Published: March 2025

Imagine the sensation of a sudden, sharp electric shock to your face, intense and unyielding. Now, imagine that happening repeatedly, day after day, without any warning — pain so excruciating it brings you to your knees. This was a daily struggle for Michelle Kupé. After months of testing, she was diagnosed with trigeminal neuralgia, a rare condition that had a debilitating effect on her life. Desperate for relief, she sought help from The Ottawa Hospital’s neurosurgery team, hoping to regain control of her life.

In December 2017, Michelle scheduled an appointment with her dentist to investigate a strange buzzing sensation in her cheek, which she initially thought was a tooth infection or dental problem. After taking x-rays, the dentist found no issues with her teeth, but the sensation persisted, leaving Michelle with the feeling that something wasn’t right.

By the time the new year arrived, Michelle was preparing to set off on a cruise with her girlfriends. However, the persistent buzzing sensation and the overall sense that something wasn’t right led her to return to the dentist’s office. With no clear explanation for the strange sensations, she was prescribed antibiotics to rule out a sinus infection or other potential issues. During her trip, Michelle couldn’t shake a nagging thought. “The entire time I was there, I kept thinking, ‘Something has happened to me… and I’m not well.’ I was deeply aware that my life was taking a different turn. Something was wrong.”

Trigeminal neuralgia’s excruciating progression

As the buzzing sensation and pain intensified, Michelle returned to the dentist for a third time. It was then the dentist suspected the symptoms might suggest a rare condition called trigeminal neuralgia — a condition that causes severe, electric-shock-like pain on one side of the face. The dentist advised her to make an appointment with her family doctor and see a neurologist as soon as possible.

“It went from this buzzing sensation in my face to feeling like I was being electrocuted. It felt like I was being stabbed, like an electric current was running through my face.”

— Michelle Kupé

As she waited to see a neurologist, the symptoms worsened. “It went from this buzzing sensation in my face to feeling like I was being electrocuted. It felt like I was being stabbed, like an electric current was running through my face.”

As each attack eased, Michelle was terrified to touch or move any muscle in her face, fearing the pain would return. Eventually, she saw a neurologist, who confirmed that she had trigeminal neuralgia. But while one mystery was solved, another emerged. There are three potential causes for this condition: multiple sclerosis, a brain tumor, or vascular compression.

All about trigeminal neuralgia

Trigeminal neuralgia is a rare and exceedingly painful chronic pain disorder that involves the trigeminal nerve on the side of the face. The nerve runs from the top of the ear and then splits into three branches that run to the eye, the cheek, and the jaw.

Learn more

As Michelle waited for an MRI, she continued to run her successful real estate business and care for her five children. Her condition remained stable with medication into the spring of 2018, with occasional, painful flare-ups. But, as time progressed, things started to deteriorate quickly, with attacks becoming more frequent and debilitating. Eating, brushing teeth, and even smiling were becoming unbearable.

“I remember thinking, I don’t think I’m going to be able to go on. Something as simple as a light breeze could cause an attack,” she recalls. “With thoughts of another winter approaching, my husband and I talked about moving somewhere warm because I couldn’t imagine a cold wind hitting my face.”

Debilitating shocks to Michelle’s body

MRI results eventually revealed her condition was the result of a vascular compression and she was referred to Dr. Adam Sachs, current Division Head of Neurosurgery at The Ottawa Hospital.

Dr. Sachs and his team see patients for a wide variety of facial pain, but he says trigeminal neuralgia can be one of the worst. It affects the trigeminal nerves, which carry signals from the face to the brain, and causes intense pain like an electric shock on one side of the face. “The MRI showed that a vessel loop of an artery that goes to the brain stem and cerebellum was compressing the trigeminal nerve — that was the cause of the pain,” he explains.

Director of Neuromodulation and Functional Neurosurgery and Scientist at The Ottawa Hospital

Find out how Dr. Sachs thinks brains are like computers, what he loves about The Ottawa Hospital, and why you might find him fighting a co-worker on his break.

Read our Q&A with Dr. Sachs

“It feels like a high voltage electrical shock running through your face or some people describe it as a dagger being jammed into their face.”

— Dr. Adam Sachs

For patients, like Michelle, the condition can be unbearable. “It feels like a high voltage electrical shock running through your face, or some people describe it as a dagger being jammed into their face,” explains Dr. Sachs. “People are using those terms not to be colourful, but because that’s the closest thing they can come up with, and we hear these terms again and again.”

Modern microsurgical technique with the help of Teflon

While surgical treatment has been available for decades, recent advances have provided new treatment options — modern microsurgical techniques that are more effective and safer. As Dr. Sachs explains, the tools they have today are state-of-the-art.

When it comes time for surgery, it’s an intricate procedure with the patient’s head turned because the surgical team must access a small space at the back of the head called the cerebellopontine angle or CP angle. “That’s where we see all the nerves and the arteries that go to very critical structures of the brain stem. It’s close to the facial nerve, and if damaged, it results in facial palsy.”

In Michelle’s case, the artery had a large vein wrapped around the nerve, and so Dr. Sachs called in his colleague Dr. John Sinclair to assist with the surgery because of the complexity.

“We decided even though it was a large vein, to carefully dissect it off the nerve in addition to the artery. Then we put little Teflon pads under both the vein and the artery to keep them away from the trigeminal nerve,” says Dr. Sachs.

The Teflon creates a physical barrier that will keep the vein and the artery from the nerve, but also keep the blood flowing through them, so they will continue to function.

“We tear it up to microscopic pieces of the Teflon, shaped like cigars, and it creates a barrier because it stays — it’s not going to absorb into the body,” explains Dr. Sachs.

For the most complex parts of the procedure, the neurosurgical team uses high-magnification microscopes and microscopic knives.

Pain is an invisible disease

When it comes to cases of trigeminal neuralgia, our hospital sees patients from across Eastern Ontario. According to Dr. Sachs, not all cases are debilitating like Michelle’s, but for many, the pain they are experiencing is made worse by the fact that those around them don’t always understand what the patient is going through.

"She wasn't even able to smile or laugh for a year. Every time she would smile, she’d have these attacks and pain. So, treating pain is rewarding as a physician because we're able to help relieve it, and that can be transformative for the patient.”

— Dr. Adam Sachs

“Michelle is a very personable individual. She loves to be around family, friends and to laugh and enjoy life. She wasn’t even able to smile or laugh for a year. Every time she would smile, she’d have these attacks and pain,” explains Dr. Sachs. “So, treating pain is rewarding as a physician because we’re able to help relieve it, and that can be transformative for the patient.”

“I remember waking up from surgery and knowing immediately that I didn’t have electricity running through my face. The relief was immediate,” says Michelle.

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The following image contains content that may be unsettling or sensitive to some viewers.

The scar from Michelle’s surgery

"The relief was immediate."

— Michelle Kupé

The gratitude she feels runs deep, not only for those who helped take away the agonizing pain, but also for the nursing staff in the neuro ICU — she can’t remember all their names, but she will never forget their compassion.

“This one particular nurse was so kind. I remember slowly waking up after the surgery with him rubbing my arm and saying, ‘You’ve had a rough day today, but you did great,’” she says. “I felt encompassed by caring people who had my best interests at heart. I never for a moment felt abandoned when I was at my most vulnerable.”

Regaining her life back

After five days in the hospital following her surgery, Michelle returned home to her five children and husband Rob. Within five months, she was able to return to work, but continued with physiotherapy for about a year. Today, she can experience bad headaches and is still seen by the pain clinic, but she’s living a full life again — now as an empty nester with her kids grown up and exploring the world.

Michelle reflects on a full circle moment from many years ago when her parents first heard about Dr. Sinclair returning from the United States to his hometown of Ottawa and his efforts to bring a CyberKnife radiosurgery robot to our hospital.

“My parents heard about this CyberKnife and they rallied to support his efforts. Who would have known that years later the neurology department would be where their daughter would end up? We had no other connection really with neurology at the time, and yet this emerging neurosurgery tool was something my parents were really passionate about making sure people had access to.”

It’s a perfect example of the impact of philanthropy and never knowing who it will benefit.

“We believe things don’t happen by accident. The way it lined up and how it all unfolded was part of the plan for my life and shows it’s important to keep giving back.”

Listen to Dr. Adam Sachs talk about the role vital role of the neurosurgical team at The Ottawa Hospital.

Listen Now:

Categories: Neuro, Technology, Technology

A CANCER JOURNEY

A journey through two cancers and the BRCA gene mutation

Published: February 2025

When Jennifer Hollington was diagnosed with ovarian cancer, she didn’t see it coming. This shocking news started her down a path she never imagined, including two more significant medical developments: the discovery she had the BRCA gene mutation, and a skin cancer diagnosis.

While well-versed in the healthcare sphere because of her job with Health Canada and the Public Health Agency of Canada, Jen wasn’t prepared for the health crisis she faced in 2020 at the height of the pandemic. However, she was introduced to a large multidisciplinary team of healthcare professionals at The Ottawa Hospital, who helped guide her through this cancer journey.

It was late July 2020 when Jen woke up in the middle of the night with intense pain in her side. After a call to Telehealth Ontario, she went to a local Emergency Department, where blood work and an ultrasound revealed the shocking news — Jen’s tests pointed to a likely diagnosis of ovarian cancer.

