Category: Innovation and Technology

Published: July 2024

Imagine a constant whooshing sound, like a washing machine, in your ear day in and day out — 24 hours a day; never a peaceful moment — even when you’re trying to sleep. For millions of people worldwide, the cause is something known as pulsatile tinnitus. Now, in a world first, The Ottawa Hospital has discovered a potential cure for the majority who live with this debilitating condition.

Chris Scharff-Cole had lived with pulsatile tinnitus for years, but like many, she didn’t know what was wrong and was constantly searching for help. The now-retired psychotherapist from Deep River, two hours west of Ottawa, spent 30 years helping others using her horses as a part of her therapy practice. As a long-time horse person, Chris has seen her share of injuries over the years — including multiple joint replacements. While she’s learned to live with chronic pain, it was that constant sound coming from her right ear that left her wondering how she would ever find peace again.

It wasn’t until she met Dr. Robert Fahed, Interventional Neuroradiologist and Stroke Neurologist at The Ottawa Hospital, that she finally found relief.

Chris with one of her horses
Chris with one of her horses
Chris and her husband together at their horse ranch
Chris and her husband together at their horse ranch
Chris and Messiah's Majesty
Chris and Messiah's Majesty
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Read our Q&A with Dr. Robert Fahed

Brain aneurysm brings patient to the Civic’s Emergency Department

In 2021, Chris was suffering significant pain, so her doctor sent her to Pembroke for an MRI. That scan showed a brain aneurysm, and she was transported by ambulance to the Civic Campus’s Emergency Department. “I had extreme head pain. When I was asked to describe it between 1-10, I said it was 13,” explains Chris.

While waiting with paramedics in the Emergency Department, a top surgeon came down to see her. That was her first introduction to Dr. Fahed. “He listened to the side of my head, and he knew what to do. He said, ‘It’s ok, we’re getting things ready for you.’ It was so busy, but he was truly compassionate.”

“There was a throbbing in my head 24 hours a day that sounded like a washing machine. The pumping in my right ear was constant. It distorted my ability to hear, but mostly, I couldn’t sleep."

— Chris Scharff-Cole

Dr. Fahed and his team performed surgery on the aneurysm, and it was a success, but during regular follow-up, Dr. Fahed uncovered an underlying problem impacting Chris’ quality of life.

Chris had pulsatile tinnitus. “There was a throbbing in my head 24 hours a day that sounded like a washing machine. The pumping in my right ear was constant. It distorted my ability to hear, but mostly, I couldn’t sleep. Even when I fell into a sleep from exhaustion it would wake me up.”

“She had been suffering for years, but when Christine complained to her doctors, she had been told there’s nothing wrong with her ears — multiple scans said everything is normal,” says Dr. Fahed.

He adds it was actually an underlying vessel condition that was the real culprit, one that not many ENT specialists or radiologists know to look for on scans. “This vessel is close to your ear. It’s disrupting blood flow and that’s generating waves. It’s because your ears are fine that you’re able to hear that abnormal flow disruption.”

“No one else in Canada is caring for those patients.”

— Dr. Robert Fahed

What is pulsatile tinnitus?

It’s estimated that 750 million people around the world are affected by some form of tinnitus, and Dr. Fahed says 10 to 20% of those patients have pulsatile tinnitus. Unlike the more common forms, they don’t usually hear a ringing sound, but rather they hear a whooshing sound, like a heartbeat sound constantly in their ear. “Ninety percent of these patients with a pulsatile tinnitus have an underlying curable vascular cause. Among the possible techniques/devices that can be used is the technique we have pioneered with Christine,” explains Dr. Fahed.

The challenge is most people live with this problem because they’re not able to find a solution — much like Chris. But a team at The Ottawa Hospital is giving hope to those suffering. “What’s tough with this is there are vey few people around the world who know how to manage those patients, do the proper work, find a cause, and treat them,” explains Dr. Fahed.

That is why in late 2023, The Ottawa Hospital’s Pulsatile Tinnitus Clinic was launched. The only other clinic is in Toronto. “No one else in Canada is caring for those patients,” says Dr. Fahed.

It was Chris’s case that inspired this leading interventional neuroradiologist, one of only four in Canada, to focus more of his time on this area of medicine.

Pioneering a new treatment for pulsatile tinnitus

In March 2023, Chris was the first patient to undergo a new technique pioneered at The Ottawa Hospital. There are various reasons for pulsatile tinnitus, and the cause for Chris’ was a venous diverticulum, which is a rare defect that consists of an outpouching in the wall of a venous sinus, a vein that carries blood from the brain.

This new technique is called Intrasaccular Flow Disruption. According to Dr. Fahed, it consists of putting a small sphere of metal inside the vein pouch. The sphere traps the blood inside the diverticulum, then creates a clot and the blood will no longer enter that vein. “It’s the blood flow inside that outpouching that is creating waves that are heard by the ear, because of its proximity to the ear.”

"It’s minimally invasive surgery, we go through the groin, we fix whatever anomaly we find, and we cure your pulsatile tinnitus."

— Dr. Robert Fahed

Unlike other techniques used, this one doesn’t require a stent. There are no blood thinners required and the patient requires no medication afterwards.

“The patient comes in for a day procedure. It’s minimally invasive surgery, we go through the groin, we fix whatever anomaly we find, and we cure your pulsatile tinnitus. When you wake up from the procedure the sound is gone. You’re home the same day. It’s incredible,” says Dr. Fahed.

That day when Chris woke up from the procedure, her life changed completely. “When I opened my eyes I said, ‘It’s gone.’ I had total trust in Dr. Fahed. He is gifted. Life is peaceful. I appreciate each day that I’m not haunted by that sound. Every day I wake up is a blessing.”

Not settling for the status quo

She was glad to go first and now hopes it will help others in the future. “We’re absolutely blessed to have access to this type of care. I’m glad to be a recipient, and I hope more people will have this procedure. I’m so grateful and we do what we can to support the hospital – I’m so glad we have Dr. Fahed at The Ottawa Hospital,” shares Chris.

“The Ottawa Hospital pioneered this new technique — we thought outside the box to make it happen.”

– Dr. Robert Fahed

Referrals can be faxed to
613-761-5360
Dr. Robert Fahed
- Ottawa Pulsatile Tinnitus Clinic.

As of July 2024, Dr. Fahed and his team have treated 17 patients for this form of pulsatile tinnitus. It’s important to know that the technique can be used to treat other cerebrovascular conditions and patients are welcome to reach out to the Pulsatile Tinnitus Clinic to learn more.

“It’s another example of how TOH is at the forefront of innovative care,” says Dr. Fahed. “The Ottawa Hospital pioneered this new technique — we thought outside the box to make it happen.”

Dr. Fahed adds this is just the beginning. It’s the launch of a new area of care.

To learn about Dr. Robert Fahed’s “disruptive innovations” in stroke care, listen to episode 73 of Pulse Podcast.

Listen Now:

Categories: Cancer, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care

Published: April 2024

Picture hundreds of medical images mapped out into a concise report so a surgical team can plan a complicated surgery to remove a rare cancerous tumour. Then, picture a virtual reality (VR) system taking all that imaging and giving the surgeon a 3D view that allows them to move within the patient’s body — just like a video game — before surgery. It’s a whole new way of surgical planning, and this new technology was used for the first time in Canada right here at The Ottawa Hospital (TOH).  

When Emeric Leblanc was 13, he started to have pain in his left leg. It was initially believed to be growing pains, but as months went by, the pain worsened. “I used to play basketball, and then I couldn’t anymore because it hurt so much. It would keep me awake at night. Then it got to the point where I had trouble walking,” explains Emeric.  

Eventually, he would undergo a series of tests. On December 8, 2021, now 14 years old, Emeric sat with his mom and dad at CHEO and learned he had Ewing sarcoma. This type of cancer forms in the bones — most often in children between age 10 and 20. The teen’s growing tumour was in his pelvis and about 12 cm in diameter — the size of a grapefruit.  

Fishing is something Emeric is happy to be back doing.
During treatment in hospital

Grasping the complexity of a Ewing sarcoma tumour

While it was a shock to hear the word cancer, deep down Emeric says he already expected further tests would reveal it was cancerous. What was especially hard to digest was the news that he wasn’t going back to school.  

“Everything changed in that moment,” explains Emeric’s mom, Hélène Lachance. “There was a lot of information to digest about the treatment plan and how we could prepare him for that.” 

He returned to school to retrieve all his belongings because chemotherapy treatment started right away. He needed to have his braces removed, and was referred to a fertility clinic, because chemotherapy could make him infertile. It was a great deal for this teen to absorb. No longer as active as he wanted to be, he became much more invested in video games — a sign of what was to come, since VR would be used to help save his life. 

A collaborative team effort

“It was a collaboration of top-notch medical oncology, radiation oncology, and surgical teams between TOH and CHEO. A lot of great people came together to help Emeric.”

— Dr. Joel Werier

For more than a year, Emeric spent most of his time in the hospital. A team from The Ottawa Hospital and CHEO came together to give him the best possible chance at a healthy, active life. “It was a collaboration of top-notch medical oncology, radiation oncology, and surgical teams between TOH and CHEO. A lot of great people came together to help Emeric,” explains Dr. Joel Werier, Head of The Ottawa Hospital Sarcoma Program and orthopaedic oncologist. 

Also, an integral part of the team effort was Dr. Kawan Rakhra, a senior musculoskeletal radiologist at our hospital. Both doctors are also working with Realize Medical, the company behind the new VR technology used for Emeric’s surgery.  

They each played a pivotal role in tackling Emeric’s challenging case. The tumour was on the pelvis and coming quite close to the left hip joint. The goal was to remove part of the pelvis but save the hip joint, because without it, he wouldn’t have the same function of his leg. However, removing a pelvis is probably one of the more complex surgeries in medicine, according to Dr. Werier. 

Dr. Joel Werier is an orthopaedic oncologist and Head of The Ottawa Hospital Sarcoma Program

Stepping inside the patient through VR

That’s where the unique use of technology comes into play. The first step was chemotherapy to try to shrink the tumour, followed by radiation. With the tumour located on Emeric’s pelvis, a plan was needed to save his hip joint.  

