Episode 77: That Crohn’s Life with Annelise Bretthauer

Episode 77: That Crohn’s Life with Annelise Bretthauer


Annelise Bretthauer is a certified financial planner (CFP) professional living in Oregon. Diagnosed with dyslexia as a teen, she’s always turned to hard work to overcome adversity. But that hard work only paid off so much…until she got sick. In 2017, Annelise was diagnosed with Crohn’s disease. Faced with career overhaul and a choice between her passion and her health, she redesigned her life around her diagnosis to better serve both her body and her growing client list. In her own words, “I’ll be the first to tell you, I have not overcome the challenges of the disease but I continue to learn how to protect my body and pursue my passion at the same time.” With the launch of Rise Up Financial, she’s on a mission to integrate health and wellness into her clients’ finances, and believes that wellness should be a part of the planning process whether you are facing chronic disease…or not. The unforeseen twists and turns life has handed her have given her an understanding of how to ride life’s rollercoaster securely and confidently, and have taught her to manage finances to nourish her life. Her advocacy work has been growing steadily, and as she continues to spread her wings…we welcome her to Uninvisible Pod!




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Lauren: Okay, guys, thank you so much for joining us. I am here with Annelise Bretthauer, who is a certified financial planner professional and the founder of Rise Up Financial. She's got a personal connection to the invisible illness community, and is working specifically to help us with our finances. So Annelise, thank you so much for joining us.

Annelise: Lauren, thank you so much for having me. This is so fun.

Lauren: It’s such a pleasure. We've had a couple of chats before this. It's just been great to be in touch with you. And I'm excited for everyone on the show, who's listening, to to hear more about your story. So, let's start from the top. Can you tell us when and how you first realized that you were sick, and what you did to take control of your symptoms?

Annelise: I have kind of an unusual story. I have Crohn's disease, and it was back in 2017… late 2016, early 2017. My grandmother had passed away. At the same time, I was studying really hard for the Certified Financial Planner exam. And my first symptom was blood in my stool. And that was all I had for probably a month, and I felt totally fine, just noticing blood in my stool. And I remember sitting in the parking lot of Target and calling the advice nurse, because it kept happening. And her telling me immediately to go to the emergency room. And I was, like, “But I feel fine!” And to be honest, that was kind of the end of the conversation.

She told me to go to the emergency room and instead, I went into Target and bought whatever I needed.

Lauren: Spent too much money.

Annelise: Exactly.

Lauren: I also wonder if, as women, we're used to bleeding from one of those areas. And then if you have a little blood in your stool, do you think, oh, maybe it's just a little bit of period that isn’t active — and you don't think it's a big deal if you're not having any pain?

Annelise: I have never thought of it like that. And I think you're totally right. Because I wasn't having pain, I wasn't having any any other symptoms. I just kind of brushed it off. But in the weeks following, I started getting more symptoms, and started having more blood and mucus in my stool, and urgency, and all of those things that are kind of classic IBD symptoms. By late March, early April … I had gotten a GI appointment … I'd gotten in for the initial appointment, and they were, like, “Okay, we need to get you in for colonoscopy. It's going to be six weeks from now.” And I got to the point where I was going to the bathroom at least every hour in so much pain that I was calling them, crying. I had five calls to them, crying. So eventually they got me in for an emergency colonoscopy.

Lauren: How old were you at this point?

Annelise: I was 25.

Lauren: So you were an adult patient. But that's kind of late to be diagnosed, from my understanding of the different stories I've heard thus far. Most people are diagnosed when they’re children, aren’t they.

Annelise: Yep. And most people have a more drawn-out, less immediately dramatic story, where they really suffer through the diagnosis process, or the doctors can't quite figure it out.

I guess I should consider myself lucky that I was a part of that group where I had very classic symptoms and was diagnosed very quickly.

But from the mental aspect, I was so convinced that it came on so fast, it was going to go away just as fast as it came on.

Lauren: Sure, because we think of illness in cycles, like a flu or a cold.

Annelise: Yep, exactly. And that's really all I had experienced. I was on antibiotics for a long time when I was baby. But besides that, I was going to the doctor for a sinus infection, or that sort of thing. So it was hard to kind of wrap my mind around the diagnosis. And when I went in, after my colonoscopy for my doctor's appointment, the doctor asked me to bring my parents. I was 25, an adult, living on my own …

Lauren: That’s kind of a doctor-patient confidentiality issue there.

Annelise: I hadn't thought about that! But yeah, it is.

Lauren: Typically, that's no one's business but your own.

Annelise: Yeah. That didn't even occur to me at the time. I just thought, okay, sure, I'll bring my parents.

Lauren: Are you close with your parents?

Annelise: Yeah.

Lauren: So that was an okay thing to share.

Annelise: Yeah. But the doctor didn't know that.

Lauren: That’s very weird. Makes you wonder, would he have said that to a 25-year-old man? He said it to a 25-year-old woman. I wonder whether he would have had a 25-year-old man bring his parents in. Somehow, I doubt it.

Annelise: Yeah, probably not. So, I brought my parents in. They kind of sat me down and said, "You're going to be sick forever. And we need to put you on an immunosuppressant.”

And I was, like, “Whoa, hold on. A couple of months ago, I was normal, healthy.” Quote unquote ‘normal’.

And so the only thing I would say yes to is mesalamine. So I was on mesalamine enemas, mesalamine suppository, oral mesalamine, a bunch of supplements. I was so sick from just taking a million pills a day that really didn't do anything.

Lauren: Yeah. You weren't convinced of the treatments until the treatment you chose didn't work.

Annelise: Yeah. And I'm a financial planner, so I'm somebody who goes and likes to do research and gets into the nitty gritty. She wanted me to go on Remicade or Stelara. So I did research and thought, oh, this is not something I want to to do. Anyway, it took a bit of time of going through that and things getting even worse, to the point where I couldn't even put pants on. I was in so much pain. And how I coped at work was just to put myself in fight-of-flight, to take my mind off the pain and the suffering. And it worked really well until I was so extremely exhausted that one day I just realized my life was going in a direction … that none of my priorities were straight.

Lauren: Yeah. And not completely in your control if you're on someone else's clock as well, when you're dealing with a chronic illness.

Annelise: And I realized it was me, it was my mindset. There was a problem here. I think part of that came from … I also have dyslexia. And the way I had coped with that through school, and successfully, was to just work harder and longer than everybody else.

Lauren: So you thought you could solve this problem the same way.

Annelise: Exactly. I was so convinced because I had seen it work for the first 25 years of my life, that this was the way to solve all. I was very wrong.

Lauren: Well, it's a humbling lesson to learn, but it's an important one, isn't it — that sometimes our bodies teach us lessons that we're struggling to learn. But ultimately, it's important to understand that we need to re-prioritize what's going on in our lives.

Annelise: Yeah, it gave me a clearer lens of what I really wanted my priorities to be in life. And it was hard, because I loved my job. It was my dream job, for an investment firm here in Portland, Oregon. And I had spent years working towards getting there.

And everything was so great about it, except that my brain was loving it but my body was deteriorating in a way I had never experienced before.

So I did the only thing I knew how to do, which is go get a therapist.

Lauren: Smart.

Annelise: And it was the best decision I've made in my illness journey. I got really lucky because I think sometimes it can be hard to find the right fit for a therapist.

Lauren: Absolutely. Especially if you're dealing with chronic illness. You want to be working with someone who understands what that's like.

Annelise: Yeah. And she has been amazing. I was working with her for about a year until I realized … I have to leave this job to put the energy that I need to into my body, to start to heal enough so that my life is sustainable.

Lauren: So this all pivoted into you founding Rise Up Financial. And I'm wondering, first of all at this point, now that you have your own business, how you're balancing the demands of work and life as you manage symptoms, and the various medications that you have to take. How does that work for you? And how do you recommend other Spoonies do the same?

Annelise: Yeah. So really quick, I eventually realized that I did need Remicade. It didn't put me in remission, but it got me to a place where I could function — which I'm grateful for at this point. But I love this question. And I want to be really honest and say that I have not figured out the balance yet.

Lauren: You’re not the first person who’s said that!

Annelise: There’s part of me that thinks that this is a constant, evolving challenge for somebody with illness.

Because we change as people, our illness changes over time. Our family life changes.

So, in my opinion, it's more about finding your individual formula. And things like, enough sleep. I mean simple things like enough sleep and nutrition, which I completely ignored. I was commuting almost an hour each way and getting to work by 6.30 in the morning, when the market opens here on the west coast. So that put me, you know, getting up really, really early.

Lauren: Yeah, that sounds pretty painful to me!

Annelise: It's fun to watch the sun come up every morning, but …

Lauren: But if you're not a morning person, you're also fighting your body's instincts. That can't help but aggravate symptoms of various chronic illnesses, depending on what you've got going on, for sure.

