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Excruciating chest pains woke Phyllis Holmes from a deep sleep. A trip to the emergency room revealed a twist in her small intestine. Doctors used an uncommon technique that involved leaving her abdomen clamped open for two days after surgery – it’s the reason Phyllis is alive today.

The first of many miracles

For 18 months Phyllis experienced on-and-off pain in her chest. Some episodes lasted for only a few minutes, while others lasted for several hours. Unable to pinpoint the cause of her pain, Phyllis’ doctor started an elimination process; sending her for various tests, including a visit to the University of Ottawa Heart Institute. When results revealed it wasn’t her heart that was causing such discomfort, doctors ordered a CT scan hoping it would provide some answers.

However, only a few days prior to her scheduled appointment, Phyllis jolted awake in excruciating pain. Lying next to her, concerned, was her husband, Brian Jackson, who insisted they pay a visit to the emergency room. Her pain persisted as they checked in at The Ottawa Hospital’s General Campus. Recognizing the severity of her pain, the admitting staff immediately put her in an examination room.

A life-threatening diagnosis

Dr. Guillaume Martel and Phyllis Holmes embrace at The Ottawa Hospital. — *Dr. Guillaume Martel and Phyllis Holmes*

After several tests, Phyllis underwent a CT scan. The results showed her life was on the line.

As Phyllis recalls her experience, she describes hearing only one thing – they would need to perform emergency surgery immediately. “That was all I heard,” said Phyllis. “We have to do emergency surgery or you may be faced with a life-threatening circumstance.”

What the CT scan revealed was a small twist in her intestine, causing her entire bowel to turn purple, almost black. “Her whole small intestine was dying,” said Phyllis’ surgeon, Dr. Guillaume Martel, “which is not survivable. But we got to her quickly, and that day, things lined up perfectly.”

Traditionally, with a bowel in such a condition, surgeons would have removed the section of the bowel that was compromised. However, in Phyllis’ case, almost her entire bowel was jeopardized. Removing such a large portion of her bowel would have reduced her to being fed through IV nutrition for the rest of her life.

A mid-surgery decision

Once Phyllis was in the operating room, doctors were able to more accurately assess the severity of the damage caused to her intestine. Some vitality in her bowel remained— an encouraging sign that there was a chance it could be saved. Rather than remove the intestine, they decided to leave her abdomen clamped open and wait.

For two days Phyllis lay sedated in the intensive care unit, her abdomen left open. Throughout that time, Brian recalls the nurses and doctors were attentive and compassionate, letting him know what was going on every step of the way. “I was always in the loop about what was going on,” said Brian, something that he was grateful for during a particularly emotional and stressful time.

“Leaving a patient open can be a form of damage control,” explained Dr. Martel. This technique relieved a lot of pressure in Phyllis’ abdomen, allowing time to see whether her bowel would survive. However, it can be difficult for a doctor to know if this technique will work for one patient over another. Luckily, in Phyllis’ case, it did.

The wait was over

When Phyllis was brought back to the operating room for her second surgery, Dr. Balaa, the surgeon, told Brian what to expect. It could be a long procedure, where they would remove part of her intestine, and in its place attach a colostomy bag. Brian settled in for a long and stressful wait, unsure of what life might be like once Phyllis’ surgery was complete. But less than an hour later, Dr. Balaa appeared with incredible news.

When they took off the covering, a sheet that protected her abdomen while she lay clamped open, her intestine was healthy and back to normal again. To their amazement, her intestine remained viable and all they needed to do was stitch her back up.

Recovery period

The next morning Phyllis woke to Brian’s warm smile at her bedside. While she was unaware of the incredible turn of events, she was grateful to be alive.

She remained at the hospital for a week after the first surgery. While she recovered, Phyllis recalls receiving exceptional care. “The doctors always had so much time for me when they did their rounds,” said Phyllis. “They were very patient and engaged in my situation, it was heartwarming and wonderful.” Phyllis was so grateful, she wanted to show her appreciation.

Showing Gratitude

Dr. Guillaume at The Ottawa Hospital — *Dr. Guillaume Martel was part of a team that saved Phyllis’ life.*

That’s when Phyllis heard of the Gratitude Award Program. This program was developed as a thoughtful way for patients to say thank you to the caregivers who go above and beyond to provide extraordinary care, every day. It’s a way for patients, like Phyllis, to recognize caregivers by giving a gift in their honour to The Ottawa Hospital. The caregivers are presented with a Gratitude Award pin and a special message from the patient letting them know the special care given did not go unnoticed.

Honouring Dr. Martel and several others through the Gratitude Award Program was a meaningful way for Phyllis to say thank you. “I wanted to be able to give something in return,” said Phyllis.

Dr. Martel was touched by the gesture. “When you receive a pin from a patient like Phyllis, it’s very gratifying,” explained Dr. Martel. “It’s something you can feel good about receiving.”

A healing experience

Phyllis’ journey at The Ottawa Hospital was far more than an emergency room visit and two surgeries. When asked to reflect on her experience, she tells a story of compassionate care and healing, both physically and mentally. “I felt that even though I was there to heal physically, I was getting psychological support as well,” Phyllis explained. “Everyone would use eye contact, or they’d touch my hand with compassion. It was very personal. I saw the divinity in those people,” explained Phyllis. “I saw it. I experienced it first-hand. And it is healing. That is the healing that takes place when you have those very special encounters. It heals you.”

Today, Phyllis feels incredibly grateful for the care she received at The Ottawa Hospital. “It was second to none,” she said.

