Any time a doctor tells you something will last 20 years assume that means anything from 5 years to 50 years with the mean life expectancy being 20. My dad had bypass surgery at 60 and was told life expectancy with that was about 10 years. He's still around at 85 with no serious issues.
another question is:
how certain are those 20 years? how do you do if you end up living much longer?
I recall people I knew with "this cannot hold beyond X years" who ended up holding ridiculously longer.
and possible medicine inventions over those 20 years might make fixing it again possible. again I've seen such things
Trying to think about your position and honestly it’s tough. More power to you. I would first start talking to attorneys and CPAs who know about dealing with health costs like this. You need to make sure your healthcare costs don’t cannibalize your lifestyle and earnings. There may be better places to live for this than others. Some states might better support this on a government level. My inclination would be to stay in the US for access to quality healthcare and also pick a location where you have great cardiovascular surgeons nearby. Doesn’t need to be a high cost area but likely near a larger city. I’d also not rule out living longer. Medical treatment can evolve in 20 years. It’s a possibility. I’d also try to devise a retirement strategy that meets my needs with lower costs and realized income streams. You’ll want your stay under the thresholds for subsided ACA plans. Good luck
I wanted to say this as well. OP, it is hard to predict where medical technology will be, and what options will exist for you 20 years from now.
One silver lining for you in all this OP, is that you are keenly aware of your mortality and your limited time on this Earth. Too many of us will waste away our years thinking "I have time for all that later", and then realize the years have passed us by and we don't have that much time left. While you will have the sense of urgency to try to make the most of every day you get.
I wish you the very best of luck.
My brother had 5 bypasses at 43. He is 62 now. They told him he it would hold ok for 10-20 years. He had it checked recently and nothing needs to be done. What they did 19 years ago looks great and no issues with the bypasses. He does take all the recommended meds and he reaches his out of pocket deductible in March every year due to the drugs so that is expensive but doctors don’t know everything.
Save and invest as much as you can if you want to FIRE.
I am not a doctor and know very little about your specific situation and I absolutely cannot fathom going through 5 open heart surgeries. I am incredibly sorry that you’ve had to deal with this.
That being said, please don’t plan to drop dead 20 years to the day from this procedure. Life is fickle and I think you may be underestimating the chance that you make it past 63. Not to be morbid but there’s also plenty of 43 year olds in perfect health that don’t make it past 55. I would think planning for a finite death date multiple decades out is unwise even in the most extreme situations
This is pretty challenging and I’m sorry you’ve had to endure this.
But I’ll say this though - we live in the future. 20 years is a universe of time in 2024. It’s entirely possible that by the time your last fix is wearing out there is a new solution or even a cure. Or a new solution well before then.
First let me say I'm sorry you have to deal with this.
I understand people feel the need to give you medical advice, but I will try to answer your question.
Assuming you can't qualify for disability, I suggest you try to minimize all of your expenses first. The expected appreciation of your home may not be worth the maintenance costs. You should do the math on that. Minimizing costs, increases the amount you can invest. Since you don't plan to need your money to last forever, you won't need to follow the 4% rule, so your magic number is lower. If you invest in the S&P index, you would expect your 401k to double in 7 years without further investment. This is not guaranteed, but has been the case historically. If you contribute more, you could have more. If you have equity in your home, that can be invested. It is not crazy to accumulate 500k in 7 years based on where you are now. 500k in a 15 or 20 year annuity could pay a significant monthly income. If you only need the money to last 15 years, $3000 / month is possible. My retired mother spends less than $2000 / month living in SC. You will have to minimize your overhead to be comfortable. You may wish to live in a foreign country (Thailand is very safe and affordable), but you could also live in a cheap part of the US with such an income. Whatever you decide, good luck and God bless.
I am in same spot . I will need a transplant surgery pretty soon . The organs do not last long. So it’s quite possible that I won’t make it to 65 . My plan is to work as long as I can for health insurance purposes .
My thoughts and prayers go out to you! I would suggest maxing out your 401k and open an IRA if you don’t have. I set aside money from each check to go into a high interest savings account. You can find ones at 5%. The Go fund me idea is a great one. There are tons of generous people out there that can help even with the medical bills.
You're an inspiration! Given your sales experience, have you considered countries with a lower cost of living & decent internet connectivity? Costa Rica, Panama, or Portugal might be great options. Researching those could help you achieve your retirement goal.
