On the way to the health clinic, some 60 miles west, I drive through a town called Denmark. This makes me happy and I slow down a little to savor it. It is only two houses and a township building. In the landlocked landscape that is Ohio, the sound of “Denmark” in my head conjures windy beaches, words with ø’s, Danish pastries. I want to go to real-Denmark some day.
Last winter, I had to drive through blowing snow across Denmark as I visited the clinic every two weeks. I had signed up as a guinea pig for a study of a new drug, a PCSK9 inhibitor. (Whenever I see “PCSK9,” I think “pesky.”) The drug contains antibodies that block PCSK9, a protein that reduces the liver’s ability to remove bad LDL cholesterol. I first read about the study in the New York Times and found a pharmaceutical company that was running a study in Ohio. The study is conducted in a small office room stuffed with notebooks on clinical trials, testing instruments, and Sean Hannity bloviating on the radio.
Because I had a heart attack five years ago, at the “young” age of 48, and persistently high LDL cholesterol, I was a prime candidate for the study. My father died of a heart attack at 62, attributed largely to a combination of high triglycerides and high LDL. My sister died when she was 52—the coroner said she had “tiny arteries,” three of which were blocked.
I had the widow-maker – my left anterior descending (LAD) coronary artery was more than 90% blocked. You can read more about that here. I read somewhere that heart attack survivors fear having another attack and surviving more than they do dying. I’m glad I’m not the only one. So much about heart disease is related to lifestyle—diet, smoking, stress, obesity, sedentary habits. Guilt and shame come easy.
According to the CDC, about 600,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths and slightly more than cancer. Every year about 720,000 Americans have a heart attack. I have seen five friends die of heart disease in the last four years and only one was older than 55.
Within a couple of months of my first visit, I was accepted into the study. Every two weeks, I give myself a shot in the thigh. It hurts a little. The needle is large. When I asked the administrator how long the study lasts, how long I would need to give myself shots, she told me, “Until there is an event.” An event? She didn’t say anything. Then I realized she meant until I have another heart attack. (A mean statistic that terrified me during the first couple of years after my heart attack was the 50% chance that I would have another one, and likely die, within two years. My heart was a landmine with a hair trigger that could explode at any time.)
Technically, I should not know if I am receiving the drug or a placebo. It is a double-blind experiment. However, I get my lipids tested every six months before my visit with my cardiologist. When I had blood drawn earlier this year, I learned that my total cholesterol was cut in half – from over 200 to just 113. My LDL went from 108 to 40. My triglycerides dropped from 305 to 139. For each percentage drop, my heart disease risk drops by the same percentage. I was shocked, grateful, and cautiously optimistic.