In conversation with Hanny Dusault, FH consultant

'Puzzling out family trees is the most enjoyable work there is.'

Hanny Dusault is a research nurse and FH consultant with several years of experience. She has been working at Erasmus Medical Center for 34 years and witnessed the founding of StOEH together with Prof. Sijbrands more than 16 years ago. For many years, StOEH conducted population screening among families with hereditary high cholesterol. From Erasmus, she continued her work for StOEH and later for LEEFH.

risk factors "I enjoy working and interacting with people the most," says Hanny Dusault. "I give people all the information they need. I reassure them. Because how do you move forward when you've just heard that you have familial hypercholesterolemia (FH)? That's no small thing!" It is Hanny Dusault's job to ensure that people know how to keep their risk factors as low as possible. "I explain a lot to patients about a low-cholesterol diet and how they can live as healthily as possible. I also think it's very important that we, as healthcare providers, are easily accessible during the 'what now' process. People have a lot of questions, and we are there for them to answer these questions as best we can."

Adherence to therapy or not?
According to Hanny Dusault, the largest group of patients is motivated to receive help. What's more, patients also support each other. However, there is a group of people who are not so compliant with therapy, and this is a cause for concern for the research nurse. Why is this group unwilling to be helped? Dusault: "These are often young people who are not concerned about it. They don't want to be tested, they don't want to change their lifestyle, and they don't want to be 'sick'. It's a shame that these people don't come back, because we can provide them with excellent support and they can take control of their own health if they are well informed. People are always welcome here, by the way. No matter how long they stay away. Young people are often not very aware of the future. Until they want to have children or have them themselves. Then you often see a change. People start thinking about themselves and the future and then decide to go through the screening and treatment process after all. Hanny is happy to guide them through this.At Sofia Children's Hospital, the research nurse has seen many children with FH grow up and has guided them to the adult clinic.

"You shouldn't scare people"
An important part of healthcare is the early detection of FH in families. It is a major risk if people are not treated while they have sky-high cholesterol levels and are unaware of it. "However, we cannot force people to cooperate," explains Hanny Dusault. "But you can't feel high cholesterol, and that can be dangerous." Hanny Dusault is not in favor of scaring people, though. She believes it is important to make everything discussable and to let people take control of their own health. Moreover, families are often shocked when they see up close what can happen if you have FH.

Many questions
Every year, there is an information evening about FH at the Erasmus Medical Center in Rotterdam. Dr. Roeters van Lennep explains exactly what FH entails. "New FH families" often have many questions.

Puzzling in the subway
Hanny Dusault finds mapping FH families to be a very enjoyable part of her work. "Puzzling with a family tree is my favorite thing to do." Hanny also gets a lot of satisfaction from working with people, because you really get to know them. In those 34 years, she has shared joys and sorrows with many families. However, the research nurse does not take her work home with her, either literally or figuratively. "For privacy reasons, I'm not allowed to take files home with me," she says. "Everything disappears behind locked doors at Erasmus MC. But puzzling over family trees? Yes, that continues while I'm sitting on the subway on my way home!"