Archives des Patient Care | The Ottawa Hospital Foundation

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.

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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, Innovation and Technology, Neuro, New Campus Development, Strengthening Critical Services, Technology, Trauma

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 is proud to now be a part of.

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: Technology, Technology

Published: June 2024

Sean Sisk has photographed some of the biggest musicians in the world. He was doing just that in July 2023 at Bluesfest when he started to feel off. He developed a fever and was unusually tired. Within days, the popular local photographer was taken to hospital, where he remained for 15 weeks after being diagnosed with invasive group A streptococcal (strep A) disease — and it was ravaging his body.

When asked to recall those days, the 49-year-old needs his wife Erin Fraser’s help, because he has no memory of it. Sean worked the first four days of Bluesfest, but by Sunday, he developed a fever and didn’t go to the show. The fever was quite high, off and on. He slept a lot and tried to stay hydrated despite not having much of an appetite. Sean noticed a bit of redness on one leg, but shrugged it off as a sunburn from the festival.

“But three days after his first symptoms, he developed cramping pain in his lower abdomen and, his hip was hurting. Then, his breathing became laboured, and by the middle of the night, he developed cold sweats,” explains Erin.

In the early morning hours of Thursday, they called an ambulance — a decision that ultimately saved Sean’s life. He was taken to the Montfort Hospital, where he stayed for three weeks before being transferred to The Ottawa Hospital’s General Campus.

What is flesh-eating disease?

Necrotizing fasciitis — or flesh-eating disease — is a rare but extremely serious and quickly progressing infection of the tissue around the muscles (the fascia). There are only 90 to 200 cases of flesh-eating disease in Canada each year, and it is fatal in 20–30% of cases.

Flesh-eating disease is most commonly caused by strep A bacteria, although some other bacteria may cause it as well.

Learn More

Strep A rapidly attacking Sean’s body

Blood work revealed Sean had developed a severe invasive group A strep infection (iGAS), and he was in septic shock with multiple system organ failure. This infection caused the development of necrotizing fasciitis — also known as flesh-eating disease, and it was attacking his right leg.

Sean was very sick. He was in the ICU, intubated, and on medications to tackle the infection, but his kidneys had shut down. Things became so critical in those early days in hospital that Sean went into cardiac arrest on four different occasions — three of which were in one massive code lasting between 30 and 60 minutes.

Once he was stable enough, he had surgery on his right leg to remove the necrotizing fasciitis. It’s believed the infection entered through a small scratch he had on his right calf, causing the redness that Sean initially thought was a sunburn. A fist-size piece of his thigh was removed, and luckily, his leg was saved. Sean was placed in a medically induced coma to help fight the disease, and his family was left to wonder if the Sean they knew would ever return to them.

"His organs were shutting down because they were overwhelmed with infection. His life was at risk.”

— Dr. Kwadwo Kyeremanteng

“It was a lot of weeks of not knowing what the fallout of that cardiac arrest would be. And it was waiting to see if he would wake up. And if he woke up, what was he going to be like? What kind of physical capacity was he going to be in at that point because there’s a lot of ramifications for being that sick,” says Erin.

During his time in the ICU, Dr. Kwadwo Kyeremanteng, a critical care and palliative care physician at our hospital, was among those who cared for Sean. “He had multi-organ failure, meaning that his organs were shutting down because they were overwhelmed with infection. His life was at risk.”

As Dr. Kyeremanteng explains, strep A is an extremely serious infection that can lead to death. “It is a rapidly progressive rash that develops, and it evolves into the deep layers of the skin. At times, it could require amputation, but because it’s such an aggressive infection, your body’s response to it can be quite toxic. Your blood pressure drops, your ability to get blood flow to your kidneys — to other vital organs, like your liver or intestines, can be compromised.”

Emerging from six weeks in a coma

Despite everything Sean went through, he finally came out of the coma, but it was a slow and gradual process. His body had been through a traumatic experience. “One of my first memories was when my ICU physiotherapist wanted to get me into a wheelchair. I remember that was the absolute last thing I wanted to do. But she just made it as enjoyable as it possibly could have been. She and the team in the ICU — they were just awesome.”

