Losing health insurance was a major setback for Sebastian.

He had relied on his Covered California insurance for access to affordable prostate screening and treatment for chronic hemorrhoids and painful bowel movements, but when the premium cost became too high, he could no longer afford coverage. Without insurance, his options for care were limited.

A friend told him about John Muir Mobile Health Clinic, where he could get medical help regardless of his insurance status. There, his primary care provider (PCP) referred him to our program for hemorrhoid treatment. He qualified and we connected him with Dr. Salvador Guevara, who specializes in colon and rectal surgery.

At first, Dr. Guevara pursued a nonsurgical solution by prescribing medication to reduce the size of the hemorrhoids, but when flare-ups and swelling persisted, surgery became necessary. Dr. Guevara and his team at John Muir Health performed a hemorrhoidectomy. While the operation was successful, Dr. Guevara continued to monitor Sebastian’s recovery. Despite the hemorrhoid removal Sebastian continued to experience painful bowel movements for several months due to tight muscles in the area.

To help relieve the discomfort, Dr. Guevara performed an additional procedure, injecting medication directly into the muscles to help them relax. The effect of the medication was not immediate, it was expected to take a few months for the muscles to respond. If the first injection did not work additional injections could help—or another surgery, this time to loosen the muscles allowing for normal bowel movements—could provide long-term relief. Dr. Guevara assured Sebastian that the surgery had a high success rate but that they first would wait to see if the injections gave him relief.

Determined to heal, Sebastian has been intentional about his recovery, increasing his water and fiber intake while closely following Dr. Guevara’s advice. He appreciates Dr. Guevara’s expertise and the way he takes the time to explain every step in Spanish. Although it took some time, the injections did eventually provide the needed solution. The anal muscles have relaxed, and Sebastian’s bowel movements are no longer painful.

As a handyman, Sebastian depends on his physical well-being to keep working. Thanks to the generosity of Dr. Guevara and the team at John Muir Health, Sebastian’s medical issue is resolved. Sebastian is relieved to put this chapter behind him, free from pain and able to focus on his craft and his future.

Story and photo shared with patient’s permission. Patient’s name has been changed.