Category: Patient Care

Originally published: July, 2021

Two-time winner of the Show Jumping World Cup and Olympic equestrian silver medalist Ian Millar knows his way around horses. His long and storied career even led to his nickname, Captain Canada. But after a rare accident on his farm in Perth, he was rushed to The Ottawa Hospital Trauma Centre with a severe arm injury. Ian was quickly losing blood, causing deep concern for his life.

“My main barn guy, who has medical training, rushed to help along with my family. They thought I was in big trouble because of the amount of blood I was losing.”

– Ian Millar

In late October 2020, Ian was riding a young mare when something startled her. She reared up on her hind legs, and then came down hard and spun around, causing Ian to be tossed over her head and onto the ground. “I was sailing through the air; I knew exactly what I was going to do in terms of landing to make sure there was no damage. Normally, the horse will do what it can to avoid stepping on you, but this one came down on me three times,” says Ian.

Significant blood loss 

The 74-year-old could feel pain through his ribs and one leg. However, the real concern was the damage to his left arm, just above the elbow. “I tried to get up but the bleeding was significant. The wound was about eight inches in length and I could see the nerves and muscles. My main barn guy, who has medical training, rushed to help along with my family. They thought I was in big trouble because of the amount of blood I was losing.”

“They were beyond words. I want to say there were about six team members there when I arrived, and they were ready to rock and roll.”

– Ian Millar

A tourniquet was quickly created to stop the bleeding while a call went out to 9-1-1 for help. Within minutes, paramedics arrived and whisked him to Carleton Place, where the helicopter was waiting to fly him to our Trauma Centre.

Ian remained conscious the entire time and says the air ambulance paramedics were fantastic as they helped control the bleeding and keep him calm until they arrived at the hospital. When wheeled into the Trauma Centre, Ian says an exceptional team awaited him. “They were beyond words. I want to say there were about six team members there when I arrived, and they were ready to rock and roll.”

Ian Millar, ©Millar Brooke Farm

Trauma Centre serving eastern Ontario 

With the uncertainty over the extent of damage to Ian’s arm, he would need the most advanced treatment options available. Our hospital has the only Level 1 Trauma Centre in eastern Ontario for adults — this is where the most critically injured patients from across the region, including Québec in some cases, come to for lifesaving care, often bypassing smaller community hospitals.  

“I had just walked into the resuscitation bay when we received the call that an ORNGE air ambulance was on the way, and there was the risk of the life-threatening arterial bleed.”

– Dr. Edmund Kwok

Today, when patients like Ian arrive by air ambulance to the Civic Campus, they need to be rushed across busy Carling Avenue from the helipad to the hospital. All that will change when the New Campus Development site on Carling Avenue is complete in 2028. Our new hospital campus will save crucial time with dedicated high-speed elevators that will bring critically ill and severely injured patients directly from the rooftop helipad to a trauma bay.  

Specialized teams ready 

When Ian arrived, Dr. Edmund Kwok, an Emergency Department (ED) physician and Director of Quality Improvement Unit for the ED at our hospital, was waiting. He still vividly remembers that day. “It was the beginning of my shift. I had just walked into the resuscitation bay when we received the call that an ORNGE air ambulance was on the way, and there was the risk of the life-threatening arterial bleed,” recalls Dr. Kwok.

With that call, Dr. Kwok and his team prepared the trauma bay for the patient’s arrival. “When it’s an ORNGE ambulance we know it’s more severe. Our team, including physicians like myself, the nurses, and respiratory therapists are ready.”

Ian was conscious, stable, and after a full assessment, the main concern remained his arm. Dr. Kwok and his team had to determine if the injury was an arterial or venous bleed — one being much more challenging than the other is. “The arterial injuries can bleed out very quickly. Therefore, it is a potentially life-threatening situation. It’s like plumbing. When we release the pressure it has to be done in a very controlled manner,” explains Dr. Kwok. 

Dr. Edmund Kwok is a physician in the Emergency Department at The Ottawa Hospital

Expert team collaboration

Once they removed the tourniquet, Ian started to bleed out. “We put a call out to vascular, orthopaedic, and plastic surgeons. We needed these specialists involved, and their response was prompt. We had the vascular team at the bedside before Ian’s imaging was completed.” 

“Before this, I didn’t know the Civic Campus was the only trauma centre in our region. The care I received was unbelievable. We’re fortunate to have that team of experts ready for any injury. It seemed to me every specialty was waiting and ready to help.”

– Ian Millar

Ultimately, the vascular physician determined it was not an arterial bleed and repaired the damage to the veins before handing it off to the plastic surgeon to close the wound. It all happened very quickly, but Dr. Kwok is quick to point out this is a perfect example of having access to each specialty to ensure a positive outcome for the patient. “This is a classic example of an injury which involved different specialists. Vascular and plastic surgeons provide highly specialized services, and to have them all in one location and able to respond promptly made a huge difference in this patient’s outcome because the tourniquet couldn’t have been left on for much longer.”

The damage to Ian’s arm put him at high risk for bone injury, and that’s why it was essential to have orthopaedics on site. The vascular team stopped the bleeding by tying off vessels right at the bedside while Ian awaited a CT scan and angiogram. 

Going home six hours later 

Remarkably, Ian went home about six hours after he was rushed into hospital. Dr. Kwok says it was an extraordinary case. “I’m glad we were able to help get Ian back home so quickly. He got really lucky. Had this happened to his head, the outcome could have been very different.”

Even more amazing, there were no broken bones, only a dislocated rib and a superficial leg wound. For Ian, it was an eye-opening experience. “Before this, I didn’t know the Civic Campus was the only trauma centre in our region. The care I received was unbelievable. We’re fortunate to have that team of experts ready for any injury. It seemed to me every specialty was waiting and ready to help.”

Ian Millar, ©Millar Brooke Farm

As an emergency medicine physician, Dr. Kwok admits it’s wonderful to see a story like Ian’s have this kind of ending. “No words can explain how positive it is to see Ian’s outcome. It rejuvenates our team and it reminds us we are making a difference.” 

The Olympian was back riding within a couple of weeks with full use of his arm. And for that, he’s grateful for the team that cared for him. “They were a well-oiled machine. It made me proud to be a Canadian.” 

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

Categories: Trauma, Trauma

When Petra Smith heard the news that she was pregnant, she thought the experience would be the greatest joy of her life. But instead, her mental health took a drastic turn for the worse. She battled peripartum depression and thoughts of suicide. When the thought of taking another step became too hard to bear, she sought out treatment and care from our experts who were ready to help her through her darkest time.

Bipolar disorder diagnosis

Petra is no stranger to the realities of living with a mental illness having been diagnosed with bipolar disorder at 21 years old. Nearly a decade later, she still remembers the first time she felt something wasn’t quite right.

She was behaving erratically and experienced an extreme shift in mood that often characterizes bipolar disorder. She experienced high levels of energy and extreme euphoria for several weeks followed by a depressive phase that was difficult to pull out of. Petra’s family encouraged her to speak with her physician, and it wasn’t long until she received an official diagnosis.

“I am fortunate to have a family that is incredibly supportive and encouraging about finding me the help I need to manage my disorder,” said Petra. “A solid support system is key for any person who has been diagnosed with a mental illness.”

This support from family, and the support she would later receive from our hospital, would be critical as Petra’s journey unfolded.

Petra with her family.
Petra with her family and her son, William.

Battling depression during pregnancy

When Petra received news that she was pregnant, she was thrilled. But what started off as an exciting time was soon overshadowed by darkness. Just two months into her pregnancy Petra’s mental health began to deteriorate. Unsure how this would affect her unborn child, she concealed her emotions from anyone outside of her family. With her thoughts buried deep under a smile, she suffered in silence. “I was under this illusion that I couldn’t get any help for how I was feeling,” said Petra. “I feared that I would be seen as an unfit mother and that my baby would be taken away from me.”

