The hazardous heart

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Steven Russell's chest just before the shaving.
Steven Russell's chest just before the shaving.

Out Health

She held the razor high in the air. I caught a glint of the fluorescent lights reflecting on the bright metal of the blades as her hand clutched the plastic handle tightly to aim them toward my naked chest. I attempted to form the word, “No!” but it was too late. She had swiftly cut a swath of my chest hair that toppled over my belly like a rappelling rock climber and then trundled across the exam room floor like a dry desert tumbleweed.

My heart sank. “My husband is going to disown me,” I admitted to her. “At a minimum there goes my centerfold career,” I continued. She guffawed as she deforested three more patches around my heart. “This is the only way to get a good reading,” she said. She then hooked up all sorts of patches and wires to the stubbly flesh of my chest. “The doctor will be in shortly,” she said as she left the room. I was a bit anxious.

This was my first stress test. I had been to see this cardiologist at the advice of my primary care physician. He had discovered some irregularity with my heartbeat when I was 60 and wanted it to be monitored by a specialist. Also, my cholesterol levels were high enough for some concern.

The doctor did come in after only a few minutes, so I quickly put away my phone where I had started a Words With Friends game. Soon I was walking and running on the treadmill under his supervision, and during a moment when I wasn’t breathing too heavily, I asked him about an article I had read. I told him about a study that found members of the LGBTQ community are at higher risk for cardiovascular problems than the general population. He said that he had heard of such studies, and added that he could understand why, given the increased stress that many members of the community undergo.

The article I had read was in Circulation, a publication of the American Heart Association. It expanded the risks to include other chronic issues such as stroke, arthritis, and back problems. It found that many psychosocial stressors that members of the LGBTQ community experience interact with other minority stressors, and general life stressors, to make such health issues more prevalent.

The Circulation article said, “Today, most national health surveillance systems within the United States measure sexual orientation in some form. And although there are lingering discussions of how to optimally measure these constructs, the emerging data are being rapidly mined, linking health disparities among sexual minorities to the social harm of discrimination.” Great. So, we have Covid, HIV, Monkey Pox, and now I’m more prone to a heart attack because I’m gay? I wasn’t ready for that.

A week or so after the stress test I went back in to see the cardiologist for a follow-up. He assured me that as far as my heart is concerned, I’m “boring.” But we did talk about a lot of ways that I could take better care of myself, increased risk or not. Well, that, and I’m 62. Eating better to help lower my cholesterol levels in order not to have to take medication, keeping up with adequate exercise, and coming back to see him in six months were among the things we discussed. I will be getting a stress test every year, and frequent monitoring. At least I have been able to convince them to do the other tests without the razor.

One thing to be vigilant about: It matters who is at the helm. I spoke to Ken Thorpe, Chairman of the Partnership to Fight Chronic Disease, and Chair of the Department of Health Policy & Management at the Rollins School of Public Health, Emory University. He explained that we know the prevalence of several chronic conditions is higher in the LGBTQ community, but we need to find out why. He stressed that more data needs to be collected, and more research needs to be done. Those elected and those in control of such research need to know the importance of this information.

Steven Russell's chest and the razor close up just before the shaving.
Steven Russell’s chest and the razor close up just before the shaving.

According to the American Journal of Public Health, the National Survey of Older Americans Act Participants (NSOAAP) in 2017 stopped asking participants about their sexual orientation. The Journal continues, “The removal of this inquiry is extremely troubling. The federal data in the NSOAAP are critical for evaluating whether federally funded aging programs, including nutrition, transportation, case management, homemaker, and caregiver support services for seniors, accurately reflect the demographics of the United States. Failing to document whether these programs are meeting the needs of lesbian, gay, bisexual, and transgender (LGBT) seniors will result in ill-informed decisions about how to use limited public resources to meet the needs of older adults across the country. High-quality, accurate data that capture the diversity of the older adult community are essential to ensuring that LGBT older adults ‘count,’ both in a literal sense and in terms of fundamental protections for a vulnerable population.”

It matters who gets elected to positions that make such important decisions about our health. I’d gladly shave my chest every day if it means crucial data can get collected so that members of the LGBTQ community can lead healthier lives. We need to count.

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