It’s time to propel our world-class teams with the world’s greatest technology.
The future of healthcare is embedded with technology and innovation.
Planted in the heart of Canada’s high-tech sector, our new hospital will leverage local talent to ensure it is the most technologically advanced in the country — providing the most sophisticated, leading-edge care to every patient.
The Virtual Healthcare Hub
The Virtual Healthcare Hub will be strategically located on the grounds of our new campus and will be a first point of contact for patients. It will improve communication with their healthcare providers and ensure all but the most critically ill are treated outside a hospital setting. Innovation like this will allow us to provide the right care, in the right space, with the right provider.
Innovation = the right care, in the right space, with the right provider
Unrivalled data analytics means unparalleled care
‘Big data’ might be new for other institutions, but in the last two decades, we’ve become widely recognized as a world-leader in healthcare analytics and implementation.
We plan to deploy the most advanced data analytics platform in the country, if not the world. Harnessing data will allow us to enhance care for patients everywhere.
“We are now poised to go to the next level — by harnessing data and using the latest digital technology and artificial intelligence to save lives.”
— Dr. Alan Forster, Vice-President of Innovation and Quality, The Ottawa Hospital
Breaking ground with high-tech healthcare
Extraordinary people with access to extraordinary technology can do extraordinary things.
With a living laboratory space to ideate, develop, test, and scale digital innovations, we’ll address some of the world’s biggest healthcare challenges and train the innovators of tomorrow.
“Together, we are redefining what is possible and stepping boldly into the future of healthcare. Innovations that happen right here at our hospital will have a global impact for generations. With your support, we will lead the way.”
— Cameron Love, President & CEO, The Ottawa Hospital
Technology that transforms personalized care
We’re committed to developing technology that will help save lives. Wearable and mobile technology will not only empower patients to manage their health but will also allow medical staff to monitor their journey and provide care when it’s needed — driving a critical shift in the delivery of healthcare.
Together, we can bring the latest medical advances to every patient.
It's time to create a better tomorrow.
About the Campaign to Create Tomorrow
The Campaign to Create Tomorrow is the largest fundraising campaign in our region’s history. It will help fulfil the most ambitious vision ever for the future of The Ottawa Hospital, focused on four critical pillars.
Through our unique collaborative model of clinicians and researchers working side-by-side, we will bring groundbreaking discoveries to patients in Ottawa — and around the world.
It’s time for a building that matches the capabilities of our people and meets the needs of every patient.
Our bold plan includes a $2.8 billion, world-class healthcare centre — a continuously evolving tool for innovation and state-of-the-art technology that brings the latest medical advances and research breakthroughs to the bedside.
YESTERDAY
When the Civic hospital opened in 1924, lifesaving medicine like penicillin and vaccines for diseases like influenza, measles, and polio seemed impossible.
TODAY
We’re internationally recognized for our groundbreaking work in cancer, stroke, Parkinson’s, and Multiple Sclerosis.
TOMORROW
Our new hospital campus will be the most technologically advanced research hospital in the country. It will transform how we care for patients.
How will we get there?
With your help. Our $500-million campaign goal will require unprecedented support from the community. Together, we will build Ottawa’s most important healthcare infrastructure project and re-imagine the future of healthcare.
SINGLE-PATIENT ROOMS
With space for loved ones to spend the night and a private, accessible bathroom, patients will have the privacy they need to heal. Each room will be equipped with a “smart” digital screen that will connect them with their care provider, health information, and appointments while allowing them to order a meal and stay in touch with friends and family.
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Space for loved ones to spend the night.
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"Smart" in-room digital screens will connect patients to their care providers, health information, and appointments while allowing them to order a meal and stay in touch with loved ones.
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Dedicated hand hygiene stations will be located inside the door for healthcare providers and visitors.
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Extra space around the patient bed will give healthcare workers unfettered access to deliver care.
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Floor-to-ceiling windows for an abundance of natural light and electrochromic glass that allows the patient to control the level of tinting.
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Private, accessible bathrooms each with their own shower.
Space for loved ones to spend the night.
Dedicated hand hygiene stations will be located inside the door for healthcare providers and visitors.
Private, accessible bathrooms each with their own shower.
Extra space around the patient bed will give healthcare workers unfettered access to deliver care.
"Smart" in-room digital screens will connect patients to their care providers, health information, and appointments while allowing them to order a meal and stay in touch with loved ones.