Dr. Guillaume Martel

In August 2019, Dr. Guillaume Martel was announced as the first Arnie Vered Family Chair in Hepato-Pancreato-Biliary Research. Dr. Martel is a gifted surgeon at The Ottawa Hospital who has saved and prolonged the lives of countless patients, particularly those with cancer. An international search conducted for this Research Chair found the best candidate right here in Ottawa. This Research Chair provides the opportunity for innovative clinical trials and cutting-edge surgical techniques that will benefit our patients for years to come. This was made possible through the generous support of the Vered Family, alongside other donors.

“When Arnie got sick, he needed to travel to Montreal for treatment. It was so hard for him to be away from home and our six children. We wanted to help make it possible for people to receive treatment right here in Ottawa. This Chair is an important part of his legacy.” – Liz Vered, donor

You can hear Dr. Guillaume Martel discuss complex abdominal surgeries as well as his research into pancreatic, liver, and bile duct cancers by downloading Pulse podcast.

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

Categories: Donors, Gratitude Award, Innovation and Technology, Patient Care

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,

Hospital around the world are looking to The Ottawa Hospital tDr. Fahad AlKherayf and Dr. Shaun Kilty standing in an operating room at The Ottawa Hospital. — *Hospitals around the world are looking to The Ottawa Hospital to learn about the type of minimally invasive brain surgery performed by Dr. Fahad Alkherayf (right) and Dr. Shaun Kilty.*

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.

Denis Paquette sitting outside at a table at The Ottawa Hospital. — *Denis Paquette’s hearing was restored after receiving minimally invasive brain surgery at The Ottawa Hospital.*

“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.

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

Categories: Innovation and Technology, Neuro, Technology

Local activist donor pledges $500,000 to take on cancer

*Gavin Murphy takes pride in describing himself an activist donor.*

Gavin Murphy is unwavering when it comes to his desire to maintain a world-class health care system in our city. He’s unwilling to settle for anything less and he doesn’t think anyone in our community should either. Gavin believes each resident needs to play an active role in giving back, and that’s why this self-described “activist” donor is sharing his story – a story he hopes will lead to a cure for cancer.

This New Edinburgh resident has committed $500,000 to support the Radiation Medicine Program at The Ottawa Hospital – it’s what he wants his lasting legacy to be.

While the Ottawa lawyer isn’t looking for public recognition, he’s not shy about sharing the news of his gift as he hopes it will inspire others to do the same. “Scarce government resources requires those in a position to give significant gifts to step forward and support The Ottawa Hospital.” Gavin adds, “By giving serious thought to my philanthropy, I am hoping to help improve discovery and care for our families, friends, and neighbours.”

Gavin’s interest in cutting-edge research is what enticed him to make this tremendous gift to Radiation Medicine Program with the hope that findings will one day be published. He’s excited about the opportunities which lie ahead and the advancements that will be made.

“I want to give this money while I’m still alive. It’s great that people leave money in their estates, I think that’s wonderful but I want to see the fruits of my labour, in my lifetime.” – Gavin Murphy

It’s the fruits of his labour, which will leave his fingerprints on advancements in cancer care to help others in the future. For Gavin, that’s truly exciting. “I like the idea of funding new, innovative technology. It will leave a lasting legacy and this gift is providing the building blocks for future research in this field.”

Donor support is vital to providing doctors and researchers with state-of-the-art tools. It’s also what allows The Ottawa Hospital to be a trailblazer when it comes to transformational advancements. Dr. Miller MacPherson, the Head of Medical Physics at The Ottawa Hospital says, “It’s the generosity of donors like Gavin which allows The Ottawa Hospital to be innovative with new technologies. This support will provide insight for new discoveries and will have an impact on care through research and technology advancements in the field of cancer research.”
Dr. Jason Pantarotto, Head of Radiation Oncology at The Ottawa Hospital, echoes that sentiment, noting that donations to the Radiation Medicine Program are particularly precious. “Despite radiotherapy being a key treatment for nearly 5,000 cancer patients each year in Ottawa, the amount of research dollars available to improve the science is pretty sparse. We are extremely grateful to donors, such as Gavin, who see the benefits of investing in the team and equipment that exists here at The Ottawa Hospital.”

For Gavin, his ultimate goal is to help find a cure for cancer.

“This gift will provide a foundation to greater understanding of cancer and I hope it will help obliterate cancer sometime down the road.”- Gavin Murphy

The reality is The Ottawa Hospital will touch each person in our community in some way. For Gavin, that’s a good reason for not only himself but also for others to step forward. “If people want to be well looked after in a world-class system, we have to ensure a world-class system is maintained.”

The way Gavin sees it, we’ll all need The Ottawa Hospital at some point, and there’s a way for each person in our community to support it. “You need people who are in the position to give, and those who can give smaller amounts, in greater numbers to support the hospital equally.”

Download Pulse podcast to hear Gavin’s message to the community about why future support is critically important.

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

Categories: Cancer, Donors, Innovation and Technology, Technology, World-Leading Research

It was an unimaginable brain tumour diagnosis that Natasha Lewis never saw coming. It started one morning, in 2016; the mother of three remembers waking up with a strange symptom.

“I looked in the mirror and noticed my tongue was twisting to the left,” recalled Natasha. Her first thought was that she had a stroke, but she was confused by the fact the rest of her body seemed normal.

She went for tests at The Ottawa Hospital  and three days later, her life changed. Natasha was driving when she got the call. Tests revealed a tumour in her brain. “I felt so sick when I heard the news that I had to pull over.”

