Liquid Meals

Forty minutes north of Toronto sits a multi-acre property, complete with a small barn and two horses. There is a large garage that houses more horsepower, but this time, the Harley-Davidson variety. The owners, David and Pearl, thrive in this peaceful rural setting, spending all the time they can being active outdoors. But last summer, at a time that should have been spent doing all the things they love, an unexpected diagnosis brought them to a standstill.

After noticing a number of symptoms, David went through a series of tests before learning he had oral cancer. His full-time job as a blacksmith was put aside to focus on getting through seven weeks of radiation and three rounds of chemotherapy at Sunnybrook. It was tiring to say the least. And at a time when David needed his physical strength more than ever, he was losing weight. Treatment had made swallowing difficult and nausea a daily reality. David needed a feeding tube.

Feeding tubes, or G tubes (short for gastrostomy tubes), are placed through the abdominal wall to allow liquid feeding formula and/or medications to go directly into the stomach. They’re often used for cancer and ALS patients, as well as those who have had a stroke or trauma. They look like simple rubber tubing with a valve on one end that opens to allow liquid in through a syringe. Typically, G tubes protrude about one foot from the abdomen, leaving patients to use tape or gauze to try and tuck them away. While necessary, their design can be an inconvenience. That’s why David was thrilled to learn he would be the first patient at Sunnybrook to receive a newer type that he would barely notice.

The MIC-KEY sits flush against the abdomen and allows patients much more freedom of movement. Not only is it tiny (about the size of a dime), it comes with a detachable adapter that connects when feeding. David demonstrated in his kitchen, pulling up his shirt and connecting the rubber tube through a valve. After placing several syringes of Ensure in the tube, he flushed it with water and disconnected it. Mealtime was done in five minutes flat. Down went the shirt and off went David, able to get back to daily living without the inconvenience of typical G tube.

While it’s not ideal for everyone (like those with wider abdominal girth), it is another option for many. “Basically, you can do everything,” David told me. “The feeding tube didn’t stop me from any part of my life at all.” With his treatment complete, he is slowly weaning back to eating by mouth and hopes to have the MIC-KEY removed soon. But for the time he needed it, he’s grateful to have had a less intrusive option.

Watch this week's video on YouTube

Snap, Crackle and Replace

Warning: this video contains graphic images of surgery

I was about nine years old, decked out in my Sunday best, preparing with the rest of my grade school choir to belt out some holiday songs for the packed house of anxious and proud parents attending the Christmas concert. A quiet hush washed over the audience as we took our place on the risers and the lights dimmed. As our music teacher took her place in front of us and got ready to cue the first line of Silent Night, you could hear the proverbial pin drop. The only sound that broke it was the cracking joints of middle-aged parents bending down to capture the moment on film.

Don’t ask me why I remember that, but I do. It was simply gross to me at the time. Today, as life has a cruel way of doing, things have come full circle. My joints are increasingly verbal. And while (knock on wood) they are still functioning well, I realize that I’m smack in the middle of a demographic that is increasingly indicated for joint replacement surgery. Dr. Jeffrey Gollish, a top orthopedic surgeon at The Holland Centre says, we’re seeing a real shift in who is going under the knife. Those aged 55 used to be the exception. Today, they make up nearly a third of patients getting new parts, so to speak.

Part of the change comes from advances to the joint replacement components, with most functioning better and lasting 15 years or more The Holland Centre has also advanced the understanding of when surgery is needed, knowing that the lower people start out on the functional scale, the worse they fare even after surgery. So when your midlife crisis collides with joint replacement surgery, please don’t feel alone.

I know that crackling joints don’t mean surgery is in the cards, but a decline in your daily functioning certainly warrants an assessment. So does an increasing reliance on pain relieving medications. As one of the largest hip and knee replacement centres in Canada, The Holland recently won an award for their model of care, which cuts down on wait times and streams patients into the level of care they need: surgery, physiotherapy or otherwise. Click here to get more information on their programs and services, no matter how old or young you are.

Watch this week's video on YouTube

Rubbernecking

During a soggy week at the end of October, the usually bare grassy patch in front of Sunnybrook’s main building was transformed into a M.A.S.H-like set up. An expansive cream-colored compound had many people doing double takes and peering inside the canvas doorway to figure out what was going on (myself included). What greeted me were at least two dozen medical experts buzzing around, simulating a mock casualty exercise. They were all clad in bright red coats and baseball hats, all adorned with the Emergency Medical Assistance Team (EMAT) logo. Luckily, as I soon learned, this was just a test run. But if you ever see this scene pop up in your neighborhood, you can be sure something has gone terribly wrong.

EMAT was established post-SARS, when the province realized the need for specially trained experts who could work in situations never encountered before. From e-coli evacuations to the G8 Summit, EMAT has been there. Known as the ‘hospital on wheels’, EMAT is a first-of-its-kind mobile medical field unit that can be deployed anywhere in Ontario with road access within 24 hours. It has the capacity to hold 56 beds. In short, it’s very cool.

EMAT’s latest deployment in July 2011 included a 20-hour drive to Thunder Bay to assist with evacuees from fire-threatened communities in Northwestern Ontario. As one member of the 150-member team told me, they never know when the call will come. What follows is always an adrenaline-fueled experience that leaves staff both parts exhausted and exhilarated (but mostly the latter).

Because of the very noticeable paramilitary set up, EMAT usually elicits a fair share of rubbernecking. Tours from town mayors, city controllers and other official types are common. Good to know my reaction on the Sunnybrook campus was the norm!

To do your own virtual rubbernecking, check out more information on EMAT.

Watch this week's video on YouTube