Floor-to-ceiling windows for an abundance of natural light and electrochromic glass that allows the patient to control the level of tinting.
INNOVATIVE DESIGN FOR A HEALTHIER PLANET
We aim to be net-zero when it comes to our carbon footprint.
With innovation infused into every detail of our new hospital, it will withstand climate change and environmental disasters, while supporting water conservation, energy-efficient building services, and green transportation.
Reducing energy demands and incorporating renewable energy technologies
Using low-carbon fuel sources
Designing for climate and disaster resilience
Building accessible, enclosed pathways for pedestrians, wheelchair users, cyclists, and LRT passengers
Addressing human and food waste
Using micro-grid and smart-grid design for hydro
Planning for water conservation
Preparing for widespread adoption of zero-emission vehicles, including adding EV charging stations
BUILDING ONE OF CANADA'S MOST ACCESSIBLE HOSPITALS
Incorporating best practices of universal accessibility and ensuring compliance with the Accessibility for Ontarians with Disabilities Act (AODA), the hospital design aims to accommodate a wide range of abilities and make navigating the 2.5-million-square-foot facility efficient for everyone.
Well connected to public transit.
Easy to understand and predictable wayfinding.
Moving sidewalks will help people to get to their destinations quickly and comfortably.
Each patient room will have an accessible washroom and extra space for wheelchairs and other mobility aids.
Patients can access their private washroom through double sliding doors that meet on a corner to allow for a direct route from the bed.
INCLUSIVITY AND DIVERSITY
We’ll continue to focus on recruiting a diverse workforce and providing dignified and compassionate care to patients of any age, ethnicity, gender, sexual orientation, religious background, or socioeconomic status.
The Ottawa Hospital works together with and seeks guidance from an Indigenous Peoples Advisory Circle to build a common future for Indigenous health and healing. With an evolving membership of First Nation, Métis, and Inuit communities, organizations and health service providers, the Circle informs design and development planning for the new campus.
It's time to create a better tomorrow. It's time to rethink impossible.
“We're completely transforming how our children, grandchildren, and great-grandchildren will be cared for. No one else will do this for us. It's our turn.”
Roger GreenbergChair, Campaign to Create Tomorrow
"I see the new hospital campus as visionary —much like the original Civic Hospital was 100 years ago. It will be a world-class facility that will attract the best talent to Ottawa, providing enhanced healthcare and significant investment in research. The benefits of this project will be felt across the entire region, and the impact on the economy will be immediate and without parallel.”
Tony SottileRetired CEO of Modern Niagara
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“We're completely transforming how our children, grandchildren, and great-grandchildren will be cared for. No one else will do this for us. It's our turn.”
"I see the new hospital campus as visionary —much like the original Civic Hospital was 100 years ago. It will be a world-class facility that will attract the best talent to Ottawa, providing enhanced healthcare and significant investment in research. The benefits of this project will be felt across the entire region, and the impact on the economy will be immediate and without parallel.”
The Campaign to Create Tomorrow is the largest fundraising campaign in our region’s history. It will help fulfil the most ambitious vision ever for the future of The Ottawa Hospital, focused on four critical pillars.
NEW CAMPUS DEVELOPMENT
INNOVATION & TECHNOLOGY
See how we’ll become the most technologically advanced hospital in the country, using the latest tools to provide the right care in the right space with the right provider.
Through our unique collaborative model of clinicians and researchers working side-by-side, we will bring groundbreaking discoveries to patients in Ottawa — and around the world.
The Ottawa Hospital has made great strides in addressing today’s most pressing challenges in neuroscience. We are internationally recognized for our groundbreaking research and treatment of many neurological diseases, such as stroke, neuromuscular illnesses, and Parkinson’s disease (PD).
In fact, we are one of very few centres in Canada where neurologists work hand-in-hand with basic scientists to tackle unsolved problems. Our goal is to foster new ideas and expand our range of clinical trials to quickly bring cutting-edge treatments directly to our patients. Some of the discoveries that lead to new interventions have been made here.
Parkinson’s disease is the second most common neurodegenerative disease after Alzheimer’s, affecting over 100,000 Canadians. The disease continues to mystify according to Dr. Michael Schlossmacher, a neurologist and the Bhargava Family Research Chair in Neurodegeneration at The Ottawa Hospital. This Chair is an example of one way philanthropists, like the Bhargava family, actively support the hospital.
