THE HOLLYWOOD REPORTER 69 JULY 31, 2019
You have an inoperable tumor on your liver”?
I figured he wouldn’t, and I was right. My
arteries had zero calcifications and there was
no sign of anything that looked cancerous.
My prostate was slightly enlarged, but that
seemed normal to him, and wasn’t something
to worry about since my PSA was 1.3 (above 4
being dangerous).
Five years earlier, I had been told by a doc-
tor, an ultrasound technician, a radiologist
and a urologist that I had a hernia, then that I
didn’t have a hernia, then that I did, then that
I had two hernias. Dr. Hernandez showed me
that I did not have a hernia. A massive win.
After looking at my pancreas, liver, kidneys
and everything else, and being shown what
cancer and other diseases would look like in
those organs, I was pronounced disease-free. I
felt a level of relief I never imagined.
Two follow-up consultations were scheduled
for the coming weeks, the first to go over lab
results and further review my MRI and CT
scans, the second to brief me on my genome
sequencing. But at that moment, everything
went as well, or better, than I had hoped.
DRIVING BACK
to L.A., traffic
was awful, but my
mood was unusually buoyant, and that
feeling continued for the next two weeks. I
attributed this elation to the silencing of a
subconscious din of angst playing in the
background of my mind. The unknown
became known, like at night when you think
you hear a noise in your house and you go to
see if there is an intruder and nervously turn
on the lights to see that you’re the only one
there. It’s one thing to have your blood drawn
and heart EKGed in a physical every year, then
being told you’re “OK” — as far as they can
tell. It’s quite another to actually look at your
own organs and see that there is nothing
scary going on.
My next conversation with Dr. Doney, two
weeks later, reinforced my serenity. During
the call, I learned that most of what they could
find out from my blood was quite good. The
analysis of my visceral fat (the fat around
one’s middle, both the pinchable kind and
that which surrounds one’s organs and can
only be detected by the MRI) was exception-
ally low: a VAT index of 0.25, with norms
ranging between 0.98 and 1.94. High visceral
fat is linked to diabetes, liver disease, can-
cer, Alzheimer’s and is the single strongest
body composition risk factor for cardiac
events. Dr. Doney told me to “keep doing what
you’re doing.”THAT NIGHT,
I mentioned to my
girlfriend, whom I’d
convinced to make an HN appointment, that I
have an exceptional visceral fat ratio. She said
now she didn’t want to go, because she was
sure that her visceral fat would be higher than
mine. She’s very competitive.
Two and a half weeks later, I had my final
consultation via video with Dr. Doney to
go over my genome sequencing. I asked if
we could right away get to whether or not I
carried the APOE4 gene allele. Dr. Doney’s
calmness led me to believe that everything
was as I had hoped. I was wrong. He explained
that my sequencing showed that I had the
homozygous APOE4 gene alleles — I had
received one from my mother and one from
my father — and that my chances of devel-
oping Alzheimer’s disease were between
30 percent and 55 percent. I wasn’t surprised,
nor immediately uneasy with the news.
Dr. Doney re-explained how my genes were
only one component of risk and that lifestyle
factors could reduce the chances of having
Alzheimer’s by a third. We discussed how diet,
exercise and intellectual engagement had
proven to change outcomes with Alzheimer’s.
I knew and believed all of that. But when he
said, “I don’t want you to walk away from this
feeling that you’re on your own,” my emo-
tional state shifted. I felt a wave of gloom
wash over me.
The day before I had, coincidentally, visited
my mother in the dementia care facility where
she lives. My mother seemed content, though
she had no idea who I was nor could say any-
thing comprehensible, but the others present
did not appear at all comfortable nor happy,
as best I could tell. Nobody could even ask a
simple question and most had to be spoon
fed by attendants and physically moved if
even a slight adjustment in their position was
required. I don’t think any knew where they
were. I didn’t want to even imagine myself in a
similar circumstance.
Dr. Doney went on about how I could talk to
their genetics expert, then some other stuff
that I don’t think I fully heard, and asked if I
had any questions. I composed myself and told
him that I did not.
We moved on to the rest of my genome
report. I had none of the 87 cancer risk genes.All of my polygenic risk factors — groups of
genes that can point to an elevated possibility
of getting illness, especially cancer — were
within normal levels, except for thyroid can-
cer, which wasn’t alarming, since that usually
shows up in younger people and is twice as
likely in women.
The hourlong review ended with being told
that I’d be sent the full packet of genomic
information, including many non-health
related items about my genetic ancestry and a
complete file of results that I could share with
my physician. Dr. Doney reiterated that I could
contact him at any time.
The rest of that day and much of the next,
I felt anxious and unsure how having this
awareness would affect me long-term. I won-
dered if everyone was right, that I had sought
out knowledge that I would have been better
off not receiving.
Thinking it through, I realized I was no
different than I was prior to my trip to
San Diego, other than having been roused
from the fantasy that my parents had been
afflicted due solely to their own choices.
An unfavorable reading of two alleles is not
diagnostic of disease, but rather an oppor-
tunity to make changes in one’s behavior
and keep aware of possible treatments that
might help to avoid or moderate disease. If my
genes put me at a 55 percent chance of hav-
ing Alzheimer’s and my behavior could lessen
that by 30 percent, that indicated I have only
a 38.5 percent chance of becoming demented.
That my odds of maintaining my cognition
appeared to be better than not seemed like
a victory.
Eventually, I found consolation in confir-
mation of my overall state of good health.
Had they found a mass on my liver or a large
amount of calcification in my arteries, the
next steps would have been frightening,
painful and life-changing. The way I’d lived
my life for the past three decades meant that
I would not have to struggle with changes
in diet, exercise and cognitive training. The
only thing I was doing wrong was not getting
enough sleep, and this experience prompted
me to focus on my sleep hygiene, which would
benefit me in more ways than one.
So, yes, I was happy I had gone to Health
Nucleus and found out what I did. I would
recommend it to anyone who can afford it
and who wants to do everything possible to
stay healthy for as long as possible. Yet, more
important than the insight I gained on my
health status, in fact one of the most profound
pieces of wisdom that I know will help me in
years to come, and that could probably help
anyone, really, is ... well ... uh ... I forgot what I
was going to say.Gavin Polone, a THR contributing editor, is
a film and TV producer whose next project is
Zombieland: Double Tap (Oct. 18).