Dr. Kyeremanteng says Sean showed incredible resilience throughout the whole experience — he had a positive mindset and outlook despite everything he had gone through.

“When I think of how grateful Sean was for the care he was receiving and his positive outlook on life moving forward, that makes you appreciate the work that you do,” says Dr. Kyeremanteng. “Sean’s story is like fuel to keep us going. When you’re burned out and tired, a story like Sean’s elevates you.”

As each day passed, Sean showed signs of improvement and was eventually well enough to leave the ICU. He then spent a week in nephrology to monitor his kidney function and to recover before being medically stable enough for rehab. His next big step in recovery was moving to The Ottawa Hospital’s Rehabilitation Centre.

Meet the A-team of Sean's rehab

When Dr. Guy Trudel, a rehabilitation physician and researcher at our hospital, first met Sean at the end of August, he recalls a man who was scared and uncertain as to what his future looked like. He had spent six weeks in a coma.

“Sean was very anxious trying to come to terms with what was happening to him. He had been through a traumatic ordeal, and he was lost. He was uncertain as to what his future would look like,” explains Dr. Trudel.

“We assess every patient individual goals and plan our intervention as a highly collaborative and interdisciplinary team."

— Dr. Guy Trudel

Lucky for Sean, the Rehab Centre is well equipped with a specialized team to help patients just like him — patients who have multiple health issues, both mental and physical. “We assess every patient individual goals and plan our intervention as a highly collaborative and interdisciplinary team. We set individual rehabilitation programs for the patient according to their deficits and goals, and we review that progress regularly. It’s teamwork,” says Dr. Trudel.

A part of that collaborative team is Frankie Nadeau. She’s an occupational therapist who specializes in complex orthopaedic rehab care. Frankie works with patients who have had lengthy hospital stays and require help with mobility, including daily living activities such as washing and dressing. There is also support with home equipment and set-up for transition back home from hospital — the goal is to gain strength and learn skills to increase independence.

When it came to Sean, the team had to approach things incrementally. He was weak and in pain from the wound on his leg. “He wasn’t mobile when he came to us. He really couldn’t do much on his own as he was so weak,” explains Ms. Nadeau. “Sean was also very afraid to move and required a lot of reassurance. We had to introduce new skills slowly and practice them regularly to build his confidence. Humour worked very well with Sean. That’s probably why he and I connected so well.”

That confidence would come, and as it did, gradually more tasks were added. Sean was involved with group programs as well as physiotherapy. With each new task, he trusted the team more, and his confidence got stronger, as well as his body. “That allowed him to trust our approach with him. He knew we wouldn’t ask him to do something that we didn’t feel that he could do.”

A huge element of that trust also came from Sean’s work with Dr. Bryce Mulligan, a psychologist at the Rehab Centre, who had an important message when the two first met. “No matter what happens, you’re not alone,” shares Dr. Mulligan. “These are people that survive these really unlikely, often horrific things, and no matter how complicated or overwhelming a situation is, you’re never on your own.”

“These are people that survive these really unlikely, often horrific things, and no matter how complicated or overwhelming a situation is, you're never on your own.”

– Dr. Bryce Mulligan

Would he ever regain his past life

There was a time early on when Dr. Mulligan remembers Sean didn’t want to hold his camera because he wasn’t sure he could. Would he ever be able to take pictures again? That was his livelihood. Sean suffered neuropathy (damage to the nerves) in his fingers, and the unknown worried him.

“I saw how he was scared. He was overwhelmed. I think he needed to know that the scary parts were over, but nobody could tell him whether that was the case. It was not clear yet what he would get back.”

One of the things that Sean wanted to get back to as well was cooking — he loves cooking for his family.

“Getting him into the kitchen was important because we could use this activity to work on his standing tolerance and the use his hands. That was incredibly motivating for him.”

