Listen to Your Heart
A Heart-to-Heart About Hearts
by Hank Trout

My husband Rick has been on a diet for a month. He joined one of those online programs that helps him plan low-calorie low-fat meals, tracks his caloric intake, and sends him positive inspirational memos, cheering him on. He’s lost eighteen pounds so far, and I couldn’t be prouder of him or happier.

Aesthetics had nothing to do with Rick’s decision to diet. Frankly, I think his “dad bod” gets sexier by the day! No, his was not an ego-driven decision based on “looks.” It was a medical decision. On the cusp of sixty years of age, Rick has entered that time of life when carrying excess belly fat can cause all sorts of medical problems. And so I heartily applaud his decision to diet.

By “belly fat,” I’m not referring to the soft layer of subcutaneous fat right under the skin, the pinch-an-inch kind of fat. Belly fat, aka visceral fat, lies deep inside the torso, packing in tight around the abdominal organs (liver, intestines, and stomach). Carrying too much belly fat puts us at risk of developing high blood pressure, Type 2 diabetes, stroke, and migraines. According to a study in 2010, published in the Annals of Neurology, excess belly fat may make our brains shrink and boost our risk of Alzheimer’s Disease and other forms of dementia.

Perhaps the most worrisome effect of excess belly fat is that it increases the risk of dying of heart disease or a heart attack. According to a study published in the December 15, 2015 Annals of Internal Medicine, even if you’re not technically “overweight,” your “spare tire” (known as central or abdominal obesity) puts you at higher risk of dying of heart disease, regardless of the presence of other factors such as smoking and diabetes. Further, if you’ve survived one heart attack, your belly fat increases your risk of a second, more severe attack.

Maybe we need to rethink the whole “dad bod” thing.

We long-term HIV/AIDS survivors should especially take this information to heart (no pun intended). We already know that our bodies age faster than our HIV-negative counterparts. Ravaged by the attacks of the virus on our immune systems and the insidious effects of some of the medications we’ve taken since 1996, our bodies are more susceptible to osteoporosis, bone loss and frailty, Hepatitis C and other diseases of the liver, balance issues that lead to crippling falls, kidney malfunction, premature hearing loss, blindness due to CMV infection, diabetes, cancer, leukemia, dementia, and of course heart disease. According to a 2018 study published by the Health Resources and Services Administration, HIV/AIDS Bureau (HRSA), we long-term HIV/AIDS survivors are at higher risk for coronary artery disease, hypertension, myocardial fibrosis, congestive heart failure, cardiac tumors, and ischemic stroke. To put it bluntly, as early as 2009 the National Institutes of Health had determined that “Patients on HAART therapy have a 26% increased relative risk of a myocardial infarction”—i.e., a heart attack—some twelve to fifteen years earlier than our HIV-negative friends.

If we long-term survivors ignore the warnings about the effect of belly fat on our hearts, we do so at our peril.

Heart health issues have been on my mind since I was five years old. Literally. You see, I was born with a malformed heart—the valves leading into my heart were too large, the valves leading out were too small, and as a result my heart was swelling inside me, crowding other organs and rubbing against my ribcage, which caused small holes in the lower chamber of my heart. The only remedy was a very experimental and very risky surgery——the procedure had been tried only twice before, and both kids died during the operation. I was the third child to undergo this particular kind of open-heart surgery (and I have the 13-inch-long scar to show for it). I remember as clearly as if it had happened yesterday hearing Dr. John Effler, the surgeon, tell my parents—with me sitting right there taking it in—“Even if the surgery is successful, your son is going to die before he’s fifteen.”

That was only the first of many death sentences I’ve outlived.

A couple years ago, I was rushed to the E.R. with all the classic signs of a heart attack. The signs were wrong, fortunately, but the incident scared the bejeebus out of me. During a follow-up visit to the doctor, one of the nurses did a sonogram examination of my heart. As I lay there, clutching Rick’s hand, watching my heart beat on the screen and simultaneously feeling every thumpa-thump it made, I remembered Dr. Effler and his prognosis, his death sentence pronounced over a terrified five-year-old, and I cried. You poor old battered thing, I thought, looking at my heart, thank you.

So when Rick announced that he was going on a diet to get rid of his belly fat, I was very happy. One of my greatest joys in life for the last two decades has been lying down with Rick and putting my ear to his chest and listening to the strong, rhythmic beat of his heart. Listening to his heartbeat calms me down, transports me to a quieter, saner, safer place.
Listen to your own heart. And take care of it.

Hank Trout, Senior Editor, edited Drummer, Malebox, and Folsom magazines in the early 1980s. A long-term survivor of HIV/AIDS (diagnosed in 1989), he is a forty-year resident of San Francisco, where he lives with his husband Rick.