Category: Patient Care

A resident of Goose Bay, N.L., most of his life, John Bookalam lives for the outdoors. He loves adventures, including international cycling and skiing in the winter. The retired guidance counsellor cherishes that time even more today, after a harrowing medical diagnosis unexpectedly led him to The Ottawa Hospital for neurosurgery.

It all began in late winter of 2017 when John returned from teaching a ski lesson. He was unloading his gear from his SUV when he hit the back of his head hard on the hatch door. Initially concerned he might have a concussion, John quickly eliminated the possibility thanks to his first-aid training. However, a week later, he followed up with his family doctor and an ultrasound revealed what appeared to be a hematoma, a collection of blood outside a blood vessel, which would normally resolve itself. “But the next week, I had to see my doctor again and the hematoma went from four centimetres on the ultrasound to eight centimetres,” says John.

“I was so nervous. I could hardly think.”

— John Bookalam
John on his last solo cycle in the mountainous north west part of the isle of Majorca before his lifesaving neurosurgery at The Ottawa Hospital.
John on his last solo cycle in the mountainous north west part of the isle of Majorca before his 2017 illness.

The situation turns dire

John’s care team in Goose Bay closely monitored him for many weeks. However, by the end of May, he developed symptoms similar to the flu. “I was burning up. I was on fire and I immediately went to the emergency department of my local hospital. Those symptoms would be a bad omen,” says John.

A CAT scan revealed the hematoma had grown from eight centimetres to 10.6, and the situation was becoming dire. He needed a skilled neurosurgery team to help him — a team that was not available in Newfoundland and Labrador. With roots back in Ontario, he turned to his dear friend, Nadia Marshy, from the Ottawa area for guidance.

Nadia vividly remembers the day she got the call from “Labrador John,” a nickname she gave him through their cycling adventures. She was sitting at her desk when she picked up the phone — John was at his wit’s end. “I knew he’d been hit hard on the head and it had caused a large bump. That was weeks earlier, so I presumed that he was all healed up by now. John proceeded to tell me that not only was the bump much larger, but he was in constant pain,” recalls Nadia.

“She played a vital role in identifying The Ottawa Hospital as an emergency life-line to receive lifesaving surgery.”

— John Bookalam

Calling on our neurosurgery experts for help

Following that call, Nadia was beside herself and she knew her friend was in a medical emergency. “Here I was sitting in my sunny downtown Ottawa office with The Ottawa Hospital and all of its innovation and world-class services next door, and there was my dear friend with this massive, infected lump the size of a grapefruit in desperate need of help and so far away.”

Next, Nadia worked to get John in touch with the neurosurgery department at our hospital — she had witnessed the skill firsthand in 2012 when Dr. John Sinclair performed two lifesaving surgeries on someone close to her. “I gave Labrador John the contact information, and within a few short days, he was on a plane to Ottawa,” explains Nadia.

John, far left, with Nadia, with cycling group. fourth from right
John, far left, and Nadia, fourth from the right.

John credits Nadia for helping save his life. “She played a vital role in identifying The Ottawa Hospital as an emergency life-line to receive lifesaving surgery.”

Once John landed at the Ottawa airport, he went straight to the Civic Campus with all his documents in hand. He met with neurosurgeon Dr. Howard Lesiuk and plastic surgeon Dr. Daniel Peters and handed them his scans to review. They determined the situation was worse than anticipated, and John would need surgery as soon as possible. “I was so nervous. I could hardly think,” recalls John.

A shocking discovery

The surgery would be long and difficult, and it uncovered something far worse than John had ever imagined when he embarked on the trip to Ottawa. Doctors discovered a non-Hodgkin lymphoma tumour on the back right-hand side of his skull and part of his skull was badly infected. While the news was devastating, John recalls the reassuring words that came from Dr. Peters before surgery. “He said I had a strong heart and tremendous lungs, and both would help me during the complicated surgery.”

“We are blessed to have some of the best minds and the most skillful surgeons on the planet right in our backyard. I am convinced what they did for Labrador John is what no one else could have done, and ultimately saved his life.”

