Author Topic: Crohny Lifestyles  (Read 3788 times)

SporeSpawn

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Crohny Lifestyles
« on: December 02, 2014, 05:58:09 AM »
Any other forum members here have Crohn's Disease or a similar IBD? I've had it for about two years, since starting grad school. It's funny because, for me, getting diagnosed jump-started the changes of attitude that led to me being here. When you aren't sure how your body's going to hold out in the far future, you put everything into making things right now.

Being financially independent is a big deal for someone with Crohn's because, aside from the medicine and preventative measures needed, I'm almost guaranteed to have surgery a few times in my life and it could come pretty much any day, any time. So, being able to absorb surgery (and possibly cancer) is a huge necessity for me. My career field makes it a bit easier, since it's government based and loaded with nice perks, but when I cut the umbilical, I plan to have a fat fat egg ready that can take scalpels, chemo, and the like whenever it strikes.

But as far as the nitty-gritty, day to day, Crohn's really only gives me more reason to go mustachian and control my diet, exercise, and habits strictly and frugally. The best things for my body is cutting out the excess and trimming the fat. And, I won't lie, when I've been faced with social pressures to do a few non-mustachian things (eat out or eat bad being the big two), I don't mind playing the "Oh... but the Crohn's" card. I've got a chronic disease. I've damn well earned that card!

RetiredAt63

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Re: Crohny Lifestyles
« Reply #1 on: December 02, 2014, 06:03:56 AM »
Nothing diagnosed, but I find that I am extremely sensitive to wheat.  You would not believe the pushers out there (or you probably would).  "Oh one little bite won't hurt you."  Yes it will.  For the really pushy ones, I now say "If I eat that, tomorrow I will have the equivalent of food poisoning (or stomach flu)".  That line is being really effective.  And do I want my life activities controlled by someone else's choice of what I eat?  No. 

guitar_stitch

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Re: Crohny Lifestyles
« Reply #2 on: December 02, 2014, 07:29:39 AM »
I have some form of IBS.  Working medical channels to figure out WHAT it is right now.  They're leaning toward microscopic colitis....

Young me took advantage of the tax free HSA option and had been saving a while before this hit.  Now I find myself proud of earlier me as I spend gobs of cash for diagnostics.

samburger

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Re: Crohny Lifestyles
« Reply #3 on: December 02, 2014, 10:36:07 AM »
Ulcerative colitis here! I'm glad you started this thread--I've been thinking a lot about how my health affects my FIRE plans.

UC is less surgery-prone than Crohn's, so that's not as big of a worry for me, but UC is more likely to cluster with other autoimmune disorders. I'm smack in the middle of getting a diagnosis for what I suspect is one of those fun sister diseases.

I haven't been thinking about costs because I've been in remission for 8 solid years (no meds, just diet management), but shit. My stash could quickly go from a retirement stash to a medical fund. What if our medical bills are bigger than planned and I can't work?

Are you taking your Crohn's into account when you calculate your FIRE number? How do you put a figure on it?

SporeSpawn

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Re: Crohny Lifestyles
« Reply #4 on: December 02, 2014, 12:56:06 PM »
With the ACA eliminating the pest of "Pre-existing Conditions" I plan to just pay for insurance. I know this is a faux pas, but Crohn's isn't something you can easily measure out, "100k in surgery in five years, 3k in diagnosis next year, 1k in medication over the next five years, evenly." It's a constant flow, up and down. I'm only just starting my career and, since my field is benefits-rich, I plan to let the state pay for my health insurance as long as I want them to. When that's finished, I'll buy my own.

It's the same reason I plan to buy insurance for cryonics. I don't expect to be able to raise the funds fast enough for when I'll need them. Crohn's doesn't have a particular short life span these days, but I've not heard of anyone diagnosed with it young living past 60. So I've got to plan for early ailment, early disability, early death. No biggie. I can do it. I'll just have to take the gamble that, if I live to 100, I'll have blown money that could have turned into gold. If I make it that far, I will care far less about the lost money than I will at my impressive luck. All it'll have cost me is a few more years in a field I love and the ability to sleep soundly at night knowing I don't have to pray the Crohn's doesn't go rampant before I get "enough."

samburger

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Re: Crohny Lifestyles
« Reply #5 on: December 02, 2014, 02:26:10 PM »
With the ACA eliminating the pest of "Pre-existing Conditions" I plan to just pay for insurance. I know this is a faux pas, but Crohn's isn't something you can easily measure out, "100k in surgery in five years, 3k in diagnosis next year, 1k in medication over the next five years, evenly." It's a constant flow, up and down. I'm only just starting my career and, since my field is benefits-rich, I plan to let the state pay for my health insurance as long as I want them to. When that's finished, I'll buy my own.

So you aren't sure, in other words! Insurance premiums are insurance premiums, but I can't figure out what I should be planning, on average, over that. $5k/year? $10k? It's impossible to know and it freaks me out. (I know you can't give me the answer, just curious how you're thinking!) I'm also early in my career, so I have time to figure it out.