“This is where the VR system was really critical. It allowed us to clearly understand the exact anatomy of the tumour and its relation to important structures, including the hip joint,” explains Dr. Werier. 

To best prepare a team to care for a patient, Dr. Rakhra must examine a litany of scans. In his area of expertise, whether it’s an X-ray, ultrasound, CT scan, MRI, or more, there can sometimes be 1,000+ images to scroll through, review, and create a detailed report to help with staging a cancer or planning a surgery. It takes an extensive amount of time and can be overwhelming.  

“If as the saying goes, ‘A picture is worth 1,000 words,' well then a 3D virtual reality model is worth a million, and it's going to transform how we use radiology in surgical planning.”
— Dr. Kawan Rakhra
Q&A with Dr. Rawan Rakhra

“Tumours tend to be complex and challenging for radiologists, surgeons, and oncologists to really understand the intricate anatomy, the location, and relationship to other critical tissues in the organs,” explains Dr. Rakhra. 

The VR system is a game-changer on many levels. Using technology previously used by the video gaming industry, surgical teams can view a customized 3D image of the tumour, then VR headsets help them step inside the patient’s virtual space and make a much more concise surgical plan. “It’s a paradigm shift in radiology where, traditionally, we look at these raw CT or MRI images and generate independent, descriptive reports that are sent to surgeons. But now, we found a way to further process them, integrate them, and convert them into a 3D model, which is a far more informative and powerful tool,” says Dr. Rakhra. “If as the saying goes, ‘A picture is worth 1,000 words,’ well then a 3D virtual reality model is worth a million, and it’s going to transform how we use radiology in surgical planning.” 

VR at The Ottawa Hospital

There is virtually nothing as disruptive in healthcare right now as VR — or virtual reality, if you’ll excuse the pun. This technology is being used across disciplines to improve patient safety, outcomes, and efficiency, while reducing costs and recovery times. It is transforming training and education today, with lifesaving implications tomorrow. 

VR in action

A whole new perspective for the surgical team

For Dr. Werier, it gives a whole new perspective for him and his surgical team. “It allows me to see things the way they’re meant to be seen — in three dimensions, the way our eyes would see them,” explains Dr. Werier. “It allows us to better understand the intricate anatomy and manipulate the images — for example, move nerves out of the way. We can share this with other members of the team and with the patient.” 

And there lies another key benefit to this technology — the patient gets a much better understanding of their diagnosis and care plan. “When you show a tumour on an MRI scan, it’s not quite as appreciated as it is in a VR system,” adds Dr. Werier.  

As for Emeric, he experienced VR by playing video games in the past, but this took him inside his own body to view what his surgical team had to do and to better understand the process.

Emeric in hospital after surgery.

“It was very cool. I could move it around — zoom in, zoom out. I could see the important veins and nerves that they try not to cut. It was also cool that I was the first to experience this.”

— Emeric Leblanc

On July 5, 2022, he became the first patient in Canada to undergo surgery using this new VR program. It was a very delicate surgery that included removing the left side of his pelvis and removing the entire tumour. Thanks to this technology, Dr. Werier was able to save the teen’s hip joint, allowing Emeric to regain his mobility and resume the activities he loved so much — like fishing and camping.

Emeric camping.
Often, Emeric can be found fishing on his dad’s boat.

Immense gratitude to have a skilled team and technology close to home

As a parent, it was a stressful time, but Hélène says seeing the tumour through the VR provided reassurance. “It was such a big surgery but seeing all this and the expertise of the team, I knew they were going to take care of my son. Dr. Werier was awesome. I mean, he saved my son’s life. We’ll always be grateful to him.” 

After Emeric recovered from the 14-hour surgery, he required more chemotherapy, but today he’s doing well. Dr. Werier explains the goal was curative, and they will monitor Emeric closely in the coming years.  

“It’s a complex operation — he’s a remarkable young man, and he did great. The VR helped us a lot. It’s much more intuitive, it gets people on the same page, and it’s much more efficient. It builds confidence in the surgical team.” 

The teen, who is now 16, is back at school, back with his friends, and getting stronger every day. The only difference now is he wears a shoe with a thicker sole on his left foot because his leg is slightly shorter. He also plays video games with a whole new appreciation for VR gaming. 

It’s this technology that is setting the stage for the next generation of surgeons and will give healthcare teams the most effective opportunities to provide the best care options to patients.

“This is the next evolution in how we look at things — a lot of this technology is homegrown in Ottawa, and I think it’s going to lead the virtual technology medical imaging industry. We’re excited about it,” says Dr. Werier.

Download or stream episode 96 to hear more about the impact of the VR technology on patient care with Dr. Kawan Rakhra.

Listen Now:

This success story began with the creation of Realize Medical in 2019, an Ottawa start-up company led by Dr. Justin Sutherland and Dr. Daniel La Russa. Both are physicists at The Ottawa Hospital, who saw an opportunity to further advance patient care using a technology most of us associate with video games. Other key contributors are Dr. Teresa Flaxman and Dr. Yusra Al Mosuli. In fact, Dr. Flaxman has been instrumental in elevating the 3D visualization program within our hospital and has been at the core of the VR modelling process with Drs. Werier and Rakhra since the early developments. Dr. Mosuli has been instrumental in the path forward including the Canadian first moment for this software program, Elucis, and Emeric’s surgery.

Research is critical for finding the best ways to use this technology and proving that it’a effective. Realize Medical has many research collaborations with various teams at The Ottawa Hospital to evaluate and implement their technology.

The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa. All researchers at The Ottawa Hospital follow a Responsible Innovation framework for developing and commercializing innovations in a responsible way.

Categories: Innovation and Technology, Innovation and Technology, Innovation and Technology, Innovation and Technology, Innovation and Technology, Innovation and Technology, Innovation and Technology, Innovation and Technology, Innovation and Technology, Innovation and Technology, Technology

Published: November 2022

When caring for patients who suffer from a stroke — time is of the essence. In Canada, stroke is the third leading cause of death and disability in adults, but an innovative and ever-evolving stroke treatment, called thrombectomy, used at The Ottawa Hospital, is a game changer. The Ottawa Hospital is recognized worldwide for expertise in neuroscience, and we’ve made significant strides in addressing today’s most pressing challenges in neuroscience — including our international, groundbreaking work in stroke. In fact, we are leading the way in how stroke care is delivered in Canada, including the use of thrombectomy.

innovation

Innovation and Technology

The future of healthcare at our new hospital campus will be embedded with technology and innovation that will equip our experts, like Dr. Robert Fahed, with the most sophisticated tools.

Ten years ago, a thrombectomy was an experimental stroke treatment — with life-altering potential. Dr. Robert Fahed was a medical student doing his residency program in neurology at a prestigious hospital in Paris, France, when he was first introduced to this novel procedure. In fact, he vividly recalls the results from the first thrombectomy he witnessed. “A woman in her 50s suffered a massive stroke. Her right side was paralyzed, and she was unable to speak because of the stroke. Unfortunately, she wasn’t a candidate for a drug used to dissolve the clot in the brain,” explains Dr. Fahed. “I thought to myself, this poor woman will be paralyzed for the rest of her life, if she survives.”

That’s when a member of the care team explained they were going to try an experimental treatment called thrombectomy. Dr. Fahed continued with his rounds and 30 minutes later, he received a shocking call. “The patient was moving her right arm. She wasn’t paralyzed anymore. I immediately thought, ‘I don’t know what happened in that room, but I want to be the one doing these interventions. I want to be the one bringing those people back to life. That’s what I want to do.’”

Attracting the best and brightest from around the world

Today, Dr. Fahed is one of only four interventional neuroradiologists and stroke neurologists in Canada. He was recruited to The Ottawa Hospital in 2019 — fulfilling his childhood dream of coming to live in Canada.

His parents immigrated to France from Syria before he and his sister were born, hoping for a better life for their children. Growing up in the suburbs of Paris, Dr. Fahed watched his father, a neurologist, care for patients day in and day out. And so, the field of neurology was a natural path for him to follow. “I’ve always liked neurology. It was pretty clear to me that I wanted to become a doctor. I was seeing my father as my hero. One of my very first electives was in stroke neurology.”

“The Ottawa Hospital is famous for its expertise in stroke. We have a very strong stroke program, and are a high-volume centre where we perform these treatments 150 to 200 times a year.”

— Dr. Robert Fahed
Meet Dr. Fahed
“The Ottawa Hospital is famous for its expertise in stroke. We have a very strong stroke program, and are a high-volume centre where we perform these treatments 150 to 200 times a year.”

— Dr. Robert Fahed
Meet Dr. Fahed

What are the symptoms of a stroke?

  • Sudden weakness, numbness, or paralysis, especially on one side of the body
  • Sudden confusion, difficulty speaking or understanding when others are speaking
  • Sudden trouble seeing — including blurred or double vision — in one or both eyes
  • Sudden trouble walking, dizziness, or loss of balance
  • Sudden severe headache with no other explanation

Dr. Fahed did most of his training at the Rothschild Hospital in France, which he describes as one of the centres where interventional neurology was pioneered. But this young physician also had a deep desire to do research, so he completed a master’s degree in Montreal before returning to Paris — but always longed to come back to Canada. “The Ottawa Hospital is known for its great research infrastructure and how much it supports researchers.” 

New technology changes the outcome for stroke patients

One-quarter of Canadians living with stroke are under age 65, and the risk of stroke rises rapidly after age 55. Eighty-seven percent of all strokes are ischemic strokes — when a vessel supplying blood to the brain is blocked by a clot.

The late Dr. Cheemun Lum and Dr. Dar Dowlatshahi helped pioneer a technique called endovascular thrombectomy (ET) that saved the lives of numerous stroke patients. The findings from the trial known as ESCAPE were released in 2015. This unique procedure is performed by inserting a thin tube in the groin, where it travels through an artery until it reaches the clot in the brain. With the help of X-ray technology, the clot is then sucked out with the help of a pump, restoring blood flow to the brain.

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A major blood vessel in the brain is blocked by a blood clot, causing an acute ischemic stroke.
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A thin catheter inserted into the groin travels through an artery until it reached the clot. A stent passes through the catheter and engages with the clot.
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The stent is then pulled back taking the clot with it. The goal is to remove the entire clot on the first try to restore blood flow as quickly as possible, limiting damage caused by the stroke.  
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Blood flow is restored, and brain function can often improve immediately.
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“We're aiming to remove the clot completely, on the first try. We call it a home run.”

