Published: August 2023

For almost a year, the last thing Aida Attar remembered about a trip to her friend’s cottage on August 27, 2022, was they had stopped for snacks in Smith Falls. The next thing she recalled was waking up in the ICU of the Civic Campus of The Ottawa Hospital — two months later. She had been airlifted to our hospital’s Trauma Centre after suffering a seizure while swimming and then drowning as a result. While she had been resuscitated, this young woman was clinging to life and multiple specialty teams came together to help save her.

It was that late summer day in August when the 18-year-old university student was swimming in a lake with her friend, Taylor. Taylor has since explained to Aida that while they were together in the water, Aida started staring off. “I just suddenly looked off in the distance. I let go of the floating dock and I went under,” explains Aida. “My friend thought maybe I just dunked my head in the water to cool off, but then she grabbed me by the hair and pulled me up to the surface.” 

What no one realized at the time was she’d had a seizure, which incapacitated her and caused her to go under.

From that moment, there was a flurry of activity to help revive the young woman. As Aida’s friend worked to keep her head above the surface, Taylor’s mom hurried into the water to help bring Aida to shore as she remained unresponsive. Meanwhile, Aida’s grandfather rushed away on an ATV to meet the paramedics, who had been called and were trying to reach the remote area as quickly as possible.  

With help on the way, intense efforts continued to try to revive Aida, including CPR. But by this time, she started vomiting and her jaw was locked – so she was aspirating her vomit. It was a terrifying situation for everyone involved who were all desperately trying to help Aida. 

The race to get lifesaving care

Paramedics rushed the young woman to the Perth and Smiths Falls District Hospital – still unresponsive. Aida’s family, many of whom have cottages in the area, quickly assembled to be by her side, including her aunt, Dr. Catherine Mann.

Thankfully, Aida was resuscitated and stabilized thanks to a team there led by Dr. Annelise Miller, but it was determined she needed specialized care, so the decision was made to airlift her to The Ottawa Hospital’s Civic Campus, home of the region’s only trauma centre for adults.

Her care in Smiths Falls was crucial to what would follow, according to Dr. Erin Rosenberg, an ICU physician at The Ottawa Hospital. “The Smiths Falls team did an absolutely incredible job of resuscitating her and getting her back. When she was transferred to us, her ARDS, or acute respiratory distress syndrome, was so bad that we couldn’t provide her with enough oxygen, even with the ventilator,” she recalls. “That’s why she needed to go to the University of Ottawa Heart Institute to be put on the ECMO.”

The team at Civic Campus, led by Dr. Akshai Iyengar, stabilized Aida and then she was transferred to the Heart Institute through the tunnels of the hospital. She was placed on the ECMO machine, and the wait began.

An ECMO (extra corporeal membrane oxygenation) is used to pump blood outside the body to a heart-lung machine that removes carbon dioxide and sends rewarmed, oxygen-filled blood back to tissues in the body. This machine allows the blood to bypass the heart and lungs, giving them time to rest and heal.

Aida Attar at the Civic Campus of The Ottawa Hospital.
Aida Attar at the Civic Campus of The Ottawa Hospital.

Aida remained on the machine, in a medically induced coma, for 35 days while her family endured an excruciating wait. “I’m grateful for all the work the Heart Institute did to get me on the ECMO and for not giving up on me over that time,” says Aida. 

Dr. Erin Rosenberg
Dr. Erin Rosenberg works in the ICU at The Ottawa Hospital.

Youth was on her side

The first glimmer of hope was weeks later, in early October, when Aida was removed from the ECMO machine and returned to the ICU at the Civic Campus – she was still in critical condition. That’s when Dr. Rosenberg first met Aida.

“We see a lot of really sick people in the ICU, but what we don't often see is people who are as young as her. When we do, it can feel like the stakes are higher — there's an entire life ahead of her.”

– Dr. Erin Rosenberg

“We see a lot of really sick people in the ICU, but what we don’t often see is people who are as young as her. When we do, it can feel like the stakes are higher — there’s an entire life ahead of her.”

Aida’s age was also on her side. “I told her parents at the time, if she was 40 or 60, we would be having a very different conversation. I don’t think she would be here,” recalls Dr. Rosenberg. “What was on her side was the fact that she was 19 years old. Her brain and her body will be a lot more able to get through this compared to someone older than her.”

Aida’s family continued to be by her side – watching and waiting. “She had turned 19 during that time, and her body has been through so much,” recalls her aunt, Dr. Mann. “She’d been under anesthesia for five weeks. She was slowly weaned from that, and then her lungs had to get used to not being ventilated. So the care team took gradual steps to remove her from the ventilator. First, it was 30 minutes, then a couple of hours, and they continued that process.”

A weakened state and confusion

When Aida finally regained consciousness, she was weak after being in a critical state for two months. “I had no muscle tone. I couldn’t sit up on my own. I couldn’t walk. I don’t even remember being able to move my arms to scratch myself because I was so weak.” 

