Getting The Answers

Watch this week’s video http://www.youtube.com/watch?v=xcco2i3YHTg


Victoria Kadey considered herself an expert at breastfeeding, having nursed her first son until he was a toddler. So when her second son was born, she had every intention of doing the same thing. But her plan was cut short after the gut-wrenching discovery of a hard lump in one breast. After weeks of testing and back and forth, her worst fear was realized: it was breast cancer. Not only was the news an emotional bomb for Victoria, but she had no idea what this meant for her youngest son. He was attachment parented and nursed on demand, so in addition to the physical aspects of nutrition, their whole relationship was based on nursing.

Fortunately, Victoria was able to get the information and guidance she needed at Sunnybrook’s Breastfeeding Clinic. The Clinic is only for women who are Sunnybrook patients, and provides breastfeeding counseling, education and care plans. While patients are provided breastfeeding support from specially trained nurses, some may need additional assistance after they go home. That was especially true for Victoria, who found herself in the difficult situation of dealing with both a cancer diagnosis and its effect on her youngest son.

Being the largest breastfeeding centre in Ontario, and staffed with nurses, nurse practitioners and lactation consultants, the Clinic is a very busy place, seeing about 3,500 patients every year. Lactation Consultant Beth Nolson says, it’s all about helping women reach their goals. “We know that support is huge in terms of maintaining a woman’s desire to breastfeed long-term. If they hit a challenge and don’t have the support, their chances of stopping earlier than they had planned are greater.” Nolson says, the Clinic also helps women like Victoria, searching for the best approach in more unusual circumstances. It’s all about considering the needs of both mother and baby.

To this day, after undergoing a year of difficult cancer treatment, Victoria counts her time at the Breastfeeding Clinic among the best care she received throughout her ordeal. Victoria is now under surveillance and doing well, as are her boys. Her youngest will be turning 3 in May, the same age Victoria weaned her first son off the breast. It will be a time to celebrate new milestones, and hopefully, a new chapter of good health for all.

For more information on the clinic, or the 24-hour helpline, click here.

The Ultimate Gift

Watch this week's video http://www.youtube.com/watch?v=4fRdz2axCX0

I met with Alyshia Higgins a few weeks ago at her relative’s home north of the city. It’s a serene spot, with horses grazing the many acres of property. This summer, she’ll be getting married on the grounds, but the day will be a mix of emotions. It’s only been a few months since losing her father, Malcolm, after a car accident left him with a severe brain injury. During that difficult time, she and her siblings had to say goodbye to their father, but not before fulfilling his final wish.

“We were having lunch about a year and half ago, and I was fooling around with his wallet and pulled out a blank organ donation card. And I said, what is this doing here?” Alyshia recalls as we sat in the den talking. “And he said, haven’t you signed yours? He then went on about this being one of the most important decisions you could ever make.”

As a police officer, Malcolm’s line of work put him face to face with the frailties of life everyday. And he was very vocal about his own wishes should tragedy ever strike close to home: he wanted to donate his organs and tissues if at all possible. “It’s not something you ever anticipate, but I feel we were very fortunate because he had that discussion with us,” says Alyshia. “I know a lot of people don’t.”

She’s right. Despite overwhelming support for the idea of organ and tissue donation, only about 17% of Ontarians have registered their consent. That means every 3 days, someone in this province dies waiting.

Just 1 donor can potentially save the lives of 8 people through solid organ donation, and enhance the lives of up to 75 others through tissue donation, including eyes, skin and heart valves. Sunnybrook is one of 21 Ontario hospitals with a Trillium Gift of Life Network Coordinator on staff, who helps inform families about donation. Craig Johnston acknowledges that donation isn’t right for everyone. What’s important is having the conversation, so families aren’t burdened with guessing what their loved one would have wanted during a time of tragedy.

Alyshia knows her dad was able to save several lives, and shares the thank you cards she received from the recipients openly. “I am so grateful to you,” she reads, “the donor family, for donating this precious gift of life to me. Now I will be able to continue my life with good health with my wife, family and friends.” She stops reading and smiles. “We knew we were making the right decision. For us, it wasn’t a difficult decision to make. It was just a decision made during a difficult time.”

