Heart Matters

My doctor suggested I get a CAC test. This is the current “in” thing for guessing at heart health and my risk for an MI. It measures hard plaque buildup in the coronary arteries. (But not the soft plaques, which hide from the CT and can still kill me, oh well.) I have a strong family history of heart disease and some other risk factors, so getting the test made sense. Plus, it has been three years since my brain clot, and I needed a new thing to worry about.

But I had to admit, if my coronaries were clogging up, it would be good to know. Plus, in this case, I was confident. I do what I am supposed to. I exercise, sleep eight hours, have good blood pressure, keep my weight under control, and eat fiber. Okay, I don’t eat fiber, but who does? And yes, I could socialize more, but people scare me. Unless you count the lady at the cash register at the grocery store, in which case, we are back to fiber being my only area of potential improvement.

In summary, I am doing most of the things I should be doing to give my heart a chance, and the ones I’m not doing aren’t subject to much modification.

But by far, the biggest factor in getting the test was my wife. She had the scan done and was given a perfect score of 0. No plaque, at all, anywhere. (except, see above about soft plaque.) I needed to find a way to stop her humble bragging.

The test was quick and painless. Lie flat and let the machine pull me into its cave. It tells me when to breathe in, when to exhale, and then spits me out. But lying on my back, inside the CT donut, I did have time to wonder. When I exercised, was I getting winded quicker? Naah, the air was just getting thicker and hotter in Florida. If I could bike twenty miles at a stretch, being a little short of breath was normal.

Two days after the test, my wife suggests I look and see if the results are in. It’s early, but not impossible for them to be back. I open the portal, and my heart sinks, or more accurately fails. My score is high, very high, and it is bad, very bad. Pick an artery, and it is about to blow. Google’s diagnosis is that cardiac angiograms are in my future. Unless I am having symptoms, in which case I should immediately go to the ER for stents or bypass surgery. And though I wasn’t having symptoms a second ago, I am NOW. I am nauseous and clammy and sweaty, and my heart rate is up.

Bad stuff happens. A pain-free life is not owed to me. And getting older means more stuff happens, I know. But still, this news hits me hard. It opens old wounds. My fantasies of a vigorous retirement are once again being put in the shredder. I remember all the feelings from before, the mini-deaths it takes to stay alive.

This was now a second wake-up call to envision my wake. Once again, that day is coming sooner than I had penciled it in. I had plans for lazy visits to grandchildren, writing offbeat Substacks, making wobbly clay pots, and breaking the record for a 70-year-old in the 400-meter dash. All gone. Now the next few visits with family will be seen through the lens of, ‘this could be the last time.’ The big dreams, pushed to my peripheral vision by the clot, were to be blocked out entirely. (Don’t go away, though. This story doesn’t end here or anywhere near here.)

There is a meditative practice called Maranasati. Part of it is imagining your death in creative ways. A person thinks of things like their funeral or their rotting body. It is meant to help a person face their fear of dying and release the fingers of anxiety that can choke one’s happiness. It is supposed to foster joy while one is alive through this greater appreciation and freedom. Recognizing the unpredictability of life, how this breath could be my last, and understanding that my bank account will never be big enough to buy my way out of where we are all headed, is the gist of the practice.

This bad CAC score became an involuntary maranasati session. I also obsessively searched the internet for what to do pharmacologically and non-pharmacologically. I flipped through web pages faster and faster.

And then I stopped and thought fuck this. I mean, really and truly, fuck this. Excuse my Klingon, but I was being forced to meditate on my death and/or scrounge around for clues on how to squeeze out another day. Screw both of those. I had done what I could, and it wasn’t enough. So be it. Death, you win. But I also quit. Death, I will not offer you false praise. Nor was I going to try to fight my way to a plaque-free life.

I didn’t know what to do, so I went numb and stared at the TV. I couldn’t even tell you what show we were watching.

Death whispered, “You need to make the most of this one wild and precious life.” Mary Oliver had helped me in the past with this wonderful phrase. But this was a different day, a different time.

I responded. “You know, Death, that is a lot of pressure. How about this? How about asking me what I am going to do with my (at times) calm and average life? In fact, how about my being allowed to have the comfort of boredom, the luxury of taking life for granted at times? How about I waste time playing solitaire (or as I call it, solace-stare) right now without one tinsel of guilt. How about the gall of that, Death? Maybe those are good ideas.”

It turns out, I am not the most mature or evolved human to have ever lived. Huh, imagine that.

Maybe one secret to life for me is being able to say, ‘That’s it.’ Like, I have Bugs Bunny as my therapist. “That’s all, folks.” But I don’t mean give up, I mean surrender and join in “as is.” Live with warts and flaws and lots of questions left unanswered. Live however I can in the moment. For me, happiness can become a mechanical rabbit I chase around a track. My task might be finding some way for imperfect me to live in an imperfect world. That is a shot at peace. The peace bunny I can catch.

I am all for meditation, self-help tools, and other tricks of my trade. I have been helped by all of them. I believe there is a right time for the right therapy, or crystal, or self-help book, or whatever. Even Maranasati-ing has helped in the past. Right now, though, the best therapy for me, I think, would be the ‘That’s It,’ therapy. What my numb heart was saying, as I read my dangerously high CAC score and looked at but did not watch the TV show, was, “No More.”

I went to bed and woke up in the same numb fog.

The nurse from my doctor’s office called in the middle of my morning coffee. “You probably haven’t had a chance to look at your CAC results yet,” Oh, if you only knew, “but there was a mistake, the number is 10 times too high. They will correct it and send out the right result later. Oh, and by the way, I read your book and loved it. I read it in two days-”

“Wait, wait. I mean, thanks, but you said it is a false report?”

“Yes, no biggie. But your book was great. How you showed there was still love and value to being-”

“Yeah, yeah, I heard you, good book and all,” blah blah blah, “But my heart is at least sort of okay?”

“Yes. But the part I liked best in the book was….” and she kept on complimenting me. It was a good kind of crazy. I had a chance at several vigorous years, and someone liked my book. In time, I even asked her opinion about my plan for book two.

But let’s give Mr./Ms. Maranasati, the credit they deserve. The experience ended up re-focusing me on what my priorities were. The false-result debacle has inspired me to work on my list. Also, in my search for how to lower my LDLs and prevent more plaque from forming, I did come up with one solid, low-cost, research-backed recommendation. After every meal, walk for ten minutes. Twelve years of higher education can get the darndest results.

It’s been seven days of walking after I eat. If I have forgotten my daily fiber, I grab some of my neighbor’s grass. I plan to do this for a year straight and then ask for a repeat CAC test. Here is how I envision things happening. My doctor’s office will call and say, “We think there has been a mistake, your CAC score is zero, but we will recheck it. And by the way, I loved your second book…”