Diagnosis shatters mom’s world

Natasha had a schwannoma tumour on her hypoglossal nerve, which controls the tongue. Schwannomas are rarely found in the brain and even more rarely on that specific nerve. Her mind was racing. “I was only 38 years old, a wife, and mother of three young children.”

When she got home to St. Isidore, east of Ottawa, she sat with her youngest daughter as she relayed the information to her husband. “I had tears falling down my face. I didn’t know what was going to happen.”

All this time she thought she was healthy. “I was losing weight, running, and training for marathons and triathlons.” All she could think about were her three, beautiful, young children. What would this mean for them?

“We’re in the right place. We’re in Canada, we’re close to Ottawa, we’ll get the best care.”
– Marvin Lewis

However, her husband, Marvin, was a pillar of strength. She remembers him saying, “We’re in the right place. We’re in Canada, we’re close to Ottawa, we’ll get the best care.” She adds, “He has never been so right.”

What is a schwannoma?

Schwannomas are nervous system tumours that occur in Schwann cells, which are found in the nerve sheath — the tissue covering the nerves. They most often occur in the peripheral nervous system, which runs throughout the whole body. More rarely, they occur in the central nervous system, which includes the brain and spinal cord. While they are usually benign — or noncancerous — in very rare cases, schwannomas can become cancerous.

The challenge of non-cancerous brain tumours

Natasha was cared for at The Ottawa Hospital – one of the few hospitals in Canada that could help her because of the complexity of her diagnosis. Dr. Fahad Alkherayf, a world-class skull base surgeon told her the tumour was benign and he would closely monitor her in the months ahead.

Normally, a schwannoma is a tumour that grows in the sheaths of nerves in the peripheral nervous system, or the parts of the nervous system that aren’t in your brain or spinal cord. Schwannomas are usually low-grade tumours, meaning they can often be successfully treated, but they’re still serious and can be life-threatening. It is estimated that in 2021, there will be 27 new primary brain tumours diagnosed every day in Canada. Non-malignant tumours account for almost two-thirds of all primary brain tumours.

Condition deteriorating

Less than a year later, while the tumour had grown only slightly, Natasha’s quality of life was deteriorating.

She was scared to see what was happening with her body. Initially, there was drooling from both sides of her mouth, then Natasha started slurring her words. It was a little embarrassing, but she could handle it. In addition, swallowing became more difficult and her shoulder felt like it was on fire. That’s when she lost the ability to move it and couldn’t use it to work out. Even worse, she couldn’t lift her children.

By May 2018, it was time to operate when the side effects continued to worsen.

Surgeons ready for complex procedure

It was an intricate 10-hour brain surgery. Dr. Alkherayf brought in ear surgeon, Dr. David Schramm, a colleague at The Ottawa Hospital, to assist because of where the tumor was located. Dr. Alkherayf wanted to have another highly-skilled surgeon with him because the tumour was near the ear canal.

Hospital-bound Natasha with Dr. Fahad Alkerayf — Natasha with Dr. Alkherayf

The surgical team accessed her brain through the base of the skull. While minimally invasive surgeries are becoming more common than open surgeries, where the brain is accessed through a more invasive and significant incision, it wasn’t an option for Natasha because there were too many nerves to navigate. With traditional surgery, patients can spend a week recovering in the hospital.  With minimally invasive surgery, they sometimes go home the same day. In Natasha’s case, though complex and intricate, open surgery was the less risky option and she benefitted from the expertise available to her right here in Ottawa.

Dr. Alkherayf knew they likely couldn’t remove all of the tumour because of those surrounding nerves; damaging them meant Natasha might  lose her ability to hear and swallow. While these risks were terrifying for Natasha, Dr. Alkherayf made her feel confident and gave her hope.

“I remember Dr. Alkherayf said there would be another chapter in my life. I held on to those words.”
– Natasha Lewis

Incredibly, her surgeons were able to remove ninety-nine percent of the tumour leaving only a small sliver so they didn’t have to cut the nerves.

Journey continues after remarkable recovery

Following her surgery, Natasha made a remarkable recovery. She has her hearing — it’s a little muffled but she’s told over time it will return to normal. She’s back at work, her speech is back to normal, and she can swallow without difficulty.

This active mom’s recovery has been nothing short of remarkable. Four months post-surgery, Natasha ran the Commander’s challenge at the Army Run. She started training for a marathon and she has the dream of qualifying for the Boston Marathon.

However, in 2019, she received news the tumour had grown back, despite being told the odds of that were low. Natasha was devastated, but her healthcare team would turn to the CyberKnife – a revolutionary piece of equipment that arrived at The Ottawa Hospital in 2010, as a result of donor support.

“At first I was nervous to have the CyberKnife treatment. I had to go by myself because we had no one to watch the kids. However, the staff was very patient, kind, and made you feel warm and safe. I was able to watch a movie and the machine did the work,” recalls Natasha. She would have three, one-hour treatments.

“I had to go by myself because we had no one to watch the kids. However, the staff was very patient, kind, and made you feel warm and safe.”
– Natasha Lewis

Today, she prays that “Jim,” the name she’s given the tumour, will not come back. While there’s uncertainty over what will happen next, she continues to be active with her running and most importantly, she can run, play with, and hug her three children. “I can hear them laugh and tell me they love me. There is no greater feeling in the world,” smiles Natasha.

Listen to Pulse Podcast to learn more about Natasha’s story and how Dr. Fahad Alkherayf provided her with specialized care.