New life

As her pregnancy progressed, Petra’s mental health continued to spiral without support — until the birth of her son, William, in 2018.

“I was really amazed by the care I received at The Ottawa Hospital. When I gave birth to my son, I trusted the team with my life. They took the time to keep me informed and reassured me throughout my C-section. I was in excellent hands.”

Following her surgery, Petra’s nurses checked in on her often to ensure she was recovering well. They gave the new mom tips on how to breastfeed and how to change William’s diaper. She developed a special bond with her healthcare team, so Petra felt comfortable opening up about her depression for the first time. After confiding in one of our nurses, she was referred to Dr. Jasmine Gandhi, Medical Director of the Perinatal Mental Health Program.

Petra holding William, following his birth.

Dr. Gandhi was determined to help her and scheduled an appointment soon after. But leading up to the appointment, Petra’s depression worsened significantly. As feelings of complete hopelessness and exhaustion washed over her, she became increasingly suicidal. Unable to get the thought out of her mind, she couldn’t fathom taking another step. “I was at the lowest point a human being can be,” Petra said. “I remember feeling that a human body should not be allowed to keep moving when it feels this way. It was like torture. And I had to care for a newborn baby on top of that.”

As Petra’s follow up appointment approached, her mother Sylvia urged her to be honest with Dr. Gandhi about how she was feeling — this was the only way Petra would get the help that she desperately needed.

Taking her mother’s advice would turn out to be the best decision of Petra’s life — not only saving her life, but creating a better one for William, too.

A diagnosis

On the day of her appointment, Petra’s father, Evan, drove her and waited outside during the hour-long meeting. Little did Evan know, he would drive home alone that day.

“When I was first admitted she looked me directly in the eyes and said, ‘We’re going to get you feeling better.’”

– Petra Smith
Dr. Jasmine Gandhi is a physician in the mental health program at The Ottawa Hospital.

Sitting in Dr. Gandhi’s office, Petra disclosed how she was feeling, including the fact that she was having suicidal thoughts. Concerned for Petra’s safety and that of her baby, Dr. Gandhi admitted her as an inpatient to the Perinatal Mental Health Clinic on the spot.

What Petra was experiencing was peripartum depression. Similar to postpartum depression, peripartum depression is a long-lasting and severe form of clinical depression experienced during pregnancy and up to one year after giving birth. Although experienced differently for each patient, symptoms can include severe mood swings, difficulty bonding with one’s baby, feelings of hopelessness, severe anxiety, and thoughts of harming yourself or your baby. As someone who was previously diagnosed with bipolar disorder, Petra was predisposed to this illness. But opening up to Dr. Gandhi was a significant moment on her road to healing. “It felt like a weight had been lifted,” said Petra. “I didn’t want suicide to be my way out. I wanted to live, and I wanted to live well. And, I wanted to be a good mom to my son.”

Walking in to our Perinatal Mental Health Clinic for the first time, Petra recalls feeling nervous but grateful she was finally getting the help she needed.

Perinatal Mental Health Clinic at The Ottawa Hospital

Our Perinatal Mental Health Clinic provides specialized psychiatric support for people, just like Petra, who are experiencing mental health challenges before, during, and after pregnancy. Prepared to take on even the most complex cases, the Perinatal Mental Health Clinic cares for parents experiencing peripartum depression, anxiety, and psychosis, as well as P-PTSD. During its inception, this cutting-edge program was one of the few of its kind in Canada. Designed to fill a significant gap, this innovative program was created to provide a unique treatment and recovery plan for new and expectant parents.

“When I first arrived at The Ottawa Hospital, I felt broken. But when I left, I felt like I could go on and not just survive another day, but thrive.”

– Petra Smith

Our multidisciplinary team of psychiatrists, social workers, and nurses treat nearly 400 patients a year. “For our moms, and their families, it can be truly life changing to get mental health treatment during the peripartum period, which is the time shortly before, during, or after giving birth,” said Dr. Gandhi. This program ensures pregnant parents are getting the support that they need to create a better life for themselves and their children, and Petra did just that.

Read more about our unique Perinatal Mental Health program.

Road to recovery

Petra spent the next 12 days getting personalized treatment while staying in the psychiatric unit. She responded well to medication and attended both group and one-on-one therapy sessions. After just a few days, Petra started to feel more like herself again. “I went from long sleepless nights with my son to getting on medication that I needed to make me think straight,” said Petra. “I knew I was getting better for myself and for William.”

Petra with her son William.
Petra and William.

“It could have been the worst-case scenario for Petra. Instead, she’s thriving and doing so well.”

– Dr. Jasmine Gandhi

She put her faith in Dr. Veronica McCarthy, a physician in our Mental Health unit, who was determined to get Petra back on her feet and feeling well. “She was so caring, thoughtful, and attentive,” said Petra, when speaking of Dr. McCarthy. “When I was first admitted she looked me directly in the eyes and said, ‘We’re going to get you feeling better.’ In that moment I believed her, and it turns out she was exactly right. She’s a fantastic physician.”

Dr. McCarthy took great care to tailor Petra’s treatment to her specific needs, finding solutions that would work long term and would be a good fit with Petra’s everyday life at home.

While Petra may have felt broken when she first arrived, when she left, she was not only ready to survive, but also to thrive. And she had an action plan to ensure it.

A bright future

While in our care, Petra began to plan for a happy and successful future that included going to college, getting a diploma, and getting up on her own two feet. Now, she’s near graduation from a law clerk program and looks forward to providing a fruitful life for her son.

“As a physician, one of the most gratifying things that you can experience is knowing that you had some small part in saving someone’s life,” said Dr. Gandhi. “It could have been the worst-case scenario for Petra. Instead, she’s thriving and doing so well. She is an amazing light.”

Petra was treated at The Ottawa Hospital for peripartum depression after giving birth.
Petra was treated for peripartum depression after giving birth.

Forever grateful for the care she received, Petra’s message is one of hope for anyone with mental health issues — a reminder to reach out for help, even when things seem impossible. Because there is always hope for a better tomorrow. “I couldn’t feel more grateful to be healthy and well again. Because of the care I received at The Ottawa Hospital, I have a bright future to look forward to with my son.”

Read our Q&A with the new head of Mental Health at The Ottawa Hospital, Dr. Jess Fiedorowicz

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

Categories: Mental Health

Growing up, Dan Lynch learned to help others whenever he could. It was something instilled in him as a young boy by his parents and it’s a quality he’s carried throughout his life. It’s what inspired him and his wife, Wendy, to leave a gift in their will to support multiple myeloma research at The Ottawa Hospital following his care at the Cancer Center’s Medical Day Care Unit.

Born and raised in Montreal, Dan spent 30 years as an aircraft mechanic. He met Wendy in 1988, thanks to some mutual friends who invited them to a party. Two years later, they married and by 1991, they settled on a picturesque piece of property in Green Valley, Ontario — near Lancaster. It’s a sprawling 43 acres which keeps Dan busy. “There’s always something to do here with about 200,000 trees. I’m up early to feed the dog and cats, and then I’m on my way, but by 1 p.m. I need to relax because I get tired easier these days,” he says.

Flu-like symptoms and concern for his kidneys 

The reason for his fatigue these days dates back to July 2019. It all started when he had persistent flu symptoms for two weeks — he just couldn’t shake them. Wendy’s prompting convinced him to go to the Glengarry Memorial Hospital in nearby Alexandria. “Blood tests revealed my creatinine levels were extremely high, and there were concerns about my kidney function,” explains Dan.

“I never realized how important The Ottawa Hospital was until I needed it. Until 2019, I had never been sick in all of my 66 years.”