– Dr. Robert Fahed

While this was a groundbreaking procedure, more work was needed to better perfect it as they could only re-open the blocked artery 50 to 60% of the time. “That clot is not always easy to remove. Sometimes you need to try multiple times. Sometimes you can only remove part of it. If you can only partially reopen the vessel, you only partially restore blood flow, which means that some regions of the brain will be damaged. So, we’re aiming to remove the clot completely, on the first try. We call it a home run,” says Dr. Fahed.

These home runs are becoming increasingly common thanks to new technology — and the results can be lifechanging. A patient can go from being paralyzed and unable to speak to talking and walking within 20 minutes of the procedure.

How can you check if someone is having a stroke?

If you suspect someone is having a stroke, experts recommend using the F.A.S.T. method.

  • Face: Ask them to smile. Look for if one side droops.
  • Arms: Ask them to raise their arms. Look for if one arm doesn’t lift as high or at all.
  • Speech: Ask them to speak. Look for if their words are slurred or seem unusual.
  • Time: If any of these signs appear, call 911 right away, and note when the first sign appeared.

How we helped refine the technology to provide better outcomes

Recently, a new catheter device developed by a start-up in Kitchener-Waterloo showed promise at removing the clot on the first try. The company reached out to our stroke team for help in testing the effectiveness of the Health Canada approved equipment. “The Ottawa Hospital is famous for its expertise in stroke. We have a very strong stroke program and are a high-volume centre where we perform these treatments 150 to 200 times a year,” says Dr. Fahed.  

He adds, “We also have unparalleled scientific expertise in the design of studies to evaluate these tools. Because when you create a tool, you can’t just use it. You need to try it, evaluate it, and see if it’s safe and efficient. So, the company approached me and Dr. Brian Drake to investigate.” 

They used 3D-printed silicone models to test this new stroke treatment option using fake clots in 3D-printed blood vessels that mimic a brain. They spent many hours trying different ways to use this catheter. “We wanted to determine the best and most effective way to use it in patients, and we found an approach that was very promising and extremely efficient in the silicone model. Then we designed a study that uses the catheter in stroke patients, and we will compare the results of this trial with trials using different tools and devices,” says Dr. Fahed.  

"If the results continue this way, it's a major game changer. It's going to be a huge revolution in this field.”

– Dr. Robert Fahed
Inside the angiosuite at The Ottawa Hospital, Dr. Robert Fahed navigates a catheter through a model of the circulatory system.
Inside the angiosuite at The Ottawa Hospital, Dr. Robert Fahed navigates a catheter through a model of the circulatory system.
This 3D-printed silicone model is used to test this new stroke treatment option. It uses fake clots in 3D-printed blood vessels that mimic a brain.

So far, the results are extremely promising. The success rate of pulling the clot out on the first try — the ‘home run’ — has increased significantly since using this newly devised catheter. “We are now able to pull the clot out completely on the first try in the vast majority of patients. If the results continue this way, it’s a major game changer. It’s going to be a huge revolution in this field.” 

What’s the connection between COVID-19 and strokes?

COVID-19 has been found to cause neurological complications, not just respiratory issues. Early studies show that COVID-19 could more than double the risk of a stroke, especially in people with other risk factors. Multiple studies have shown even young people are at a higher risk of stroke because of COVID-19. People who experience a stroke with COVID-19 are also at a higher risk for death or disability.

Disruptive innovations and treatments thanks to research

Dr. Robert Fahed_neuroradiology_The Ottawa Hospital_profile

“I'm proud to be part of such disruptive innovations and treatments — there is a lot of excitement in our field because the future is even brighter.”

– Dr. Robert Fahed

This treatment could be transformative for stroke patients and their families, and it if it continues to be successful, the benefits will be felt across the country impacting thousands — saving the lives of more people and saving them from disability. “I’m proud to be part of such disruptive innovations and treatments — there is a lot of excitement in our field,” smiles Dr. Fahed. 

Research plays a vital role in where we are today and the innovative advancements we’ve seen to date. “Today’s research is tomorrow’s care. What we are studying today will be the cutting-edge, groundbreaking, disruptive treatment that we can offer to our patients tomorrow,” explains Dr. Fahed.

His constant search for new stroke treatment options continues in the research he does today. Dr. Fahed is currently assessing whether algorithms used to determine which people are eligible for thrombectomy may be missing some patients. He’s testing these algorithms to make sure they give the same answers when assessed by different physicians or machines. There’s also research into the type of drugs to give stroke patients when they’re with paramedics, prior to the arrival at the hospital.  

Patient Testimonial
Mary Vanstone arrived at the Civic Campus of The Ottawa Hospital on September 27, 2022, after suffering a stroke at her home in Perth, Ontario.
Patient Testimonial
The ischemic stroke had completely paralyzed her left side. Dr. Robert Fahed was in the Interventional Neuroradiology Angio suite that afternoon and performed a thrombectomy on Mary shortly after her arrival.
Patient Testimonial
“They initially didn’t know what the long-term effects would be for me physically and even my brain when I first arrived. But I’m even better than I was before. They said I would likely be in for a week, but the next day, after the procedure, they said I could go home — everything was good! The hospital was fantastic. It was amazing.”

– Mary Vanstone
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According to Dr. Fahed, the future is bright, rapidly changing, and improving the lives of more patients. “The pace of evolution and improvement is exponentially higher and better every year. My job is already so different than what it was 10 years ago when I started. And 10 years from now, it will be a completely different field. We will be doing so many more things and doing them so much better.”

It’s a world that continues to fascinate this physician, much like that first thrombectomy he witnessed years ago.

“Today's research is tomorrow's care. What we are studying today will be the cutting-edge, groundbreaking, disruptive treatment that we can offer to our patients tomorrow.”

– Dr. Robert Fahed

Key stroke stats and facts

  • Ischemic strokes happen when a blood vessel to the brain is obstructed by a blood clot
  • 87% of all strokes are ischemic
  • A transient ischemic attack, known as a “mini-stroke,” is caused by a temporary clot
  • Hemorrhagic strokes happen when a weakened blood vessel ruptures
  • Strokes are the leading cause of disability in adults in Canada
  • Each year, approximately 50,000 people suffer strokes in Canada
  • Two thirds of all strokes happen in people over 65
  • Your risk of a stroke doubles every 10 years after turning 55
  • Men have a slightly higher risk of stroke than women
  • Risk factors for a stroke include: a family history, high blood pressure, high cholesterol, drug abuse, a high weight, inactivity, excessive alcohol consumption, smoking, sleep apnea, and diabetes

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

Categories: Neuro, World-Leading Research, World-Leading Research, World-Leading Research, World-Leading Research

Published: July 2023

To say The Ottawa Hospital is ahead of the game when it comes to data in healthcare is no exaggeration. In fact, for two decades we’ve been exploring the role of “big data”, while other institutions are only getting started. Today, our hospital is a world-leader in this field and has ambitious plans to deploy one of the most advanced data analytics platforms in Canada, if not the world.

It’s that drive to better serve our patients and our people that attracted Dr. Alan Forster to The Ottawa Hospital 20 years ago. “I left Harvard Medical School to become a part of a healthcare community that was completely committed to reorienting around patient safety and quality of care.”

Today, the Vice-President of Innovation and Quality and senior scientist at our hospital is quick to point out that while our hospital’s research community may have seemed smaller than Harvard’s or other centres around the world, he didn’t it see that way — and he still doesn’t. “We do punch above our weight in terms of impact,” explains Dr. Forster.

The Ottawa Hospital is leading the way in data in healthcare.

What is Big Data?

The term Big Data gained momentum in the early 2000s and refers to data that is large, complex, and rapidly generated. It is collected and mined by organizations for information, learning, and other analytics purposes including predictive modelling. The amount of data created by the healthcare industry through digitized records, medical technologies, and other sources means Big Data could change healthcare — if used effectively.

Why the desire for data to drive healthcare?

As a specialist in internal medicine, Dr. Forster was keenly aware of the patient journey, the role of the care team, and how that information flows. Or in some cases doesn’t. He was also aware of how little information was available to care teams regarding the patients they see. At the same time, there was no system in place to share information with the patient or the patient’s other care providers.

Dr. Alan Forster is the Executive Vice President and Chief Innovation and Quality Officer at The Ottawa Hospital.

Even more astonishing to Dr. Forster, there was also no ability to collect and store this information, or to monitor results, compare data, and learn from it. “After we provided patients with some of the most advanced technologies known to humankind, we could not even communicate our treatments or evaluate the impacts of what we did.”

He would use what he learned at Harvard — known at the time as one of the few hospitals in the world with a fully functional electronic medical record system — to drive change when he returned to his hometown of Ottawa. He knew a data warehouse would allow The Ottawa Hospital to study and monitor patient care efficiently and effectively.  

Where does healthcare data come from?

Healthcare data is generated from a huge range of sources, from medical records and staff schedules to wellness apps and wearable technology.

And so in 2004, with the full backing of the hospital’s leadership and funding from the Canada Foundation for Innovation, Dr. Forster began to build the infrastructure needed to house all this data. Five years later, The Ottawa Hospital’s Enterprise data warehouse was born.

For the first time, everything from basic patient information, surveys, and clinical notes to data from labs, pharmacies, and radiology, as well as financial and human resources data were housed in one place. These electronic medical records, from as far back as 1996, pulled information together from across the hospital in a standardized format. Housing it in a “warehouse” also allowed for studying and monitoring of patient care in a way that simply wasn’t possible before. In fact, healthcare providers could track a patient through all their interactions with the hospital, whether they visit a lab, the Emergency Department, or a clinic appointment.

But that was only the beginning.

Comparing apples to apples

Next up was aligning the whole hospital to use data to drive us forward. Deanna Rothwell, the Director of Analytics, leads the charge for the self-serve and data request services. “We build dashboards to find key performance indicators for leaders, so they have a single view of the truth and the facts of the hospital.”

“The demand for data is growing exponentially because of the awareness about how data can drive better decisions.