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

Categories: Creating Tomorrow, Innovation and Technology, Patient Care

After experiencing vision problems, severe headaches, and repeated transient ischemic attacks (TIA’s) –mini-strokes, John Fairchild was diagnosed with a tumour on his pituitary gland. With each TIA being potentially fatal or causing paralysis, and with surgery being high-risk, John began making detailed plans to help his wife carry on without him.

That was until September 2015, when minimally invasive brain surgery at The Ottawa Hospital saved his life.

In 2011, John had been told by a doctor in Edmonton that he had a tumour in his pituitary gland and the operation to remove it was too risky. The doctor advised him to wait several years until the procedure had been improved.

Five years later, John and his wife Suzanne had moved to Ottawa, and he was having regular TIA’s. During these mini strokes, his vision was reduced to seeing through a small hole, and his memory and speech were impaired. The 71-year-old was referred to see Neurosurgeon Dr. Fahad Alkherayf at The Ottawa Hospital. Dr. Alkherayf recommended John undergo the newly available minimally invasive brain surgery. With this technique, his tumour, which was benign, would be removed through his nostrils instead of the traditional more radical and risky surgery, which required opening up his skull.

The benefits of minimally invasive brain surgery

“It is a new field in neurosurgery,” said Dr. Alkherayf, who has advanced minimally invasive brain surgery techniques in recent years. “There are no incisions in the skull, no cut in the skin. Everything is done through the nose.”

This operation is safer with surgery time greatly reduced. It means patients not only spend less time in the operating room, but they go home sooner. They experience less complications and better recovery.

John Fairchild at home following his minimally invasive brain surgery at The Ottawa Hospital. — *John Fairchild at home following his surgery*

Vision and hope restored

“I believed there was some risk of being blind or dead after the operation, as it was so new,” said John. “I spent two months before the operation, training to carry on being blind. I taught my wife how to use the snow blower and handle the finances.

“When I opened my eyes in the recovery room, I could see a clock on the wall, and I could see the time! I wasn’t blind.”
— John Fairchild

The Ottawa Hospital is a North American leader in this procedure.

“We have been asked for consultations internationally,” said Dr. Fahad Alkherayf. “It’s a very exciting technique that has definitely improved patient care during these surgeries.”

A bright future

In the year since the operation, John has resumed his active life.

“Thanks to The Ottawa Hospital’s virtuoso surgery team, I am again now in vital good health – curling, skiing, golfing — with excellent vision and no headaches. I am extremely grateful for the extraordinary care I received in the hospital, and wonderful after-care.”

“I am so well now, you’d never know anything was ever wrong with me. I am very proud of the hospital and the medical team. You guys saved my life.”
— John Fairchild

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

Categories: Innovation and Technology, Neuro

They were born at The Ottawa Hospital on December 22, 2006, three and a half months premature. Rhys was 1 lb 8 oz, his identical twin Cullen was 1 lb 4 oz, brother Liam was 1 lb 10 oz, and his identical twin Daniel was 1 lb 3 oz.

“We knew it was quadruplets when I had the first ultrasound at eight weeks. There were four heart beats,” said Nora Shipton, the boys’ mother. “We had two sets of identical twins born by caesarean section. There was an amazing team of 25 people in the delivery room.”

The boys were born exceptionally early at 26 weeks and two days. Babies born before 35 weeks are considered high risk—their lungs and hearts aren’t fully developed yet.

Specialized Care at The Ottawa Hospital

When the White quadruplets were admitted to the Neonatal Intensive Care Unit (NICU) at The Ottawa Hospital’s General Campus, making sure they kept breathing was critical. Liam didn’t need a tube to open his airway but received oxygen through a nose tube instead. The other three boys, however needed to be intubated (a breathing tube needed to be inserted). On top of breathing problems, Rhys and Liam also had heart surgery to correct faulty heart valves and were operated on the same day.

Sadly, despite every effort brother Cullen passed away on January 16, 2007 and brother Daniel two days later.

“The care that we received at the NICU was beyond excellent. The nurses and the doctors were so caring and attentive and helped us through the roller coaster that all NICU parents ride. We will forever be grateful to them for the love and the care that they gave to all of our babies.”
– Nora Shipton

A Bittersweet Return Home

Liam spent 88 days and Rhys 98 days in the NICU. It was bittersweet for Nora and Rob when Liam and Rhys finally came home.

Three months after losing two of their sons, Nora and Rob White decided that they wanted to give back; to help support the NICU team who had helped Liam and Rhys survive their early entry into the world. Initially, they were inspired to contribute towards a twin water bed that was needed. The boys were in individual water beds but co-sleeping was proven to help healing. They realized, however that the water bed was a one-time gift and preferred something that would continue to give over time, as a need would arise. Nora’s late father, Ralph Shipton, researched Legacy Endowment Funds, it was just the thing they were looking for. The family then created the Cullen James and Daniel Morgan White Legacy Endowment Fund, which would contribute over the long term to meet the endless needs of the NICU.

The NICU graduates today

Liam and Rhys on the first day of Grade 7.

At 13, the boys are active and busy. They enjoy downhill skiing, swimming and camping. Their grandparents own a farm, so they like to go out on their ATVs, drive the tractors and fish. Rhys is a voracious reader and loves swimming. Liam also enjoys swimming and does horseback riding. Like many children, they struggle in math a little bit. They are happy, healthy boys.