For more information on organ and tissue donation, visit the Trillium Gift of Life Network website. giftoflife.on.ca

A New Kind of Calculator

Watch this week’s video http://www.youtube.com/watch?v=399TSClQMOU

In my house, as likely in many others, my husband and I split the duties. Not only does it lighten the load, but it’s also the perfect way to weasel out of tasks I hate. I get the bathrooms and John gets the bills, and that’s a good thing, considering I never had a mind for numbers. I always excused my mathematical shortfalls by arguing, “That’s what calculators are for!” So you can imagine my delight when I learned that a new type of calculator was not only validating my love of the tool in general, but helping men spot a potential killer.

Here at Sunnybrook, Dr. Robert Nam is a real dynamo. Not only is he one of the country’s top uro-oncologists and surgeons, but he’s also a brilliant researcher. For the past few years, he’s been developing Sunnybrook’s Prostate Cancer Risk Calculator, which is really a fancy way of describing a simple checklist men can fill out with their family doctors. It considers things like a man’s age, ethnicity, family history of prostate cancer and their PSA score. “It instantly gives you your risk for having prostate cancer or aggressive prostate cancer,” Dr. Nam told me. “And you can use that data to determine if you need a biopsy or not. It was started because we realized PSA was a terrible test to evaluate men for prostate cancer,” he said, referring to the imprecise nature of the measurement.

Dr. Nam hopes men will use this new calculator as a way of taking charge of their screening, knowing it will spare many from unnecessary biopsies and stress. This all goes hand in hand with Sunnybrook’s Rapid Results Clinic, which cuts down on the time from biopsy to results from about 3 weeks, to just 72 hours. While it is a lot for men to process in such a short time, I believe there’s something to be said for getting through painful experiences as quickly as possible.

This calculator is intended for men over the age of 50. But if a man has a family history of prostate cancer, Dr. Nam says filling it out earlier, around 40 or 45, is a good idea. “Go to your family physician and say, I want to be evaluated for my risk for having prostate cancer, or aggressive prostate cancer, which is the key.” It’s not a perfect tool, but Dr. Nam says it’s most effective at identifying men with very aggressive prostate cancer, and particularly those with normal PSA levels, as those are the men who often fall through the cracks.

Dr. Nam’s vision for the calculator is that it be globally adopted to better select men for prostate cancer biopsy and screening. More immediately, he says it’s about raising awareness among family doctors and their male patients. Personally, I always found calculators to be lifesaving. Now at Sunnybrook, they really are!

The Disaster Playhouse

Watch this week’s video: http://www.youtube.com/watch?v=kYXRrb9493k

Everywhere you look, there is chaos. Some people have severe burns, and other clutch at deep wounds on their arms and legs. Dozens more wander around in shock, disoriented and withdrawn. Even some first responders have been injured by the intensity of the blast, which has rocked a 25-story apartment building and everyone in it. It’s hard to know where to begin to help, but luckily, that’s exactly the reason for this mock disaster.

Welcome to Sunnybrook’s mass exercise, which this year recreated the Wellesley Fire, a massive 6-alarm blaze that gutted a Toronto highrise in 2010. Several Ontario hospitals, and a wide array of health care disciplines came together to play out the horrifying scenes on a cool Saturday in March. “SARS really put emergency preparedness on the forefront of our minds,” says Dr. Laurie Mazurik, the grand maestro of this event (known officially as the Strategic Lead of Sunnybrook’s Disaster Emergency Preparedness). “It made me and others think we certainly need to prepare for future events, as this wouldn’t be the last.”

So, as if in a Hollywood movie set, the cast was prepared well in advance. Actors were given their roles, and played them out on a specially designated floor at Centennial College. This giant disaster playhouse was mocked up to include an emergency room, critical care unit, mini operating room, family information area and command centre. And let me tell you, with people screaming, crying and made up to look truly injured, it was easy to forget this was just a training exercise. But that’s a good thing. When preparing for the worst-case scenario, after all, you want to bring out the best in people.

The idea of disaster training was born here at Sunnybrook in 2004, and started out as an engaging simulation exercise for medical residents. But as the popularity of the event grew, so did the realization this was a great way to prioritize speedy care and smooth patient flow. It has since grown to include preparation for terrorist attacks, mass pandemics, school shootings and even the G8 Summit, and will be used in advance of the 2015 Pan Am Games.

Pardon the pun, but it all goes to show that practice makes perfect, even in the most imperfect of circumstances.