NOTE: FACTION TALK IS NOW ON CHANNEL 137

So, tune in Saturday August 5th to Faction Talk, channel 137, at 4 PM East, 1 PM West.

Phone #: 844-686-5863 

If you miss the episode, you can hear it on demand on the SiriusXM app. Search: Lefsetz

Re: The Heart Scan

I’m 65 and the coronary calcium score of 362 that you got?  I got tested for the first time this year, and it was 751!!

And I’m one of those annoying health freaks who has been doing everything right since the Reagan administration.  My weight is perfect, I have a flat stomach, can still play full-court basketball, I look 10 years younger than my age, my jeans are the same size since college, I can play two hours of singles tennis, have a full head of hair, eat very little sugar, eat a big ass salad just about every night, I go to the gym 5x a week, walk about 7,000 steps a day …

… and yet the historical cholesterol damage I’ve accumulated over the decades is apparently through the roof!!!  My doctor says not to blame myself but that’s hard not to do.

Really threw me for a loop.  I’ve heard the Cleerly is a good thing to get.  I’m almost afraid to get it, though.  

I just wanted to write this in case anyone gives you sh*t about writing about your personal life and stuff like this.  I LOVE IT, always have.  You are the best antidote to AI Slop I can think of.  

1

I had to go to Torrance.

Those playing the home game will remember that I see this heart doctor who says if I follow her program, I’ll never die of a heart attack, no patient has yet. And like seemingly every good doctor in Los Angeles, she doesn’t take insurance, which means I’ve got to pay $2500 a year for the privilege.

And they draw blood in her office. And do ultrasounds too. But you have to go out for some tests, like this CT scan with contrast. You know, where they pump this iodine solution into your veins while you’re inside the machine, that gives you a metallic taste in your mouth and makes you feel warm all over.

Now the last time I went across the street, to that scan center on Wilshire. All good except they missed my vein twice and I insisted they bring a new person in to do it, which they were not happy about.

So why did I have to go all the way to Torrance?

I called and got this vague response about the doctor preferring it and there being some benefit so, I agreed.

Now when I first moved to Los Angeles…

It was like my records came alive. El Monte…you mean where Legion Stadium was, from the Zappa record? And Pico and Sepulveda. All the references were right up close and personal.

In addition there were other landmarks of interest, and we partook of them. Me and my girlfriend thought nothing of going deep into the Valley for what was said were the best chips in L.A. (they were, made on the spot, I still think about them), or into the hood to get barbecue from Mr. Jim’s (“You don’t need no teeth to eat Mr. Jim’s meat.”). Or to a movie. Actually, I remember one holiday going to a movie theatre in Torrance to see “Popeye.” I was alone and at that point I saw nearly everything, but despite it being a Robert Altman film it wasn’t really worth it.

Driving south the coast goes from Playa del Rey to Manhattan Beach to Hermosa Beach to Redondo Beach to Palos Verdes. And if you go inland from there, you get Torrance. And the bike path goes all the way down to Redondo, and I rode down there on a regular basis back in the day, however the wind always blows south, so the ride back up was always a slog.

I’ve been to all the coastal restaurants and bars, it’s a different lifestyle down there. I’ve experienced it. But not for years. Because the traffic is just too bad and been there/done that.

As for the traffic… I’d drive from West L.A. to Valley Circle to see a film in that dump of a duplex. No one would do that today.

But you reach a certain age… Is it that I’ve done it all. Or that I’m not interested in doing that which I have not? The seventies are positively weird. In your twenties and into your thirties it’s all about going out. But once you’re in your sixties it becomes about staying home. Most of the people I know no longer even go out to eat on a regular basis. They certainly won’t go on the weekend. Is this how it’s going to be going forward? Or do I have to go to new cities and countries just to explore? But even worse, reach a certain age and you realize you’re never going to get everywhere.

So Torrance…

Exactly how long is it going to take me to get there?

I could tell you all about the psychology of traffic in Los Angeles, but I must say with the advent of map apps, it’s gotten so much easier. But when you’re trying to plan days in advance… The maps will give you a reading, but it’s not definitive.

