Archives des Technology | The Ottawa Hospital Foundation

Published: July 2026

Read time: 4 mins

Published: July 2026

Read time: 4 mins

More than eight billion people live on Earth. Fewer than 700 have ever left it to venture into space. Robert Thirsk is one of them.

Long before Robert became an astronaut with the Canadian Space Agency (CSA), he was a young boy living in British Columbia watching the Apollo moon landing on television with his family. When the broadcast ended, he ran outside to look up at the moon. He was captivated. The astronauts who had travelled there seemed impossibly brave. From that moment, he dreamed of following in their footsteps.

Years later, he would do exactly that.

“It was at that moment I realized I had fulfilled a childhood dream.”

— Robert Thirsk

In 1996, Robert first launched into space and spent 17 days aboard Space Shuttle Columbia. Then in 2009, he spent 6 months in orbit, floating weightless aboard the International Space Station and looking down on Earth from a perspective few people will ever experience. He still remembers the first time he saw the sun rising across the Atlantic Ocean from above.

“It was at that moment I realized I had fulfilled a childhood dream,” said Robert.

But years after returning from space, an unexpected problem here on Earth began affecting his daily life.

More than a pinched nerve

At first, Robert assumed it was a pinched nerve. Whenever he gazed ahead or to his right, numbness and tingling would radiate from his right shoulder down his arm and into his fingers. The sensation disappeared almost immediately when he turned his head the other way. But every time he looked to his right again, it returned.

He thought it would resolve on its own with the help of a few exercises. Instead, it persisted, and the symptoms began interfering with everyday activities such as driving and watching television. As time passed, he also noticed a loss of strength in his upper arm. For someone who has maintained an active lifestyle and pushed the limits of human performance — as an engineer, a physician, and an astronaut — the loss of function was difficult to accept.

“I couldn’t go through the rest of my life only looking to my left,” said Robert.

A novel approach to spine surgery

As the symptoms worsened, Robert was referred to Dr. Safraz Mohammed, neurosurgeon at The Ottawa Hospital. Imaging, including X-rays and an MRI, revealed osteoarthritis in his cervical spine. A degenerated disc at the C5-C6 level had herniated and was compressing a nerve root in Robert’s neck, triggering the numbness, tingling, and weakness that was disrupting his life.

The diagnosis brought an important decision. Traditionally, many patients with this type of condition undergo spinal fusion surgery, a procedure that permanently joins two vertebrae together. While highly effective at relieving pain and stabilizing the spine, it eliminates movement at that level of the spine. For Robert, maintaining the mobility of his neck was essential.

Dr. Mohammed believed Robert could benefit from a novel procedure known as artificial disc replacement. Unlike spinal fusion, artificial disc replacement uses an implanted device designed to preserve movement in the neck while relieving pressure on the affected nerve.

Not every patient is a candidate for the procedure, but Robert’s overall health, active lifestyle, and strong bone quality made him an excellent fit.

“Artificial disc replacement allows us to treat the source of the problem while preserving motion in the neck,” said Dr. Mohammed. “For patients, it can provide excellent symptom relief while helping them maintain the active lifestyle they enjoy.”

It also meant Robert could benefit from expertise available at only a few hospitals in Ontario. Dr. Mohammed is among the region’s leading spine surgeons trained to perform the highly specialized procedure. In fact, he is helping train other surgeons to offer it across the province.

Prepared for launch … and surgery

For Robert, the decision felt surprisingly familiar. Throughout his career as an astronaut, he learned that extraordinary outcomes depend on extraordinary teams. After discussing the risks and benefits of each option with Dr. Mohammed, Robert felt confident he was in the right hands and wanted to move forward with the innovative procedure.

Despite the complexity of the operation, he wasn’t nervous on the day of surgery. His years of astronaut training taught him that trust matters when outcomes depend on a highly skilled team. In many ways, the feeling reminded him of walking out to the launch pad before both of his space missions. “You might think astronauts would be nervous at that moment,” said Robert. “But actually, we’re reflecting on the quality of our training as well as the preparation of our ground support team. Prior to both launches, I had complete confidence in the abilities of myself, my crew mates, and the ground team to accomplish our ambitious mission objectives.”

That same sense of confidence carried him into the operating room.

