Vittorio Petrin has never seen his grandchildren’s faces. The Italian draftsman started to lose his peripheral vision in the early 1980’s after his second son was born, forcing him to leave work and take an early pension. He was diagnosed with retinitis pigmentosa, a genetic disorder that causes the cells in the retina to break down. There is no cure. His vision steadily got worse until he couldn’t see any light at all.
Before his vision went dark, Vittorio spent six years building a model of St. Mark’s Basilica in Venice, using over 3,000 copper pieces. “It was the most beautiful place I’d seen, and I wanted to replicate it. Working on it kept my mind away from what was going to happen,” he says.
“My dad was an artist. He was able to draw phenomenally, he liked taking videos. Sight was important to him,” says Vittorio’s son Dino Petrin. “He never complained about going blind, we never saw it as children. He always had a sense of humour and a strong character. He never asked for any pity, he just took it in stride.”
Millions of people in North America live with retinal diseases like retinitis pigmentosa, glaucoma, retinal ischemia and age-related macular degeneration. These diseases are poorly understood, progressive, and often untreatable.
But thanks to promising gene and cell therapies in development, Dino hopes that one day people like his father won’t have to lose their vision.
“Soon we’ll be able to do what our lab has been trying to do all along – bring XIAP gene therapy into the clinic.”– Dr. Catherine Tsilfidis
A discovery with game-changing potential
Dr. Catherine Tsilfidis can imagine the day when the first patient is treated with the retinal disease gene therapy her lab has worked on for the past 20 years. While it won’t happen tomorrow, that day is not far off.
“XIAP gene therapy is exciting because it keeps cells in the back of the eye from dying,” said Dr. Tsilfidis, a senior scientist at The Ottawa Hospital and associate professor at the University of Ottawa. “It could slow or stop vision loss caused by many different retinal diseases.”
Dr. Tsilfidis is leading a world-class team of researchers that recently received $2.4 M from the Ontario Research Fund to develop gene and cell therapies for retinal diseases. One of their goals is to do the work needed to bring XIAP gene therapy into clinical trials, which could start in the next few years.
The time is right for gene and cell therapy
The promise of replacing defective genes and cells in the eye with healthy ones is undeniable. While these fields are still in their infancy, they are expected to grow exponentially over the next decade. Gene therapy for the eyes has particularly taken off, with Health Canada approval of the first gene therapy for a rare genetic form of vision loss in 2020.
“This research program could make Ontario a leader in the fields of both gene and stem cell therapy– Dr. Pierre Mattar
When it comes to cell therapies, Ottawa and Toronto are major hubs in the growing area of stem cell research. As partners in the retinal research program led by Dr. Tsilfidis, UHN scientist Dr. Valerie Wallace will work on increasing the survival of transplanted stem cells in the eye, while The Ottawa Hospital’s Dr. Pierre Mattar aims to develop stem cell therapies for retinal ganglion cell diseases such as glaucoma. “This research program could make Ontario a leader in the fields of both gene and stem cell therapy,” said Dr. Mattar. “By learning the best way to mass produce and integrate stem cells for retinal disease, we can advance stem cell research in other fields.”
Collaboration between lab researchers and clinicians key to success
The incredible challenge of bringing a basic science discovery to clinical trials requires an exceptional team. For this research program, Dr. Tsilfidis assembled a “dream team” of long-time collaborators and new partners.
As a basic scientist, Dr. Tsilfidis has always worked closely with clinicians to help ensure her research reflects patient needs.
“Ophthalmologists help us identify the most important questions to ask,” said Dr. Tsilfidis. “Our lab started working on diseases like Leber hereditary optic neuropathy and glaucoma because clinicians told us how much of a problem they were.”
Two of Dr. Tsilfidis’ long-time clinical collaborators, Drs. Stuart Coupland and Brian Leonard, are part of this new retinal research program. They are joined by retina specialists Drs. Bernard Hurley and Michael Dollin, who will assist in developing clinical trial protocols.
“Our researchers have an incredible track record of taking discoveries from the lab to the bedside,”– Dr. Duncan Stewart
Dr. Tsilfidis’ lab and office are just down the hall from the ophthalmologists’ offices and clinics, which makes collaboration easier. This kind of co-location of scientists and clinicians has been key to The Ottawa Hospital’s success in translating discoveries from the lab bench to the patient bedside.
Leveraging our biomanufacturing expertise at The Ottawa Hospital
In addition to clinical experts, the team knew they needed new resources and partners to be successful.
“We’ve been very much a basic science lab in the past,” said Dr. Tsilfidis. “Now that we’re at the stage that we want to get XIAP to the clinic, we need all the help we can get.”
One missing piece was a special clinical-grade virus used to deliver the XIAP gene into the eye, known as an adeno-associated virus (AAV). Finding cost-effective sources of AAVs has been a major bottleneck for getting gene therapy trials and treatments off the ground.