“It was in 1961 when one of my teachers in Vienna first discovered the Lazarus-type effect of how dopamine therapy can suppress the symptoms of Parkinson’s. That was six decades ago, and we now understand more of the mechanisms underlying the motoric deficits, but we still don’t have a therapy in place to stop the illness in its tracks,” says Dr. Schlossmacher.
Thinking outside the box for Parkinson’s treatment
“If we want to treat Parkinson’s, slow it down or stop it, it will only happen through research that identifies better ways to separate subtypes of the illness and confirm targets to develop drugs for interventions.”
– Dr. Michael Schlossmacher
While progress is slow and often frustrating for patients, active research continues to probe for answers. “If we want to treat Parkinson’s, slow it down or stop it, it will only happen through research that identifies better ways to separate subtypes of the illness and confirm targets to develop drugs for interventions. Then, we’ll need to test them in the clinic and, upon demonstration of safety, apply them to a large body of patients in trials to gauge efficacy,” explains Dr. Schlossmacher. He is quick to point out that our Parkinson’s Research Consortium has made a name for itself in Canada and internationally, both on the clinical side and through basic research. Some of the clinical research activity is directed at improved integration of care delivery that we have already available today.
Philanthropy and grants play a pivotal role in moving research forward. For Dr. Schlossmacher and his team, it often allows them the opportunity to develop ideas that are largely out of the mainstream and represent ‘outside the box’ thinking. “Philanthropy has the potential to transform research activities by amplifying them and supporting talented trainees that can work on creative, new ideas.”
Over the years, research has shown more than 80% of people with Parkinson’s disease suffer from a reduced sense of smell — it often occurs years before the onset of typical movement-related symptoms. Understanding those early indicators could help in an early diagnosis for patients.
Recently, a US $9-million grant from the Aligning Science Across Parkinson’s (ASAP) initiative was announced to further explore this idea. The hope is to determine whether scent-processing nerves that connect the inside of the nose to the brain may play a role in the development of the disease. Dr. Schlossmacher is the overall leader of the effort.
Dr. Julianna Tomlinson, the scientific program manager for the international team and co-director of research in the Schlossmacher Lab at our hospital, explains the importance of this study. “For us, this is an incredible opportunity to align efforts around the world, because it brings together scientists previously anchored in the PD field with researchers who heretofore have been working outside the field of Parkinson’s.”
There are eight institutes in five countries collaborating on this global study. It’s a unique opportunity to get answers to questions that scientists here in Ottawa have been asking for quite some time, including what role environmental triggers (other than toxins) play in Parkinson’s disease as they interact with genetics. “Right now, the treatments for Parkinson’s help the symptoms but they do not stop the progression of the disease. If we can identify disease processes at an early stage, then hopefully we will be able to stop or at least slow its progression before it reaches those later stages,” says Dr. Tomlinson.
The Ottawa Hospital leads this international effort
There are five main areas that this interdisciplinary and multinational study is pursuing. Our hospital’s focus is on how the immune system relates to Parkinson’s. Specifically, laboratory models will determine how viruses and bacteria could lead to changes in the body that are linked to pathology that is seen in the diseased human brain. Understanding the function of genes that are linked to Parkinson’s and whether those genes could be functioning in the immune system, rather than just in the brain, will also be explored.
The support of our hospital is instrumental in being able to lead this international effort. “There are so many people who are involved in making this work. It’s a full team effort, including financial officers, publication experts, and colleagues with knowledge in technology transfer,” explains Dr. Tomlinson.
Ultimately, it’s about finding answers for our patients and their family members who are desperately waiting for a breakthrough. As Dr. Schlossmacher explains, that’s why the world will be watching these scientists. “From an innovation and creativity perspective, we are setting the stage as a team as to how complex research avenues could be brought together, where people work collaboratively and constructively. We don’t undermine each other; we really complement each other and enable each other.”
Making the patient connection
For nearly two decades, Kelly McDonald felt there was something physically wrong with her, but even an eventual diagnosis of fibromyalgia in her 30s didn’t provide her with the answers she needed. McDonald, a professional photographer with a sharp eye, always knew something was off. Her stance wasn’t great, she struggled with her posture, and she’d get tired easily. However, solving her health mystery was an ongoing challenge and source of frustration. “You know, people think you’re a hypochondriac,” says Kelly.