Speedy recovery

The surgery was completed successfully, and Robert felt the results immediately. When he woke up after surgery, the symptoms that had disrupted his life were gone. “I noticed right away the numbness and tingling had disappeared,” said Robert. “How remarkable!”

What impressed him just as much was the speed of recovery. Even after such a complex operation, he spent just one night in hospital before returning home.

Within a few months, Robert had returned to all of the activities he previously enjoyed, moving freely without experiencing any symptoms.

What happens to the body in space?

While The Ottawa Hospital helped restore Robert’s mobility and quality of life, researchers at our hospital have spent years studying how spaceflight affects the human body.

For decades, Dr. Guy Trudel, a rehabilitation physician and senior scientist at The Ottawa Hospital, has been at the forefront of that work. His internationally recognized research has helped the Canadian Space Agency and scientific partners around the world better understand how prolonged exposure to weightlessness changes muscles, bones, joints, and the spine.

Much of his work combines clinical research with experiments on astronauts in space and space analog studies. In the studies, on Earth, healthy volunteers participate in controlled bed rest experiments that simulate the effects of microgravity. Researchers carefully track changes in muscle strength, bone density, circulation, and the spine using advanced imaging and physiological testing.

“The body adapts remarkably well to space, but returning to gravity places new demands on bones, muscles, and the spine.”

— Dr. Guy Trudel

In space, astronauts grow taller as spinal discs expand without the constant pull of gravity. Many experience back pain during missions, and research suggests spaceflight may increase the risk of spinal problems after returning to Earth.

“We know that spaceflight affects the musculoskeletal system in many ways,” said Dr. Trudel. “The body adapts remarkably well to space, but returning to gravity places new demands on bones, muscles, and the spine.”

His work has also led to important discoveries about changes in bone marrow. The MARROW study, published in Nature Medicine, led to a better understanding of space anemia, a condition which affects astronauts after spaceflight. His team is now entering the next phase of research through the SPARK study, which will build on earlier findings identified through MARROW, with data collected from astronauts before, during, and after spaceflight.

Meet researcher and physician Dr. Guy Trudel

Discover what space travel has taught Dr. Trudel about the human body, how he became interested in this field of research in the first place, and whether he’d ever go to space himself.

Read our Q&A with Dr. Trudel

The impact of this research also extends beyond space exploration.

“The same changes we see in astronauts can also occur in patients who are immobilized for long periods of time,” said Dr. Trudel. By studying how the body responds to weightlessness, researchers are gaining insights that could help improve care for patients on Earth who spend long periods of time in bed due to illness or injury. Those discoveries could help identify new ways to prevent muscle loss, preserve bone health, and improve recovery for patients.

Whether Robert’s spinal ailment was connected to his time in space is impossible to know with certainty, but his experience highlights two areas where The Ottawa Hospital is making a difference: delivering leading-edge care for patients today and while advancing research that could help shape the future of human space exploration.

Life without limitations

Today, Robert is back to the active lifestyle he loves. Looking back, he is grateful for the expertise, innovation, and care that helped restore his mobility. For Robert, the experience was a reminder that exploration takes place at a variety of frontiers, including surgical and scientific.

Whether advancing our understanding of the human body through spaceflight research or offering cutting-edge surgical options closer to home, The Ottawa Hospital continues to push the boundaries of what is possible for patients in Ottawa and far beyond.

Categories: Innovation and Technology, Patient Care, Technology

For years, the dedicated volunteers of The Ottawa Hospital Auxiliary have been a powerful force behind patient care. This year, that extraordinary commitment continues with a remarkable $1.35 million gift to help fund leading-edge equipment that will enhance care for patients across our hospital.

The Auxiliary will support several critical pieces of equipment to ensure patients and healthcare teams have access the tools they need to continue to deliver exceptional care today and into the future. While the equipment itself may not always be visible to patients and families, its impact is felt everyday across our hospital.

Supporting better care for patients

Every piece of innovative technology and advanced medical equipment has the potential to change a life. It could be your neighbour who is rushed to our Emergency Department in need of critical care or a friend undergoing a complex procedure. It could even be a newborn grandchild arriving weeks earlier than expected and in need of specialized care in their first days of life.

When those moments happen, patients and their families count on healthcare teams to have access to the best possible tools and technology. The equipment supported through the Auxiliary will help care teams across The Ottawa Hospital deliver safer, more responsive, and more personalized care.

