There is a confusion of terms. First, the Budget Reconciliation process is NOT the same as the "nuclear option" that is available in the Senate.
If Reid and Pelosi get together and want to ram through something using the Budget Reconciliation process, then substantial changes will need to be made to both the House and Senate bills, due to the limitations of Reconciliation as specified in the Congressional Budget Act of 1974.
If the Dems want to employ the "nuclear option", they would take the House bill to the Senate floor, and through parliamentary chicanery, they would ram through the bill by doing away with the filibuster, and passing it on a simple majority vote. I SERIOUSLY doubt that they could even get a simple majority to engage in such an undermining of the spirit of the Senate.
I also don't think that the Budget Reconciliation process is going to help them that much, again because of the limitation of the CBA of 1974 - but it is a possibility that they could get some things passed - like medicare expansion - using reconciliation.
Given the results of Tuesday's election, I doubt that Pelosi has 218 votes for such a maneuver, and I don't think Reid can scare up 50 votes in his chamber, FWIW.