Annelise: Yeah, I think, in general, for everyone, not enough sleep is inflammation-inducing. There's parts of a formula that I think are universal, but then other parts that are very individual.

Lauren: So you've made it work now around a schedule that is more comfortable for you though?

Annelise: Yeah, exactly. So when I'm scheduling, even scheduling this interview, it's thinking … Okay, did I get up early yesterday? How much had I done yesterday? What do I need to do today to be able to bring my full self here?

Lauren: So it seems like, from what you and I have discussed, that a lot of this journey for you — while it was perhaps a bit shorter than the typical journey to diagnosis and symptom management — it inspired you to change the way you were living your life. And you've decided to start offering services specifically for people who are dealing with rising medical costs. So why is financial planning so important for Spoonies?

Annelise: Great question. Financial planning is important for everyone, but especially for our community because we're dealing with a lot more from a financial perspective than a “healthy” person. Not only with ongoing expenses … classically you think about doctors’ appointments, procedures, medications … but there's so much more to lifestyle changes with chronic disease — from spending money on organic food and supplements … and an expensive new pillow. I bought a $70 pillow to help me sleep better. Just things like that, that really add up.

Lauren: And realizing that so much of the way that we understand our sleep and our lifestyle is also not necessarily designed around our best health.

Annelise: Yeah, and financial strain is stressful.

And we all know that stress is a big indicator in all of these chronic diseases.

Lauren: A massive indicator. Or you're just a person who lives with chronic stress and you're always in fight-or-flight. And that's not good for you, either.

Annelise: It's no way to live. I lived that life. And yes, on the outside, I had a great job and everything was fantastic. But on the inside, I was falling apart, in pieces. I think money is a really important piece to de-stressing, to planning, to feeling stable, to having the energy we need to put towards our health.

Lauren: So how have you designed what you're offering? In terms of courses, and one-on-one coaching for people in the chronic illness community?

Annelise: Yeah. I love that. So, my business is twofold. One, I want to create a sustainable business for Rise Up Financial, but the other side of it is having impact. And thanks to you, Lauren, I've kind of gone down the patient advocacy route.

Lauren: Yay!

Annelise: I’m just entering that world, and it's very fulfilling. There's a lot of people who can't afford one-on-one financial planning. So I'm building that impact side of my business to be able to support people who either aren't ready to work one-on-one or can't afford it.

Lauren: And we're talking about a community here that has bigger financial concerns in that our health insurance premiums and our bills are going to be higher than the average bear’s, right?

Annelise: Absolutely. There's no doubt about it. And if you decide to change jobs, looking at the health coverage of your potential employers, is probably top of our list. I would argue that should be, along with being able to accommodate our needs, and that sort of thing.

Lauren: Absolutely. It's interesting because certainly there's an overlap there with sort of like healthcare concierge work, right. And being able to really understand what you're paying for, what benefits you're then eligible for, and what you need to push for if you need more.

Annelise: Yeah. And for people that I work one-on-one with, I do that with them. We sit down with your summary benefits and we understand it together.

And maybe we even call your health insurance company together, to get clarification.

Sometimes, just having that person there with you to ask some of the questions and take notes, and then de-brief, is really helpful.

Lauren: So, we know that you're going to be offering these courses, and and by the time this episode goes to air, hopefully the first one will be out. And we'll certainly link to that on the episode page. But I'm wondering whether you've got a Top Three Tips list for financial planning for Spoonies. What would you recommend for those of us who have these additional concerns financially … what would your top three This-Is-How-You-Get-It-Together list look like?

Annelise: Love this! Okay. So, I want to preface all of these tips by saying it's really important to leave the past in the past, especially when it comes to money. So, whatever you decide to do going forward, if you've made money decisions in the past that you don't feel that great about, it's okay. Leave them there. You're here now, and you have so much ahead of you. So, I really like to teach clients to open an account only for their health expenses.

Lauren: That’s smart.

Annelise: I teach the “bucket approach” for budgeting in general. So you can have accounts for any of your financial goals, but especially for Spoonies, having a health expense account and having the habit of putting money into it each time you get paid, is what’s really important. So it doesn’t matter if it’s $5 or $5,000, it’s creating that habit of building that cushion for your health. And then saving. It’s the same process repeated for any other goal you have. So that's number one. There's a cool account called a Health Savings Account, which is great for people who don't have a lot of health expenses, because in order to be eligible for a Health Savings Account, you have to have a high-deductible plan. So there's a lot coming out of your pocket to be eligible. But if your spouse has access to something like that, and they don’t have the same kind of expenses you do, that can be a good option. It's triple tax free, the money goes in pre-tax, and it can grow if you invest it, tax free. And it comes out tax free, so long as you use it for health care purposes. I'm going to add a pro tip here, because sometimes banks will charge fees for multiple accounts. So if you're running into that with the bank you use now, I use Charles Schwab Bank and have no problem; they don't charge any fees. You can have three debit cards if you want.

