Optional Surgical Procedure (and saving money by doing it?)

[LeaRae]

Hi all,

I am in a position where I have about $60,000 in student loan debt, about a  $42,000/year base income, and I am paying my student loans off with over 50% of my salary and 100% of my monthly bonus which sometimes approaches 30% of my monthly salary.

I have a condition that requires me to buy several medications, the most expensive of which costs me $45 per month (about $55 total expense per month).

There is an optional surgical procedure that would prevent me from ever having to take that medication again, saving me $45 per month, for life.  The cost of the procedure is between $2,000 and $3,000.  I will use the worst-case $3000 in the estimates.  I would like to do it as soon as possible, because the medication has other negative side effects other than leaking money.  (I am not allowed to eat bananas! ... among other, more medical, side effects.)

However, the newly planted mustachian in me is having trouble reconciling that vs. paying off my student loans as quickly as possible.  I could pay them off in 2-3 years, depending largely on how big my monthly bonuses are, and get the procedure after.

Would the $3,000 cost of the surgery (worst case) make the $540 savings per year worth while?  I'd break even in under 6 years, and I would otherwise be required to stay on the medication for the rest of my life.  I would also be able to attribute the now-free $45/mo to my loans, to help make up the $3000 I rerouted to pay for the procedure.

What do you think?  Are bananas in my oatmeal and $45 unspent dollars per month worth spending $3000 now?

Thank you for you advise!

Lea

[Charlotte]

As a lover of bananas, and a person who recently spent $4000 for Lasik, I say do it!

(This advice assumes that the student loan debt is your only non-mortgage debt).

However, save up and pay cash for the surgery.

[Half-Borg]

You are getting 18% ROI, plus better health and bananas. The interest on your student loans is likely a lot lower. So you are better off, even if you put it on a credit card. I would save up for it if necessary anyway.

[Kira]

I would go for it. Depending on the condition, the medication might not work forever. I had a friend who had to have surgery because the sphincter at the top of her stomach didn't close properly. She'd been on acid reducers for years but eventually got to the point that the medication meant she was producing pretty much no stomach acid which led to other problems. So if this will negate the need for medicine it also negates the possibility of the medicine no longer working and by that point you are older and not so fit for surgery and possibly have other sequelae to this medical condition. Plus you never know what will happen in the future.. you might get to the "need to do it" point at a time in your life when you don't have health insurance, etc.

[Mega]

Is the surgical option 100% for sure going to cure you? If so, that is an 18% return, and I would do it. It is likely a huge QOL improvement as well.

What are the potential side effects of the surgury? You should weigh those as well.

[Rebecca Stapler]

I agree with others. One thing I learned from this site is that, even if you decide to "go for it" on a purchase, it doesn't mean that you will necessarily spend as much as you think. e.g., a lot of mustacians DIY their home improvements, etc. So ... you obviously can't DIY your surgery, but if there is a way to make it even more affordable, I would pursue that. The first thing that comes to mind is (1) whether your insurance covers any part of the procedure (I'm assuming you already looked into this, though) and (2) whether you can use flex spending or an FSA to cover the cost. If that's possible, I would get money in the flex spending / FSA and postpone the procedure until you can use that money.

[Spork]

It's really hard for me to have an opinion here with the data at hand.  I'm not prying for personal info here...  It's just hard to know with what's been said so far how intolerable the condition is, what the possible side effects of medication, the risks of surgery, etc.

I grew up in a very medical family...  In general (there are always side cases that don't apply) I learned that optional surgery should always be avoided.  There are a ton of people that have had awesome, life fulfilling benefits from optional surgery.   I totally understand that.   But any surgery has risks.   Even where the risk is minimal, I was taught:  "If it needs to be done... don't falter.  Do it.  If you just want it to be done... you seriously need to consider alternatives."

[Rural]

It's really hard for me to have an opinion here with the data at hand.  I'm not prying for personal info here...  It's just hard to know with what's been said so far how intolerable the condition is, what the possible side effects of medication, the risks of surgery, etc.