Crohn's doesn't have a particular short life span these days, but I've not heard of anyone diagnosed with it young living past 60.

Whoa there! That's a function of medicine, not the fixed mortality of the disease. Biologics have only been on the market for a hot second, and in 2014 we're only just starting to talk about the miraculous effects of fecal implantation. There's no reason to expect you won't live as long as you would without the Crohn's. There is lots of reason to expect we'll shrivel and ache faster than most, though..

SporeSpawn

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Re: Crohny Lifestyles
« Reply #6 on: December 02, 2014, 03:42:09 PM »
With the ACA eliminating the pest of "Pre-existing Conditions" I plan to just pay for insurance. I know this is a faux pas, but Crohn's isn't something you can easily measure out, "100k in surgery in five years, 3k in diagnosis next year, 1k in medication over the next five years, evenly." It's a constant flow, up and down. I'm only just starting my career and, since my field is benefits-rich, I plan to let the state pay for my health insurance as long as I want them to. When that's finished, I'll buy my own.

So you aren't sure, in other words! Insurance premiums are insurance premiums, but I can't figure out what I should be planning, on average, over that. $5k/year? $10k? It's impossible to know and it freaks me out. (I know you can't give me the answer, just curious how you're thinking!) I'm also early in my career, so I have time to figure it out.

Afraid so. As I said, with my field, I'm not overly concerned with independent prices on insurance since my employer provides through benefits. However, a quick Google search turned up this (http://www.ccfa.org/assets/pdfs/managing-costs-of-ibd.pdf) from the Crohns and Colitis Foundation. It prices cost-per-year for the medical insurer for Crohns at $19k and for Colitis $15k. Again, that's for the insurer and, obviously, the prices vary. It's going to depend on whether you need surgery and how frequent, what medicine you take, how many diagnostics you need, secondary illnesses (I have osteopenia because of Crohns which demands Bonivia to prevent spinal fractures). I can say that I've not yet reached a price tag that high, even with colonoscopy and tests.

Another source (http://www.ncbi.nlm.nih.gov/pubmed/10950042), the American Journal of Gastroenterology, breaks down the pricing for Crohns itself into mild, moderate (me!), and severe, with price tags at, respectively, 6k/year, 10k/year, and 37k/year. Since Colitis seems to be a slightly smaller price tag, you can probably go off these estimates as being a little on the safe side for colitis.

If I took an average of 20k/year (just for a nice round number that's also on the high end to allow for safety margin), using the 4% rule, it would require a 500k nest egg to draw that off of, yearly. Again, though, that's an average. If you have severe, it'll be substantially higher; however, inverse, if your Crohns/Colitis is NOT severe, odds are you'll have good years and bad years. One year, you'll spend the bare minimum on meds and check ups. One year, you'll have to bear down the cost of surgery. So, I doubt anyone is going to see a perfect average of 20k (or whatever) per year.

Oh, and that 500k nest egg to pull the 20k/year off of? I went ahead and crunched the numbers (very quickly). If you could put back $3050 per month at 7% interest (compounded once a year), you'd hit 500k in ten years. Roughly. In other words, you'd need make an extra $36k a year. Or save for a few more years. Save for 15 years, you cut that price down to $1675/$20k/year. And, let's add in 24k/year, the cost old MMM himself says is enough for a family of three. A little high for my tastes, but hey. That's a 600k nest egg on top of the 500k medicine egg. 1.1M total.

To reach 1.1M (at a very very rough estimate of 7% interest compounded once annually) in 15 years, you'd need, roughly, $3750/month or $45,000/year. Meaning, if we're using the save 75% rule, that's a rough rough salary of 60k/year. After taxes, of course. If you pushed things back to 20, then you're looking at $2225/month or $26,700/year or a total yearly salary of $35,600 (after taxes). Whew! Seriously, if anyone sees problems with the math, let me know. It was done on the fly.

Honestly, the numbers are surprisingly friendly, and I did that without realizing what I'd find. Of course, you'd need to save for all your other living costs beside, but if you put yourself on a 15-20 year time frame to retire right at the start of your career (for me, that's retirement by 45), then you've got plenty of time to scrap enough enough of a nest egg to cover both the average cost of your ailment AND standard living. Now, complications can occur. Cancer is a nastier threat for people with Crohns/Colitis and we're more likely to see the beast. However, some of that cost is already figured into those averages the sources provided (hospitalization and such) and there would be some overlap. And if you don't live healthy, that's going to increase costs too.

BUT! I might have to change my attitude towards the whole thing after doing that little round of math. FI with Crohns/Colitis is not entirely out of hand. It requires a higher price tag which means either more saving or more working depending on your salary. I hope to be earning 60k in the next year and, if I'm lucky, at least 80k at my peak. So even with the added burden, that's not impossible. The key thing is to understand your specific situation and make use of the resources available to you.