Advanced patient monitors will help clinicians detect changes in a patient’s condition sooner, specialized neonatal incubators will support vulnerable newborns as they grow and develop, and new airway management technology will help healthcare teams respond quickly during critical moments when every second counts.

Thanks to investments like this, people across the National Capital Region can access world-class care close to home, when they need it most.

Impact powered by our community

The Auxiliary’s gift is a result of thousands of acts of generosity from volunteers, patients, families, staff, and community members who support fundraising efforts throughout the year. From gift shop purchases to volunteer-led initiatives, every contribution helps advance patient care and bring vital equipment to our hospital.

“We are so pleased to be part of the hospital community, and we are focused on continuing to make a positive difference in the lives of TOH patients.”

— Tracy Murphy, President of the Board of Directors, The Ottawa Hospital Auxiliary

“The Auxiliary volunteers, staff, and members choose to be involved with the organization because we believe strongly that our work makes a difference in the lives of patients and families,” said Tracy Murphy, President of the Board of Directors, The Ottawa Hospital Auxiliary. “We see the tangible results of our efforts, and this profoundly impacts everyone connected to the Auxiliary. We are so pleased to be part of the hospital community, and we are focused on continuing to make a positive difference in the lives of TOH patients.”

Learn more about the Auxiliary’s impact here.

Published: June 2026

Read time: 4 min

Published: June 2026

Read time: 4 min

Cheryl Langill didn’t end up at our hospital’s Emergency Department because of one glaring symptom or obvious illness. Instead, a series of subtle changes over time gradually became impossible to ignore.

First, her husband, Steve, noticed shifts in her behaviour that just didn’t feel like the Cheryl he had known for 22 years. She was more irritable than usual and quick to become frustrated in ways that felt out of character.

“I didn’t recognize my wife anymore,” said Steve. Even their teenage children sensed something wasn’t right.

There were also physical changes. Cheryl experienced small facial spasms that would come and go. Then, during a routine eye exam, she learned the vision in her left eye had significantly deteriorated.

But even then, when her family raised concerns, Cheryl struggled to recognize how much had changed. From her perspective, nothing was seriously wrong. As the changes progressed, the impact on Cheryl’s daily life became harder to ignore. They even impacted her work performance, and eventually, she lost her job.

“I remember people telling me something wasn’t right, but I just didn’t see it,” said Cheryl. “I kept telling everyone I was fine because I felt like myself.”

On their own, Cheryl’s symptoms didn’t seem particularly alarming. But together, they told a different story — one that ultimately led to her husband bringing her to our Emergency Department in search of answers.

A life-altering diagnosis

What Cheryl’s care team discovered during that hospital visit in June 2021 sent shock waves through the Langill family.

A CT scan revealed a large brain tumour — a meningioma the size of a golf ball that had likely been growing undetected for years. Over time, the tumour began pressing against critical areas of her brain, causing the changes in vision and behaviour, and even limiting her ability to recognize something was very wrong.

“The tumour was located in the front part of the brain,” explained Dr. Safraz Mohammed, neurosurgeon at The Ottawa Hospital. “That area plays a significant role in personality, judgment, and behaviour.”

In Cheryl’s case, the tumour was also affecting her optic nerve, which explained the vision loss in her left eye.

Although the tumour was benign and slow growing, its size and location made it dangerous. Without surgery, her condition would continue to deteriorate, so a complex surgery was Cheryl’s only option.

Left: Before surgery, Cheryl’s scan shows a large meningioma pressing on critical areas of the brain. Right: After surgery, most of the tumour has been safely removed, significantly improving her condition.

Planning for a high-risk surgery

Before moving forward, Cheryl’s care team acted quickly to stabilize her condition: medication to reduce swelling in her brain and anti-seizure medication to prevent further facial spasms.

At the same time, a highly detailed surgical plan was already taking shape. The procedure would require removing a portion of the front part of her skull and the bones around her left eye to safely access the tumour. From there, surgeons would use advanced tools, including an ultrasonic aspirator, to carefully break down and remove the tumour while preserving the surrounding brain tissue.

Meet Neurosurgeon Dr. Safraz Mohammed

Find out more about how Dr. Mohammed is pushing the boundaries of neurosurgery and commitment to educating the next generation of doctors.

Read our Q&A with Dr. Mohammed

This technology allows surgeons to target the tumour cells while protecting the healthy parts of her brain — a precision that is essential when operating in such a sensitive area.

