Young Vagina, Old Heart
Because nothing says ‘health journey’ like a doctor praising your private parts
I lay in my cropped blue paper gown on the white paper sheets of the examining table at my OB-GYN’s office staring at a cheesy cat poster on the ceiling. It’s the same poster I’ve seen many times before. It’s been there so long that the orange cat face has faded and the paper is creased. I’m guessing this cute little furry face is placed above the examining table to distract from the uncomfortable feeling of having a plastic speculum shoved inside of you. The blue paper gown that covered my bare bottom was ripping from the constant movement.
“Scoot down,” he said.
My feet were in the cold metal stirrups and my ass was hanging off the edge of the table but he continued to tell me to scoot, so I scooted. He inserted the speculum and opened it like a starving duck’s bill, did the quick swab he needed, then pulled the speculum out. A moment later his gel-coated, gloved fingers were inside me.
“Ouch,” I said.
“Wow, you’re always so sensitive down there!”
“Isn’t everyone?” I asked.
He pulled out his fingers, stood up, yanked off his gloves and said, “You have the vagina of a 20-year-old.”
Most women might find this comment offensive, but not me. I was flattered. So flattered that I left his office with a skip in my step and a smile on my face.
“I’ve still got it,” I thought quietly to myself. I’m not entirely sure why I took it that way. Maybe I was at a low point that day and needed the ego boost.
It was post-Covid and I hadn’t seen him since the pandemic started. I relied on daily Google searches for answers to all my medical questions because it gave me the privacy to indulge what my friends and family might call obsessive behavior. I had a simple test: if I searched my symptoms and the word cancer didn’t show up in the results, I could exhale, at least for the day. It didn’t matter that I was now married to a doctor. I still felt embarrassed by how much space those fears took up inside me.
Maybe the worry made sense. I had already lost two of the people I loved most to cancer.
My grandmother died of breast cancer that metastasized to her bones and brain. My mother prayed and pleaded with God or one of the saints to just give her a limp and not the same cancer that took her mother’s life.
Apparently, God or the saints were too busy to grant wishes.
We watched in anguish as our mother faced the same disease that took our grandmother’s life. It took our mother’s life too but not before taking her breasts, her hair, her memory and her dignity. She died a horrible death which left my sister and I grief-stricken and terrified.
Each yearly mammogram brought body-shaking anxiety until the “normal mammogram” was reported. My daily long drives in L.A. traffic to the college where I taught often involved feeling myself up for any sign of a lump. I would sometimes press my breasts so hard that they’d ache and bruise. The thought of losing my breasts, my hair and my mind consumed me.
My mother once told me that worrying about something that may never happen was a waste of energy. Her favorite line was, “You could get hit by a bus.”
And then the bus hit.
In all my Google research, I never searched for heart disease because I’m a woman. Let’s be more specific. I’m a passionate Italian woman whose heart beats loud and strong; who feels it break when hearing Puccini, and never once did I think my heart was broken from coronary artery disease.
After all, heart disease was for men. It didn’t matter that my father dropped dead at 57 of a massive heart attack and all but one of his five brothers died of heart attacks at a young age. It didn’t matter that their sons were dropping dead. It didn’t matter that every doctor I’d seen was told about my family history, including numerous cardiologists. According to them, I was fine.
It also didn’t matter that I’d had decades of alarmingly high cholesterol, off the charts glucose levels, and nonstop palpitations that started from my 30s. I guess I just presented well. This is how doctors describe patients. “The patient presents…”
I “present” as charming, charismatic, and younger than my age, or so I’m told. I wear fashionable clothes, have long blonde hair, and as my son says, I walk into a room like I own the place. On the outside, I don’t look like someone with heart disease. But looking healthy doesn’t mean being healthy.
Even someone like the actress Susan Lucci didn’t fit that stereotype. She was thin, fit, and known for daily Pilates. She was given a clean bill of health when doctors later discovered major blockages in her main artery. Her risk factors were there all along. Her father died in his 40s from heart disease yet the focus was often on her mother, who lived past 100, rather than the warning embedded in her family history. Even with a healthy appearance and reassurances from doctors, the disease was quietly progressing.
Doctor’s note. “The patient presents as a healthy, vibrant woman complaining of shortness of breath, concerns of her high cholesterol and glucose numbers, and insomnia. Family history of heart disease and breast cancer. Discussed anxiety. Gained 15 pounds during Covid. Suggested weight loss, exercise, a statin, and consultation with a psychologist. Oh, and she has the vagina of a 20-year-old.” Okay, the last sentence wasn’t in the notes.
After my daughter and daughter-in-law told me that the comments made by my OB-GYN were “gross” and “inappropriate,” I decided to follow up on my own. I went to a lab for comprehensive blood work to get concrete answers. Some of the results were nothing new: abnormally high cholesterol and glucose, but now I was pre-diabetic, insulin resistant, and had high inflammation levels.
I made an appointment with a cardiologist who looked at my bloodwork and said it was “nothing that abnormal.” He prescribed a statin and a baby aspirin. This is what is known as “standard of care.” What it really means is that the doctor has been doling out the same medical advice and prescription drugs for 25 years. But I was armed with research and dressed like a lawyer ready to make my case. I demanded a Coronary Artery Calcium Scan, also known as a CAC. He refused and told me that it was unnecessary, so my husband ordered it. Result: 256 CAC score with plaque all located in the Left Anterior Descending Artery (LAD), aka the “widowmaker.”