“It was a scary and unexpected diagnosis. I came to terms with it only after repeating it many times to family, friends, and co-workers,” she explains.

A stage 3 ovarian cancer diagnosis

By early August, Jen took a leave from her job as the Assistant Deputy Minister of Communications for Health Canada and the Public Health Agency of Canada. Not long after that, she met Dr. Wylam Faught, head of the division of gynecologic oncology based at the Shirley E. Greenberg Women’s Health Centre at the Riverside Campus.

“He sees you as a person, not simply as a patient who is on a long list of patients.”

— Jen Hollington

Dr. Faught took time to walk Jen through what her journey might look like with what he suspected was stage 3 ovarian cancer. “We’re pretty realistic when meeting with a patient who faces this diagnosis. We try to start into the treatment journey with the patient’s eyes wide open — every patient is different.”

For Jen, this approach was exactly what she needed. “Dr. Faught was very empathic, but also realistic about the challenges of ovarian cancer, which I appreciated. He sees you as a person, not simply as a patient who is on a long list of patients. It was comforting to know that we were moving forward, but it was also scary.”

The impact of research on patients facing ovarian cancer

In 2024, an estimated 3,000 Canadian women were diagnosed with ovarian cancer. The disease impacts women of all ages, but it’s more common in women who have gone through menopause. Sadly, the current five-year survival rate is only 45%, and that’s why research at all levels plays a critical role in advancing new treatment options.

Researchers like Dr. Barbara Vanderhyden and her team at the Vanderhyden laboratory at The Ottawa Hospital are dedicated to studying this disease.

Read our Q&A with Dr. Tien Le

Testing shows the BRCA2 gene mutation

In late August, Jen underwent surgery to remove her uterus, cervix, ovaries, and Fallopian tubes, followed by six rounds of chemotherapy. Her gynecologic oncologist, Dr. Tien Le, was able to remove most of the visible cancer. The final pathology report confirmed Jen had stage 3 high-grade serous carcinoma arising from her ovary. Luckily, this meant there were very good initial treatment options to manage her cancer.

“Dr. Le told me they are increasingly looking at ovarian cancer as a chronic disease, to keep people living longer and longer. I found this especially encouraging,” says Jen.

That pathology report also indicated her ovarian tumour cells carried the BRCA2 gene mutation. Genetic testing was suggested to see if she was a carrier of the gene change. This would have further impact on immediate family members and direct further treatment for the patient.

All humans have the BRCA genes (BRCA1 and BRCA2). You inherit one from each of your parents, and if one parent has a mutation, there is a 50% chance you will inherit it. These genetic mutations are known to predispose carriers to develop hereditary breast and ovarian cancers, among other cancers.

“Patients with this mutation tend to have a much better prognosis than someone who is not a carrier of the gene change, because there are more treatment options, and the patient is more responsive to chemotherapy. It was positive news overall.”

— Dr. Wylam Faught

By the spring of 2021, genetic test results showed Jen had a mutation in her BRCA2 gene, which subsequent testing revealed she had inherited from her father. This presented another medical hurdle, namely a significant risk of developing breast and other cancers.

While the news was initially alarming to Jen, Dr. Faught explained it offered hope. “Patients with this mutation tend to have a much better prognosis than someone who is not a carrier of the gene change, because there are more treatment options, and the patient is more responsive to chemotherapy. It was positive news overall.”

Once her chemotherapy was complete, Jen was eligible for an effective new class of oral medication known as PARP inhibitors called Olaparib. “It’s only been in the last handful of years that this group of patients with the BRCA gene mutation have benefitted from this new drug, which in some cases has the potential for putting them into remission. So, within her diagnosis of ovarian cancer, there was this silver lining,” explains Dr. Faught.

Optimizing her chances for the future

With the results of the genetic testing placing Jen at a higher risk of breast cancer, Dr. Le referred her to Dr. Erin Cordeiro, a breast surgical oncologist at The Ottawa Hospital.

“Dr. Cordeiro was clear, respectful, and kind as she answered all my questions and provided the detailed information I needed to make my final decision on one of two options,” says Jen.

Those options included continuing with annual mammograms and breast MRIs through Ontario’s high-risk screening program or having a preventive bilateral mastectomy. Armed with plenty of statistics, like how preventive surgery would reduce her risk of developing breast cancer by 95%, Jen considered the options.

“I pretty much knew right then and there, surgery was the best option for me. I was so reassured by the call with Dr. Cordeiro. I came away knowing so much more about my options as well as their advantages and disadvantages.”

Her next step was to meet with a plastic surgeon, because as Dr. Cordeiro explained it, she would remove the breast tissue and the plastic surgeon would reconstruct the breasts during the same surgery.

Then another cancer diagnosis

Shortly before the appointments relating to her mastectomy, Jen inquired with her family doctor about an itchy patch of skin near her anus that had persisted for a few years but seemed harmless enough. In September 2021, she met with a dermatologist, who did a biopsy. “He mentioned the possibility of cancer. I thought ‘Good grief, as if I need more cancer in my life.’”

Within days, the news was confirmed, Jen had a second cancer — anal margin squamous cell carcinoma — perianal skin cancer. This news introduced her to a whole new cancer team at our hospital who rallied around her.

Colorectal surgeon Dr. Robin Boushey removed an almost one-centimeter tumour. When the post-surgery pathology report indicated that pre-cancerous cells remained in the margins, Dr. Boushey referred Jen to radiation oncologist Dr. Jenny Jin.

“The pathology showed there were precancerous tumours along the cut edge of the tumour. We knew that she would have quite a high risk of local recurrence if there was no further treatment,” explains Dr. Jin.

“There’s been no evidence of any recurrence, and soon she’ll be three years out. The highest rates of recurrence are in the first two years, and so her chances are getting better.”

— Dr. Jenny Jin

Another surgery was possible, but that brought some risks and could impact Jen’s quality of life. “If she were to have more resected, it would mean that she’d likely end up with a permanent ostomy pouch for bowel movements, so we went with an organ preservation approach,” explains Dr. Jin.

By February 2022, Jen finished 25 treatments of radiation. “She’s done very well ever since. There’s been no evidence of any recurrence, and soon she’ll be three years out. The highest rates of recurrence are in the first two years, and so her chances are getting better,” says Dr. Jin.

For Jen, it was another big hurdle she’d overcome.

Jen and Nurse Hillary ringing the radiation bell at Irving Greenberg Family Cancer Centre

Jen ringing the bell at The Ottawa Hospital

The overarching support along the way

One thing that stands out to Jen along this journey has been the many multi-disciplinary teams who cared for her, including many nurses and allied health professionals. One in particular had a huge impact. Jacinthe Lepage has been a nurse at The Ottawa Hospital for over 30 years, and she’s spent most of her career working in gynecology oncology.

More recently, her role has evolved to include a first-of-its-kind nurse-led PARP inhibitor clinic at our hospital’s Cancer Centre.

“The clinic first opened in March 2023 and there’s no other clinic like it – anywhere in Canada,” explains Jacinthe. “There’s a lot of monitoring and calls when somebody is on this drug, so I’m the nurse that’s there for those patients.”

It’s this experience, compassion, and candor that Jacinthe brings to patients that resonated with Jen. “Jacinthe is fabulous, and she’s been with me through this whole experience. A voice of comfort and reason when I have questions. She’s always there.”

Jacinthe Lepage, clinical oncology nurse

“I don’t see the cancer when I talk to them, because I know that they don’t want to be identified as that. To me, it’s very important to treat the person behind all this.”

— Jacinthe Lepage

For Jacinthe, it’s a special role that she takes very seriously, and it’s different for each person. “We treat the cancer, but I see the person behind all this. I don’t see the cancer when I talk to them, because I know that they don’t want to be identified as that. To me, it’s very important to treat the person behind all this.”

As she explains, they need to be able to open up and ask any questions. “I know some are afraid to ask questions about death and dying, about prognosis and all that, but I always tell myself, if they have the guts to ask, I can’t hide anything. When they ask, it’s because they are ready for the answer.”

Hope for patients in the future facing an ovarian cancer diagnosis

Four-and-a-half-years after this cancer journey started, Jen remains cancer-free. There have been some bumps in the road, including with her breast reconstruction surgery — a process that continues. She’s even offered hope and guidance to others through the blog she started, Jenesis, which has also been therapeutic for her.

“At this point, with no evidence of disease, the risk of recurrence is quite low. Dr. Faught estimated my risk of recurrence to be less than 10%. I almost cried when he said that.”

— Jen Hollington

In November 2024, she reached a significant milestone when doctors recommended she come off the PARP inhibitor drug, which suppresses the growth of cancerous ovarian tumours. “There’s no evidence that staying on the drug would have a long-term benefit beyond two years,” explains Dr. Faught.

It was a challenging decision for Jen, as there was comfort in knowing she was taking this drug and doing well. “At this point, with no evidence of disease, the risk of recurrence is quite low. Dr. Faught estimated my risk of recurrence to be less than 10%. I almost cried when he said that, remembering that he had told me in August 2020 that the risk of recurrence in ovarian cancer is about 80%,” shares Jen.

According to Dr. Le, there is new hope on the horizon for patients with ovarian cancers. “We are embarking on a new program at The Ottawa Hospital to advance the care and improve survivals for ovarian cancer patients in the form of HIPEC treatment. This involves administering heated chemotherapy solution right into the abdominal cavity at the time of surgery for their cancers. This strategy has been shown to significantly improve the survival for patients with ovarian cancer in selected cases.”