– Dan Lynch

Based on those test results, doctors had Dan transferred by ambulance to The Ottawa Hospital for possible emergency dialysis. However, following further testing, Dan and Wendy received a devastating diagnosis. “The doctors told me that the problem with my kidneys was the result of my having cancer – multiple myeloma,” he remembers.

The news was shocking. While Dan hadn’t been feeling well, he never imagined the words cancer or multiple myeloma.

What is multiple myeloma? 

Dan and Wendy Lynch
Dan and Wendy Lynch at their home in Green Valley.

Multiple myeloma is a rare form of cancer that forms in plasma cells. These cells are a type of white blood cell that produce antibodies to help fight off infection. When someone is diagnosed with multiple myeloma, their plasma cells are changing, dividing uncontrollably — making more cells that are abnormal.

Symptoms can include bone pain, fatigue, and weakness from anemia, kidney abnormalities — all symptoms that Dan had experienced.

Men are more likely than women to be diagnosed with multiple myeloma and the median age of diagnosis is 68. This form of cancer is discovered through routine blood tests for other conditions, or a doctor might order a test for it if a patient has the symptoms. There are a variety of ways to treat patients with this type of cancer, including a stem cell transplant.  

“It was a learning experience and we’ll always be a part of the hospital because of the care Dan received.” 

— Wendy Lynch

There are two major types of stem cell transplants. Allogeneic, when stem cells come from a donor, and autologous, when a patient, like Dan, can provide their stem cells.   

Initially, Dan remained in hospital for about ten days to stabilize him. He then returned to our Cancer Centre every Friday for chemotherapy treatment for 16 weeks. This would prepare him for a stem cell transplant and Dan learned he could be his own donor. “Not everyone is able to donate their own stem cells. I felt very lucky to be able to do so, thus reducing the chances of infection and/or incompatibility with the donor’s cells,” he admits.

Medical Day Care Unit plays a crucial role 

By January 2020, Dan’s care team had harvested his stem cells, four bags in fact, and froze them in preparation for replacing them back into his body. On February 17, Dan was admitted to the hospital and given a large dose of chemotherapy. Two days later — his reinfusion day — his now healthy stem cells were placed back in his body, giving Dan a new lease on life. 

“I’m in remission. The disease is not curable, but it can be treated. The staff at the Cancer Centre saved my life.”

— Dan Lynch

Both of these procedures happened as an outpatient in our Medical Day Care Unit (MDCU). The Ottawa Hospital Transplantation and Cellular Therapy (TCT) Program performs about 200 transplants a year. Our TCT program was the first program outside of the United States to receive accreditation from the Foundation for the Accreditation of Cellular Therapy (FACT), which sets the global standard for top quality patient care in cellular therapies. The TCT provides care across four sites including the MDCU where Dan received his stem cell transplant.

“I’m in remission. The disease is not curable, but it can be treated. The staff at the Cancer Centre saved my life,” says Dan.

Forever grateful to The Ottawa Hospital 

On March 7, 2020, he returned home to the couple’s sprawling land — the property that brought so much joy to him and his wife — to start the next chapter of their lives.

Today, Dan and Wendy are thankful for our hospital — admitting they didn’t realize the significant role it played. “I never realized how important The Ottawa Hospital was until I needed it. Until 2019, I had never been sick in all of my 66 years,” he says.

“Take some time to think about what you can do to help others. It feels good to make a positive contribution to help the hospital both now and in the future.” 

— Dan Lynch

For Wendy, standing alongside her husband throughout this journey and witnessing the incredible care he received, fills her with gratitude. “It was a learning experience and we’ll always be a part of the hospital because of the care Dan received.”

Dan and Wendy Lynch
Dan and Wendy Lynch are leaving a gift in their will to our hospital.

The couple decided they wanted to do something significant to say “thank you” to our hospital. Thinking back to those values taught to him many years ago by his parents, Dan and Wendy decided they would leave a gift in their will to support The Ottawa Hospital. “We’re so grateful for what they did for me. Thanks to all the doctors, nurses, orderlies, nursing assistants, and volunteers who work so hard for patients like me. Their compassion and professionalism towards their patients under difficult circumstances is beyond reproach. Now I want to help the people who saved me.” Dan adds, “Drs. Gregory Hundemer, Arleigh McCurdy, and Michael Kennah played an important role in my care, and I can’t thank them enough.”

Dan also offers some friendly advice to others about planning for the future. “Try to do what you can and do all you can. Take some time to think about what you can do to help others. It feels good to make a positive contribution to help the hospital both now and in the future. We never know what will happen. A devastating diagnosis to you, your family, and friends can hit when you least expect. The members of the treatment teams at The Ottawa Hospital will always be there for us; let’s be there for them now and in the years to come.”

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

Categories: Cancer, Gift In Will

For months, Mina King had been dealing with painful leg ulcers caused by atherosclerosis, a condition that restricts blood flow and can result in amputation if left untreated. As a lifelong musician, this prognosis would mean more than losing her legs, it would jeopardize her ability to play the piano — one of her greatest passions. But, a cutting-edge surgery technique at The Ottawa Hospital, the collaboration of our experts at the Limb Preservation Clinic (LPC), and ongoing virtual care to monitor her healing, kept Mina from missing a beat.

Ulcers: A persistent problem

When Mina first developed sores on both of her legs, she hoped they would eventually go away with time and care. But after almost a year and a half of appointments and regular monitoring at the LPC, things weren’t heading in the right direction.

“Bypass surgeries are very complex and take several hours to complete. Not every hospital is able to perform these surgeries because they’re so technically demanding, and the vessels are so small, but The Ottawa Hospital does more of these intricate procedures than any other hospital in Ontario.”

— Dr. Sudhir Nagpal

“Even though I was getting treated for my leg ulcers, they didn’t improve in size or seem to get any better. And they were painful too,” says Mina, an 89 year old retired music teacher and lifelong musician.

Mina Jean King pictured with her husband, Stan, was treated for atherosclerosis at The Ottawa Hospital.
Mina with her husband, Stan.

Mina’s ulcers were caused by atherosclerosis, a condition where an artery’s blood circulation is slowed because of plaque buildup. While the condition is commonly caused by diabetes, it can also develop with age. Without medical attention, the ulcers can worsen, causing infections or risk of losing a limb.

“If Mina’s leg ulcers worsened, we would have to amputate her legs to save her life,” says Dr. Sudhir Nagpal, division chief of vascular surgery at The Ottawa Hospital and surgeon in Mina’s care. While it would save her life, a double amputation would mean Mina could no longer use the foot pedals of her piano — which she plays every day. “It’s been the strength of my life to be able to play the piano,” says Mina. “I knew something would have to be done.”

After a CT scan in 2020 revealed blood clots had formed in both of Mina’s legs, her care team decided it was time to take action.

Bypassing the blockage

Illustration of a leg bypass
Leg bypass illustration: as arterial blockage worsens, a graft is needed to increase bloodflow to the lower limbs.

Luckily, Mina’s ulcers hadn’t progressed to the point where she needed full amputations and surgery was still a viable option.

In August 2020, surgeons and interventional radiologists at our hospital were able to perform a minimally invasive surgery on her right leg, placing a stent in the artery, to improve blood flow and keep the artery open. However, this approach didn’t work for her other leg.

To get blood flowing in her left leg, surgeons performed a complex leg artery bypass surgery, rerouting her blood supply around the blocked artery with a graft – like a road detour. During Mina’s nearly five hour procedure, a team of highly-skilled experts in vascular surgery used magnifying glasses to carefully connect Mina’s vein around the blocked artery, above and below the obstruction, to create a new route for blood to flow.

Thankfully, Mina had access to this specialized surgical technique at our hospital — a procedure not available everywhere.

“Bypass surgeries are very complex and take several hours to complete. Not every hospital is able to perform these surgeries because they’re so technically demanding, and the vessels are so small, but The Ottawa Hospital does more of these intricate procedures than any other hospital in Ontario,” says Dr. Nagpal.