So I’ve got to book a time that’s not too early and not too late. Because the afternoon traffic coming back is hellish.

So, they want me to be there at 10:50 to be ready for an 11:20 scan. I know it’s all b.s., they do this so you won’t be late, and I’m always on time.

But when I called to book the appointment, they were going through the details and told me my doctor prescribed a Cleerly and insurance didn’t cover it and it would be $950 cash.

WHAT?

I told them I’d call them back.

So I immediately went to Dr. Google and it told me a Cleerly was AI plaque mapping.

Yeah, right. Whenever I hear AI, my eyes roll into the back of my head. Like with the cannabis fever of a few years back. CBD will cure anything! Did you ever try it? Multiple brands of CBD ointments never worked for me (don’t worry, I didn’t pay, I got them for free), and no one ever talks about them anymore.

So I e-mailed the doctor, was this really necessary? And she didn’t insist I get the Cleerly, but she spoke of its advantages and highly recommended it.

So I’ve got to ask myself, do I feel lucky?

2

So someone close to me whose name I won’t mention found out they needed three stents and a heart valve. When I got this person one on one, they told me they hadn’t gone for a physical in five years, only a prostate test. But they’d been taking the statin, right?

Nope. They just started when this was all diagnosed back in April.

That’s what you’ve got to know about my generation. They’re anti-pill. But now we’re at the age where it all catches up with you, everything they warned you about. Now your arteries are filling up with plaque. It’s like rust, it never sleeps.

So I guess I’m gonna spend the $950. What does it matter if I die?

And I always remember the words of Narada Michael Walden…he told me money comes, and money goes. That’s the truth. Whenever I think I’m getting ahead, I get a big bill. As for laying out the $6250 for the Valeda eye treatments last year… The FDA ultimately approved the treatment and I got all my money back in July!

So I’m driving down to Torrance. And I’m getting uptight about the gridlock going north, wondering how bad my return trip will be, and I get off at Normandie and I immediately ask myself…

WHERE THE HELL AM I?

Who lives here? Because if you work in L.A., if you commute, you’re going to waste half your life on the freeway. And if you don’t, why not live even further away, in a nicer location?

Normandie is four lanes and endless. On one side is a vast wasteland, on the other is those condos you see everywhere. Recent construction, behind a wall. People buying a piece of the rock to live on top of one another. The condos were nearly new, and that’s nice, but you’re living out here?

And I’m driving and driving, miles, and then the map app tells me to get ready to make a left.

BUT THERE’S NOTHING THERE!

Oh, a couple of broken down houses… But it looks more like a nuclear wasteland than a location for a hospital.

But I make a left, then a right and…

There’s an open parking lot. If you can find a hospital sans parking structure in L.A…I’ve never been to one.

Even better, THEY DON’T CHARGE!

How can this be?

But it looks full. And I’m investigating a space on the street, pondering if it’s legal, but then I find a space right in front of the Farima Czyzyk Center for Cardiac Research and Wellness at the Lundquist Institute. (That’s right, don’t ask me to pronounce it.)

And they want my credit card right away. At least I’ll get points.

And the waiting area is not crowded, but there’s someone on the phone…

Now this is a heart scan, so some of the folks don’t look so good. Do I really want to tell her to stop talking on the phone, she could be close to death!

I gave her the stink eye, which didn’t work.

Even worse…the Wi-Fi sucked. Don’t you hate that? Where they’ve got WIFI, but it’s glacially slow, almost unusable. But I only had one bar of cellular signal…

So I got up and moved closer to the door and got two, which I needed, because then they told me they were running an hour late.

Turned out to be an hour fifteen, but who’s counting. ME!

So the woman helping me is nice, but I’ve got to ask her, where does she live?

She’s taken aback…

No, I don’t want your address, just the general location.

She lives just south of Compton so the drive is usually fifteen minutes. Then she starts telling me the exact route in both directions, how sometimes she gets on the 105… I just wanted to commiserate on the schlepp there, I wasn’t looking for driving advice.

Ultimately they called me in and one thing I’ve got to say is they had it together. Unlike at the place on Wilshire, two people worked simultaneously and were hands-on. One getting me in the right position, one piercing my vein and…

By time it was all through was I really going to wait for the bone density test they proffered when I was checking in, saying I was due and it was covered by insurance?