While more and more centres are adopting this therapy, The Ottawa Hospital would be only the second hospital in Ontario to provide it to patients. It’s new advancements like this one that give patients like Jen hope for more effective treatment options and better survival.

As Jen moves forward, she embraces parts of life that she may not have noticed before. “Special moments that once may have seemed mundane have become clearer and brighter as I live each day, grateful that I am still here.”

Categories:

Published: January 2025

Always an active person, Kumar Visvanatha started to notice a concerning change in his habits in 2020. Now retired from the high-tech industry, he often spent time cycling, travelling to Colorado to hike, or flying, as he was a licensed pilot. However, with the arrival of the pandemic, like so many others, he was often isolated from doing the activities he loved, and this started to have a significant impact on his wellbeing.

“This is when I started feeling anxious, down, and lower energy. I thought there was something physically wrong with me. I never thought about depression.”

— Kumar Visvanatha

Little did he know, this downward spiral would continue, and in 2022, the situation was exacerbated when Kumar started to have back pain, which eventually became a chronic issue, and his quality of life became progressively worse. Without a family doctor, he bounced between physicians at walk-in clinics, but he wasn’t getting any answers or relief.

“This is when I started feeling anxious, down, and lower energy. I thought there was something physically wrong with me. I never thought about depression,” says Kumar.

Eventually, Kumar no longer recognized himself, so he turned to the mental health team at The Ottawa Hospital for help.

A downward spiral into depression

After several tests, Kumar learned there was nothing physically wrong with him, but he continued to see his quality of life decline. By the summer of 2023, this normally active and engaged man found himself in a place he’d never been. “I didn’t recognize the person I had become. When I looked in the mirror, I didn’t know who I was,” shares Kumar.

“I didn’t feel like I had any hope.”

— Kumar Visvanatha

His energy levels were low, he couldn’t sleep, he didn’t want to do anything — as he describes it, he would “mope around the house.” Kumar also didn’t go out to social events because he didn’t understand what was happening to him or how to explain it to others who were used to him being active and social. Kumar felt completely isolated. “I didn’t feel like I had any hope.”

That’s when his partner insisted on bringing him to the Emergency Department at The Ottawa Hospital’s Civic Campus in July 2023, and he first met Dr. Andrew Greene, a psychiatrist at our hospital. “He’d essentially hit his rock bottom. He was feeling like he’d never be himself again,” explains Dr. Greene.

Seeking help for depression at The Ottawa Hospital

This wasn’t Kumar’s first introduction to The Ottawa Hospital, but this time was under very different circumstances. Before retirement, Kumar worked at JDS Uniphase, where the team rallied to raise $15 million for the Critical Care Unit at the General Campus — which is now named the JDS Uniphase Employee Legacy Critical Care Wing. Kumar had no idea that one day, he would be on the receiving end of critical mental health care at The Ottawa Hospital.

Thankfully, the Mental Health program provides early diagnosis and treatment of severe mental illness. With two psychiatric emergency services and 96 acute in-patient beds, our hospital is often the first place those experiencing a mental health crisis in our city will turn to for help. Beyond that, we operate three regional programs that treat patients with first episode psychosis, eating disorders, perinatal mental health, as well as a mobile crisis team in our community.  The Mental Health program is also a leader in research, which brings innovative new therapies to patients.

The challenge with depression is it pushes people to do and think the exact opposite of what’s needed to get better. It pushes people to isolate themselves, stop going outside and doing activities.
— Dr. Andrew Greene

One of the first observations Dr. Greene made was that Kumar was self-aware of what was happening and wanted to get better, but he needed help to ensure things were going to change. He was diagnosed with major depressive disorder — a mental health condition in which someone is feeling very low and not able to enjoy things the way they normally would over a prolonged period.

“It’s very persistent. Typically, we’re talking about this going on for months or sometimes even years. The challenge with depression is it pushes people to do and think the exact opposite of what’s needed to get better,” says Dr. Greene. “It pushes people to isolate themselves, stop going outside and doing activities. That tends to make it progressively worse.”

After an assessment in the Emergency Department, Kumar was sent home with medication and a plan to attend the transitional skills program.

Transitional Skills Program offers solutions

Kumar agreed to participate in the half-day hospital program, called the Transitional Skills Program, where the patient participates four days a week and focuses on cognitive behavioral therapy.

“We’re helping people address the way they’re thinking about things,” explains Dr. Greene. “In some cases, perhaps in a negative way or ruminating with very dark thoughts, and how that’s affecting their mood. We also look at how their behaviours — things they’re doing or not doing — are impacting their mood.”

Kumar credits the program with having a significant impact on his recovery. “Among the various topics taught in the course, I really resonated with mindfulness, self-compassion, and cognitive behavioural therapy, and I use these skills regularly today.”

“It happened gradually. I started to have more energy, and then I found myself walking and cycling again."

— Kumar Visvanatha

He also credits other aspects of the program, including the emotional regulation group, the goal setting group, and gratitude journal, as a few examples.

Over time, Kumar continued to have appointments with Dr. Greene, and there was a process of finding the right medication and dosage. In addition to the in-hospital program, he also met regularly with a therapist.

It certainly took time and patience, but by April 2024, Kumar started to see signs of his old self returning. “It happened gradually. I started to have more energy, and then I found myself walking and cycling again. This too was medicine for me, and I slowly started getting better.”

Back to his active, healthy living

“Major depressive disorder is a temporary illness. I can't tell you when it's going to get better, but it is going to get better. That’s really important for people to understand.” 

— Dr. Andrew Greene

It was an important message for patients like Kumar to hear. “I didn’t see this coming. I really didn’t understand depression. I remember thinking if you’re sad or something, get out and do something fun. But I know now that you can’t just snap out of it. And I’ve learned depression can happen to anybody.”

Today, Kumar is back enjoying life and active again. He’s truly grateful for the care he received and for the support from his loving partner and a couple of very close friends, who were there whenever he needed them. They would check on him regularly and insist on getting outdoors and going for walks.

And now when he looks in the mirror, he sees someone different than he did two years ago. “I see myself again … but I’m a little older,” Kumar says with a smile.

If someone needs help:

If you know someone who may be suffering from depression and needs help, the best place to start is by visiting your family doctor. If you don’t have access to a family doctor, you can go to AccessMHA.ca. This is a centralized intake service for our region that brings together all the mental health and addiction services. Once you register yourself, you will get a phone appointment with an intake worker, who will help match you with the appropriate care.

The Distress Centre of Ottawa and Region is available 24/7 for anyone experiencing any type of mental health crisis and can be reached at 613-238-3311. If you are experiencing suicidal thoughts, you can call or text 9-8-8: where a crisis supporter will help you without judgment.

Listen to Dr. Andrew Greene guest on Pulse Podcast to learn more about depression and mental health care at our hospital.

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Categories: Mental Health

Among the hundreds of birth announcements in the Ottawa Citizen over the years mentioning Dr. Manuel “Manny” Gluck as the delivering doctor, two are of particular note and significance, especially today: Justin Trudeau and Alexandre “Sacha” Trudeau, born on Christmas Day in 1971 and 1973 respectively. What are the odds?

Both boys were delivered by Dr. Gluck, a prominent Ottawa obstetrician and gynaecologist, who worked out of the Ottawa Civic Hospital. Dr. Gluck, who was the family doctor for the Trudeau family, passed away in 2023, but after almost two decades at the Civic, his memory and his impact lives on for countless families.

“He was really proud to be a doctor and really proud to bring babies into this world,” says his wife, Cheryle Hothersall-Gluck. “To hold a newborn in his arms, to deliver life, well, that meant everything to him.”

Dr. Gluck was also instrumental in helping shift societal norms surrounding childbirth, championing the idea that fathers should be encouraged to be in the delivery room. This paved the way for many families to embrace this precious moment together.

Known by so many patients for his kindness and remarkable ability to listen with deep compassion, it’s interesting to note that medicine wasn’t Dr. Gluck’s first choice. He started his professional career as a biochemist with the Department of Agriculture before graduating with a medical degree from the University of Ottawa in 1956. He worked at Mount Sinai Beth Israel in New York City and Jewish General Hospital and St. Mary’s Hospital in Montreal before returning to his hometown of Ottawa and becoming an integral part of the very fabric of the Civic.

As for his relationship with the Trudeaus, Mrs. Hothersall-Gluck says her husband was rather nonchalant about that.  

Cheryle Hothersall-Gluck and Dr. Manuel (Manny) Gluck

“Well, I heard that Margaret really liked him, and Pierre did too,” she recalls, “and so it just came about that he continued to deliver their babies!”

Dr. Gluck died on August 25, 2023, at the age of 95 within the walls of the same hospital where he brought forth so much life.

Categories: Creating Tomorrow, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, TOH Family

Published: December 2024

When Sophie Leblond Robert was rushed to The Ottawa Hospital’s Civic Campus — which houses the Champlain Regional Stroke Network — time was not on her side. Sophie was 35 years old, an interior designer, and married with two children, when she suffered a brain stem stroke. But our team of internationally recognized stroke experts were ready.

