How chronic disease drove an Ohio 27-year-old to bankruptcy

An array 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’d never pay off was just collateral damage.

“I had been hounded by creditors, all of that, my credit score was obnoxiously low, and it got to the point where I was able to collect 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 disease for decades. Most occur in his gut.

At 8 years old, he was diagnosed with irritable bowel syndrome, a chronic disorder in the large intestine that causes cramping, abdominal pain, diarrhea and constipation. In 2012, he picked up a potentially lethal bacterial infection that inflames the colon and typically 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 Chapman had ulcerative colitis, a serious inflammatory condition that can cause bleeding, internal ulcers in the colon. Four years later, doctors would remove his colon. But in the meantime, other doctors detected a rare condition in his brain called Moyamoya, which causes blood vessels that deliver blood and oxygen to narrow and close off. It caused Chapman a stroke in 2015, and a surgical bypass procedure in 2019.

I lost my entire early 20s being sick. I was not truly ‘healthy’ until I was 27 or 28.
– Kolton Chapman

By November 2020, his health had “relatively” stabilized. He manages the diseases, and a new job offers robust insurance. Thing are looking up since he borrowed $2,000 from his grandfather to initiate Chapter 7 bankruptcy proceedings in federal court.

Rationing pills

When doctors first diagnosed the ulcerative colitis, they initially figured 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 over 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. After a job change, however, his new insurer required he pay $800 out of pocket for each treatment. Soon the drug seemed to lose its potency in keeping his pain down, 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 made up 15% of Takeda’s $32 billion in total revenue last year, its CEO told Bloomberg.

Treating Moyamoya wasn’t any cheaper. Hitting his $5,000 deductible by the end of January each year became 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 a large chunk of it (he was on a high-deductible health plan).

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

His current insurer only pays for eight pills per 30 days. Sometimes he blows through the whole bottle in a week and is on his own 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 out and still end up with one or two going into next month. With the price of it, and the way my insurance company treats it like gold, I have to ration it out.”

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

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

His ulcerative colitis was perhaps at its worse when he took classes part time at Columbus State. He was in pain and failing his classes. Enough was enough.

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

Getting his colon removed in 2018 stabilized his health and put the ulcerative colitis on the back burner. Chapman said he still has some problems 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 centurial pandemic, unrelated chronic health conditions led Chapman to join the estimated 530,000 Americans who turn to bankruptcy because of health problems.

Life with gut problems

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

“There’s probably a solid 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 like protein shakes and even that was hard to do. So really living with it on a daily basis is being hungry but knowing you can’t eat.”

Most of those meals were just plain rice and chicken. For a stretch, he was only eating junior bacon cheeseburgers from Wendy’s — the only thing he said his stomach could tolerate.

Beyond health and finance, the bowel problems in particular built social barriers. People don’t like to talk about their poop. Friends would invite Chapman to restaurants, and he’d quietly decline. 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 avoid essentially the shame of having to talk about it.”

As Chapman’s health has stabilized, so too have his finances. He and his wife aren’t living paycheck to paycheck anymore. They’re looking for a bigger apartment now — the bankruptcy wipes out any chance of him getting a decent loan to buy a home until it falls off his credit report in 2027.

Now, he’s waiting on approval for a brain scan to check in for signs of Moyamoya on the healthy side of his brain. His insurer, Chapman said, is being a “pain” about approving it. He needs another scan done that he’s been putting off to check in on a prior colon surgery.

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

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

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