“Every movement matters in brain surgery,” said Dr. Mohammed. “You’re constantly balancing how much you can safely remove while protecting the parts of the brain that make someone who they are.”

Inside the operating room

Just five days after arriving at our hospital, Cheryl was in the operating room for lifesaving surgery.

“I didn’t even know anything was wrong, and then suddenly I was preparing for brain surgery.”

— Cheryl Langill

“It was a lot to take in,” said Cheryl. “Just days before, I didn’t even know anything was wrong, and then suddenly I was preparing for brain surgery.”

Over the course of the complex and intricate eight-hour surgery, Dr. Mohammed and his team worked meticulously to remove the tumour, but a portion of it was compressing a critical artery that supplies blood to the brain.

Removing that portion of the tumour would reduce the chance of it continuing to grow, but operating near such an important artery required extreme precision — even the slightest disruption to blood flow could have serious consequences.

“This is an important part of the brain that affects movement and speech,” said Dr. Mohammed. “So, you’re not just thinking about the surgery in front of you — you’re thinking about what any decision could mean for the patient long term.”

The team made the decision to carefully proceed. During that process, Cheryl experienced a small stroke — a known risk in a surgery of this complexity. To prevent further harm, the team chose to stop short of removing the small piece of remaining tumour.

Despite the challenge, the surgery was considered a success. Most of Cheryl’s tumour had been safely removed, relieving the pressure on her brain and optic nerve, preventing further damage.

The road to recovery

In the days that followed, Cheryl began her recovery in hospital, supported by a team of physiotherapists, occupational therapists, nurses, and physicians who worked together to help her regain strength and independence.

“A patient’s vision doesn’t often return in cases like this.”

— Dr. Safraz Mohammed

Early signs of recovery were encouraging. Her vision drastically improved, and the changes in her personality and behaviour that had concerned her family started to fade.

“It was a big relief,” said Steve. “It felt like we were getting Cheryl back.”

For her care team, those early improvements were significant. “A patient’s vision doesn’t often return in cases like this,” said Dr. Mohammed. “This was a very positive outcome.”

Advanced radiation treatment

While surgery removed most of the tumour, Cheryl’s care didn’t end there.

In 2024, follow-up imaging showed the remaining portion of her tumour had started to grow. To address this, Cheryl underwent targeted radiation treatment at The Ottawa Hospital Cancer Centre.

This treatment used highly precise technology to deliver radiation directly to the tumour while minimizing exposure to surrounding healthy tissue. It offered a non-invasive option to help control tumour growth without the risk of another major surgery.

For Cheryl, it was an important additional step in managing her condition safely and effectively.

Looking ahead

Today, a year after her final radiation treatment, Cheryl’s most recent scans show her tumour has stopped growing. While her journey isn’t over, the outcome so far is encouraging.

Now, she volunteers at The Ottawa Hospital Cancer Centre, supporting patients and families who are navigating their own difficult journeys — something that has become deeply meaningful to her.

“I’m so grateful for the care I received, and volunteering is my way of giving back to the hospital that saved my life.”

— Cheryl Langill

“I know how overwhelming it can feel to be a patient,” said Cheryl. “I’m so grateful for the care I received, and volunteering is my way of giving back to the hospital that saved my life.”

For her family, the difference is already clear. It’s a reminder of how far Cheryl has come and what was made possible through expert care, advanced technology, donor support, and a team that was ready when it mattered most.

Categories: Neuro, Patient Care, Technology

Published: October 2025

Read time: 3 mins

Published: October 2025

Read time: 3 mins

When Danika Fleury decided to move to Ottawa to kick off her teaching career, it was about having the opportunity to experience a big city. Little did she know, at such an early stage in life, she would need access to a hospital that specializes in complex medical care. From an early-stage breast cancer diagnosis to endometriosis surgery, The Ottawa Hospital was ready when Danika needed answers.

This elementary school teacher at Broadview Public School grew up in Sudbury, Ontario, and made the move to Ottawa in 2014. Since then, she has loved living in Canada’s capital — exploring the green spaces, bike paths, and all the festivals our city has to offer.

At the end of summer in 2021, Danika and her fiancé were planning to elope to British Columbia. Leading up to that time she noticed a lump in her breast seemed to be getting bigger. “I’ve always had lumps in my breasts. So, from time to time I would have an ultrasound, and there was never anything to worry about. But this one lump was bigger than the rest, and seemed to be growing,” explains Danika.

