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Feeling Secure?

It has been almost two weeks since learning my heart scan results and I have yet to figure out just what is going on. My doctor has been silent leading me to believe that despite the harsh wording in the patient info guide they provide with the results, I am likely not at death’s door. The plaque in my arteries likely formed over a long period of time and has therefore been there for years. And I think back to some of my hikes this past summer, in the extreme heat and humidity, often 14-miles or more, over 20-miles once, and all done without any heart symptoms at all (or dropping dead).

And over the last few years I have really busted my butt in the yard moving around massive pieces of trees, loads of dirt, and large rocks – all without any signs that my heart might have been struggling. I did a cardio stress test somewhere after turning fifty which came out fine. (The test was done because being adopted, I have no family medical history so he was just being sure.)

Now I know you can be in great cardiovascular shape and still die of heart disease; witness Jim Fixx. He was a guy who began jogging for fitness. At one point he was well over 200lbs and was smoking two packs a day. He started to run for fitness and weight loss and then wrote about it. Through his books he ultimately became the person who began the jogging craze in America and who popularized running for fitness. He died, of a heart attack, while running at age 52. He had one coronary artery blocked 95%, another 85%, and a third 70%.

His story reminds me that you can feel great, perform really well, never feel or notice a thing during extreme stress and exercise, and then – much like a light switch being flipped – your life is over in a heartbeat. So I am rattled with all this. Despite the varying and oft contrary interpretations of Cicero’s tale, I feel like the sword of Damocles is hanging above my head now. That the preciously thin horse tail hair suspending that sword above me could suddenly just break anytime, anywhere. And this is something I never, ever considered as a valid or viable fear within my lifetime. I never considered that my heart could be the weak link to take me down; I have always been proud of my fitness and capacity for great and extreme exercise. So this news has me shaken.

And the news is, of course, why I immediately agreed to the statin. While I remain convinced that my arterial build up is from years past, and that my current life style of eating and hiking is actually helping me, not harming me, I obviously have to pay heed to my somewhat high cholesterol levels and tend to that. And I am. However, I am hating the side effects of the statin; I often find myself sort of dizzy, or lightheaded – foggy perhaps – through the day. I am also incredibly tired, I often feel like I could fall asleep in seconds were I to sit and allow it. But a small price to pay for the relative peace of mind.

I’ve analyzed the test results and have realized that there are four arteries studied as part of this test. Each is examined for plaque and is assigned a score. The four scores are them combined for a final test score. They generally summarize that final score by level; below 100 your arteries are relatively plaque free and you are at very low risk. Scoring between 100-300 means you have plaque build-up and places you at moderate risk of a cardiac event. A score above 300 is a sign of extensive disease and of significant risk. As a reminder, my score was 548, so….

However, reviewing my results I find the one artery was scored 375; a second came in at 111, and the last two were 33 and 29. So one artery accounts for two-thirds of my score; if that one artery came in the same as the second, my score would have been below 300 and would have painted a whole different picture. But it is, what it is.

The test cannot determine if you have a blockage; it only “sees” plaque build-up. To determine if there is a blockage other tests are necessary and my doctor is still determining what, if any, may be needed. Personally I am now at the place where I really crave some peace of mind. I am rattled and need some sort of a life ring, a reassurance by a doctor that even though that one vessel has a lot of plaque, there is no blockage and no need for concern.

Since beginning this post, two things have occurred: I went on an 18.5-mile hike and I shoveled out my driveway with the heaviest, wettest snow imaginable. And I did not die during either event – nor even feel any ill effects. I am slowly reconciling the fact that I am likely as healthy as I have been for the last 20 or even 30 years, just didn’t know about the plaque back then. I feel great (medicine side effects notwithstanding) and while I was honestly kind of scared while tackling that miserably heavy snow, I finished strong and without any real physical discomfort. I think I am adjusting and filing this artery scan under things I should probably know but still wish I didn’t!

Security; is that a genuinely valid feeling? For example, I always, always, always felt safe and secure hiking and shoveling. Always, that is, until I learned of my cardiac artery plaque build-up. And then I suddenly felt weak and vulnerable. I am slowly working through that, but it certainly rattled my sense of feeling safe and secure while performing either activity.

So what is security? It is, I am sorry to say, mostly a figment of our imaginations; a mindset; a cognitive sedative that allows us to relax. There is chance of death every time we drive on a highway. But, most of us drive every day and rarely see any accidents. And even more rarely are we in one. But witness a nasty accident, or worse – be in a nasty wreck – and your sense of security will be greatly diminished and you will be scared to drive the next time you get behind the wheel. Because the risk is real. But we minimize it because doing so enables us to relax and enjoy the activity.

Many of us are fearful of an intruder breaking into our home. Depending upon where you live and how rare or common break-ins may be, one might get a dog, install stronger locks, invest in an alarm system, buy a weapon, set up cameras, or take similar steps in an attempt to mitigate the risk. And whether you settle on just the dog, or get the dog, the gun, the cameras, and everything else completely rests with your own internal sense of security. Once you have identified the risk, and have taken a step (or steps) to combat that risk, you will stop taking steps once you “feel” secure.

And that basically defines security; it is you convincing yourself that you have done all that is needed to ensure your security and that it is ok to relax, let your guard down, and not worry. Consider my case once again – that plaque has surely been in my arteries for years without me knowing about it – so of course, I never worried about it. I felt safe in shoveling heavy wet snow; I felt secure about hiking 15 or 20 miles. Never worried or felt anxious that I was at risk. But…I was at risk. Just never knew it. And you can’t fear a risk you don’t know about. What is that old saying? “Ignorance is bliss.” Stay well dear reader!

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