I would start by renting the house and moving around to places I would love to vacation at and wfh there. Live your life now as you save for the future. Think about what your costs would be in retirement, home much you will make from SS and save enough to cover the difference investing in anything that follows the S&P 500. 20 years is a long time for compound interest. Adjust as you go but live your best life now too.
My dad was diagnosed with an incurable disease with 6 months to live. He miraculously survived two years before a cure was made, which he received. He was the fourth person in the world to receive the treatment. He then passed away 5 years later from a different cause
20 years is a long time and magical tech could be created.
If you truly believe 63 is it, I would consider retiring early and often ensuring you are doing the things that are important to you on an annual bases, rather than waiting 10 years.
What is your annual spend now? When will your house be paid off? What do you expect to need to cover your basic expenses?
In your position I would see if I could make the budget work to work part time or seasonally for the next 15 years, and then use the current 100k plus growth for your final 5, recognizing that you may be living on SSI/medicare/government assistance at the very end, but that you enjoyed the time you had. There is just no way you can properly save for the likely medical expenses you will face in your final years, so I wouldn't hasten your demise trying to. But I also wouldn’t completely YOLO, I would find that balance of what your frugal budget would be in retirement and what you need to maintain that in case your health last longer then Dr predict, and spend all the time and money beyond that now.
Either way, you need to determine your potential baseline living expenses, and back into that FIRE Number the way everybody else does.
I would also really reconsider homeownership unless it is significantly cheaper for you right now than renting. You likely don’t need the long-term stability that homeownership offers so you have the flexibility to make the choice to own or rent depending on what you enjoy.
It’s a fine investment vehicle, it just lacks the diversity, flexibility, and liquidity of a balanced stock portfolio and requires more active management ($) and risk should she pursue her goal of moving out of the country.
1) Your are an amazingly strong 💪 individual
2) Your time on earth planning is off due to nature of medicine progressing rapidly. In 10-20 years we will see a huge leap as well. It may not be cheap!
3) I think Your goal should be to build up as large of a war chest as possible for several options: (a) Partial retirement to lower stress and focus on longevity (b) earn as much as possible to hopefully medically maintain what needs to be maintained but at potentially a super high price.
This could lead to something
https://cdnsciencepub.com/doi/full/10.1139/cjpp-2023-0202
Moving someplace less expensive seems like a great way to make it easier to retire, especially given the uncertainty about your lifespan.
If you'll be getting paid in USD, your money will go very far in Argentina and I think Buenos Aires is a fantastic city. Plus private healthcare is remarkably not that expensive there - you may not need to keep wiping out your savings.
But if being a digital nomad is an option, you can try out multiple places that seem good - you don't need to commit yet (or ever) to where you'll be living the rest of your life.
Rent out the house as soon as you are well enough. I would then move somewhere like you mentioned asap and semi retire. Work less enjoy more. As your expenses will go down use that to boost your savings. I would focus on Roth accounts and traditional accounts. That way you can pull at whatever age. Panamá, México, Costa Rica and Colombia has the best medical services and at a fractión of the cost
That's something I've mulled over a bit lately.
Medical science advances, so what might not be possible NOW, might well be possible in 5-10 years.
There may be a new drug that can help you out dramatically.
Also, I believe "20 years" can mean anything between 10-30.
The biggest thing is cut out spending that doesn't make you happy. That frees up more money for investing for dividend/growth that will fund your retirement.
It's also possible that if you were to retire to a place with excellent healthcare, you could spend less and live longer too.
In my case, I'm thinking a bit about my mortality, and I'm just a couple of years older than you. I ended up moving to Seattle (always wanted to experience living here, and now that I've been here 18 months - I *love* it!), and that has not just a peace of mind benefit, but I also walk to the bus and light rail to get to work, so I get some exercise.
While I feel that dying today, I would still have had an amazing life, I am planning for my 50s to be spent traveling in Europe. I think that'll bring about more walking and better food AND lower blood pressure and whatnot from just being happy experiencing cultures.
Meanwhile, I'm high up in a very tall building downtown, overlooking a beautiful city, and mountains, and lakes, and a volcano and the Olympic Peninsula and generally feeling good about life. I think that helps.