Discovery of a growing lump

Her doctor suggested an ultrasound and she and her fiancé went ahead with their wedding plans and enjoyed a beautiful ceremony. “It was enchanting — like a fairy tale. During that amazing trip, I do remember thinking ‘What if I have cancer?’ Then I thought, ‘I’m young and I’m healthy. This doesn’t happen to young people.’”

Upon her return, and back to the classroom, it was well into the fall when she finally booked the ultrasound. Within hours of that test, Danika received a call about scheduling a biopsy. “Immediately my heart sank.”

“I had been worried, but I really didn’t think it was going to happen. I was only 30 years old. That’s when everything changed.”

— Danika Fleury

By the new year, Danika received the news she never expected to hear, she had breast cancer. It was on the day of her biopsy, our specialized team conducted an ultrasound and discovered a smaller hidden lump which turned out to be cancerous. The initial lump was benign. “I was shocked. I had been worried, but I really didn’t think it was going to happen. I was only 30 years old. That’s when everything changed.”

From there, Danika was referred to The Ottawa Hospital’s Rose Ages Breast Health Centre at the General Campus where she met with surgeon Dr. Lisa Findlay-Shirras.

The good news for Danika was her breast cancer was in an early-stage. But because she was so young, that brought other aspects for the care team to consider.

“She went through genetic testing, which we do for many of our younger patients. Thankfully that was negative,” explains Dr. Findlay-Shirras. “We removed the tumour and she chose to have a mastectomy, to avoid the need for radiation, and then breast reconstruction, which is often the choice for a lot of our younger patients.”

Helping young women navigate through cancer and fertility

Another important factor for young patients is their family planning. “We don’t want a patient, like Danika, to get pregnant for a couple of years when it’s a hormone sensitive tumour where the risk of recurrence is highest. I remember that being a really difficult recommendation for Danika to reconcile,” adds Dr. Findlay-Shirras. 

The Ottawa Hospital has a new program, started by medical oncologist Dr. Amirrtha Srikanthan, especially for young women. According to Dr. Findlay-Shirras these patients require a different approach because they have to make difficult discussions about fertility.

“If you haven’t had your family yet when you get diagnosed with breast cancer, it’s reconciling the future you had envisioned for yourself and how it might be affected, and potentially not possible, because of breast cancer treatment. And that’s something you must grieve, which is really hard. So, having resources that are specific to young women is essential.”

Newly married, and ready to start a family, this was difficult for Danika. Due to her breast cancer diagnosis, she had to stop taking birth control pills because the hormones involved can lead to potential recurrence. That’s when she developed symptoms of endometriosis. “I had painful periods and ovarian cysts from a young age. In my 20s, severe pelvic pain led my gynecologist to suspect endometriosis and put me on continuous birth control to suppress my symptoms,” explains Danika. “When I stopped, the endometriosis reared its ugly head and my symptoms became debilitating, setting off a wave of new referrals, tests, and ultimately another surgery.”

What is endometriosis?

Dr. Sony Singh, surgeon and Head of Obstetrics, Gynecology, and Newborn Care, at The Ottawa Hospital has been advocating for people living with endometriosis for years. It’s a chronic condition where tissue like the lining of the uterus, grows outside the uterus in the pelvic area. It’s often experienced as painful periods and patients are put on the birth control pill or other hormonal medications. While this may reduce the pain, it doesn’t stop the progression of the condition. 

“Women are often told their pain is normal and they should live with it. There’s still a lot of misunderstanding and confusion about the disease,” says Dr. Singh.

Meet Dr. Sony Singh

Find out how he’s changing the ways we find and treat endometriosis at The Ottawa Hospital.

Read our Q&A with Dr. Singh

It’s important to recognize that not all women want to be on hormones and some can’t be, like Danika after a breast cancer diagnosis. That’s when the team at the Shirley E. Greenberg Women’s Health Centre needs to look into alternatives, such as non-hormonal treatment options and/or surgery. Surgery, in complex cases, requires an interdisciplinary team with advanced expertise. “The Ottawa Hospital’s endometriosis expertise is nationally recognized as one of the best,” says Dr. Singh.

Danika’s case was certainly a standout to Dr. Singh and his team. “This is one of the most complex cases that I, and our hospital, has ever done for endometriosis.”

