Fun and Games in the O.R...

Watch this week’s video: http://www.youtube.com/watch?v=f5Ep3oqicVU


Sunnybrook’s Dr. Calvin Law remembers driving to Montreal with his father years ago. Sitting in the passenger seat, Dr. Law was in charge of navigating. Too bad he fell asleep. Map in lap, they missed the proper exit by more than the proverbial mile. Today, he uses this story to explain the importance of bringing a cool new gaming system into his operating room.

Until now, surgeons like Dr. Law have been using their own “maps” in the operating room: images of the patient that help guide each surgery. But these were located on computers outside the sterile zone, making for a big fat inconvenience. “There was this gap between two huge advances. One was just getting better at surgeries. And also, all the advances we’ve made in imaging, but they need each other,” Dr. Law told me. “And where was the bridge to bring them together?”

Turns out, that bridge was the Xbox Kinect, which interprets body movements into a language the computer understands, removing the need for a remote control. This is perfect for the operating room because it means surgeons don’t have to leave the sterile field to check scans of the patient. In short, it becomes a hands-free GPS system in surgery.

“So what the Xbox Kinect allowed us to do was, with the wave of our hands, all of the sudden the computer is with us, the images are right in front of where we are working, and we’re able to bring that computer as if it were the last member of our team, right into the working field of the operating room.”

How cool is that?

I watched, intrigued, as Dr. Law demonstrated the system for me outside Sunnybrook’s surgical suites. Arms in the air, he gently moved them around and down, in turn manipulating the brain scan pulled up on the computer screen 5 feet away. It’s not a sight you see everyday, attracting equal ribbing and admiration from fellow surgeons walking by. Undeterred by the tai chi jokes, Dr. Law continued on, telling me that this will change the way surgeons interact with imaging in the operating room, potentially forever. “It’s really given us a new way to work with the images without breaking sterility or obviously putting our patients at risk.”

It’s funny where the seeds of genius ideas are planted and in this case, when two long-time friends were out for a jog. Matt Strickland, a general surgery resident was telling his engineer friend Jaime Tremaine about the need for accessing CT, MRI and other scans during surgery. Knowing the Xbox Kinect had potential beyond gaming, they consulted another engineer friend, Greg Brigley. A few roles of electrical tape later, and voila, they were able to bring fun and games into the operating room! Dr. Law was more than happy to try it out.

So far, this application has been tested in about a dozen patients with great results, helping save time and expedite the flow of surgery. Dr. Law says, even he was surprised at how quickly and naturally it was picked up by staff and students. He says this application will be especially important in cancer surgery, where attacking so-called enemy tumors precisely will benefit a patient’s quality of life and overall recovery by sparing healthy surrounding tissue. It’s like hitting the bulls eye every time.

Another benefit? Dr. Law was having a blast. And who doesn’t want a happy surgeon? Unlike the trip to Montreal, there’s no getting lost with this in the operating room.
For more information, click here.

PARTY On...

Watch this week's video: http://www.youtube.com/watch?v=UVeCTkQYB3o

They are the glorified jobs you see endlessly profiled on cop and drama shows. The first responders to a scene faced with the gruesome task of documenting a life shattering tragedy into evidence bags. It’s one thing to watch these television portraits while unwinding at the end of a long work day. It’s quite another to live the reality. But that’s something Sergeant Tim Burrows and Constable Hugh Smith do everyday. Overseeing media communications, they are responsible for attending any major collision that Traffic Service is involved in. Fatalities are not uncommon. Talk about a tough job.

“The ones we are on are usually as people would say, spectacular,” says Smith. “It’s the carnage involved, how violent the collision really is. What gets to the officers when we’re investigating is, this was so preventable. Why are we here at 3 in the morning, and someone has passed away? Then you find it was due to either some kind of impairment, or distracted driving. By the time they look up, it’s all over for somebody.”

Smith and Burrows have, collectively, 44 years experience, and have banned the word “accident” from their nomenclature, preferring terms like “incident” or “collision”. So here’s what they can definitively say: every collision is both life altering (if not life threatening) and preventable, and anyone who sees what they do will never be the same.

Enter Sunnybrook’s P.A.R.T.Y program. Short for “Prevent Alcohol and Risk-Related Trauma in Youth”, it’s the medical version of scared straight. Twice a week, a group of high school students come close to stepping in the shoes of Smith, Burrows and other first responders. They view graphic videos of real incidents, tour the trauma and critical care units, and meet with patients whose lives have been irreparably altered as a result of poor decisions-like drinking or driving or not wearing a seatbelt. In short, these teens smash into the worst-case scenario head on.

P.A.R.T.Y. is a particular source of pride for Sunnybrook. Born here, it’s now been adopted and copied locally and internationally. And now, important 10-year data on the program finally quantifies what those involved have long-suspected: it really works. The new study, published in the Journal of Trauma, finds teens who attended P.A.R.T.Y. had fewer injuries, driving offenses and collisions, not to mention a reduction in serious and catastrophic injuries.

Burrows and I met last week for a drive around the west end of the city. He told me the biggest challenge with any safety measure is changing behavior, something P.A.R.T.Y. does with a bang. “If you can start that at the youth, that’s where you’re going to get the win because it keeps on growing.” He also defends the graphic nature of the program. Unlike the shows and video games kids are bombarded with, P.A.R.T.Y. is clear in its message that real life has no reset button.

Smith agrees, saying that each student will leave enriched in some way from the P.A.R.T.Y. experience. “Maybe not the whole program, but they’re going to take something that relates to them. Hopefully that little message, as we say, spreads to 2 friends and so on.”