It wouldn’t be until 2021, at the age of 52, when Kelly was diagnosed with Parkinson’s disease. In recent years, she started to develop tremors, her handwriting deteriorated, and she increasingly had a hard time getting her foot properly placed in her shoe. It was at that point, Kelly’s husband convinced her to see her doctor. Soon her right side became stiff and at times, she also felt numb. Kelly thought she was having a stroke.
“I consider myself a Parkinson’s warrior. I want to be a warrior. I want to bring more awareness to this disease, and I want people to be diagnosed earlier.”
– Kelly McDonald
Kelly McDonald
Knitting is a passion that Kelly won’t yet give up.
When Kelly met with a neurologist at The Ottawa Hospital, tests revealed she had Parkinson’s — a diagnosis that she, surprisingly, welcomed. “I was just relieved, because I thought I was going to die from a stroke, like my dad did,” remembers Kelly.
Kelly’s father also had suffered from Parkinson’s. Moreover, soon after her diagnosis, she learned even more about her family history, namely that it also had affected the paternal side of her family. She is being cared for by Dr. David Grimes, the Head of the Division of Neurology at our hospital and an expert in movement disorders. It was Dr. Grimes who asked Kelly whether she would be interested in a study known as the Parkinson’s Progression Markers Initiative (PPMI).
Kelly admits that there were some dark days after her initial diagnosis. But in coming to terms with her new reality, she woke up one morning with a new view on her life. “I decided I have this, let’s do something good. I consider myself a Parkinson’s warrior. I want to be a warrior. I want to bring more awareness to this disease, and I want people to be diagnosed earlier,” explains Kelly.
“A lot of people start to tremor when they’re older, and some people think it’s a disease that only affects older people. But Michael J. Fox was diagnosed when he was 29.”
– Kelly McDonald
She enrolled in the PPMI study to help all those living with a Parkinson’s gene mutation, like her, that don’t realize they have it. It’s not until the shaking begins that the red flag goes up. “A lot of people start to tremor when they’re older and some people think it’s a disease that only affects older people. But Michael J. Fox was diagnosed when he was 29.”
What is PPMI?
PPMI is a landmark study led by The Michael J. Fox Foundation investigating better treatment options and prevention of the disease.
The Ottawa Hospital is one of nearly 50 sites across 12 countries participating in the expansion of the PPMI study. The team at our hospital is recruiting people recently diagnosed with Parkinson’s, who are not yet taking medication to control symptoms, as well as people age 60 and older who do not have Parkinson’s but are living with certain risk factors. Those interested in enrolling at The Ottawa Hospital can find the detailed eligibility criteria and how to contact the study team here. The Ottawa Hospital was the first Canadian study site to recruit participants when the study started to include sites outside the US; the expansion phase of the study means there could be 4,000 participants across all sites by the end of 2023.
“We are proud to be partnering with The Michael J. Fox Foundation and other PPMI site participants, and we are very grateful to the study’s dedicated volunteers who are helping us to move toward a future of disease prevention and better options for those living with Parkinson’s.”
– Dr. Tiago Mestre
Dr. Tiago Mestre is the principal investigator at our hospital, and he explains initial discoveries from this global study have already had an impact. “Early findings have revolutionized the understanding of Parkinson’s biology and the design of clinical trials testing potential new treatments, but there is much more to uncover. We are proud to be partnering with The Michael J. Fox Foundation and other PPMI site participants, and we are very grateful to the study’s dedicated volunteers who are helping us to move toward a future of disease prevention and better options for those living with Parkinson’s.”
Kelly joined the study mid-2021 and she’ll be monitored for 13 years. She says it’s been an amazing experience so far and she’d encourage others to consider joining. “Not only do you gain information about yourself and current information on your condition, but a study like this can help other people in the future. It also seems like Parkinson’s runs in my family. I could learn important information that could help my sister or my niece.” says Kelly.
For now, she’s looking ahead and doesn’t lose focus, whether it’s on her photography or as a warrior combatting Parkinson’s.
This story contains information about eating disorders including anorexia and bulimia.
The long-term effects of the COVID-19 pandemic are only now starting to come to light, but mental health is certainly one area impacted the most, including an escalating demand for our eating disorder services, according to Dr. Ruxandra Antochi, Medical Director of the Eating Disorders Program (EDP) at The Ottawa Hospital.
With the help of the Ontario Ministry of Health Roadmap to Wellness, our hospital will work to fill critical gaps in the care of patients with eating disorders, particularly in youth. The EDP is a multidisciplinary program that provides treatment for people with eating disorders such as anorexia nervosa and bulimia nervosa.