“I couldn’t retain information. It was hard, but the team helped get me through those moments including one physiotherapist in particular, Michelle Cummings. She had a huge impact on my recovery.”

– Aida Attar

Aida’s immune system was also weak, and she was at risk of infections. Often, she would open her eyes and get very confused. “Any time she would sort of come to, or even if she didn’t have her eyes open, we would provide her some comfort as to what happened and where she was — even if we had to do that repeatedly,” says Dr. Rosenberg. “It was just like the first time she was hearing it again.” 

Finally, Aida was able to move out of ICU and into what’s called AMA (Acute Monitoring Area) for about a week. There she had the tracheotomy tube, catheter, and feeding tube removed – she was able to start eating on her own again. 

Although there were some signs of improvement and Aida was surrounded by an exceptional care team, she remembers going through many emotions. “I felt very alone. Even if my family had been there 23 hours and 59 minutes of the day, that one minute alone felt like a year. I was shy, and I didn’t understand what was going on. I couldn’t retain information,” explains Aida. “It was hard, but the team helped get me through those moments including one physiotherapist in particular, Michelle Cummings. She had a huge impact on my recovery.”  

Aida Attar and Michelle Cummings.

How our Rehabilitation Centre helps Aida’s recovery

The CAREN system

CAREN stands for Computer-Assisted Rehabilitation Environment system. The 180-degree screens work in combination with a moving platform, a remote-controlled treadmill, and surround sound.

As Aida’s recovery continued, she started to understand the complexity of what her body had been through because of this traumatic experience. By mid-November, she moved to our Rehabilitation Centre at the General Campus – this would be another big step in Aida’s recovery.  

The care in rehab was two-fold — to help both her body and her brain recover. Part of learning to walk independently again involved using the CAREN system, a unique 3D virtual reality system funded through community support in partnership with the Canadian Armed Forces. But because she had an anoxic brain injury, caused by a complete lack of oxygen to the brain while she was underwater, a big part of rehab was focused on treating her brain injury. “My memory was just shot — I couldn’t remember anything short-term,” says Aida. “My speech was mixed up. My brain was not braining, and it needed some help.”

Incredibly, after everything Aida went through, on December 8, 2022, she was able to go home. She walked out of the Rehab Centre on her own, and her memory continued to improve. It was a recovery beyond what Dr. Rosenberg expected. 

“She actually exceeded our expectations in terms of how fast she would get better.”

– Dr. Erin Rosenberg

“I remember initially preparing her family to anticipate her being in the ICU until December and probably in the hospital longer than that. So, she actually exceeded our expectations in terms of how fast she would get better.”

Today, Aida is getting her life back on track — she’s stronger each day. She’s driving again, working in retail, and plans to return to Carleton University in the fall to continue her studies in neuroscience. “I had finished my first year of university before the accident. I worked as a research assistant in a neuroscience lab at Carleton in the summer of 2022. In fact, I was working on a traumatic brain injury project at the time.”

Deep gratitude for those who saved her life

While she doesn’t remember many details from the first half of her hospital stay, Aida is grateful for the team that gave her a fighting chance. “I would be dead if they hadn’t done all that they did. The doctors just worked so hard. I mean so many things went wrong. I had blood infections and allergic reactions — I was just a hot mess. They kept going — they didn’t lose hope or give up on me. It was the next level of care, and I don’t think I would have got through it without that.”

Aida Attar at home with her family.
Aida Attar at home with her family.

“The healthcare team works hard, and these people worked hard. We’re deeply grateful to everyone, in particular Drs. Iyengar and Rosenberg. It was traumatizing for our whole family and that team never gave up on Aida.”

– Dr. Catherine Mann

Every step of the way, there was exceptional care — something that’s not lost on Dr. Mann. “There were a whole bunch of incredible people and a couple that stand out. When Aida arrived at the Civic Campus, Dr. Iyengar was there, and he was devoted. Then Dr. Rosenberg was there for each day when Aida returned to the Civic’s ICU in October and so many others.”

That’s what inspired Dr. Mann, who was a physician at The Ottawa Hospital for 22 years, to make a gift to The Ottawa Hospital — a thank you to the team that saved her niece’s life. “The healthcare team works hard, and these people worked hard. We’re deeply grateful to everyone, in particular Drs. Iyengar and Rosenberg. It was traumatizing for our whole family and that team never gave up on Aida.”

For Dr. Rosenberg to see this success story is what she loves about her job. Not every story ends this way but when it does, it’s rewarding for the whole team. “Aida came back to visit in the ICU a couple of weeks ago, just to say hi to everyone. And everyone was so happy to see her — they remember her as a patient, all the nurses. I think seeing those success stories are really, really rewarding for us. And I think it’s why we do what we do.” 

Aida Attar returning to the water for the first time since her seizure.
Aida Attar returning to the water for the first time since her seizure.