– Deanna Rothwell

This gives true data comparisons to analyze the data equally — an apples-to-apples comparison. Ms. Rothwell explains how when she first began her role in 2008, each person would come to meetings with different versions of a metric, like hospital admissions as an example. “People would have different definitions and retrieve data from different places. There was no standardization and there was also no standardized way of slicing and dicing the organization. So, we put a lot of effort into how we define things and a platform where everyone could get the same results,” she explains.

The process began to align the physician and administrative teams with the same scorecard and messaging. Ms. Rothwell’s team played a key role in ensuring easy access to information when it was needed. Dashboards were created to not only allow various teams or departments and research groups to see current results and trends over time, but also to drill down to different areas of the organization that are relevant to specific service lines or departments.

However, as the desire for data continues to grow a new challenge has emerged —accessing numbers quickly. “The demand for data is growing exponentially because of the awareness about how data can drive better decisions. Today, there’s more data out there, especially with EPIC, and that demand continues to increase. We wanted to provide a platform where people could safely and securely explore data on their terms,” explains Ms. Rothwell.

Big Data could:

Reduce healthcare organizations’ costs by 25%

Result in earlier diagnosis and improved outcomes

Help prevent disease

Accelerate research and discovery

Improve quality of care

Reduce medical error and adverse outcomes

What is the MDClone effect?

This is where MDClone comes in and it’s a game changer for our hospital. “MDClone offers a platform where people can self-serve and ask any data question they want at any time. So, they no longer must go through a queue of the analytics team,” explains Ms. Rothwell. “It’s data at their fingertips.”

“It uses synthetic data which means it is made up data about made up people rather than the patient’s personal details. That’s why it’s so exciting — you don’t have to worry about privacy.”

– Dr. Alan Forster

Our introduction to MDClone came through our partnership with the Sheba Medical Centre ARC (Accelerate, Redesign, and Collaborate) Network based in Israel. Developed in 2018, our partnership has grown and the Network itself has also grown globally.

Ziv Ofek, CEO of MDClone, leads a workshop on the use of MDClone technology for data analytics.

The MDClone platform is a powerful, self-service data analytics environment enabling healthcare collaboration, research, and innovation. Our hospital recently implemented the software to gain easier access to data for all physicians, researchers, and staff. As early adopters of the technology, we’ve been able to fulfil a niche of self-serve data.

MDClone removes the largest roadblock faced by anyone wanting to access data at our hospital — privacy. As Dr. Forster explains, the company provides an innovative approach to solving those problems. “It uses synthetic data which means it is made up data about made up people rather than the patient’s personal details. That’s why it’s so exciting — you don’t have to worry about privacy.”

What are the benefits of synthetic data?

The synthetic data behaves and has the same characteristics as the real data, without being the real data. Once you’ve decided if you’re on the right track with the synthetic data then you can apply to access real data with appropriate approvals to drive your results. An example could be a hospital employee who’s trying to determine how to reduce anemia for patients who go through surgery. They could use lab data to determine:

  • The number of patients who are going into the operating room.
  • What their rates of anemia are?
  • What their long-term outcomes are, or even short-term?
  • How long are they in the hospital?
  • Do they have complications when they’re in the hospital?

The data can show trends that can influence or inform future care and determine the cause of problems needing to be solved. Ms. Rothwell explains, “If I can reduce anemia by x percent, I know that I would reduce the hospital’s re-admission rate by 10 percent, just as an example. I can also estimate the impact of that on the hospital overall. I can then use data to monitor my progress on that issue and evaluate the outcomes. You need data at all points of the quality improvement process.”

What is Synthetic Data?

Synthetic data is artificially created data that stands in for real data while reflecting the actual statistical information from the original data. Synthetic data prevents users from identifying any individuals from the data, making it the most private solution to healthcare data analytics.

Leading the pack with healthcare data analytics

“As a healthcare organization we are ahead of the game, and we’ve been ahead of the game for many years. The ability to get your hands on synthetic data is phenomenal. It’s a great story for The Ottawa Hospital.”

– Deanna Rothwell

This all began as a pilot project in 2020 when the hospital’s data warehouse information was uploaded into MDClone and a trial run began. Then a training program was established with 250 individuals trained to date and more waiting due to high demand.

Did you know?

1600 BCE

The first known medical record is an Egyptian papyrus text from 1600 BCE

1663

The first use of statistical analysis was a study on bubonic plague mortality in 1663.

1969

The first electronic health record was created in 1969.

Data is also driving research at our hospital. When a study is being conducted, a scientist must wait for approval from the Research Ethics Board (REB) to get access to data. But with the MDClone’s synthetic data, they can do some early legwork. “You can do all of your exploratory work and analysis, understand the feasibility of the study, understand what the data is going to look like, and in parallel submit your REB application. People can go onto the platform, explore it themselves, and figure out exactly what data is going to be meaningful to them. So, when their REB approval comes in, they may have already completed the study design and analysis with synthetic data, so that speeds it up enormously,” says Ms. Rothwell.

Ultimately, it’s about accessing data faster to make better decisions, inform care, and find answers to provide better results for our patients. “As a healthcare organization we are ahead of the game, and we’ve been ahead of the game for many years. The ability to get your hands on synthetic data is phenomenal. It’s a great story for The Ottawa Hospital,” says Ms. Rothwell.

It all comes from data because data helps us know what’s working, helps us identify where the gaps are, and helps us develop solutions to improve — all of that rests on the data.”

— Dr. Alan Forster

Listen Now: How data drives better care for patients

Data and technology make for a bright future in healthcare

New Campus Development

At the New Campus Development on Carling Avenue, data that will inform better patient outcomes and a better patient experience. The new Centre for Innovation and Virtual Care is an excellent example of that — equipping patients with take-home technology, empowering them to manage their health using the latest artificial intelligence. Care teams will be able to remotely monitor a patient’s health journey and provide care when it’s needed.

“We will have better ways to support care providers to help patients rehabilitate. It all comes from data because data helps us know what’s working, helps us identify where the gaps are, and helps us develop solutions to improve — all of that rests on the data,” explains Dr. Forster.

City Connections

Being in Ottawa, at the heart of Canada’s high-tech sector has allowed us to stay ahead of the curve when it comes to technology and innovation — whether it’s training programs through our colleges and universities, the launch of the TD AIM Hub, or our relationship with Invest Ottawa — the economic agency for the City of Ottawa. Our connections to the business community have led to very tangible benefits.

In the future, we will provide living laboratory space to ideate, develop, test, and scale digital innovations and incubator space for revenue-generating partnerships with leading companies and thinkers addressing healthcare’s biggest challenges — all while training the next generation of healthcare innovators.

Categories: Creating Tomorrow, Patient Care, Technology, Technology, Technology, Technology

Vittorio Petrin has never seen his grandchildren’s faces. The Italian draftsman started to lose his peripheral vision in the early 1980’s after his second son was born, forcing him to leave work and take an early pension. He was diagnosed with retinitis pigmentosa, a genetic disorder that causes the cells in the retina to break down. There is no cure. His vision steadily got worse until he couldn’t see any light at all.

Before his vision went dark, Vittorio spent six years building a model of St. Mark’s Basilica in Venice, using over 3,000 copper pieces. “It was the most beautiful place I’d seen, and I wanted to replicate it. Working on it kept my mind away from what was going to happen,” he says.

An image of Vittorio Petrin with a replica of St. Mark’s Basilica he built while losing his vision to retinitis pigmentosa.
Vittorio Petrin with a replica of St. Mark’s Basilica he built while losing his vision to retinitis pigmentosa.

“My dad was an artist. He was able to draw phenomenally, he liked taking videos. Sight was important to him,” says Vittorio’s son Dino Petrin. “He never complained about going blind, we never saw it as children. He always had a sense of humour and a strong character. He never asked for any pity, he just took it in stride.”

Millions of people in North America live with retinal diseases like retinitis pigmentosa, glaucoma, retinal ischemia and age-related macular degeneration. These diseases are poorly understood, progressive, and often untreatable.

But thanks to promising gene and cell therapies in development, Dino hopes that one day people like his father won’t have to lose their vision.

Dr. Catherine Tsilfidis' research is aimed at developing a gene therapy strategy that blocks apoptosis and slows down retinal disease progression.
Dr. Catherine Tsilfidis

“Soon we’ll be able to do what our lab has been trying to do all along – bring XIAP gene therapy into the clinic.”

– Dr. Catherine Tsilfidis

A discovery with game-changing potential

Dr. Catherine Tsilfidis can imagine the day when the first patient is treated with the retinal disease gene therapy her lab has worked on for the past 20 years. While it won’t happen tomorrow, that day is not far off.

“XIAP gene therapy is exciting because it keeps cells in the back of the eye from dying,” said Dr. Tsilfidis, a senior scientist at The Ottawa Hospital and associate professor at the University of Ottawa. “It could slow or stop vision loss caused by many different retinal diseases.”

Dr. Tsilfidis is leading a world-class team of researchers that recently received $2.4 M from the Ontario Research Fund to develop gene and cell therapies for retinal diseases. One of their goals is to do the work needed to bring XIAP gene therapy into clinical trials, which could start in the next few years.

The time is right for gene and cell therapy

The promise of replacing defective genes and cells in the eye with healthy ones is undeniable. While these fields are still in their infancy, they are expected to grow exponentially over the next decade. Gene therapy for the eyes has particularly taken off, with Health Canada approval of the first gene therapy for a rare genetic form of vision loss in 2020.

“This research program could make Ontario a leader in the fields of both gene and stem cell therapy

– Dr. Pierre Mattar

When it comes to cell therapies, Ottawa and Toronto are major hubs in the growing area of stem cell research. As partners in the retinal research program led by Dr. Tsilfidis, UHN scientist Dr. Valerie Wallace will work on increasing the survival of transplanted stem cells in the eye, while The Ottawa Hospital’s Dr. Pierre Mattar aims to develop stem cell therapies for retinal ganglion cell diseases such as glaucoma. “This research program could make Ontario a leader in the fields of both gene and stem cell therapy,” said Dr. Mattar. “By learning the best way to mass produce and integrate stem cells for retinal disease, we can advance stem cell research in other fields.”

