managed a complex array of illnesses for decades. Most occur in his intestine.

At age 8, he was diagnosed with irritable bowel syndrome, a chronic disorder of the large intestine that causes cramps, abdominal pain, diarrhea and constipation. In 2012, she contracted a potentially lethal bacterial infection that inflames the colon and usually spreads in hospitals and nursing homes; he’s not sure how he got it. As can be common with C. diff infections, Chapman was reinfected about 10 times.

In attempting to diagnose the bacterial infection, a colonoscopy in January 2014 revealed that Chapman had ulcerative colitis, a serious inflammatory condition that can cause internal, bleeding ulcers in the colon. Four years later, doctors removed his colon. But in the meantime, other doctors have detected a rare condition in her brain called Moyamoya, which causes the blood vessels that carry blood and oxygen to narrow and close. It caused Chapman a stroke in 2015 and a surgical bypass procedure in 2019.

I lost all my first 20 years being sick. I wasn’t truly ‘healthy’ until I was 27 or 28 years old.

By November 2020, his health had “relatively” stabilized. Manage illnesses and a new job offers solid insurance. Things are looking up since she borrowed $2,000 from her grandfather to start Chapter 7 bankruptcy proceedings in federal court.

ration pills

When doctors first diagnosed ulcerative colitis, they initially thought it was a mild case and prescribed a drug called Lialda. After two years, Chapman had active bleeding and required blood transfusions. They switched him to another drug called Entyvio, a monoclonal antibody.

At the time, her insurance covered the entire cost of $7,500 per infusion, every six weeks. However, after a job change, his new insurer required that she pay $800 out of her pocket for each treatment. Soon, the drug seemed to lose its pain-control potency, forcing him to seek (and pay for) infusions every four weeks.

Entyvio is made by Millennium Pharmaceuticals, which was acquired in 2008 by Takeda Pharmaceutical Co. The company reported more than $2 billion in profits last year. Entyvio accounted for 15% of Takeda’s $32 billion in total revenue last year, its CEO told Bloomberg.

Treating Moyamoya was not cheaper. Meeting her $5,000 deductible at the end of January each year became a regular occurrence.

The day before Thanksgiving 2019, doctors removed an artery from Chapman’s temple and taped it to the surface of his brain to bypass the blockage. She cost him $15,000, even after insurance paid for a large portion (she was on a high-deductible health plan).

He takes a medicine called Ubrelvy to control the migraines that come with Moyamoya. When he started taking them, a 12-pill unit cost about $1,000. You would owe $100 after insurance, but sometimes the manufacturer offers coupons that lower your share of the cost to $5.

His current insurer only pays for eight pills per 30 days. Sometimes the whole bottle is used up in a week and is left alone for the rest of the month.

“That’s especially true in the spring and thunderstorm season,” he said. “But normally, I can stretch all eight and end up with one or two for the next month. With the price and the way my insurance company treats it like gold, I have to ration it.”

Ubrelvy is made by AbbVie, which acquired original manufacturer Allergan in May 2020. The company made more than $11.5 billion in profit last year. Her recent TV ad for Ubrelvy featured tennis legend Serena Williams.

Other cost burdens arose. Chapman came out as trans in early 2013. Insurance covered the costs of hormone therapy but refused to pay for the surgical transition. Their increased need for Entyvio infusions meant higher costs.

His ulcerative colitis may have gotten worse when he took classes part-time at Columbus State. He was sore and flunking his class. Enough already.

“I was going to have to choose between paying for my school or paying for my medications,” he said. “And I need my medications to stay alive.”

Colon removal in 2018 stabilized his health and put ulcerative colitis on the back burner. Chapman said he still has some issues and probably goes to the bathroom more than most people, but he’s healthier now than he was then.

The debt, however, festered. In the heart of a century-old pandemic, unrelated chronic health conditions led Chapman to join the estimated 530,000 Americans who file for bankruptcy due to health problems.

Photo courtesy of Kolton Chapman.

Life with intestinal problems

For a time, eating was less a source of pleasure than a necessary evil to get through Chapman’s days.

“There were probably two whole years where I ate maybe one meal a day just because I couldn’t. I wasn’t hungry and I knew it hurt to eat,” Chapman said. “So I drank a lot of protein shakes and even that was hard to do. So really living with that on a daily basis is being hungry but knowing you can’t eat.”

Most of those meals were just rice and chicken. For a while, she only ate Wendy’s junior bacon cheeseburgers, the only thing she said her stomach could tolerate.

Beyond health and finances, gut problems in particular built social barriers. People don’t like to talk about their poo. Friends invited Chapman to restaurants and he silently refused. It’s easier that way than explaining, no, I can’t go out to eat because I might need to spend three hours in the bathroom.

“That’s not something you want to have to tell your friends,” he said. “So you end up isolating yourself just to essentially avoid the embarrassment of having to talk about it.”

As Chapman’s health has stabilized, so have his finances. He and his wife no longer live paycheck to paycheck. Now they’re looking for a bigger apartment — bankruptcy eliminates any chance of him getting a decent loan to buy a house until it’s removed from his credit report in 2027.

Now, he is awaiting approval for a brain scan to detect signs of Moyamoya in the healthy side of his brain. Her insurer, Chapman said, is being a “pain” for approving it. She needs to have another scan that she has been putting off to check on previous colon surgery.

He currently works for the National Registry of Emergency Medical Technicians. With a steady job and better health, Chapman recently re-enrolled at Franklin University in Columbus to study IT.

“At almost 30 years old, I am finally going back to school to do what I started,” he said.

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