Running for a Reason

In May 2020, Liam and Rhys are doing something extraordinary for The Ottawa Hospital NICU. They are running 5kms as a family-team in the Ottawa Race Weekend. On top of doing something fun and healthy, they are running to raise money for the NICU and running for their two brothers Cullen and Daniel, in the hope of keeping future families like theirs together.

Money that is raised through the Cullen James and Daniel Morgan White Legacy Endowment Fund (aka Preemies 4 Preemies), gets put towards things that the babies need.  It may go towards helping purchase a large item like an incubator or a waterbed, which helps maintain a baby’s body temperature when they come out of the incubator, or smaller items like waterless milk bottle warmers, positioning aids, cell phone sterilizers or kangaroo care chairs. The endowment fund was set up in memory of Cullen and Daniel and it will continue to help other families who will need the latest, most innovative care for their preemies. Thanks to the forward thinking of their grandfather, their brothers’ Legacy Endowment Fund can keep on giving into the future.

Visit Their Fundraising Page

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

Categories: Donors, Innovation and Technology, NICU

A parent’s worst nightmare

14-year-old Spencer’s eye became reddish and tearing for more than a week; and this strange blockage was protruding from his nose. Despite repeated efforts, it would not come out.

That’s when Spencer’s mom, Ellen, knew he needed help and they would ultimately end up in CHEO’s emergency department. Doctors ordered a CT scan. It was around midnight; Ellen recalls when the results came in.

“A gravely concerned looking doctor asked me, ‘Did you know that Spencer has a tumour in his head?’”

It was not the news any parent wants to hear.

The growth, which was protruding from Spencer’s nose, was biopsied. While benign, that tumour was resulting in the quick deterioration of Spencer’s health. When Ellen asked to see the CT scan, she recalls searching the picture for a grape or golf ball sized image attached to a nose growth.

“I didn’t see any and asked where it was. ‘It’s the grey area’, the doctor said.”

The grey area was over half of his face.

“I didn’t even want to think about what his face would end up looking like after all the cutting they’d have to do to remove so much material, but I had to ask.”

The doctor revealed the tumour was larger than any he had ever worked with. It was for that reason and the fact it was reaching up to the floor of the brain, he told Spencer’s parents they couldn’t perform the surgery.

This type of tumour would need a specialized team of an ear, nose and throat doctor along with a neurosurgeon working together. Ellen recalls thinking she would take her son anywhere in the country to get the help he needed.

Specialized care at The Ottawa Hospital

However, the specialized care was nearby at The Ottawa Hospital. A highly skilled team would perform minimally invasive surgery and remove the tumour through Spencer’s nose.

Just over a week later, with his condition worsening, Spencer was to be admitted to The Ottawa Hospital. He had another CT, an MRI, and the specialized team was monitoring his optic nerve behind his bulging eye to ensure it wasn’t being severed by the growing tumour.

Two days later Spencer underwent a 4-hour surgery, which helped stop 80% of the blood flow feeding the tumour. The remaining 20% would maintain blood flow to his brain.

The next day the highly skilled team, which included Drs. Fahad Alkherayf and Shaun Kilty performed an eight-hour surgery. With expert precision, and state-of-the-art technology, they would remove the large tumour from Spencer’s face and base layer of the brain. They also rebuilt that layer to prevent the fluids that protect the brain from leaking out.

This minimally invasive surgery, removing the tumour and rebuilding the layer, was performed through Spencer’s nose by Dr. Alkherayf who has the greatest number of surgical hours of training for this procedure in Canada.

A Canadian Medical First

In order to rebuild the brain layer, 3D printing technology also aided doctors during the surgery. Ellen says it’s remarkable. “It’s really pretty cool the advancements which have been made to help patients in our community.” In 2016, The Ottawa Hospital became the first hospital in Canada to have an integrated medical 3D printer.

Ellen says her initial concerns of recovery completely faded thanks to this minimally invasive technique. “It was incredible. Spencer was home again only three days after surgery!”

When she thinks back to the fear of the initial diagnosis to where Spencer is today, back at school and active, several thoughts comes to mind.

“I was immensely grateful to God and The Ottawa Hospital, and I truly feel that we were in the best hands.”

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

Categories: Innovation and Technology, Neuro, Technology

A bystander only sees neurosurgeon Dr. Adam Sachs wearing large goggles, looking at the air between the two wands he moves back and forth in front of him. What Dr. Sachs sees is a three-dimensional image of a patient’s brain, with its electrical activity superimposed. This isn’t a video game. It’s the cutting-edge of deep brain stimulation and neurosurgery technology.

Wearing virtual reality goggles, Dr. Sachs can view an accurate, computer-generated 3D image of a patient’s brain with Parkinson’s disease, created using the patient’s own MRIs. The patients’ brain activity recorded from microelectrodes can be visualized in this virtual world. With the two wands, or joysticks, he can move the three-dimensional brain around, seeing it from all angles. He can also remove layers of the brain to look inside at the exact spot where he will place a DBS electrode during deep brain stimulation (DBS) surgery. He is hoping to soon use this technology in the operating room.

This medical 3D virtual reality system was developed at The Ottawa Hospital, and is expected to be the first of its kind in the world to be used for deep brain stimulation surgery. Drs. Justin Sutherland and Daniel La Russa are clinical medical physicists in the hospital’s radiation oncology department. The two used their imaging expertise to develop a virtual reality system that combines a patient’s MRIs and CT scans to create a 3D image of a patient’s organ or body part to give surgeons a detailed, accurate representation of the surgical area.