Identifying a safer anesthesia option – thanks to research

At the time of Mina’s surgery, our researchers had just wrapped up a study on anesthesia and leg artery bypass surgery. The study, which was published in The British Medical Journal in November 2020, showed that patients who had surgery to improve blood flow in their legs fared better and were able to leave the hospital earlier if they had lighter forms of anesthesia, such as epidural anesthesia, that don’t require a breathing tube.

Dr. Sudhir Nagpal The Ottawa Hospital
Dr. Sudhir Nagpal, division chief of vascular surgery at The Ottawa Hospital.

“We’re able to provide excellent, nation-leading clinical care because of the experts we have access to and the research happening right here in the clinic at The Ottawa Hospital.”

— Dr. Sudhir Nagpal

Because Mina’s surgeons had early access to the study’s results at the time of her procedure, they were able to recommend that she opt for the epidural anesthesia. “They asked me what kind of anesthesia I wanted to have and described the different ones but suggested that being 89, it would be safer to get the epidural,” says Mina. “And it all went really smoothly.”

According to Dr. Nagpal, having this research happening under our roof is critical. “Mina was able to benefit from some of the research we’re doing and have a better outcome.”

Access to world-class care

Despite the complexity, Mina’s surgeries were a success. But her path back to the piano wasn’t over yet. One week after her surgery, Mina was discharged to continue her recovery at home with the help of virtual care through the LPC.

The clinic, which began as a pilot project several years ago, brings together care providers from across our hospital with expertise in lower-body wounds. While in the clinic’s care, patients like Mina have access to experts in vascular surgery, wound care, plastic surgery, infection prevention and control, orthopedics, chiropody, and more. The model of care means that patients can access the experts they need without long delays. In fact, it’s a model that hospitals across the country are looking to follow.

“The collaboration between multiple different skill sets and specialties all in one place is what really separates our Limb Preservation Clinic from others like it in Canada,” explains Dr. Nagpal. “We’re able to provide excellent, world-class clinical care because of the experts we have access to and the research happening right here in the clinic at The Ottawa Hospital.”

Mina, with her family, had leg artery bypass surgery at The Ottawa Hospital.
Mina with son David, daughter Jennifer, and husband Stan.

Mina’s care team tracked the progress of her ulcers through a wound care software called how2trak. With the help of an at-home nurse who made weekly visits to Mina’s home following her surgery, photos of Mina’s leg wounds were uploaded into the software and analyzed by her care team to determine if the wound was getting better or worse over time.

“Through this software, we’re able to see that Mina’s ulcers have gone from being fairly large in size to the point where they’re almost healed,” says Dr. Nagpal. “We can do all this while she’s in the comfort of her home.”

Back at the piano

As Mina’s condition improved, her visits with the at-home nurse and experts in the LPC became less frequent. “I feel quite happy about the way things have gone. I don’t have pain now,” says Mina. “Dr. Nagpal was an excellent doctor.”

“It’s been the strength of my life to be able to play the piano.”

— Mina King

Now, with her ulcers nearly healed and access to the expertise of her care team just a virtual call away, Mina is back to her routine of playing the piano every day — without worry.

“I was very glad to get back home and get back to my piano. I think it was one of the things that helped me recover so quickly,” she says. “When I get tired, or anything’s bothering me, I sit down at the piano and it seems to just take it all away.”

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

Categories: World-Leading Research

Originally published: May, 2021

Early in the fall of 2020, Michele Juma noticed the vision in her left eye was becoming cloudy. The Sault Ste. Marie resident initially turned to her family doctor for answers. She learned she had a meningioma tumour — and time was not on her side to save her vision. Fearing she would face blindness, Michele, a mom of four, eventually travelled to The Ottawa Hospital where she could receive specialized care — care she could not receive close to home.

It was early November when MRI results revealed the mass at the base of her frontal lobe. “By this time, I lost my ability to see colour in my left eye — my vision was deteriorating. It was like looking through a frosted window,” remembers Michele. While her right eye would start compensating to get her through her day-to-day, Michele was finding the routine of caring for her teenage boys and working a challenge and knew she needed to see a specialist. Soon, she and her husband were making plans for the eight-hour drive to Ottawa to meet with Dr. Danah Albreiki at the University of Ottawa Eye Institute located at The Ottawa Hospital.

Seeking answers at the University of Ottawa Eye Institute

The University of Ottawa Eye Institute was founded in 1992 as the home of The Ottawa Hospital’s Department of Ophthalmology. It is a major clinical, teaching, and research centre in Canada specializing in diseases and conditions that affect the eyes. Dr. Albreiki’s expertise focuses on neuro-ophthalmology and adult strabismus surgery, which focuses on straightening misaligned eyes.

Born and raised in Saudi Arabia, Dr. Albreiki says our Eye Institute plays an international role in sharing our expertise with patients and ophthalmologists in more than 86 countries around the world. As one example, she explains, the Ottawa Eye Institute has an affiliation with India Srikiran Institute of Ophthalmology in Kakinada, Andhra Pradesh. Affiliations like these provide an opportunity for the ophthalmology residents to travel and explore ophthalmology in a very different setting.

Having done her ophthalmology residency in Ottawa, Dr. Albreiki reflects on the importance of teaching. “I think the Eye Institute is honestly an amazing academic place where staff are dedicated first and foremost to their patients, but have a heavy focus for teaching the ophthalmology residents. This ripple effect extends beyond Ottawa and will travel wherever the residents end up working as they share their knowledge and expertise with their communities. As a matter of fact, Michele was seen first by our neuro-ophthalmology fellow Dr. Noran Badeeb who came all the way from Saudi Arabia to train with us.”

Michele, pictured with her family, was treated at the Ottawa Hospital for meningioma tumour.
Michele with her family.

“The danger is it’s very close to the optic nerve, and Michele is a good example of how people can quickly deteriorate with these tumours, and they are at high risk of losing their vision.”

— Dr. Fahad Alkherayf

By early December, Michele met Dr. Albreiki’s team and she learned what was happening with the tumour. “If we leave tumours that are compressing on the optic nerve for too long, there is a high chance that it will damage the optic nerve which subsequently leads to permanent vision loss,” explains Dr. Albreiki. She adds, “Despite the severe vision loss that had happened, we were able to determine, by way of ophthalmic diagnostic testing, that Michele’s optic nerve appeared more suffocated than actually dead. By removing the suffocation, we would allow the optic nerve to breathe again and there would be a good chance she would regain part, if not all, of her vision.”

For that to happen, they would need to act fast.

Understanding meningioma tumours

Knowing Michele had travelled from Sault Ste. Marie for her initial meeting at the Eye Institute, Dr. Albreiki arranged for her to meet later that day with world-class, skull base surgeon Dr. Fahad Alkherayf who set in motion a plan to remove the mass.

He explained to Michele that she had a skull base meningioma. The tumour was about three centimetres by three centimetres — about the size of a golf ball. The biggest challenge with removing these types of tumours is often their location. “How you can reach it without damaging the brain around it and the things attached to it is key. If you’re not careful, and you end up injuring any of these structures, unfortunately, the outcome is devastating,” explains Dr. Alkherayf.

“The Ottawa Hospital is one of the main leading centres in minimally invasive skull base surgery, and I think that speaks to the expertise we have in our centre.”

— Dr. Fahad Alkherayf

Minimally invasive surgery offers new treatment options

Minimally invasive skull base surgery uses a narrow scope with a light to access and remove tumours through the nose.

The treatment used today for a meningioma tumour is relatively new. In the past, it was a much more invasive procedure known as a craniotomy, which results in a large incision with a higher risk of injuring the optic nerve. However, today minimally invasive surgery allows much more effective and safer care for our patients. “Instead of the old, traditional way of going through the skull, and lifting the brain — today, we go through the nose,” explains Dr. Alkherayf. This means no incision, faster recovery time, reduced pain, a higher accuracy rate compared to traditional open surgery, and a shorter hospital stay.