Lauren: And there are a lot of like online banks opening now where you can just open up little savings accounts. Capital One, I think, has one and there are no-fee accounts, no minimum, all that kind of thing, which is really great.

Annelise: Yes. So if you're running into that at your bank branch that you're using right now, there are other options. So, pro tip there.

And then tip number two: make sure you have a will and healthcare directives.

Especially for us young Spoonies. You don't think about having a will. But we all need one.

Lauren: I actually only just wrote my will last year, this time last year. So it's interesting you bring that up. And I'm in my 30s. So yeah, it's important to do. In a way, I can understand the resistance, because it’s directly facing the idea of mortality. Just because you have a chronic illness doesn't mean you're going to die faster, but it’s important to face these things in our lives anyway, and get okay with where we're at and understand our priorities in life in general, isn't it.

Annelise: Yes. And that tip is not just for our Spoonie community. It's for everyone. If you have a bank account, if you own a car, if you own anything, you should have a will. Keep that one in mind. And then third … it can be really hard … this one is Spoonie community-specific … to be approved for life insurance or long-term disability when you have a chronic illness. So if your employer offers group life and group long-term disability, take advantage of it. You don't have to go in the underwriting process because you're looped in with everybody else. And you never know when you're going to need long-term disability.

Lauren: I think these are really wonderful tips. Can you tie them in with any other general tips for Spoonies that you have learned from your journey as well? Do you have any tips for living with chronic illness that you would want to share with everyone, too — aside from the financial side of things?

Annelise: Give yourself grace.

I have to remind myself of this every single day, because I'm one of those people who's always looking for more.

Actually, I'm looking right now … I'm sitting at my desk, and I have eight affirmations that I read to myself.

Lauren: That’s lovely!

Annelise:  And number two is: “I'm at ease with life.” Mindset is so important. And there's no such thing as perfection in this world. But ‘acceptance of wherever you are today’ has been helpful for me.

Lauren: It sounds like you've got to that place. It was a journey, for sure. But you definitely got there with the help of your therapist, and looking at the way you were living your life and how it was affecting your body. And then your mindset. It’s a multi-step process, but it's an important one to go through, isn't it.

Annelise: Absolutely. If we were sitting here four years ago, I probably would be telling you that there are ways to perfection, and that life should be hard. I just have such a different lens on what it means to be well now.

Lauren: And that being well becomes a wealth in and of itself, doesn't it. We don't realize, until we lose our health, how important it is and how our entire lives are centered around it.

Annelise: Yeah, I am a big believer that money is to be used for living your life more intentionally. Money is just a piece of paper or a number on a computer screen. It's what you do with it that can nourish your life. And that's the reason it's important. Not because it’s a decimal point.

Lauren: Absolutely. And I love that you named your company Rise Up Financial because it's so symbolic of not only the journey financially, but the journey mentally, the journey in our hearts. The journey through chronic illness is so much about that. I'm sure you also have clients who are not necessarily Spoonies, too, but you know that you're able to give people the perspective of being able to be prepared for you-never-know. And having that HSA or having that savings account that will be your cushion and give you that peace of mind as necessary.

Annelise: I think the perspective is really helpful when leading discussions with clients, whether they're in our Spoonie community or not, about what they want from their life. And how do we use money to help you get there.

So when I talk to clients about changing their budgeting habits and their financial habits, I like to start with something that's very approachable.

And the best place to start is just to get in the habit of opening up your banking app every day. All you have to do is click that button.

I even have moved my banking app right next to my messaging app. At the bottom of your phone so that you see it. And once you get comfortable just opening the app, you will start to naturally become more curious. And that will lead to clicking on your credit card or clicking on your checking account.

Lauren: It just makes you more aware.

Annelise: Yeah, but don't even go there at first. Just start by opening the app and kind of release some of that fear. Because most people only open the app when they have to go pay their credit card once a month. And there's so much anxiety that comes with that. We can reduce some of that just by getting into these kind of step habits.