Stepping back into the water

In late May of 2023, Aida was visiting her aunt’s cottage and she went back into the water for the first time since the accident. As she felt the cold water on her feet and legs, memories started to flood back to her. “I instantly remembered when I was in the water with Taylor. It took me back to that day, and that was shocking because I didn’t think I would have remembered that.” 

While she’s grateful to have her life back, there is still the unknown of what caused the seizure that day. Tests continue, but for now she takes precautions like wearing a lifejacket when swimming. “That piece is also hard for me. It’s hard to have gone through all that and not have an answer as to why this happened.” 

But what she does know, is she wouldn’t be here if it wasn’t for each person who played a part in her recovery, and for that she’s grateful.  

Published: April 2023

Find out why he credits a “prehab” study for his quick recovery 

In May 2021, Christopher Wanczycki’s oncologist gave him some unexpected bad news — there was a two-inch tumour in his rectum. Five weeks after his January 2022 cancer surgery, the 63-year-old was back on the cross-country ski trails. He credits his quick recovery to participating in a national “prehab” clinical trial led by researchers at The Ottawa Hospital.  

“Without this program, I can’t imagine what my recovery would have been like,” he says. “I would highly recommend it for anyone in my shoes getting ready for surgery and for post-surgery recovery.” 

Christopher underwent aggressive radiation and chemotherapy to shrink the stage 3B tumour in his rectum, and his oncologist recommended surgery to confirm all the cancer was gone. 

“I was kind of beaten up at that point, and my oncologist had mentioned that it would take a couple of months for the effects of the chemotherapy to leave my system,” he remembers. “At a final chemotherapy infusion round, I was advised to bulk up, to just eat whatever I could to gain back the weight before my surgery.” 

Christopher had lost 37 pounds during chemo and had little appetite. In addition, the swelling and numbness in his legs and feet from chemo made walking uncomfortable. 

He took the time between the end of his chemotherapy in October 2021 and before his January 2022 surgery to try to gain some weight back, start some mild exercise, and return to his regular activities. 

Christopher Wanczycki skiing.

That’s when prehab kicked in. At the suggestion of his cancer coach, a person assigned through the hospital to help patients navigate their cancer journey, Christopher agreed to join one of the world’s largest prehab clinical trials in November 2021, led by Dr. Daniel McIsaac and his team. 

What is prehab?

“Prehab is a bit like training for a race, but instead you’re training for surgery,” said Dr. McIsaac, a scientist and anesthesiologist at The Ottawa Hospital, and Chair in Innovative Perioperative Care at the University of Ottawa. “It’s structured, sustained exercise and nutrition over time that makes the muscles, heart, and lungs stronger. A lot of the exercises focus on strengthening the legs and abdominal muscles, which you need to get out of bed after surgery.”

“Prehab is a bit like training for a race, but instead you’re training for surgery.”

– Dr. Daniel McIsaac

Previous studies have shown that young, healthy people who did prehab before surgery recovered faster and had fewer complications.  

“We know that the healthier someone is going into surgery, the sooner they will recover and get back to their daily activities,” said Dr. McIsaac.  

However, most Canadians who need major surgery are 65 or older, and many more are weakened by health challenges. While this population has a lot to gain from prehab, it’s usually harder for them to complete the exercises.     

Dr. McIsaac’s research program aims to make prehab more feasible for older people with health challenges, so they can reap the rewards of a faster recovery. 

What does prehab look like? 

When Christopher joined the prehab study in November 2021, research assistant Keely Barnes showed him exercises and stretches to do at home at least three times a week and gave him written and video instructions to follow. Most of the exercises could be done while sitting in a chair.  

Christopher Wanczycki skiing.

Keely also asked him to walk, bike, or swim for at least 20 minutes, three times a week and gave him a pedometer to track his distance. 

Christopher loved skiing, biking, and other outdoor activities before his cancer diagnosis, so he didn’t mind all the exercise. In fact, he enjoyed the distraction.    

“I discovered as a cancer patient, you need something to focus on daily, just to get your mind off things,” he says. “With this study, I decided to give myself a goal, something to focus on each day, and strive to increase the exercise repetitions each week.”  

Keely called Christopher every week to see how many repetitions and steps he’d done. Not only was this good motivation to do the exercises, but she also checked to see if any of the exercises were causing him trouble. Together, they figured how to adapt them.  

By mid-December 2021, Christopher started cross-country skiing again. All that exercise had also improved his appetite, which helped him gain back the weight he’d lost during chemo.  

Research with patient experience at the core 

“Patients have told us loud and clear that prehab research needs to be a priority,” said Dr. McIsaac. “They are eager to get back to their daily lives after they’ve had surgery, and prehab can help them do that.”  

However, like with any exercise, you need to put in the work to get the benefits. And for older people living with pain and other health issues, putting in that work can be more difficult.  

A pilot prehab study run by Dr. McIsaac’s team found that older patients with health issues who had at least 80% adherence to the prehab program could walk farther and had lower self-reported disability scores after surgery compared to those who did not participate. However, the average adherence was only 60%, not enough to see benefits.  