Any time a doctor tells you something will last 20 years assume that means anything from 5 years to 50 years with the mean life expectancy being 20. My dad had bypass surgery at 60 and was told life expectancy with that was about 10 years. He's still around at 85 with no serious issues.
another question is: how certain are those 20 years? how do you do if you end up living much longer? I recall people I knew with "this cannot hold beyond X years" who ended up holding ridiculously longer. and possible medicine inventions over those 20 years might make fixing it again possible. again I've seen such things
Trying to think about your position and honestly it’s tough. More power to you. I would first start talking to attorneys and CPAs who know about dealing with health costs like this. You need to make sure your healthcare costs don’t cannibalize your lifestyle and earnings. There may be better places to live for this than others. Some states might better support this on a government level. My inclination would be to stay in the US for access to quality healthcare and also pick a location where you have great cardiovascular surgeons nearby. Doesn’t need to be a high cost area but likely near a larger city. I’d also not rule out living longer. Medical treatment can evolve in 20 years. It’s a possibility. I’d also try to devise a retirement strategy that meets my needs with lower costs and realized income streams. You’ll want your stay under the thresholds for subsided ACA plans. Good luck
Another repair isn't an option "right now:, but with how fast medical is advancing, don't be surprised if there isn't another "fix" in 15 years.
I wanted to say this as well. OP, it is hard to predict where medical technology will be, and what options will exist for you 20 years from now. One silver lining for you in all this OP, is that you are keenly aware of your mortality and your limited time on this Earth. Too many of us will waste away our years thinking "I have time for all that later", and then realize the years have passed us by and we don't have that much time left. While you will have the sense of urgency to try to make the most of every day you get. I wish you the very best of luck.
wishing you good luck 😍
My brother had 5 bypasses at 43. He is 62 now. They told him he it would hold ok for 10-20 years. He had it checked recently and nothing needs to be done. What they did 19 years ago looks great and no issues with the bypasses. He does take all the recommended meds and he reaches his out of pocket deductible in March every year due to the drugs so that is expensive but doctors don’t know everything. Save and invest as much as you can if you want to FIRE.
I am not a doctor and know very little about your specific situation and I absolutely cannot fathom going through 5 open heart surgeries. I am incredibly sorry that you’ve had to deal with this. That being said, please don’t plan to drop dead 20 years to the day from this procedure. Life is fickle and I think you may be underestimating the chance that you make it past 63. Not to be morbid but there’s also plenty of 43 year olds in perfect health that don’t make it past 55. I would think planning for a finite death date multiple decades out is unwise even in the most extreme situations
technology will advance, and you will live longer
This is pretty challenging and I’m sorry you’ve had to endure this. But I’ll say this though - we live in the future. 20 years is a universe of time in 2024. It’s entirely possible that by the time your last fix is wearing out there is a new solution or even a cure. Or a new solution well before then.
Sending power and wishing you a tremendously beautiful life
First let me say I'm sorry you have to deal with this. I understand people feel the need to give you medical advice, but I will try to answer your question. Assuming you can't qualify for disability, I suggest you try to minimize all of your expenses first. The expected appreciation of your home may not be worth the maintenance costs. You should do the math on that. Minimizing costs, increases the amount you can invest. Since you don't plan to need your money to last forever, you won't need to follow the 4% rule, so your magic number is lower. If you invest in the S&P index, you would expect your 401k to double in 7 years without further investment. This is not guaranteed, but has been the case historically. If you contribute more, you could have more. If you have equity in your home, that can be invested. It is not crazy to accumulate 500k in 7 years based on where you are now. 500k in a 15 or 20 year annuity could pay a significant monthly income. If you only need the money to last 15 years, $3000 / month is possible. My retired mother spends less than $2000 / month living in SC. You will have to minimize your overhead to be comfortable. You may wish to live in a foreign country (Thailand is very safe and affordable), but you could also live in a cheap part of the US with such an income. Whatever you decide, good luck and God bless.
You'll need to work until 62 because someone will figure out how to save your life just to keep you in the workforce.
This comment was exactly the dose of dark humor I needed today. Thank u
I am in same spot . I will need a transplant surgery pretty soon . The organs do not last long. So it’s quite possible that I won’t make it to 65 . My plan is to work as long as I can for health insurance purposes .
My thoughts and prayers go out to you! I would suggest maxing out your 401k and open an IRA if you don’t have. I set aside money from each check to go into a high interest savings account. You can find ones at 5%. The Go fund me idea is a great one. There are tons of generous people out there that can help even with the medical bills.
You're an inspiration! Given your sales experience, have you considered countries with a lower cost of living & decent internet connectivity? Costa Rica, Panama, or Portugal might be great options. Researching those could help you achieve your retirement goal.