Thankfully, The Ottawa Hospital is home to the Biotherapeutics Manufacturing Centre (BMC), a world-class facility that has manufactured more than a dozen different virus- and cell-based products for human clinical trials on four continents. Experts at the BMC were already starting to expand into AAV manufacturing when Dr. Tsilfidis approached them about collaborating on the retinal research program.
The BMC has since been working with Dr. Tsilfidis and her team to develop a process to manufacture the AAVs the team will need for Health Canada approval of the XIAP gene therapy for clinical trials.
The BMC is on track to become the first facility in in Canada to make clinical-grade AAV vectors for gene therapy studies. This new expertise will help them support other gene therapy trials with a focus on rare disease.
How to plan a world-class clinical trial
In addition to the clinical-grade virus, the retinal research team needed help planning a future clinical trial of XIAP gene therapy. Fortunately, there are no shortage of clinical trial experts at The Ottawa Hospital.
“I’ve never planned a clinical trial before,” said Dr. Tsilfidis “But I knew someone who had – Dr. Dean Fergusson. I’ve always been impressed by the rigorous trails he’s helped develop. When I asked for his advice, he referred me to the Ottawa Methods Centre.”
The Ottawa Methods Centre is The Ottawa Hospital’s one-stop shop for research expertise and support. Their goal is to help all clinicians, staff and researchers at the hospital conduct the highest quality research, using the best methods. They support over 200 research projects a year, led by clinical and basic researchers alike.
“The Ottawa Methods Centre has been amazing to work with,” said Dr. Tsilfidis. “Their research methodology expertise has strengthened this research program and our funding applications.”
At the Ottawa Methods Centre, the team is leveraging the Blueprint Translational Research Group’s Excelerator program, designed to enable efficient translation of basic research discoveries to the clinic through rigorous methods and approaches. Co-led by Dr. Dean Fergusson and Dr. Manoj Lalu, the program will help design the clinical trial protocol, and support the clinical trial application to Health Canada through systematic reviews of available pre-clinical and clinical data.
Research program holds enormous promise
Tackling retinal disease will be a big challenge, but Dr. Tsilfidis has assembled an excellent team of partners both old and new to move this research program forward.
“These therapies could be life-changing. If we could cure or slow down the progression of vision loss, that would be amazing.”– Dino Petrin
“Our researchers have an incredible track record of taking discoveries from the lab to the bedside, but it can only be done through team efforts like this one,” said Dr. Duncan Stewart, Executive Vice-President of Research at The Ottawa Hospital and professor of medicine at the University of Ottawa. “Fully leveraging our basic and clinical expertise, as well as our world-class core research resources is the key to getting new treatments to the patients who need them.”
For Dr. Tsilfidis, the excitement is palpable. “Soon we’ll be able to do what our lab has been trying to do all along – bring XIAP gene therapy into the clinic.”
Dino, a former graduate student in Dr. Tsilfidis’ lab, sees the potential of gene therapies to help people like his father. “These therapies could be life-changing,” he said, “If we could cure or slow down the progression of vision loss, that would be amazing.”
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
Originally published: May, 2021
Early in the fall of 2020, Michele Juma noticed the vision in her left eye was becoming cloudy. The Sault Ste. Marie resident initially turned to her family doctor for answers. She learned she had a meningioma tumour — and time was not on her side to save her vision. Fearing she would face blindness, Michele, a mom of four, eventually travelled to The Ottawa Hospital where she could receive specialized care — care she could not receive close to home.
It was early November when MRI results revealed the mass at the base of her frontal lobe. “By this time, I lost my ability to see colour in my left eye — my vision was deteriorating. It was like looking through a frosted window,” remembers Michele. While her right eye would start compensating to get her through her day-to-day, Michele was finding the routine of caring for her teenage boys and working a challenge and knew she needed to see a specialist. Soon, she and her husband were making plans for the eight-hour drive to Ottawa to meet with Dr. Danah Albreiki at the University of Ottawa Eye Institute located at The Ottawa Hospital.
Seeking answers at the University of Ottawa Eye Institute
The University of Ottawa Eye Institute was founded in 1992 as the home of The Ottawa Hospital’s Department of Ophthalmology. It is a major clinical, teaching, and research centre in Canada specializing in diseases and conditions that affect the eyes. Dr. Albreiki’s expertise focuses on neuro-ophthalmology and adult strabismus surgery, which focuses on straightening misaligned eyes.
Born and raised in Saudi Arabia, Dr. Albreiki says our Eye Institute plays an international role in sharing our expertise with patients and ophthalmologists in more than 86 countries around the world. As one example, she explains, the Ottawa Eye Institute has an affiliation with India Srikiran Institute of Ophthalmology in Kakinada, Andhra Pradesh. Affiliations like these provide an opportunity for the ophthalmology residents to travel and explore ophthalmology in a very different setting.