“For a prehab program to be successful, we need to support and motivate participants and personalize the exercises to their needs.”

– Dr. Daniel McIsaac

Based on these findings, the team added more personalized and tailored programming to their current national prehab trial at 11 sites across Canada. This trial recruits about 10 new patients a week, and so far, overall adherence has been much closer to 80%. The team aims to recruit 750 people by the end of 2023, with results published in the subsequent years. 

“For a prehab program to be successful, we need to support and motivate participants and personalize the exercises to their needs,” said Dr. McIsaac. “Our research assistants call participants week after week, so they get to know them well and can help them through any challenges they’re facing.” 

This year, the team plans to launch a smaller trial in Ontario to test a different way of delivering prehab through virtual group sessions. Unlike the national trial where patients are recruited by their surgical team, patients will be able to refer themselves to the trial.   

“If we want to bring prehab into everyday clinical practice, we need a process that will work in the real world,” says Dr. McIsaac. “We think that virtual group sessions will probably be more feasible for healthcare providers than individual phone calls. But we won’t know if that model works for participants unless we test it.” 

Patient partners share key insights 

One of the team’s secret weapons is having patient partners on their side. Team members like Gurlie Kidd, a retired social worker who had surgery at The Ottawa Hospital in 2017, help make sure the research stays relevant to patients.  

Gurlie’s input has helped the team better understand how and when to ask surgical patients about taking part in studies, to reduce the burden put on patients. She and other patient partners have also helped the team set priorities and adjust the study’s design, including sending regular updates to patients involved. 

“As a member of this research team, I have felt heard,” says Gurlie. “There is a respect for patients and patient input that is kind of amazing. It legitimizes some of the things that we have gone through and acknowledges our expertise.” 

“I can’t imagine what my recovery would have been like without it” 

After two months of prehab, Christopher felt confident and ready when his surgery date arrived in January 2022. The colorectal surgery went well, and his surgeon removed some additional Stage 1 cancer that was growing near the tumour.  

Christopher was amazed by how soon he could leave the hospital after surgery. 

“A cancer diagnosis is never easy. The treatment phases are challenging, and I believe participating in this prehab clinical trial was an important part of my treatment plan.”  

– Christopher Wanczycki

“My surgery was on a Monday. By Wednesday, I could sit in a chair to eat lunch. On Thursday, I had dressed myself, and was up at the nursing station trying to check myself out. By Friday, I was climbing the stairs at home. That would not have been possible without the prehab program.” 

Christopher and his wife at Gros Morne Summit September 2022.

He continued to do prehab exercises for a month after his surgery. A week later — only five weeks after surgery — he was regularly back on his cross-country skis. In April 2022, he was finally declared cancer free.  

In September 2022, Christopher hiked to the top of Gros Morne Mountain in Newfoundland with an ileostomy bag, just eight months after his surgery.  

He’s grateful to be able to be back to all those activities he loves and credits the prehab study for his quick recovery. 

“I’m 100% certain that it does make a difference physically, but also psychologically, to give someone goals, something to work towards. Also, cancer is so hard on your family, on your wife and kids. With this exercise program, my wife could see my progress, and that I was getting better.”  

In December 2022, Christopher underwent a successful ileostomy reversal operation. He has since resumed downhill and cross-country skiing.  

 “A cancer diagnosis is never easy,” he says, “The treatment phases are challenging, and I believe participating in this prehab clinical trial was an important part of my treatment plan.”   

Christopher with his family.
Christopher with his daughter and friend.

All research at The Ottawa Hospital depends on infrastructure and support services funded by generous donors to The Ottawa Hospital Foundation. Dr. McIsaac’s research is also funded by the Canadian Institutes of Health Research, the PSI Foundation, the International Anesthesia Research Society, and the Canadian Frailty Network and enabled by the Ottawa Methods Centre and the Office for Patient Engagement in Research Activities

Originally published: February 2021
Updated: July 2022

When Casey Delaney was struck by an out-of-control personal watercraft two years ago, her life came to a sudden stop. Having sustained a severe traumatic brain injury, doctors weren’t sure if she’d be able to walk, talk or return to her passion for teaching, ever again. But thanks to specialized rehab therapy at The Ottawa Hospital’s Rehabilitation Centre, Casey was given the opportunity to get her life back on course.

The accident that changed everything

On Canada Day in 2018, Casey and her friends were sitting on an inflatable raft near the Gatineau River shoreline when the driver of a nearby personal watercraft lost control, hitting Casey and leaving her immediately unconscious.

Casey in hospital bed at The Ottawa Hospital
Casey in the hospital.

Her boyfriend at the time, Scott, performed CPR until the paramedics arrived and Casey was rushed to a local hospital. However, her injuries were extensive and complex, so she was quickly transferred to our Trauma Centre at the Civic Campus for lifesaving treatment.