“In some ways, the pandemic has increased access to care for patients by taking down the geographical barriers, because virtual care can be accessed from everywhere. Before the pandemic, patients who traveled from elsewhere had to pay for a hotel to stay nearby and be able to attend the Monday through Friday program.”
— Dr. Ruxandra Antochi
It traditionally serves patients in the eastern Ontario region. As Dr. Antochi explains, with services stretched since the pandemic, our EDP has welcomed patients from right across Ontario. “In some ways, the pandemic has increased access to care for patients by taking down the geographical barriers, because virtual care can be accessed from everywhere. Before the pandemic, patients who traveled from elsewhere, had to pay for a hotel to stay nearby and be able to attend the Monday through Friday program.” So, while virtual care is more accessible to patients, the increase in patients also puts increased pressure on the program and staff providing the care.
“When I was growing up, I always wanted to be someone else or look a certain way.”
— Hannah Hotzwik
Eating disorder warning signs
Unusual preoccupation with weight, food, calories, nutrients, dieting, or exercise
Eliminating certain foods or restricting whole categories of food
Abnormal, antisocial behaviour when eating with others
Strict food rituals (different foods can’t touch, eating only one type of food etc.)
Skipping meals or only taking small portions
Noticeable weight fluctuation
Stomach issues and complaints (reflux)
Menstrual irregularities (missing periods)
Poor dental, skin, hair, or nail health
Extreme mood swings
Trouble concentrating
Dizziness when standing
Seeking help during the pandemic
Originally from the Toronto area, Hannah Hotzwik is 20 years old and has been attending Carleton University for two years — in the midst of a pandemic like many other students. Hannah explains she always had body image issues, but the isolation of the pandemic amplified her mental health problems. “When I was growing up, I always wanted to be someone else or look a certain way. Then in the beginning of 2021, I first noticed that this might be an eating disorder. I had some health issues in late 2020 that caused me to lose my appetite, so I wasn’t eating as much and while I didn’t initially think, I’m going to be skinny, it turned into that,” says Hannah.
It wasn’t long before Hannah realized she was looking skinnier and “the way she always wanted to look”. It tied back to the 19 years she spent believing that thinner was better. She then became hyper-aware of what she was eating, her calorie intake, and her activity level. She recalls it being a stressful time and then the situation started a downward spiral. “I had returned to residence in 2021 after the holidays before any of my roommates. I remember thinking this is the perfect opportunity. Nobody will know I was eating as little as possible,” recalls Hannah.
When Hannah’s roommates eventually returned, they were concerned because she was looking very thin. She eventually confided in them saying she may have an eating disorder. A few months later, Hannah was seeking a referral to the EDP at The Ottawa Hospital.
By May, Hannah had her first appointment with Dr. Antochi, who recommended her for the day hospital program, however, the wait would be two to three months. On September 7, 2021, Hannah was accepted into the program. Looking back, she remembers that wait was difficult. “It was hard. It was a lot of emotional drainage and avoidance. I didn’t have the skills yet to get through those times.”
Seeking help during the pandemic
Originally from the Toronto area, Hannah Hotzwik is 20 years old and has been attending Carleton University for two years — in the midst of a pandemic like many other students. Hannah explains she always had body image issues, but the isolation of the pandemic amplified her mental health problems. “When I was growing up, I always wanted to be someone else or look a certain way. Then in the beginning of 2021, I first noticed that this might be an eating disorder. I had some health issues in late 2020 that caused me to lose my appetite, so I wasn’t eating as much and while I didn’t initially think, I’m going to be skinny, it turned into that,” says Hannah.
It wasn’t long before Hannah realized she was looking skinnier and “the way she always wanted to look”. It tied back to the 19 years she spent believing that thinner was better. She then became hyper-aware of what she was eating, her calorie intake, and her activity level. She recalls it being a stressful time and then the situation started a downward spiral. “I had returned to residence in 2021 after the holidays before any of my roommates. I remember thinking this is the perfect opportunity. Nobody will know I was eating as little as possible,” recalls Hannah.
When Hannah’s roommates eventually returned, they were concerned because she was looking very thin. She eventually confided in them saying she may have an eating disorder. A few months later, Hannah was seeking a referral to the EDP at The Ottawa Hospital.