The Ottawa Hospital has established itself as a leader in Canada when it comes to this type of minimally invasive surgery. Dr. Alkherayf says we’re one of the largest centres in Canada doing it. “If we look across the country, The Ottawa Hospital is one of the main leading centres in minimally invasive skull base surgery, and I think that speaks to the expertise we have in our centre. It’s not just surgeons but it takes a good anesthesia, nursing, and neurophysiology team, so the surgeon can function well. I think what’s unique about our hospital is we have this full package providing care to our patients.”

Having access to this expertise is a significant advantage for patients like Michele, who required urgent surgery due to the rapid growth of the tumour and the risk of it causing blindness not only in her left eye but in her other eye as well. After meeting with Dr. Alkherayf as well as Dr. Shaun Kilty, an ear, nose, and throat (ENT) specialist, her surgery was scheduled for December 17, 2020.

Michele remembers feeling anxious and nervous. “It was all really overwhelming — and surreal. When I think that I’d been walking around with this tumour probably for years…it was kind of unbelievable to me to think of the whole gravity of the situation.” However, Michele says she knew she was in good hands. “I do have to say that when I met with Drs. Albreiki, Alkherayf, and Kilty, they were very reassuring and answered all our questions, significantly reducing my anxiety.”

Michele being wheeled into surgery at The Ottawa Hospital to remove her meningioma tumour.
Michele being wheeled into surgery at The Ottawa Hospital to remove her meningioma tumour.

Specialized technique used only at The Ottawa Hospital

Leaving their four sons at home, Michele and her husband arrived back in Ottawa just over a week before Christmas. The minimally invasive surgery would last eight hours with Drs. Alkherayf and Kilty working alongside one another to remove the tumour piece by piece — through Michele’s nose.

“The monitoring helped ensure we didn’t pull too hard on her optic nerve. If it wasn’t for this specialized technique, I don’t think we would have achieved the same results.”

— Dr. Fahad Alkherayf
Continuous evoked visual potential goggles are used by surgeons during some brain and skull surgeons to monitor a patient’s vision and avoid damaging the optic nerve.

During the procedure, Dr. Alkherayf was able to monitor Michele’s vision. In fact, our hospital is the only centre in Canada using this specialized technique. “We have established a method where we can receive a signal from the eye, as well as from the optic nerve and the brain, about what’s happening to the vision while the patient is asleep.” Goggles — which resemble swimming goggles — are placed on the patient while they’re under anesthetic. The goggles send a flashing light, which sends a signal into their retina, and then it travels down their optic nerve, crosses the chiasma (the back of the optic nerves where they meet), and then travels to the vision centre of the brain. The signals will change if the surgeon’s pushing or pulling the optic nerves and potentially damaging them.

According to Dr. Alkherayf, this technique was critical during Michele’s surgery. “Her tumour was basically glued to her optic nerve, which explains why she was having this significant vision problem. The monitoring helped ensure we didn’t pull on her optic nerve. If it wasn’t for this specialized technique, I don’t think we might have achieved the same results.”

The future is looking clear

For the first five days after surgery, Michele says there was a lot of sleeping, but she remembers the moment when she woke up for the first time and she opened her eyes. “My husband was there, and I was able to see — it was right away that I could see again!” Even better news, before Michele was released from the hospital on Christmas Eve, Dr. Alkherayf shared the news she had been hoping for – the tumour was benign, and he was able to completely remove it.

“I’m grateful to be able to watch my sons continue to grow and, of course, to have the chance to be part of the activities they love most, like swimming and hockey.”

— Michele Juma

With this life-changing news in hand, Michele and her husband began their long drive back home to Sault Ste. Marie arriving home at 11:30 p.m. on December 24, just in time to be with their children for Christmas. “It was like a Hallmark movie,” laughs Michele.

Michele, with her husband and four sons, after arriving home in time for Christmas in 2020.

Today, her vision is fully restored. She’s back at work and keeping up with the busy life that comes with raising four teenage boys. “I consider myself to be so incredibly fortunate to have had Drs. Alkherayf and Kilty conduct this surgery. When I think about the complexity of what they did, I never cease to be amazed, and I feel truly blessed.”

While she and her family truly appreciate the exceptional skill of both physicians, Michele adds they were kind, compassionate, and empathic throughout her journey. “As scary as all this was, I can honestly say that I always felt confident that I was in very good hands.” She adds, “I’m grateful to be able to watch my sons continue to grow and, of course, to have the chance to be part of the activities they love most, like swimming and hockey.”

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

Categories: COVID-19, Innovation and Technology, Technology

When COVID-19 moved into the Ottawa region in March of 2020, we were in uncharted territory. However, despite the rapidly changing information in the early days, and the unknowns about this virus, something very clear began to emerge – unity. The community would soon show an outpouring of support for The Ottawa Hospital while healthcare teams rallied together to care for patients.

“Thank you to our generous donors – some who reached out for the first time.”
– Tim Kluke

As our front-line workers would go into the hospital each day to face the virus head-on, the community stayed home to help flatten the curve. Nevertheless, it became obvious residents wanted to do more – and they did. Donations both big and small began streaming in and the COVID-19 Emergency Response Fund was created. To date, more than $2 million has been generously donated to support our hospital’s COVID-19 efforts and these donations have already been put to work. Tim Kluke, President and CEO of The Ottawa Hospital Foundation, says this support has made a world of a difference supporting both research and care projects. “This proves once again that we really are stronger when we pull together. Thank you to our generous donors – some of whom have even reached out for the first time. Research currently underway will allow us to better understand and treat the virus, to keep our patients and our community safe.” Donations continue to be accepted today.

Personal Protective Equipment (PPE) was another way our community lent a helping hand. The Ottawa Chinese Community quickly mobilized and raised over $120,000 to purchase necessary equipment like ventilators and PPE for our staff.

In Their Own Words: Good Days, Bad Days, and What Keeps Them Coming Back

Stepping into the unknown

While the community united to show their support for our front-line workers, a COVID-19 floor was created at both the General and Civic Campuses to care for the patients who tested positive for the virus. The team at the General Campus that had originally cared for Thoracic, ENT (Ear, Nose, and Throat), and surgical patients would, almost overnight, become the team caring for COVID-19 patients. Little did they know at the time, they would be caring for these patients for well over a year. “We have a background in lungs and breathing issues on our unit, so we were a natural fit to care for these patients,” says Vanessa Large, a registered nurse at our hospital for the past four years.

Vanessa Large, Kristine Belmore, and Leah Mills worked on the “COVID floor” in 2020. Pictured above wearing personal protective equipment (Image 1) and without (Image 2).

Nevertheless, it was a daunting and draining task. Kristine Belmore is a registered nurse who has been at our hospital for 11 years and never did she imagine her career taking this step. “I was working the day the first positive patients came in. We were constantly getting new updates on protocols for caring for these patients – not just daily but during our shifts,” says Belmore. She adds, “It was the equivalent of how I felt when I was a new nurse preparing for a shift — I didn’t sleep well. I was anxious and there was the fear of the unknown.”

Leah Mills was just three years into her career as a registered nurse when she found herself caring for COVID-19 patients. “There was no easing into the COVID transition; it turned our world upside down,” says Leah.

Resilience as weeks turn into months

Dr. Samantha Halman helps a COVID-19 patient communicate with their loved ones via an iPad.
Dr. Samantha Halman helps a patient communicate with their loved ones via an iPad.

In those early weeks of caring for patients, there was the struggle of watching some patients go from appearing stable to suddenly clinging to life. Those days would take an emotional toll on these nurses. “The increase in demand during the surge of patients was overwhelming. Over time it became easier because we had concrete policies in place and we started recognizing a pattern in patient’s decline,” recalls Leah.