The Ottawa Hospital's Dr. Pierre Mattar aims to develop stem cell therapies for retinal ganglion cell diseases such as glaucoma.
Dr. Pierre Mattar

Collaboration between lab researchers and clinicians key to success

The incredible challenge of bringing a basic science discovery to clinical trials requires an exceptional team. For this research program, Dr. Tsilfidis assembled a “dream team” of long-time collaborators and new partners.

As a basic scientist, Dr. Tsilfidis has always worked closely with clinicians to help ensure her research reflects patient needs.

“Ophthalmologists help us identify the most important questions to ask,” said Dr. Tsilfidis. “Our lab started working on diseases like Leber hereditary optic neuropathy and glaucoma because clinicians told us how much of a problem they were.”

Two of Dr. Tsilfidis’ long-time clinical collaborators, Drs. Stuart Coupland and Brian Leonard, are part of this new retinal research program. They are joined by retina specialists Drs. Bernard Hurley and Michael Dollin, who will assist in developing clinical trial protocols.

“Our researchers have an incredible track record of taking discoveries from the lab to the bedside,”

– Dr. Duncan Stewart

Dr. Tsilfidis’ lab and office are just down the hall from the ophthalmologists’ offices and clinics, which makes collaboration easier. This kind of co-location of scientists and clinicians has been key to The Ottawa Hospital’s success in translating discoveries from the lab bench to the patient bedside.

The highly skilled team at The Ottawa Hospital's Biotherapeutics Manufacturing Centre will make the clinical-grade virus to deliver gene therapy into the eye.
The highly skilled team at our Biotherapeutics Manufacturing Centre will make the clinical-grade virus to deliver gene therapy into the eye.

Leveraging our biomanufacturing expertise at The Ottawa Hospital

In addition to clinical experts, the team knew they needed new resources and partners to be successful.

“We’ve been very much a basic science lab in the past,” said Dr. Tsilfidis. “Now that we’re at the stage that we want to get XIAP to the clinic, we need all the help we can get.”

One missing piece was a special clinical-grade virus used to deliver the XIAP gene into the eye, known as an adeno-associated virus (AAV). Finding cost-effective sources of AAVs has been a major bottleneck for getting gene therapy trials and treatments off the ground.

Thankfully, The Ottawa Hospital is home to the Biotherapeutics Manufacturing Centre (BMC), a world-class facility that has manufactured more than a dozen different virus- and cell-based products for human clinical trials on four continents. Experts at the BMC were already starting to expand into AAV manufacturing when Dr. Tsilfidis approached them about collaborating on the retinal research program.

The BMC has since been working with Dr. Tsilfidis and her team to develop a process to manufacture the AAVs the team will need for Health Canada approval of the XIAP gene therapy for clinical trials.

The BMC is on track to become the first facility in in Canada to make clinical-grade AAV vectors for gene therapy studies. This new expertise will help them support other gene therapy trials with a focus on rare disease.

Learn more about our Biotherapeutics Manufacturing Centre.

How to plan a world-class clinical trial

In addition to the clinical-grade virus, the retinal research team needed help planning a future clinical trial of XIAP gene therapy. Fortunately, there are no shortage of clinical trial experts at The Ottawa Hospital.

“I’ve never planned a clinical trial before,” said Dr. Tsilfidis “But I knew someone who had – Dr. Dean Fergusson. I’ve always been impressed by the rigorous trails he’s helped develop. When I asked for his advice, he referred me to the Ottawa Methods Centre.”

The Ottawa Methods Centre is The Ottawa Hospital’s one-stop shop for research expertise and support. Their goal is to help all clinicians, staff and researchers at the hospital conduct the highest quality research, using the best methods. They support over 200 research projects a year, led by clinical and basic researchers alike.

“The Ottawa Methods Centre has been amazing to work with,” said Dr. Tsilfidis. “Their research methodology expertise has strengthened this research program and our funding applications.”

Drs. Manoj Lalu and Dean Fergusson along with other experts at the Ottawa Methods Centre are helping to plan a future clinical trial of gene therapy for retinal disease.
Drs. Manoj Lalu and Dean Fergusson along with other experts at the Ottawa Methods Centre are helping to plan a future clinical trial of gene therapy for retinal disease.

At the Ottawa Methods Centre, the team is leveraging the Blueprint Translational Research Group’s Excelerator program, designed to enable efficient translation of basic research discoveries to the clinic through rigorous methods and approaches. Co-led by Dr. Dean Fergusson and Dr. Manoj Lalu, the program will help design the clinical trial protocol, and support the clinical trial application to Health Canada through systematic reviews of available pre-clinical and clinical data.

Research program holds enormous promise

Tackling retinal disease will be a big challenge, but Dr. Tsilfidis has assembled an excellent team of partners both old and new to move this research program forward.

“These therapies could be life-changing. If we could cure or slow down the progression of vision loss, that would be amazing.”

– Dino Petrin

“Our researchers have an incredible track record of taking discoveries from the lab to the bedside, but it can only be done through team efforts like this one,” said Dr. Duncan Stewart, Executive Vice-President of Research at The Ottawa Hospital and professor of medicine at the University of Ottawa. “Fully leveraging our basic and clinical expertise, as well as our world-class core research resources is the key to getting new treatments to the patients who need them.”

For Dr. Tsilfidis, the excitement is palpable. “Soon we’ll be able to do what our lab has been trying to do all along – bring XIAP gene therapy into the clinic.”

Dino, a former graduate student in Dr. Tsilfidis’ lab, sees the potential of gene therapies to help people like his father. “These therapies could be life-changing,” he said, “If we could cure or slow down the progression of vision loss, that would be amazing.”

Vittorio Petrin pictured with his wife Maria Petrin
Vittorio Petrin with his wife Maria Petrin

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

Categories: Biotherapeutics, Clinical Trials, Stem Cell

Browse Current Issues

  • Twenty-ninth Edition – Construction update: An inside look as crews build the parking garage at The Ottawa Hospital’s new campus
  • Twenty-eighth Edition – $59 million grant fuels biotherapeutics expansion at The Ottawa Hospital’s new campus
  • Twenty-seventh Edition – Designing the operating rooms of the future
  • Twenty-sixth Edition – Construction update: Aerial view of The Ottawa Hospital’s new campus
  • Twenty-fifth Edition – Adapting to patient need: The Ottawa Hospital’s new campus increasing access to life-sustaining dialysis
  • Twenty-fourth Edition – Development Phase Agreement begins for The Ottawa Hospital’s new campus
  • Twenty-third Edition – Building the best hospital for you
  • Twenty-second Edition – The Ottawa Hospital and Hydro Ottawa partner on innovative new central utility plant
  • Twenty-first Edition – The Ottawa Hospital’s new campus development an economic anchor for our community
  • Twentieth Edition – The Ottawa Hospital’s new campus reaches milestone as next stage of procurement begins
  • Nineteenth Edition – The Ottawa Hospital’s new campus design showcased on international stage
  • Eighteenth Edition – Indigenous partnerships and The Ottawa Hospital’s journey of reconciliation
  • Seventeenth Edition – Bird’s eye view as construction progresses at The Ottawa Hospital’s new campus
  • Sixteenth Edition – Modern sustainability in a new state-of-the-art hospital
  • Fifteenth Edition – Construction of The Ottawa Hospital’s new campus continues
  • Fourteenth Edition – A hospital for everyone: Building one of Canada’s most accessible hospitals
  • Thirteenth Edition – Welcome to The Ottawa Hospital’s inpatient room of the future; The Ottawa Hospital and building trades unions sign historic agreement
  • Twelfth Edition – The Ottawa Hospital and Infrastructure Ontario Seek Design and Development Team for New Hospital Build
  • Eleventh Edition – Tree relocation begins at the New Campus Development
  • Tenth Edition – The New Campus Development gets the green light from Ontario government, the new hospital construction to boost Ottawa’s GDP by $2 billion, and more!
  • Ninth Edition – Parking structure highlights, getting to the new campus, naturalizing the site, and more.
  • Eighth Edition – How a new trauma centre will save lives, an update on the Indigenous Peoples Advisory Circle, a feature on artwork by Algonquin artists Simon Brascoupé and Mairi Brascoupé, and a letter on hospital parking by Chiefs of Staff from hospitals across the region.
  • Seventh Edition – A commitment to the canopy at the New Civic Campus, creating a transit-oriented hospital, and more.
  • Sixth Edition – New sustainability benchmarks in the New Campus Development, an update on the Indigenous Peoples Advisory Circle, an an interview with Orleans Councillor Matt Luloff, and more.
  • Fifth Edition – The proposed design of the cutting-edge new campus, “Early works” projects beginning on the New Campus Development, an interview with River Ward Councillor Riley Brockington, and more.
  • Fourth Edition – How the finance team is planning for a $2.8 billion hospital, an interview with Chair of Ottawa’s Planning Committee Jan Harder, how the New Campus Development will transform the patient experience – and more!
  • Third Edition – How architects are designing the hospital with Ottawa’s daylight and weather patterns in mind, a look at groundbreaking research, and the team working hard behind the scenes to plan a hospital for the future.
  • Second Edition – What it means to build a universally accessible hospital, how the environmental cleanup of the site is beginning, and more.
  • First Edition – How we will partner with the Unionized Building and Construction Trades Council.

Innovating Today. Creating Tomorrow.
Innovation & Technology

At our new hospital, exceptional people with access to exceptional technology will pioneer truly groundbreaking, patient-focused healthcare.

It’s time to propel our world-class teams with the world’s greatest technology.

The future of healthcare is embedded with technology and innovation.

Planted in the heart of Canada’s high-tech sector, our new hospital will leverage local talent to ensure it is the most technologically advanced in the country — providing the most sophisticated, leading-edge care to every patient. 

The Virtual Healthcare Hub

The Virtual Healthcare Hub will be strategically located on the grounds of our new campus and will be a first point of contact for patients. It will improve communication with their healthcare providers and ensure all but the most critically ill are treated outside a hospital setting. Innovation like this will allow us to provide the right care, in the right space, with the right provider.

Innovation = the right care, in the right space, with the right provider

Unrivalled data analytics means unparalleled care

‘Big data’ might be new for other institutions, but in the last two decades, we’ve become widely recognized as a world-leader in healthcare analytics and implementation. 