By May, Hannah had her first appointment with Dr. Antochi, who recommended her for the day hospital program, however, the wait would be two to three months. On September 7, 2021, Hannah was accepted into the program. Looking back, she remembers that wait was difficult. “It was hard. It was a lot of emotional drainage and avoidance. I didn’t have the skills yet to get through those times.”
Eating disorder warning signs
Unusual preoccupation with weight, food, calories, nutrients, dieting, or exercise
Eliminating certain foods or restricting whole categories of food
Abnormal, antisocial behaviour when eating with others
Strict food rituals (different foods can’t touch, eating only one type of food etc.)
Skipping meals or only taking small portions
Noticeable weight fluctuation
Stomach issues and complaints (reflux)
Menstrual irregularities (missing periods)
Poor dental, skin, hair, or nail health
Extreme mood swings
Trouble concentrating
Dizziness when standing
Entering the Eating Disorder Program
After the initial consultation at the hospital, there are three options of care: the patient can be admitted to the inpatient program at the hospital, enter the day hospital program, or they can be given community-based resources.
As part of the programs, and under the guidance of a dietitian, patients are offered a meal plan they are expected to follow and complete each day. Patients also take part in skill building including through cognitive behavioral therapy, dialectical behavioral therapy, and nutritional education.
“Learning to build these skills and to be able to use them to deal with intense negative emotions instead of resorting back to the eating disorder symptoms is critical,” explains Dr. Antochi.
Some patients also require medications, especially for comorbid conditions that frequenctly co-occur for someone who’s suffering from an eating disorder. “Most common comorbidities could be depression, anxiety, PTSD, addiction, or personality disorder,” explains Dr. Antochi.
Did you know?
Approximately 600,000 to 900,000 Canadians are living with an eating disorder at any given time.
Eating disorders are the second deadliest mental illness.
A higher weight is associated with a higher risk of developing an eating disorder.
Transgender and/or nonbinary people are more likely to develop eating disorders, which may be linked to gender dysphoria.
Eating disorders are serious mental and physical illnesses that involve a complicated and damaging relationship with eating, food, weight, exercise, and body image. They can affect anyone and can often be life-threatening, but recovery is possible.
What is body dysmorphia?
Body dysmorphic disorder (BDD) involves someone having an intense focus on a part of their body, leading to a disproportionate and/or inaccurate view of how they appear. In people with eating disorders, their BDD often focusses on weight.
What is anorexia?
Stemming from Greek for “a loss of appetite,” anorexia nervosa has three main criteria that need to be met for a DSM-5 diagnosis: a restriction of food leading to a significantly lower weight than expected for the individual, an intense fear of gaining weight, and a disturbance in the way the person sees their body.
What is orthorexia?
Named in 1996, orthorexia is not an official diagnosis, but describes a preoccupation with eating in a “healthy” way that becomes obsessive to the point of being disruptive.
What is bulimia?
Bulimia nervosa is characterized by cycles of overeating (binging) and ridding the body of that food through self-induced vomiting, laxatives, or other means (purging). In some cases, people may also excessively exercise or fast (avoid eating food for extended periods).
What is binge eating disorder?
While most people overeat on occasion, binge eating disorder involves eating an unusually large amount of food in a short time, feeling out of control in the moment, and feelings of guilt and shame.
Finding her own voice
Hannah recalls being nervous early on about whether the program would work for her. Her doctors explained this was normal. “At the beginning of the program, your eating disorder voice is so loud. And it’s so controlling that it’s convinced you that you don’t need this. But the point of the program for me was to be able to identify my own voice and what my body and my mind wanted, rather than the disorder,” says Hannah.
For eight weeks, Hannah was enrolled in the day program, which was done virtually. With each week, she progressed in small steps from eating in group sessions to becoming more comfortable with gaining weight. Then Hannah began the post-day hospital Relapse Prevention Program for the next 12 weeks. “The first four sessions are weekly. So, each week, I would talk to one of the nurses and Dr. Antochi. We reviewed what I’ve had to eat that day. And I’d have homework to complete, and we’d go over it together. Then we’d talk about skills and how to deal with things that cause stress, anxiety, and other issues that might lead back to going to my safe space of my eating disorder.”
After completing their program, patients move on to the Eating Disorder Transition Program that continues their care in a community outpatient-based setting.
Hannah Hotzwik enjoys spending time outdoors.
After completing their program, patients move on to the Eating Disorder Transition Program that continues their care in a community outpatient-based setting.
