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April 16, 2014

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Politics:

Back to work after heart surgery, Rep. Horsford touts affordable care

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Steve Marcus

Rep. Steven Horsford, D-Nev., responds to a question during a town hall meeting at the Cora Coleman Senior Center in Las Vegas on Thursday, March 28, 2013.

Rep. Steven Horsford walked into his North Las Vegas office Monday morning, returning to work for the first time since major heart surgery in early July.

In an interview with the Sun, the Democratic congressman told the story of his heart disease, the six-way bypass surgery, and to what extent he believes he can return to his work representing the northern Las Vegas Valley and much of rural Nevada.

Horsford, a few pounds lighter than before the surgery, radiated optimism as he sat in his fifth-floor office at North Las Vegas City Hall.

“All signs are that I am on a 100 percent road to recovery,” he said. “I feel like I am going to be an even more effective congressman than I was before this.”

Elected in November, Horsford went to Congress this year and almost immediately found out he had health problems. Congressional doctors said in late January that he might have an enlarged heart. They discovered in follow-up tests that he had “pretty severe” blockages in the arteries of his heart and would need immediate surgery, Horsford said.

As a 40-year-old in good health, he didn’t want to believe the diagnosis.

“I've had prior physicals, none of which led me to believe or have any concern that I had issues with my heart,” he said. “Honestly, I was in a bit of denial. I thought that there had to be something wrong, that the tests had to come back wrong. ... I didn't have any major symptoms. I didn't have any chest pain or tightness or other typical symptoms.”

So he got a second opinion at Inova Heart and Vascular Institute in Virginia, where doctors confirmed the diagnosis and recommendation.

Horsford had high blood pressure and high cholesterol, both of which increase the risk of heart attack. Two of his grandparents had died from heart failure, further increasing the risk that he might die young if he did not have preventive surgery, he said.

Doctors told him that he had a 99 percent chance of surviving the open-heart surgery, and they said the procedure had to be done soon.

“If I waited, obviously, I was at risk of having a heart attack, and because of the travel and because of the strain and stress of the job ... their recommendation to me was to get this done as quickly as possible,” he said.

After first telling his wife, Sonya, he flew home to North Las Vegas to tell his children what was happening.

“I said, ‘Daddy's going to be well and we're going to come out of this strong,' and I told them I loved them,” he said of his conversation with his children, Benjamin, Bryson and Ella.

Steven and Sonya Horsford flew back to Washington, D.C., and entered Inova Heart and Vascular Institute on July 1 for the surgery.

Surgeons there opened his chest cavity and stripped two veins from his leg and one artery from his arm, putting them in his heart to bypass the blocked areas where blood didn’t properly flow.

The process ended up being a six-way bypass surgery, a rare procedure.

“They did not initially know it was going to be six-way,” Horsford said. “That wasn't known obviously until they were in surgery and it was required that they do all six.”

After the surgery, he spent nearly two weeks at Inova before coming home to North Las Vegas on July 12.

The surgery is a fairly common way to reduce the risk of heart attack, said Jay Shen, a UNLV professor of health care administration and policy.

“It’s kind of a routine procedure, and in the U.S.A., doctors have pretty good experience in doing this,” he said, noting that former Vice President Dick Cheney underwent heart transplant surgery at Inova Heart and Vascular Institute and that President Bill Clinton and talk show host David Letterman have also had bypass surgeries.

In the coming month, Horsford said, he’ll work in the 4th Congressional District he represents during lawmakers' August recess, and he expects to return to Washington in September.

Apart from losing a few pounds, he bears few visual signs of the surgery. He showed a Sun reporter a scar running from his left wrist up his forearm, where doctors had removed an artery. He said his health will have no bearing on his ability to represent the district.

His doctors have asked him to eat a healthier diet, exercise more and take measures to reduce stress. They haven’t asked him to take an extended leave of absence.

He’s undergoing physical therapy with a Las Vegas physician whom Horsford declined to name.

In addition to the cost of the therapy and payments to congressional doctors who noticed the heart condition, the cost of the surgery was about $80,000, Horsford said.

He said his family would’ve been able to afford the procedure without congressional health insurance.

Still, he said such high prices are a problem when it comes to good preventive medicine, surgery and follow-up care.

“No person in America should have to go bankrupt because of one surgery or procedure or treatment like this, and it's why we have to make health care work in this country,” he said. “We have in Nevada over 300,000 people who are uninsured, and their ability to even access the type of preventive medicine that would allow them to get the care they need is part of why we have to make health care work in America.”

Shen said the $80,000 price tag is “within a reasonable range” for a heart bypass surgery and that the surgery is more easily available to people such as Horsford, who has good health insurance as a member of Congress.

Horsford also used his surgery to address the Affordable Care Act, President Barack Obama’s health care law. After speaking at length about his physical therapy and recovery from surgery, Horsford did not lose a moment to praise the Democratic president’s law.

“I think it's a pivotal time,” he said. “We're talking about the implementation of the Affordable Care Act, what's good about it, what's not. For me, as an example, I now have a pre-existing condition. I cannot be denied insurance because of this open heart surgery, and neither should any other person in America.”

He said he’ll work on implementing the law through his work on a congressional oversight committee.

But that’s a far-off goal. On Monday, the congressman was thankful just to be back at work.

He spent the day signing a pile of “thank you” cards on his desk for people who had wished him good health.

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