Having done her ophthalmology residency in Ottawa, Dr. Albreiki reflects on the importance of teaching. “I think the Eye Institute is honestly an amazing academic place where staff are dedicated first and foremost to their patients, but have a heavy focus for teaching the ophthalmology residents. This ripple effect extends beyond Ottawa and will travel wherever the residents end up working as they share their knowledge and expertise with their communities. As a matter of fact, Michele was seen first by our neuro-ophthalmology fellow Dr. Noran Badeeb who came all the way from Saudi Arabia to train with us.”
“The danger is it’s very close to the optic nerve, and Michele is a good example of how people can quickly deteriorate with these tumours, and they are at high risk of losing their vision.”— Dr. Fahad Alkherayf
By early December, Michele met Dr. Albreiki’s team and she learned what was happening with the tumour. “If we leave tumours that are compressing on the optic nerve for too long, there is a high chance that it will damage the optic nerve which subsequently leads to permanent vision loss,” explains Dr. Albreiki. She adds, “Despite the severe vision loss that had happened, we were able to determine, by way of ophthalmic diagnostic testing, that Michele’s optic nerve appeared more suffocated than actually dead. By removing the suffocation, we would allow the optic nerve to breathe again and there would be a good chance she would regain part, if not all, of her vision.”
For that to happen, they would need to act fast.
Understanding meningioma tumours
Knowing Michele had travelled from Sault Ste. Marie for her initial meeting at the Eye Institute, Dr. Albreiki arranged for her to meet later that day with world-class, skull base surgeon Dr. Fahad Alkherayf who set in motion a plan to remove the mass.
He explained to Michele that she had a skull base meningioma. The tumour was about three centimetres by three centimetres — about the size of a golf ball. The biggest challenge with removing these types of tumours is often their location. “How you can reach it without damaging the brain around it and the things attached to it is key. If you’re not careful, and you end up injuring any of these structures, unfortunately, the outcome is devastating,” explains Dr. Alkherayf.
“The Ottawa Hospital is one of the main leading centres in minimally invasive skull base surgery, and I think that speaks to the expertise we have in our centre.”— Dr. Fahad Alkherayf
Minimally invasive surgery offers new treatment options
The treatment used today for a meningioma tumour is relatively new. In the past, it was a much more invasive procedure known as a craniotomy, which results in a large incision with a higher risk of injuring the optic nerve. However, today minimally invasive surgery allows much more effective and safer care for our patients. “Instead of the old, traditional way of going through the skull, and lifting the brain — today, we go through the nose,” explains Dr. Alkherayf. This means no incision, faster recovery time, reduced pain, a higher accuracy rate compared to traditional open surgery, and a shorter hospital stay.
The Ottawa Hospital has established itself as a leader in Canada when it comes to this type of minimally invasive surgery. Dr. Alkherayf says we’re one of the largest centres in Canada doing it. “If we look across the country, The Ottawa Hospital is one of the main leading centres in minimally invasive skull base surgery, and I think that speaks to the expertise we have in our centre. It’s not just surgeons but it takes a good anesthesia, nursing, and neurophysiology team, so the surgeon can function well. I think what’s unique about our hospital is we have this full package providing care to our patients.”
Having access to this expertise is a significant advantage for patients like Michele, who required urgent surgery due to the rapid growth of the tumour and the risk of it causing blindness not only in her left eye but in her other eye as well. After meeting with Dr. Alkherayf as well as Dr. Shaun Kilty, an ear, nose, and throat (ENT) specialist, her surgery was scheduled for December 17, 2020.
Michele remembers feeling anxious and nervous. “It was all really overwhelming — and surreal. When I think that I’d been walking around with this tumour probably for years…it was kind of unbelievable to me to think of the whole gravity of the situation.” However, Michele says she knew she was in good hands. “I do have to say that when I met with Drs. Albreiki, Alkherayf, and Kilty, they were very reassuring and answered all our questions, significantly reducing my anxiety.”
Specialized technique used only at The Ottawa Hospital
Leaving their four sons at home, Michele and her husband arrived back in Ottawa just over a week before Christmas. The minimally invasive surgery would last eight hours with Drs. Alkherayf and Kilty working alongside one another to remove the tumour piece by piece — through Michele’s nose.
“The monitoring helped ensure we didn’t pull too hard on her optic nerve. If it wasn’t for this specialized technique, I don’t think we would have achieved the same results.”— Dr. Fahad Alkherayf
During the procedure, Dr. Alkherayf was able to monitor Michele’s vision. In fact, our hospital is the only centre in Canada using this specialized technique. “We have established a method where we can receive a signal from the eye, as well as from the optic nerve and the brain, about what’s happening to the vision while the patient is asleep.” Goggles — which resemble swimming goggles — are placed on the patient while they’re under anesthetic. The goggles send a flashing light, which sends a signal into their retina, and then it travels down their optic nerve, crosses the chiasma (the back of the optic nerves where they meet), and then travels to the vision centre of the brain. The signals will change if the surgeon’s pushing or pulling the optic nerves and potentially damaging them.