Grateful for access to care
As Hannah continues her journey, she’s grateful to the EDP for giving her the skills to live a healthier life both physically and mentally. She continues her studies at Carleton University in physical geography and is passionate about climate change and reducing our carbon footprint. “I definitely would not be where I am today without this program. When I look back to before the program, I wasn’t doing well. Now I can confidently say, I’m doing a lot better. I still have challenges and hard days. But the hospital provided me with so many resources and skills that I don’t react the same way as I used to.”
“Now I can confidently say, I’m doing a lot better. I still have challenges and hard days. But the hospital provided me with so many resources and skills that I don’t react the same way as I used to.”
— Hannah Hotzwik
Did you know?
The Ottawa Hospital is a major provider of mental healthcare in the region. “With two psychiatric emergency services, more than 90 beds, a day hospital program, outpatient services, a mobile crisis program, and specialty programs in eating disorders, first episode psychosis and perinatal psychiatry, we are often the first place patients turn to for help,” explains Dr. Jess Fiedorowicz, Head and Chief of our Department of Mental Health.
For Dr. Antochi, there are many others waiting for help and that’s why The Ottawa Hospital wants to expand the Eating Disorder Transition Program to include two additional streams to help meet patient needs. One would be the Eating Disorder Youth (EDY) service in collaboration with CHEO and the other would be the Eating Disorder Readiness (EDR) program which will proactively care for patients awaiting their first assessment or who are currently waitlisted for admission into intensive services by providing them with support and education. “The goals of care in the EDP are centered on patient engagement in collaboration with the healthcare team. It has been inspiring to witness the courage and determination of persons with eating disorders on their journeys towards health improvements and recovery. In addition, it has been a rewarding experience to be part of the EDP team, working alongside colleagues with a strong commitment and dedication towards the best interest of patients’ care,” explains Dr. Antochi.
Who to call for help?
If you or someone you know is experiencing serious mental health problems, call the Mental Health Crisis Line toll free at 1-866-996-0991, or locally at 613-722-6914, 24 hours a day. If you are in immediate danger or a life-threatening situation, call 911 immediately. If you need urgent medical attention go to your nearest hospital.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
Categories: Mental Health, Patient Care, Patient Care, Patient Care, Patient Care, Strengthening Critical Services
March 1, 2022 – Through a $2-million donation from TD Bank Group (TD), The Ottawa Hospital will create the new TD Artificial Intelligence in Medicine (AIM) Hub that will accelerate the development and use of artificial intelligence (AI) in healthcare. AI has the potential to transform the prevention, diagnosis, and treatment of chronic diseases such as diabetes, kidney disease, cancer, heart disease, and brain conditions. It could be a game changer for patients not only in Ottawa but also across Canada and around the globe.
Dr. Doug Manuel, senior scientist at The Ottawa Hospital and distinguished professor at the University of Ottawa, will lead this innovative project. Dr. Manuel explained the TD AIM Hub will build on our world-leading experience developing mathematics models or algorithms to not only improve diagnosis and treatment but also predict potential issues and outcomes. “From a simple technology perspective, complex data and algorithms currently take nine months to three years to develop and implement. We are proposing an aligned model in which this cycle will take only days.”
Traditionally, this has been a huge gap, with the vast majority of AI innovations never progressing beyond the earliest stages of research. Dr. Alan Forster, Executive Vice-President, Chief Innovation and Quality Officer, and senior scientist at The Ottawa Hospital explained how this platform would help bridge this gap. “The TD AIM Hub will engage patients and their loved ones directly in the development of AI tools from the earliest stages to ensure the patient experience is front and centre. It would be a collaborative effort between patients, physicians, scientists, and programmers. Importantly, we will evaluate the impact of the AI tools to improve outcomes that matter most to patients.”
“At TD, we are thrilled to provide funding to The Ottawa Hospital to help extend innovative AI technology capabilities and advance quality healthcare in the region,” said Tara-Lynn Hughes, Senior Vice President, TD Bank Group. “Through the TD Ready Commitment, the Bank’s corporate citizenship platform, this important initiative will help patients living with cardiac conditions, cancer, and other chronic diseases access equitable and personalized care.”
The TD AIM Hub will ensure that our hospital is ideally positioned to take advantage of the incredible potential of artificial intelligence, according to Dr. Duncan Stewart, Executive Vice-President, Research and senior scientist at The Ottawa Hospital. “In the past, it has been a challenge to implement increasingly complex algorithms into practice. This new virtual Hub will revolutionize our ability to use AI to transform the practice of medicine. I am thrilled that TD has had the foresight and generosity of spirit to support this innovative initiative to harness complex data to improve healthcare.”
