SunnyView

Worried To Death

2012-02-13T08:03:00.000-08:00

I was tucking my son into bed a few weeks ago when he started asking some heavy questions. Normally, I would take any conversation immediately preceding lights out as a stalling tactic, but I couldn’t leave him hanging when he asked if we were all going to die one day.

I took a moment and thought about how to answer him in an age-appropriate way. Pulling out the old “flower” metaphor (used no doubt by millions of parents before me), I explained that life is a cycle, and that yes, every beginning has to have an end. He stared at me wide-eyed, so I quickly added there was no reason to worry because he is young and that’s a long way off. A few seconds passed and then he asked if I was going to die soon, because I’m old. Bruised ego aside, I assured him with a prompt “no” and kiss on the forehead. That seemed to do it as he rolled over and grabbed his bear.

He felt better, but all I could think was I potentially just lied to my kid. What I should have said was “Honey, mommy is doing everything she can to stay healthy, but really, I could get hit by a bus tomorrow. Plus, some are predicting the world will end this December. Sleep tight!” Honesty is over-rated, plus the kid needed to sleep. What’s a parent to do?

Want to live for a long time? Go to the gym,
quit smoking and eat healthy - all things
that have been shown to extend the average lifespan.

When it comes to dealing with things that are essentially out of our hands, Dr. Kelsey Collimore, a clinical and research fellow in Sunnybrook’s Department of Psychiatry says to remember that our interpretation of events is key. What you choose to focus on gives that event or thought importance. So if you haven’t already, stop Google searching “death and Mayans”. I think it’s fair to say we’re all too busy to die, let alone sit around and worry about it.

While as inevitable as taxes, death is usually far less predictable. That’s another reason why I find all this Mayan doomsday talk such a waste of time. Not only is the idea bunk in my opinion, but it also takes the focus away from what we really should be concentrating on. Want to live for a long time? Go to the gym. Quit smoking. And stop eating foods your grandmother wouldn’t recognize. Aim to surpass the national average lifespan by relying on credible life extending evidence, and hey, if the world gets annihilated by a giant meteor in the meantime, at least you can say you tried (and looked great in your jeans in the process). And as I recently did, you can at least lie to your child with a decent hint of integrity in your eyes. Here’s to making death, and worry, the last things on our to-do lists.

The Surgery App

2012-02-03T09:33:00.000-08:00

Last fall, a member of my family underwent surgery here at Sunnybrook. He had an incredible surgeon, and we couldn’t have asked for a better outcome. But as many families know, it’s torture sitting in the waiting room, eager for any snippet of news. There are only so many repetitive news wheels you can watch, and eventually, even the most tantalizing gossip magazines lose their entertainment value. As much as we didn’t want to keep bugging the clerk at the check-in desk, we did. So did everyone else. “No news yet? When might we have some news? How about now?” I equate it to driving in the car with my kids, who keep asking if we are there yet. Even after hearing the word ‘no’, they just can’t help themselves from asking again five minutes later. It all made for a very long and tiring day.

OR Status can be viewed at sunnybrook.ca/orstatus

It’s a reality dozens face on a daily basis, but thankfully, a new app developed at Sunnybrook is putting information into the hands of those who need it most: family members and loved ones. Called OR Status, this tool essentially gives each patient a tracking number that they can share if they wish. Then, it’s easy for loved ones to go online to see when the surgery started, and importantly, when it finished. That frees up the time in between to do something other than sit, wait and worry.

I spoke with one woman who used it during her mother’s surgery. “You don’t feel like you’re off in a place and you have no idea what’s going on until the surgeon comes out for you hours later,” she told me. “We knew that things were progressing and going fine, so that was nice.”

OR Status now makes Sunnybrook one of the few hospitals in Ontario to offer real-time information on patients undergoing surgery. What a simple, wonderful idea. Now if only someone could develop a tool to prevent my kids from ever bugging me on long car rides…

To find out more about OR STATUS, click here.

Less is More

2012-01-16T13:41:00.000-08:00

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?

2012-01-09T08:59:00.000-08:00

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.

Harry's Workshop

2011-12-20T08:32:00.000-08:00

Tucked away in a ground level corner of the Odette Cancer Centre sits an office like no other. The nondescript white door opens to reveal an expansive workshop that wraps around one corner and back down another. A gaggle of tubing, drills, heavy machinery and materials I’ve never seen before litter wooden workbenches and wall-length shelving. The smell reminds me of my grade seven shop class. But what’s being created here couldn’t be more far removed from ash trays and birdhouses. Harry Easton and his team in medical physics are busy helping patients, one invention at a time.

His office walls are a visual monument to the thought process he brings to the job everyday. Let’s just say, Harry has a certain brilliance I never will. “What’s that square thing with the holes in it?” I asked. Harry explained that was a customized grid used to make sure breast cancer patients get precise treatment. “And what about that round ball hanging over there?” I asked. That, he told me, has actually changed care for patients with inoperable brain tumours, making sure they get right dose of radiation within sub-millimeter accuracy. Okie dokie, then.

However humbling the interview was for me, Harry never held airs. In fact, he’s one of the friendliest people I’ve ever had the pleasure of talking to. And despite the average 15 projects he’s juggling at any given time, and responsibility to keep all the multi-million dollar cancer machines running smoothly, his door is always open to curious patients. And many times a day, Odette Cancer Centre staff saunter in with problems that need solving, or even crude sketches on scraps of paper, hoping Harry and his team can make them real. They always do.

“So out of all the things you’ve built, what’s your favorite?” I asked at the end of our interview. “I have a twelve string acoustic guitar that I’ve built! That’s my favorite thing!” As totally unexpected as his answer was, I was thrilled that at least it was an object I could identify! Not that I could play it, though…

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Bright Hats and Kitty Litter

2011-12-12T08:33:00.000-08:00

There’s an old saying that if you want to get sick, go to the doctor’s office. No doubt, it’s usually a concentrated mass of coughing people within a confined square footage (not to mention whatever is lingering on those magazines). So how is it that so many doctors and nurses are able to stave off illness year in and year out? My curiosity led me to Sunnybrook’s Occupational Health & Safety Department, where frontline staff have literally seen and treated it all. What better place to arm myself with immune boosting information?

I met with Christine Ader, a lovely nurse who (true to expectation) rarely gets sick. In hand she had her top tips to stay healthy until the Sorels get officially packed away into the basement. It is the season of lists, after all. Things to do, things to buy, and now, things to help you avoid flus, falls and frenetic schedules. I sat down with my camera and started recording.

Staying well appears to be a gentle balance of lifestyle and common sense. There are the obvious methods, like frequent hand washing, regular exercise and adequate sleep. But just as critical are brightly colored scarves, shoe shopping and kitty litter. Yes, this seemingly random mix will help you tackle the season with healthy fervor (and will make much more sense after you watch my video.) And if the gift of safe sex lands under your tree, she recommends opening it without hesitation. I think that tip falls somewhere between exercise, stress relief and making the season bright…

Here’s hoping Ader’s advice helps you avoid the doctor’s office this year. Better to be reading your own magazines at home curled up by the fire. Happy holidays!

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Liquid Meals

2011-11-28T06:57:00.000-08:00

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.

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Snap, Crackle and Replace

2011-11-15T09:22:00.000-08:00

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.

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Rubbernecking

2011-11-07T06:14:00.000-08:00

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.

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The Big Picture: Meet one of Sunnybrook's Veterans Centre residents

2011-10-31T08:06:00.000-07:00

Sunnybrook is blessed with an amazing photography team who, arguably, know every person (and their backstory!) in this ten thousand strong workforce. So when I got an email from one of them with a video link, I was intrigued.

What appeared on my computer was completely unexpected: an old black and white mini-documentary of a young Reuters photographer named Patricia Holden. Over a peppy male voiceover, the video showed Patricia on assignment photographing a baby, and then returning back to the newsroom to develop her film and finish the job. Like an early Mary Tyler Moore, she was dressed in a knee-length tweed skirt and smart hat, world at her feet. How appropriate that the Pathe Pictorial video, produced just after the Second World War, was entitled “Women Going Places.” Today, more than half a century later, Patricia is still going places, having recently become a new resident of Sunnybrook’s Veterans Centre. I literally couldn’t wait to meet her in person.

A few days after watching this grainy slice of history on my MAC, I walked into Patricia’s room over in Sunnybrook’s K wing. She was sitting quietly by the window in a wheelchair, looking outside at the early fall weather. Her windowsill was covered with pictures in frames, as was the wall behind her bed. From General Eisenhower to Shirley Temple, it was a fabulously random mix that I was soon to learn perfectly reflected her unexpected ascent into this line of work. She turned to say hello and shake my hand. Despite the decades that had divided her from that early video, I recognized her right away. Eyes never change, you know? After a few pleasantries, I started our interview with what I thought was a simple question: How did you get into photography? As I mentioned earlier, her path into this pioneering role for women of her day wasn’t at all what I had expected.

In 1942, Patricia and some girlfriends happened to walk by a recruitment office when they noticed some very cute boys hanging around outside. Thinking it would be a good way to find dates, they signed up for the Royal Canadian Air Force. But as only the cruel ways of fate can script, Patricia was posted to the Women’s manning depot. No men allowed! Frustrated with the all-female environment, she jumped at a Wing Officer’s offer to keep busy by learning the art of photography. Following a challenging course, she passed and started her career in pictures. While she admits to professionally feeling like a babe in the woods for a while, she was happy her new job at least opened the door to more co-ed working environments!

Over the next few years, Patricia would go on to capture a huge range of images, from weddings and medal presentations to funerals and bombings. After the war, Reuters hired her to shoot fashion, celebrities and various daily assignments. It was there that the documentary emailed to me was produced. You can view the entire thing here yourself.

Just so you know, Patricia eventually enjoyed many dates and even found herself a honey. Art Collins was a fighter pilot who was awarded the French Legion of Honour and distinguished Flying Cross. They married and raised five children together. While she didn’t meet him on that sunny day outside the recruitment office in 1942, we all know love works on its own schedule.

Now windowed, Patricia has been a resident of Sunnybrook’s Veterans Centre for several months. Amazingly, she remembers being sent on assignment here to photograph Sunnybrook’s opening. We sat and talked about how funny the coincidence of that was, when things come full circle in life. Kind of like seeing a video from the 1940’s and then meeting its main character in person. Funny and wonderfully unexpected.

With Remembrance Day around the corner, it’s a reminder of the value in the stories and lessons we can learn from our veterans. Take the time to ask and listen. As I learned, it just might be one of the most surprising and fulfilling conversations you’ll ever have.

For more information on the Veterans Centre, and learn how you can help support a Veteran through Operation Raise a Flag.

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- blog post and video by Monica Matys

Body Language

2011-10-28T05:58:00.000-07:00

You’ve lived with your body for a while, and you know what it can do. If that ever deviates, even for just a few minutes, be warned. Arnold Bobkin’s story speaks to this loud and clear. Earlier this year, he was in the shower when the trouble started. He suddenly became paralyzed on one side, and was afraid he would fall over if he took a step. Trying to make nothing of it, he muddled through, dried off and proceeded to style his hair by plugging the blow dryer into his ear. He topped off his morning grooming routine by brushing his teeth with his finger. At this point, he wife insisted it was time to go to the emergency department.

Good thing he did. Arnold was having a TIA, short for transient ischemic attack. TIA’s are like mini-strokes, and put people at serious risk of having a full-blown stroke, often within hours or days. If Arnold had ignored his symptoms, and not received care at Sunnybrook’s High-Risk TIA Unit with its dream team of experts, he likely wouldn’t be golfing three times a week like he does now. Doctors found a major blockage in the carotid artery in his neck, which is a serious red flag. Surgery is usually the fix, but the trick is getting it done quickly if you are having symptoms.

Outside Sunnybrook, it’s been found that not all symptomatic patients receive this procedure within the recommended time frame of two weeks, something Sunnybrook experts are working with the Ontario Stroke Network to change. As the saying goes, time is brain.

Remember that if you are having symptoms of a TIA, including sudden trouble speaking, seeing or moving, call 911 right away. There are protocols in place to direct patients with TIA or stroke symptoms to a designated Regional Stroke Centre like Sunnybrook. Or, like Arnold, listen when a loved one tells you it’s time to go to the hospital.

“It’s a very strange phenomenon that happens to your body that you don’t know what is going on,” he recounted. “For whatever reasons, I didn’t know what I was going through until my wife told me. If the worst had happened, I would have had a major stroke within the hours afterwards.”

Thankfully, that wasn’t the case, but the shot of Arnold’s arteries in my video clearly illustrates how dire his situation was. It all goes to show that what you can’t see can hurt you. So if your body is trying to tell you something, make sure to listen.

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Next Day Knowledge

2011-10-24T11:36:00.000-07:00

Call it the genetic grab bag. Everyone has one, but whether you’ve stuck your proverbial hand in it yet is another matter. In my family, there is a history of heart problems and bad eyesight. For other families, like Cori Woolley’s, breast cancer is the monster in the closet.

Both Cori’s mother and aunt had breast cancer, and having just celebrated her 49th birthday, Cori was well aware that she had reached the age when her sister had been diagnosed. But that’s where the similarities end. Cori’s sister took about six months of testing to get her diagnosis. After finding a lump in her breast, it only took Cori a matter of days to get the good news that she didn’t have the disease.

Cori was a patient in Sunnybrook’s Breast Rapid Diagnostic Unit, or RDU, which gives next-day diagnosis and personalized screening recommendations for all patients. A Nurse Navigator walks each patient through the process from start to finish, which often includes ultrasounds, mammograms and, potentially, a biopsy. It’s a huge advance, cutting down typical wait times from weeks to mere days.

“I can’t imagine having to wait for results and wondering what’s going on in your body and the feeling that does bring on, inevitably, for me was only a couple of days,” Cori told me. “Right then and there on the spot they said, this does not look like cancer. I got hugs all around. Everyone was very emotional. It was really a very special experience.”

Cori knows she is still at increased risk, and will receive ongoing monitoring appropriate to her situation, which includes annual mammography and follow-up in Sunnybrook’s High Risk Clinic.

Whatever the contents of your grab bag, it’s all about managing the contents as best you can. Prevention, screening and knowledge are the best tools around. Make sure to get yours!

Click here for more information on Sunnybrook’s Breast Cancer Care.

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Mind Your Heart

2011-10-17T07:05:00.000-07:00

My first job out of university was at a medical publishing company in Montreal. It was staffed with several of my friends from school, all settling for the trade off of low pay for some real work experience. While I was busy learning the foreign ways of doctor speak, language of health care, it was a colleague in my office that taught me my first life lesson about mental illness.

I’ll call her Sue in this blog, and she was a sweet, almost soft-spoken girl I barely noticed until she returned to work after our first Christmas break at the company. Her personality seemed to have taken a drastic shift, bubbling over with energy and a euphoric kind of happiness. Within a day or two, that elation would cycle into episodes of extreme sadness. This continued for several months, and while we all noticed it, no one knew what to make of it. The irony strikes me now that we were all working in medical communications and couldn’t put a finger on bipolar disorder.

Known in the past as manic depression, bipolar disorder can lift and drop its host between opposing mood swings that can last from hours to months. Bipolar disorder also increases the risk of heart disease, accelerating the onset by up to 15 years. The big question is, why?

A new and unique Sunnybrook study is hoping to find out. Researchers will use high-resolution ultrasound to look at the blood vessel functioning in the forearms of teens to look for potential clues about heart disease risk. For example, is there inflammation? A blood test will also be done to look for things like proteins that could offer an answer. Participants are still being recruited, so if you’re interested, you can contact Katelyn at 416-480-5283.

The hope in studying teens is that the connection between heart disease and bipolar disorder will become more clear. Teens are typically in better physical condition, so any differences in, say, how the blood vessels work should be easier to spot. It’s also a pretty rare for specialists from the head, heart and imaging all come together for research, so what they find should be intriguing.

It’s been many years since I last saw Sue. Through family support, and the insistence of a senior editor at my old company, she eventually did get proper diagnosis and care for her bipolar disorder. The last I heard, she was doing well and enjoying married life with children. Hopefully, with ongoing research, more people like her can be helped in the future.

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A Different Perspective

2011-10-03T06:51:00.000-07:00

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When I remember back to being 20, life was all about school, boyfriends and the future (not always in that order!) Nothing heavy, even though these simple scenarios may have played out dramatically at the time. There wasn’t a thought in my head about getting sick. Now, with the wisdom of hindsight, I realize how fortunate I was.

Johanna Stuehrenberg didn’t have that luxury. Last year, she started having trouble with her vision. She initially thought her glasses were to blame, but then other symptoms, like vomiting and headaches, started. After a trip to a walk-in clinic, the doctor there assured her it was probably just stress and definitely not a brain tumour. What consolation, she remembers. But that diagnosis couldn’t have been more off the mark.

Johanna’s symptoms persisted, and worsened, so she went back to the doctor. A CT scan finally revealed there was a major problem: liquid pressuring her brain that would require immediate surgery. Sunnybrook surgeons successfully removed a 4-centimeter cancerous tumour from Johanna’s brain, and she was then treated with radiation. What a physical and emotional journey to endure in just a few short weeks.

Now, more than a year after her ordeal, Johanna is doing extremely well. We met outside the Odette Cancer Centre for her interview, and what I saw was a beautiful and funny young woman having to, at a very young age, re-plan her life. Part of that rebuilding, she says, is sharing her story to help other younger cancer survivors. “I think when you hear about cancer, you think of older people, forties or up,” she told me. “But there are so many that are young and don’t have the great support.”

Fortunately, Johanna found support in the community and has an extremely strong family unit. Her parents even bought her a cat after her ordeal. (He is the same gray colour represented on the Brain Cancer Awareness Ribbon campaign, but that was total serendipity.) Sunnybrook’s Patient and Family Support team is also helping Johanna rehabilitate, and reintegrate, into everyday living.

“Cancer is not a chance to give up on life,” Johanna says. Hopefully, now is the time she can start thinking about school, boyfriends and the future again, in whatever order she wants.

For more information on Sunnybrook’s family support group, click here.

Hernia Repair

2011-09-19T11:25:00.000-07:00

Watch this week's video on YouTube (warning: contains graphic images of surgery)

Barbara Danbrook’s health story is a living testimonial to the expression, ‘adding insult to injury’. Over the past three years, she’s been diagnosed with two different types of cancer and lived through extended treatments and surgeries. Having survived all that, you would think it would be time to celebrate. But not so fast. What came next was unexpected, and crushing: a massive abdominal hernia, leading an appearance she describes as a “pregnancy which had slipped”. Not only did her physical condition make daily pleasures, like simple walking, nearly impossible, but the psychological stress of yet another health problem was heavy. “I couldn’t believe actually that after all the radiation and chemo and the two surgeries that I had to deal with something else.”

It’s a problem that’s becoming more pervasive, says Sunnybrook surgeon Dr. Fred Brenneman. More people are surviving cancer surgeries and traumas, which is wonderful. But both are also major hernia triggers. Hernias are weaknesses in the abdominal wall, and the bowel literally protrudes, often causing discomfort, fatigue and seriously hampering activities of daily living.

Hernias are often repaired using a synthetic mesh made of plastic-like material, to help contain and tuck in the bowel. But infections can happen, especially when bowel surgery is also required. That’s where a new biologic mesh, cell-free and made of human or pig skin, is much better for patients, says Dr. Brenneman. Fewer infections mean fewer surgeries for patients, and less time in the hospital. You can click on my video to see it being surgically implanted into a patient.

The trick with the biologic mesh is the cost, which is about five times more expensive that the synthetic version. Dr. Brenneman says, it’s a clear example of funding not keeping pace with innovation. Plus, he says when you factor in the cost of reduced surgeries and hospital stays, the economics equal out. Part of Sunnybrook’s role is raising awareness about this biologic mesh, and hopefully securing future funding for the growing number of patients who could benefit. In the meantime, Dr. Brenneman says, every donation counts. Click here to learn more about the mesh, and an upcoming fundraising event in October 2011.

Thankfully, Barbara’s health story may just have a happy ending yet. After her synthetic mesh developed complications, Dr. Brenneman replaced it with the biologic mesh. The difference was instant, and to date, lasting. “As far as the biologic mesh, I would say to people, do it. You’ll be so much more comfortable and you’ll feel so much better about yourself.” She hopes her story will help educate others facing a similar situation, to not settle for suffering.

It's Not Cancer...

2011-09-06T06:37:00.000-07:00

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A few years ago, my job had me crossing paths with a woman living in Toronto. We would liaise on projects about three times a year, and this went on for nearly a decade. While we developed a very close professional bond, I was always left somewhat puzzled by her physical appearance. She had no hair, no eyebrows or eyelashes, and yet seemed otherwise well. Thoughts of cancer treatment did cross my mind, but her boundless energy and the unaltering state of her appearance year after year made that unlikely. Then one day, in an e-mail that seemed out of the blue, she kindly explained that she had alopecia. Of course, I thought. Why hadn’t I considered that? And more importantly, had I made her feel that in some way she had to explain herself?

It all goes to say, ignorance is not always bliss, so here are a few things I’ve since learned. Alopecia areata is a chronic condition that can affect anyone at anytime or age. Resulting in hair loss in small patches, the whole head or the entire body, alopecia can come and go without warning and the cause is unknown. And it’s extremely common. If you were riding the subway, let’s just say at least two people in your car would be affected.

Here at Sunnybrook, we’re lucky to have a literal hair loss guru on staff. Dr. Jeff Donovan has treated countless patients with alopecia, and he told me that personal support and appropriate treatment can make a world of difference for patients. There are a variety of options, ranging from creams to injections. And Sunnybrook is also one of the few hair loss clinics in the country to offer a topical chemical treatment called DCPC, which is about 60% effective in promoting hair growth.

It was in this clinic that I met Beverley, a patient of Dr. Donovan’s who in mid-life, started experiencing hair loss. “I thought, gee, this is odd,” she told me. “And then consistently, it just fell out. It was really hard.” Beverley now comes in for weekly DCPC treatments, which last about 5 minutes and consist of a giant Q-tip saturated in the medication being rubbed all over her scalp. While the medication does cause some temporary discomfort, Beverley described it as not too bad.

But just as important as dealing with the physical side of alopecia, she told me, was managing the psychological toll. “I think the main thing is to not lose your own personality, not to get depressed even though it’s difficult at times. You’re still the same person and you’re getting help. When you come here, you’re getting help.”

Beverley agreed to talk to me for this story to try and help other patients and to educate the public about the condition. That’s knowledge I could have used a few years ago myself. And knowing how pervasive alopecia is, hopefully this can help you, too.

For more information on the Sunnybrook Hair Loss Clinic, click here.

For additional information or support to to: The National Alopecia Areata Foundation and The Canadian Alopecia Areata Foundation.

Call me (later)...

2011-08-22T10:46:00.000-07:00

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I’ll be the first to admit, I’ve done it. As a former reporter, and a busy mother of two, there always seemed to be a reason to be on my phone in the car. Setting up interviews, booking appointments and the list goes on and on. So many reasons to be instantly available, and yet, the only one that really matters doesn’t support the theory at all: staying alive.

Ontario’s ban on using electronic devices while driving was a wake up call to the facts: that using a cell phone while driving is as dangerous as getting behind the wheel drunk and dramatically reduces reaction time. It’s like that old game of drawing imaginary circles on your stomach while patting your head and jumping up and down on one foot. Juggle too many balls, and inevitably, one (or more) will drop.

Case in point, Constable Keith Ingram cites a London-based study that found on a daily basis, two pedestrians there either end up in the trauma unit or die because they were using their cell phones. Two a day! They walk into mailboxes, street poles or moving traffic because they are distracted. “If we can’t walk while using a cell phone we certainly can’t drive while using a cell phone,” he says. “At some point we have to say, how important are these calls to us? Are they worth dying for?”

My vote is a definite “no”, and have changed my ways since the provincial legislation was introduced. My phone now stays in my purse until I turn off the ignition. Funny thing is, all my work is still getting done and all those appointments are still being booked. Go figure, life goes on! Andmaking sure I’m part of it is really the point.

Learn about Sunnybrook’s RBC First Office for Injury Prevention.

Visit sunnybrook.ca/labourday and tweet with the hashtag #SafeLabourDayChoices to spread awareness about injury prevention this long weekend.

Small Wonders

2011-08-15T07:02:00.000-07:00

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The morning I spent at Kate Robson’s home was about as normal as you can get. Showered and ready by 7 AM when I arrived, she made her way to the kitchen to wash up blueberries to add to the cereal and oatmeal of her two young daughters, Maggie and Grace. The banter was sweet, sprinkled with reminders to please sit nicely while you eat, while the girls giggled over knock-knock jokes. Kate’s husband darted in and out of the room, grabbing toast and preparing for the day himself. As I filmed quietly in the corner of room, it was hard to imagine how a family scene so serene could have had such a dramatic beginning.

Maggie, now 6, was born a preemie at just 25 weeks. Grace, now 3, was also born premature at 33 weeks. Kate remembers well how touch and go those times were, and how emotionally draining it was to live, quite literally, on the edge two times over. One particularly bad day, Kate emotionally recalled how unclear Maggie’s survival would be. “I met a mom whose baby had been through a very similar story, but a few weeks before, and her baby was now doing really well. In that moment, she changed my life. She made me feel that it was OK to hope.”

Hope prevailed, and Kate and her husband felt compelled to pay it forward. They both started volunteering with Sunnybrook in 2006. Four years later, she would read a unique posting that tweaked her interest for obvious reasons: “Calling all moms and dads! Sunnybrook is searching for the perfect parent to join its Neonatal Intensive Care Unit (NICU).” With a Masters in adult education under her belt, and her strong connection to the NICU, Kate was a natural fit. Call her Sunnybrook’s first official professional parent.

“Being in the NICU, it’s hard to imagine that life can look different. And I think it’s really important for parents to imagine that the future can look quite bright,” Kate told me. “Your baby is not going to be an NICU baby forever, you will leave this place and there will be joy in your life. But it’s hard to imagine that unless you have someone to talk to.”

And talk she does, to dozens of parents and families each week, offering advice, support and connections at a time when isolation can overwhelm. First-time mom Farzana Rahmaty, whose daughter was born at just under 2 pounds, called Kate her light through the fog. “She definitely holds your hand and helps guide you.” Kate also produces a newsletter, organizes events for parents who often spend months in the NICU, and delivers a special gift package. “When a baby comes early, parents can often feel the experience has been stolen from them. You often don’t do prenatal classes and a baby shower is fraught with anxiety. For a lot of our families, this is the first baby gift they get.”

But the best part of the gift, in my opinion, is the message Kate offers with it: “You’re a parent, you have a baby, so celebrate.”

For more information on Sunnybrook’s NICU, click here.

Radiation for Prostate Cancer

2011-08-05T08:10:00.000-07:00

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Freiderich Duerr spent the bulk of his career surrounded by laughter. He worked as the hairdresser for The Royal Canadian Air Farce for years, and from his friendly demeanor, it’s no stretch to see him as part of the comedic landscape. An avid entertainer himself (albeit on the homefront) Freiderich was always hosting parties and serving up favorite cocktails. But when he received the news that he had prostate cancer, all the joy came to a screeching halt.

Like anyone in his shoes, Freiderich carefully considered his options, eventually opting for radiation therapy at Sunnybrook. Radiation can be an effective and relatively non-invasive way to treat men, and candidates are typically older and not fit for surgery. But it is time consuming. Freiderich’s treatment was once daily, Monday to Friday, for eight weeks. As one oncologist explained, the fatigue many men experience with radiation may have a lot to do with having to face their cancer so physically day in and day out. Radiation works on the principle of energy damaging the DNA of cancer cells, and is done daily to achieve that goal while allowing healthy cells to repair in the meantime.

A few weeks ago, I followed Freiderich through one of his treatments, which took about ten minutes top to bottom. After changing into a hospital gown, he was positioned on the treatment table while the machine was loaded with the proper coordinates. Then, a series of beams zapped the areas needing treatment. All done, until the next day anyway. Despite the daily grind, Freiderich told me he was “very pleased” with his treatment, and even more so with the people helping him through it. He had even started cooking his favorite dishes for Sunnybrook staff. I little bit of joy was seeping back.

Having just completed his course of treatment last week, Freiderich is now hoping to focus back on the fun parts of his life again. Gardening, cooking and time with friends. What better way to celebrate getting to the end of long hard road? Wishing you all the best Freiderich!

For more information on all types of radiation therapy, check out my full patient education video on radiation therapy.

The Snooki Effect

2011-07-05T08:17:00.000-07:00

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Hours in the sun during peak UV periods? Check. Baby oil? Check. A total disregard for the increased risk even one severe burn poses on my overall lifetime risk of skin cancer? Double check. Ah, the sweet ignorance of being fifteen. What was I thinking? Like many, I wanted a golden glow. I really wasn’t equating tanned skin to damaged skin, a realization I’m now appreciating more than ever. As I prepare to celebrate my fourth decade next year, I can’t help but think 40 is only the new 30 if you’re smart at 15.

Judging by the group of girlfriends who would regularly join me in my backyard self-sabotage, I know I’m not alone. And after speaking with Sunnybrook patient Lindsey Beamish, who is ten years my junior, the allure of the tan is still alive and well. “I loved that healthy glow, I loved to look like I had been in the sun,” this former self-confessed sun worshipper told me. That was until she noticed a small mole on her thigh had become a bit red. “It wasn’t a scary looking mole,” she said. That made the news of skin cancer at 24-years-old even harder to believe.

“When this touched me five years ago, I thought, this can’t happen to me. And when I actually went to the cancer clinic, I was one of the youngest in there and thought, I shouldn’t be here!” But if you have skin, you’re at risk. Simple as that.

According to a recent poll from The Canadian Cancer Society (CCS), 51% of Ontarians surveyed believe tanned people look more attractive. CCS experts say that perhaps the pop-culture “Snooki effect” of shows like Jersey Shore continues to feed our obsession with tanning. But the danger is how frequently skin cancers are being seen in a younger demographic. Their statistics show that skin cancer continues to be one of the biggest cancers for those aged 15 to 29.

To be safe, seek shade, avoid direct sunlight during peak UV periods and wear a broad-spectrum sunscreen. Sunnybrook Dermatologist Dr. Kucy Pon recommends an SPF 30, which will protect you from about 97% of harmful UV rays. Just make sure you apply enough. You’ll need about a shot glass full to cover your body adequately (that must tie back to Jersey Shore somehow…)

Lindsey now takes five minutes every month to do a full head-to-toe body check to uncover any potential changes. And suntanning is no longer part of her vocabulary. We even conducted our interview in the shade of a large tree outside her office.

Besides the wisdom of hindsight, Lindsey and I now share a different passion: self-tanners and tinted moisturizers. They’re an easy and harmless way of getting golden without the health risks. And while some sunlight is an important way of getting adequate amounts of Vitamin D, sunscreen is now our second skin.
For more information, click here.

Flash Burns

2011-06-27T12:15:00.000-07:00

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Shane O’Dowd-Rutherford was only nine years old when he and a friend decided to cook up some homemade fireworks. It was the season, after all, so the duo started mixing household items they’d found under the kitchen sink. Within two minutes, the concoction (ripe with highly flammable solvents) exploded, the eruption landing on Shane’s shirt. It quickly ignited, leading to the pattern of injuries Shane sustained: burns to his neck, chest arms and face. In the short time it took Shane’s mother to duck out to help her other son uncover some toy cars buried in the family’s backyard sandbox, Shane’s life would be forever changed.

It would be nice if Shane’s story was unique, but it’s not. Dr. Marc Jeschke, Director of Sunnybrook’s Ross Tilley Burn Centre, tells me he treats hundreds of these types of injuries every year. Incredibly, people throwing igniters into campfires, reaching to flip burgers with their bare hands or lighting fireworks without even reading the instructions. The circumstances vary, but the outcomes are equally horrific: flash burns causing disfigurement, pain and often numerous surgical procedures to correct. Fortunately, Dr. Jeschke says there isn’t a lot of magic when it comes to prevention. Always supervise children, use common sense and enjoy your alcohol after the BBQing is done (I can see the bumper sticker now: don’t guzzle and grill!)

If this brief shout out from the injury prevention soapbox doesn’t do it, and you do suffer a burn, know that cold water is the way to go. Dr. Jeschke has seen it all when it comes to kitchen cupboard remedies (jam, butter, oil…) that only aggravate the injury further. In short, keep the condiments for your burgers and seek prompt medical attention.

Having walked the walk, Shane says it’s just important to be conscious whenever you’re doing something even remotely dangerous. As he learned, one second of carelessness can turn into 25 years of recovery (and still counting).

For more information, click here or check out the great information offered by Toronto Fire Services.

Rinse, Dry, Repeat...

2011-06-20T08:18:00.000-07:00

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Eat your vegetables! They’ll make you strong. Those carrots will help your eyesight. And oh ya, make sure you wash everything properly or you could suffer serious gastrointestinal symptoms, kidney failure or even death. OK? Now eat up. (You’ve just experienced my inner thought process after learning about the virulent new strain of e-coli originating in Europe).

Meal preparation will never be the same, and maybe that’s a good thing. While I’m the first to admit to eating an apple from the grocery store after just shining it up on my pant leg, or to pouring pre-washed salad straight onto my dinner plate, this e-coli outbreak is a tragic reminder of how serious, and even deadly, the consequences of improper food preparation can be. And it’s not a foreign problem. Here in Canada, there are about 13 million cases of food-borne illness every year. That number could be slashed by 85% with safe food handling practices alone.

I set out to learn how to protect myself from any invisible bacteria, and enlisted the advice of two registered dietitians at Sunnybrook. Here’s a little true and false synopsis of what I uncovered:

True or false: It’s enough to wash your produce under cold running water. 
True! For foods like apples and tomatoes, run them under the water until it runs clear. For produce with a hard rind, like a cantaloupe, invest in a produce brush to get into all the nooks and crannies before you cut it up. And remember, if you soak it, you’ll still need to wash it under running water to remove any harmful bacteria. For lettuce, make sure to separate the leaves and wash each one separately.

True or false: You need to wash your produce with soap. 
False! Enough cold running water will do the trick.

True or false: All produce is safe for everyone if prepared properly.  
False! The dietitians told me that The Canadian Food Inspection Agency recommends children, infants, the elderly and immuno-compromised don’t consume mung bean sprouts and alfalfa sprouts because they have a high contamination rate of e-coli and salmonella.

True or false: If the package says pre-washed, you don’t need to wash it at home. 
True! (Hurray, at least I was doing something right!)

There are some other great tips you can see in my video, including why the eyeball test should never be used to judge food safety (yes, I’m guilty of that, too). But when you know better, you do better, so here’s to turning over a fresh new (safe) leaf.

A Bad Case of Hockey Fever

2011-06-13T14:03:00.000-07:00

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When Dr. Donald Redelmeier studies something, the headlines almost write themselves. His quirky yet intriguing research has uncovered some unique and important gems: election day can be fatal (more traffic and rushed drivers), texting and driving can be deadly (yup, he’s the one that make the link) and now the newest research on hockey and health: when the big games are on, emergency department visits drop like a puck at centre ice.

During one particular shift at Sunnybrook last year, Dr. Redelmeier noticed how unusually quiet things seemed. Turns out, it was the day of the Olympic gold medal hockey game, reported by broadcasters as being the highest-rated game ever in Canadian history. Coincidence? He thought not. He set out to study his observation and found that indeed, Ontario’s emergency departments saw 136 fewer patients per hour during that 3 hour broadcast. The biggest drop was seen in middle-aged men. (I’d love to see what beer sales were that day!)

To get the first-hand scoop on this, I went to talk to Teresa Korogyi, the Patient Care Manager for Sunnybrook’s emergency department. Sure enough, it came as no surprise to her that big sporting events of all kinds have an impact. “A lot of times people register before the game and it would be six, seven o’clock and the first thing they say is, how long is it going to be? I’ve to be out of here at seven-thirty, the game is on tonight and I have to see it!”

The important thing is, don’t let your buddies smack talk you into ignoring that shooting chest pain as just a consequence of the bucket of wings you just consumed. In other words, come to the hospital if you need to, when you need to. It’s really never a convenient time to be sick, but you can at least rest assured that there is a television in the waiting room. Now there’s something to bet your life on.

Prostate Cancer

2011-06-07T07:13:00.000-07:00

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They say life happens when you’re busy making other plans. For Joel Shafer, that came with a cruel twist of timing. Two days before his birthday, and two days after his wedding anniversary, he got the unexpected news that he had prostate cancer. Faced with the reality of now what, Joel started doing his homework. Having recently settled into retirement, this certainly wasn’t what he’d hoped to be filling the hours with.

The statistics sound like background hum until you are the one in six affected (or the countless spouses and family members trying to steady the waters). Deciding on a course of treatment is different and difficult for every man, trying to weigh the balance between what can be both a deadly and slow growing cancer. For Joel, after much consideration, surgery was his choice. So he embarked a treatment path that’s delivered to about 200 men a year here at Sunnybrook Health Sciences Centre: complete prostate removal, known in medical speak as radical prostatectomy.

Dr. Robert Nam is one of the top surgeons in Canada doing this procedure. I sat in on one of his surgeries last week, and watched him deliver what he calls the ‘Nam Deluxe’: a delicate sparing of nerves around the prostate, allowing the vast majority of men to recover with little to no impact on their urinary or erectile function over time. (There’s a reason the term “surgical precision” has made it into our vocabulary. Having witnessed it firsthand, I think Dr. Nam had a lot to do with it.)

Joel is now several months post-op, and doing very well. I met with him at his home in a well-established neighborhood. Family photos adorning the walls, he now hopes to get back to the business of being retired. For men facing the same diagnosis he did only months ago, he encourages them to read up and reach out to those who have been there. Understand you should take a little time before you make any decisions, he told me. And when all is said and done, you put your faith in the doctors and the process.

To watch Dr. Nam walk you through a radical prostatectomy, click here.

Did you know?
Men should have a PSA test done at age 50, or earlier if they have a family history of prostate cancer. Make sure to complete Sunnybrook’s Prostate Cancer Risk Calculator with your family doctor.

30 Seconds or less...

2011-05-16T07:12:00.000-07:00

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TV has seriously messed with my mind. Either I worked in the medium for too many years, or have watched too many documentaries on A&E. Either way, I commonly see my day unfolding like a movie script, and my biggest fear is approaching the commercial break. It’s all going along so well. What ugly thing is lurking on the other end of the 3-minute ad loop? What did I not see coming?

OK, back in the real world, I’m neither a movie star nor a panicked mess. It’s true that a lot of things in life can happen quickly. Say falling in love or falling down the stairs. The difference, I suppose, is that love can take you by surprise while that tumble could have most likely been completely prevented.

As the May long weekend kicks both the summer and trauma seasons into high gear, this is my little soapbox moment to remind everyone to take good care. Sunnybrook is the place where the physically shattered come to literally get rebuilt. And with all the high-tech medical approaches out there, the best one still comes down to common sense. Likelihood is, if you take just a few extra seconds to think about what you’re doing, you’ll never have to step foot in this place. I’ll drink to that! But of course call a cab afterwards…

So here’s a thought: live your life as though it was a documentary cutting to a commercial break. What will happen next? You be the director and make it a happy ending.

Happy May 24!