All endometriosis

Find out more about endometriosis: who first found it, why it happens, and how The Ottawa Hospital can help.

Learn more

Planning a complex endometriosis surgery

What many don’t know is endometriosis can go beyond the pelvic area and invade other organs such as the bowel, the bladder, ureter, and the kidneys. In Danika’s case, Dr. Singh credits Dr. Kelly Harper, a diagnostic radiologist, who has specialized training in this area, for conducting advanced imaging and determining that Danika’s endometriosis had invaded into the pelvic nerves, which support muscle function, and the ability to walk and move.

"Advanced radiology imaging for endometriosis is something we’re well known for.”

— Dr. Sony Singh

“For the first time at The Ottawa Hospital, we have an expert who’s able to tell me that it’s invading the pelvic nerves and that’s an amazing step for us and our patients. Advanced radiology imaging for endometriosis is something we’re well known for,” says Dr. Singh.  

Not only was the team able to identify what was causing all the pain for Danika, but there is also a research program that does virtual reality (VR) through a hospital start-up known as Realize Medical. They created a VR model of the pelvis to not only give this young woman a better understanding about how the disease was impacting her, but also to help the team prepare for surgery.

“All of this together provides this individual with care close to home — patients who would have otherwise had no options or had to travel outside the country to get this care,” adds Dr. Singh.

“This is a complex pelvic-neurosurgery and we’re conducting top-level prep for complex women’s health that has been limited to a few institutions globally.”

— Dr. Sony Singh

The University of Ottawa Skills and Simulation Centre at the Civic Campus is where Dr. Singh brought together his team in advance of Danika’s surgery. Dr. Singh explains that thanks to the VR model, they were able to simulate the surgery and understand exactly what would happen in the operating room. “This is a complex pelvic-neurosurgery and we’re conducting top-level prep for complex women’s health that has been limited to a few institutions globally”

“Every single person that I interacted with during my care was so lovely, warm, and kind. They were very respectful of me as a person and my wishes and really took the time to understand what was important to me.”

— Danika Fleury

Since the surgery in early September 2025, Danika continues to be cared for by two specialized teams at The Ottawa Hospital. “I’m healing well and already feeling significant relief from pain. I can’t thank Dr. Singh and his team enough for their care, expertise, and use of advanced technology in managing my complex surgery. They have preserved my mobility, restored my overall wellbeing and reproductive health, and most importantly, given me hope, and the chance to get back to living my life fully.” 

While she never expected this intensive type of medical care at her age, she’s grateful to each care provider who has helped her along the way.

“Every single person that I interacted with during my care was so lovely, warm, and kind. They were very respectful of me as a person and my wishes and really took the time to understand what was important to me.”

For Dr. Singh, he’ll continue to advocate to ensure more people understand there is hope. “The Shirley Greenberg Women’s Health Centre is a centrer of excellence for endometriosis. We have hired a triage nurse who helps triage all the referrals from family doctors. The more people know, the more we can help these women who have suffered for too long.”

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

Published: May 2025

The Ottawa Hospital is creating a comprehensive epilepsy program — a one-stop shop, if you will — that will have a huge impact on patients. As a complement to this specialized care, the hospital completed its first-ever stereoelectroencephalography (stereo EEG) procedure on January 13, 2025. This minimally invasive surgery identifies the precise areas in the brain where seizures originate and provides care teams with detailed information to develop more targeted and effective treatment plans for those with epilepsy.

Previously, patients from our region needed to travel to Southern Ontario for this type of procedure. Now, care can be delivered closer to home, saving patients time, money, and allowing them to stay close to family.  

“We’ve all seen it on TV or in the movies.”

Epilepsy is a neurological disorder, and a seizure is a sudden burst of electrical activity in the brain that causes a temporary disturbance in the way brain cells communicate with each other. The kind of seizure a person has depends on which part and how much of the brain is affected by the electrical disturbance.

A seizure may take many different forms, including a blank stare, uncontrolled movements, altered awareness, odd sensations, such as smelling something that’s not actually there, or convulsions.

Dr. Tadeu Fantaneanu, the Medical Director of the Epilepsy Program in our EEG laboratory, explains the latter is known as tonic-clonic seizure, previously called a grand mal seizure. “That’s when the person falls to the ground, foams at the mouth, and shakes. We’ve all seen it on TV or in movies.”