Crohn's doesn't have a particular short life span these days, but I've not heard of anyone diagnosed with it young living past 60.

Whoa there! That's a function of medicine, not the fixed mortality of the disease. Biologics have only been on the market for a hot second, and in 2014 we're only just starting to talk about the miraculous effects of fecal implantation. There's no reason to expect you won't live as long as you would without the Crohn's. There is lots of reason to expect we'll shrivel and ache faster than most, though..

True enough. After all, if I've only heard of 60 year olds passing away, clearly they were born sixty years ago, before Crohns and similar illnesses had proper treatments. And, as you mention, we're seeing the first steps in biologics (which are still in the "biplane" era of their life) and artificial GI tracts (which, if properly developed, could devestate the problem at its source, even if it doesn't cure it). As far as aches and shrivelling, that's not so much an issue as, you know, DEATH since it can be dealt with with the right habits and skills.

The main cause for concern is secondary illnesses. As I mentioned, I've got osteopenia from my Crohns, and Crohns/Colitis have higher risk of cancer, which is not only annoyingly fatal at times but damned expensive (the jerk). Best way to cut costs here is to be as healthy as you can, which can beautifully link with trimming the fat. Smokes? Grind them to dust beneath your feet! Eating out? Please! You can cook better for your gut than the man at Escape. A car? Nonsense! You've got to stay active anyway to relieve tension and stress and keep your insides feeling fresh and strong.

The better handhold you can get on your secondaries, the more butt you'll kick with both your condition itself and your wallet. This is also good because, with changing conditions, you'll be doing a lot of diagnostics and check ups. Clearing out the arteries and lungs and keeping the body moving will help alleviate other problems that you might mistake for a Crohns/Colitis flare up and, so, prevent you from having to worry/spend money without reason on something you could have avoided by exercising regularly.

Greenroller

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Re: Crohny Lifestyles
« Reply #7 on: December 02, 2014, 09:00:26 PM »
Yes, Celiac here and am going thru exactly what you described. Set to have a colon resection done in a couple weeks to have cancer removed. You are right- it can happen at anytime I am 36 years old. Best to be as financially and emotionally prepared as possible.

SporeSpawn

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Re: Crohny Lifestyles
« Reply #8 on: December 03, 2014, 07:42:50 AM »
Sorry to hear Greenroller. I hope things go smoothly enough for you.

Maybe you can answer samburger's question better than I can regarding what to be prepared for, financially. The emotional part everyone just has to deal with on their own.

MayDay

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Re: Crohny Lifestyles
« Reply #9 on: December 03, 2014, 08:57:34 AM »
Yes, Celiac here and am going thru exactly what you described. Set to have a colon resection done in a couple weeks to have cancer removed. You are right- it can happen at anytime I am 36 years old. Best to be as financially and emotionally prepared as possible.

Ask your doctor about Lynch Syndrome. Colon cancer before age 50 is rare and often caused by Lynch.

I have Lynch (presumed, as my mother has it) so I have all the fun of annual colonoscopies and every other year upper endoscopies. Plus other extra cancer screening.  So far all I've had is a few non-cancerous polyps. My sister (28) has already had precancerous polyps.

SporeSpawn

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Re: Crohny Lifestyles
« Reply #10 on: December 04, 2014, 09:00:32 AM »
Branching off what MayDay said, I've noticed something about GI diseases such as IBD and Celiac and the like during my reading, and that is that they're often quite vague and overlapping. Diagnosis of any GI ailment always seems like narrowing down the choices at best and scrying at worst. I know, for me, my symptoms have (in the two years I've been diagnosed) never matched up to the official symptoms of Crohn's. It's always been asymptomatic signs, such as the way my tract looks from colonoscopy.

This just underscores how your health is your own responsibility, both to understand and to plan for. Doctors can help you, but only you can know how you actually feel and respond to things, and you need to plan your life accordingly.

kmt88

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Re: Crohny Lifestyles
« Reply #11 on: February 16, 2015, 04:48:41 PM »
Hi all, I searched for this topic as I've recently come to terms with my own UC related risks.  I've been diagnosed for 8 years now and generally have high risk factors for colon cancer, colon removal, etc (pan-colitis, diagnosed at age 18, etc).

The costs associated with managing this disease give my FIRE plans serious pause.  How do I plan for that?  Will I need to work to maintain "good" healthcare?

Moreover, if statistically speaking there's a good chance I'll need surgery, how should I spend my next ten years?  I'm generally in remission now, and my FIRE plans involve long distance thru-hiking & extended travel through developing countries.  If my disease has a high likelihood to get worse, should I take my savings and hike/travel sooner rather than later?

I have a well paying job that I love with good health benefits now, and it would not be easy to find something as cushy if I left now. 

I know no one can answer these questions but me... I just wanted to throw them out there since y'all seem to have similar thoughts.