I grew up in a very medical family...  In general (there are always side cases that don't apply) I learned that optional surgery should always be avoided.  There are a ton of people that have had awesome, life fulfilling benefits from optional surgery.   I totally understand that.   But any surgery has risks.   Even where the risk is minimal, I was taught:  "If it needs to be done... don't falter.  Do it.  If you just want it to be done... you seriously need to consider alternatives."

+1

Staph. The odds are still pretty good, but for me, unless I'm miserable, "pretty good" isn't good enough when the downside is so very bad.

[FuckRx]

well i don't think anyone is prying into personal things here but a little more detail would help me out...if it's a nissen procedure you are doing then i would say the chances of it working are low and not that favorable of a procedure... if it's a gastric bypass/sleeve that you are doing then it really depends on what kind of risk factors you have to justify that procedure.
one other factor, with surgery comes complications, complications can cost money and time. surgeries that are elective should always be approached cautiously.

[LeaRae]

Well you asked, and I am not shy, so please be respectful.

The drug, Spironolactone, is a potassium sparing diuretic which makes me pee a lot and unable to eat bananas.  It futtses with my blood pressure, and messes with my kidneys in the long run, as well. 

It is usually taken as a diuretic for heart surgery patients for 1-2 weeks before heart surgery at a dose of 25mg-100mg/day.  I am on 200mg/day because one of its side effects - reduction in the body's testosterone production - is very beneficial for me, a transgender female. 

I have already been taking it for nearly three years, and one could even say I am used to it.  I mean, as much as one could get used to not eating bananas and peeing a lot.

On Spiro, my testosterone level is near 0, and I am already sterile.  That's why an Orchiectomy, surgical removal of the testes, makes sense.  And saves me money.  It is an outpatient procedure done under local anesthetic.  Other than the general risk of infection and bleeding from any surgery, there is little other risk to the procedure for me.

http://www.transwhat.org
http://youtu.be/NRcPXtqdKjE
http://www.upmccancercenter.com/cancer/prostate/hormoneorchtherapy.cfm

[Rural]

How much psychological benefit will you get from the surgery? I'd imagine that's a consideration in your situation.

Outpatient is less scary in the surgery risks department, too.

[totoro]

I'd be inclined to do this if you have carefully examined the risks.  It seems it is more of a financial than risk issue for you at this point.  If so, the financial return seems to justify the cost.

[LeaRae]

I am an anomaly in the transgender community, thinking that transgender care is not medically necessary (for me**) to be happy.  For most people, there would be a huge psychological/emotional gain from doing it.  I, on the other hand, am mostly excited about getting off the Spiro, and saving money.

How did Half-Borg calculate the 18% ROI?

[pattertall]

Given all of the information you presented, I'd go ahead with the surgery.  It sounds like the quality of life improvements alone may be worth it--even of it's not important to you psychologically--and you'll save money in the long run as well.

For what it's worth, I had a radical orchiectomy, though it was not optional (cancer) and removed just one testicle in my case.  The surgeon assured me that it is just about the most routine surgery possible and I was able to (slowly) walk out of the hospital under my own power just a few hours after surgery.  I think the total cost (covered by my insurance) was about 3,600 for me, but that's in DC, a very high cost of living area.

I wish you well with whatever option you pursue!

[bogart]

Based on what you say about the side effects of the different options you are considering, alone (that is, the side effects alone), I think I'd choose the surgery.  It seems like a healthier alternative in the long run, and good health = money.  Or, more accurately, poor health = less money (or no money) (and maybe no earning power).

Sounds like you are contemplating spending $3K in order to earn $45 per month (spend $45 less per month).  That works out to an 18% return, it's as if you just paid off a CC with a $3K balance at 18% and are now no longer accruing $45 in interest expenses every month.

Good luck to you whatever you decide; I hope you have a support network that can help you immediate post-op stage if you go that route.

[Rebecca Stapler]

Well you asked, and I am not shy, so please be respectful.