Our program serves approximately 13,000 people living with epilepsy in our region. We also have what’s called a transfer and transition clinic with CHEO. “Those are patients who have had epilepsies since they were quite young, potentially since birth or later on in their childhood years or adolescent years, and they get referred to us when it comes time to transfer into adult care,” he says.

According to Dr. Fantaneanu, epilepsy can affect anyone at any age, but there are two peaks — prior to age six and over 65. In young patients, it’s usually because of genetics, and in older patients, it’s often because of the damage that a brain will accumulate over a lifetime.

Building a comprehensive epilepsy program

In the last five years, our hospital’s Epilepsy Program has grown tremendously, thanks to a partnership with the Ministry of Health and a $12-million grant, as well as donations from the community. As Dr. Fantaneanu explains, the goal of the grant is for The Ottawa Hospital to become a regional epilepsy surgery centre. That’s a provincial designation and it will ensure that we will have the ability to perform high-level surgeries that are not currently available in this region.

Dr. Fantaneanu says this is something patients in Eastern Ontario desperately need. “They could have their tests and care done here, but eventually, if surgery was needed, they would be a referred to a hospital in Toronto or London — as many as seven to eight hours away.”

Travel that takes time, money, and patients away from their loved ones and careers. “Patients would have to be away from their families at a vulnerable time in their lives, when they’re admitted in the hospital, potentially after a brain surgery,” he adds.

Over the course of the past several years, Dr. Fantaneanu and his team have built up testing capabilities for patients and the monitoring unit continues to grow. It’s where the team evaluates patients who have seizures. It’s currently a four-bed unit and at the new hospital campus it will be a six-bed unit — all private rooms. 

Attracting the best and the brightest in epilepsy care

It was the impressive plans to build a comprehensive epilepsy centre that attracted Dr. Alan Chalil to our hospital in 2024, to become the Surgical Director of the Epilepsy Program. He is a neurosurgeon with training focused mainly on epilepsy and surgical treatment of epilepsy — that includes implantation of stereo EEG. He completed his training in London, home of the largest surgical epilepsy centre in Canada, and Emory University in Atlanta.

“It was a very unique opportunity because it seemed like bringing in my training would be the last piece of the puzzle to fit into that whole picture in terms of how to treat epilepsy,” says Dr. Chalil. “Coming to a new team that’s being developed was a nice opportunity and also a big challenge.”

“Epilepsy surgery is about finding that delicate balance: freeing the patient from seizures while preserving the brain’s normal function. That’s why it means so much to me."

— Dr. Alan Chalil

As he explains, while epilepsy surgery has been practiced for over 80 years, the transition to stereo EEG in North America continues to highlight many unknowns. “Epilepsy doesn’t have to define a person’s life, but its unpredictable nature can still disrupt it in profound ways. Seizures can interfere with everything — work, relationships, social life, even financial stability,” explains Dr. Chalil. “Epilepsy surgery is about finding that delicate balance: freeing the patient from seizures while preserving the brain’s normal function. That’s why it means so much to me.”

Meet neurosurgeon Dr. Alan Chalil

Learn more about how our experts in The Ottawa Hospital’s life-changing Surgical Epilepsy Program are giving patients their lives back every day.

Read our Q&A with Dr. Chalil

The first stereo EEG at The Ottawa Hospital

An EEG is the recording of brain waves by putting small electrodes on the patient’s head, which are connected to a computer, and recording electrical activity in the brain. It helps diagnose a variety of brain conditions.

In contrast, the stereo EEG places these electrodes inside the brain through tiny pinholes. In January 2025, Dr. Chalil performed our hospital’s first-ever stereo EEG. This minimally invasive surgery identifies the precise areas in the brain where seizures originate.

“There could be anywhere between 10 to 20 electrodes per patient. We make a small nick in the skin, like a pinhole, and then drill into the skull,” he explains. “We have a defined trajectory — we know exactly where we are going and what structures we’re going to pass through to get to our target. Then we put the electrode in. It takes about 10 to 15 minutes per electrode.”

Once the patient wakes up, with the implanted electrodes, they get a CT scan. From there, Dr. Chalil will build a model for his colleagues on the neurology team that tells them where each electrode is placed in the brain. This helps determine where the seizure is starting and where it is spreading.