According to Dr. Alkherayf, this technique was critical during Michele’s surgery. “Her tumour was basically glued to her optic nerve, which explains why she was having this significant vision problem. The monitoring helped ensure we didn’t pull on her optic nerve. If it wasn’t for this specialized technique, I don’t think we might have achieved the same results.”
Listen to Michele Juma and world-leading neurosurgeon, Dr. Fahad Alkherayf discuss the removal of a complex meningioma brain tumour on An Hour To Give.
The future is looking clear
For the first five days after surgery, Michele says there was a lot of sleeping, but she remembers the moment when she woke up for the first time and she opened her eyes. “My husband was there, and I was able to see — it was right away that I could see again!” Even better news, before Michele was released from the hospital on Christmas Eve, Dr. Alkherayf shared the news she had been hoping for – the tumour was benign, and he was able to completely remove it.
“I’m grateful to be able to watch my sons continue to grow and, of course, to have the chance to be part of the activities they love most, like swimming and hockey.”— Michele Juma
With this life-changing news in hand, Michele and her husband began their long drive back home to Sault Ste. Marie arriving home at 11:30 p.m. on December 24, just in time to be with their children for Christmas. “It was like a Hallmark movie,” laughs Michele.
Today, her vision is fully restored. She’s back at work and keeping up with the busy life that comes with raising four teenage boys. “I consider myself to be so incredibly fortunate to have had Drs. Alkherayf and Kilty conduct this surgery. When I think about the complexity of what they did, I never cease to be amazed, and I feel truly blessed.”
While she and her family truly appreciate the exceptional skill of both physicians, Michele adds they were kind, compassionate, and empathic throughout her journey. “As scary as all this was, I can honestly say that I always felt confident that I was in very good hands.” She adds, “I’m grateful to be able to watch my sons continue to grow and, of course, to have the chance to be part of the activities they love most, like swimming and hockey.”
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
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.
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 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.”
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.
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.
“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
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.
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?
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.
“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.
“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.
“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.
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.
We each have a defining moment in our life — a moment that changes our life forever. For some, that moment is not as clearly defined as it is for others. For Kimberly Mountain, that moment was the discovery of a cancerous brain tumour.
In February, 2011, Kimberly was 28 years old and out with her then-boyfriend, Matt Mountain, when she felt a weird, strong twitch on the right side of her face as they were driving. “Then all I remember is waking up. Our car was pulled over on the side of the highway. Paramedics were there, and I heard Matt say, ‘Kim just had a seizure’,” recalls Kimberly.
Kimberly was rushed by ambulance to the trauma centre at the Civic Campus of The Ottawa Hospital. She would have another seizure, and then an MRI revealed a brain tumour on her right frontal lobe. That moment changed her life.
For two weeks, The Ottawa Hospital became Kimberly’s second home. Her family and Matt never left her side. “Oddly enough, my memories of being in the hospital aren’t of a sad time at all. They are actually some of my favourite memories, filled with friends and family. Everyone I loved was there. And we made friends with the amazing nurses and staff,” says Kimberly.
Awake brain surgery
On March 7, 2011, Kimberly had brain surgery. Her surgeon, Dr. Charles Agbi, would keep her awake for the operation. This is a highly-specialized surgical procedure that requires a team approach led by an experienced neurosurgeon and a neuroanesthesiologist. It enables the neurosurgeon to remove tumours that would otherwise be inoperable because they are too close to areas of the brain that control vision, language, and body movement. Regular surgery could result in a significant loss of function. By keeping Kimberly awake, the medical team was able to ask her to move certain body parts and speak during the procedure.
When she thinks back to the operation, she remembers never being worried. “I guess the hospital staff had made me feel safe and confident.”
During surgery, Kimberly could feel the vibrations of the team drilling into her head, but she didn’t mind it. “I kept talking, laughing, and singing Disney songs, like “Hakuna Matata.” I was telling them how I was going to go to Disney World when it was over. Five hours seemed like just one,” says Kimberly.
For Dr. Agbi, this type of interaction is critical to the success of the surgery. “If they’re only answering questions [surgery staff] are asking them, sometimes we might miss something.”
It is advances in technology like Kimberly experienced that allow neurosurgeons at The Ottawa Hospital to provide transformational care.
In fact, donor support brought a specialized microscope to Ottawa, allowing surgeons to perform fluorescence-guided surgery. The technique requires patients to drink a liquid containing 5-aminolevulinic acid (5-ALA) several hours before surgery. The liquid concentrates in the cancerous tissue and not in normal brain tissue. As a result, malignant gliomas “glow” a fluorescent pink color under a special blue wavelength of light generated by the microscope. This allows surgeons to completely remove the tumour in many more patients, with recent studies showing that this can now be achieved in 70 percent of surgeries compared to the previous 30 percent average. The first surgery of this kind in Canada was performed at The Ottawa Hospital.