To reduce swelling in her brain, doctors carefully removed the left half of Casey’s skull – which was later replaced with titanium mesh – and put her in a medically-induced coma. Casey was diagnosed with a severe traumatic brain injury and her medically induced coma was extended for two weeks. Her doctors weren’t sure if she’d ever be able to walk, use her arms, or remember her loved ones. But when Casey woke up, there was hope.

“I had issues with walking at first, but I was getting up as soon as I could, and that’s pretty lucky,” says Casey, who was just 26 at the time. Lucky as she was, Casey wasn’t left completely unscathed. She had newfound weaknesses on the right side of her body and issues with memory and balance that required special care.

But our experts were ready to help Casey work through these challenges and give her the chance to return to life as she knew it.

A long road ahead

In August 2018, Casey was transferred to our specialized brain injury rehabilitation program, one of only a handful like it in Ontario, that treats patients from all over eastern Ontario and as far as Nunavut. It was there that Casey participated in two months of intensive therapy, followed by what was expected to be years of outpatient rehab.

Those who survive a traumatic brain injury are often faced with life-long side effects – both physical and cognitive, that can prevent them from living independently or participating in social activities, and can cause changes in personality and behaviour. Rehabilitation can help a person regain function in these areas, and our specialists work with patients for the duration of what can be a long road to recovery.

Casey in room at The Ottawa Hospital
Casey recovering in hospital.

“If you break your leg, you might expect recovery to take about three months. Brain injury is probably one to two years of ongoing recovery,” explains Dr. Shawn Marshall, physiatrist and division head of physical medicine and rehabilitation, who worked closely with Casey throughout her care. “Because Casey had a severe traumatic brain injury, her prognosis for return to full-time work was less than 50 percent.”

Casey, a passionate kindergarten teacher, wasn’t going to let this prognosis hold her back from getting back to life, and the classroom, as soon as she could.

“I was like, ‘They’re wrong. I’m going back to teaching in September,’ which to be clear, I was not back in September,” says Casey. But, she was ready to give it her all.

Setting the stage for recovery

For patients like Casey, their care in the Trauma Centre sets the stage for their journey to recovery. Ongoing research happening right here at our hospital can help inform and improve this care.

At the time of her admission, Dr. Shane English, an ICU physician and researcher at The Ottawa Hospital, was recruiting participants for an international research trial that was investigating how to manage low blood levels in patients with a brain injury – and Casey was the perfect candidate.

“This study was brought here to truly provide the best care possible to our patients.”

– Dr. Shane English
Casey at The Ottawa Hospital
Casey with her father during recovery.

Typically, blood transfusions are only given to trauma patients with very low red blood cell levels (anemia). However, those with brain injuries are more susceptible to low hemoglobin levels and researchers were examining whether transfusions should be given more liberally to prevent significant anemia and how this might lead to improved outcomes.

“Our job is to preserve everything we can to give them the best chances of a recovery later,” says Dr. English. “We’ve been really active in brain injury and trauma research and this study was brought here to truly provide the best care possible to our patients.”

Getting back on her feet

Throughout her rehabilitation, Casey was fortunate not only to have access to the latest cutting-edge treatments, but also to be cared for by an extensive and collaborative care team of experts, including nurses, physiotherapists, occupational therapists, psychologists, social workers, speech-language pathologists, and physiatrists.

“The most effective therapies are the ones that are meaningful to you, that engage you, and that are practical to you. Rehabilitation is about getting your life back.”

– Dr. Shawn Marshall

These experts, many of whom are involved in establishing the guidelines and best practices for traumatic brain injury care and management in Ontario, helped Casey through daily, three to five-hour intensive therapy sessions. Because no two brain injuries are alike, Casey’s care team developed a highly customized rehabilitation program that focused on improving areas where her injury caused difficulties so she could regain function and return home.

In some of her therapy sessions, Casey was taken into specialized rooms that mimicked areas of a home, like a bathroom and kitchen, to learn strategies to overcome her injury. Looking back, Casey remembers being surprised by some of the therapy sessions she participated in, which included activities like cooking and woodworking.

“Dr. Marshall was amazing and always had the next step ready to go. That’s what my brain needed.”

– Casey Delaney

“I had fine motor type classes, which seemed silly to me at the time. I teach my kindergarten students fine motor skills, but looking back, that was something I struggled with,” says Casey with a laugh. “I remember being so proud that I was able to bring home a meal I’d cooked and present it to Scott, which I hadn’t done in ages.”

While activities like cooking may seem simple, our experts say they are complex tasks for the brain and played an integral role in Casey’s rehabilitation. “When you do therapy, the most effective therapies are the ones that are meaningful to you, that engage you, and that are practical to you,” explains Dr. Marshall. “Rehabilitation is about getting your life back.”

An exceptional recovery

After only two months of therapy, Casey had made great progress in her rehabilitation and was ready to take the next step – going home. “By September I was out of the hospital and at home. That was huge,” says Casey. There was even more reason to celebrate when Scott, who had been by Casey’s side throughout her recovery, proposed.