Lauren: I feel like a lot of people who would come to you, especially Spoonies, would be people who are already dealing with debt. Do you have tips for also getting people from … say they've put all their hospital bills on a credit card, and now they've got to pay the bill and they don't have that in the bank account. What do you recommend for people who are in that kind of situation where they need to get out of the hole?

Annelise: We create a spending plan. There's definitely some discomfort that comes with it, because we sit down and we look at what your spending has looked like for maybe the past six months, maybe even up to a year depending, and start to categorize things. What’s going where. And then looking at your spending and applying that to what your priorities are. So where can we change some of these things? It's a lot easier when you have somebody, a financial planner, doing it with you … to sit down and say, “Okay, your nails look amazing. But your credit card is feeling a little bit tight because of these health bills. So what can we do to change some of those things?”

Lauren: To focus more on necessity. But what if that's the thing that gives you joy? I suppose you find somewhere else to cut around the corners.

Annelise: Absolutely.

It is all about what is going to provide the most fulfillment for you.

So if that monthly manicure is that thing, but you're happy to make coffee at home versus going to Starbucks and you have to spend a little time thinking of it, we’re going to create a system so that every night after dinner, you're going to get that coffee pot ready, it's going to automatically be ready for you at 7.30 when you're headed out the door. So it’s very personalized, looking at some of those things.

Lauren: It’s very individual, and everyone's going to be different in what matters to them the most, and what gives them joy and where they are financially, too.

Annelise: Exactly. And my job is not to to tell you what gives you joy. My job is to help you use your money, to create more joy and less stress.

Lauren: I love that. Because I think people think about money and they just get stressed. There's not a lot of joy unless you have extra. And it's just nice to be able to change that perspective and and allow that necessary part of our lives to become something joyful, too.

Annelise: Exactly.

And to be totally honest with you, even people who have really high incomes suffer from the same issue.

They don't know where their money is going, and so taking the time to kind of parse it out is important. Whether you are living paycheck to paycheck, or you're making a high, six-figure income. We're all kind of climbing the same mountain.

Lauren: I think that's really lovely. Very well put.

Annelise: Thank you. Our website is RiseUpFP.com. FP is for financial planning. And you can follow me on Instagram @AnneliseBretthauer. It's a long name. I'm not going to try to spell it for you.

Lauren: Don’t worry, we'll link it on the episode page!

Annelise: Perfect. And I’m Annelise Bretthauer on Facebook, as well. You can find me at any of those places. Thank you so much, Lauren. This has been so fun.

Lauren: We're having this short little interview, but I want to keep talking! This is always like one of those things … you get into a really meaningful discussion, and you're like, wait, that's it? There's so much more I want to know, and I'm sure our listeners are wanting to know more. So I'm sure that they can get in touch with you, and always learn more that way.

Annelise: Yeah, absolutely. And if they have a specific financial topic that they want to know about, let Lauren or myself know, so that we can either do this again, or I can create a special course for it. We want to provide you value. So if there's something specific … I know taxes are coming around, I’ve heard that a few times!

Lauren: You heard it from me this morning!

Annelise: And I heard it from someone yesterday, and I'm thinking about it. So whatever it is, we want to just keep giving you more knowledge so that you can make the best choice for you.

Lauren: Absolutely. The idea here being that yes, this is a service that's available to you. But also, this is someone who gets it. And understands what the priorities need to be, and also understands the point of view. I think that's a really big thing here … knowing that there's someone who's been in your shoes. I know exactly what it's like to feel like you're scrambling just to pay a hospital bill. Just having that peace of mind that you're working with someone who gets it, I think is huge. And I think everyone's gonna get a lot out of this. I'm excited for everyone to check you out.

Annelise: Good. Me, too. I'm always looking for other ways to have impact with our community. Lauren, what you've done is so great. You’re so great at telling all the the gory details of the stories and getting your guests to do the same. You're driving in the car listening to UnInvisiblePod, thinking, Oh, me too!

Lauren: (laughs). It’s the other MeToo!

Annelise: Oh, God, yes!

Lauren: The reason I started the podcast was that I needed to know that I wasn't alone. And while there are plenty of support groups out there, you need to hear a story sometimes. Just to hear the ins and outs, and really feel like you are on the same page with someone. It's amazing, all these interviews I do. In some ways, it's the same story; we're getting the same kind of validation, and there are a lot of overlaps and similarities. In other ways, everyone’s completely individual. And that's what's so exciting about how diverse that community is. Thank you so much for coming on and sharing some of your story, and I'm really excited for everything that's to come with Rise Up Financial.

Annelise: Thanks so much, Lauren. I really appreciate you having me.


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