“Dr. Nicholas sat down, held my hand, and said the word — cancer. Everything went blurry, and this time I couldn’t stop the tears. I had been strong up until that moment.” – Kimberly Mountain
Oncologist reveals brain tumour is cancerous
When pathology tests on the tumour came back several weeks later, Kimberly met with her oncologist, Dr. Garth Nicholas, and he revealed the news she feared the most. “Dr. Nicholas sat down, held my hand, and said the word — cancer. Everything went blurry, and this time I couldn’t stop the tears. I had been strong up until that moment,” remembers Kimberly.
During her cancer treatment, Kimberly faced 30 rounds of radiation, followed by chemotherapy. Matt, who had proposed during Kim’s long stay in the hospital, took her on trips to amusement parks or convertible drives to help get her through the difficult times. The couple even made a special trip to Disney World. “All I could think of during my brain surgery was how happy and carefree it was there. The world was suddenly much more exciting, and I was aware of every little smell, feeling, and moment—something I think maybe only cancer patients can appreciate.”
This all provided Kimberly with a distraction from the side effects, the tiredness, and the hair loss. Losing her hair was one of the most difficult parts of treatment. “I hated losing my long, beautiful hair.”
Less than a year later, on January 6, 2012, Kimberly received her last chemotherapy treatment. “I asked those pills to eat that cancer.” Her wish would be realized when an MRI could not detect any residual cancer. Kimberly transformed into a cancer survivor.
Through a mother’s eyes
Kimberly has become known for never showing up for an appointment without a small contingent of supporters. She always has her family by her side, including her mother, Cyndy Pearson. Cyndy laughs that Kimberly always has an entourage—even when she learned her tumour was cancerous. “We were all there. When there’s something important, we’re all there. When Dr. Garth Nicholas leaned over, and said, ‘Kim you have cancer,’ we were all crying.”
Cyndy is grateful to The Ottawa Hospital for saving Kimberly, her youngest of three children. She points out March 7, 2011 is a new date circled on the family’s calendar—Kimberley’s re-birthday.
Cyndy is also forever grateful for Dr. Agbi’s care. “If this surgery hadn’t happened, she wouldn’t be having any more birthdays. If the hospital had not been able to save her…” Cyndy’s voice trails off.
“Even if the cancer does come back, I am confident that The Ottawa Hospital will be able to save me again, thanks to its constant innovative research and clinical trials that are making treatment better and saving lives.” — Kimberly Mountain
Cancer survivor ten years later
Today, Kimberly has a tattoo on the back of her neck that reads “Hakuna Matata – March 7, 2011”. She celebrates every milestone — including being cancer free — with family, friends, and of course Matt, who never left her side and who is now her husband. You could say it’s like a Disney ending.
Not everything went back to normal. “My precious hair will never be the same,” says Kimberly. “There’s a big spot where my hair will never grow back. The whole right side of my head is permanently bald.” However, always finding the positive, Kimberly says she can do her hair in ten seconds these days, thanks to a few different wigs, “I may actually own more wigs than shoes.”
All joking aside, Kimberly is grateful for each day. “Even if the cancer does come back, I am confident that The Ottawa Hospital will be able to save me again, thanks to its constant innovative research and clinical trials that are making treatment better and saving lives.”
For now, Kimberly takes it one day at a time, celebrating life’s little moments each day.
Hear Kimberly Mountain on Pulse: The Ottawa Hospital Foundation Podcast.
The Ottawa Hospital was the first Canadian hospital to have an integrated medical 3D printing program for pre-surgical planning and education. Since the arrival of the program, made possible by the generosity of a donor, The Ottawa Hospital has been a leader in innovative advancements in this area. Doctors have been able to harness 3D printing to create detailed anatomical plans before a patient arrives in the operating room, reducing the need for invasive surgery, and ultimately improving outcomes with a significant cost savings. It’s this program, which positions the hospital’s Medical Imaging Department at the forefront of international developments in radiology and is revolutionizing the way surgery is done. It’s this kind of forward thinking that allowed The Ottawa Hospital to be ready when the COVID-19 pandemic arrived in Ottawa, mobilizing innovative 3D printing technology at the hospital, in local companies, and out in the community, to quickly create PPE for front-line workers.
Ready to face the pandemic
As members of The Ottawa Hospital’s 3D Printing Laboratory watched how COVID-19 was spreading throughout China and Europe, they quickly became aware of how some parts of the world were facing dramatic equipment shortages. That’s when Dr. Adnan Sheikh, Director of the 3D Printing Laboratory, and his team started to think creatively about how they could help their colleagues be better prepared for the pandemic.
“I reached out to Dr. David Neilipovitz, Department Head of Critical Care, to offer help and we identified many areas where the 3D Printing Lab would be in the best position to help in case of any shortages,” says Dr. Sheikh.
From that conversation, the 3D printing team started developing several different designs of PPE (Personal Protective Equipment) to help safeguard colleagues who would be caring for patients critically ill from COVID-19.
“We were able to create oxygen tents, goggles, tube connectors, intubation shields, and face shields which are a key piece of equipment,” explains Dr. Sheikh.
These transformational advancements wouldn’t have been possible just five years ago.
