The Cost of Care: Bob’s Story

Burns had experienced a “widowmaker” heart attack. This happens when a branch of the left coronary (also known as the left anterior descending artery) becomes completely blocked. This artery supplies oxygen to a large amount of heart muscle tissue, so a blockage in this artery can cause cardiac arrest.

He was taken by ambulance to Deerfield Beach Health Center before being transferred to Broward General Medical Center in Fort Lauderdale.

It was too windy and rainy that day to transfer him by helicopter, so his medical team loaded him into an ambulance. Members of the local police force provided an escort, ferrying the ambulance through heavy traffic along Interstate 95. Many police officers in the area knew Burns from his time serving as the head wrestling coach for the Police Athletic League.

When Burns arrived at Broward General, his cardiologist began to administer therapeutic hypothermia to lower his body temperature to about 92°F. Also known as targeted temperature management, this procedure is used to limit brain damage after blood flow to the brain has been interrupted due to cardiac arrest.

Burns spent the next 11 days in a medically induced coma. While he was lying unconscious, Burns’s doctor warned his wife that he might never wake up.

“They told my wife that I may be neurologically dead,” Burns told Healthline, “and they weren’t going to operate on me.”

But on April 8, 2012, his medical team reversed the coma, and Burns opened his eyes.

A few days later, he underwent surgery to have three stents placed in his heart. Stents are small metal tubes that are inserted into narrowed or blocked arteries to open them up.

He spent another week in the intensive care unit and four days at a rehabilitation center after the surgery. Finally, after 26 days of treatment, he returned home on April 24, 2012.

When he left the intensive care unit, the staff gave Burns a standing ovation.

“What’s going on?” he asked. “It’s no big deal. I’m just walking out here.”

“Don’t you know?” one of the nurses replied. “Many people who come in here in your condition don’t walk out.”

When Burns returned home, he felt like a different man.

He had always prided himself on his strength and self-sufficiency, but he could barely shower or cook a meal without feeling exhausted.

He was worried he would spend the rest of his life dependent on his wife for care.

“Being self-sufficient is what I always was. I never needed anyone for anything, and to go ahead and not be that anymore, that was crushing,” he said.

“I thought that my wife was going to have to push me in a wheelchair. I thought I was going to be with an oxygen tank. I didn’t know how we were going to pay the bills,” he continued.

However, Burns began to regain his strength and stamina over time. In fact, after several weeks of rest and rehabilitation, he was able to play a gig with his band. After five months, Burns was given the clear to return to his job at Deerfield Beach High.

To support his recovery process, Burns enrolled in a cardiac rehabilitation program at the hospital. Through this program, he received nutrition advice and exercised under medical supervision.

“They would put me on a monitor,” he recalled, “and the wrestling coach in me would get yelled at all of the time for always exceeding what my heart was supposed to do.”

Burns had always watched his weight and worked out regularly, but some of his lifestyle habits may have been hard on his body.

He started to get more sleep. He cut red meat out of his diet. He reduced the amount of salt he ate. And he limited himself to one drink of alcohol per day.

In addition to lifestyle changes, Burns’s doctors also prescribed medications to lower his risk of another heart attack. These included blood thinners, beta-blockers, cholesterol medication, and baby aspirin.

He also takes vitamin B and vitamin D supplements, hypothyroid medication to manage his thyroid hormone levels, and pantoprazole to soothe his stomach lining.

“Taking as many pills as I did at one time, that irritated my stomach,” Burns said. “So they added another pill,” he added with a laugh.

To monitor his heart, he attends annual check-ups with his cardiologist. He also undergoes occasional tests to assess his heart’s condition.

During his latest appointment at the cardiology unit, his blood pressure reading was different in one arm compared to the other. This could be a sign of a blocked artery on one side of his body.

To check for a potential blockage, his cardiologist has ordered an MRI, cardiac stress test, and echocardiogram. Burns is waiting for his insurance company to approve those tests.

Burns has an employer-sponsored health insurance plan, paid for by the School Board of Broward County. It covered most of the costs of his treatment following his heart attack.

The total bill for his ambulance rides, heart surgery, and hospital stay came to more than $500,000 in 2012. “I’m the Half-Million Dollar Man,” he joked.

Thanks to his health insurance coverage, his family only paid a small fraction of that hospital bill. “It was $1,264 that we had to put out,” Burns said.

Burns didn’t have to pay anything out of pocket for the cardiac rehab program he attended. His out-of-pocket costs for medication have also been relatively low.

“I was surprised the first year,” he recalled. “We were using Walgreens, and after the first year, it didn’t total to a whole lot. It came out to about $450.”

Until recently, he only paid $30 in copay charges to visit his primary care doctor and $25 for each appointment with a specialist.

The cost of that care increased two years ago, when the school board switched health insurance providers from Coventry to Aetna. Now he pays the same amount for primary care visits, but his copay charge for specialist appointments has increased from $25 to $45. The school board covers the cost of his family’s monthly insurance premiums.

The plan also provides paid sick leave coverage, which helped his family meet their financial needs when he was recovering from his heart attack.

“I had enough sick days to cover everything and still maintain my salary. I used them all, but I was lucky enough to have them,” he added.

Many people aren’t as fortunate.

In 2018, only half of adults under age 65 had employer-sponsored health insurance coverage in the United States. Most of those workers had to pay for a portion of their premiums. On average, they contributed 29 percent of the premium for family coverage.

In the same year, 91 percent of federal and state government employees had access to paid sick leave. But only 71 percent of people in the private industry had access to paid leave. On average, those private-sector workers received only seven days of paid leave after one year of employment and eight days of paid leave after 20 years of employment.

These days, Burns is trying to follow his prescribed treatment plan as closely as possible while feeling grateful for the support he’s received from his family and other community members.

“I pray for everybody at night time because I had so many thousands of people praying for me,” he said. “I had two hundred churches across the nation praying for me. I had kids from wrestling groups, I had teachers in my education circle, as well as the coaches in my coaching circle.”

Since returning to Deerfield Beach High seven years ago, he’s stepped back from the role of head wrestling coach to take up the mantle of assistant wrestling coach instead. He still demonstrates techniques to his students, but he no longer wrestles with them.

“I can demonstrate all I want, but because of the blood thinners I take and the way my skin is, I bleed whenever a kid rubs his shoe on me,” he explained.

When his father-in-law suggested that it might be time to retire, Burns disagreed.

“God didn’t put me back to retire,” he said. “He put me back to yell at kids and that’s what I’ll do.”