The excruciating ordeal began in May 2020, when she felt a pain in her neck. She went to her family doctor first, who prescribed some medication, but it provided little relief. The same result occurred after seeing her chiropractor. Then, she felt an odd sensation in her neck as she turned to check on her kids in the car one day. A week later, as she was gardening in her backyard in mid-June when she turned and felt a tweak in her neck — she knew something was wrong. But Sophie had previously suffered from seizures, so she assumed that’s what was happening.

Upon her arrival at the Civic’s Emergency Department, she was met by the stroke team, who assessed that Sophie had a tear in her vertebral artery, which runs from the back of the neck to another key artery known as the basilar. When a tear like that happens, it can cause clots to form inside the arteries and those clots can dangerously block blood flow to the brain. 

Lifesaving clot “busting”

The situation was urgent and the clots were life-threatening. Sophie was immediately treated with a strong clot busting medicine and prepped for a thrombectomy to have the clots removed from the main artery in the back part of the brain.

As Dr. Daniel Lelli, a neurologist, neuro-ophthalmologist, and a member of the stroke team explains, if that artery is clotted, a patient can’t survive.

“You need the brainstem to be able to breathe and to be alive. So, the team performed a mechanical thrombectomy and removed the clot, but unfortunately, Sophie kept having repeat clotting blocking the blood flow to the brain every time the clot was removed,” explains Dr. Lelli.

The quick-acting stroke team decided to use multiple stents to force the main artery, the basilar artery, and vertebral artery open. Thankfully, that quick intervention reestablished blood flow and saved Sophie’s life.

Locked-in syndrome

Because of the stroke she suffered, Sophie faced a new and frightening challenge — a condition called locked-in syndrome. This can happen when a stroke damages the brain stem, causing complete paralysis while still conscious. 

“The brain stem is a highway of nerves that go from your brain down to your arms and legs, and it also controls many other things, like moving your mouth and eyes, and swallowing,” says Dr. Lelli.

“The only thing I could do was open and close my eyelids. I couldn’t do anything else."

— Sophie Leblond Robert

For Sophie it was a horrifying ordeal. “The only thing I could do was open and close my eyelids. I couldn’t do anything else. I could feel pain, but couldn’t communicate that.”

Sophie was moved to the neurological acute care unit, which is the highest level of care outside the intensive care unit, where she had a tracheostomy — this would help get air to lungs — and a feeding tube.

Doctors didn’t know if she’d survive, and her chances of ever being able to move again were slim.

Sophie was trapped inside her body and her family had no idea if she had any awareness of what was going on around her. That’s when her loved ones started to look for a way to communicate with her.

Sophie’s devoted mom, Suzanne Leblond, recalls very early on she asked her daughter some questions — she asked her daughter to blink twice for “no” and once for “yes.” She asked if her name was Joanne — Sophie blinked twice. Then she asked if her name was Mary. Two more blinks. When she asked if Sophie was her name — one blink.

“So, it was very, very evident that we could communicate with her, but it took a lot out of her, so we just had to take our time in between each question,” says Suzanne.

What is locked-in syndrome?

Locked-in syndrome is a rare neurological disorder in which part of the brainstem is damaged, causing a disconnect between the brain and body. The result is that the person’s cognitive function remains intact, but they have near-complete paralysis. Most people will be able to hear and blink or move their eyes to communicate.

Learn More

Long road to recovery

This was the first chapter in a long and painful road towards recovery, with so many unknowns. But Sophie had an integrated care team and her mom and husband with her around the clock.

It wasn’t until about the four-week mark of Sophie’s hospitalization that the next positive sign happened. One day, she was able to move one finger on her left hand — a small but important step. It also provided a little comic relief. “The first thing I could move was my left middle finger. So, I was known as the F*** you girl for a good two months,” laughs Sophie. 

"We started by showing her and her family ways to start moving the limbs to try to get the brain to relearn."

— Linda Powers

It’s around that time when Linda Powers, a physiotherapist specializing in stroke, first met Sophie. She’s cared for patients at The Ottawa Hospital for 28 years, and most of that time she’s worked on the stroke unit. Linda brought a great deal of experience to this young patient’s rehabilitation.

“Sophie’s left side was stronger from the very beginning. We started by showing her and her family ways to start moving the limbs to try to get the brain to relearn,” says Linda.

Admittedly, this is where a significant amount of trust is built between the patient and the care team. It starts with getting the patient to sit at the edge of the bed and learning to control their sitting balance. “That was one of the first things we did with Sophie, and she needed full support — she couldn’t even hold up her own head.”

Next, it was getting Sophie out of bed. As Linda explains, this is done using a sling like a hammock, that lifts the patient up to a chair. It was another two months before they tried the pivot transfer, where Sophie would put partial weight on a leg to move from one seat to another.

It was a slow process. “But she had all the right things in place, her age, the intervention of the stroke team in those early days, the physio of course, because the more you do in the first six months, the more likely your recovery is going to be,” says Linda. “She also had an incredible family to support her when we weren’t there.”

A full team approach to recovery

After six weeks in hospital, Sophie was still having a hard time controlling her eyes because of the stroke, so Dr. Lelli was brought on to Sophie’s case because of his specialty as a neuro-ophthalmologist.

“When she tried to look somewhere, Sophie couldn’t control the movement. Her eyes would overshoot and undershoot where she wanted them to go, and then she would get dizzy. She had a lot of trouble focusing as well. This was all because of the different muscles and the control mechanisms affected by the stroke,” explains Dr. Lelli.

"I said if I'm doing this, I'm doing this to the fullest. I'm going wear those high heels shoes again. I'm going to drive again. I’ve got this. I'm doing this."

— Sophie Leblond Robert

He worked with the occupational therapists and physiotherapists to ensure Sophie had exercises to try and get control of her eye movement again. A shining example of the full team required to come together to aid in the recovery of a patient after suffering from a severe stroke.

Sophie’s sheer determination was a great factor in this long road to recovery. While initially she worried about being a burden to her family, she wanted her life back — every aspect of it, even though the early odds were against her. “I said if I’m doing this, I’m doing this to the fullest. I’m going wear those high heels shoes again. I’m going to drive again. I’ve got this. I’m doing this.”

Then, after four-and-a-half months on the neuro unit, facing an uphill battle and a laundry list of complications as a result of the stroke — she fought through it all and was moved to The Ottawa Hospital’s Rehabilitation Centre.

That’s where a whole new team stepped in to provide care, including Andrea Chase, a physiotherapist caring for neurological patients. She’s been a part of our hospital’s team for about 20 years. She explains that normally after suffering a stroke, patients go to the Bruyère Centre, but because of the locked-in syndrome, Sophie required the specialized team at our hospital.

"Feisty and determined"

When Andrea first met Sophie, she recalls that while she had many difficulties, she was feisty and determined. At this point, Sophie had difficulty moving her limbs, controlling her vision — sometimes just even looking in a busy environment was too much. She had a soft, weak voice and it was difficult to talk or cough or even breathe. She also had difficulty swallowing.

“Basically, cognitively she was aware. She was herself, but all the systems we take for granted as healthy people were affected. She had many really complex needs.”

— Andrea Chase

“Basically, cognitively she was aware. She was herself, but all the systems we take for granted as healthy people were affected. She had many really complex needs,” Andrea continues. “But right from the very beginning she was determined. She told me she was going to get better. She talked about her cute little girls, her husband, and her artwork. She’s an artist, and she wanted to get back to it all right away.”

That’s where setting goals becomes a very important part of the care program. A patient is starting from the very beginning in many cases according to Ms. Chase. “We start working on simple things, almost back to child development. We might need multiple staff to work on simple things like sitting up, rolling over in bed. Then we gradually work at adding on more like standing and then walking. When she was able to get a little bit more mobile to stand and take some steps, we did take her to our virtual reality lab.”

Known as the CAREN system — it’s state-of-the-art technology that allows patients to explore and interact with room-sized 3D scenarios. The 180-degree screens work in combination with a moving platform, a remote-controlled treadmill, and surround sound. Patients are in the safety of a harness as they regain skills, strength, and confidence.

An "extra magical" discharge from the hospital

With each day, Sophie defied the odds, getting better and better. Soon, she set out a new goal for herself. “She really wanted to go home for Christmas,” says Andrea. “And we got her home to her kids and family. It was an extra magical discharge date for sure.”

“I just needed to be home. I wanted to make it fun for them that mommy was home.”

— Sophie Leblond Robert

It was magical indeed. Because of the pandemic, Sophie had only seen her two daughters three times in six months. “I just needed to be home. I wanted to make it fun for them that mommy was home.”

It was that sheer determination of a mother wanting to reunite with her children that pushed Sophie. She went from just walking a few steps on the parallel bars when she first arrived at the Rehab Centre to making sure she could climb steps to get home because she lived in a two-story house. She continued to defy the odds. “I’m a stubborn redhead, and I wanted to prove I could do it.”

The milestones along the way have all been significant, including her first words, for the second time in her life. Thanks to the help of her speech therapist, Karen Mallet, learning to talk again was just as special to Sophie’s mom as it was the first time. “I’ll always remember the first time, about three months into her care, she was able to whisper ‘hello’. It was amazing,” says Suzanne.

Speaking led to re-learning French and she’s also back to painting, and getting her driver’s license again — and oh yes, she’s back to wearing high heels.