— Nadia Marshy

While the news was devastating, Nadia recalls after the surgery, the pain John had experienced for so many weeks was already subsiding. “He received incredible care. The night before his surgery, he was weak, in agony, and couldn’t hold his head up for any length of time because of the pain and the weight of the mass on his head. The next day, he was able to lie on his head and rest in comfort,” says Nadia.



Next, John was transferred to the Cancer Centre at the General Campus for testing to learn more about the tumour. “I underwent a lengthy procedure by an incredible team to diagnose my lymphoma type.”

Primary central nervous system lymphoma

Diagnosed with primary central nervous system lymphoma (PCNSL), John began chemotherapy treatment here in Ottawa before returning home where he would continue his care at the St. John’s Cancer Centre.

Primary central nervous system lymphoma is an uncommon form of non-Hodgkin lymphoma. It starts in the brain or spinal cord, in the membranes that cover and protect the brain and spinal cord, or in the eyes. This type of cancer is more common in older adults with the average age at diagnosis being 65.

Further testing revealed John had diffuse large B-cell lymphoma – BB Expressor — an aggressive type of lymphoma.

However, after months of treatment, good news came on February 26, 2018, when John learned he was cancer free.

“After almost four years, I’m cancer free and I’ve healed after three head surgeries. I’ve resumed my cross-country skiing and marathon road cycling.”

— John Bookalam

Not yet out of the woods

His journey, though, was far from over. John returned to Ottawa for one more surgery for skull base osteomyelitis — an invasive infection. Other treatments back home didn’t prove helpful and, once again, John required specialized care.

A highly skilled team at The Ottawa Hospital came together again to perform another difficult surgery. They would use a procedure called debridement and they would need to produce a new blood supply to the area. Debridement is when the surgeon removes as much of the diseased bone as possible and takes a small part of the surrounding healthy bone to ensure they have removed all infected areas. “They scraped the bone down until there was no sign of the infection and then did skin grafting on the back of my head,” explains John. The second part of the procedure was even more complex and involved taking an artery from his back, transplanting it to his head — creating a vital blood supply from his ears to the back of his skull. “I thank plastic surgeon, Dr. Sarah Shiga for being there in my time of need. If it were not for team Shiga and Lesiuk, I would never have achieved the quality of life I have today.”

“I owe much gratitude to the surgeons and staff at The Ottawa Hospital. Hopefully, my story will inspire others to donate so others can regain a quality of life as I have in abundance today.”

— John Bookalam

As a result of the debridement, he lost a significant amount of bone at the rear of his skull. Today, he must be very careful — he wears a helmet even when he’s driving to protect his brain, but his adventures continue. John’s grateful for each day and each outing he’s able to plan. “After almost four years, I’m cancer free and I’ve healed after three head surgeries. I’ve resumed my cross-country skiing and marathon road cycling.”

Nadia is also grateful for what she witnessed. “We are blessed to have some of the best minds and the most skillful surgeons on the planet right in our backyard. I am convinced what they did for Labrador John is what no one else could have done, and ultimately saved his life.”

Labrador John continues to say thank you

John’s gratitude goes beyond just words. He started by recognizing his care team through our Gratitude Award Program. While it was an important way for him to say thank you, it’s the special note he got in return from Dr. Shiga, who was a part of the second surgery, that made the donation extra special. “She wrote me a beautiful, personal handwritten letter. That’s one of the best letters ever sent to me,” says John.

The 73-year-old didn’t stop there though. He became a member of the hospital’s President’s Council when he committed to support our hospital with a donation of $1,000 a year. “I owe much gratitude to the surgeons and staff at The Ottawa Hospital. Hopefully, my story will inspire others to donate so others can regain a quality of life as I have in abundance today.”

Nadia is just as happy to see her friend back living his active life. “To see Labrador John fully recovered and cycling up challenging hills and covering incredible distances is fantastic. Those surgeons gave him his life back. He never takes a moment for granted,” says Nadia.

And John says he never will. “I will always donate that $1,000 a year to The Ottawa Hospital until I pass from the earth.”

John Bookalam, Summit of San Salvador ,received lifesaving surgery at The Ottawa Hospital after being diagnosed with primary central nervous system lymphoma.
John, Summit at the summit of San Salvador.