— Frankie Nadeau

As time progressed, Sean began to work in the kitchen at the Rehab Centre, and he learned to function in that environment again. His goal was to get back home for family taco night. “Getting him into the kitchen was important because we could use this activity to work on his standing tolerance and the use his hands. That was incredibly motivating for him,” explains Ms. Nadeau.

And so, once Sean was strong enough to perform a car transfer and access his home, he was able to do overnight visits back home with his family. Eventually, after 15 weeks in hospital, on October 26, 2023, Sean was discharged from the Rehab Centre.

A special kind of person to provide care

Today, Sean continues to heal. His kidney function continues to improve, he no longer needs a cane to walk, and he’s back behind the camera part time. He also has a deep gratitude for everyone who helped him along the way. He’s echoed that to each member of his team who will listen, and it’s certainly not lost on them.

“Sean has left a lasting impression on the team who cared for him, as well,” says Dr. Mulligan. “It is a privilege to be involved with somebody like him and watch him get his life back — which I learned was a life that had touched many other lives in the community.”

"It’s easy to fall into a dark spot and be woe is me, but I never wanted to lose, especially because I have three kids. I didn’t want to lose. That was never an option.”

— Sean Sisk

As Sean reflects on the care team that was there for him day in and day out, he says thank you. “They gave me normalcy through conversation, but they also pushed me to find that little extra bit in me to help me succeed. It’s easy to fall into a dark spot and be woe is me, but I never wanted to lose, especially because I have three kids. I didn’t want to lose. That was never an option,” says Sean.

This well-loved photographer also wants the broader community to understand how fortunate our city is to have access to this kind of specialized care — care he’ll always remember and that impacted who he is today. “It was hard to leave the hospital in a sense, because you feel safe. But it’s nice to be back with my kids and living life because, I can tell you, there were a few times, I wasn’t sure I’d get back.”

Download episode 98 of Pulse Podcast to hear Frankie Nadeau talk about her role as an occupational therapist at the Rehabilitation Centre and the connection she had with Sean.

Listen Now:

Categories: Rehab

Published: May 2024

Emmy Cogan was extremely tiny when she arrived in this world, but the impact of her birth was big. Born at 23 weeks gestation, she weighed only 515 grams — that’s just over one pound. Emmy was one of nine babies enrolled in a world-first cell therapy trial to heal the lungs of preemies and was the first in North America to receive the therapy. Now, that promising trial is ready for its next phase.

Her early arrival happened not long after first-time parents Alicia Racine and Mike Cogan returned from a trip to Hawaii. Alicia was back at work as a 911 operator for the Ottawa Police when her water broke.

“My sister works with me, and she brought me to The Ottawa Hospital’s General Campus. I was in a lot of pain, and I wasn’t too sure what was going on. And then we found out that it was contractions, and I started dilating,” explains Alicia.

The baby would hold on for another six days before being born on February 20, 2023. Those few extra days in the womb were critical to give Emmy a chance at life. “It changed the game entirely for us and her. She was able to be intubated, and she just started fighting from that moment on,” explains Mike.

Health challenges lie ahead

Initially, Emmy was cared for in The Ottawa Hospital’s Neonatal Intensive Care Unit (NICU), followed by 10 days at CHEO before returning to our hospital.

Emmy’s first month of life faced many challenges, including a duct between her heart and lungs that wouldn’t close, gastro-intestinal issues causing her to become septic, and concerns of a blood infection. Once Emmy got through those life-threatening issues, she was extubated and put on a high-flow oxygen. “We got to hold her for the first time at that point and my parents were able to be there for that, which was really nice,” says Mike.

Emmy also developed bronchopulmonary dysplasia (BPD). This is a condition known to affect many preemies. Because these infants are born so prematurely, their tiny lungs are underdeveloped and require extra oxygen to help them breathe properly. But giving this oxygen — critical for survival — can damage their tiny lungs. It’s like starting life with emphysema.

The devastating impact of BPD

In Canada, 1,000 babies are diagnosed with BPD every year. That number jumps to approximately 150,000 worldwide. Often, babies with BPD develop other chronic lung diseases, such as asthma, and may require prolonged oxygen and ventilation.