“This is an innovative technology. It’s really evolved and it’s changing the way we practice medicine.”— Dr. Adnan Sheikh
Testing the prototypes
Once the 3D lab began producing pieces of PPE, each one needed to be tested. Dr. Neilipovitz played a key role in testing these designs in advance, allowing The Ottawa Hospital to be innovative during challenging times.
“Thanks to our 3D team, they allowed us to think outside the box and quickly find us solutions to be ready to help our patients.”— Dr. David Neilipovitz
In fact, Dr. Neilipovitz and his team in the ICU were instrumental in helping the 3D team refine and test prototypes to ensure they were up to the task. A crucial step in the process and one that required patience, expertise, and an open mind.
A perfect example was an intubation shield designed with the help of Leonard Lapensee, an Imaging Technician, who works at the hospital. The ICU team tested this prototype; they modified it and it was later mass-produced. This is now used in the ICU, operating rooms, and emergency rooms.
Community support takes The Ottawa Hospital to the next level
Once they received the green light for the 3D equipment, The Ottawa Hospital was then able to produce as much quantity as the lab could handle. However, the collaboration went beyond the lab and even the walls of The Ottawa Hospital.
“We knew we had limited resources and were aware that we wouldn’t be able to manufacture and print everything in the lab. So, we prototyped these devices and pushed them out for production at different sites at The Ottawa Hospital. We also reached out to volunteers in the community who had offered to help.”
There was a collaboration with the University of Ottawa Makerspace led by engineering professor Dr. Hanan Anis and her team to help with the design and prototyping process. It didn’t stop there—the community support continued to grow to help produce PPE such as face shields, and even headbands.
A good example of that support was when Ottawa resident Marc Beal stepped forward to lend a hand. “Due to resource constraints, we needed help printing headbands for face shields. Marc and his friends, who have home 3D printers, approached us and printed these headbands for us,” explains Dr. Sheikh.
Another key piece of equipment was the oxygen helmet, which is used with patients who require a constant flow of oxygen. Once again, the 3D lab was able to prototype it. “We tested it and once we were convinced that it would help our patients, we reached out to Darcy Cullum at Ottawa Mould Craft, who was happy to work with us.”
Ultimately, that community support allowed The Ottawa Hospital to ensure staff have the PPE needed to keep both care team members and patients safe during the peak of COVID-19.
The best part of all, notes Dr. Sheikh, is that this all came about organically. “Colleagues helping colleagues—having an open mind and being willing to integrate what we can contribute. That included assessing the gear and testing it out to make it reality. I feel privileged to live in Ottawa; our community support system is the best in the world!”
COVID-19 may have turned the world upside down but it was a forward-thinking donor in 2016, who allowed The Ottawa Hospital to have the technology in place to be ready when our patients needed us most.
“With COVID-19 everything has changed. 3D printing now has a different role in the medical world.”— Dr. Adnan Sheikh
For more than 200 years, no one has been able to solve the Parkinson puzzle. Parkinson’s disease is the second most common neurodegenerative disease after Alzheimer’s. It affects approximately 100,000 Canadians—8,000 here in Ottawa. The national number is expected to double by 2050. Each day, many of those patients face uncontrolled trembling in their hands and limbs, the inability to speak loudly, loss of sense of smell, and pains from stiffness.
While the exact cause of the disease remains a mystery, dedicated researchers at The Ottawa Hospital are gaining ground—determined to solve the puzzle. Ottawa is a recognized centre for neuroscience research. Dr. Michael Schlossmacher is the director of the Neuroscience program at The Ottawa Hospital and while he admits Parkinson’s is complicated and complex, there is hope.
“I strongly believe we can solve that riddle. We have the expertise to make a major contribution to a cure for this disease.” Dr. Michael Schlossmacher
Predicting the risk of Parkinson’s
For Schlossmacher, a step forward in unravelling the mystery of this disease came when he was struck by the idea of a mathematical equation, which could potentially foreshadow the disease before it develops. “I’m convinced that by entering known risk factors for Parkinson’s into this model, it is indeed possible to predict who will get the disease.”
Risk factors for Parkinson’s disease include:
- chronic constipation
- reduced sense of smell
- family history
- chronic inflammation such as hepatitis or types of inflammatory bowel disease,
- environmental exposures
- head injuries
- gender, as Parkinson’s affect more men than women
Dr. Schlossmacher and his team of researchers are currently combing through data to test the accuracy of their theory to predict Parkinson’s.
Meet two of the Parkinson’s powerhouses dedicated to finding a cure
To date, Dr. Schlossmacher and his team have analyzed more than 1,000 people, and the results are promising. “The surprising thing so far is the prediction formula is right in 88 to 91 percent of the cases to tell us who has Parkinson’s and who doesn’t—and this is without even examining the movements of a patient.”
The goal is now to expand to field testing in the next two years. According to Dr. Schlossmacher, should the results show the mathematical equation works, this could allow doctors to identify patients who have high scores. “We could modify some of the risk factors, and potentially delay or avoid developing Parkinson’s altogether.”