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

Categories: Cancer, Donors, Donors, Donors, Gratitude Award, Neuro

Admitted to The Ottawa Hospital in 2017, Anita Descheneau had feelings of hopelessness. For years, dating back to her teens, Anita was seeking help. That help included many years searching for assistance with other healthcare providers, for what she describes as mental and emotional distress — yet she felt left without a clear diagnosis or treatment roadmap.

The mother of four recalls dark times that winter. On the outside, things may have appeared fine. She was physically healthy, exercising, and had simplified her life. Yet despite feeling as if she was doing everything right, she was spiraling downward. By February, Anita arrived at our Emergency Department, and on Family Day weekend she was admitted overnight. Then in March, she was admitted to our acute Mental Health Unit, where she received care for several weeks. “I was in a state of suicidality,” recalls Anita.

“When I came to the hospital, I could not explain how I was feeling at all. Now, after four years, I can articulate how I’m feeling after an investment of huge amounts of individual and group therapy.”

– Anita Descheneau

Diagnosed with borderline personality disorder, and then later also with major depressive disorder, Anita started getting answers to the questions she has had for decades about her mental health. She remembers meeting psychiatrist Dr. Daniel Saul and the confidence he instilled in her — hope that she could get better. “Dr. Saul has been extremely supportive and committed to helping me get well again and to stay out of the hospital. He listens very thoughtfully, continues to encourage, validates me, and gently offers insight,” says Anita.

Anita Descheneau
Anita Descheneau

Today, Anita continues to receive care from our mental health team through different outpatient programs. Looking back, she realizes how far she’s come. “When I came to the hospital, I could not explain how I was feeling at all. Now, after four years, I can articulate how I’m feeling after an investment of huge amounts of individual and group therapy. That says something about the time that they have invested into my life, and that’s something that I’m very grateful for.”

“In my experience, the DBT approach is unique in its ability to validate our patients’ experiences and emotional responses, while also helping them to learn new ways to respond to their challenges.”

– Vicki Larsen

The Ottawa Hospital’s Mental Health program provides early diagnosis and treatment of severe mental illness. We currently have 96 beds for those patients and our hospital is often the first place those experiencing a mental health crisis will turn to for acute care. Group therapies like the Working with Emotion group and Dialectical Behaviour Therapy Skills Group (DBT) provided Anita with the tools and skills she needs each day. Run by psychiatrist, Dr. Christine Dickson, and social worker, Vicki Larsen, DBT and related therapies provide psychological tools in a group setting, including mindfulness and Cognitive Behavioural Therapy (CBT) concepts. This helps manage strong emotions, cope with suicidal impulses, navigate times of crisis, handle the complexities of relationships, and manage feelings of emptiness or an unstable sense of self.

“In my experience, the DBT approach is unique in its ability to validate our patients’ experiences and emotional responses, while also helping them to learn new ways to respond to their challenges. These skills allow them to be more grounded, more confident, and more able to work towards the goals that are important to them,” explains Vicki. “I have definitely seen this kind of growth in Anita; it has been a pleasure to work with someone who does her very best to use the skills that she has learned in DBT.”

Anita Descheneau sought assistance at The Ottawa Hospital for her mental health.

“Acknowledging that I know they are truly helping me and how immensely grateful I am, was and is highly important to me.”

– Anita Descheneau

Anita confirms she’s experienced those kinds of results herself. “The DBT groups helped me learn skills and keep using them in the future.” She has learned skills to not only take care of herself, but also to be the mother and wife she wants to be for her four children and husband back home.

Grateful for the exceptional treatment she received, Anita wanted to say thank you to those who played a key role in helping her on her journey. She did so through our Gratitude Award Program — donating in honour of Dr. Saul and Vicki Larsen, who was Anita’s social worker. “Acknowledging that I know they are truly helping me and how immensely grateful I am, was and is highly important to me,” explains Anita.

Anita on vacation with her family
Anita on vacation with her family.

Q: What inspired you to give to The Ottawa Hospital Foundation?

A: The opportunity to recognize that they are truly helping me and how immensely grateful I am for their consistent wisdom, time, and patience is what inspired me to make a donation.

Q: What is the message you’d like to share about the care you received?