The drug, Spironolactone, is a potassium sparing diuretic which makes me pee a lot and unable to eat bananas.  It futtses with my blood pressure, and messes with my kidneys in the long run, as well. 

This makes it clearer to me -- it sounds like the drug has potential negative side effects in the long-term, and given the low risk of the surgery it is a much bigger no-brainer. If you are happy with the changes the medication has given you and you are ready to make them permanent, then go for it!

[Mega]

It seems weird to write this, but having your testes removed is an incredibly low risk surgury. Think about how many cats, dogs, etc have had this surgury. I imagine this is one of the most common surguries in the world, when you include all animals.

Try and find a sympathetic doctor, or one of those medical studies to see if you can save $$$.

[Spork]

With the additional details...  No judgment here, but it's so far outside of my universe that I can't honestly say what I'd do.  There have to be some pretty serious physical/hormonal/emotional aspects here and I can't intelligently say what makes sense in your situation.

I think this is sort of a big thing, so I'd think it over carefully.   I can see how having the surgery might be emotionally/physically beneficial to you... and I can also understand how it might not be.

Bottom line:  I wouldn't make this decision based on whether or not you'd be saving money.  I'd determine what was best for you and follow that path instead.  Good luck.

[Kira]

Given that additional information I would say yes, definitely go ahead with the surgery. The short term cost is nothing compared to what might happen to your kidneys over the long term. Be kind to your kidneys!! Plus I would think this is a great psychological benefit for you. You don't need 'em anyway.

[Catbert]

Yes, I'd do it.  More for the long term side effects of your current medication, however, than to save money in the long run.   I'd try to save up at least part of cost before doing it.

Good luck, whatever you decide.

[lifejoy]

If I were you I would be worried about taking the drug long-term. I don't like to take medicine as much as possible.

Good luck with everything :) And props to you for being analytical!

[Mr.Macinstache]

The Oklahoma Center for Surgery is a great option if you want to compare costs too. Their pricing is listed upfront.

http://www.surgerycenterok.com/

[Half-Borg]

How did Half-Borg calculate the 18% ROI?

Easy really:
45*12=540
540/3000=0.18
0.18=18%

So from what information you gave, it makes sense financially. For side effects ask your doctor, for emotional stuff ask yourself. I have no idea about any of it :)

[LeaRae]

I have a Dr. appointment next week as part of my routine checkup and I will talk to my doc about it then! 

That ROI calculation is easy peasy, I actually figured it out myself shortly after asking!

Thanks everyone :-)

[MrsPete]

I'm glad you explained the condition -- at first I was thinking that you were trying to justify Lasik surgery and the $45/month was for contacts.  If that were the case, I'd have said pay off the student loan, THEN have the optional surgery.

However, after hearing the details, I say schedule the surgery as soon as possible.  Reasons, which are repetitive:

- The surgery is low risk, and you have no reason to think you won't recover quickly.
- The medication may not always work as well for you as it does now.
- Things do go wrong with medications occasionally:  They become unavailable, you take them wrong, your insurance decides not to cover your meds in the future, the factory makes a mistake in dosage.  Rare, but possible.  Removing the need for medication removes the possibility that life can interfere with your medication. 
- If you do it now, you can choose a reasonably convenient time; if you wait, your body may choose the worst possible moment for you to NEED the surgery. 
- You will be excused from the inconvenience of buying the medication and taking it each day. 

I had some surgery two years ago (nothing similar to yours at all, but that's not important), and I cannot tell you how much my life has improved.  My condition crept up on me slowly, and I had genuinely failed to realize just how much it was affecting me . . . until it was gone.  I'd do it again, even if I had to repeat the process every year. 

[Rachelocity]

Don't worry about saving $, worry about saving your kidneys.  You can always earn more money, but kidneys are not a renewable resource.  My mom was on dialysis because of huge amounts of diuretics given for her heart problems, and it was, quite frankly, hellish.  The money is secondary, because you don't want to risk having to live with a chronic illness like kidney failure. 

[theSchmett]

Your health comes first!