For Dr. Lelli, to see how far Sophie has come since the summer of 2020, is amazing. He points to the stroke team that is ready to provide the most advanced treatments. “The stroke code mobilized all the resources of the hospital for that patient. It’s a wonderful team to be part of and it’s really a well-oiled machine, because the quicker we get her treated, the more likely it is that we limit the damage, and that we can enable a recovery like this one.”

That exceptional care continues along the way of the patient’s recovery. “I didn’t know if she was going to get out of a bed again — that’s how bad it was,” says Dr. Lelli. “It’s really amazing, and it’s because of all those treatments she got, from the mechanical thrombectomy to the efforts that she’s put in and all the people that have worked around her, like the rehab specialists — and because she just wouldn’t give up.” 

Categories: Rehab

Published: November 2024

The pace at which medical advancements are taking place in the field of immunotherapy is staggering. Immunotherapy harnesses a patient’s own immune system to attack their cancer, and The Ottawa Hospital is at the forefront of research in this area — from the development of new therapies to clinicals trials. In fact, our hospital hosts BioCanRx, a national network for immunotherapy research and has pioneered a number of unique immunotherapies made directly of cells and viruses. These groundbreaking immunotherapies, developed right here, are pushing the boundaries of medicine and transforming patient care.

“The field of oncology is like a hurricane of clinical trials. Every six months now, we are trying to implement practice-changing data or chase promising data.”

— Dr. Michael Ong

Unlike traditional treatments like chemotherapy, immunotherapy can adapt to a patient’s cancer, which can lead to improvements that can last years — even after the patient has stopped treatment.

For Dr. Michael Ong, a medical oncologist and clinical investigator at The Ottawa Hospital, it’s reassuring to see the combination of incredible progress and long-term success for patients during his career. “The field of oncology is like a hurricane of clinical trials. Every six months now, we are trying to implement practice-changing data or chase promising data.”

The survival rates for metastatic melanoma, for example, have gone from only 20% surviving one year to 50% not only surviving 10 years, but also being both cancer-free and treatment-free. This is thanks to immunotherapy.

Immunotherapy shows promise for bladder cancers

Now, experts like Dr. Ong are asking what other cancers can be treated with immunotherapy and how to harness its full potential. “Over the years, we’ve been doing melanoma surgery for those who are high risk, and then treating with immunotherapy after surgery. But it turns out immunotherapy works better before surgery happens, because the immune system can be better trained against the cancer when there’s more cancer present,” explains Dr. Ong.

That means treating with immunotherapy first, and envisioning a future where surgery could one day be unnecessary. This would be a huge improvement for patients’ quality of life.

Recently, the results of a clinical trial led by Dr. Ong at The Ottawa Hospital as part of a multinational effort were presented at a conference in Barcelona, Spain. In this trial, chemotherapy and immunotherapy were prescribed before surgery in patients with bladder cancer. The group that had immunotherapy prior to surgery had a lower rate of cancer recurrence and higher cure rate, and it is now considered standard of care to offer pre-operative immunotherapy.

“It’s so exciting to have recruited patients to this trial and contributed to this global effort that ultimately improved how we treat our patients with bladder cancer,” explains Dr. Ong.

The next generation of trials may look at whether there is a need to remove a patient’s bladder if they are super responders. “Not everyone will get away without surgery, but even if some patients can avoid it, then it’s a huge advancement. We are talking about complete response rates from pre-operative treatment that are now exceeding 50% in bladder cancer,” says Dr. Ong. “So, by the time of surgery, we’re not even seeing any more cancer cells. That begs the question, ‘Do we need to take out the bladder’.”

The fact that each person’s cancer is unique adds to the complexity of the disease and treatment. But the potential impact of immunotherapy is reaching even farther.

What is prostate cancer?

Prostate cancer is a type of cancer that can develop in the prostate — a small, walnut-shaped gland in the male reproductive system that produces seminal fluid.

Learn More

How some prostate cancer patients may benefit

There have previously been significant efforts to evaluate if immunotherapy works in patients with prostate cancer. Multiple phase-three prostate cancer clinical trials have had largely disappointing results. However, within every one of these trials, there were a small proportion of patients who benefitted, and it shows that 3 out of 100 patients can actually benefit significantly from immunotherapy.

It has taken time and more data to understand who these patients were, but it has come down to something called mismatch repair deficiency, which seems to be the most promising way to identify patients that will respond to immunotherapy. “Normally when cancer cells copy their DNA, mistakes (or mismatches) in copying happen. The mismatch repair system will normally catch and fix those errors. But if this repair system is deficient or faulty, these mistakes are tolerated and DNA mutations accumulate rapidly,” says Dr. Ong.

Cancers generally become more aggressive when more mutations accumulate. “It turns out, however, that these ‘ugly’ mutated cancers are actually very sensitive to immunotherapy,” according to Dr. Ong.

That’s incredible news for a small but specific group of patients with prostate cancer, like Larry Trickey.

Stage 4 prostate cancer diagnosis

Larry Trickey, a retired computer specialist, was diagnosed with a highly aggressive prostate cancer in 2022. His scans showed the cancer had spread to the bladder and pelvis. It was the height of the pandemic, adding to the stress, and surgery was not possible. Initially, he began standard hormone treatment, then his oncologist, Dr. Dominick Bossé, suggested he enroll in a study that involved genomic testing of his tumour and access to a new treatment called a PARP inhibitor.

“When Mr. Trickey and his wife walked into my office with determination and hope, they were deeply supportive of one another and committed to finding the best path forward,” explains Dr. Bossé. “As always with research, the addition of a new form of care on top of standard treatment could make it more challenging to tolerate, but may also uncover new ways to treat cancer efficiently. Mr. Trickey was willing to take that risk.”

While initially Larry had benefit from the treatment, the effect was relatively short-lived, with the cancer worsening in 2023. He then received some radiation treatment and in a surprising turn of events, the radiation triggered an abscopal effect — a very rare phenomenon where the immune system kicks in to fight cancer after radiation releases.

“It was a remarkable moment. Mr. Trickey put his trust in me to hold off on further treatments while he benefited from this abscopal effect and until the cancer showed signs of progression, with the hope of enrolling him in an immunotherapy trial as our next option,” says Dr. Bossé.

“The entire team rallied together — the research team, radiology, oncology — to get him promptly into that trial."

— Dr. Dominick Bossé

Clinical trial led by Dr. Ong

Within months, Larry’s condition started to deteriorate and that’s when Dr. Bossé said it was time to see if he could enroll in a clinical trial that Dr. Ong was running. “The entire team rallied together — the research team, radiology, oncology — to get him promptly into that trial. Despite the alarming news of progression, Mr. Trickey agreed to multiple tests for the trial eligibility, which he met just in time, hours only before the trial closed.”

Larry remembers the call vividly. “It was around suppertime when Dr. Bossé called, and he seemed to be very ecstatic about one of the mutations I had,” remembers Larry. “There was a study looking for patients with that mutation. He was so excited when he saw the results and what it could mean for me.”

Hundreds of patients in Canada have been enrolled in this study over the last five years, but Larry was the last one accepted before the trial completed.

“It was kind of like winning the lottery to have that mutation. I was very lucky that it allowed me to get into this more aggressive study. If it was successful, it would really make a huge difference,” says Larry.

And Larry needed a win because by this time he had multiple metastases, including one in his left shoulder that was progressively weakening his arm. His stomach was bloated, and he was in pain because of the size of the tumour on his prostate and the difficulty of having bowel movements.

“Things were getting desperate for me. My son and his wife were expecting their first child around Christmas, and I didn’t know if I would ever get to meet my first grandchild.”

Astonishing results from immunotherapy clinical trial

By mid-February 2024, Larry started on the PC-BETS study, with the Canadian Cancer Trials Group, for which Dr. Ong is a national co-chair. The results were astounding, and his condition improved very quickly after receiving two types of immunotherapies in combination.

"The cancer just melted away."

— Dr. Michael Ong

“The cancer just melted away. His PSA (prostate-specific antigen) in February 2024 before we started the trial was high. By April, his PSA was undetectable, and it’s stayed undetectable. The scans in July 2024 showed only a small residual nodule on the left adrenal gland. All the other sites of cancer have disappeared on his scans, and by the next scan, it’ll hopefully all be gone,” explains Dr. Ong.

To put this in perspective, a few cycles of chemotherapy would have maintained his life, but would not have improved it in the end. This clinical trial truly changed Larry’s life.

"If it wasn't for the trial, for sure, I don't think I'd be here now."

— Larry Trickey

Larry will continue with monthly immunotherapy treatment, but Dr. Ong says for how long is something that is also still being studied. “There’s an open question with immunotherapy right now to understand how long we need to deliver these treatments even when the scans normalize. That doesn’t mean every last cancer cell is gone. There are currently studies trying to address that.”

Today, the 69-year-old is enjoying every moment as a grandfather, and now he’s optimistic he’ll be able to celebrate that special milestone of his grandson’s first birthday. He’s also gaining his strength back, little by little, and he’s got movement back in his left arm. “If it wasn’t for the trial, for sure, I don’t think I’d be here now.”

He and his wife are deeply grateful to the cancer care team who have been with them every step of the way. “The nursing team honestly feels like family, especially Rayelle Richard, she’s really terrific. She gives me my infusions and is my contact to Dr. Bossé and Dr. Ong. It is such a supportive team at the Cancer Centre.”