Additionally, they have a high rate of hospital readmissions in the first two years of life. Babies with BPD often have problems in other organs as well, such as the brain or eyes. There is currently no cure, but this world-first clinical trial led by Dr. Bernard Thébaud, a senior scientist and neonatologist, hopes to change that.

Two decades ago, Dr. Thébaud’s team discovered that stem cells from the umbilical cord — known as mesenchymal stromal cells (MSCs) — could heal lung injury and prevent BPD in newborn rodents. Since then, the team has worked tirelessly, here at home and collaborating with other scientists around the world, to bring this novel therapy to babies and their families through clinical trials. While other trials have tested MSCs for treatment of BPD in premature babies, no other group has used MSCs taken from the whole umbilical cord and processed them the way that Dr. Thébaud’s team has. 

What is bronchopulmonary dysplasia?

Bronchopulmonary dysplasia — or BPD — is a chronic lung disease that most often occurs in premature or low-weight babies who have received supplemental oxygen or received mechanical ventilation for long periods.

Learn More

“In our rodent research, we’ve used stem cells isolated from the umbilical cords of healthy newborns to prevent lung injury or even to some degree regenerate the damaged lung,” says Dr. Thébaud. “We foresee that these stem cells, given during a certain time during the hospital stay of these babies, could prevent the progression of the disease.”

Shortly after Emmy’s birth, her parents met Chantal Horth, a clinical trial coordinator, and were introduced to Dr. Thébaud. “Chantal came to us and said Emmy qualified for the trial,” remembers Mike. “It sounded like a great opportunity.”

"Being a preemie, she’s going to have some health issues, and anything that could help her, we wanted to give her that extra shot."

— Alicia Racine

Saying ‘yes’ to a world-first clinical trial

The couple met with Dr. Thébaud, and he answered a long list of questions they had about the trial. “He’s a very personable guy, and it was very easy to talk to him. We trusted him. Being a preemie, she’s going to have some health issues, and anything that could help her, we wanted to give her that extra shot,” says Alicia.

To qualify for the trial, the premature babies — born at 23- or 24-weeks’ gestation at The Ottawa Hospital — had to be seven to 21 days old and treated in the NICU. They also had to require 35% oxygen. This level of oxygen puts them at 60-70% risk of developing BPD. Sunnybrook Health Sciences Centre recruited one baby, becoming the second site involved.

On March 3, 2023, at 11 days old, Emmy received an IV infusion of umbilical cord tissue grown from the donated cords of healthy newborns. It was a special moment for everyone involved. She was the first baby in North America to receive this kind of therapy.

"This is the first trial of its kind in the world, and what could be more rewarding than helping preemies?"

– Dr. Bernard Thébaud

“Dr. Thébaud administered the stem cells, and everyone clapped,” says Mike. “She will have follow-up appointments at different stages for two years, and then she’s going to be followed up by phone for 10 years.”

For Dr. Thébaud, it was a moment he and his team had dreamed about. “It was an exciting and huge milestone when that day arrived — after 20 years of work we were able to test this therapy for the first time in a patient. This is the first trial of its kind in the world and what could be more rewarding than helping preemies?”

The next step for this stem cell trial

Thanks to those nine tiny patients, including Emmy, recruitment for the Phase 1 trial is now complete. The purpose of this trial is to test the feasibility and safety of the stem cell therapy. The next phase will test safety as well as how effective it is.

"All the stars lined up to have her be a part of that little piece of history — something that could impact babies like her in the future.”

– Alicia Racine

“Now we can determine if this therapy will make a difference in patients,” explains Dr. Thébaud. “There will be two groups in the next phase — one that will receive cells and one that will receive the placebo — it’s a randomized controlled trial. We’ll need 168 patients to determine if these stem cells make a difference.”