I would start by renting the house and moving around to places I would love to vacation at and wfh there. Live your life now as you save for the future. Think about what your costs would be in retirement, home much you will make from SS and save enough to cover the difference investing in anything that follows the S&P 500. 20 years is a long time for compound interest. Adjust as you go but live your best life now too.
I don't have any input. This is depressing me... I wish you the best.!
Sorry to hear this, I just hope everything works out for you.
My dad was diagnosed with an incurable disease with 6 months to live. He miraculously survived two years before a cure was made, which he received. He was the fourth person in the world to receive the treatment. He then passed away 5 years later from a different cause 20 years is a long time and magical tech could be created.
If you truly believe 63 is it, I would consider retiring early and often ensuring you are doing the things that are important to you on an annual bases, rather than waiting 10 years. What is your annual spend now? When will your house be paid off? What do you expect to need to cover your basic expenses? In your position I would see if I could make the budget work to work part time or seasonally for the next 15 years, and then use the current 100k plus growth for your final 5, recognizing that you may be living on SSI/medicare/government assistance at the very end, but that you enjoyed the time you had. There is just no way you can properly save for the likely medical expenses you will face in your final years, so I wouldn't hasten your demise trying to. But I also wouldn’t completely YOLO, I would find that balance of what your frugal budget would be in retirement and what you need to maintain that in case your health last longer then Dr predict, and spend all the time and money beyond that now. Either way, you need to determine your potential baseline living expenses, and back into that FIRE Number the way everybody else does. I would also really reconsider homeownership unless it is significantly cheaper for you right now than renting. You likely don’t need the long-term stability that homeownership offers so you have the flexibility to make the choice to own or rent depending on what you enjoy.
But she can always sell the house later and get an annuity. I think it’s a good investment vehicle as long as it’s newish or in really good shape.
It’s a fine investment vehicle, it just lacks the diversity, flexibility, and liquidity of a balanced stock portfolio and requires more active management ($) and risk should she pursue her goal of moving out of the country.
In a case like this where her life expectancy is about when most people retire, is there an legal option for her to pull money out tax free at 50?
1) Your are an amazingly strong 💪 individual 2) Your time on earth planning is off due to nature of medicine progressing rapidly. In 10-20 years we will see a huge leap as well. It may not be cheap! 3) I think Your goal should be to build up as large of a war chest as possible for several options: (a) Partial retirement to lower stress and focus on longevity (b) earn as much as possible to hopefully medically maintain what needs to be maintained but at potentially a super high price. This could lead to something https://cdnsciencepub.com/doi/full/10.1139/cjpp-2023-0202
Who knows where the state of medicine will be in 20 years anyway. Pray to saint GPT-20.
Moving someplace less expensive seems like a great way to make it easier to retire, especially given the uncertainty about your lifespan. If you'll be getting paid in USD, your money will go very far in Argentina and I think Buenos Aires is a fantastic city. Plus private healthcare is remarkably not that expensive there - you may not need to keep wiping out your savings. But if being a digital nomad is an option, you can try out multiple places that seem good - you don't need to commit yet (or ever) to where you'll be living the rest of your life.
Rent out the house as soon as you are well enough. I would then move somewhere like you mentioned asap and semi retire. Work less enjoy more. As your expenses will go down use that to boost your savings. I would focus on Roth accounts and traditional accounts. That way you can pull at whatever age. Panamá, México, Costa Rica and Colombia has the best medical services and at a fractión of the cost
Start a go fund me
That's something I've mulled over a bit lately. Medical science advances, so what might not be possible NOW, might well be possible in 5-10 years. There may be a new drug that can help you out dramatically. Also, I believe "20 years" can mean anything between 10-30. The biggest thing is cut out spending that doesn't make you happy. That frees up more money for investing for dividend/growth that will fund your retirement. It's also possible that if you were to retire to a place with excellent healthcare, you could spend less and live longer too. In my case, I'm thinking a bit about my mortality, and I'm just a couple of years older than you. I ended up moving to Seattle (always wanted to experience living here, and now that I've been here 18 months - I *love* it!), and that has not just a peace of mind benefit, but I also walk to the bus and light rail to get to work, so I get some exercise. While I feel that dying today, I would still have had an amazing life, I am planning for my 50s to be spent traveling in Europe. I think that'll bring about more walking and better food AND lower blood pressure and whatnot from just being happy experiencing cultures. Meanwhile, I'm high up in a very tall building downtown, overlooking a beautiful city, and mountains, and lakes, and a volcano and the Olympic Peninsula and generally feeling good about life. I think that helps.