We plan to deploy the most advanced data analytics platform in the country, if not the world. Harnessing data will allow us to enhance care for patients everywhere. 

“We are now poised to go to the next level — by harnessing data and using the latest digital technology and artificial intelligence to save lives.”

— Dr. Alan Forster, Vice-President of Innovation and Quality, The Ottawa Hospital

Breaking ground with high-tech healthcare

Extraordinary people with access to extraordinary technology can do extraordinary things. 

With a living laboratory space to ideate, develop, test, and scale digital innovations, we’ll address some of the world’s biggest healthcare challenges and train the innovators of tomorrow. 

“Together, we are redefining what is possible and stepping boldly into the future of healthcare. Innovations that happen right here at our hospital will have a global impact for generations. With your support, we will lead the way.”

— Cameron Love, President & CEO, The Ottawa Hospital

Technology that transforms personalized care

We’re committed to developing technology that will help save lives.
Wearable and mobile technology will not only empower patients to manage their health but will also allow medical staff to monitor their journey and provide care when it’s needed — driving a critical shift in the delivery of healthcare.

Together, we can bring the latest medical advances to every patient.

It's time to create a better tomorrow.

About the Campaign to Create Tomorrow

The Campaign to Create Tomorrow is the largest fundraising campaign in our region’s history. It will help fulfil the most ambitious vision ever for the future of The Ottawa Hospital, focused on four critical pillars.  

NEW CAMPUS DEVELOPMENT

Discover how this $2.8 billion, world-class academic healthcare centre will push our hospital to the very top tier of healthcare and research worldwide.
Learn More

INNOVATION & TECHNOLOGY

WORLD LEADING RESEARCH

Through our unique collaborative model of clinicians and researchers working side-by-side, we will bring groundbreaking discoveries to patients in Ottawa — and around the world.
Learn More

STRENGTHENING CRITICAL SERVICES

From trauma care to cancer advancements to neuroscience, we will strengthen our critical services for patients across the region.
Learn More

The Ottawa Hospital has made great strides in addressing today’s most pressing challenges in neuroscience. We are internationally recognized for our groundbreaking research and treatment of many neurological diseases, such as stroke, neuromuscular illnesses, and Parkinson’s disease (PD).

In fact, we are one of very few centres in Canada where neurologists work hand-in-hand with basic scientists to tackle unsolved problems. Our goal is to foster new ideas and expand our range of clinical trials to quickly bring cutting-edge treatments directly to our patients. Some of the discoveries that lead to new interventions have been made here.

Parkinson’s disease is the second most common neurodegenerative disease after Alzheimer’s, affecting over 100,000 Canadians. The disease continues to mystify according to Dr. Michael Schlossmacher, a neurologist and the Bhargava Family Research Chair in Neurodegeneration at The Ottawa Hospital. This Chair is an example of one way philanthropists, like the Bhargava family, actively support the hospital.

“It was in 1961 when one of my teachers in Vienna first discovered the Lazarus-type effect of how dopamine therapy can suppress the symptoms of Parkinson’s. That was six decades ago, and we now understand more of the mechanisms underlying the motoric deficits, but we still don’t have a therapy in place to stop the illness in its tracks,” says Dr. Schlossmacher.

Thinking outside the box for Parkinson’s treatment

Dr. Michael Schlossmacher, The Ottawa Hospital

“If we want to treat Parkinson’s, slow it down or stop it, it will only happen through research that identifies better ways to separate subtypes of the illness and confirm targets to develop drugs for interventions.”

– Dr. Michael Schlossmacher

While progress is slow and often frustrating for patients, active research continues to probe for answers. “If we want to treat Parkinson’s, slow it down or stop it, it will only happen through research that identifies better ways to separate subtypes of the illness and confirm targets to develop drugs for interventions. Then, we’ll need to test them in the clinic and, upon demonstration of safety, apply them to a large body of patients in trials to gauge efficacy,” explains Dr. Schlossmacher. He is quick to point out that our Parkinson’s Research Consortium has made a name for itself in Canada and internationally, both on the clinical side and through basic research. Some of the clinical research activity is directed at improved integration of care delivery that we have already available today.

Philanthropy and grants play a pivotal role in moving research forward. For Dr. Schlossmacher and his team, it often allows them the opportunity to develop ideas that are largely out of the mainstream and represent ‘outside the box’ thinking. “Philanthropy has the potential to transform research activities by amplifying them and supporting talented trainees that can work on creative, new ideas.”

Does Parkinson’s start in the nose?

Over the years, research has shown more than 80% of people with Parkinson’s disease suffer from a reduced sense of smell — it often occurs years before the onset of typical movement-related symptoms. Understanding those early indicators could help in an early diagnosis for patients.

Recently, a US $9-million grant from the Aligning Science Across Parkinson’s (ASAP) initiative was announced to further explore this idea. The hope is to determine whether scent-processing nerves that connect the inside of the nose to the brain may play a role in the development of the disease. Dr. Schlossmacher is the overall leader of the effort.

Dr. Julianna Tomlinson, the scientific program manager for the international team and co-director of research in the Schlossmacher Lab at our hospital, explains the importance of this study. “For us, this is an incredible opportunity to align efforts around the world, because it brings together scientists previously anchored in the PD field with researchers who heretofore have been working outside the field of Parkinson’s.”

There are eight institutes in five countries collaborating on this global study. It’s a unique opportunity to get answers to questions that scientists here in Ottawa have been asking for quite some time, including what role environmental triggers (other than toxins) play in Parkinson’s disease as they interact with genetics. “Right now, the treatments for Parkinson’s help the symptoms but they do not stop the progression of the disease. If we can identify disease processes at an early stage, then hopefully we will be able to stop or at least slow its progression before it reaches those later stages,” says Dr. Tomlinson.

The Ottawa Hospital leads this international effort

There are five main areas that this interdisciplinary and multinational study is pursuing. Our hospital’s focus is on how the immune system relates to Parkinson’s. Specifically, laboratory models will determine how viruses and bacteria could lead to changes in the body that are linked to pathology that is seen in the diseased human brain. Understanding the function of genes that are linked to Parkinson’s and whether those genes could be functioning in the immune system, rather than just in the brain, will also be explored.

The support of our hospital is instrumental in being able to lead this international effort. “There are so many people who are involved in making this work. It’s a full team effort, including financial officers, publication experts, and colleagues with knowledge in technology transfer,” explains Dr. Tomlinson.

Ultimately, it’s about finding answers for our patients and their family members who are desperately waiting for a breakthrough. As Dr. Schlossmacher explains, that’s why the world will be watching these scientists. “From an innovation and creativity perspective, we are setting the stage as a team as to how complex research avenues could be brought together, where people work collaboratively and constructively. We don’t undermine each other; we really complement each other and enable each other.”

Making the patient connection

For nearly two decades, Kelly McDonald felt there was something physically wrong with her, but even an eventual diagnosis of fibromyalgia in her 30s didn’t provide her with the answers she needed. McDonald, a professional photographer with a sharp eye, always knew something was off. Her stance wasn’t great, she struggled with her posture, and she’d get tired easily. However, solving her health mystery was an ongoing challenge and source of frustration. “You know, people think you’re a hypochondriac,” says Kelly.

It wouldn’t be until 2021, at the age of 52, when Kelly was diagnosed with Parkinson’s disease. In recent years, she started to develop tremors, her handwriting deteriorated, and she increasingly had a hard time getting her foot properly placed in her shoe. It was at that point, Kelly’s husband convinced her to see her doctor. Soon her right side became stiff and at times, she also felt numb. Kelly thought she was having a stroke.

“I consider myself a Parkinson’s warrior. I want to be a warrior. I want to bring more awareness to this disease, and I want people to be diagnosed earlier.”

– Kelly McDonald

Kelly McDonald
Knitting is a passion that Kelly won’t yet
give up.

When Kelly met with a neurologist at The Ottawa Hospital, tests revealed she had Parkinson’s — a diagnosis that she, surprisingly, welcomed. “I was just relieved, because I thought I was going to die from a stroke, like my dad did,” remembers Kelly.

Kelly’s father also had suffered from Parkinson’s. Moreover, soon after her diagnosis, she learned even more about her family history, namely that it also had affected the paternal side of her family. She is being cared for by Dr. David Grimes, the Head of the Division of Neurology at our hospital and an expert in movement disorders. It was Dr. Grimes who asked Kelly whether she would be interested in a study known as the Parkinson’s Progression Markers Initiative (PPMI).

Kelly admits that there were some dark days after her initial diagnosis. But in coming to terms with her new reality, she woke up one morning with a new view on her life. “I decided I have this, let’s do something good. I consider myself a Parkinson’s warrior. I want to be a warrior. I want to bring more awareness to this disease, and I want people to be diagnosed earlier,” explains Kelly.

“A lot of people start to tremor when they’re older, and some people think it’s a disease that only affects older people. But Michael J. Fox was diagnosed when he was 29.”

– Kelly McDonald

She enrolled in the PPMI study to help all those living with a Parkinson’s gene mutation, like her, that don’t realize they have it. It’s not until the shaking begins that the red flag goes up. “A lot of people start to tremor when they’re older and some people think it’s a disease that only affects older people. But Michael J. Fox was diagnosed when he was 29.”

What is PPMI?

PPMI is a landmark study led by The Michael J. Fox Foundation investigating better treatment options and prevention of the disease.

The Ottawa Hospital is one of nearly 50 sites across 12 countries participating in the expansion of the PPMI study. The team at our hospital is recruiting people recently diagnosed with Parkinson’s, who are not yet taking medication to control symptoms, as well as people age 60 and older who do not have Parkinson’s but are living with certain risk factors. Those interested in enrolling at The Ottawa Hospital can find the detailed eligibility criteria and how to contact the study team here. The Ottawa Hospital was the first Canadian study site to recruit participants when the study started to include sites outside the US; the expansion phase of the study means there could be 4,000 participants across all sites by the end of 2023.  

“We are proud to be partnering with The Michael J. Fox Foundation and other PPMI site participants, and we are very grateful to the study’s dedicated volunteers who are helping us to move toward a future of disease prevention and better options for those living with Parkinson’s.” 