What’s next in the field of immunotherapy?

For Dr. Ong, the goal is to find the right fit of treatment for each patient — it’s about individual analysis for each prostate cancer patient.

He also points to the importance of having access to things like The Ottawa Hospital’s molecular lab, funded by donors, which allows our scientists to do this kind of specialized testing and to provide much more personalization of care to patients. “We need to be at the forefront and test our patients for those mismatch repair alterations and get them immunotherapy when indicated,” says Dr. Ong. “That will be a significant advancement and will benefit more patients like Larry.”

Admittedly, the field is complex and moving at a rapid pace. Since he entered the medical oncology field 15 years ago, the change has been remarkable.

“I was a little bit concerned at that time that I would only ever be just delivering chemotherapy and never having a big impact. I was clearly wrong. Today, we’re seeing this totally new technology called antibody-drug conjugates that is revolutionizing bladder cancer treatment. They target the cancer specifically and then deliver high potency chemotherapy inside the cancer cells and that’s the huge advance of bladder cancer right now when combined with immunotherapy.”

Next is to bring this success to other patients with different types of cancers. The way to that will be through more cutting-edge research and clinical trials.

The Ottawa Hospital is also leading the way in research to develop and manufacture new cancer immunotherapies. For example, laboratory scientists like Drs. John Bell and Carolina Ilkow are developing biotherapies that use cells, genes and viruses to unleash an immune attack against cancer cells. They worked with clinician scientist Dr. Natasha Kekre and others to develop the first made-in-Canada CAR-T cell therapy. Other clinician researchers, like Dr. Alissa Visram and Dr. Rebecca Auer, are also developing new cancer immunotherapies and working to bring these to patients. This kind of research is fuelled by core facilities and platforms like The Ottawa Hospital’s Biotherapeutics Manufacturing Centre as well as networks like BioCanRx.

Categories: Clinical Trials, Immunotherapy, World-Leading Research

Published: October 2024

Brandon Peacock shares the story of the afternoon of June 29, 2020, when he was shot three times — an innocent victim in a drive-by shooting — and rushed to The Ottawa Hospital Trauma Centre. This is Brandon’s story, told in his own words. 

CONTENT WARNING: This story contains details of serious injuries due to gun violence.

It was late June 2020, and we were in the midst of the pandemic, so I was working my 9 to 5 job from home, like so many others. I was only 23 at the time. The hot summer weather had moved in, and my hair was getting long, so, I decided to drop by my barbershop late one afternoon for a quick cut — I’d be in and out.

Instead, my life changed the moment I approached the shop’s door — I was caught in the crossfire of a drive-by shooting. I was in the wrong place at the wrong time.

As the shots rang out, I used my large frame to shield the woman who was opening the door of the building. I felt three bullets hit me. One went through the bottom left of my shoulder blade — it came out of my collar bone and missed my heart and my lungs. The theory is the bullet ricocheted off one of my rib bones, because most of my ribs were broken on the left side.

The second bullet hit me in the left knee, it was a ricochet bullet that hit the wall first before hitting me. It wasn’t too bad. But it was the third bullet that blew the femoral artery in my right leg. It’s described as “a kill shot” in most cases.

“I was determined to survive.”

The woman who I helped shield grabbed some towels and started compressing my wounds to slow the bleeding as much as she could. I was losing blood quickly from my leg.

I knew it wasn’t good, but despite everything, as I lay there waiting for help, I was confident I was going to make it through — I just need to keep fighting. I never felt scared; I was determined to survive.

During those first minutes while help was on the way, the woman dialed my mom so I could talk to her. I told her what happened, and I said, ‘I love you and don’t worry.’

The first police officer was on scene within four minutes. He got a tourniquet on my leg right away which gave us enough time to make it to the hospital. That officer was instrumental in keeping me alive long enough to reach the Trauma Centre. From what I was told, had he arrived 30 seconds later, my outcome might have been very different. When healthcare professionals say mere seconds matter — they mean it.

“He talked to me the whole time. He spoke to me like I was his son.”

My memory obviously gets a little foggy here, but it was early evening, around 6 p.m., when I arrived at The Ottawa Hospital’s Trauma Centre at the Civic Campus — thankfully it wasn’t too far away from the scene. From that point on, everything happened so fast.

I was suddenly surrounded by incredible surgeons from each division — I now know they’re the trauma team. There were also residents and nurses — really anyone you could possibly think of was ready.

I remember there was a woman who was the trauma lead — I got the sense she had a military background because of the way she took command of the situation. She was exceptional. I later learned her name was Dr. Jacinthe Lampron. She was the perfect blend of keeping me hopeful while also telling me what they were doing.

The whole team was exceptional. I vividly remember another man caring for me who talked to me the whole time. He spoke to me like I was his son.

They did a full assessment, and my leg was a major concern. Next, I had CT scans – everything was happening fast. My parents were told I had a 50/50 chance of survival and there was a good chance I might lose my leg.

As you can imagine, they were distraught, but they remained hopeful that I would beat the odds.

Meet Trauma Medical Director Dr. Jacinthe Lampron

"We turned a life-threatening gunshot wound into a story of survival, thanks to our unwavering commitment to patient care."
— Dr. Jacinthe Lampron

Read our Q&A with Dr. Lampron

“I still had both of my legs, but I wasn’t out of the woods.”

I had what’s known as compartment syndrome, which happens when there’s a painful build-up of pressure around your muscles. Mine was the result of all the blood that had pooled in my right leg. I needed a double fasciotomy — another term I had never heard of before. It is an emergency procedure to relieve the pressure, but we didn’t know if it would save my leg.

This surgery was critical to what my future would look like and took about eight hours. In addition to the double fasciotomy, they also performed a femoral bypass to take the vein out of my left leg to replace the artery in my right leg. The surgery was long, but I made it through to the next day. When I woke up in the ICU the next morning, I still had both of my legs, but I wasn’t out of the woods.

Did you know?

In 2023-24, there were 1,148 trauma patients treated at The Ottawa Hospital

Did you know?

Our Trauma service had a 10% increase in volume in 2023-24 compared to the year before

Did you know?

The leading causes of injuries are falls and motor vehicle collisions, at 43.1% and 34.4% respectively

Did you know?

13% of trauma visits were for a penetrating injury (gunshot, knife, or other penetrating wound)

Did you know?

We had 149 cases of penetrating injuries in 2023-2024

Did you know?

37 of those cases were gunshot wounds

Did you know?

The average length of stay for a trauma admission is just over five days

“The idea of single-patient rooms when the new hospital campus opens will make the world of difference for patients, like me.”

I now had a breathing tube and was hooked up to so many different devices. I had multiple blood transfusions, and my weight was down significantly — I was frail. My leg was a big balloon, my ribs were broken, so all I could do was lie in bed.

Because of the pandemic, I was moved to a room where I had to share space with one and then two other people. I must admit, I didn’t get much sleep at that point. In fact, the idea of single-patient rooms when the new hospital campus opens will make a world of difference for patients like me, and will provide a much better environment for recovery, including sleep.

By day two, I tried to opt out of pain medication. I’d drift off to sleep and I’d dream I was running and playing sports with my friends but then I’d wake up to this reality. So, I got off those meds quickly — it was tough, but that’s when I really started to process everything I’d been through. I wanted to have a clear mind to understand what happened, and then I started to make mental progress quickly.

By day five, I was supposed to have a skin graft because of how big the fasciotomy was on my right leg, but the surgeries kept getting pushed. Then Dr. Linden Head, a plastics specialist, came in and suggested he could stitch up the leg over a three-day period and he did it. Thanks to him, it eliminated the need for a painful skin graft and a process that they originally thought would take two weeks, so I was grateful. He was incredible.

“That’s when a real sense of determination set in for me.”

After that, it was important I didn’t move any more than necessary to ensure the incision healed. That wasn’t too hard because I wasn’t able to anyway. However, by day nine the physiotherapy team got me up and I used a walker. That’s when a real sense of determination set in for me — I wanted to go home, and I was ready to do whatever it took to make that happen.

I remember my physiotherapist told me if I could walk down the hallway, get into the stairwell, and then walk up two steps, I could leave because that’s all it would take me technically to get home. I said, ‘Let’s do it’.  But she said ‘No, no. We need to work up to that.’

Determined to get the green light for my release, I said, ‘I’m going to do it right now’, and I did. I walked down the hall, up those two steps, turned around, walked back. When I got back, I remember drinking three Gatorades. 

That walk was the hardest thing I’ve ever done, and since then I’ve trained for two marathons and now, I’m training for Ironman Canada. But the hardest thing I’ve ever done in my life was that hallway walk.

The next day, I got the green light to go home. Admittedly, I may have coaxed my medical team a little, but incredibly, I left hospital ten days after I was rushed in, clinging to life. I left in a wheelchair and my dad carried me into the house — my body was very weak.

“He worked with me five hours a day, seven days a week in his home gym.”

However, from that day on it was about building up my body strength again and coming to terms with the violent act I innocently found myself in the centre of on that late June afternoon.

Now remember, we were in the middle of the pandemic. My best friend was a physiotherapist, his office was closed, and he worked with me five hours a day, seven days a week in his home gym. Together, we worked hard, and I pushed through with sheer determination for 90 days. We were inseparable.

