How a chronic illness drove a 27-year-old Ohio out of business

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 saddled the now 29-year-old Chapman with a $45,000 debt he would never repay was just collateral damage.

“I had been harassed by creditors, all of it, my credit rating was obnoxiously low, and I got to the point where I was able to collect enough of everything, add it all up, and realize my only way out was bankruptcy. “, he said.

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

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, he contracted a life-threatening bacterial infection that inflames the colon and is usually spread in hospitals and nursing homes. He doesn’t know how he contracted it. As may be common with C. difficile infectionsChapman was re-infected about 10 times.

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

I lost my entire twenties by being sick. I wasn’t really “healthy” until I was 27 or 28.

In November 2020, his state of health had “relatively” stabilized. He manages illnesses, and a new job gives him solid confidence. Things are looking up since he borrowed $2,000 from his grandfather to file Chapter 7 bankruptcy proceedings in federal court.

Ration pills

When doctors first diagnosed ulcerative colitis, they initially thought it was a mild case and put him on 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, his insurance covered the full cost of $7,500 per infusion, every six weeks. However, after a job change, his new insurer demanded that he pay $800 out of pocket for each treatment. Soon the medication seemed to lose its ability to reduce his pain, forcing him to request (and pay for) infusions every four weeks.

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

It wasn’t cheaper to treat Moyamoya. Hitting his $5,000 deductible at the end of January each year has become a regular occurrence.

The day before Thanksgiving in 2019, doctors extracted an artery from Chapman’s temple and attached it to the surface of his brain to bypass the blockage. It cost him $15,000, even after insurance paid for most of it (he had a high-deductible health plan).

He takes a drug called Ubrelvy to manage the migraines that come with Moyamoya. When he started taking them, a unit of 12 pills cost around $1,000. He owed $100 after insurance, but sometimes the manufacturer offers coupons that reduce his share of the cost to $5.

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

“That’s especially true in the spring and during stormy season,” he said. “But normally I can stretch all eight and end up with one or two next month. With its 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 over $11.5 billion in profits Last year. His recent TV ad for Ubrelvy featuring tennis legend Serena Williams.

Other financial charges arose. Chapman came out as trans in early 2013. Insurance covered the costs of hormone therapy but refused to pay for any surgical transitions. His increased need for Entyvio infusions meant increased costs.

His ulcerative colitis may have been at its worst when he took part-time classes at Columbus State. He suffered and failed his classes. Enough was enough.

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

Having his colon removed in 2018 stabilized his health and put ulcerative colitis on the back burner. Chapman said he still has problems and probably goes to the bathroom more than most people, but is healthier now than he was then.

The debt, however, got worse. Amid a century-old pandemic, unrelated chronic health issues led Chapman to join the estimate 530,000 Americans who are turning to bankruptcy due to health problems.

Photo courtesy of Kolton Chapman.

Living with intestinal problems

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

“There’s probably a good two 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 living with it on a daily basis is being hungry but knowing you can’t eat.

Most of these meals were just plain rice and chicken. For a while, he only ate Wendy’s Junior Bacon Cheeseburgers – the only thing he said his stomach could tolerate.

Beyond health and finances, intestinal problems have notably built social barriers. People don’t like to talk about their poo. Friends invited Chapman to a restaurant, and he quietly declined. 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.

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

As Chapman’s health stabilized, so did his finances. He and his wife no longer live from paycheck to paycheck. They are now looking for a bigger flat – bankruptcy kills any chance he will get a decent loan to buy a house until he hits his credit report in 2027.

Now he is awaiting approval for a brain scan to check for signs of Moyamoya on the healthy side of his brain. His insurer, Chapman said, is having trouble approving him. He needs another CT scan he’s been carrying over to verify a previous colon operation.

He currently works for the National Registry of Paramedics. With a stable job and better health, Chapman recently re-enrolled at Franklin University in Columbus to study computer science.

“At almost 30, I’m finally going back to school to do what I started,” he said.

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Anne G. Cash