– Dr. Tiago Mestre

Dr. Tiago Mestre is the principal investigator at our hospital, and he explains initial discoveries from this global study have already had an impact. “Early findings have revolutionized the understanding of Parkinson’s biology and the design of clinical trials testing potential new treatments, but there is much more to uncover. We are proud to be partnering with The Michael J. Fox Foundation and other PPMI site participants, and we are very grateful to the study’s dedicated volunteers who are helping us to move toward a future of disease prevention and better options for those living with Parkinson’s.”  

Kelly joined the study mid-2021 and she’ll be monitored for 13 years. She says it’s been an amazing experience so far and she’d encourage others to consider joining. “Not only do you gain information about yourself and current information on your condition, but a study like this can help other people in the future. It also seems like Parkinson’s runs in my family. I could learn important information that could help my sister or my niece.” says Kelly.

For now, she’s looking ahead and doesn’t lose focus, whether it’s on her photography or as a warrior combatting Parkinson’s.

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

Categories: Neuro, Parkinson's

Originally published: January, 2022

When Owen Snider faced the news that his lymphoma had returned for the third time in ten years, he knew his options were running out. But a transformational new treatment known as CAR-T therapy gave him renewed hope. The Ottawa Hospital was recruiting patients for a clinical trial investigating a made-in-Canada approach to this cutting-edge treatment. He just needed to qualify for the trial.

In 2010, Owen was diagnosed with large B-cell lymphoma. In his early 60s at the time, he went through a chemotherapy treatment known as R-CHOP. For most people, it lasts 18 weeks. “It was a rigorous treatment. I got through it okay and was six years clear, but then it came back — the lymphoma returned in 2016,” says Owen.

When the cancer returned, his care team at The Ottawa Hospital vetted him for a stem cell transplant. By the summer of that year, he went through what he called an intensive program using his own stem cells. A high dose of chemotherapy was used to remove harmful immune cells in preparation for the transplant of his own healthy cells. “It’s pretty brutal, and after two or three months of wishing maybe I wasn’t around, things improved. I was clear for another four years.”

“I was given five or six months to live. My wife and I were downhearted with that news.”

— Owen Snider

Lymphoma returns for a third time

Following his stem cell transplant, Owen remained healthy for four years, enjoying retirement at his home in a beautiful, wooded area near Calabogie, where he lives with his wife, Judith Snider. But then Owen faced his biggest challenge yet when the lymphoma returned — again. This time, the diagnosis came in May 2020, in the midst of the pandemic. “I remember my oncologist saying they’ve done pretty much everything they could. I was given five or six months to live. My wife and I were downhearted with that news. I was basically going to be kept as comfortable as possible for six months,” remembers Owen.

Judith and Owen Snider kayaking.
Judith and Owen Snider kayaking.

However, one week later Owen received a lifeline. His oncologist called to say a CAR-T therapy clinical trial had opened at The Ottawa Hospital — a Canadian first. They wanted to see if he would be a good candidate. Throughout June of 2020, he went through a battery of tests and scans to see if he qualified for the trial.

“This type of immunotherapy research is groundbreaking, and it’s never been done in Canada before.”

– Dr. Natasha Kekre

By mid-June, Owen got the green light. He was a candidate for the clinical trial, and didn’t hesitate to enroll. “I either participate in the trial or I lie around here for four or five months waiting for the end. Which choice would you have made? The positive way to put it is that I was very excited to be a part of the trial. We’re the kind of people where the glass is always half-full,” explains Owen.

What is CAR-T therapy?

CAR T-cell therapy is a type of immune therapy that is an emerging biotherapeutic treatment that harnesses the power of a patient’s own immune cells, known as T-cells, to treat their cancer. T-cells play a critical role by killing abnormal cells, such as cells infected by germs or cancer cells. In some cancers, like lymphoma or leukemia, cancerous cells become invisible to the T-cells that are meant to kill them. In CAR-T therapy, the T-cells are collected and reprogrammed in the lab to recognize and destroy the cancerous cells.

Dr. Natasha Kekre is a hematologist and associate scientist at The Ottawa Hospital. She is leading the development of Canada’s first CAR-T research platform in collaboration with the BC Cancer Centre. “This type of immunotherapy research is groundbreaking, and it’s never been done in Canada before. This is a therapy that uses a patient’s own immune system. It’s personalized medicine — it’s very individualized to each patient,” explains Dr. Kekre.

The Ottawa Hospital is one of the first hospitals in Canada to participate in nationally-led CAR-T trials, and as one of Canada’s top research and treatment centres, the hospital is ideally positioned to play a lead role in bringing an innovative CAR-T research program to Canada, and to Canadian patients.

Going for the Pac-Man effect

In late June 2020, Owen went through apheresis which is the process of withdrawing the T-cells in his blood. “They put an IV in my right arm, and ran the tubing through the machine, and the machine processes the blood and pumps it back through the tubing into my other arm. I lay there on the bed for three or four hours, without moving I should add.”

“It’s just like Pac-Man, the modified T-cells ran around in my blood stream, chomping away at the lymphoma.”

– Owen Snider

Those T-cells were then sent to a lab in BC, re-programmed, and then returned to our hospital two weeks later. Then the T-cells were re-administered just like a blood transfusion. “It allows for that new immune therapy in these cells to go and find the patient’s cancer cells, attack them, and kill them. And it also stimulates the immune system in that patient to further go attack and fight their cancer,” explains Dr. Kekre.

On July 2, Owen received a PICC line and then went through three days of chemotherapy. Four days later he was re-injected with his T-cells and they got to work. “It’s just like Pac-Man, the modified T-cells ran around in my bloodstream, chomping away at the lymphoma.”

His re-programmed T-cells were specifically looking for cancer cells to kill. Owen would need to wait to find out if it was working.

Owen Snider, seen at home, was treated for lymphoma as part of a CAR-T clinical trial.
Owen Snider

Did the CAR T-cells therapy work?

One month later, Owen and Judith received some exceptional news. “At my check-up 30 days after getting my T-cells back, I was almost clear of cancer. The scan showed that there was almost nothing left. I was gobsmacked,” he says.

By the three-month mark, Owen says he was as “clean as a whistle.” Eighteen months later, there is still no sign of lymphoma.

For Dr. Kekre, giving patients like Owen new hope for the future is what inspires her. “For the first time, I think in a long time, Owen felt that the lymphoma might actually be disappearing. He’s had multiple scans since then that show the same thing. And so now, I think he’s starting to believe it. And I think that’s the reality of why I do this, because patients like him who had no options before, could soon have the option of CAR-T therapy. That’s what happened for Owen and that’s what we hope will happen for many more patients,” says Dr. Kekre.

Dr. Natasha Kekre and Owen Snider. Owen was treated for lymphoma as part of a CAR-T clinical trial at The Ottawa Hospital.
Dr. Natasha Kekre and Owen Snider. Owen was treated for lymphoma as part of a CAR-T clinical trial.

What’s next for the clinical trial?

Dr. Kekre and her team are monitoring all patients enrolled in the trial and published preliminary results in June 2022. The purpose of the clinical trial is to provide proof to Health Canada this therapy is safe. “The reality is that we have a data safety monitoring board, which watches for the safety of the trial, and they’ve had no concerns. So, from a safety point of view, we’re very happy with the trial. And that’s why we are still open and we’re still able to enroll more patients,” explains Dr. Kekre.

Why is The Ottawa Hospital unique in its CAR-T therapy?

CAR-T therapy needs to be individually manufactured for each patient using the patient’s own cells combined with large amounts of highly pure virus to deliver the chimeric antigen receptors (CAR) gene. The Ottawa Hospital’s Biotherapeutics Manufacturing Centre is ideally positioned to manufacture the clinical grade virus needed to create CAR T-cells for clinical trials. In fact, we have the only facility in Canada that has produced this kind of virus for clinical trials.

The hope is that one-day CAR T-cell therapy may also be a treatment for a variety of cancers. “The world is watching us,” explains Dr. Kekre. “We’ve had a lot of attention from Denmark, and a few other European countries are reaching out. They believe in a system similar to ours, where patients all have the right to access healthcare. If CAR T-cells are here to stay, they have to be done in a sustainable approach for our patients. And that’s a big part of what we are building — this is only the beginning. And that’s what people are looking at us to see how we do it.”

“Without philanthropy, we wouldn’t have a Biotherapeutics Manufacturing Centre or a Methods Centre at The Ottawa Hospital, and we wouldn’t be able to do innovative clinical trials like this.”

– Dr. Natasha Kekre

This made-in-Canada CAR T-cell research platform will give Canadian patients more access to innovative clinical trials. “Canadian cancer patients shouldn’t have to wait for the research to be done elsewhere but be able to participate in innovative clinical trials here at home,” says Dr. Kekre.

Grateful for each day and philanthropic support for research

Today, Owen appreciates each day and a good quality of life thanks to the clinical trial. He feels strong and can’t wait for the day when he and Judith can travel again — grateful for the lifesaving research. “It was an honour and a privilege to be chosen for the trial.”

He also credits the extraordinary care team and those special moments when he visited the hospital. “I can tell you that I always felt more than comfortable. I felt encouraged by anyone I met. The team on 5 West as we know it, is wonderful. I had an occasion to go back there last spring, and it was like walking back into Cheers — everybody knows your name.”

As a longtime supporter of The Ottawa Hospital, and to see philanthropy play an important role in making this clinical trial a reality, he’s an even bigger advocate for encouraging support for our hospital. “All I can say is that the core funding of hospitals doesn’t provide for some of the innovative and cutting-edge things that go on, or maybe some really specialized piece of equipment. And that’s where the community donor can help and contribute to that effort.”

Owen and Judith Snider. Owen was accepted into a made-in-Canada CAR-T therapy clinical trial at The Ottawa Hospital to treat his lymphoma.
Owen and Judith Snider.

For Dr. Kekre, philanthropy provides the spark for clinical trials like this, and can help to keep them moving forward. “Without philanthropy, we wouldn’t have a Biotherapeutics Manufacturing Centre or a Methods Centre at The Ottawa Hospital, and we wouldn’t be able to do innovative clinical trials like this. We need this kind of research to get to a place where all Canadians can benefit from these therapies. Without philanthropy, we would never get there.”

And to Dr. Kekre, her team, and their collective efforts to give more patients hope, Owen has a simple message: “Thank you. The whole program is outstanding.”