So I asked how long the wait would be. And was told that they’d already done it, as part of the CT scan!

And I was relieved and thinking how great this was until I got ahold of my internist who told me although I was due for a bone scan, the one he prescribed was different. If only I knew.

3

So I was a bit woozy on the way home. Which I won’t say was a breeze, but that cluster of stopped cars had worked its way out and I was a bit off the rest of the day, which the info didn’t say would happen, but was this just a result of not getting enough sleep the night before?

So now it comes down to the results.

They told me there was an app, but I wasn’t gonna check. Last time I had this test it said I was about to have a heart attack and when I went to see the doctor she remarked how good my numbers were. Huh? It’s all about interpretation, about the movement more than the exact number, and I was good.

Not so good I could ignore continued treatment.

I take a statin and zetia and some other stuff… She sends the blood to the Boston Heart lab, she creates a unique program for each patient, there is no one size fits all solution to creeping heart disease.

But curious, I clicked on the e-mail and could then download the results.

Hell, I’ve gotten this far, this is what the CT angiogram said:
______

The coronary system is right dominant.

Left main (less than 30%) with mild calcified plaque.

The left anterior descending coronary artery with mild disease. Proximal LAD (less than 30%) with mild mixed plaque. Mid LAD (30-49%) with moderate calcified plaque.

The left circumflex coronary artery with minimal disease. Proximal CX (less than 30%) with mild calcified plaque. The obtuse marginal branches are without disease.

The right coronary artery is normal. The LPDA and PLB are without disease.

The left ventricle is of normal size, wall thickness. The left atrium, right ventricle and right atrium are normal. The pericardium, mediastinum and aorta are normal as are the remainder of the cardiac structures.
______

So what does that all mean?

Well, at the bottom of the report, it said this:

“Impression: Non-obstructive CAD. Moderate atherosclerosis.”

Well that doesn’t sound good. So I went to Dr. Google and you could read it either way, freak out or just hang in there.

But wait! There’s another report!

This is the Coronary Calcium Report.

Well, they come up with a number.

My score on the Left Main was 3

My score on the Left Anterior Descending was 267.

Circumflex was 92.

Right was 0.

For a grand total of 362!

So what does that mean?

Let me quote:

“As compared to other persons of your age and gender you are in the 50th percentile, with 100 percentile being the highest scores seen in this age category among over 30,000 persons scanned at Harbor-UCLA. Using data from over 30,000 patients, scores are reported based on averages for age and gender. The calcium score suggests a degree of coronary disease which is: Average. Your score is average among people of your age and gender.”

Well, that doesn’t sound bad.

Now when you scroll down the page there are some charts, with interpretations and behavior recommendations.

The top one says the diagnosis is “Moderate plaque burden.”

The interpretation is “Moderate, non-obstructive artery disease high likely.”

What are the recommendations?

1. Institute risk factor modification and clinical follow up.

2. Ensure strict adherence to NCEP cholesterol-lowering guidelines Recommend an appropriate exercise program.

3. Aspirin and cholesterol therapy recommended.

4

As for the Cleerly?

I’m still waiting.

But reading all the above…are you doing everything you can to prevent death, or do you have your head in the sand. I’ve got to ask you, do you feel lucky?

I’ll leave you with that.

1

I was used to the Al Kooper version, with a lot more production. But I was out hiking in the mountains listening to the Spotify playlist I created for the “Too Busy Thinking About My Baby” missive and when it slipped into the Johnnie Taylor version of “Toe Hold” I truly got the lyrics for the very first time. Funny how that works, it’s half a century later and suddenly you get the meaning of a song. Sometimes I was just oblivious, other times I was too young to understand at the time, and I’ve always marveled at how these musicians/songwriters were so insightful at such a young age, hell, Jackson Browne was sixteen when he wrote “These Days.”