While babies for the first phase were recruited from NICUs at The Ottawa Hospital and Sunnybrook Health Sciences Centre, the next phase will be a multi-centre trial across the country. Dr. Thébaud hopes it will begin by the end of 2024 and it will take two years.

“Working with babies is, I think, the most beautiful job on Earth. Because they’re born, and they have all their life and all their potential in front of them. Our task is to give them a great jumpstart,” says Dr. Thébaud.

As for Emmy, she left the hospital five months after she was born, and while Mike and Alicia don’t know if the stem cells impacted her health, Emmy is doing well. “We don’t know what she would be like without it, but she’s awesome right now,” says Mike. “We felt very fortunate to be in the right place at the right time for our little girl.”

It’s something Alicia feels makes Emmy all the more unique. “All the stars lined up to have her be a part of that little piece of history — something that could impact babies like her in the future,” explains Alicia.

That’s certainly what Dr. Thébaud is hoping for. “It would change the way we care for premature babies. It’s my hope that these tiny patients have a chance to thrive, grow up, and have an impact on the world around them.”

Emmy doesn’t know she’s made history, but that’s ok. For now, she’s keeping her parents busy. She’s pulling herself up and will be walking in no time. She’s also been off oxygen since November 2023, giving her even more mobility. “It was really fun to have her free. We had a cordless baby for the first time! That was a big step when she didn’t need to rely on the oxygen anymore,” smiles Mike.

This Phase 1 trial is funded by the Stem Cell Network with in-kind matching funds from MDTB Cells GmbH. Dr. Thébaud’s research is also possible because of funding from the Ontario Institute for Regenerative Medicine, the Canadian Institutes of Health Research, The Ottawa Hospital Foundation, and the CHEO Foundation. 

Categories: Clinical Trials, NICU, Stem Cell, World-Leading Research, World-Leading Research

Published: April 2024

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

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

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

Grasping the complexity of a Ewing sarcoma tumour

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

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

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

A collaborative team effort

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

— Dr. Joel Werier

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

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

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

Stepping inside the patient through VR

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

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

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

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

Q&A with Dr. Rawan Rakhra

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

VR at The Ottawa Hospital

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

VR in action

3D VR is used to increase the accuracy of deep brain stimulation surgery for patients with Parkinson’s

The Rehabilitation Centre’s virtual reality system helps patients in rehab recover skills like balancing and walking

Patients undergoing cancer treatment can get coaching or take a virtual getaway to the mountains or the beach

A whole new perspective for the surgical team

For Dr. Werier, it gives a whole new perspective for him and his surgical team. “It allows me to see things the way they’re meant to be seen — in three dimensions, the way our eyes would see them,” explains Dr. Werier. “It allows us to better understand the intricate anatomy and manipulate the images — for example, move nerves out of the way. We can share this with other members of the team and with the patient.”
And there lies another key benefit to this technology — the patient gets a much better understanding of their diagnosis and care plan. “When you show a tumour on an MRI scan, it’s not quite as appreciated as it is in a VR system,” adds Dr. Werier.
As for Emeric, he experienced VR by playing video games in the past, but this took him inside his own body to view what his surgical team had to do and to better understand the process.

Emeric in hospital after surgery.

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

— Emeric Leblanc

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

Emeric camping.

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

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

As a parent, it was a stressful time, but Hélène says seeing the tumour through the VR provided reassurance. “It was such a big surgery but seeing all this and the expertise of the team, I knew they were going to take care of my son. Dr. Werier was awesome. I mean, he saved my son’s life. We’ll always be grateful to him.”
After Emeric recovered from the 14-hour surgery, he required more chemotherapy, but today he’s doing well. Dr. Werier explains the goal was curative, and they will monitor Emeric closely in the coming years.
“It’s a complex operation — he’s a remarkable young man, and he did great. The VR helped us a lot. It’s much more intuitive, it gets people on the same page, and it’s much more efficient. It builds confidence in the surgical team.”

