Going to Emergency? Know This...

My parents have always been planners. Whenever they had to drive somewhere new, my dad would have the map out on the kitchen table, navigating the route hours before the rubber hit the road. And of course, a thorough check of the traffic reports was always mandatory. As a teenager, I used to roll my eyes. What’s life without some spontaneity? I’ve since learned that there are definitely times where it’s better to be prepared.

Visiting the emergency room is actually one of those times. Of course, when accidents or acute situations happen, the luxury of time and planning go out the window. Then it’s a case of getting help as quickly as possible. But many visits to emergency can actually be managed more efficiently.

Experts here at Sunnybrook say, it all starts with patients using their discretion. Is the problem you’re experiencing new? Is it serious? Those questions often need an expert to answer, but in some cases, like a flu or cold, it could be a better approach to call your family physician first. TeleHealth Ontario is another option for all those non-urgent problems that always seem to happen in the middle of the night.

If you are coming to emergency, it’s recommended that you bring a complete list of the medications and supplements you are currently taking, and as much information on your medical history as possible. Also, avoid eating or drinking. If certain tests need to be performed, that can actually delay the process of getting your diagnosis.

And while it’s tempting to bring as many people with you as possible for emotional support, remember that many hospitals have a 2-visitor policy. Here at Sunnybrook, the emergency department may be dealing with as many as 50 patients at a time, and providing the best care means having the space to do so. It’s also for the consideration of other patients being treated.

Sunnybrook has the highest acuity of ill patients in Ontario, likely because of the specialized programs available here. That includes being a Regional Stroke Centre and housing the largest trauma program in the country. Sunnybrook has also done some amazing things to reduce wait times, including incorporating different zones in the emergency department for different levels of illness, taking on more physician hours and new initiatives to improve patient flow.

That said, health care is always a partnership between the patient and provider. So back to the driving metaphor, take the wheel when you can. As I now carry on my parents’ tradition of checking roadmaps (OK, Google maps!) and weather reports, I fully know that unforeseen traffic problems could put a wrench in my plans. But I do what I can, and hope for the best.

Something New for Depression?

Of all the health issues plaguing the human race, the one about to take the lead is often invisible and ignored. In the next five years, the World Health Organization predicts depression will become the number one public health problem worldwide. That’s simply astounding.

There are treatments, including medications and talk therapy. Even light (a box that emits bright light that you sit in front of for 30 minutes daily) and ion (a smaller box that removes positive ions from the air) therapy have been helpful in boosting feel-good brain chemicals for seasonal depression that happens during the winter months. But there is no perfect fix, so the push is always on to find a better approach.

That’s the motivation behind a new 3-year Canadian study, which Sunnybrook plays an important role in. Will light and ion therapy, when combined with medication, actually help people suffering from major depression? It’s an interesting concept, that if found to work, could have major public health implications. In the province of Ontario alone, one quarter of people will face major depression in their lifetime.

Study recruiters at Sunnybrook are currently looking for participants. You must be between 18 and 60 year of age and experiencing major depression. That means you have been feeling sad or down, having lost interest or motivation in your usual activities for 2 weeks or more. This might also be accompanied by a loss of appetite, and trouble sleeping or concentrating. For more information on the study, call 416-480-4444.

The Hat

For 60 years, Dorrie Aber has kept a little piece of history folded up in her linen drawer. Packed neatly in a thin piece of tissue paper, she recently opened up the delicate treasure to show me what was inside. At first glance, it just looked like a cotton handkerchief. But then Dorrie’s fingers moved to unveil a bright red cross stitched on the middle of the front hem. This is the hat Dorrie was given when she started volunteering with the Red Cross, and Sunnybrook’s Veteran’s Hospital, back in the 1940’s. As she draped it over her hair, kerchief style, for old times sake, her 103-year-old eyes lit up as if it had all happened yesterday.

As with all tokens of nostalgia, they are kept as reminders of special people or places. Dorrie’s hat is no different. As she tucked the cotton behind her nape, she talked about volunteering in the kitchen and making bacon and eggs for the vets. Her religion forbids pork, but she sure loved the smell! And many of the friendships she made here have turned out to be life long.

Dorrie now lives in the U.S., but she visited Sunnybrook just last week to tour the Veteran’s Centre, as well as areas of the hospital that hadn’t even been built when she started volunteering here. She was amazed at how much things had changed, with all those wide-open fields now home to one of the country’s top medical facilities.

Dorrie was also here to give her hat back to Sunnybrook. A donation of sorts, but also a gesture of coming full circle. Dorrie still volunteers at a hospital near her Florida residence, and despite her life long dedication to giving back, still insists that she’s received far more.

As Dorrie took the hat off her head for the last time, this centenarian hoped it would be a symbol for the future. “I’m hoping there will never be another war,” she told me. Then, with her daughter on one arm and granddaughter on the other, she headed home to see her great grandchildren. I couldn’t help but feel inspired, not only to live to see 100, but to spend more than half that time helping others.

Dorrie’s hat will be on display outside Sunnybrook’s Harlequin’s cafeteria (in E-Wing) until the fall.

Very Cool Medicine

On a hot summer day, it sounds like a dream. Cooling blankets and ice-filled baggies to beat the heat. Bring it on! But in the hospital world, this approach is actually being used as a legitimate medical procedure. For Sunnybrook patients who have had a cardiac arrest and are in a coma, this medically induced form of hypothermia can be a savior, in many cases sparing the brain any further injury.

Sunnybrook Health Sciences Centre is one of the higher volume hospitals offering this procedure, treating about 40 patients this way every year. Body temperature is lowered from the normal 37 degrees to about 34 degrees celcius, and held there for about one day. The cold is thought to help by protecting cells from damage and death. Simply put, that means patients recover more fully.

I spent the morning with Emergency Physician Dr. Steven Brooks, who has been researching and administering this technique for years. He walked me through each step on a medical mannequin. Chilled IV fluids are circulated through the patient’s body while clear bags of ice are stacked under the patient’s arms, neck and groin. A special machine-operated cooling blanket is also placed under the patient to help lower their body temperature. And because patients are in a coma and given sedatives, they never feel a thing.

The trick now is cooling more patients who need it. Sunnybrook is involved in a collaborative study to better understand the best way to deliver this type of treatment. And Dr. Brooks hopes to soon coordinate a special team to do the work, making this a cold approach that’s actually quite heartwarming.

For more information, click here.