“We became their only sources of human connection, we became their second family. We would be there holding an iPad so they could see the friendly smile of a loved one – sometimes it was to say goodbye.” – Vanessa Large

The playbook had to be reinvented and new ideas had to be considered to help calm patients when they struggled to breathe or feared what might happen next. Then there were the layers of PPE, which created an additional level of safety but also a new challenge. “Caring for patients, especially the elderly who can be confused, was difficult because they can’t see your facial expressions – we had to find new ways to reassure patients when they were scared. We also became the link between the patient and the family, through phone calls and video calls – something we’ve never done before,” says Kristine.

Vanessa agrees adding, “We became their only sources of human connection, we became their second family. We would be there holding an iPad so they could see the friendly smile of a loved one – sometimes it was to say goodbye.”

Mentally and emotionally, the long haul of this pandemic started to wear on these nurses. Leah explains they’re used to helping patients heal and get better. “We’re feeling burned out and exhausted seeing patients decline quickly and sometimes die. It’s not what I’ve been used to in my role.”

Thankfully, over the past year, this dedicated care team has helped ensure the majority of COVID-19 patients have been able to regain their health and return home to their loved ones.

The nurses of the “COVID floor”

“Working on the COVID-19 Unit, with the numbers going up and down, you never know which point is going to be the tipping point.”
— Leah
“The best part about starting on the COVID-19 Unit was the team. Everyone was very supportive, willing to teach the newbies on the unit. And, the patients especially, they were very accommodating, and I will remember them for a long time to come.”
— Margaret
“My worst part of this year was seeing a lot of suffering and not being able to help as much as I would want to.”
— Michael
“COVID-19 has taught me to really value and cherish the time that I had with my family, my friends, and my colleagues.”
— Jeannette

COVID-19 patient grateful for compassionate care

One of the patients, who experienced firsthand compassionate care on the COVID-19 floor, was Fr. Alex Michalopulos. The Greek Orthodox priest spent 10 days in our hospital. He couldn’t be more thankful to be feeling better today. “For the times when the doctors or nurses came in to see me, for the times when I was reassured—I’m thankful I was well taken care of with love and respect for human life.”

“I have a lot more respect for the medical professionals. I always had, but this time it was at a different level. They were there for me.” – Fr. Alex Michalopulos

Fr. Alex Michalopoulos was treated for COVID-19 at The Ottawa Hospital last year.
Father Alex Michalopoulos of the Greek Orthodox Church. Father Alex was treated for COVID-19 at The Ottawa Hospital last year.

As tears well up in his eyes, and he stops briefly to regain his emotions, Fr. Michalopulos says it’s sometimes good to be on the other side, to feel what others are going through. “I have a lot more respect for the medical professionals. I always had, but this time it was at a different level. They were there for me.”

He adds, “They held my hand. They showed compassion. They showed a lot of respect and love. I will be forever grateful for them.” It was that special touch, and care from complete strangers that helped give Fr. Michalopulos the strength to get back home to the family he loves and eventually to his parish family.

“I will always remember how I was treated by strangers. I admire them and will always pray for them.”

In an effort to do his part to help, Fr. Michalopulos is participating in research that is investigating the long-term effects of the virus. Drs. Sara J. Abdallah and Juthaporn Cowan are checking in on participating patients, like Fr. Michalopulos at three, six, and 12 months after they were initially infected.

He explains why it was important to become involved. “I thought it would be useful to help researchers understand the effects and lingering effects of the virus in gathering information to help create a vaccine and or a cure.”

Giving back through research

Researchers at our hospital have been deeply involved in the global race to combat COVID-19. They are exploring more than 60 research projects to support the worldwide effort to find better ways to treat and prevent the virus. A number of those projects have been supported by donors through the COVID-19 Emergency Response Fund, including a world-first clinical trial, led by Dr. Rebecca Auer, which aims to protect cancer patients from COVID-19 – to date, 22 patients, have been recruited.

Dr. John Bell is a senior scientist in the cancer therapeutics program at The Ottawa Hospital.
Dr. Carolina Ilkow is a scientist in the cancer therapeutics program at The Ottawa Hospital.

Drs. John Bell and Carolina Ilkow are harnessing their expertise in making cancer-fighting viruses to develop a vaccine against COVID-19 — a made-in-Canada solution. In addition, our Biotherapeutics Manufacturing Centre is helping to manufacture three other COVID vaccines for clinical trials, as well as an experimental stem cell therapy.

Pushing forward despite a challenging year

As research continues to produce more answers and vaccines continue to roll out across the region, the team caring for patients remains steadfast. “The vaccine brings us hope. I remember how exciting it was when I received mine,” says Kristine.

A nurse at The Ottawa Hospital administers the COVID vaccine to a healthcare worker.
Venus Lucero, a nurse at The Ottawa Hospital, administers the hospital’s first dose of the COVID vaccine.

There is hope someday they can start getting back to the way things used to be, or at least close to it. For Kristine, it would mean not worrying about hugging her children when she comes home from work.

For Leah, it would mean letting her mind shut off for the first time in a year – and truly relax. For Vanessa, it would mean the excitement of spending time with her fiancé, Colin – also a frontline worker – as they’ve been isolated from each other during the pandemic. Despite the challenges, each one takes great pride in the care they’ve been able to provide during these unprecedented times. And how they also helped each other along the way.

Check out Pulse Podcast to hear more about a year of working on the COVID floor.

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

Categories: Biotherapeutics, COVID-19, Donors, Gratitude Award, World-Leading Research

Clarence Byrd was always keenly aware of how he wanted to live his life and what would happen when he was gone. He passed away peacefully on May 30, 2020, through the Medical Assistance in Dying (MAiD) program. In the days leading up to his passing at his home in downtown Ottawa, he carefully planned how he would leave a gift in his will to The Ottawa Hospital — ensuring his strong belief in philanthropy would continue for years to come.

Clarence and his wife, Ida Chen, were married for 43 years. It was a beautiful life, during which they did almost everything together. “From day one, we were best friends, and our complementary skills allowed us to produce more than 150 books on financial accounting and taxation including Canadian Tax Principles, the leading tax text for Canada’s colleges and universities,” wrote Clarence before he died.

“Our life together was beyond our wildest dreams; it was a wonderful romance.”

— Clarence Byrd

After retiring from teaching 15 years ago, Clarence and Ida were together constantly. They loved the outdoors and enjoyed every minute of their time together hiking, skiing, or biking all over North America.

Shocked by a cancer diagnosis

However, in December 2016, Ida faced a shocking diagnosis – glioblastoma, a particularly aggressive type of brain tumour. She faced multiple surgeries, one that included a revolutionary microscope, which was on loan to our hospital at the time. Shortly after that particular surgery, recognizing how vital this piece of equipment was, Clarence and Ida made a substantial contribution towards its purchase. Philanthropy was always an important part of their life and thanks to their generosity, many patients have benefitted from this lifesaving surgical tool, one of only a handful in Canada.

Clarence and Ida skating
Clarence and Ida skating on the Rideau Canal Skateway.

By November 6, 2019, Clarence said goodbye to the love of his life. Ida passed away peacefully with medical assistance. She no longer had to suffer.

Unbelievably, less than four months after Ida’s death, Clarence was diagnosed with esophageal cancer. He would learn that because of the tumour’s location, surgery was not an option, and he was given 12 to 18 months to live.

That’s when Clarence set into motion his plan for how he would live the rest of his days and what would happen to his estate when he was gone. He applied for MAiD and was approved. This news gave Clarence the peace of mind he needed, “There was tremendous comfort knowing that I would not have to undergo unnecessary suffering at the end of my life,” wrote Clarence.