“The patient is then admitted to the Epilepsy Monitoring Unit (EMU) for a week or up to a month, sometimes even longer, until we get enough seizures to study,” he says.

The team then correlates the electrical signal they saw from the electrodes during a seizure, along with their previous information, and come up with a treatment plan. Treatment options can vary from removing a small section of the brain, to deep-brain stimulation, or even a newly acquired piece of technology called the radio frequency generator.

This new tech can be brought right to the patient’s bedside where Drs. Fantaneanu and Chalil can send an electric signal to generate a lesion that’s about 3 to 5mm thick. “It’s very small, but it’s very effective. And that lesion could cause a disruption in the epilepsy network and eliminate seizures up to 30% of the time,” Dr. Chalil explains.

While that number isn’t huge, he adds it’s reasonably effective because no other surgery is required.

“It's the last piece in a big picture to make Ottawa a centre of excellence for treatment of epilepsy.”

— Dr. Alan Chalil

As the team continues to further establish the program, they look to add new laser technology to provide patients with even better results, which can eliminate seizures from 60 to 75% of the time, depending on the type of seizure. They also hope to use these techniques in the coming year, driven in large part by an ongoing randomized controlled trial. “It’s called the slate trial, and it will give us a definitive number of comparisons between temporal lobe resection and laser ablations in treating a specific type of temporal lope epilepsy,” says Dr. Chalil.

For now, the completion of five stereo EEGs is a significant step. “It’s the last piece in a big picture to make Ottawa a centre of excellence for treatment of epilepsy. If we demonstrate that we can do it, interpret it safely, and produce meaningful surgeries out of it, then these patients will not need to travel anywhere else,” says Dr. Chalil.

Learn more about The Ottawa Hospital’s Epilepsy Program in episode xx of Pulse Podcast with Dr. Tadeu Fantaneanu.

Listen Now:

Categories: Innovation and Technology, Patient Care, Strengthening Critical Services, Technology

Published: March 2025

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

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

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

Trigeminal neuralgia’s excruciating progression

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

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

— Michelle Kupé

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

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

All about trigeminal neuralgia

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

Learn more

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

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

Debilitating shocks to Michelle’s body

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

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

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

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

Read our Q&A with Dr. Sachs

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

— Dr. Adam Sachs

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

Modern microsurgical technique with the help of Teflon

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

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

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

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

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

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

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

Pain is an invisible disease

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

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

— Dr. Adam Sachs

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

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

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

The scar from Michelle’s surgery

"The relief was immediate."

— Michelle Kupé

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

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

Regaining her life back

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

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

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

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

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

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

Listen Now:

Categories: Neuro, Patient Care, Technology

Published: September 2024

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

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

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

Designing state-of-the-art operating rooms

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

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

– Lisa Young

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

Optimizing workflow in and around the ORs

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

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

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

– Dr. Sudhir Sundaresan

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

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

New neurosurgery rooms will come with innovative technology

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

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

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

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

Digital solutions for a proactive approach to care

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

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

– Glen Kearns

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

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

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

– Mathieu LeBreton

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

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

The role of AI

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

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

A hub for biotherapeutics research

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

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

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

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

Looking ahead to the next century of healthcare in Ottawa

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

Together, we are creating tomorrow for generations to come.

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

Published: July 2024

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

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

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

Chris and her husband together at their horse ranch

Brain aneurysm brings patient to the Civic’s Emergency Department

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

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

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

— Chris Scharff-Cole

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

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

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

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

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

— Dr. Robert Fahed

What is pulsatile tinnitus?

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

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

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

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

Pioneering a new treatment for pulsatile tinnitus

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

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

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

— Dr. Robert Fahed

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

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

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

Not settling for the status quo

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

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

– Dr. Robert Fahed

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

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

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

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

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

Listen Now:

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

Published: April 2024

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

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

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

Grasping the complexity of a Ewing sarcoma tumour

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

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

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

A collaborative team effort

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

— Dr. Joel Werier

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

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

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

Stepping inside the patient through VR

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

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

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

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

Q&A with Dr. Rawan Rakhra

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

VR at The Ottawa Hospital

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

VR in action

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

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

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

A whole new perspective for the surgical team

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

Emeric in hospital after surgery.

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

— Emeric Leblanc

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

Emeric camping.

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

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

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

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

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

Listen Now:

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

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

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

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

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 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 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 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 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.

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.

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

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