Casey continued with daily therapy at our hospital, which became less frequent as she improved. Amazingly, by the following September, Casey was back to work full-time, doing the things she loves and no longer needed therapy.

In addition to support from her family, Casey credits her care team for giving her the tools and care she needed to bounce back, beat her prognosis, and have the opportunity for a healthy future. “Dr. Marshall was amazing and always had the next step ready to go,” says Casey. “That’s what my brain needed.”

For our experts, her recovery was nothing short of exceptional.

Casey Delaney and Scott
Casey and Scott at their summer 2021 wedding.

“The take-home of her case is how you can be drifting on a river and one second later your life is turned over and affected for the rest of your life. Casey’s story is one of someone who’s really worked hard,” says Dr. Marshall. “She progressed to getting back to the things she loves, to her family, and impressively, back to teaching on a full-time basis, which is pretty remarkable.”

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

Originally published: September, 2020
Updated: July, 2022

“Leaner and meaner than ever”

When Fran hit the 18-month mark of his recovery, his care team didn’t want him to get his hopes up. Typically, once patients with Guillain Barré Syndrome (GBS) reach that point, they don’t see much more improvement, but five years later, Fran is still making strides. “I was able to stand up on skates this past winter and started skating for the first time since my diagnosis. Then just a month ago, I regained feeling in my feet. It was a feeling that I haven’t experienced since I got GBS,” explains Fran.

He’s even back to long-distance cycling and is feeling stronger each day. “I’m leaner and meaner than ever,” says Fran with that infectious smile.

Read Fran’s original story below and learn why he’s so grateful for the care he received at The Ottawa Hospital.

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

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

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

What is Guillain Barré Syndrome?

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

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

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

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

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

A more challenging road to recovery

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

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

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

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

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

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

Rehab team ready with state-of-the art technology

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

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

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

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

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

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

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

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

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

Continuing the road to recovery

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

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

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

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

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

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

Giving back as a volunteer

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

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

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

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

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

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

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

Originally published: September, 2021

Dr. Kirsty Boyd was six weeks into her medical career when a patient with catastrophic injuries was rushed to The Ottawa Hospital Trauma Centre. Karen Toop had been hit by a snowplow while crossing the street on her way home from work — half her pelvis was missing when she arrived at our hospital. A multi-disciplinary team that included reconstructive plastic surgery, would not only work to save her life and get her back to her family but would also implement a unique idea to drastically improve her quality of life.

From the moment the accident happened, Karen knew her injuries were devastating. She remembers thinking about her five-year-old son at home as she lay helplessly on the road. “I kept thinking ‘I can’t leave him without a mother’.”

Karen lost consciousness briefly and she remembers waking up in the ambulance and speaking to the paramedic. “I asked him to tell my son I love him because I really did think I was going to die. And then he said to me ‘No, no, you tell him’ and I didn’t say anything back.”

“The injury Karen had was the kind of thing we will see once in our career. It’s not a typical day for us to see that kind of an injury.”

— Dr. Kirsty Boyd

Ready for the most challenging cases

It was January 23, 2012, when Karen was rushed into our Trauma Centre. Dr. Boyd will never forget the day. “The injury Karen had was the kind of thing we will see once in our career. It’s not a typical day for us to see that kind of an injury.”

Karen Toop in hospital bed
Karen Toop was treated for severe injuries at The Ottawa Hospital after being hit by a snowplow.

Her injuries were devastating. She lost one leg, her left pelvis, and several internal organs. It took the vascular, general, and trauma surgical teams to stabilize her. Two days later, the 40-year-old would be wheeled back into the operating room (OR) for plastic surgery for the first time. “I was very much a small part of a big team of people looking after Karen. Dr. Murray Allen, my mentor who’s now retired, was an integral part of the case. I was relatively new on staff when she came in and was originally consulted by the other surgical services for assistance with her wound care because she had a fairly large soft tissue deficit following her injury,” explains Dr. Boyd.

This was the beginning of a long road to recovery, including multiple surgeries over the many months. Karen spent two-and-a-half months in the Intensive Care Unit. While she recalls some scary moments, she also remembers the healthcare team surrounding her and helping her — each hour, each day. “They were phenomenal. I had this one nurse, Lynne, who was such a strong advocate for me — always looking out, making sure I was as comfortable as I could be — she really helped me.”

Thinking outside the box

Karen’s most significant reconstruction surgery didn’t happen until October 18, 2012. It took months of planning by the plastic surgery team and required combining existing reconstructive techniques in a novel way to rebuild Karen’s pelvis and restore her independence.

Losing a portion of her pelvis in the accident meant Karen couldn’t sit up. “I wasn’t able to sit up more than 20 degrees from my bed. I had to eat like that, and drink like that and do everything from that position,” remembers Karen.