Educating others well into the future

Laura Wilding, Advanced Practice Nurse at The Ottawa Hospital and Program Manager, Champlain Regional MAiD Network, helped plan both Clarence and Ida’s procedures. Since MAiD was introduced four years ago, patients have come forward to tell Laura that they want to support the hospital by leaving a gift in their will. Clarence made it very clear to her that’s what he wanted to do. “He actually delayed having MAiD to make sure his donation was allocated the way he wanted,” says Laura.

“They found that the doctors, nurses, and staff were all so accommodating and knowledgeable about their conditions. This was the reason that Clarence wanted to leave his gift to the hospital.”

— Joshua Smith

The couple had successful careers, and it was important to Clarence to use his good fortune to help pave the way for the future, even after he was gone. Laura recalls Clarence saying, “’We have money, we are philanthropists, and we feel strongly that more people need to know and understand MAiD.’”

Clarence and Ida on a hiking adventure – Banff National Park.
The couple enjoyed playing music together at their home.

Clarence’s accountant, Joshua Smith, a partner at Welch LLP, explains that Clarence and Ida’s experiences at The Ottawa Hospital left an impression. “They found that the doctors, nurses, and staff were all so accommodating and knowledgeable about their conditions. This was the reason that Clarence wanted to leave his gift to the hospital,” says Joshua.

“His generosity will have a long-term impact on care at the hospital and Clarence knew that.”

— Laura Wilding

Margaret Tardiff was a close friend of the couple. She emphasized how education was always so important to Clarence and his gift to our hospital will honour that well into the future. “He was always educating himself and others; he felt that education would help people to understand the value of the MAiD program,” says Margaret.

A lasting legacy

Clarence’s legacy will be felt for decades by patients and their families at our hospital. “His generosity will have a long-term impact on care at the hospital and Clarence knew that,” says Laura.

Clarence passed away at the age of 82 in his home, on his own terms, and with his estate planned exactly to his wishes. It marked the end of a well-celebrated life that included 43 years with his beloved wife, Ida. In fact, Clarence wrote in an article for the Ottawa Citizen before his death, “Our life together was beyond our wildest dreams; it was a wonderful romance.”

A wonderful life with a legacy that will live on thanks to Clarence’s forward thinking to support The Ottawa Hospital – a philanthropist to the very end.

Clarence at Yoho National Park
Clarence in Yoho National Park, BC.

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

Categories: Donors, Donors, Donors, Gift In Will

“We are the only Level 1 Trauma Centre for adults in eastern Ontario, so we see the most critically injured patients from all across the region, including Quebec in certain circumstances. Our team has the capacity to handle almost any injury.”

– Dr. Maher Matar

As darkness falls over the city and most are sleeping, that’s when many of our patients arrive at the Trauma Centre. My name is Maher Matar, I’m a trauma surgeon at The Ottawa Hospital, and it’s not unusual to be jolted out of a sound sleep in the middle of the night after a Code One is called. I have just minutes, 20 minutes to be exact, to pull myself together, arrive at the Emergency Department (ED) of the Civic Campus, and join the rest of the trauma team that has assembled. All of us are ready and functioning at 110%. Lives depend on it.

Dr. Matar, trauma surgeon
Dr. Maher Matar, trauma surgeon at The Ottawa Hospital.

The only Level 1 Trauma Team for adults in the region

We are the only Level 1 Trauma Centre for adults in eastern Ontario, so we see the most critically injured patients from all across the region, including Québec in certain circumstances. Our team has the capacity to handle almost any injury.

Our team includes a trauma team leader like myself, as well as an anesthesiologist, a team of emergency nurses, a group of resident physicians, and respiratory therapists — this allows us to be ready for the wide variety of complex cases that we handle, or when a Code One is called.

A Code One means a patient with significant injuries is coming to the hospital and we need all resources gathered at the ED. It could be a few patients involved in a high-speed motor vehicle collision or a single patient that fell down the stairs. By contrast, a large-scale incident like the Westboro bus crash or any other community disaster results in a Code Orange being called

Life as a TOH Trauma Surgeon

Life as a TOH Trauma Surgeon

5 Videos

Snowmobile crash brings life-threatening injuries

Back on January 18, 2020, I was jolted awake from the comfort of my warm bed, when I got a call in the middle of the night from a nearby Québec hospital. They had a patient with a transected aorta – that means the aorta, the main blood vessel that travels from the heart, had ruptured or torn. When I heard that, I knew the patient’s chances of making it to our hospital were slim.

His name was Cody Howard, and while visiting from Arizona, he had been in a snowmobile crash in Ripon, Québec, about 70 minutes from Ottawa. The fact that he made it to the first hospital was hopeful, but with this type of injury, he could suddenly crash. Cody needed our expertise to help save him.

Trauma team during a training session at The Ottawa Hospital
Doctors, nurses, and specialists work on a trauma patient in an intense training simulation in the trauma bay at The Ottawa Hospital.

I began caring for Cody on that phone call, explaining to the team on the other end of the phone what medications should be started and how Cody should be transferred to our Trauma Centre.

“The patient was lying flat and, incredibly, he was awake and alert. He knew he was in a very precarious situation.”
– Dr. Maher Matar

As I drove to the hospital, I called Cheryl Symington, a charge nurse who was working in the ED that night. She’s a team lead and she’s amazing. I told her “This is a bad one. I need everyone on deck.”

The trauma team is ready

I immediately called the vascular surgery team and told them to be on standby as soon as Cody arrived.

Cody made it to the Trauma Centre with his younger brother, Trevor Howard, who had not been involved in the crash. Cody was lying flat and incredibly, he was awake and alert. He knew he was in a very precarious situation. In fact, even a small movement could have been fatal. We did our assessment from A to Z, the same way we do it every single time, making sure we don’t miss any injuries. As this is happening, I’m on the phone with Dr. Prasad Jetty, a vascular surgeon. He also consulted with a cardiac surgeon, Dr. Fraser Rubens. You know, we’re lucky to have that kind of skill close by at the University of Ottawa Heart Institute.

“In my 30 plus years as an ED nurse, that was by far the most difficult yet most rewarding night. Dr. Matar, Dr. Jetty, and Dr. Reubens are each highly skilled specialists in their fields. Together they are a team beyond description. The stars aligned that night.”
– Cheryl Syminton

Dr. Rubens came to the trauma bay – a cardiac surgeon rarely comes to the trauma bay – that’s an indicator of the severity of this injury. At this point, the three of us were discussing the patient and we agreed he had a very high chance of dying on the operating table; there was also the potential for paralysis. Everything happened fast – this all took place in the first 30 minutes of Cody arriving.

Making the difficult call to the family

I then called the patient’s father in Arizona who also happens to be a doctor. I had to tell him the grim news. However, I promised him the people taking care of his son were the best in the entire region. I told him to focus on getting to Ottawa and that we’ll take care of the rest.

It’s never easy making those calls. Breaking bad news to family members or letting someone know their loved one is going in for a very serious surgery – it weighs on you. Thankfully, social workers at our hospital are always there to help. If I’m busy caring for the patient, a social worker receives the family and updates them on what’s going on. They play an immense role in our ED.

More injured patients arrive

As Cody’s surgery plan was being made, his brother, Trevor, came up to me and said, ‘there are two more of us’ I said, ‘excuse me?’ I was shocked! He explained that another brother, Bret, and his brother-in-law were also injured in the snowmobile crash and were still at a nearby hospital in Québec.

“I promised him the people taking care of his son were the best trained in the entire region. I told him to focus on getting to Ottawa and we’ll take care of the rest.”

– Dr. Maher Matar

That’s when the compassionate side of caring plays a key role in the work we do – in the work we all do. We can’t have the family arrive in Ottawa and have to go back and forth between two hospitals, worried about their injured kids. They were already dealing with enough stress and needed to be together.