Here’s to that. For more information on P.A.R.T.Y., click here.

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Look Up...

Watch this week's video: http://www.youtube.com/watch?v=BAknPMwO-Xs


Daphne Tully first picked up a paintbrush the year I was born. Back in 1972, she was listening to a CBC radio interview with a watercolor artist who insisted the talent can be picked up by anyone at any stage. “The only thing an artist needs to do is to work everyday for five years and be determined to do it,” recalls Daphne of the on-air conversation. “Well, I’m a very determined person!” The next day, she went out and bought a how-to book and some supplies. Her hands have resembled rainbows ever since.

The day I visited Daphne at her Toronto home, she was mixing deep blue and green paints on an ironing board set up in her kitchen, a room that serves the duel purpose of food preparation and artistic realization. A petite woman with a soft voice, she seemed totally immersed in the task at hand. And far departed from her favorite medium of watercolors, today’s painting would have even the most disinterested in art looking twice.

To imagine how truly cool her latest painting is, first picture yourself walking through the hallways of Sunnybrook (or any hospital for that matter). Now look up. What do you see? Likely a stark white and bland expanse of ceiling, adorned only with the occasional water stain. But with the wave of their magic brushes, Daphne and other volunteer artists at Sunnybrook offer patients, families and staff a little visual candy. One by one, they are transforming these utilitarian ceiling tiles into original works of art, and even recreations of paintings from artistic bigwigs like Van Gogh. Sky’s the limit (pardon the pun).

The Ceiling Tile Project started over a decade ago when a patient commented on how ugly they were to look at. It’s now evolved into a fundraising vehicle for the Sunnybrook Volunteer Association (SVA). In addition to revenue generated from plant sales, the gift shop, the beauty salon, holiday greeting card drives, coffee carts, used books sales and art shows, the $100 cost to sponsor a ceiling tile helps pad out the SVA’s 8 year, $1.5 million pledge towards capital expansion of the Emergency and Trauma Department.

The problem is, only about 70 of the ceiling tiles have been officially sponsored, leaving hundreds of these small works of art unclaimed. The SVA is urging people to consider them for birthday gifts, wedding registries and even memorials. Each sponsored tile is commemorated with the sponsor’s name on the wall below, making their contribution clear to those perusing the hallways.

Of late, the tiles have provoked some healthy interdepartmental competition. A group of 5 trauma surgeons headed up by Dr. Peter Chu, recently sponsored 36 tiles to adorn the hallway wrapping around the nursing station on C5. This last stop for recovering trauma patients now has a gallery-like feel that is truly uplifting for patients coming in. “I challenge other wards and programs to do the same for their inpatient wards!” says Dr. Chu. His colleague Dr. Homer Tien adds that a positive state of mind can help with a patient’s recovery. “Hopefully these pictures can contribute to that.”

Daphne has no doubt about the healing power associated with art. “It’s really the pleasure we can give to the patients, or the comfort we can give them, that’s what I enjoy.” It’s medicine she been benefiting from personally for over half her life, so why not spread the joy? If you’d like to do the same, click here for more information.

Taking the Pain Away...

Watch this week's video: http://www.youtube.com/watch?v= LI6og7OLEI8

I’ve lost count of the number of times I’ve nearly or completely passed out after getting a needle. First come the sweats, then the black spots, and finally, the floor. I know, how pathetic for a former health reporter and a current hospital employee! After giving birth twice, my tolerance to needles has increased slightly, but it’s game over if they keep jabbing it in trying to find the right spot.

This said, what could I possibly have in common with someone who makes a living giving needles? Apparently more than I thought. Sunnybrook anaesthesiologist Dr. Colin McCartney and I shared a good chuckle when he admitted he hates them, too. “I don’t mind giving them, but receiving them is another matter! I’m as frightened of needles as anybody!” (Just in case you were wondering, yes, the irony is duly noted.)

But that could partly be what has fuelled his passion to make the whole experience of receiving an anesthetic as pleasant as possible. Traditionally, to find the right spot to inject the needle, nerve stimulation would be used. But that’s an imprecise method, often leading to several tries while the patient starts feeling like a human pin cushion. It also leads to a higher risk of other complications, like bleeding, convulsions and even nerve injury.

Dr. McCartney has been a leader in studying and teaching a better method, which uses ultrasound to literally lay out a roadmap of where the needle and anesthetic need to go. It’s a brilliant concept that has been shown to work very well, and make patients like Stanley Hurst a lot happier.

To fill you in on Stanley’s story, in short, he’s had a rough go. He was doing some repairs on his cottage roof when he lost his footing and fell. Instead of landing on both feet, the impact was absorbed by only one, causing those ankle bones to shatter. When I met him, he was being prepped for surgery number 7 at Sunnybrook’s Holland Orthopedic and Arthritic Centre. Dr. McCartney administered his anesthesia using the ultrasound-guided technique, while Stanley looked on in interest. “Actually, it feels more comfortable knowing what’s going on.”

Knowing the lowly needle is up there among the most dreaded symbols of health care, Dr. McCartney says distraction can be a great thing for the patient. Stanley didn’t even flinch as the needle went in, too wrapped up in the black and white scene unfolding on the screen in front of him. And most importantly, he got the right dose in the right spot.

The ultrasound-guided technique is becoming more common in surgical suites across Ontario, but there are some bumps in the road. It takes a lot of training, and some ultrasound machines cost as much as a Lexus. That said, the benefits to the patient are amazing. I’ll go out on a limb and estimate fainting rates across the province will fall by 90% (myself included).

For a link to Dr. McCartney’s blog, click here.