This nickname for the LAD says it all. The medical community’s use of this term reinforces the patriarchal notion that only men suffer from heart disease, even though heart disease is the number one killer of women. Let me say that again. HEART DISEASE IS THE NUMBER ONE KILLER OF WOMEN. Not breast cancer. Not ovarian cancer. HEART DISEASE. This fact caused me to stop obsessively examining my breasts.
I went back to the cardiologist who I will now refer to as “Dr. Clueless.”
“So now what? You found that you have something to worry about? The treatment is the same so what’s the big deal?” he said with a smirk on his face.
So I did something I vowed not to do. I cried.
“You’re not the first woman to cry in my office,” he said.
My tears quickly turned to rage and I scared him into ordering a nuclear stress test which he said was the “gold standard for finding blockages.”
I arrived in my pink sweats and tennis shoes ready to run. I jumped on the treadmill with Cher’s music blaring in my ears as they injected me with dye and moved me from the treadmill into a scanner that took pictures of my heart.
The verdict was in. “No blockages!” he said. He added that I have the exercise tolerance of a 30-year-old. Do they teach this dialogue in medical school? I can’t tell you how many women have shared that they’ve been told they have the bloodwork of a 20-year-old or the stamina of a much younger person.
I did some research and learned that nuclear stress tests only showed blockages greater than 70 percent. I went back to Dr. Clueless to discuss the results and my findings.
I asked for a CT angiogram to determine if there were any blockages. He refused and said the treatment for blockages is the same. He told me that I was just looking for something else to stress me out. He also told me (again) about a woman who cried in his office over the results of her CT angiogram.I guess this guy has all kinds of women crying in his office. But I didn’t cry this time. I just vowed to never step foot in his office again.
I returned home and turned my office into a research lab. I moved from Google to PubMed and researched every peer-reviewed meta study I could find on heart disease. My desk was piled with folders marked “CAC/CT ANGIO” and “CAD/ATHEROSCLEROSIS,” and “DIET” and ‘FAMILY HISTORY OF HEART DISEASE” and “TREATMENTS.” I contacted members of my father’s family who could tell me more about our health history. I found that many women in our family had high cholesterol, high glucose, and diabetes. And none had ever had a CAC scan. They just took a statin and an aspirin, as recommended by their doctors.
As I looked through the studies, a world-renowned research cardiologist and expert on coronary artery disease and CAC scoring kept coming up. To my surprise, this doctor conducts his research at a major hospital in Los Angeles County. My goal was to get this rockstar cardiologist to see me and thanks to a very persuasive email, I became his patient.
My first appointment with Dr. Rockstar was unlike any of my past experiences. This doctor didn’t make jokes or tell me I looked healthy or young for my age. He just listened. We discussed my CAC score and he ordered a CT Angiogram, an FFRCT blood flow study, and a Cleerly AI study that breaks down the plaque in your heart to show vulnerable vs. stable plaque, and pinpoints the level of blockages, if any.
The test was easy but the results were frightening. I had coronary artery disease with a 50-60 percent stenosis (blockage) in my LAD with a 30 percent restricted blood flow to my heart.
We decided on an aggressive treatment plan that includes a Mediterranean diet, daily exercise, and a slew of the latest and research-proven pharmaceuticals and supplements.
There is no cure for coronary artery disease but you can do your best to stop the progression.
This became my goal. I immediately lost the Covid pounds I’d gained and reversed all of my abnormal blood tests. Dr. Rockstar repeats the CT Angiogram every year and he closely monitors my bloodwork every three months. He tweaks the plan as needed and I trust his instincts.
So far, I’ve managed to stop the progression, or at least slow it way down. I’ve also slightly increased the blood flow to my heart.
There are Italian family members on my father’s side who say they’d rather die sooner than give up their favorite foods, or that they just want to take a statin and be left alone. These are the same people, who like me, lost their fathers, uncles or brothers to heart disease. And I fear that some may one day lose their mothers, sisters, and aunts.
For a long time, I thought that appearance worked in my favor. Now I wonder if I should have dressed the part of a sick woman instead, bent over a walker, barely breathing and impossible to ignore. But even then, I suspect I would have been dismissed. I would have likely been written off as already a lost cause.
Looking back, it’s hard not to feel defeated. So many years passed before a doctor finally took my family history seriously. There were never any tests ordered other than a lipid (cholesterol) panel and the standard complete blood count and metabolic panel, which is how I knew I had chronic high glucose. I saw several cardiologists throughout my life and not one ever even put a stethoscope up to my heart. They all wanted to focus on my confessions of anxiety and they always attributed this to any symptoms of concern. I’m told this is often too common.
When my anxiety comes rushing in, usually in the middle of the night, I picture my father looking like a million bucks in his custom made suit clutching his chest and collapsing on a Los Angeles sidewalk. The paramedics cut the designer silk tie off his neck and worked on him until he was pronounced dead on the way to the hospital. Like me, my dad presented well. He was strong and handsome and no one would ever suspect that beneath his expensive suits, thick mustache and bulging muscles was a damaged heart that would kill him.
I told my cardiologist about my father’s death and how scared I am of dying of a heart attack. He reminded me that the therapies available today were not an option for my dad in the 1970s. Having heart disease is stressful but I’m lucky to live in a time when medical advances help keep me alive. Sometimes not knowing is its own kind of comfort, but data and early detection might save your life.
I recently took the MESA test which scores your risk of a heart event in the next 10 years. My risk is 6.2 percent. It also calculates your artery age. Mine is 76.
All things considered, I’d rather have a 76-year-old vagina and a 20-year-old heart.
Update: Heart disease reversal is possible. To read the protocol that’s changing my life, read my latest post:
