Rare pheochromocytoma tumour gives young man the battle of his life

Bryde Fresque needed a skilled team and a complex surgery to come up with a diagnosis of pheochromocytoma – a rare tumour that left his future uncertain.

Rare is a word used to describe Bryde Fresque on many levels. He has a zest for life that sets him apart. In fact, his physician Dr. Carolyn Nessim, a surgical oncologist and clinician investigator at The Ottawa Hospital saw this firsthand when Bryde faced a diagnosis that would have him battle for his life, with one rare condition after the other. Ultimately, it would take a skilled team to come up with a diagnosis and treatment for Bryde – a pheochromocytoma – an uncommon tumour that left Bryde’s future uncertain.

Bryde’s journey to his diagnosis of a rare cancerous tumour began on Boxing Day of 2012. He was travelling home from Napanee when he started to have pain in his left side. He stopped at a pharmacy just outside Ottawa and by the time he got to the counter he was doubled over in pain. The pharmacist told Bryde to get to the closest hospital — a community hospital was not far away.

Not long after arriving in their emergency room, Bryde was sent by ambulance to The Ottawa Hospital where he could receive care that is more specialized. He was in a tremendous amount of pain. Upon arrival, Bryde was suffering from a spontaneous hemorrhagic rupture of the left adrenal gland and he was bleeding significantly. Thankfully, he was in good hands as our interventional radiologists performed an emergency embolization procedure. This is a procedure where a guide wire was placed in a vessel in his leg and that allowed physicians to get all the way to the bleeding vessel by the adrenal gland, at which point they injected a product that plugged the vessel and stopped the bleeding. He was hospitalized for ten days before he was able to go home.

Unusual symptoms continue to develop

Bryde continued to feel off. A young, active man, Bryde recalls unusual symptoms that he couldn’t shake. “I remember feeling really sweaty, I couldn’t cool down properly. I would stand under the gym’s cold water shower for 15 minutes post bike ride and it didn’t make a difference,” recalls Bryde.

By the summer of 2013, he was going through a battery of tests and questions at our Cancer Centre to try to pinpoint the diagnosis.

“He had such rare conditions – one right after the other.” – Dr. Carolyn Nessim

Bryde kayaking in Iceland with Natalie. — Bryde and Natalie kayaking in Iceland.

Though, at only 32 years old, cancer was the furthest thing from Bryde’s mind. “I was young, healthy, a non-smoker, non-drug user, and active. That active part of my life was actually the only time I initially showed symptoms. That’s when I would overheat on even the coolest days and couldn’t cool down afterwards.”

The spontaneous rupture of Bryde’s adrenal gland six months earlier contributed to the challenge of pinpointing a diagnosis. It was believed he suffered from a large hematoma – a large residual clot after the bleed. “He had such rare conditions – one right after the other. A spontaneous rupture of an adrenal gland happens very rarely. I would say the challenge is that because the blood clot is so significant, it hides the underlying tumour and so it’s difficult to identify on imaging,” says Dr. Nessim.

Pinpointing the cause

Bryde at The Ottawa Hospital — Bryde Fresque was treated for a rare cancer at The Ottawa Hospital.

As time progressed, Bryde developed issues breathing, he couldn’t bend in certain directions, and then he noticed a distention on his left side. Signs that had been pointing to a hematoma didn’t add up because a hematoma should have healed within a few months, according to Dr. Nessim. That’s when she started looking at the fact this could be a tumour.

Bryde’s case ultimately landed with The Ottawa Hospital Sarcoma Tumour Board. “We meet every Friday to discuss complex cases like Bryde’s. Everyone is in the room including medical oncology, radiation oncology, pathology, radiology, and surgery. We take each individual case and we discuss it as a group to determine the best course of action for a patient,” explains Dr. Nessim.

This panel of experts decided that surgery was the best course of action to not only diagnose Bryde’s condition but to treat him at the same time and remove this tumour that had significantly affected his quality of life. Given the large size of the tumour and the extent of organs it seemed to be invading on imaging, this would be a long and extensive operation with many potential risks and complications that would be best mitigated by a specialized team. The sarcoma team is well equipped and knowledgeable in how to do these complex operations. Our hospital is one of the three Cancer Care Ontario designated Sarcoma Centers in the province. Although Bryde did not have a form of sarcoma, the surgical approach for a pheochromocytoma is the same.

Most unusual pre-op visit

By the fall of 2013, the mass located on Bryde’s left side was now the size of a cinder block. Staying true to his rare and unique personality, Bryde, who loves Halloween, showed up for his pre-op appointment on October 31, 2013, wearing his homemade Iron Man costume!

On November 15, a huge team of more than 20 medical professionals assembled in the operating room. As Bryde lay on the operating table awaiting surgery, he recalls Dr. Nessim telling the team about the Halloween pre-op appointment, “Then she looked down at me and said, ‘Take a deep breath, Iron Man’ as I was intubated.”

Bryde had to put his full trust in Dr. Nessim and her team during the complex, 12-hour surgery. The procedure can carry several risks because although Bryde seemed to have a non-functional pheochromocytoma, with the stress of surgery there is always the risk of stimulating the tumour causing it to release adrenaline, which can lead to a serious increase in blood pressure during surgery. Bryde was given some special medications during the operation to help ensure that didn’t happen.

“I feel privileged every time I’ve been able to help a patient.” – Dr. Carolyn Nessim

Dr. Carolyn Nessim, The Ottawa Hospital — Dr. Carolyn Nessim, Bryde’s surgical oncologist.

Just prior to going into the operating room for this intricate surgery, Dr. Nessim reviewed the scans one last time and then visualized each step, planning the order they would follow to remove the tumour successfully. The highly skilled group alongside Dr. Nessim included a urologist, a thoracic surgeon, and a Hepato-Biliary and pancreatic surgeon, along with two anesthesiologists. “It was a big case,” says Dr. Nessim.

Bryde had his left kidney removed, as well as his left adrenal gland, and a third of his pancreas. They performed a colon, bowel, and diaphragm resection and reconstruction for each, removed his spleen as well as an accessory spleen, which can be found in many patients, 10 lymph nodes, and the hematoma. Thankfully, Dr. Nessim was also able to remove the entire tumour. The surgery was a success.

Finding the answers

Bryde spent a total of 40 days in hospital recovering, and it was during that time that he finally received an explanation for his symptoms. He was diagnosed with pheochromocytoma, which is a rare form of tumour that can be cancerous. They usually form on one of the body’s two adrenal glands, which are located above the kidneys, and approximately 10% of pheochromocytomas spread to other parts of the body. Pheochromocytomas can be dangerous because they may produce an excessive amount of the hormone adrenaline, which makes people sick, primarily by increasing their blood pressure. In Bryde’s case, what made a diagnosis challenging before surgery was that his pheochromocytoma was considered non-functional, and his urinary tests for adrenaline markers were negative. But it’s possible it was releasing low levels of adrenalin all along.

“The Ottawa Hospital is very well positioned in the study and treatment of this rare but dangerous tumour.” – Dr. Neal Rowe.

“It potentially explains all his sweating and feeling very flushed and hot as maybe he had a subclinical release of adrenaline,” confirms Dr. Nessim. Bryde also learned the tumour was cancerous.

Expertise in pheochromocytomas

Bryde with his wife and child — Bryde Fresque, his wife Natalie, and their son Edmond.

Much of the research, around the globe and here at our hospital, focuses on timely detection and treatment of pheochromocytoma. Dr. Neal Rowe is a clinical urologist at The Ottawa Hospital researching this type of tumour. “There are several known genes that increase the risk of a patient developing a pheochromocytoma. By identifying these genes in people, we can test family members, achieve early detection, and better understand the biology behind why these tumors form.” Dr. Rowe says this type of tumour affects between one to two cases per 100,000.

“Thanks to Dr. Nessim and the team at The Ottawa Hospital, I got better – I get to enjoy my life to the fullest. I got to marry the girl of my dreams and I got to become a father.” – Bryde Fresque

“The Ottawa Hospital is very well positioned in the study and treatment of this rare but dangerous tumour. We have a collaborative group of experts in endocrinology and medical genetics in addition to a dedicated team of anesthesiologists and surgeons. With our research and development of various national initiatives, I think we’re front and centre,” says Dr. Rowe.

Moving forward, upwards, and giving back

Today, Bryde is seven years post surgery, and cancer free, with no signs of recurrence. While his recovery took time, he’s back to living his active life and truly grateful for the care he received. In fact, to raise funds and awareness for rare neuro endocrine cancers, Bryde and his wife, Natalie, climbed Mount Kilimanjaro in Tanzania, as well as the highest pass in the world, located in Annapurna range of the Himalayas in Nepal – all while still being considered a cancer patient.

Bryde and Natalie at Uhuru Peak on Mount Kilimanjaro. — Bryde and Natalie on Mount Kilimanjaro.

“Being a cancer patient or being sick is a life-changing event. Thanks to Dr. Nessim and the team at The Ottawa Hospital, I got better – I get to enjoy my life to the fullest. I got to marry the girl of my dreams and I got to become a father.” He adds, “I honestly think if I had been anywhere else, if I had been under anyone else’s care, I probably wouldn’t be here today. I really wouldn’t.”

That’s why Bryde also holds an annual Halloween fundraising party, known as Spadinaween, to support our hospital. To date, he’s raised over $10,000 and Dr. Nessim even drops by to show her support.

The special bond between this patient and physician continues, as Bryde even enrolled to help Dr. Nessim with a global research project on sarcomas. For Bryde, it’s an honour to help other patients. “Me giving back to The Ottawa Hospital has come full circle as I was invited to partake in an international study on sarcomas with Dr. Nessim and other doctors from the UK, Italy, the States, Netherlands, and Australia – to help improve the patient experience. If I can turn a negative into a positive. I’m in!”

Seeing Bryde thrive today is what makes those long, grueling days in the operating room and the constant search for answers worthwhile. “It’s why I do my job. It’s the biggest joy and most rewarding,” says Dr. Nessim. “I feel privileged every time I’ve been able to help a patient.”

Download Pulse podcast today and hear Bryde and Dr. Nessim share more about his journey with a rare, cancerous tumour.

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.

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Trauma and healing after explosion in Afghanistan

Bushra Saeed-Khan was just eight weeks into what was to be a year-long tour in Afghanistan when her light armoured vehicle ran over an improvised explosive device. She was one of only a few to survive the incident. What followed was a long journey from trauma to healing, including nearly 50 surgeries and years of intensive rehab. The injuries that nearly took her life were repaired by a dedicated team of experts at The Ottawa Hospital.

It was a routine patrol in Kandahar that altered the course of Bushra Saeed-Khan’s life forever. In one brief instant, the detonation of an improvised explosive device (IED) changed everything. She went from a Federal employee on an assignment in Afghanistan, to an amputee trauma survivor grappling with Post-Traumatic Stress Disorder (PTSD). The complexity of Bushra’s traumatic injuries brought her to The Ottawa Hospital where a dedicated team of experts were ready to help her get back home.

Facing a war zone

Bushra was just eight weeks into a year-long tour in Afghanistan when she received permission to accompany troops “outside of the wire” – beyond the protection and confines of a military base. When their mission was complete, they headed back. It was then the light armoured vehicle (LAV) Bushra was travelling in ran over an IED buried underground.

Bushra in Kandahar — Bushra *(left)*, in Kandahar, prior to departing the base on the day of the attack.

She recalls hearing a loud bang, one unlike anything she’s ever heard, before being momentarily knocked out. When she came to, there was silence. Confusion and shock paralyzed her entire body. But it didn’t matter; she was pinned down inside the vehicle, unable to move. Fear filled her every thought. Was she the only survivor? Could the vehicle go up in flames while she was stuck inside it? Was there anyone around to save her? Each racing thought was as anxiety-inducing as the other, while in a war-torn country, miles away from base, from safety, her family, and her home.

Four soldiers and one civilian, who had become Bushra’s friend, died that day, on December 30, 2009. Bushra, one of just five survivors, is lucky to be alive. But she didn’t walk away unscathed. To this day, she continues to feel the ripple effects of the incident more than a decade later.

Seeking medical attention

After witnessing the explosion, troops in the second LAV acted quickly, requesting back up to assist the survivors. As they came to Bushra’s aid, it was clear her injuries were severe. Her entire body was affected by the blast. The force of the explosion was so fierce it left Bushra’s abdomen exposed, and her legs critically wounded – a portion of one completely gone.

Bushra in Germany — Bushra waking in Germany.

Bushra was airlifted by helicopter to a military base for emergency medical care before she was transported to a hospital in Landstuhl, Germany, where she was placed in a medically induced coma. As doctors worked to stabilize her for the long flight to the Trauma Centre at The Ottawa Hospital’s Civic Campus, Bushra was introduced to the name Dr. Nancy Dudek, Medical Director of the Amputee Program. Bushra needed to start to think about recovery and Dr. Dudek would soon become Bushra’s primary caregiver for over a decade. “I didn’t realize at the time just how much of an impact Dr. Dudek would have on my life.”

Road to healing and recovery

Once Bushra was in our care, experts began working around the clock to repair the extensive damage that had been done by the IED. “I remember the first time I met Bushra,” says Dr. Dudek. “She had just arrived at the hospital and had a lot of injuries. The most critical question I had for her at that time was regarding her leg.” Bushra’s leg was severely damaged, and it was clear they would have to amputate it. Since her femur bone was also fractured, they needed to decide if her orthopedic surgeon would perform a full amputation of the leg or fix her femur and save as much of her leg as possible. “It’s really important, when possible, to include the person who will be receiving the amputation in that decision,” says Dr. Dudek. “We want our patients to have a say in what’s going to happen to their body.” In the end, as a team, they decided to fix Bushra’s fractured femur and perform a through-knee amputation.

This was the first of several surgeries Bushra underwent at our hospital. “Within the first week of being in the trauma unit I had what felt like over 20 surgeries,” says Bushra. “That’s when I stopped trying to keep track.”

The women of the Rehab Centre

Once Bushra was medically well enough to leave the trauma unit, she was moved to the Rehabilitation Centre. This is where she would remain for over a year as an inpatient, followed by six months as an outpatient. Under the care of some of the best physiotherapists and prosthetists in the field, Bushra had to relearn how to perform the most basic tasks, such as lifting her arms, moving her head and sitting upright in bed, before eventually learning how to walk with a prosthetic leg. “I call them ‘the women of the Rehab Centre,’” says Bushra. “They’re just so brilliant in their respective fields, but also so kind and caring. It was really nice to see.”

Bushra at the Rehab Centre, learning to stand. — Bushra learning to stand again.

At the time, Bushra was still in great discomfort, not just from her surgeries but from flashbacks of the incident, her survivor’s guilt, and the thought of living the rest of her life with a disability. Working through those emotions felt like mountains she had to climb and conquer, and some days they were too much to bear. “At one point, I even contemplated suicide. Some days I couldn’t even get out of bed. Not just because of the physical reasons, but mentally I couldn’t deal with everything I had to fight through that day,” says Bushra. It wasn’t long before she was introduced to Dr. Josie Marino, a now-retired psychologist at our hospital. Dr. Marino was instrumental in Bushra’s care, helping her overcome those mental obstacles. “PTSD never really goes away, it comes back when times get rough, but Josie gave me the tools that I needed to cope,” Bushra explains.

“I like giving patients the confidence that they can do more than they think,”
– Marie Andrée.

On those more difficult days, Bushra’s physiotherapist, Marie Andrée Paquin, would adapt and cater the exercises to the pain she was experiencing. If Bushra didn’t feel well enough to leave her room, Marie Andrée would have her perform exercises in bed. On the days she was feeling stronger, she would push her a little bit further. “I like giving patients the confidence that they can do more than they think,” says Marie Andrée.

She even went as far as having Bushra perform exercises that mimicked dance moves so that she could dance at her sister’s wedding. “It was really nice that they were so flexible in my care, tailoring it to exactly what I needed,” says Bushra.

Discovering hope

Bushra, prosthetic leg — Bushra’s prosthesis.

After Bushra’s amputation, she couldn’t help but worry about the future. After all, she had never met someone with a prosthetic leg. “My family and I were very worried about what type of life I would have,” says Bushra. Realizing this, Dr. Dudek asked a former patient of hers to visit with Bushra. “I remember so clearly, this woman walking into my trauma unit room. It was shocking for me to see her walking around and playing with her kids,” says Bushra. “I am thankful that Dr. Dudek introduced me to this woman. That was a pivotal moment for me.” After that meeting, Bushra no longer worried. Rather, she was filled with hope.

This gave Bushra the confidence she needed to try a prosthetic leg. She met with Laura Scholtes, a prosthetist at our hospital, who fitted her with a new artificial limb. It wasn’t long before she got the hang of it and once she did, she was introduced to the Computer-Assisted Rehabilitation Environment (CAREN) System.

The CAREN System

Bushra hasn’t been the only patient who has experienced injury in Afghanistan. In realizing the need, the Canadian Armed Forces and our community raised funds to bring this virtual reality system to Ottawa — one of only two cities in Canada who have it. The CAREN System has been instrumental for patients in the Rehab Centre.

Bushra Saeed on the Computer-Assisted Rehabilitation Environment — Bushra on the CAREN System.

“The CAREN System was amazing,” says Bushra, when asked about her experience with this unique virtual reality rehabilitation equipment. It combines incredibly large 3D graphics and a platform that moves with the person as they explore a virtual 3D world on a remote-controlled treadmill. “It’s very safe and a great way to challenge a patient’s balance,” explains Marie Andrée.

“The CAREN System was really a catalyst in my recovery as I was able to learn how to walk with a prosthesis and push myself in an environment that I knew was safe,” says Bushra. “And it trains you to walk on all kinds of surfaces. There was even a setting for paddle boarding. It was really a lot of fun.” Training in the CAREN System boosted her confidence. Today she’s riding her bicycle, and excelling in her career as a diplomat, something she didn’t expect she would be able to do.

New life after trauma

Bushra with her baby — Bushra holding her daughter.

One of the very first questions on Bushra’s mind after her surgery to reconstruct her abdomen was whether or not she would be able to have a baby. The injuries were so extensive that surgeons had to insert a mesh lining to help rebuild the abdominal wall. At the time, her physicians were unsure if her body would be able to adapt to carry a child to full term. Eight years later, Bushra announced she was pregnant, and much like she adapted to a new normal with a disability, her body was able to adapt to a growing baby.

“They are my guardian angels. My heroes. They saved my life.” – Bushra Saeed-Khan

As Bushra’s belly grew, so did her challenges with her prosthesis. Laura was able to monitor Bushra throughout the duration of her pregnancy to ensure that her prosthesis fit her limb comfortably. But in the last two months of her pregnancy, Bushra was no longer able to walk with ease and temporarily switched to a wheelchair. As she was prepped to undergo a c-section, Dr. Dudek worked alongside Bushra’s obstetrician, Dr. Laura M. Gaudet, to ensure that Bushra had the most accessible birthing room possible, one with a doorframe wide enough to fit her wheelchair, and a bed that could be lowered so that she could more easily get in and out.

The day after Bushra gave birth to a beautiful baby girl, Dr. Dudek was there to meet her. “After my initial surgery, my doctors weren’t sure if I would be able to have children. And then eight years later there was Dr. Dudek holding my baby,” says Bushra. “So, it was a special moment. It really felt like everything was coming full circle.”

Today, Bushra is able to play with her two-year-old daughter, just like the patient she met in hospital with the prosthetic leg early on in her recovery. Those feelings of hope have become reality.

More than a decade later

More than a decade after the incident, it would be easy to look at Bushra and be impressed by how far she’s come. But she accepts each compliment about her recovery with humility, because she knows she didn’t do it alone – she was backed by some of the best healthcare workers in the country. “I’m a product of my circumstances and I was fortunate to have the support structure offered by the Rehab Centre at The Ottawa Hospital,” says Bushra. “It felt like a team effort and it’s thanks to my caregivers that I was able to gain independence. They are my guardian angels. My heroes. They saved my life.”

Download Pulse Podcast today and listen to Bushra’s story.

With your support today, we can give new life to patients, just like Bushra.

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A Conversation with the CEO

Join us for this exclusive opportunity to meet the new President and CEO of The Ottawa Hospital, Cameron Love. You’ll hear Cameron’s vision and strategy for the future of our hospital. You’ll also get a glimpse of the new Civic development site on Carling Avenue.

Our Speakers

Cameron Love:

Cameron Love is the President and Chief Executive Officer of The Ottawa Hospital. He took on this leadership role as of July 1, 2020, in an unprecedented time as Ontario’s health system adapts to new a service model in the wake of COVID-19.  Through this experience, and as Executive Vice-President and Chief Operating Officer of The Ottawa Hospital since 2014, he was responsible for the leadership and oversight of programs and services across the hospital, and their integration into regional programs throughout the Champlain region. He’s been with TOH for over twenty years.

Evan Solomon:

Evan Solomon is Host of CTV’s weekly political program, Question Period and host of Power Play. He also hosts a daily radio program on 580 CFRA. Solomon is a two-time Gemini Award-winner and best-selling author who has covered federal and provincial politics, news, and current events for more than 15 years.

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Creating Tomorrow Lottery - Create your dream tomorrow!

Win big by supporting The Ottawa Hospital

OCTOBER 21, 2020 OTTAWA, ON – The Ottawa Hospital Foundation has launched the Creating Tomorrow Community Lottery for 2020. This is a 50/50 lottery which will see 50 percent of the funds go to the person with the winning ticket and 50 percent of the funds will support patient care and research at The Ottawa Hospital.

The grand prize draw will be held on December 22, 2020. The more tickets sold – the bigger the jackpot! There’s incentive for participants to get their tickets early – anyone who purchases a ticket by noon on Nov. 13 will be entered into the early bird draw to be held later that day. The early bird prize is $1,000 and the winner of the early bird will be entered back in for a chance to win the grand prize draw.

Tim Kluke, President and CEO of The Ottawa Hospital Foundation, said this is a win-win for our community. “This is an incredible opportunity for someone to win some big money while also making a big impact on patient care, research, and allowing us to purchase the latest equipment to create a better tomorrow for our patients.”

Tickets must be purchased online at CreatingTomorrowLottery.ca.

5 tickets for $10
15 tickets for $20
100 tickets for $50

There are a limited number of tickets for this year’s lottery. Create your dream for tomorrow by supporting The Ottawa Hospital. Tickets on sale beginning October 22, 2020 at 10 a.m.

There are a limited number of tickets for this year’s lottery. Create your dream for tomorrow by supporting The Ottawa Hospital. Tickets on sale beginning October 22, 2020 at 10 a.m.

About The Ottawa Hospital:

The Ottawa Hospital is one of Canada’s top learning and research hospitals, where excellent care is inspired by research and driven by compassion. As the third-largest employer in Ottawa, our support staff, researchers, nurses, physicians, and volunteers never stop seeking solutions to the most complex healthcare challenges.

Our multi-campus hospital, affiliated with the University of Ottawa, attracts some of the most influential scientific minds from around the world. Our focus on learning and research leads to new techniques and discoveries that are adopted globally to improve patient care.

We are the Regional Trauma Centre for eastern Ontario and have been accredited with Exemplary Standing for healthcare delivery — the highest rating from Accreditation Canada. We are also home to world-leading research programs focused on cancer therapeutics, neuroscience, regenerative medicine, chronic disease, and practice-changing research.

Backed by generous support from the community, we are committed to providing the world-class, compassionate care we would want for our loved ones.

For more information about The Ottawa Hospital, visit ohfoundation.ca.

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From leukemia patient to multi-marathoner – with a walker

Leukemia, radiation and chemotherapy, a bone marrow transplant, and a blood clot in his intestine and neck haven’t slowed Robert Hardy down. In fact, he feels stronger than ever and is ‘walker-running’ marathons in support of The Ottawa Hospital.

Robert (Bob) Hardy has been in a fight for his life for more than 20 years. From a bone marrow transplant for leukemia, to a blood clot in his intestine and his neck, it seems nothing can slow him down. In fact, thanks to lifesaving care at The Ottawa Hospital, he’s stronger than ever and unwavering in his desire to compete in some of the most renowned marathons around the world — with his walker. Beating his personal best time, year after year, you wouldn’t suspect that this ‘Walker-Runner’ initially had only a 40% chance of survival.

A startling diagnosis

There was a time many years ago when Bob believed he only had six months to live. Feeling slightly fatigued, but healthy overall, he went for a routine physical. When his examination results returned, Bob received startling news. At only 46 years old, and long before experiencing any side effects of the disease, he was diagnosed with leukemia. Bob and his wife, Vittorina, were stunned. All they could think about was how they would tell their two young girls, Shannon and Leah, who at the time were only 13 and nine. “It was a really big shock for all of us. The thought of having to tell our children wasn’t easy, but it wasn’t something I was willing to hide from them either,” said Bob.

But if you’re looking for a woe-is-me attitude, you won’t get it from Bob. Even a diagnosis of this magnitude couldn’t bring him down. “When I told my youngest daughter, Leah, about my diagnosis,” said Bob, “she told me ‘you’re too strong to die, dad.’” That was the encouragement Bob needed to hear. It was her words that motivated him to fight back and beat the disease.

Robert Hardy, in 1997, standing by the water — Robert Hardy in 1997.

A fight for his life

Up until Bob’s leukemia diagnosis he was studying jiu-jitsu – and fit as ever. But while he waited for a match donor for a bone marrow transplant, the medication, interferon, that doctors prescribed to maintain his health was making him weak. Bob was struggling to continue with his training. “I wanted to get my black belt before undergoing my bone marrow transplant,” expressed Bob. He felt a black belt would give him the confidence he needed to begin the long road to healing and recovery. Knowing just how much this milestone would mean to Bob, his doctors allowed him to temporarily discontinue taking interferon for two months prior to Bob’s black belt test, so that he could continue training for the big day. And when that day came, he got his black belt – with honours. It was only then that he felt ready for his bone marrow transplant and the ups and downs that would follow.

A perfect match

After a year of taking interferon, a six-antigen match donor for the bone marrow transplant was found. At the time, performing a bone marrow transplant using an unrelated donor was still relatively new. But researchers discovered that patients can have a match donor outside of their family. “It isn’t common for two people to have the same set of six antigens if they aren’t blood related. I was lucky. They found a perfect match,” explained Bob. More recently, however, advances in research have allowed our experts to perform a transplant using an incompatible donor, significantly reducing the time patients must wait for a match donor. “What this means is that, where once many did not have a donor, now almost everyone has one,” explained Dr. Huebsch. “This research is truly groundbreaking.”

Robert Hardy during his leukemia treatment — Robert Hardy undergoing treatment for leukemia.

With a donor ready to help, the pre-transplant treatment of high doses of chemotherapy and radiation to suppress Bob’s immune system began. Four weeks later, his immune system was primed to receive the bone marrow transplant. He underwent this procedure at The Ottawa Hospital, and remained in our care for three weeks to ensure the transplanted healthy cells were multiplying – and they were.

Bone marrow is the soft, fatty tissue inside your bones, which produces blood cells. A transplant, inserted into the blood stream through a catheter, replaces the unhealthy blood forming cells (stem cells) with healthy ones.

Although doctors wanted Bob to remain in hospital for a few weeks post treatment, he was able to go home for the majority of his recovery. In fact, Bob benefited from our innovative outpatient bone marrow transplant program that has allowed thousands of patients to be treated and recover more conveniently from home. This program was one of the first in Canada and, since its inception, our patients have been surrounded by loved ones throughout recovery.

Thrombosis expertise in Ottawa

Over the course of the next two years, Bob was in and out of the hospital. “The first two years were the hardest. I had a lot of side effects from my treatment,” said Bob. One of the most severe side effects Bob experienced was blood clotting. The first to appear was in his stomach and a second in his neck. Cancer patients are often at greater risk of blood clotting as chemotherapy is hard on the veins. Approximately one in every twenty cancer patients will experience blood clotting – often a life-threatening complication. But Bob was in good hands. He benefited from the development of a tool to help diagnose blood clots quickly, known as the Wells Rule, after Dr. Phil Wells, an expert at The Ottawa Hospital. This tool is now used in emergency rooms and taught in medical schools around the world.

“We have one of the best thrombosis departments in Canada, attracting experts in the field from across the globe.” – Dr. Marc Carrier

Researchers have since implemented a comprehensive program for managing blood-thinning medications for patients at higher risk of developing blood clots, including cancer patients like Bob. This program has ensured that patients at our hospital are more likely to have optimal blood thickness, and less likely to develop blood clots.

More recently, our experts have developed a system to identify the likelihood that a cancer patient will develop blood clots. Although this was not yet available at the time of Bob’s diagnosis, this innovative tool can classify newly diagnosed cancer patients as being at greater risk and they can receive personalized care based on their unique circumstance to prevent blood clotting. “We have one of the best thrombosis departments in Canada, attracting experts in the field from across the globe,” said Dr. Carrier, Chief, Division of Hematology. “Our highly specialized and dedicated researchers are developing groundbreaking procedures that demonstrate our commitment to continuously moving research and treatments forward, so that we can continue to provide exceptional care to each patient that walks through our doors,” said Dr. Carrier.

World-class care in Hematology

Throughout Bob’s treatment, he was cared for through The Ottawa Hospital Hematology and Thrombosis Program, one of the best and largest in Canada. Unlike many other hospitals, where patients must travel to different hospital departments and satellite locations to receive treatment, our unique program provides centralized care for patients with diseases of the lymph glands, blood, and bone marrow for patients across eastern Ontario and beyond.

“We are among the best. Ottawa is at the centre of all sorts of blood transfusion medicine and we’re one of the leading centers in the world for doing, and researching, transplantation for life threatening diseases.” – Dr. Lothar Huebsch

Robert Hardy and Dr. Lothar Huebsch in 2001. — Robert Hardy with Dr. Lothar Huebsch, 2001.

The program, which has attracted leading researchers from around the world, is renowned for the development and advancement of world-first procedures that are changing lives. “We are among the best,” explained Dr. Huebsch, Clinical Hematologist and former head of hematologic oncology. “Ottawa is at the centre of all sorts of blood transfusion medicine and we’re one of the first in the world to successfully perform transplantations for life threatening diseases.” Our Hematology and Thrombosis Program has led the way for decades, researching transplant techniques with other illnesses such as multiple sclerosis, autoimmune diseases, and lymphoma. “This is the kind of research we’ve done for 25 years, and we are one of the leading centers in the world for doing these transplants in the outpatient setting, rather than in a high intensity ward as an impatient,” said Dr. Huebsch.

Road to recovery inspires ‘walker-running’

Bob Hardy, walker running — Robert Hardy walker-running.

With so much time spent in and out of hospital throughout his treatment, Bob needed something to do to keep himself busy while he recovered. So, he got creative. “A few of us used to take our IV polls and race them down the hallways. The nurses couldn’t believe how fast we were moving!” What Bob didn’t realize at the time was racing IV polls would later spark aspirations to participate in some of the most renowned marathons.

Following treatment for the blood clot in his neck, Bob lost his sense of balance. Although he can walk short distances without an aid, he’s unable to run or walk long distance. That’s when Vittorina suggested he get a walker. “At first, I was hesitant about using a walker, but then I realized how fast I could move!” said Bob. And so began his passion for ‘walker-running’.

Bob started his walker-running career participating in the Wobbly Walker-Walk-a-thon, but soon shifted into high gear signing up as a marathoner in Run for a Reason at Tamarack Ottawa Race Weekend. His marathons not only accomplished a personal goal, but also raised funds in support of The Ottawa Hospital.

A new appreciation for life

Bob’s road to recovery hasn’t been an easy one, but there hasn’t been a day he’s felt sorry for himself. Over the years he started to get stronger and complications were fewer and far between. “I am so thankful for the treatment I received. The nurses and my doctors were outstanding – absolutely incredible,” said Bob. “I’m here today, pursuing my passion for walker-runner marathons, because of them. They saved my life.”

Of course, there are still some days that Bob feels more run down than others. On those days he tries to take a walk to reminisce on how far he’s come in his recovery. “I know what it takes to get over things and to get through things. Not only did I have the very best care at The Ottawa Hospital, I had something to live for. I was able to watch my girls grow up. And now, here I am at age 69, almost 70, I’ve overcome countless obstacles and have jumped over hurdles, and I’m really quite happy with my life. I’m really very happy.”

“I am so thankful for the treatment I received. The nurses and my doctors were outstanding – absolutely incredible.” – Bob Hardy

The Ottawa Hospital is a leading academic health, research and learning hospital proudly affiliated with the University of Ottawa.

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Defying the odds in the battle against pancreatic cancer

As a seven-year pancreatic cancer survivor, Sindy Hooper continues to defy the odds. She’s putting her faith in cancer research at The Ottawa Hospital to save her life again one day.

Devastated and shocked – that’s how Sindy Hooper and her family reacted to the diagnosis of pancreatic cancer in 2013. Especially considering pancreatic cancer survivor rates are so low. The diagnosis came at a time when Sindy would have described herself as being in the best shape of her life. But suddenly, she was facing the fight of her life, and she looked to the specialized cancer treatment and research at The Ottawa Hospital to help her fight back.

In the months leading up to Sindy’s diagnosis, she had been feeling great. She had completed her first Ironman in August 2012, and that fall she was training to complete another one. Then, in December, she started experiencing discomfort in her upper abdomen and pain in her upper back. However, towards the end of the month her skin started to get very itchy, she became a lot more tired, and she started to lose a little bit of weight. The day before her diagnosis, she woke up and her eyes were yellow. She was jaundiced.

Sindy’s husband, Dr. Jon Hooper, an ICU physician at The Ottawa Hospital initially thought it could be gallstones. The couple headed to hospital unprepared for what they were about to learn. Later that day, an ultrasound would reveal it was pancreatic cancer. “We couldn’t believe the news. I was relatively young. I had just turned 50. I was in the best shape of my life. I had no family history of cancer whatsoever,” says Sindy. Even more alarming were the survival rate statistics.

An aggressive, potent cancer

The pancreas is part of the endocrine system, a group of glands and cells that make and release hormones into the blood, controlling growth, reproduction, sleep, hunger, and metabolism. The cells in the pancreas normally make and release digestive juices to help break down food.

Pancreatic cancer starts in the cells of the pancreas. A malignant tumour of the pancreas is a group of cancer cells that can grow into and destroy nearby tissue. It can also spread to other parts of the body. There has been little progress in the fight against pancreatic cancer in the last 40 years.

The five-year survival rate is only eight percent. The average survival is six months and 75 percent of the people diagnosed with this form of cancer die within the first year.

“We see what people are going through and how we need to do better than we’re doing so far. It gives us a focus and purpose because we know here’s an urgent need for new and better therapies.” – Dr. John Bell

Pancreatic cancers are resistant to most kinds of therapy. The cells have a biology that scientists don’t completely understand, which makes them hard to detect early and hard to treat with conventional kinds of therapies that are currently available. Researchers at The Ottawa Hospital are working to offer hope to pancreatic cancer patients and while she didn’t realize it at the time, this would become very important to Sindy and her journey.

Ready for specialized care

With the alarming news of the diagnosis, Sindy prayed to make it to one year. Her team at The Ottawa Hospital developed a three-pronged care plan. “I am very thankful for having such amazing care close to home – really world-class care,” says Sindy.

The treatment would begin with Whipple surgery. “It’s a seven-hour operation – it’s huge. It can only be done in very specialized centres. I was very fortunate to have that done here in Ottawa.”

In fact, The Ottawa Hospital is one of the few hospitals in Canada to offer this type of surgery. It is used to remove tumours in the head of the pancreas or in the opening of the pancreatic duct. A team that specializes in surgery of the pancreas, liver, gallbladder, and bile duct work together to support the patient through the operation.

Sindy in hospital recovering from Whipple surgery.

In Sindy’s case, the complex surgery removed half of her pancreas, half of her stomach, her gall bladder, bile duct, duodenum, and the tumour. She was in hospital for ten days and then recovered at home for the next five weeks. “Just as I started feeling better in mid-February, I started chemotherapy. I went through 18 rounds of chemo that took me to September. There was also 28 days of radiation in between,” remembers Sindy.

“Whipple surgery is a seven hour operation – it’s huge. It can only be done in very specialized centres. I was very fortunate to have that done here in Ottawa.”
– Sindy Hooper

She was able to withstand the effects of chemo and radiation very well. Her doctors attributed that to the great shape Sindy was in. It helped her power through the treatments. “Through all my treatments, I was still training for Ironman Canada.”

Powering through to Ironman Canada

Sindy Hooper competing in 2013 Ironman Canada during cancer treatment — Sindy crossing the finish line at Ironman Canada in 2013.

Feeling good, Sindy and Jon booked a trip to Whistler, B.C. to take on Ironman Canada in August 2013, even though Sindy was still undergoing chemo treatment. She wasn’t expecting to complete the biking or running portion, but Sindy felt she could tackle the 3.86 km swim. In fact, she not only finished the swim, but also the 180 km bike, and the marathon. “We started the marathon, and it was miraculous. I just felt so good that day. I had lots of energy.”

In the end, together, they finished the Ironman at 11:37 p.m. – 23 minutes before the cut off. But it was bigger than just crossing the finish line. Sindy’s incredible strength to power through an Ironman in the middle of chemotherapy treatment attracted significant media attention. She not only increased awareness for pancreatic cancer, but she also raised $50,000 for cancer research. “Completing the Ironman, raising awareness, and all that money was an absolute gift in the midst of everything I was going through,” says Sindy.

Fundraising for all cancer patients

That $50,000 was just the starting point for this crusader. Sindy has dedicated herself to fundraising for cancer research at The Ottawa Hospital since 2014 through Run for a Reason at Tamarack Ottawa Race Weekend. Her running team is the MEMC crew (Making Every Moment Count). She tries to instill her passion for life in other people and not take things for granted. Along the way, she’s raised over $225,400 for cancer research.

Sindy does it not only for herself but also for other patients. “Cancer research is going to one day save my life again, I’m sure of it.”

“Cancer research saves lives. That’s the bottom line. Whether it’s finding new treatments or early detection methods so cancers can be picked up earlier and treated more effectively – cancer research really does save lives.” – Sindy Hooper

Sindy running in support of cancer research at The Ottawa Hospital — Sindy participating at Tamarack Ottawa Race Weekend in support of The Ottawa Hospital.

For Dr. John Bell, a senior scientist, who’s been investigating this complicated disease for decades at The Ottawa Hospital, it’s patients like Sindy who inspire him and his team of researchers. “I’m really privileged to have a lab at the Cancer Centre. That means every day, I get to see the people we are trying to help, like Sindy, who we want to have a good quality of life and a long life.”

Dr. Bell adds it’s those patients who push him to find answers and that elusive cure.“We see what people are going through and how we need to do better than we’re doing so far. It gives us a focus and purpose because we know there’s an urgent need for new and better therapies.”

One way to find those answers is through clinical trials. And it’s not lost on Dr. Bell that the patients who participate are both courageous and altruistic. “Every patient seems to say the same thing when I speak with them: ‘I don’t know if this is going to work for me, but I hope you learn something from it so that I can help somebody else.’ That’s, really what we get inspired by, that sort of attitude. Sindy has that attitude for sure.”

Finding hope for pancreatic cancer patients

Sindy with Dr. John Bell at The Ottawa Hospital — Sindy meeting Dr. John Bell in his lab.

While treatment options for pancreatic cancer are still limited, there is hope. Researchers at The Ottawa Hospital are leading the world in developing viruses that can attack cancer cells without harming normal cells. These viruses have been tested in clinical trials for other types of cancer, and Dr. Bell’s team is currently working in the laboratory to see if they can be customized for pancreatic cancer. Dr. Bell says that, “absolutely,” the findings from those previous trials could be used in future pancreatic cancer patients.

“It really is I think a burgeoning field, and I like to think we were critical in getting this started.”

As Sindy continues to put her faith in what this research will have to offer in the future, she has a simple message for Dr. Bell and his team. “Thank you for the work that you’re doing.”

“Keep working really hard because there’s a lot of people out there, like me, who are relying on research to find new, better treatments and hopefully one day a cure.”
– Sindy Hooper

2020 brings a new health concern

Even before the emergence of COVID-19, 2020 offered a new challenge to Sindy. On a flight to Hawaii, last winter she, started experiencing intense gastrointestinal pain. As soon as her flight landed, she went straight to the hospital and learned she had a partial obstruction in her GI tract. While she started to feel better, her surgeons back at The Ottawa Hospital encouraged her to return home as they were the best equipped to handle her complicated case should she develop another obstruction and she need surgery.

Back home, Sindy continued to have severe episodes of pain, developed a fever, and then a blood infection. By mid-April, COVID-19 had arrived in Ottawa and doctors were hesitant to operate, but the pain became so severe they had no choice.

Surgeons discovered a significant number of adhesions in the area of her obstructions and removed them. Sindy admits it was a stressful time being in hospital during a global pandemic. “It was so scary by myself – not having my husband there for me.”

Although, she gives credit to the incredible staff who were at her bedside for six days. “I have to say everybody was going above and beyond to make the patients feel comfortable during this time. I was impressed.”

Making plans for the future

Today, Sindy celebrates as a seven-year pancreatic cancer survivor and takes nothing for granted. After she got past that first year of survival, she prayed for two years of survival. “Every year that has passed is just completely incredible to me, Jon, and my sons.”

Every six months Sindy returns to The Ottawa Hospital for a CT scan. While it’s stressful waiting for the results, so far, each scan has resulted in good news, allowing Sindy and Jon to make plans for the next year.

Sindy biking at the International Triathlon Union — Competing at the ITU (International Triathlon Union) Olympic Distance World Championship in Cozumel, Mexico in 2016.

This year, that plan included welcoming a new member of the family – Lexey, a French Bulldog – filling their home with joy. Sindy’s plans also include more running, swimming, and biking. She’s feeling strong again after her surgery, back to training for a 50 km Ultramarines Run in November and a triathlon next summer. She continues to look to the future.

“I’m just so amazed to be defying these odds and to get to continue living, enjoying and loving life.” – Sindy Hooper

You could say that Sindy is making every moment count.

Listen to Sindy Hooper’s story in her own words during a guest appearance on Pulse: The Ottawa Hospital Foundation Podcast.

The Ottawa Hospital is a leading academic health, research and learning hospital proudly affiliated with the University of Ottawa.

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Fierce determination pushes patient to walk again after Guillain Barré Syndrome diagnosis

Avid cyclist Fran Cosper had his life change when he woke one night and couldn’t feel his legs. Doctors at The Ottawa Hospital diagnosed him with Guillain Barré Syndrome. Although he was paralyzed, Fran was determined to walk again.

Long-distance cyclist Fran Cosper described himself as being in the best shape of his life as he headed into the winter of 2017. However, in mid-February he woke up in the middle of the night unable to feel his legs. The next morning, when Fran tried getting out of bed, he slammed onto the floor – his strong legs suddenly useless. Soon after, he was diagnosed with Guillain Barré Syndrome (GBS) – facing the possibility of permanent paralysis. Little did he know the road ahead would involve a team of experts, the help of 3D virtual reality at The Ottawa Hospital, and a determination not only to walk again, but also to help other patients.

When Fran first experienced those sudden symptoms, he initially thought it couldn’t be anything serious as he was very health conscious. He attempted to make his way to the basement that morning to work out. “I went to get on my hands and knees, and fell face-first on the carpet. I thought, ‘Well, I can’t move. This is much more serious.’ My wife, Elise, came down and saw that I had facial paralysis, and thought I’d had a stroke.”

But Fran knew that strokes typically affect only one side of the body and that something else — something serious — was happening.

What is Guillain Barré Syndrome?

Fran is secured to an adjustable bed prior to using the CAREN machine at the Ottawa Hospital Rehab Centre. — Fran in hospital.

After a thorough assessment, Fran was diagnosed with GBS. This rare autoimmune disorder causes the immune system to attack the nerves, damaging the myelin sheath, which is the nerves’ protective covering. As a result, the brain can’t transmit signals to the nerves in the muscles, causing weakness, numbness or, as in Fran’s case, paralysis.

An infection or virus can bring on GBS. The 56-year-old had had two colds back-to-back, which may have thrown his immune system into overdrive. Within days, his balance was off, and he had difficulty lifting pots to cook dinner. Hours later, the disease was full blown, attacking his nervous system and Fran couldn’t move.

“It was like having an out-of-body experience. I mean my brain was working fine but my body wasn’t doing what I asked it to do.”
– Fran Cosper

“We see patients with Guillain Barré Syndrome at The Ottawa Hospital Rehabilitation Centre probably five or six times a year,” says Dr. Vidya Sreenivasan, a doctor of physical medicine and rehabilitation. Some have mild cases, but others, like Fran’s, are more serious.

A more challenging road to recovery

About one in 100,000 Canadians contracts GBS every year. Recovery can take more than a year because the nerves re-grow slowly, one millimetre per month. For Fran, the journey would be much longer.

The disease continued its nerve damage following his admission to the hospital. After two weeks, he transferred to the Rehab Centre, where his care team included doctors, psychologists, social workers, recreation therapists, physiotherapists, respirologists, occupational therapists, and nurses.

“I decided at that point, I was going to fight it. I was going to fight back and do the best I could to get better even though I didn’t know what the outcome was going to be.”
– Fran Cosper

Fran was completely dependent on this team for all of his care. He needed to be washed, dressed, and turned in bed. He couldn’t even close his eyes. The nurses had to tape his eyelids shut so he could sleep.

“It was like having an out-of-body experience. I mean my brain was working fine but my body wasn’t doing what I asked it to do,” says Fran. He also faced excruciating pain because of the damage done to his nerves. As Fran lay there unable to move in his hospital bed, he made a decision.

“Oddly, I wasn’t afraid. I decided at that point, I was going to fight it. I was going to fight back and do the best I could to get better even though I didn’t know what the outcome was going to be.”

Rehab team ready with state-of-the art technology

Fran’s excellent fitness level, as well as his determination and positive attitude, helped him through when it came to the rigorous therapy plan. He had physiotherapy five hours a day, including three times a week in the Rehab Centre pool. Within two months, he could stand and take steps with help. He learned to walk again thanks in part to our Virtual Reality lab – one of only two in Canada.

Fran in pool. — Fran would visit the Rehab Centre pool three times a week.

“The pool and this 3D room were invaluable. It would have taken me a lot longer to get my legs back if I didn’t have access to those tools.” – Fran Cosper

The CAREN (Computer-Assisted Rehabilitation Environment) system combines room-sized 3D graphics, a platform that moves with the patient in a harness, as they explore the 3D world, a dual-tread remote-controlled treadmill, and world-class motion analysis technology. Preprogrammed visual presentations allow the patient to respond to an environmental stimulus by shifting weight, increasing or decreasing speed and even making specific motions. Difficulty levels can be increased gradually as the patient progresses further in their rehabilitation treatment plans.

Fran in VR lab. — Fran learning to walk again thanks in part to our Virtual Reality lab – one of only two in Canada.

“This room is right out of sci-fi. It really challenges your body. After an hour of doing exercises, I was just sweating. The pool and this 3D room were invaluable. It would have taken me a lot longer to get my legs back if I didn’t have access to those tools.”

“I’d basically been swiped off the planet for a year. But the only negative thing about being in the hospital was the disease itself.” – Fran Cosper

For Dr. Nancy Dudek, Medical Director, Amputee Program at The Ottawa Hospital Rehabilitation Centre, this unique system offers many benefits to patients. “There’s no end to things you can do with that sort of creativity. To be able to be hooked up to a harness without the support of the parallel bars still gives you the safety aspect. It’s a very innovative and beneficial system.”

Installed in 2010 in partnership with the Canadian Forces and with support from the community, the CAREN system was initially used in part to help injured soldiers returning from Afghanistan. Since then, many patients have benefitted, including those who have had a traumatic brain injury, stroke, neuromuscular disease, amputation, or chronic pain.

Continuing the road to recovery

Released from the Rehab Centre in October 2017, tears were shed by Fran and nurses who cared for him. It was those nurses who helped Fran with day-to-day care, teaching him how to wash and dress himself and be independent again.

Fran on exercise ball — Fran receiving care from the rehab team.

“I can honestly say that the kindness and level of care I got really humbled me. The nurses and staff have just been marvellous,” says Fran. “I’d basically been swiped off the planet for a year. But the only negative thing about being in the hospital was the disease itself.”

He walked out of the Rehab Centre using a walker. When he returned a month later for a follow-up appointment, he walked in on his own.

Today, Fran is back riding his bike – not quite to the 100-kilometer distances, yet, but his therapy continues. He still deals with pain, and his arms were slower to recover. His fine motor skills in his fingers are taking longer to get back to normal. As a saxophone player, he’s motivated to get his fingers working again.

“I’m kind of at the point now where I’m thinking I may be able to play again someday. I’m hopeful that I’ll be able to play my sax because my fine dexterity is improving – it’s a work in progress.”

Giving back as a volunteer

Fran will never forget two volunteers in particular who were there for him when he was being cared for at the Rehab Centre. Chris and Claude would come and take Fran for coffee and to talk. Initially, he had no idea who these blue-vested people were, but Fran quickly learned the important role they play at the hospital.

“I remember asking Chris why he was a volunteer. Chris explained to me that he had an inoperable brain tumour, and he was going to die. He told me, ‘I figured the hospital took such good care of me that I would spend the rest of my time volunteering.’ I broke into tears and decided right there I had to become a volunteer,” says Fran.

Fran in blue vest. — Today, Fran gives back as a volunteer at our hospital.

Pre-COVID, Fran would spend two days a week meeting patients, sometimes visiting his old room at the Rehab Centre, inspiring them about what is possible. “I remember seeing a woman in a hallway; she was on a gurney and going in for surgery – she was by herself. I stopped, leaned over, and told her it was going to be ok. Afterwards, I saw her again and she said, ‘Thank you.’”

That’s why Fran proudly wears the blue vest. He’s experienced the dark days and today, he’s happy to be able to help others when they need a reassuring voice to help them through – just like Chris and Claude helped him. He’s also grateful to be able to volunteer his time at the hospital that cared for him during his long journey to recovery.

Listen to Fran Cosper in his own words during a guest appearance on Pulse: The Ottawa Hospital Foundation Podcast.

Your donation will help make sure patients like Fran have access to state-of-the-art equipment necessary to help them recover.

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Canadian armwrestling legend wins championship after arthroscopic surgery

One look at Devon Larratt’s incredibly large biceps and you might mistake him for a superhero. While he’s not a superhero, he is a world champion with a story that is anything but ordinary. And his climb to the top involved multiple surgeries, intensive rehab, and sheer determination.

It would have been hard not to be impressed while watching Devon Larratt triumphing as the Open World Champion, in both his left and right arm, in the World Armwrestling League. Chants and loud cheers extended from the crowd as Devon, a veteran of the Canadian Armed Forces, faced his opponents time and again from 2008 to 2012. What Devon did not know at this time was that all of the intense training it took to get him on the world stage was leading to the development of debilitating arthritis that was going to jeopardize his greatest passion and career. His only hope to regain his former glory was surgery at The Ottawa Hospital to restore strength in his arms.

A family affair

Devon has been interested in armwrestling for most of his life. At age 18, he entered his first tournament and has represented Canada at international competitions ever since, winning many World Championships. An impressive feat for someone who initially took up armwrestling as a hobby when he was only five years old.

One could say that for the Larratt’s, armwrestling is a family affair. “I grew up armwrestling with my grandmother,” said Devon. “The rumour around the family was that she was the Alberta women’s champion. It’s because of her that I started armwrestling.”

Devon Larratt sitting on an OR table — Devon Larratt, Canadian armwrestling champion

Military force

It wasn’t until Devon joined the Canadian Armed Forces that he got serious about his training. Eighteen years in the military provided him with the opportunity to get in the best shape of his life. “If I wasn’t on a mission,” said Devon, “I was pumping iron.”

Even while on tour overseas in Afghanistan, armwrestling played a large role in his life. Competing against fellow troops, he gained the experience he needed to one day earn himself the title as one of the best armwrestlers in the world.

Injury puts dreams on hold

Like many athletes, Devon suffered injuries that put his dreams and career in jeopardy. Armwrestling is incredibly demanding on tendons and joints. Years of trauma caused by armwrestling led to the development of osteoarthritis, with extra bone build up in his elbows.

“Both my left and right elbow joints were degraded to a point where I was in constant pain,” remembers Devon. Increased pressure in the elbow joints from abnormal mechanics while armwrestling led to a build up of extra bone in areas it shouldn’t grow. Devon was unaware this abnormal bone was breaking apart, creating loose fragments in his joints.

At the same time, Devon’s arthritis caused chronic inflammation between his elbow joint bones, eroding the cartilage in the joint and causing friction between the elbow bones. This not only caused him significant pain but it also greatly impacted his range of motion.

Unable to compete to the best of his ability and in great pain, Devon was referred to a shoulder and elbow specialist at The Ottawa Hospital.

Specialized technique

Devon’s treatment would involve three surgeries: two operations in his right elbow and one in his left. Due to the nature of his work as an armwrestler and in the military, the surgical team made use of a specialized technique – elbow arthroscopy, a minimally invasive surgery. This technique involves inserting a fibre-optic video camera through a small incision. The view inside the joint is then transmitted to a high-definition video monitor, resulting in a more precise operation. As a minimally invasive surgery, this technique preserves as much of the muscles and tendons in the elbow area as possible.

Over one cup of stray floating bone fragments and a golf-ball-size piece of abnormal bone was extracted from Devon’s elbow. Once the bone was removed, the elbow was recontoured and sculpted to correct any deformity and to restore the normal anatomy of the joint.

Expertise right here in Ottawa

Prior to the development of arthroscopic techniques, surgery involved making a long incision, cutting through layers of muscle to get to the joint. This often resulted in a slower healing time and would require a longer rehabilitation period.

Though there had been many advancements in elbow arthroscopy, until a decade ago, this was a specialty procedure not yet available in Ottawa. But a focused effort on the improvement of minimally invasive techniques at our hospital attracted skilled physicians from across the globe.

Now, with local expertise in elbows and shoulders, coupled with the latest equipment and technology, patients can be treated right here at home, in Ottawa. It is in part thanks to donor support that the latest tools were brought to The Ottawa Hospital to allow arthroscopic procedures to take place.

The potential of stem cells

In the future, athletes like Devon may be able to avoid surgery altogether by benefiting from the healing power of stem cells.

Research at The Ottawa Hospital is underway to better understand how bone regenerates, repairs, and heals. Dr. Daniel Coutu, inaugural Research Chair in Regenerative Orthopaedic Surgery, is investigating the impact that trauma, aging, and chronic degeneration have on bones, which support our joints. The star researcher, who was recruited from Switzerland, focuses on the fundamental biology of bone stem cells. He studies various inflammatory disease models caused by arthritis and is working to determine how stem cells can improve healing and recovery.

Remaining at the leading edge of stem cell research will ensure that our patients have the latest treatment options and the best chance at recovery.

“Stem cell therapy could be a game changer for professional athletes with repetitive strain bone injuries, allowing them to continue to perform to the best of their ability and give them their quality of life back.” – Dr. Daniel Coutu.

Bone plays a key role in the health of tissues, such as muscle, tendons, and cartilage that are connected to it. Although bone tissue generally repairs itself very easily, damage to the tendons, ligaments, or cartilage, is much more difficult to heal.

Fortunately, the failure rate for orthopaedic surgery is quite low, approximately two to five percent. However, the success rate drops when athletes incur repeated injuries or with age. Dr. Coutu is hoping to help fill this gap through his stem cell research so that athletes like Devon can have a better recovery rate and longer-lasting results.

“With the growing number of baby boomers and athletes suffering with aches and pains in their joints, I am hoping that our collaborative work will prolong the life of their joints. Stem cell research being conducted here in Ottawa could enable these patients to return to normal sporting activities, improving their quality of life,” said Dr. Paul E. Beaulé, Head, Orthopaedic Surgery at The Ottawa Hospital.

Becoming a champion again

After Devon’s surgeries, rehabilitation was his next focus. “I treated rehab like preparation for any other event. This, combined with the incredible work of my surgery team, helped me get back to competing less than a year later,” said Devon.

Just eleven months after undergoing three surgeries on his arms at The Ottawa Hospital, Devon was back on top – a champion once again.

Devon has since competed against and defeated, some of the most legendary armwrestlers, winning himself numerous championships across the globe.

More recently Devon has opened the gym in his garage to the public to help encourage others to be fit, to help train, and to show off his hardware. There is no doubt that armwrestling will continue to play a large role in Devon and his family’s life for years to come.

Devon with weights

“I am so grateful for my care team at The Ottawa Hospital and that we have this level of expertise right here in Ottawa. They helped me get back to competing and doing what I love.” – Devon Larratt

Devon and Dr. Pollock armwrestle

The Ottawa Hospital is a leading academic health, research and learning hospital proudly affiliated with the University of Ottawa.

Help us make more happy endings like Devon’s. With your support today, we can continue to champion healthy living tomorrow.

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Compassionate care awaited the Westboro bus crash patients

Marcie Stevens was one of 13 severely injured patients who arrived at The Ottawa Hospital Trauma Centre after the Westboro bus crash. One year later, after losing both legs, Marcie continues her recovery at the Rehabilitation Centre and she’s grateful for the compassionate care she’s received.

For an update on Marcie’s story, click here to see how far Marcie has come.

It was a bitter cold, winter day on Friday, January 11, 2019. Marcie Stevens was making her way home to Kanata for the weekend from downtown. The Public Safety employee sat on the second level of a double-decker OC Transpo bus when it crashed into the overhang of the Westboro transit station. It was 3:50 p.m.

Ten minutes away from where the crash occurred, the trauma team at The Ottawa Hospital was alerted, and a Code Orange was called. The Emergency Department began clearing space, and a large number of staff converged including surgeons, nurses, anesthetists, emergency physicians, and support staff. A massive team of about 150 people would await the injured passengers. At 4:28 p.m., the first patient arrived at The Ottawa Hospital’s Civic Campus, home to the only level 1 trauma centre in eastern Ontario. In total, 13 severely injured patients over a two-hour period were rushed to the trauma centre – one of the injured was Marcie Stevens.

Calm amidst chaos

The married mother of two recalls being conscious and considerably calm throughout the entire ordeal. Though she was pinned on the top level of the bus and critically injured, she was able to call her husband, Christopher, to tell him she couldn’t pick up their children. She even thought to call work to let them know she wouldn’t be in on Monday and was able to help to calm those around her while emergency crews worked furiously to remove them from the wreckage. Marcie would need that calm composure in the midst of adversity for what awaited her.

“I couldn’t have gotten this far without the incredible people and support from The Ottawa Hospital – from the trauma team to the ICU to the Rehab Centre – it’s incredible. Compassionate is the best word to describe it.” – Marcie Stevens

The trauma team was ready

After arriving at our Emergency Department, Marcie recalls she had lost so much blood and that after her CT scan her blood pressure began to plummet, but the trauma team was ready. “The nurse in the Emergency Department had the O negative blood in her pocket. They immediately started pumping blood back into my system. My blood pressure stabilized, and I was then rolled into the operating room. The only time I passed out was when they put the mask on to put me to sleep.”

Four physicians in an emergency room at The Ottawa Hospital

(From left to right) Dr. Ian Grant, Dr. Peter Glen, Dr. Maher Matar and Dr. Jacinthe Lampron.

Marcie would wake up on Sunday morning, groggy and swollen. That’s when she learned from her husband that both of her legs had been amputated. “I knew going into the operation that my left leg was gone, because they told me. But they were going to try to save the right leg, but they couldn’t, and on Saturday they had to take it.”

While a completely new world awaited Marcie, her positive attitude never wavered. “You adapt and that’s what I have been doing. This is the way it goes. I couldn’t have gotten this far without the incredible people and support from The Ottawa Hospital – from the trauma team to the ICU to the rehab centre – it’s incredible. Compassionate is the best word to describe it.”

Waking up to a different life

Soon after the bus crash, Dr. Nancy Dudek, Medical Director, Amputee Program at The Ottawa Hospital Rehabilitation Centre, met Marcie at her bedside for the first time. “I had regular visits with Marcie when she was in the trauma unit to determine when she would be medically ready to come to the Rehab Centre.” Our Rehabilitation Centre specializes in the physical rehabilitation of those who have experienced a disabling physical illness or injury. It serves the residents of eastern Ontario.

Dr. Dudek is quick to point out though that Marcie’s rehab started soon after she was admitted to the hospital. “We started rehabilitation plans when she was still in the Trauma Unit. She was a very avid participant of early rehab.”

Marcie Stevens and her family.

Marcie’s road to a new way of living life began with her multi-disciplinary care team helping to get her wounds healed. That would lead to teaching her how to move independently once again.

By the end of February, Marcie moved to The Ottawa Hospital’s Rehabilitation Centre. She says the staff were incredible from the moment she arrived. “I was in a room with three other women. They put the two who fell asleep early on one side and me and an older patient – the night owls – on the other.”

It was during rehabilitation that Marcie learned how to transfer from the bed to her wheelchair without a lift. She learned how to cook in a kitchen that is not accessible, to prepare for her return home, and she’s learning how to drive with hand controls.

Preparing to go home

Dr. Dudek explains there’s a great deal to cover in rehab. “We teach wheelchair skills, including what the right wheelchair is for the patient. We also had to work on strengthening, including core strengthening. Then, we talked about what would be the immediate needs to get her home to her family, including her five and 12-year-old boys.”

Marcie Stevens and Dr. Dudek — Westboro bus crash double amputee, Marcie Stevens, doing strength testing in the rehabilitation centre at The Ottawa Hospital with Dr. Nancy Dudek.

Marcie went home on Friday, April 12, 2019. Three months after arriving at the hospital. When Marcie reflects on her feelings as she was leaving the rehab centre, she takes a moment and then replies, “It was a giddy day. It’s not like I didn’t like the Rehab Centre,” she quickly qualifies her response smiling at Dr. Dudek, “but it was good to be home with the kids.”

Of course, going home didn’t mean Marcie’s rehabilitation was over, but it was a major advancement in her recovery – a recovery that she faced head on with a resilience that never wavered. Dr. Dudek says it’s been inspiring to watch Marcie over the last year. “She is an incredibly positive person. That has been consistent. It’s something that was there right from our first meeting and it hasn’t really faded. She has a ton of energy and other people really gravitate towards her. She’s very popular around here.”

“Rehab is great. It is the jewel of the hospital that nobody knows about. They are sort of hidden away here. They have to deal with so many types of injuries and states of mind. Not everyone at the centre is accepting of what happened to them,” admits Marcie.

As Marcie recounts all that she’s been through in the past year, she still jokes and laughs. When Dr. Dudek is asked if she thinks this incredible attitude helped with Marcie’s recovery, the answer comes fast. “One hundred percent. She has made significant changes and implemented new things to her life. It’s very impressive to see. We can show people the way, but we can’t do it for them.”

Moving forward

Today, Marcie and her family are moving forward. A new home is necessary – one that is fully accessible, and Marcie talks about getting back to work someday.

She misses her colleagues, but she knows that day will come with time. “I’m a very positive person and it will take time to get used to the changes in my life, to adjust to having no legs. It’s difficult. I’ll get there.”

For now, she will continue with her regular rehab. Eventually she will only need annual visits. For now, her weeks are filled with trips to the gym and the pool, all to get her stronger for the new world she faces. Despite the challenges, she embraces it all with confidence, a smile, and you could say a bit of attitude as she wheels away wearing her black leather jacket, sunglasses, and a streak of pink in her hair.

Update: Two years later

Marcie Stevens' prostheses — Marcie Stevens with her prostheses.

Today, Marcie is learning to walk again thanks to her new prosthetics. While the pandemic has caused some delays in her progress, she’s hopeful the spring will bring more good news. “I am looking at procedures to help me move easier in my prosthesis after significant weight loss,” says Marcie. She’s lost 60 pounds in an effort to better adapt to using her prosthetic legs.

In the springtime, Marcie is optimistic that she will have a chance to trial powered knees, which will allow her to move better when she sits down and stands up. She’ll also have her adapted vehicle, to help her shuttle her boys around town. In two years, Marcie has come a long way. While her recovery continues, our rehab team is with her as she takes each new step forward.

Your support will provide crucial funding
to improve the care of patients like Marcie.

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Hope despite aggressive skin cancer diagnosis

Hope because of scientists who never gave up; who were determined to turn the tables on cancer and to create a better chance of survival, for patients like Dan Collins.

Hope despite aggressive skin cancer diagnosis

Diagnosed with a stage 4 melanoma at the age of 62, Dan Collins feared for his life when he learned about the aggressive form of cancer. However, immunotherapy treatment gave him a reason to hold out hope. Dan had hope because of scientists who never gave up; who were determined to turn the tables on cancer and to create a better chance of survival, for patients like him. Hope that a cure is coming.

Discovery of a mass

Four years ago, Dan had been travelling for work, when he started noticing some pain when he’d lean his head back to rest on the plane. He recalls turning to his family doctor to get answers. An ultrasound revealed there was something inside the back of his head that looked like a cyst.

After an initial biopsy, Dan was referred to a surgeon at The Ottawa Hospital Cancer Centre. Another biopsy revealed the cyst was actually a mass. It was melanoma. “I was scared. Cancer had stripped my family of so much. I lost both of my two older brothers and my father to cancer. I feared for my life,” recalls Dan.

Unfortunately, the mass starting growing – and it was growing fast. By the end of July, just two months later, the mass went from being not visible on the back of his head, to the size of a golf ball.

His surgical oncologist, Dr. Stephanie Obaseki-Johnson, initially wanted to shrink the tumour before surgery to remove it. However, the mass was growing too quickly.

Oncologist Dr. Michael Ong of The Ottawa Hospital in a patient room. — *Dan Collins with Oncologist Dr. Michael Ong.*

Time to act

On August 11, 2015, Dan had surgery that lasted most of the day. When it was over, he had 25 staples and 38 stitches in the back of his head. As he recovered, Dan was reminded of a saying that helped him through recovery, “Never be ashamed of your scars. It just means you were stronger than whatever tried to hurt you.”

He would need that strength with the news that awaited him. Only two weeks later, the mass was back. His doctors also discovered a mass in his right lung and shadows in the lining of his belly. He had stage 4 cancer – it had metastasized. This was an aggressive cancer that left Dan thinking about the family he had already lost and what would happen to him.

The next generation of treatment

Soon, he was introduced to The Ottawa Hospital’s Dr. Michael Ong and was told about immunotherapy – the next generation of treatment, with the hope of one day eliminating traditional and sometimes harsh treatment like chemotherapy. Dr. Ong prescribed four high doses of immunotherapy. At the same time, radiation treatment began for Dan – 22 in all. His immunotherapy treatments were three weeks apart at the Cancer Centre and between each, he would have an x-ray to monitor the tumours.

“Each x-ray showed the tumours were getting smaller. That’s when the fear started shifting to hope.” – Dan Collins, patient

By December 2015, Dan finished immunotherapy treatment and the next step was to wait. “This transformational treatment was designed to train my own immune system to attack the cancer. We would have to be patient to see if my system would do just that,” says Dan.

While the shadows in Dan’s stomach lining had shrunk, the mass in his lung had not. That’s when Dr. Ong prescribed another immunotherapy drug that would require 24 treatments.

Dan learned from his oncologist that melanoma has gone from being an extremely lethal cancer, with few treatment options, to having many different effective therapies available.

“When I started as an oncologist a decade ago, melanoma was essentially untreatable. Only 25 percent would survive a year. Yet now, we can expect over three quarters of patients to be alive at one year. Many patients are cured of their metastatic cancer and come off treatment. We are now able to prevent 50 percent of high-risk melanoma from returning because of advances in immunotherapy,” says Dr. Ong.

Dan completed his last immunotherapy treatments in September 2017.

Oncologist Dr. Michael Ong posing with armed crossed at The Ottawa Hospital. — *Oncologist Dr. Michael Ong of The Ottawa Hospital.*

Today, there is no sign of cancer

When Dan thinks back to the day of his diagnosis, he remembers wondering if he was going to die. “I believe I’m here today because of research and because of those who have donated to research before me.”

He thinks back to when his older brother Rick died of cancer in 2007. “At the time he was treated, his doctor asked if he would participate in a research study. The doctor told him directly, this would not help him, but it would help somebody in the future.” Dan pauses to reflect and then continues, “I like to think, that maybe, he had a hand in helping me out today. Maybe he helped me survive. One thing I do know is that research was a game changer for me.”

The Ottawa Hospital has been a leader in bringing immunotherapy to patients. Research and life-changing treatments available at The Ottawa Hospital altered Dan’s outcome and he hopes that advancements will continue to have an impact on many more patients, not only here at home but right around the world.

To support life-saving research at The Ottawa Hospital that helps patients like Dan, please donate today.

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