A: I am more than grateful for all the time my care team, including Dr. Saul and Vicki, have given me — patiently listening, gently offering words of wisdom, and reminding me to use my skills.

Q: What did it mean to thank members of your healthcare team through the Gratitude Award Program and to support The Ottawa Hospital at the same time?

A: Beyond my gratitude for them and the entire Mental Health Unit, it is my hope and wish that by supporting The Ottawa Hospital, more funding would result in reaching considerably more patients through the unit, to receive the same exceptional care that I have and continue to receive.

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

Categories: Gratitude Award, Gratitude Award, Mental Health

Originally published: September, 2021

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

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

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

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

— Dr. Kirsty Boyd

Ready for the most challenging cases

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

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

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

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

Thinking outside the box

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

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

Dr. Kirsty Boyd
Dr. Kirsty Boyd

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

— Dr. Kirsty Boyd

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

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

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

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

The role of reconstructive surgery in trauma

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

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

— Karen Toop

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

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

Outstanding compassionate care

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

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

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

— Ryan Toop

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

Going home to her family

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

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

— Karen Toop

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

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

Leaving a gift in her will

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

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

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

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

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

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

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

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

Categories: Gift In Will, Rehab, Trauma

When Wardha discovered she was pregnant, she prepared herself for any challenge that might come with giving birth during the COVID-19 pandemic. But she didn’t expect to have a premature baby, weighing just 610 grams, only 25 weeks into her pregnancy. Following an emergency C-section, this young family was cast into a world of unknowns — filled with daily visits to The Ottawa Hospital’s Neonatal Intensive Care Unit (NICU) during a global pandemic. They never lost hope and placed their trust in our experts to give their daughter the best chance at survival.

A 610-gram baby

Up until the day baby Aya was born, Wardha was having a normal, healthy pregnancy. Just starting to feel her baby move in her belly, she relished every moment. So it came as a complete shock when her water broke early one morning — 15 weeks early. As a healthcare worker herself, Wardha knew this was far too early and their baby was in danger.

Baby Aya in a NICU incubator at The Ottawa Hospital.

Wardha’s husband, Omar, called an ambulance and she was rushed to our hospital where a healthcare team was waiting, ready to care for her.

After an ultrasound and several tests, Aya’s heartrate was dropping — she was in distress. An unborn baby is dependent on a steady stream of blood through the umbilical cold to receive oxygen and other nutrients. If blood flow is reduced, abrupt dips in the infant’s heart rate will occur. Over an extended period, this can become harmful for the baby, particularly for an already vulnerable premature infant such as Aya.

“It felt like we built a bond with Dr. Jankov. That really helped us come out of the dark.”

— Wardha Shabbir

Wardha was rushed into an emergency C-section, both for her safety and that of her baby. “I truly believe the quick action of my healthcare team in deciding I needed an emergency C-section saved my daughter’s life,” said Wardha.

What Wardha didn’t realize at the time was the trust and bond she would develop with Aya’s NICU team as they worked together to care for her.

Caring for a ‘miracle’

Wardha Shabbir feeding Aya.

The first time Wardha and Omar properly saw their daughter was after she was placed in our NICU. In the midst of wires and tubes, Aya, whose name means miracle, looked so small and fragile. “It all seemed to happen so quickly, I think I was still in shock, but it was so great to finally meet her and spend some time together as a family.” said Wardha.

On that first day, Dr. Robert Jankov, Aya’s primary caregiver, paid Wardha and Omar a visit. He took the time to carefully explain every step of Aya’s care, including each test she would undergo, potential complications that could arise throughout her development, and what they planned to do to mitigate the risk of infection. “It felt like we built a bond with Dr. Jankov,” said Wardha. “That really helped us come out of the dark. He took the time to ensure we understood Aya’s care and treatment plan and what would happen during her stay in the NICU. It was really reassuring.”

Seeing their little miracle in the incubator, it was clear they had a long road ahead of them. And tests would soon prove this to be true.

A severe breathing disorder

Aya was born so prematurely that she needed to be hooked up to IV’s and a central line to continue to receive the nutrients she needed to grow. She also required a ventilator to help her breathe. But over time, the oxygen and ventilator that Aya was on to save her life also caused her to have bronchopulmonary dysplasia (BPD), a disorder that causes irritation and inflammation in the lungs, preventing their normal development. It is one of the most common causes of death in premature babies.

