Cut From Steel

THREE PACKS A DAY. THEN 34 MORE YEARS.

Larry King smoked three packs of cigarettes a day for most of his adult life. Talking for a living on radio and television kept him busy. His heart was never on the schedule. Picture the busiest man you know, and you have Larry King in 1987.

On February 24, 1987, his heart put itself on the schedule. King was 53 years old when the heart attack hit. Surgeons gave him an emergency quintuple bypass, which means five new routes around blocked arteries.

King quit smoking after the attack. He went back to work, and in 1988 he started the Larry King Cardiac Foundation. The foundation pays for heart care for people with no insurance or limited means. His worst morning became help for strangers.

He kept hosting Larry King Live on CNN until December 2010. King died in January 2021 at the age of 87. That is 34 more years than the morning of the attack seemed to promise. He spent most of those years in front of a microphone, doing what he loved.

King liked to say his secret was simple. He asked good, short questions, and then he listened to the answers. You can use the same habit on your own heart. Ask the question before your heart asks it for you.

Your Last Checkup Came Back Normal. What Did That Actually Tell You?

▸ That everything is fine

▸ That nothing is wrong yet

▸ That the things they measured looked fine

▸ I am not sure

The third one is the honest answer, and it is a much smaller statement than it sounds.

A normal panel says nothing about the things that were not measured. And there is one test that checks what most panels completely miss — the one that is no longer part of a standard physical.

If you walked out of your last appointment reassured, this is worth ten minutes before the next one.

👉 See what most panels miss

THE WORD NORMAL

You walked out of your last physical with good news. The blood pressure reading was fine, and your cholesterol sat inside the range. Your doctor shook your hand and said he would see you next year.

I am not here to scare you. My point is smaller than that. A normal panel tells you about the things somebody measured. It says nothing about the things nobody looked at.

I know how good that handshake feels. You want to believe it, and you have earned a little good news. Still, a handshake is not a scan.

You probably assume someone looked at your arteries. Most of the time, nobody did. In other words, your heart got a phone interview when it needed a site visit.

WHAT THE PHYSICAL MISSES

You have three reasons a clean checkup can still leave you in the dark. I will take them one at a time.

01 / Numbers are not plaque

You get cholesterol numbers from a blood test. Those numbers estimate risk across a crowd of men like you. They cannot show whether plaque has already settled in your own arteries.

02 / The scan exists

Cleveland Clinic describes a coronary calcium scan as a CT picture of the heart. It measures the calcium in your coronary arteries, and that calcium marks hardened plaque. The whole visit may take 10 or 15 minutes, with no contrast dye.

03 / Nobody offers it

You will rarely hear about this scan at a routine visit. The 2018 cholesterol guideline calls it reasonable for adults 40 to 75 at intermediate risk, when the statin decision is unclear. Most insurance plans do not cover it, so it may never come up.

WHAT TO ASK THIS MONTH

You can start with one question at your next visit. Ask your doctor for your 10-year heart risk score. If you land in the middle range, ask whether a calcium score would change the plan.

You should know what the number means before you book. A score of zero means no calcium showed up. Cleveland Clinic links that to a very low risk of a heart attack over the next two to five years. The American College of Cardiology adds a warning, though. Zero does not mean zero risk.

You can also bring your family history to the visit. A father or brother with early heart trouble changes the math, and your doctor needs to hear about it.

You should also know the bill. GoodRx puts most scans somewhere between $100 and $400, usually paid out of pocket. I think that is a fair price for a look at the pipes you have been guessing about for years.

You still do the basics either way. Walk every day, lift twice a week, and stop smoking if you smoke. The scan does not replace those habits. It tells you how hard to push them.

I would rather you find calcium at 55 than a blocked artery at 60. Too many men learn about their arteries the hard way. You get to learn on purpose.

One last thing. Normal only covers what they checked. Put your arteries on the list.

— Travis

Insider Member's Corner

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