The teen, who is now 16, is back at school, back with his friends, and getting stronger every day. The only difference now is he wears a shoe with a thicker sole on his left foot because his leg is slightly shorter. He also plays video games with a whole new appreciation for VR gaming.
It’s this technology that is setting the stage for the next generation of surgeons and will give healthcare teams the most effective opportunities to provide the best care options to patients.
“This is the next evolution in how we look at things — a lot of this technology is homegrown in Ottawa, and I think it’s going to lead the virtual technology medical imaging industry. We’re excited about it,” says Dr. Werier.

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

Listen Now:

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

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

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

Categories: Cancer, Innovation and Technology, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care

Shelley with her mother, Marcella.

The mother-daughter bond is special. For some, it’s a connection that can rival any close relationship — an unconditional love. That’s certainly the case for Shelley and her mother, Marcella. That relationship was so special that Shelley decided to leave a gift in her will to The Ottawa Hospital — a gift that will ensure the love she has for her mother will live on through future generations of healthcare.
Both women have experienced care at our hospital for decades, and this gift seemed like a natural way for Shelley to say thank you and help others in the future. “My mom is my inspiration,” she says.
When Shelley was young, the family was living in Southern Ontario and she was diagnosed with scoliosis — a sideways curve of the spine that is most often diagnosed in adolescents. “I initially was cared for by SickKids in Toronto. I was involved in an experimental treatment, and over time it didn’t work and the condition progressed,” explains Shelley.
The family moved to Renfrew and as her condition worsened, Shelley was referred to the Civic Hospital in 1983 — she was just 13 years old.
She needed spinal corrective surgery and a spinal fusion. “I wasn’t in pain, but because the spine was curving, it pressed on my lungs so I would lose my breath easily. It also caused a visible deformity in my back that could lead to chronic pain in the future, so I didn’t want to go through that,” explains Shelley.

Early introduction to healthcare

With her parents by her side, she was introduced to Dr. Gordon Armstrong, a renowned orthopaedic surgeon who was well known for his work and innovations in scoliosis treatment, including for children with scoliosis like Shelley. “I remember the surgery so well. He had white, white hair and I remember thinking he was old, but he was probably 50,” she laughs.

“He had such an amazing sense of humour and he put me at ease. I remember how kind and how reassuring he was because it was a risky surgery.”

— Shelley

The details of the hospital stay are still vivid for her, despite the fact it was 40 years ago. “I can see the room I was in, along with the nurses and the orderlies. There was one orderly I had a crush on, and I’d ring the bell sometimes, so he’d come back in,” laughs Shelley.
Once the surgery was complete, this young teen now had rods in her back along with hardware — and she dubbed herself a bionic woman. The surgical technique was new at the time. It was called the Luque Rod method, where specialized wires attach each vertebra around the rods — an extraordinarily delicate procedure, recalls Shelley.
The success of this surgery allowed her to grow up and have what she describes as a great life thanks to the care she received.
In her twenties, she travelled through Europe exploring Britain, Scotland, and Wales. But she never forgot the impact Dr. Armstrong had on her life. “I was doing some research recently and I came upon an article about him. I learned he had been awarded the Order of Canada in 2001. It came full circle for me and the impact he had on orthopaedic surgery in Ottawa and patients with spinal issues, like me.”

A lifetime of care at The Ottawa Hospital

While she did enjoy travelling, she was always drawn back to Ottawa, where she eventually moved — drawn back home to her family and her mom. “I wanted to go into natural medicine, but I developed chronic fatigue syndrome and fibromyalgia so I couldn’t continue my career,” says Shelley. “I would, however, need the services of The Ottawa Hospital throughout my life, and my mom did too.”
Shelley was diagnosed with fibromyalgia in 2004, and then in 2009, she was admitted to the Civic Campus with sepsis. “I had the most amazing care. It was a type of situation where I could have passed away, but the staff were angels watching over me.”
And when it came to people watching over her, of course, Marcella was always there for her daughter — lending support through these difficult times. The two women faced health challenges over the years, in fact, they were both diagnosed with celiac disease. However, it was just another way to bond as they would often seek out new gluten-free recipes to make together — they especially liked finding new desserts.
Then in 2020, the family received devastating news — Marcella had cancer. She was diagnosed with stage 4 neuroendocrine cancer. Then, not long afterward, she learned she had esophageal cancer.
“This was all during the pandemic, but the team was ready, and my mom got the care that she needed. They were always there for her,” says Shelley.
Marcella’s care included chemotherapy and radiation — she pushed through the treatments, but sadly passed away in February 2022 at the age of 77. “She was my best friend. She fought hard — she lived one year and seven months, which was good considering how advanced the cancer was when it was discovered.”