Dr. Kirsty Boyd
Dr. Kirsty Boyd

“We explored a lot of options; we reached out to colleagues from all across the country. I mean, this was something that I don’t think had ever been done or described before.”

— Dr. Kirsty Boyd

This is when the surgical team started to think outside the box to find a way to give Karen an improved quality of life, and to get her back home to her husband and son. Drs. Allen and Boyd worked closely with Dr. Nancy Dudek from the Rehabilitation Centre, and Dr. Allan Liew from orthopedic surgery, to think of a way to get Karen a new pelvis — what’s called a neo-pelvis.

“Karen lost one leg and part of her pelvis in the accident. The other leg had all kinds of issues including poor blood flow, a loss of sensation, and significant nerve damage to the extent she couldn’t move that leg. While the leg was still attached it wasn’t functional,” explains Dr. Boyd. She adds they spent quite a bit of time in consultation with Karen and her family before the decision was made to amputate.

For Karen, it meant putting her complete trust in her care team. “The lengths they went to save my life were incredible. They asked for input from experts around the world. Everyone came together.”

Karen Toop with her son, following her accident in 2012
Karen Toop with her son, Ryan, following her accident in 2012.

The role of reconstructive surgery in trauma

The surgery was long and complicated — almost 14 hours. ”We rearranged the bone of her right leg to make a pelvis while keeping the bones attached to their soft tissue. I think origami is a very good description; you’re just rearranging things and moving them into locations close to them,” says Dr. Boyd.

“They were so kind, compassionate, and helpful.”

— Karen Toop

It was a unique approach to a complicated case, but Karen’s team saw it as the best chance to help her in the years ahead. “We explored a lot of options; we reached out to colleagues from all across the country. I mean, this was something that I don’t think had ever been done or described before,” explains Dr. Boyd.

The surgical expertise and collaborative effort was transformational for Karen’s future. “After the surgery, I was able to sit up using a chair. I mean that happened slowly. I got the chance to do a lot of physical rehab and I started on the hand bike and doing exercises, weights, and they got me back to the point where I could sit in the chair,” says Karen.

Outstanding compassionate care

Karen Toop and her son Ryan today
Karen Toop and her son Ryan today.

In addition to her physical rehab, Karen won’t soon forget the compassionate care she received throughout her recovery. “They were so kind, compassionate, and helpful. The nurses would write out the plans the doctors were making so I could visualize it better. One of my trauma members, Dr. Jacinthe Lampron, baked me a birthday cake, which she said was made with love, and nurses made cupcakes for my birthday.”

“Thank you to the doctors and nurses at The Ottawa Hospital who saved my mom’s life.”

— Ryan Toop

Strengthening Karen’s mental health and dealing with the trauma of the accident were also integral parts of her journey “They care for your emotional health through the psychologist, the physiotherapist, the physiotherapist assistants, and my personal support workers — they were all fantastic. It was incredible teamwork and just such giving people.”

Going home to her family

After 11 months in the hospital and nine months at the Rehabilitation Centre, where she learned a whole new way of living, Karen moved into a retirement home until her new, accessible home was ready.

“It was really at the beginning that I knew that I was going to put The Ottawa Hospital in my will, because the hospital gave my son his mother, and that was so powerful.”

— Karen Toop

But the most unforgettable part was being reunited with her family. “It was amazing. I can’t describe how happy we all were, to be together again,” she says.

Even more amazing was for her son, Ryan, to have his mom home. Now 14, he’s grateful to have her by his side. “Thank you to the doctors and nurses at The Ottawa Hospital who saved my mom’s life.”

Leaving a gift in her will

The whole experience left Karen enjoying the small things in life, like hugging her family or going to watch Ryan play soccer — things she will never take for granted. It also left her reflecting on those who saved her life and fought so hard to give her a good quality of life. “My accident happened in a flash. You never know when you’ll need the hospital. I went from being able-bodied to losing both my legs, so you know other things happen that maybe aren’t as drastic, but you still need the hospital.”

It’s the specialized team who were ready for Karen when she faced critical injuries, that made her decide to leave a gift in her will to The Ottawa Hospital. “It was really at the beginning that I knew that I was going to put it in my will, because the hospital gave my son his mother, and that was so powerful.”

Karen Toop and her son Ryan.
Karen and Ryan enjoying time together at their home.

She believes she’s truly fortunate to have had access to the care she received. “I got world-class healthcare, with the new technology — for example, a VAC (Vacuum-Assisted Closure) dressing. If I didn’t have that, I don’t think I would have survived because I would have gotten too many infections. There was also the hyperbaric chamber. I went there when my wounds weren’t healing and then my wounds healed.”

Karen is also thankful for the care her husband, Harvey, received at The Ottawa Hospital when he became ill — care she witnessed from the perspective of a family member this time. Sadly, Harvey passed away in November 2017.

And so, by leaving a gift in her will, she’s helping patients who will come through the doors in the future and she encourages others to consider doing the same. “It’s important for people in the community to support the hospital, especially when it comes to developing new technology and the new campus that’s going to be built. That’s an incredible endeavor for the hospital, and they need the support of the people in the community to be able to realize these goals.”