About the Canadian-Led Immunotherapies in Cancer (CLIC) research program

The CLIC research program, established in 2016, brings researchers, clinicians and patients from across Canada together to build Canadian expertise and capacity for innovation in the promising field of cellular immunotherapy for cancer, including CAR-T therapy. The first CLIC clinical trial launched in 2019 at The Ottawa Hospital and at BC Cancer, with support from BioCanRx, BC Cancer, The Ottawa Hospital Foundation and the Ontario Institute for Cancer Research. Core facilities and resources supporting CLIC include The Ottawa Hospital’s Biotherapeutics Manufacturing Centre, BC Cancer’s Conconi Family Immunotherapy Lab, the Ottawa Methods Centre and the Blueprint Translational Research Group. CLIC team investigators include Drs. Natasha Kekre, Harold Atkins, John Bell, Kevin Hay, Rob Holt, Brad Nelson, John Webb, Manoj Lalu, Kednapa Thavorn, Dean Fergusson, Justin Presseau and Jen Quizi.

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

Categories: Biotherapeutics, Cancer, Cancer, Clinical Trials, World-Leading Research

Originally published: May, 2021

Early in the fall of 2020, Michele Juma noticed the vision in her left eye was becoming cloudy. The Sault Ste. Marie resident initially turned to her family doctor for answers. She learned she had a meningioma tumour — and time was not on her side to save her vision. Fearing she would face blindness, Michele, a mom of four, eventually travelled to The Ottawa Hospital where she could receive specialized care — care she could not receive close to home.

It was early November when MRI results revealed the mass at the base of her frontal lobe. “By this time, I lost my ability to see colour in my left eye — my vision was deteriorating. It was like looking through a frosted window,” remembers Michele. While her right eye would start compensating to get her through her day-to-day, Michele was finding the routine of caring for her teenage boys and working a challenge and knew she needed to see a specialist. Soon, she and her husband were making plans for the eight-hour drive to Ottawa to meet with Dr. Danah Albreiki at the University of Ottawa Eye Institute located at The Ottawa Hospital.

Seeking answers at the University of Ottawa Eye Institute

The University of Ottawa Eye Institute was founded in 1992 as the home of The Ottawa Hospital’s Department of Ophthalmology. It is a major clinical, teaching, and research centre in Canada specializing in diseases and conditions that affect the eyes. Dr. Albreiki’s expertise focuses on neuro-ophthalmology and adult strabismus surgery, which focuses on straightening misaligned eyes.

Born and raised in Saudi Arabia, Dr. Albreiki says our Eye Institute plays an international role in sharing our expertise with patients and ophthalmologists in more than 86 countries around the world. As one example, she explains, the Ottawa Eye Institute has an affiliation with India Srikiran Institute of Ophthalmology in Kakinada, Andhra Pradesh. Affiliations like these provide an opportunity for the ophthalmology residents to travel and explore ophthalmology in a very different setting.

Having done her ophthalmology residency in Ottawa, Dr. Albreiki reflects on the importance of teaching. “I think the Eye Institute is honestly an amazing academic place where staff are dedicated first and foremost to their patients, but have a heavy focus for teaching the ophthalmology residents. This ripple effect extends beyond Ottawa and will travel wherever the residents end up working as they share their knowledge and expertise with their communities. As a matter of fact, Michele was seen first by our neuro-ophthalmology fellow Dr. Noran Badeeb who came all the way from Saudi Arabia to train with us.”

Michele, pictured with her family, was treated at the Ottawa Hospital for meningioma tumour.
Michele with her family.

“The danger is it’s very close to the optic nerve, and Michele is a good example of how people can quickly deteriorate with these tumours, and they are at high risk of losing their vision.”

— Dr. Fahad Alkherayf

By early December, Michele met Dr. Albreiki’s team and she learned what was happening with the tumour. “If we leave tumours that are compressing on the optic nerve for too long, there is a high chance that it will damage the optic nerve which subsequently leads to permanent vision loss,” explains Dr. Albreiki. She adds, “Despite the severe vision loss that had happened, we were able to determine, by way of ophthalmic diagnostic testing, that Michele’s optic nerve appeared more suffocated than actually dead. By removing the suffocation, we would allow the optic nerve to breathe again and there would be a good chance she would regain part, if not all, of her vision.”

For that to happen, they would need to act fast.

Understanding meningioma tumours

Knowing Michele had travelled from Sault Ste. Marie for her initial meeting at the Eye Institute, Dr. Albreiki arranged for her to meet later that day with world-class, skull base surgeon Dr. Fahad Alkherayf who set in motion a plan to remove the mass.

He explained to Michele that she had a skull base meningioma. The tumour was about three centimetres by three centimetres — about the size of a golf ball. The biggest challenge with removing these types of tumours is often their location. “How you can reach it without damaging the brain around it and the things attached to it is key. If you’re not careful, and you end up injuring any of these structures, unfortunately, the outcome is devastating,” explains Dr. Alkherayf.

“The Ottawa Hospital is one of the main leading centres in minimally invasive skull base surgery, and I think that speaks to the expertise we have in our centre.”

— Dr. Fahad Alkherayf

Minimally invasive surgery offers new treatment options

Minimally invasive skull base surgery uses a narrow scope with a light to access and remove tumours through the nose.

The treatment used today for a meningioma tumour is relatively new. In the past, it was a much more invasive procedure known as a craniotomy, which results in a large incision with a higher risk of injuring the optic nerve. However, today minimally invasive surgery allows much more effective and safer care for our patients. “Instead of the old, traditional way of going through the skull, and lifting the brain — today, we go through the nose,” explains Dr. Alkherayf. This means no incision, faster recovery time, reduced pain, a higher accuracy rate compared to traditional open surgery, and a shorter hospital stay.

The Ottawa Hospital has established itself as a leader in Canada when it comes to this type of minimally invasive surgery. Dr. Alkherayf says we’re one of the largest centres in Canada doing it. “If we look across the country, The Ottawa Hospital is one of the main leading centres in minimally invasive skull base surgery, and I think that speaks to the expertise we have in our centre. It’s not just surgeons but it takes a good anesthesia, nursing, and neurophysiology team, so the surgeon can function well. I think what’s unique about our hospital is we have this full package providing care to our patients.”

Having access to this expertise is a significant advantage for patients like Michele, who required urgent surgery due to the rapid growth of the tumour and the risk of it causing blindness not only in her left eye but in her other eye as well. After meeting with Dr. Alkherayf as well as Dr. Shaun Kilty, an ear, nose, and throat (ENT) specialist, her surgery was scheduled for December 17, 2020.

Michele remembers feeling anxious and nervous. “It was all really overwhelming — and surreal. When I think that I’d been walking around with this tumour probably for years…it was kind of unbelievable to me to think of the whole gravity of the situation.” However, Michele says she knew she was in good hands. “I do have to say that when I met with Drs. Albreiki, Alkherayf, and Kilty, they were very reassuring and answered all our questions, significantly reducing my anxiety.”

Michele being wheeled into surgery at The Ottawa Hospital to remove her meningioma tumour.
Michele being wheeled into surgery at The Ottawa Hospital to remove her meningioma tumour.

Specialized technique used only at The Ottawa Hospital

Leaving their four sons at home, Michele and her husband arrived back in Ottawa just over a week before Christmas. The minimally invasive surgery would last eight hours with Drs. Alkherayf and Kilty working alongside one another to remove the tumour piece by piece — through Michele’s nose.

“The monitoring helped ensure we didn’t pull too hard on her optic nerve. If it wasn’t for this specialized technique, I don’t think we would have achieved the same results.”

— Dr. Fahad Alkherayf
Continuous evoked visual potential goggles are used by surgeons during some brain and skull surgeons to monitor a patient’s vision and avoid damaging the optic nerve.

During the procedure, Dr. Alkherayf was able to monitor Michele’s vision. In fact, our hospital is the only centre in Canada using this specialized technique. “We have established a method where we can receive a signal from the eye, as well as from the optic nerve and the brain, about what’s happening to the vision while the patient is asleep.” Goggles — which resemble swimming goggles — are placed on the patient while they’re under anesthetic. The goggles send a flashing light, which sends a signal into their retina, and then it travels down their optic nerve, crosses the chiasma (the back of the optic nerves where they meet), and then travels to the vision centre of the brain. The signals will change if the surgeon’s pushing or pulling the optic nerves and potentially damaging them.

According to Dr. Alkherayf, this technique was critical during Michele’s surgery. “Her tumour was basically glued to her optic nerve, which explains why she was having this significant vision problem. The monitoring helped ensure we didn’t pull on her optic nerve. If it wasn’t for this specialized technique, I don’t think we might have achieved the same results.”

The future is looking clear

For the first five days after surgery, Michele says there was a lot of sleeping, but she remembers the moment when she woke up for the first time and she opened her eyes. “My husband was there, and I was able to see — it was right away that I could see again!” Even better news, before Michele was released from the hospital on Christmas Eve, Dr. Alkherayf shared the news she had been hoping for – the tumour was benign, and he was able to completely remove it.

“I’m grateful to be able to watch my sons continue to grow and, of course, to have the chance to be part of the activities they love most, like swimming and hockey.”

— Michele Juma

With this life-changing news in hand, Michele and her husband began their long drive back home to Sault Ste. Marie arriving home at 11:30 p.m. on December 24, just in time to be with their children for Christmas. “It was like a Hallmark movie,” laughs Michele.

Michele, with her husband and four sons, after arriving home in time for Christmas in 2020.

Today, her vision is fully restored. She’s back at work and keeping up with the busy life that comes with raising four teenage boys. “I consider myself to be so incredibly fortunate to have had Drs. Alkherayf and Kilty conduct this surgery. When I think about the complexity of what they did, I never cease to be amazed, and I feel truly blessed.”

While she and her family truly appreciate the exceptional skill of both physicians, Michele adds they were kind, compassionate, and empathic throughout her journey. “As scary as all this was, I can honestly say that I always felt confident that I was in very good hands.” She adds, “I’m grateful to be able to watch my sons continue to grow and, of course, to have the chance to be part of the activities they love most, like swimming and hockey.”

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

Categories: COVID-19
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