Marcella all bundled up for a walk the first winter she was on chemo.

A legacy gift in memory of a devoted mother

Living a modest life, Shelley reached out to our Foundation team to ask how best she could create a legacy. She wanted to do something to recognize her mother’s life, her mother’s interests, as well as their special bond. “We talked all the time; it was probably me talking the most — we shared everything. She was my confidante,” says Shelley with a smile.
After she lost her mother, Shelley started thinking about her own mortality — which was not something she’d done in her 30s and 40s — and what would happen when she was gone. With her lifelong interest in medicine, and considering the years of care our hospital provided not only her mother but also herself, Shelley decided to leave a gift in her will — a gift to honour her mom.
“My mom is the reason why I want to give to the hospital, because she was always a passionate advocate for patient care and healthcare, even when she was sick,” she says.

“This gift will honour my mom, her life, and her spirit. I always think about my mom when it comes to this gift.”

— Shelley

The future of medicine also inspired Shelley. She reads the regular updates from the hospital and our Foundation about the future of healthcare, and she wants to be a part of that — supporting the next generation of care.
“The new hospital campus being built is going to be amazing, beautiful, and state-of-the-art. I have a lot of family that live in the surrounding areas of Ottawa, and they come to the hospital for care — some are three hours away,” explains Shelley. “This hospital is serving so many people in such a wide area. I have cousins and second cousins who are having children now, so it’s like I’m helping my family in the future by leaving this gift.”

Inspired by plans for the new hospital campus and research

Marcella at the General Campus receiving emergency radiation for a tumor on her cervical spine.

When she thinks of the new campus, it also makes her reflect on her stays at the Civic and how different it will be for patients in the future. “The single rooms and places where family can stay overnight, it’s just incredible. I don’t want to be in the hospital in the future, but if I must be, that sounds like the best care and space.”

The advances in medicine and research happening in her hometown are not lost on Shelley. As someone who’s always had an interest in this field, she keeps up with the latest developments from our hospital, and the impact of the work never ceases to amaze her.

“Ottawa is a relatively small metropolitan area, but we’ve got this huge hospital and all these world-renowned surgeons, doctors, and researchers right here. So, for me, I think that’s amazing.”

“The Ottawa Hospital is a teaching and research hospital, and that inspires me to give because of the many innovations — so much is on the cusp of discovery and it’s exciting.”

— Shelley

And by leaving this gift, she’s ready to help be a part of the future of healthcare. A decision that is dedicated to her mother — a woman who left a loving imprint on her that will never fade. “Mighty Mouse was my nickname for her — she was tiny, but she was the strongest person I’ve ever known.”

Categories: Gift In Will, Mental Health, New Campus Development, Strengthening Critical Services

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What is flesh-eating disease?

Strep A rapidly attacking Sean’s body

Emerging from six weeks in a coma

Meet the A-team of Sean's rehab

Would he ever regain his past life

A special kind of person to provide care

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Health challenges lie ahead

The devastating impact of BPD

What is bronchopulmonary dysplasia?

Saying ‘yes’ to a world-first clinical trial

The next step for this stem cell trial

Grasping the complexity of a Ewing sarcoma tumour

A collaborative team effort

Stepping inside the patient through VR

VR at The Ottawa Hospital

VR in action

A whole new perspective for the surgical team

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

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Early introduction to healthcare

A lifetime of care at The Ottawa Hospital

A legacy gift in memory of a devoted mother

Inspired by plans for the new hospital campus and research

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