Historically, medical virtual reality programs were used by patients mainly for rehabilitation. Patients would wear VR-goggles to help relearn how to move through and cope with different environments. Until recently, the technology wasn’t good enough to create images of organs or tissue that could be used by clinicians in a manner that improves on current practice.

“What we are trying to do in our virtual reality lab is come up with new ways to leverage technology to help doctors and nurses, or any medical professional, do what they do better. And how better than with 3D visualization,” said Dr. Sutherland who is also an assistant professor in the University of Ottawa’s Department of Radiology. “We think the technology has only reached that point now. We’re now at a place where we want to pursue the avenue of clinicians-as-users.”

“Nowhere else in the world are they using virtual reality in this fashion.”
— Dr. Adam Sachs

One Ottawa Hospital surgeon interested in using 3D virtual reality was Dr. Sachs, who performs deep brain stimulation surgery for people with Parkinson’s. During this procedure, a microelectrode, no wider than a human hair, is implanted into a very specific area of the brain. The microelectrode then records activity from and stimulates that part of the brain and alleviates some of the patient’s symptoms, such as tremors and akinesia or the loss of ability to move their muscles voluntarily. The virtual reality system allows the electrical activity, stimulation effects and the MRI to be visualized together.

“In deep brain stimulation surgery, because the target is very small and in the middle of the brain this leaves the surgeon with the problem of how to visualize the person’s brain to understand the area and where to put the electrode,” said Dr. Sachs.

Dr. Adam Sachs holding 3D virtual reality wands. — *Neurosurgeon Dr. Adam Sachs uses virtual reality wands to manipulate a 3D image of the brain.*

He said neurosurgeons use MRIs and brain atlases to get a mental image of what the patient’s brain looks like. The problem is these atlases are maps created from many different people’s brains, but each patient’s brain is unique. As well, the brain atlases are only two-dimensional, while the brain is three-dimensional. This makes it difficult to place the microelectrode in the exact spot in the patient’s brain where it will have the best chance of halting or reducing the Parkinson’s tremors.

Dr. Chadwick Boulay, a senior research associate in the neuroscience program, understands the challenges faced by neurosurgeons when implanting an electrode at the optimal position in the brain. When Dr. Boulay learned about the 3D virtual reality technology being developed at The Ottawa Hospital, he realized the potential this had for increasing the accuracy of deep brain stimulation surgery. He and Dr. Sachs worked with Drs. Sutherland and La Russa to develop a virtual reality program that would enable them to see the patient’s brain in three dimensions.

“This is really exciting,” said Dr. Sachs. “The deep brain stimulation electrodes will be more precisely placed because we’ll be able to integrate accurate images from the patient’s anatomy and visualize it in three dimensions,” said Dr. Sachs.

He anticipates that the resulting precision of the placement of the electrode will improve outcomes for patients with Parkinson’s disease, but this will be confirmed through research. About 15 people undergo deep brain stimulation surgery at The Ottawa Hospital every year.

“We’re excited about working with the Sachs Lab because it is a perfect clinical example of using 3D visualization to better understand a spatial problem,” said Dr. Sutherland. “In this case, actually seeing a target for deep brain stimulation removes the burden on the surgeons of trying to create a 3D model in their head.”

*Drs. Daniel LaRussa, Justin Sutherland, and Chadwick Boulay have teamed up to design a 3D virtual reality program for Dr. Adam Sachs’ deep brain stimulation surgery.*

Dr. Sutherland foresees that this 3D virtual reality technology will one day be in every department throughout the hospital. He says the overall system is surprisingly inexpensive, as the computer that runs it and the goggles only cost a few thousand dollars. The possibilities for this technology are endless. He said it has huge potential for education—teaching medical anatomy—and for surgical planning. Dr. Sutherland sees Dr. Sachs’ endorsement of this system as a shining example of how doctors can use this technology to improve what they do.

“Nowhere else in the world are they using virtual reality in this fashion,” said Dr. Sachs.

The Ottawa Hospital is quickly being positioned as leaders in 3D virtual reality technology and has already gained international attention. Drs. Sutherland and La Russa have given demonstrations and been invited to talk at large medical conferences, and other institutions have contacted them with interest in using this technology.

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

Categories: Innovation and Technology, Neuro, Parkinson's, Technology

June 20, 2017, was a day like any other on the construction site, until the 14-inch diamond blade on Adrian Molloy’s power saw jammed in the concrete he was cutting and kicked back into his arm, slicing through to the bone. Though he was not particularly close The Ottawa Hospital’s Trauma Centre at the time, a new 60-minute bypass initiative brought him straight there to an assembled team of trauma experts who were ready for him.

The 40-year-old contractor had been using power saws on the job for 20 years. He was down in a hole cutting concrete when the saw kicked back. He was covered in dust so couldn’t see his arm, but knew he’d hit himself. He grabbed his right arm above the elbow, and his fingers landed on bone. Adrian knew it was a serious injury, and managed to get out of the hole and head to the road for help. His arm was bleeding badly.

“It happened so quickly, I didn’t even know I was injured,” Adrian said.

*Contractor Adrian Molloy underwent two four-and-a-half-hour surgeries to repair his partially severed arm.*

Quick thinking

At the road, two Hydro One workers were sitting in their truck getting ready to leave. When they saw Adrian, the passenger called 911. The driver jumped out, and quickly took off his belt and tightened it around Adrian’s arm in a tourniquet. He was calm, and kept Adrian talking until the ambulance arrived.

In the ambulance, Adrian heard the paramedics talking with the dispatch.