Partners Investing in Parkinson’s Research
Research is costly and community support is vital to help unleash new discoveries. In 2009, a group of investment advisors came together to create Partners Investing in Parkinson’s Research, more commonly known as PIPR. Each year, the group participates in Run for a Reason and raises money as a part of Tamarack Ottawa Race Weekend. In 11 years, the group has raised $1.4 million for The Ottawa Hospital’s researchers and clinicians.
PIPR has not only helped to fund research toward better treatment and hopefully a cure for Parkinson’s, but the group has also brought much-needed attention to the disease. For Dr. Schlossmacher, funding for research from groups like PIPR, means more hope for the future. He is quick to add that PIPR has galvanized the momentum in our community because they see how committed The Ottawa Hospital is to making a difference.
“This investment by PIPR into research at The Ottawa Hospital has been a total game-changer for us. It has allowed us to pursue projects that otherwise would not yet be funded.”
Donor dollars translate into results
PIPR’s support helped bring deep brain stimulation surgery (DBS) to The Ottawa Hospital. For someone like Karin Fuller, co-captain of team PIPR, she knows the positive impact this type of technology can have. “When my dad had that surgery he had to go to Toronto, which meant going back and forth for the appointments. It was a lot for him and for our family. Helping to bring DBS to our community is a tangible example of what we’ve been able to do as a group to support The Ottawa Hospital,” says Karin.
Also developed at The Ottawa Hospital is the world’s first 3D virtual reality system for neurosurgery. It is being used to increase the accuracy of DBS surgery for patients with Parkinson’s. Our neurosurgeons are the first in the world to use this technology in this way and the goal is to improve the outcome for patients.
Promise for the future
It’s also expected that one day 3D technology could be in every department throughout the hospital. The possibilities for this technology are endless and, in the future, it could help countless patients, beyond Parkinson’s disease.
When Dr. Schlossmacher looks at the puzzle of Parkinson’s, which he’s been investigating for 20 years, he sees promise.
“At The Ottawa Hospital, we think outside the box and that’s how we’re able to unravel mysteries through our research. Research which we hope will one day be transformational.” Dr. Michael Schlossmacher
He also has sheer determination in his eyes. “To the chagrin of my wife, I will not retire until I put a dent into it. The good news is, I may have 20 years left in the tank but, ultimately, I’d like to put myself out of business.”
Minimally invasive surgery ‘perfectly’ restores hearing
After a brain tumour began growing in to his ear, Denis Paquette was at risk of losing his hearing in both ears – a circumstance that would strip him of his ability to hear his wife’s voice forever. With traditional brain surgery deemed too risky, Dr. Fahad Alkherayf and Dr. Shaun Kilty were challenged to find a safer solution – removing the tumour through his nose.
A life unlike most
Since birth, Denis Paquette, now 66, has been deaf in one ear. It’s clear he has a deep-rooted understanding of the nuances of having such an impairment. After all, it’s all he’s ever known. Holding the phone to his good ear and turning his head while in conversation to better hear someone are habits he was quick to establish.
But in 2016, these little tricks, which he has cultivated throughout his life, started to fail him. Conversations were getting harder to hear and Denis’ wife, Nicole,
noticed that Denis was progressively increasing the volume on the television.
“I was beginning to be frustrated because people were talking to me, but I was just getting parts of the conversation,” said Denis.
Journey to diagnosis
Concerned about his hearing, Denis visited his family doctor. He was sent for various hearing tests, each showing that something was wrong. It was then that Denis was referred to Dr. David Schramm, a hearing specialist at The Ottawa Hospital. Dr. Schramm ordered an MRI that revealed Denis had a rare tumour growing in his skull and in to his inner ear. These weren’t the results Denis and Nicole were expecting.
“I didn’t know what to expect, so it was really shocking news,” said Denis.
Denis needed specialized surgery to remove the tumour and required the expertise of neurosurgeon Dr. Fahad Alkherayf and ear, nose, and throat (ENT) specialist Dr. Shaun Kilty.
Due to the complexity of Denis’ diagnosis, Dr. Alkherayf and his team were challenged to remove the tumour without jeopardizing his hearing completely.
“The tumour was growing in his skull and in to his inner ear, putting pressure on his hearing nerve on the good ear. There was a risk he would lose the rest of his hearing,” said Dr. Alkherayf.
“Despite it being a benign lesion, the impact of it was huge.” – Dr. Fahad Alkherayf
Dr. Alkherayf knew that removing the tumour through Denis’ ear could risk permanently damaging what little hearing he had left. With this in mind, Dr. Alkherayf recommended that Denis undergo the newly-available minimally invasive brain surgery. With this technique, his tumour would be removed through his nostrils instead of through his ear.
The risk was high
Traditionally, brain surgery for a case such as Denis’ would take place through the ear and require a large incision through the skull. But with only one good ear to start with, performing brain surgery in this way could permanently and completely impair his hearing.