For Karen, she feels it’s the least she can do for the team who allowed her to realize her goal of watching her young son grow into a young man.

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

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

Facing a war zone

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

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

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

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

Seeking medical attention

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

Bushra in Germany
Bushra waking in Germany.

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

Road to healing and recovery

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

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

The women of the Rehab Centre

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

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

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

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

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

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

Discovering hope

Bushra, prosthetic leg
Bushra’s prosthesis.

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

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

The CAREN System

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

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

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

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

New life after trauma

Bushra with her baby
Bushra holding her daughter.

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

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

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

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

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

More than a decade later

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

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

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

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

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

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

Calm amidst chaos

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

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

The trauma team was ready

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

Four physicians in an emergency room at The Ottawa Hospital

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

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

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

Waking up to a different life

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

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

Marcie Stevens and her family.

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

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

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

Preparing to go home

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

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

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

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

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

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

Moving forward

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

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

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

Update: Two years later

Marcie Stevens' prostheses
Marcie Stevens with her prostheses.

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

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

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

Life can change in an instant. Thankfully, Ashley Ruelland lived to tell the story of her ‘instant’ after a head-on car crash brought her to The Ottawa Hospital’s Trauma Centre with extensive, life-threatening injuries followed by months of intensive rehab.

In early March 2015, then 27-year-old Ashley was living in an apartment with her two cats. She was busy working as a construction manager, part time as an office administrator, and she had started a catering business. She had never really been sick, and had no idea where the Civic Campus of The Ottawa Hospital was located.

That changed on Friday, March 13. Ashley was driving the bride-to-be and another friend to a bachelorette party in Mont Tremblant. It was a clear day and the three were brimming with excitement.

A head-on crash

About an hour from their destination, on highway 323, a car crossed over the centre line, head on into their lane. That was Ashley’s instant. The noise from the impact was horrific, with the earth-shattering sound of grinding metal and fragmenting glass.

Ashley Ruelland lying in hospital bed
Ashley, her mother Cheryl Ruelland-Jackson, Therapeutic Paws of Canada therapy cat Pecan, and her brother Robbie Ruelland.

Miraculously, one of the first people on the scene was a resident from The Ottawa Hospital. She quickly assessed how serious Ashley’s injuries were. It took first responders over an hour to extricate Ashley from the car. She was rushed to the Hull Hospital, but because of the severity of her injuries, she was transferred to the region’s only trauma centre at The Ottawa Hospital Civic Campus.

While her friends had relatively minor injuries, Ashley had a grocery list of broken bones: from her right big toe to her ribs and just about everything in between. Most significant were an open compound femur fracture, an open left elbow fracture, right humerus fracture, crushed and broken left and right foot and ankle fractures, an open book pelvis fracture, and multiple broken lumbar vertebrae.

“This lady’s life changed forever that day,” said Dr. Guy Hébert, Head of the Department of Emergency Medicine, when he looked at the hundreds of files related to Ashley’s surgeries and treatment.

She remained in an induced coma in the intensive care unit for two months. She endured numerous reconstructive surgeries, 100 hours of orthopaedic and internal surgery, and over 100 blood transfusions and infections.

Beginning the long road to recovery

Ashley walking in parrallel bars
A year and a half after her “instant”, Ashley was able to walk again with the help of a walker.

Four months after the crash, Ashley began physiotherapy in her hospital bed and could finally eat solid food.

She had lost all of her hair and had severe nerve damage, chronic illness myopathy and neuropathy.

“I was scared to think of the life that was waiting for me outside those hospital walls.” — Ashley Ruelland

“I couldn’t feed myself, brush my own teeth or move much at all. The first couple of weeks seemed like torture. The nurses would set little goals, like sitting up in my wheelchair for 20 minutes a day. The physiotherapist and occupational therapist didn’t know if I’d ever walk again. I was scared to think of the life that was waiting for me outside those hospital walls,” said Ashley.

But then her first real sign of recovery came a few weeks later when she was able to feed herself.

Intensive rehabilitation

In August, Ashley moved to the rehabilitation centre at the General Campus where she began an intensive regime of physical, occupational and psychological therapy programs. Just before Christmas, nine months after the accident, Ashley left the hospital. Although she was in a wheelchair and hadn’t made many functional gains, Ashley felt stronger and healthier.

The young woman continued as an outpatient with rehab, and had her last surgery in February 2016, which allowed her to transfer from her bed to chair, independently.

“In May 2016, I stood independently for the first time,” she said. “And after many more weeks of painful standing and walking in the hospital’s therapy pool, I started to walk with the aid of a harness within the parallel bars. By the end of the summer, I was able to move with a walker.”

Over two years later, Ashley is walking again. In fact, not only is she walking but she’s travelling, recently returning from Ireland. She’s also in school and looking to buy a home.

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