I returned to the hospital every couple of days, for the first two weeks. Then it became a weekly appointment, and by the end of August they wanted to see me every six months. During my late August visit to the plastics team, they did a small procedure to get the remaining bullet fragment out of my leg.

Today, I still have an annual visit back to the hospital to the vascular team for what’s called ABPI testing to assess the blood flow in my leg and to make sure everything is still working well. It’s thanks to my vascular surgeon Dr. Sudhir Nagpal, and his team who set me up for incredible success.

“I ran my first 5K within 60 days of the shooting.”

My recovery was impressive. I walked into my third or fourth out-patient appointment without crutches, and I ran my first 5K within 60 days of the shooting. Then, the next thing I knew, I was able to get back on skates again. I made a lot of progress quickly and The Ottawa Hospital team was obviously the first step — they gave me the opportunity to keep fighting. 

It was during that time after my release from hospital when I realized this experience changed my life in many ways. I looked at life differently and that’s where my new path in life began — that’s where I came up with a new plan for my life.

The idea of climbing the corporate ladder was now in the review mirror, and I created Hit the Ground Running, a charity that helps trauma survivors reach their new 100%. It all came from that moment where I lay on the ground bleeding out thinking ‘If I don’t make it to tomorrow, am I going to be proud of the legacy that I’ve left behind?’ Perhaps not the typical thoughts of a 23-year-old, but that’s why I’ve changed my life plan and I’m helping others.

And so here I am, four years later, to say thank you. First, I want to thank Ottawa Police Constable Yanick Charron who got to my side quickly and gave me a fighting chance. Next, I want to thank all the talented surgeons and medical professionals at The Ottawa Hospital. I know there’s a very real possibility, with the nature of my injuries, that if we didn’t have a top tier trauma centre and this level of expertise available, I might not have survived — and I certainly may have lost my leg.

That fateful afternoon, I went from lying on the ground, wondering if I was going live, to today, building a great life that I love and helping others around the world who have experienced something very similar to me. And for that, I’m truly grateful and loving my life.

Listen to episode XX and hear Brandon Peacock’s story of survival and his gratitude for those who helped save his life.

Listen Now:

Categories: Trauma

Published: September 2024

As the 100th anniversary of the Civic Campus inches closer — marking a century of care and medical breakthroughs — plans continue for the next 100 years of healthcare in our region. The final designs of the new hospital campus will come together in the next year. During this design phase, patients, leaders and staff at The Ottawa Hospital, Indigenous partners, and members of the community are all helping to refine the details of this new state-of-the-art health and research facility.

And while designs are finalized for the new hospital, construction of the parking garage to support the new campus is well underway.

Building a new hospital is a once-in-a-lifetime opportunity and it’s an opportunity that has business leaders, families, foundations, and many other community members stepping forward to support the $500-million Campaign to Create Tomorrow, which has raised an incredible $336-million to date in the region’s largest fundraising initiative.

Designing state-of-the-art operating rooms

The new campus will increase The Ottawa Hospital’s number of operating rooms (ORs) to help meet projected volume increases for surgeries in the future. These state-of-the-art ORs will be where some of the most life-changing care is delivered. 

“It will enhance the patient experience and work efficiencies."

– Lisa Young

According to Lisa Young, Senior Planning Project Manager at The Ottawa Hospital, the functionality of that space will be key to accommodating not only more procedures, but also new equipment and technology. “It will enhance the patient experience and work efficiencies. We’re also focusing on the function of what the teams providing care do within these spaces, rather than the physical form of the building.”

Optimizing workflow in and around the ORs

Enhancements will include a bay of ‘block rooms’ where pre-surgery preparation can take place outside the main OR itself. These rooms can be used for patients receiving regional anesthesia before entering for surgery, helping reduce potential delays, and making the best use of time in the OR for both patients and care teams.

Dr. Sundaresan, Head of the Department of Surgery, and a clinical thoracic surgeon, explains that location of the ORs is vital for optimizing workflow, especially during critical moments. “The ORs at the new campus will be located next to the interventional radiology suites, which is exciting,” he says.

“When the new campus opens, we’ll have one of the most state-of-the-art surgical facilities in Canada, if not North America.”

– Dr. Sudhir Sundaresan

Interventional radiology is a medical specialty that performs minimally invasive treatments using x-ray imaging to guide small instruments, like catheters, through blood vessels and organs to treat a variety of diseases. “In the event there’s a complication during that procedure, sometimes the patient must go urgently into an OR. Now, the patient won’t have to be moved to another location to access the OR — it will be right there.”

New and emerging technologies will also enhance patient care. “When the new campus opens, we’ll have one of the most state-of-the-art surgical facilities in Canada, if not North America,” says Dr. Sundaresan. “Taking advantage of technology that will help us take surgery to the next level is one of the most exciting areas for development in the future.”

New neurosurgery rooms will come with innovative technology

Teams are also exploring innovative technologies such as an intraoperative MRI machine that captures real-time images of the brain during surgery.

Built on a rail system in the ceiling and considered a gold standard for procedures like brain tumor surgery, this MRI machine would be housed within the operating theatre, but just outside the operating room itself. If a patient needs imaging during a procedure, a door is opened, and the MRI can slide in on rails without having to relocate the patient with minimal disruption.

One of the goals in current design plans is for all ORs to have full audio video (AV) integration to help accommodate minimally invasive surgeries and for teaching purposes.

“Having AV integration in each suite provides more flexibility for patients,” Lisa explains. “We currently have specific rooms at each campus that can accommodate this, but having monitors and the ability to connect cameras in all of the ORs will be a new baseline of care that we could provide at the new campus.”

Digital solutions for a proactive approach to care

There are plenty of opportunities for technology to make a positive impact on patient care and experience.

“We’re striving to build on the digital experiences that people have in other areas of their lives to enhance the healthcare services we provide.”

– Glen Kearns

“We’re striving to build on the digital experiences that people have in other areas of their lives to enhance the healthcare services we provide,” says Glen Kearns, Executive Vice President and Chief Information Officer at The Ottawa Hospital. “Whether it’s inpatient care, preparing a patient before they even visit the hospital or following up with them at home, technology can offer solutions and more seamless care.”

Our hospital is also exploring the possibility of remote or virtual admissions to better support seamless inpatient and at-home care. The goal is to launch at the current campuses in advance, so it’s operationally ready on day one at the new campus.

“We want to leverage technology to reduce in-hospital admissions, wait times, and improve how patients interact with our teams.”

– Mathieu LeBreton

“We want to leverage technology to reduce in-hospital admissions, wait times, and improve how patients interact with our teams,” says Mathieu LeBreton, Senior Project Manager and Digital Experience Lead. “Ideally, we’ll have technology that enables and enhances workflow and reduces workflow burden on staff to improve their day-to-day experience.”

Mathieu adds that technology will be integrated to improve the experience of patients who are admitted. All rooms will be single patient and will have digital access so patients can stay connected with care providers and loved ones and access their health information, appointments, and entertainment. Throughout the new campus, technology can also help patients and visitors navigate the hospital.

The role of AI

In recent years, artificial intelligence (AI) has made great strides in becoming a useful and adaptable tool in the workplace. Our Digital Solutions team is already looking at innovative ways to harness the power of AI.

The Ottawa Hospital recently announced a trial of Dragon Ambient eXperience (DAX) Copilot which uses ambient, conversational, and generative AI to create draft clinical notes during patient appointments. With patient consent, it securely records and creates medical notes for the physician to review and approve. The Ottawa Hospital is the first in Canada to trial this innovative solution aimed at reducing physician burnout and time spent on administrative tasks and allowing physicians to spend more time interacting with patients providing care.

A hub for biotherapeutics research

The Ottawa Hospital is already a global research powerhouse, and the new campus will help take our research to unprecedented heights.

The expansion of the Biotherapeutics Manufacturing Centre (BMC) at the new campus will boost our capacity to develop and manufacture lifesaving biotherapeutics, including vaccines, gene therapies, and cell therapies right here in Ottawa.

Over the last 15 years, researchers at our hospital have led more than 20 world-first clinical trials using biotherapeutics such as stem cells, cancer-fighting viruses, and cellular immunotherapy. These trials are possible because the BMC is a specialized clean-room facility that develops and manufactures novel therapeutic products incorporating cells, genes, viruses, and other biological materials.

The BMC is the most experienced and successful facility of its kind in Canada, with more than 40 full-time staff currently based at the General Campus. It consistently operates at full capacity and is booked far in advance with both academic and industry clients — making this expansion vitally needed to further push the boundaries of research and bring more treatment options to patients.

Looking ahead to the next century of healthcare in Ottawa

When the Civic Campus first opened 100 years ago, the world had just emerged from a pandemic and the new hospital was considered the most modern in North America. Now, we find history repeating itself. We are witnessing the community rally together behind a historic campaign that will take research to the next level and help support the most modern and cutting-edge hospital campus in the country. This will transform the patient experience for generations to come, and we invite you to join us.

Together, we are creating tomorrow for generations to come.

Categories: Biotherapeutics, Creating Tomorrow, Innovation and Technology, Neuro, New Campus Development, Strengthening Critical Services, Technology, Trauma, World-Leading Research, World-Leading Research

Published: August 2024

Like many university students, Erin Brown, a kinesiology undergrad at uOttawa, was burning the candle at both ends. When she started to complain about headaches, nausea, and seeing stars, those close to her believed she was pushing herself too hard. Even her doctor initially said, ‘You need to take a break’. But as symptoms worsened, Erin soon learned it wasn’t stress or exhaustion; she had a brain tumour — and it was a type the world hadn’t seen before.