Not only could Denis lose his hearing, the traditional method of removing such a tumour has a greater risk of complication, a higher chance of infection, and demands a longer recovery period – up to six months. It would also leave a large scar, beginning in front of his ear and extending all the way up and behind it. The thought of undergoing such a procedure alone was nerve-racking.
A new surgery technique
Over the last several years, Dr. Alkherayf has advanced new techniques for removing various types of brain tumours, known as minimally invasive surgery.
Minimally invasive surgery has transformed the way operations are performed by allowing surgeries to be carried out as keyhole procedures, a surgical procedure that provides access to parts of the body without having to make large incisions. This operation is much safer, with risk of infection and recovery time greatly reduced. In many cases, patients are discharged within just a few days of surgery.
“It’s quicker to recover for patients,” said Dr. Kilty. “Because they don’t have to recover from the extensive dissection that traditional approaches [surgeries] require.”
Performing these types of surgeries requires two physicians – a neurosurgeon to remove the tumour and an ENT to provide access to the tumour through the nose and to control the endoscope. Due to the complex nature of these surgeries, Dr. Alkherayf is among a small group willing to perform them. Many are looking to The Ottawa Hospital to learn about this innovative surgery. “We have become one of the top places in Canada for this technique,” said Dr. Alkherayf.
“They did a miracle on me”
On July 20, 2016, Denis underwent a five-hour operation during which Dr. Alkherayf and Dr. Kilty were able to successfully access and remove the tumour through his nose. The insertion of a microscopic tube that would travel from the cavity of where the tumour once was to his sinuses which would prevent future buildup of fluid and prevent the chance of reoccurrence.
When he woke up, Denis was astounded that he could hear his wife’s voice. “I woke up and wow,” said Denis, “I could hear!”
Just two days after his surgery, he was discharged.
“They did a miracle on me. They did something fantastic,” said Denis, whose hearing tests have been perfect ever since.
“They did a miracle on me. They did something fantastic.” – Denis Paquette
Thanks to the care Denis received at The Ottawa Hospital and the benefits of minimally invasive surgery, he can now enjoy watching his television shows and conversing with his wife without issue. He no longer fears a life without sound.
OCTOBER 26, 2019 OTTAWA, ON – It was a sold-out night at The Ottawa Hospital Gala, presented by First Avenue Investment Counsel, which recognized three innovative researchers. The elegant ballroom of the Westin Hotel was transformed with exquisite décor and a delectable four-course meal, enjoyed by more than 700 guests. It also marked the final gala with Dr. Jack Kitts as President and CEO of The Ottawa Hospital, who will retire in 2020. Guests paid tribute to Dr. Kitts with a standing ovation for his dedication to providing compassionate and world-class care to the Ottawa community through his leadership since 2002.
The Ottawa Hospital Gala celebrated the transformational work of three researchers dedicated to improving care. Congratulations to this year’s three award winners:
Faizan Khan, recipient of the Worton Researcher in Training Award, recognized for his outstanding work on vein blood clots, including a recent British Medical Journal study establishing long-term risks and consequences of clot recurrence.
Dr. Marjorie Brand, recipient of the Chrétien Researcher of the Year Award, recognized for her groundbreaking discovery of how a blood stem cell decides whether to become a red blood cell or a platelet-forming cell.
Dr. Paul Albert, recipient of the Grimes Research Career Achievement Award, recognized for his leadership in Neuroscience, as well as his innovative work on what causes depression and how to treat it.
The Ottawa Hospital is recognized for its world-leading research that attracts internationally recognized scientists and clinicians from around the world. Tim Kluke, President and CEO of The Ottawa Hospital Foundation, emphasized that it’s corporate and individual philanthropic gifts, which make that a reality. “We are privileged to have the support of a generous community which is helping this city advance research to find new hope for patients now and in the future.”
First Avenue Investment Counsel returned as the presenting sponsor of The Ottawa Hospital Gala this year. Kash Pashootan, CEO and Chief Investment Officer at First Avenue Investment Counsel, said it’s a partnership that aligns perfectly. “Innovative research is a necessary investment in the future of health care in our community and we’re proud to fulfill our duty to The Ottawa Hospital. At First Avenue Investment Counsel, we advise families on all aspects of their financial picture including managing their assets to ensure their secure future for them and future generations. Together, we’re laying the building blocks for the future.”
About The Ottawa Hospital:
The Ottawa Hospital is one of Canada’s largest learning and research hospitals, with more than 1,200 beds, 12,000 staff members and an annual budget of about approximately $1.3 billion.
The focus on learning and research helps to develop new and innovative ways to treat patients and improve care. As a multi-campus hospital affiliated with the University of Ottawa, specialized care is delivered to the eastern Ontario region and the techniques and research discoveries are adopted around the world. The hospital engages the community at all levels to support our vision for better patient care.
From the compassion of our people to the relentless pursuit of new discoveries, The Ottawa Hospital never stops seeking solutions to the most complex patient-centred care. For more information about The Ottawa Hospital, visit ohfoundation.ca.