“I knew they were looking to bypass Kemptville, but didn’t know what was going on,” said Adrian. “I knew my best hope was The Ottawa Hospital, so was happy they said we were heading to the Trauma Centre at the Civic. I was going somewhere where they could handle my injury.”

60-minute bypass initiative

What Adrian didn’t realize was that he was one of the first patients to be part of a quality improvement initiative that the Ottawa Regional Trauma Program was testing in an effort to get patients to trauma care and provide more successful outcomes.

“Adrian was a direct recipient of our 60-minute bypass initiative,” said Mathieu LeBreton, Trauma Coordinator of the Ottawa Regional Trauma Program at The Ottawa Hospital. “Provincially, paramedics have rules that can permit them to bypass local hospitals to get to a lead trauma hospital if they are within 30 minutes of getting to a trauma centre. With the approval of all regional community hospitals, we expanded it to 60 minutes. Much of the literature suggests the sooner a patient receives definitive trauma care, the better.”

Where Adrian was injured was about a 45-minute ambulance drive to the Trauma Centre. Previously, he would’ve had to go to the nearest community hospital. LeBreton said trauma patients who need resuscitation from life-threatening injury need very resource-intensive care. They require more medical staff, access to operating rooms, imaging capabilities, more blood, and other resources that community hospitals do not have in their emergency departments. There is a team of health-care professionals at the Civic Campus specifically trained to deal with trauma situations.

Trauma team assembles

When paramedics notify the Civic Campus Emergency Department that they are bringing in a patient with multiple or life-threatening injuries, a Code 1 Trauma is called over the hospital’s intercom. This alerts the trauma team, which includes trauma surgeons, emergency physicians, nurses, anaesthesiologists, respiratory therapists, and trauma coordinator Mathieu LeBreton, to prepare for the patient’s arrival. A Code 1 Trauma also notifies the blood lab, radiology department, and operating room staff that blood-work, X-Rays, CT scans, and surgery may be needed.

“Sometimes a trauma code comes in without advance notice, and then we’re reacting to it in the moment,” said Kelly Barnett, Clinical Manager of the Trauma Unit. “Everyone has a job, and it’s a code that runs smoothly to diagnose, triage, and save the patient.”

“I’d never been to a hospital injured like this before,” said Adrian. As he lay in the ambulance, his mind raced with concerns. “I asked, ‘Do they know I’m coming? Are they ready for me?’”

Rushed to surgery

The answer was yes. The trauma team was ready and waiting for him when the ambulance arrived. When he was rushed through the emergency room doors, Adrian said he couldn’t believe, “You can get so many people in one room for one patient.” He was in the operating room within 47 minutes from the time he entered the emergency department.

“I knew my best hope was The Ottawa Hospital, so was happy they said we were heading to the Trauma Centre at the Civic. I was going somewhere where they could handle my injury.”

The power saw had cut 75 percent of his right bicep, two arteries and a nerve. In the operating room, surgeons reattached his arm. The four-and-a-half-hour surgery repaired arteries and his severed nerve. He underwent a second four-hour surgery to repair the damaged bicep with a donor muscle in November 2017.

The Ottawa Hospital’s Civic Campus is the adult lead trauma hospital for eastern Ontario. This takes in an area of 1.3 million people that includes Ottawa, stretches west to Pembroke and east to Hawkesbury. People with life-threatening injuries from Gatineau and western Quebec, as well as patients from Baffin Island and eastern Nunavut are brought to the Trauma Centre. Twenty percent of the population it serves lives in a rural area.

The Centre treated 856 trauma cases last year. One hundred and ninety-two of those patients benefited from the extended time guidelines from accident scene to trauma centre, with the average transfer time being 42 minutes.

Trauma care for 1.3 million people

The eight-bed trauma unit is dedicated to patients who have multiple injuries. This could include head or brain trauma, limb loss, vascular, spinal cord, internal organs, multiple broken bones, broken spine, or neck injuries.

“Patients come into trauma from emerge [emergency department], and once they are stabilized, they then move through the hospital, as soon as possible, in order to get them back home, into rehab, or somewhere they can convalesce,” said Kelly.

Kelly said a patient’s length of stay in the trauma unit can be as short as 24 hours or as long as several months, depending on the severity of the injury and the ability to recover and heal. The health professionals in the Centre plan the patient’s follow up care or work closely with physiotherapy, and rehabilitation services to assess their need for rehabilitation.

“I know we often compare ourselves to similar standards from regional trauma perspectives: other hospitals we benchmark against in standardizing trauma care. We look to hospitals like St. Mikes [St. Michael’s Hospital] in Toronto to see their practices, and share ideas and common goals that we are trying to achieve,” said Kelly.

The Ottawa Hospital is part of the Trauma Association of Canada where members from across the country share vibrant practices about ways to improve patient care.

Hamilton and Kingston also have trauma centres, though The Ottawa Hospital is bigger because of the larger area patients come from.

The Ottawa Hospital has one of the largest trauma centres in the province, with Sunnybrook and St. Michael’s as the two largest. However, both Toronto hospitals cater to a dense urban population. The Ottawa Hospital covers a larger geographical area, so the timing to get patients to the trauma centre from a distance and the reason why the 60-minute bypass initiative is critical.

“What we found is there have been no negative outcomes yet. People like Adrian have benefitted directly from this,” Mathieu said.

Back to work

A year later, Adrian is back on the construction site with full use of his right arm and hand.

“I lost the motion for using a screwdriver. I use it as an excuse to get out of work I don’t like. I use it to my advantage now,” laughed Adrian. “I’m doing everything I was doing before.”