The 21-year-old was in her fifth year of her undergrad in human kinetics studies in 2018 when the symptoms started. When they worsened, she paid another visit to her family doctor who did some neurological tests, but couldn’t pinpoint the cause. “He said if the symptoms continued, I should go to the nearest emergency room and get some imaging done,” explains Erin.

It wasn’t long before her dad took her to an area hospital, and after initial tests, Erin was sent to the Civic Campus of The Ottawa Hospital. Dr. Safraz Mohammed, a neurosurgeon specializing in brain and spine, was on call when Erin arrived at the Emergency Department.

“After reviewing her CT scan, we immediately ordered an MRI scan, and that unfortunately revealed a brain tumour in her right frontal lobe,” says Dr. Mohammed.

He remembers those early interactions with Erin quite well. “She had such an uplifting spirit, even at the time of diagnosis. I could see that she was an amazing person and she was going to be a great patient.”

For Erin, the feeling is quite mutual. This young doctor, just two years into his career, brought her much ease. She was admitted to F7 (the neurosciences inpatient floor) and had another MRI the next morning. When Dr. Mohammed came to meet with Erin and her family — he sat down.

“When I meet patients, I sit down at the eye level. I sit on the bed sometimes or sit on a chair close to them, because I think it’s important to be at eye level to have good patient interaction rather than having a height difference.”

He also jokes that it’s a good opportunity to sit down after operating all day or being on rounds.

A type of tumour never seen before

Erin’s tumour was quite large — the size of a small apple — and all signs indicated it was a meningioma, which is a type of tumour that develops from the membrane that covers the brain and spinal cord. In Erin’s case, it was invading the middle vein in the brain known as the superior sagittal sinus, which is a major vein and damage to it can result in devastating consequences, according to Dr. Mohammed.

“Those devastating consequences include a massive stroke, massive bleed into the brain, and unfortunately, even death. It’s a big vessel, but it has a thin wall. It would take a lot of planning for the surgery.”

After careful planning, Erin was prepped for surgery with Dr. Mohammed and his team. A continuous trans-esophageal echocardiogram was used to ensure that no air was sucked in through the main vein, as this could result in death. Dr Mohammed wanted to remove the entire tumour, given that Erin was so young. During the six-hour procedure, the tumour was completely extracted and sent for analysis.

"That’s when we discovered this tumour had elements to it that were never seen or discovered before."
— Dr. Safraz Mohammed

Q&A with Dr. Safraz Mohammed

The testing yielded the most unusual results. Dr. Mohammed learned it was a grade 3 tumour, which meant it was cancerous. “It wasn’t benign, as we suspected. It also didn’t follow the criteria for meningioma. As a result, we sent it for further testing in Toronto, and that’s when we discovered this tumour had elements to it that were never seen or discovered before,” explains Dr. Mohammed.

This new type of tumour is called a dural-based spindle cell neoplasm, characterized by a novel MN1-KMT2A fusion gene, based on the type of cells and genetics discovered within it.  This tumor was unlike anything ever seen or described before. With the neuropathologist’s help, the team was able to publish this new tumour in the medical journals.

It was difficult news for Erin to grasp. “I remember becoming so overwhelmed with emotions that I just started crying. This is a lot more serious than I thought, but Dr. Mohammed calmed me down. The nurse in the room, Nancy Mongeon, was so sweet and nice,” explains Erin.

“My parents gathered themselves too, and then we just talked about next steps. I was never scared after that because of all the reassurance I got — I just knew I was in good hands, and I just had to trust my team,” adds Erin.

Ready for treatment

Because the team was working with a new type of tumour, there was no precedent for treatment. But since they knew they were dealing with a grade 3 tumour, they recognized radiation was required.

That’s when Dr. Vimoj Nair, a radiation oncologist who specializes in the treatment of children and young adults, stepped into the picture. He brings a particular skill and knowledge in high-precision radiation therapy, including his work with the CyberKnife — a radiosurgery robot that can destroy inoperable brain tumours, as well tumours in other parts of the body. This important piece of equipment was acquired thanks to donors of The Ottawa Hospital.

“We are proud to have access to cutting-edge technology here at The Ottawa Hospital and of our decades of experience when it comes to radiation treatment.”
— Dr. Vimoj Nair

It was Dr. Nair and his research collaborators who first published the made-in-Ottawa platinum seeds used to improve an already incredibly powerful and precise radiosurgery treatment system for tumours in the liver, pancreas, and kidneys. “We are proud to have access to cutting-edge technology here at The Ottawa Hospital and of our decades of experience when it comes to radiation treatment,” explains Dr. Nair.

As Erin was so young, Dr. Nair wanted to give her the best chance at a full life, without recurrence. “It’s not just giving radiation, but there’s ensuring the patient can have good survivorship and maintain all their capacities. She’s young, and we wanted a plan to spare her memory centre, so she has full use of her brain.”

That meant targeting the tumour, but also covering the area around the tumour to treat any potential microscopic disease that human eyes or scans cannot detect. “It’s like a tree on the lawn. You can cut it down, but you still must go after the roots of the tree,” he explains. “This meant using the linear accelerator machine, which could give a lower dose per day to a wider area and allow normal irradiated brain tissue recover, instead of using the CyberKnife, where an intense radiation treatment is given to only any visible tumour.”

By late 2018, after 30 rounds of radiation, the team was hopeful.

Becoming a part of TOH family

It was during those weeks of radiation treatment that a switch flipped for Erin. It had nothing to do with her health, but rather her career aspirations. Dr. Mohammed remembers when Erin shared this part of her journey. “She talked to me about how she was so much younger than the other patients around her and how much compassion she had for the older people who were also having radiation. She started helping them up, helping them move across the room, and getting paperwork or whatever it was they needed.”

This proved to be a defining experience in her life — a spark in her journey towards healthcare.

Dr. Mohammed could see what an exceptional nurse she would make, and he was there to support her. “I wrote her a reference letter for nursing school and then her training led her to Sunnybrook Hospital in Toronto — that’s where I trained during my residency. When her program was wrapping up, I encouraged her to come to work at the Civic because it’s simply the best place to work.”

In 2021, Erin became a nurse in neurology on F7 — the same floor where she was first admitted to when her care journey began three years earlier. The neurosurgical patient became the neurosurgical nurse.

New lesion appears in a different location

As Erin’s career blossomed, she continued regular MRI scans every six months. Then in May 2022, a tiny dot on the right temporal lobe appeared in a scan.

“I discussed it at the tumour board. This is a group of neurosurgeons, radiation oncologists, and neuropathologists from our hospital who discuss complex cases. I wasn’t ready to put her through another operation just yet, so we watched this new lesion closely,” says Dr. Mohammed.

Then two months later, the lesion grew quite a bit, to the size of a grape. By October 2022, Dr. Mohammed and his team returned to the operating room with Erin to perform a right-sided craniotomy in the temporal region, along the side of her head. “This is a new, small tumour in a different location. The original tumour was gone and all the images that we’ve had so far show that nothing grew back there. So, we removed the lesion and as much dura layer or the covering of the brain as I could.”

The way it was described to Erin is this new lesion was the result of a drop metastasis — where a small cell from the original tumour dropped down the side and developed into a new tumour.

Unfortunately, just over a year later, the lesion was back, and in January 2024, Erin faced a third surgery to fully resect it, followed by more radiation. Consensus from the tumour board was radiation helped long term with the first tumour, so they should proceed with radiation on the second one.

This time, the challenge was to treat the brain in a different location but minimize overlap with the previous radiation plan, ensuring a good balance between tumour control and any short-term and long-term toxicity risks in a young patient.

“At TOH we are proud to have access to cutting-edge technology and an experienced radiation planning and therapy team. We’re able to spare the brain and it shows our expertise in treating younger brains,” explains Dr. Nair.

Focused on a career of caring

Today, Erin continues to be monitored closely and more treatments lie ahead but she also takes what she’s learned as a patient to the bedside when caring for her patients — knowing firsthand what they are going through.

“It’s such a privilege to take care of patients when they’re in their most vulnerable state, knowing the degree of what they’re going through even though each experience is different.”

— Erin Brown

She has a special connection to those younger neuro patients with whom Erin can relate. “I’ve had a couple of younger patients who were in their 30s and 40s. They just look so scared. They’re going home to their family. They have young kids. They don’t know how to navigate it, and I feel for them because I’ve kind of been in their situation. Maybe not 100%, but I know to a degree what they’re going through, so I’m able to give them that support.”

As for the unprecedented tumour that put her in the history books, she jokingly wishes they had called it an “Erinoma”. Regardless of what her future holds, she’s grateful for the highly skilled team who brought not only their expertise, but also a sense of calm during the most challenging time in her life — a team she was proud to be a part of. Today, Erin is working in the ICU at the Cornwall Community Hospital.

Categories: Cancer, Cancer, Cancer

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 and her husband together at their horse ranch

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, Innovation and Technology

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Ready for treatment

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New lesion appears in a different location

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What is pulsatile tinnitus?

Pioneering a new treatment for pulsatile tinnitus

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