Less is More

In a bright and cheery east end community centre, Lauren Singleton commands the room. Dressed in slim cut workout gear, it’s obvious she makes movement a daily priority. Lauren has been teaching fitness for years, and as she leads her class through the first set of drills, exudes joy through every sweaty step. Amazingly, despite just having a hysterectomy, her hamstring curls and lunges have more chutzpa than anyone else. It’s a very cool sight.

Lauren is exactly the type of person who will go stir crazy when sidelined by a minor injury, let alone major surgery. That, alongside other criteria, made her a great candidate for minimally invasive surgery, or MIS at Sunnybrook. One day in hospital and a few short weeks of recovery later, Lauren is now hoping more women learn about MIS procedures. Sunnybrook has the highest volume of specially trained MIS surgeons who perform the most complicated cases across Canada. Lauren found herself here looking for a second opinion. “Other doctors had said things like watch and wait, and I really wanted to get on with my life.” She was happy to find there were some viable options to consider, including MIS.

MIS replaces the need to open up the abdomen to do surgery on conditions like fibroids and endometriosis. Instead, instruments are fed through tiny incisions (ranging in size from 5 millimetres to 1 centimetre) while internal images are magnified on screens in the operating room. Think of it as video-game inspired medicine. Dr. Rose Kung is a leader in the field, and says she used to practice her hand-eye coordination with the help of Nintendo. Today, her trainees spend serious time in a specialized lab, hoping to perfect their own skills through video technology. To the layperson, it looks like you’re trying to manipulate precise movement through straw-like instruments only visible on the screen in front of you. Not easy, but truly remarkable.

Robotic technology is available, but when it comes down to patient outcomes, there is no difference in the surgeon versus robot showdown. In fact, Dr. Kung says randomized studies have found the only significant difference is cost, with robotic technology being the more pricey option. Sunnybrook was the first to offer the human MIS approach for severe endometriosis, large fibroids and many other procedures. And while there is always some recovery time expected, Dr. Kung says that quite literally, many patients feel like they’ve never had surgery at all.

Lauren didn’t go quite so far, but says she was surprised how good she felt as quickly as she did. And there is one incision she can’t even find. “Overall, I’m like 100 per cent better. I’m looking forward to getting stronger.” With more than a dozen fitness classes on her schedule each week, there’s certainly no doubt of that.
To see MIS in action, click on my video.

What's Happening Up There?

Like many patients with alopecia, Mr. Pokas wasn’t the first one to notice the condition. His wife, who’s acted as his barber for decades, noticed his usually full head of salt and pepper hair was thinning in spots. Not unusual for older men, but the severe itching was another sign. Despite the daily discomfort Mr. Pokas was experiencing, it took a full year before he sought medical advice.

It’s a typical scenario for patients with scarring alopecia, a condition that many mistake for hair loss associated with aging, says Sunnybrook Dermatologist Dr. Jeff Donovan. But scarring alopecia has telltale signs, including itching and burning of the scalp. If this is your experience, don’t ignore it. The problem in waiting is that the scars left behind when the hair falls out make regrowth a near impossibility. Timely treatment won’t be able to restore lost hair, but it can prevent further hair loss from happening in up to 70% of patients.

Treatments range from cortisone creams and lotions to injections and a variety of oral medications. It all depends on the individual and their type of scarring alopecia (there are several). But Dr. Donovan, who has seen far too many patients wait far too long to seek care, urges you see your doctor to start the discussion. Not to mention, to help alleviate your discomfort.

For more information, please watch my video.