Premature babies often need extra oxygen and mechanical intervention to breathe, but this can damage their lungs, causing a chronic lung disease. A stem cell treatment soon to be tested in clinical trials at The Ottawa Hospital may help heal the lungs of premature babies. Read more.

In Canada, 1,000 babies are diagnosed with BPD every year. Many develop other chronic lung diseases, such as asthma, and require prolonged oxygen and ventilation. Currently, there is no treatment for the disease, but one of our experts, Dr. Bernard Thébaud, is leading a Canada-first clinical trial to test the feasibility and safety of umbilical cord stem cell treatment in premature babies with BPD.

Thanks to the care Aya received, she was able to go home without oxygen or therapies for her lungs.

Dr. Bri, The gitte Lemyre
Dr. Brigitte Lemyre

Retinopathy of prematurity

Although Aya’s chances of survival improved by the day, she still had an upward battle with one health concern after another. A diagnosis that worried Wardha and Omar the most was Aya’s retinopathy of prematurity (ROP), a potentially blinding disease that involves the abnormal development of retinal blood vessels in premature infants. ROP occurs when a premature babies’ retinal blood vessels haven’t finished growing. Aya developed concerning ROP and received injections of medicine in her eyes.

“These babies have a lot of resilience.”

— Dr. Brigitte Lemyre

“I remember feeling really overwhelmed and like a failure,” said Wardha. But she felt hopeful Aya was in the care of some of the brightest minds who were determined to go above and beyond to ensure the very best outcome.

Advancing care of premature babies

Due to advances in treatment, we can care for babies who are born as young as 22 weeks. Many grow up to live healthy lives. To better address the needs of micro-preemies, the Extremely Low Gestational Age (ELGA) multidisciplinary working group was created, comprised of physicians, respiratory therapists, nutritionists, pharmacists, and preemie parents, like Wardha. Together, this group developed a care bundle including vital information on how to best treat extremely preterm babies soon after birth and during their critical first week, to ensure their best chance of survival.

“These babies have a lot of resilience,” explained Dr. Brigitte Lemyre, a physician who leads this highly committed working group. “What’s most important is the partnership with the parents and their presence at the baby’s bedside, because this affects their outcome.”

“The journey was really difficult, but we had a support system and people who care about the well-being of our daughter. It made it easier.”

— Wardha Shabbir


As a member of the ELGA working group, Wardha was able to provide insight and perspective as a mother of a premature baby. This helped guide and inform our experts on how to improve treatment and care of our tiniest patients. Wardha was able to feel heard and contribute to her daughter’s care in a meaningful way during their time in our NICU.

Compassionate care angle

Aya remained in our care for four long months. Not only did our healthcare team provide lifesaving and compassionate care to Aya, but they also looked after Wardha and Omar. Due to visitor restrictions set in place as a safety precaution during the COVID-19 pandemic, they took turns visiting Aya and were only able to visit together twice per week. This took an emotional toll on the first-time parents. “The journey was really difficult, but we had a support system and people who care about the well-being of our daughter both at home and at the hospital. That made it easier,” said Wardha.

“When we got home, we had NICU withdrawal because Aya’s caregivers became a part of our family.”

— Wardha Shabbir

Each time they visited Aya, her care team took the time to answer their questions. “No matter how many questions I had or how many times I asked them to show me how to change Aya’s diaper, they always stopped what they were doing and took the time to support me. They are all so busy and yet so patient. I really appreciated that,” said Wardha.

Back home and healthy

Now just seven months old, Aya is home and doing exceptionally well. Although thrilled to finally be discharged after four months in our NICU, leaving our hospital left Wardha and Omar with a feeling they didn’t expect. “When we got home, we had NICU withdrawal because Aya’s caregivers became a part of our family,” said Wardha. Grateful for their holistic care and how they worked together to ensure Aya would not only survive, but thrive, the NICU care team is a part of their daughter’s life story Wardha and Omar won’t soon forget.

Omar and Wardha with Aya.

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

Categories: NICU

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: Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Patient Care, Trauma

Published: June 2021

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, World-Leading Research

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