Now I always thought the original “Toe Hold” was too naked compared to the Al Kooper cover, but the other night…

The thing that truly amazed me first was Johnnie Taylor’s voice and delivery. Like most people I knew him most from “Who’s Making Love” (to your old lady, while you were out making love), another soul hit on the AM Top 40 of the day. But listening again, this guy is utterly fantastic, amazing, positively a legend whose reputation needs to excavated, studied and admired. You can’t get this on a singing competition show. The passion, the intensity.

Now the truth is we’ve got to give Kooper notice for excavating “Toe Hold,” which was a b-side to “Little Bluebird” in 1966. I never heard it on the radio, I only knew it because Kooper covered it.

But he was not the only one, the same year as it was included in “I Stand Alone,” Wilson Pickett did a version. And Pickett deserves all the props he’s received, but here he’s going through the motions compared to Taylor on his take, Pickett’s just Pickettfying the song, whereas Taylor is at his wit’s end, he’s telling us a tale from his soul, you truly believe it.

Now Ellen McIlwaine covered “Toe Hold” too. I’d like to tell you it’s delicious, but at best it’s interesting. She’s received a lot of press recently, but her take pales in comparison to Taylor’s too. The only one who comes close is Kooper, because he throws everything into the song, it’s a white man’s take on the song with horns providing the emphasis that Taylor delivers purely with his voice.

2

“All my life I’ve been a poor boy
It’s been hard to get a dime
Everything I got
I had to pay for it on time, but that’s all right”

ON TIME! When I was fifteen I knew he wasn’t talking about paying on a certain date, but I wasn’t wise enough to know what it was like to pay for something on time, not having enough cash to pay for it right up front.

“Long as I got a toe hold
Long as I got a piece of you
Long as I got a toe hold
I can make it through”

That’s all he’s looking for, he’s not asking for much, he only needs a toe hold. This is the opposite of the braggadocio of today, when everybody’s a winner, displaying their wealth. This is the truth, but sans pessimism.

“I said I went to my doctor
First thing he talked about is malnutrition
I’m not tryin’ to be a fat man
I got to look after my ambition”

The doctor takes one look and sees that this guy is struggling, he doesn’t have enough of the right food.

Yet Johnnie is not focusing on the negative, but the positive. He doesn’t want to focus on the pitfalls, but the opportunities.

“A lil’, lil’, lil’, lil’, lil’, lil’, lil’, lil’ toe hold
A lil’, lil’, lil’, lil’, lil’, lil’, lil’, lil’ toe hold”

This always stuck out to me in Kooper’s take, but it was the sound, the delivery, the way he got all the “lil'”s out. But when Taylor sings it… There’s a combination of desperation and internal strength at the same time. He believes in himself, he can make it through.

“So baby if you’re with me
Let the whole world be against me”

It’s like by singing the song Taylor has convinced himself, with her he can succeed, screw all the forces against him.

“I don’t expect to ever get rich
You may find me diggin’ in a ditch”

All he’s looking for is a toe hold, he’s willing to do whatever it takes to get by. It all works as long as he’s got her by his side.

Now with this delivery, it wouldn’t be hard to be convinced. And women were. Taylor had six acknowledged children and three others by three different women.

You’ve got the He-Men of the Universe with all the money in the world, but they haven’t got the game of the guy singing this song. That’s the power of music.

And one can say that fifty years ago the Black man was a second-class citizen sans the opportunities of today, that it’s a breakthrough to be able to boast, however…

Most people are not winners and the truth is as long as you’ve got a modicum of ambition you can cobble together a life, you can get by. And more important than the money is love, relationships, life.

Tell me all you want about Sam Altman, I’d rather be Johnnie Taylor.

The truth is back then musicians were the winners. Because of the music they created. It was right there baked into the grooves, in an era where you had to have the chops to make it, when being a nepo-baby opening for a star was not enough to garner an audience. When all that dreck of today fades away Johnnie Taylor will still be around to triumph, convincing listeners with his music.

This guy is utterly fantastic. I’d like to point to someone in today’s hit parade who’s even in the same league, but I cannot.

Although “Toe Hold” was written by Stax greats Isaac Hayes and David Porter, Johnnie Taylor truly makes it his own.

“Toe Hold” is a showstopper. One listen would inspire greatness…

And cause a plethora of wannabes to call it a day.