We called the other hospital and we arranged for immediate acceptance of the two family members, regardless of the extent of their injuries. While the brother-in-law had only minor injuries, Bret, had a significant head injury along with an injury in the abdomen. I needed to get him to the operating room to repair a ruptured bladder. The vascular surgery team and cardiac surgery team took Cody for surgery at the Heart Institute and I took Bret into emergency surgery at the Civic Campus, simultaneously.

Intense training situation with the trauma team at The Ottawa Hospital
Doctors, nurses, and specialists work on a trauma patient in an intense training simulation in the trauma bay at The Ottawa Hospital.

A successful night as lives are saved

Bret made a quick recovery. After 10 days in our hospital, he was able to fly home. It was a longer road for Cody. Thankfully, he survived surgery but faced paralysis from the waist down. The 37-year-old U.S. military veteran was in a coma for a week and remained in our care until mid-February, when he was stable enough to get a medical flight back home. He had a tough recovery, but he’s learned to walk again. The last time I spoke with him, he told me he’s now hiking.

“When you do hear ‘thank you’ from a patient or a family member, it’s humbling. It doesn’t make you walk prouder, it’s just humbling”

– Dr. Maher Matar

That was a successful day. It all started after midnight. All hands were on deck, including the highly-skilled Drs. Jetty and Rubens. We had never worked together before and those two collaborated on that case and saved the patient’s life. Also, there’s the exceptional anesthesia care provided by Dr. Adam Dryden – he worked with speed and efficiency to help save the patient. It was a team effort on many levels.

Humbling to hear the words “thank you”

And, when you hear ‘thank you’ from a patient or a family member, it’s humbling. It doesn’t make you walk prouder, it’s just humbling. There have been cases where I haven’t been able to save a life and that will always haunt me.

At the end of the day, when I walk out the hospital doors, the first thing I do is take a deep breath because the air is different outside. I just look up and I say ‘thank you’ for being able to deliver that specialized care.

Bret Howard says thank you for the compassionate, lifesaving care

“I truly don’t believe Cody would be alive today if he hadn’t been transferred to The Ottawa Hospital – that saved his life.

“Had we been somewhere other than The Ottawa Hospital, we think the outcome would have been worse, so we’re forever grateful.”

– Bret Howard

The way the team stepped in to get all of us together was a special thing to do and we won’t ever forget that – I actually don’t think that’s typical. I couldn’t have imagined going through all of this at one hospital while my brother fought for his life at The Ottawa Hospital. It meant a great deal to my family that we were all together.

Dr. Matar was incredible. Not only with my surgery but to my family – my wife and my parents. He and his team guided them along and was totally in tune with what was going on with me and my brother.

Thank you to the nurses, to the doctors, to the social workers. I could just tell they were invested in the situation with us and truly wanted to help guide us through it. Had we been somewhere other than The Ottawa Hospital, we think the outcome would have been worse, so we’re forever grateful.”

Bret and his brothers
Cody, Trevor and Bret Howard.

Research advancing trauma care

Research at The Ottawa Hospital is helping to improve survival and quality of life for people who experience severe traumatic injuries. Projects underway include:

  • developing of a simple tool to help detect major bleeding in trauma patients, so that it can be treated earlier.
  • testing new approaches to manage bleeding and blood clots in people with traumatic head injuries.
  • developing of new rehabilitation technologies and prosthetics, including a brain computer interface that could help people control a robot arm just by thinking.
  • developing a tool to help paramedics determine which trauma patients need to be immobilized on backboards, and which can be safely evaluated without immobilization.

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

Categories: Trauma

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

Facing a war zone

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

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

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

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

Seeking medical attention

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

Bushra in Germany
Bushra waking in Germany.

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

Road to healing and recovery

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

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

The women of the Rehab Centre

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

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

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

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

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

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

Discovering hope

Bushra, prosthetic leg
Bushra’s prosthesis.

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

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

The CAREN System

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

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

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

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

New life after trauma

Bushra with her baby
Bushra holding her daughter.

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

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

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

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

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

More than a decade later

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

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

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

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

The sun has set on THE RIDE, one of Ottawa’s premier cycling events, but that hasn’t stopped Mike Bull, former RIDE captain for Team Enterprise, from participating and giving back as he starts his own virtual ride as a fundraiser for The Ottawa Hospital. Charitable giving, in support of our hospital in particular, is incredibly important to Mike Bull and his family, after his wife, Rie, was rushed to our emergency department after collapsing – the result of a ruptured brain aneurysm.

It is Rie’s journey to recovery and the care that saved her life that inspires Mike to give back each year. “With every year we see that more people are willing to help out, support my ride, and donate. We are fortunate to have such an incredible neuroscience team right here in Ottawa. They saved my wife’s life.”

Subarachnoid Hemorrhage

Late one night in March 2017, Rie collapsed at home after an aneurysm had bled inside of her brain. She was rushed to The Ottawa Hospital where she was diagnosed with a subarachnoid hemorrhage which was exacerbated by a pre-existing condition requiring blood-thinning medication. Unable to speak for the first three weeks and temporarily forgetting her husband’s name and that of her two sons, her family was fearful and unsure whether or not she would recover.

Dr. Sinclair in the neurosurgery operating room
Dr. John Sinclair, Director of Cerebrovascular Surgery.

Rie underwent an 8-hour operation performed by Dr. John Sinclair, Director of Cerebrovascular Surgery. Post-surgery, he comforted Mike and his sons with a bedside manner that was both caring and compassionate. He fielded questions, explained complex medical concepts in simple terms, and reassured them that Rie was in excellent hands as she recovered.

Ready for the most complex cases

Rie’s bleeding disorder and subsequent aneurysm made her case incredibly complex. Three to four percent of the population at large have aneurysms and don’t even know it. A ruptured aneurysm often causes a sudden severe headache, which people often describe as the worst headache of their life. But when an aneurysm like Rie’s ruptures, 50% of patients do not survive the hemorrhage or die shortly after. Of the 50% of patients who survive, half survive with a life-altering impairment.

Despite the complexity of Rie’s case, her care team was ready and equipped with the knowledge and tools they needed to save her life. According to Mike, their prayers have been answered and Rie has made excellent progress.

Rie Bull
Rie Bull at home.

“She spent over a month in the ICU, a month in the Neurological Acute Care Unit, and five weeks in the Acquired Brain Injury Rehabilitation Centre. All staff members took fantastic care of my wife.” – Mike Bull

As part of her recovery, Rie had to learn English all over again, as she had reverted to her first language of Japanese. When Mike and Rie saw Dr. Sinclair in January of 2018, he was very pleased by Rie’s recovery.

Thanks to the support of donors like Mike and Rie, The Ottawa Hospital can conduct groundbreaking research to better understand how the brain functions and to continue to be among the best in Canada, recognized internationally for leading research in Parkinson’s, stroke, neuromuscular disease, and multiple sclerosis.

Grateful for exceptional care

Mike now affectionately calls it “old home week” every time he and Rie visit The Ottawa Hospital for appointments or check-ups. They are constantly running into doctors, nurses, orderlies, and custodians who are genuinely happy to see how far Rie has come and understand that her recovery is remarkable. To Mike and Rie, each one of them has played an important role in Rie’s journey.

Mike Bull with his family in support of The Ottawa Hospital
Mike and Rie Bull with their sons.

Mike is more determined than ever to give back and make a difference. He will continue to get outdoors, hop on his bike, and raise funds and awareness for our hospital. He hopes his virtual ride will serve as a reminder to everyone how important donor support is to help patients receive the care they need. “It’s doing something good for your body, for research, and the community overall. It will always be a way to say, ‘thank you, thank you, thank you’ to the team at The Ottawa Hospital!”

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

Categories: Neuro

Donate today to join Mike and Rie in supporting lifesaving research at The Ottawa Hospital.

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