Adrian Molloy with his wife Shelly — *Adrian Molloy stands with his wife Shelly outside their home.*

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

Categories: Innovation and Technology, Patient Care, Trauma

Patients don’t need to have a metal halo screwed into their skull when they receive radiation treatment with the CyberKnife. That was one of the appealing factors for neurosurgeon Dr. John Sinclair to bring the radiosurgery robot to The Ottawa Hospital.

With other radiosurgery, patients with brain tumours had to have their head held perfectly still during treatment. A metal frame or “halo” was screwed into their skull and then fastened to the table they’d lie on for treatment.

However, patients do not need to be held still when receiving CyberKnife radiosurgery. The robot uses x-rays and complex precision software to accurately track the tumour. It gives a high dose of radiation to the precise location of the brain tumour while the patient, who is fitted with a custom-made plastic mask, lies on the table.

“CyberKnife has an advantage over regular radiation because it is so much more accurate; its precision is less than a millimetre,” said Dr. Sinclair, Director of Cerebrovascular Surgery at The Ottawa Hospital. “You can give very high doses of radiation right to the lesion [tumour] and get almost no spill over to normal tissue. And as a result, we see greatly improved responses to this type of treatment compared to regular radiation.”

Dr. John Sinclair leaning against bed in the operating room — *Dr. John Sinclair was instrumental in bringing the CyberKnife to The Ottawa Hospital.*

Dr. Sinclair was first introduced to the CyberKnife when he did a fellowship at Stanford Medical Center in California. CyberKnife was invented at Stanford, so the neurosurgeon was one of the first to see the benefits of this frameless radiosurgery treatment.

When Dr. Sinclair was recruited to The Ottawa Hospital in 2005, he had hoped to bring this novel technology to patients here. At the time, it was a technology that wasn’t approved by Health Canada. So, Dr. Sinclair and his team made a case for robotic radiosurgery, presenting scientific data that validated its success.

The Ottawa Hospital was eventually one of two health research centres in Ontario allowed to test the CyberKnife. However, there was no government funding available to purchase the machine. The hospital appealed to the community, which pulled together and generously donated the entire $4 million to purchase it. CyberKnife began treating patients at The Ottawa Hospital in September 2010.

“Because it’s delivering a high dose, it’s considered similar to surgery without using a scalpel, so patients experience no blood loss, no pain, no ICU stay, or recovery time,” said Dr. Vimoj Nair, one of the radiation oncologists trained to prescribe CyberKnife treatment. “So CyberKnife radiosurgery does provide an option where people can be treated with outpatient techniques.”

With regular radiation, the daily doses were lower and patients had to come to the clinic for more radiation treatments overall. Regular radiation treatment could range from five to six weeks. With CyberKnife, radiation is focused precisely on the tumour, allowing larger doses to be given daily, therefore giving the total treatment in one to six days. The hospital’s CyberKnife has gained a reputation for improving treatment of various tumours. Dr. Nair said that because it is one of only three in Canada, patients from British Columbia to the Maritimes are occasionally referred to The Ottawa Hospital for treatment.

“At first, we would treat one tumour,” said Dr. Sinclair. “Now, we treat five or six individual tumours at a time and spare the rest of the brain. We’re sending radiation only to those metastatic tumours. There is a proportion of patients who develop cognitive problems a few months after whole-brain radiation. But with radiosurgery, because we give a higher dose of radiation only to the actual tumours, patients have improved outcomes, and so their quality of life is better.”

This has meant an increase in the number of patients having multiple tumours treated in the same session.

“Treating several tumours at once helps keep the patient’s clinic visits to a minimum,” said Radiation Therapist Julie Gratton, who has worked with CyberKnife since it was installed at The Ottawa Hospital. “Targeting individual tumours rather than treating the whole organ helps spare healthy tissues and reduce side effects.”

The CyberKnife robot — *The CyberKnife at The Ottawa Hospital is one of only three in Canada.*

Julie Gratton stands in front of the CyberKnife. — *Radiation Therapist Julie Gratton has given CyberKnife treatments to patients since 2010.*

Until 2017, 1,825 patients had been  treated with the CyberKnife. In 2018, 359 patients received 1,824 CyberKnife treatments. Gratton said that because more tumours are being treated at once in each patient, the number of treatments given per year has increased as expected.

Although 90 percent of CyberKnife treatments are for malignant or benign brain tumours, CyberKnife is also being used to treat tumours in other parts of the body. Because it doesn’t require a frame to keep the area receiving radiation still, CyberKnife’s image guidance system is used to treat tumours in organs that move constantly, such as the lungs, kidneys, liver, prostate gland, and lymph nodes. CyberKnife can precisely align the radiation beam to the tumour even when it moves. The method of tracking tumours in organs and soft tissue has been improved by research at The Ottawa Hospital.

Read more about how our team is increasing the success rate of this already powerful and precise treatment.

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

Categories: Cancer, Innovation and Technology, Technology

Mid-surgery decision to leave abdomen open for two days saves woman’s life

Category: Innovation and Technology

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The wait was over

Recovery period

Showing Gratitude

A healing experience

Dr. Guillaume Martel

Minimally invasive surgery ‘perfectly’ restores hearing

The risk was high

A new surgery technique

“They did a miracle on me”

Local activist donor pledges $500,000 to take on cancer

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The challenge of non-cancerous brain tumours

Condition deteriorating

Surgeons ready for complex procedure

Journey continues after remarkable recovery