The TD AIM Hub will have three capstone chronic disease projects including multiple chronic disease prevention, end-stage renal disease, and degenerative neurologic conditions. This platform will build on our hospital’s track record of world-firsts, including the first and largest hospital data warehouse in Canada, the first hospital-wide “synthetic” data program in Canada, and one of the most comprehensive sets of health calculators and predictive algorithms in the world, with more than 2 million users in 200 countries.
About The Ottawa Hospital:
The Ottawa Hospital is one of Canada’s top learning and research hospitals, where excellent care is inspired by research and driven by compassion. As the third-largest employer in Ottawa, our support staff, researchers, nurses, physicians, and volunteers never stop seeking solutions to the most complex healthcare challenges.
Our multi-campus hospital, affiliated with the University of Ottawa, attracts some of the most influential scientific minds from around the world. Our focus on learning and research leads to new techniques and discoveries that are adopted globally to improve patient care.
We are the Regional Trauma Centre for eastern Ontario and have been accredited with Exemplary Standing for healthcare delivery — the highest rating from Accreditation Canada. We are also home to world-leading research programs focused on cancer therapeutics, neuroscience, regenerative medicine, chronic disease, and practice-changing research.
Backed by generous support from the community, we are committed to providing the world-class, compassionate care we would want for our loved ones.
For more information about The Ottawa Hospital, visit ohfoundation.ca.
Originally published: January, 2022
When Owen Snider faced the news that his lymphoma had returned for the third time in ten years, he knew his options were running out. But a transformational new treatment known as CAR-T therapy gave him renewed hope. The Ottawa Hospital was recruiting patients for a clinical trial investigating a made-in-Canada approach to this cutting-edge treatment. He just needed to qualify for the trial.
In 2010, Owen was diagnosed with large B-cell lymphoma. In his early 60s at the time, he went through a chemotherapy treatment known as R-CHOP. For most people, it lasts 18 weeks. “It was a rigorous treatment. I got through it okay and was six years clear, but then it came back — the lymphoma returned in 2016,” says Owen.
When the cancer returned, his care team at The Ottawa Hospital vetted him for a stem cell transplant. By the summer of that year, he went through what he called an intensive program using his own stem cells. A high dose of chemotherapy was used to remove harmful immune cells in preparation for the transplant of his own healthy cells. “It’s pretty brutal, and after two or three months of wishing maybe I wasn’t around, things improved. I was clear for another four years.”
“I was given five or six months to live. My wife and I were downhearted with that news.”
— Owen Snider
Lymphoma returns for a third time
Following his stem cell transplant, Owen remained healthy for four years, enjoying retirement at his home in a beautiful, wooded area near Calabogie, where he lives with his wife, Judith Snider. But then Owen faced his biggest challenge yet when the lymphoma returned — again. This time, the diagnosis came in May 2020, in the midst of the pandemic. “I remember my oncologist saying they’ve done pretty much everything they could. I was given five or six months to live. My wife and I were downhearted with that news. I was basically going to be kept as comfortable as possible for six months,” remembers Owen.
Judith and Owen Snider kayaking.
However, one week later Owen received a lifeline. His oncologist called to say a CAR-T therapy clinical trial had opened at The Ottawa Hospital — a Canadian first. They wanted to see if he would be a good candidate. Throughout June of 2020, he went through a battery of tests and scans to see if he qualified for the trial.
“This type of immunotherapy research is groundbreaking, and it’s never been done in Canada before.”
– Dr. Natasha Kekre
By mid-June, Owen got the green light. He was a candidate for the clinical trial, and didn’t hesitate to enroll. “I either participate in the trial or I lie around here for four or five months waiting for the end. Which choice would you have made? The positive way to put it is that I was very excited to be a part of the trial. We’re the kind of people where the glass is always half-full,” explains Owen.
CAR T-cell therapy is a type of immune therapy that is an emerging biotherapeutic treatment that harnesses the power of a patient’s own immune cells, known as T-cells, to treat their cancer. T-cells play a critical role by killing abnormal cells, such as cells infected by germs or cancer cells. In some cancers, like lymphoma or leukemia, cancerous cells become invisible to the T-cells that are meant to kill them. In CAR-T therapy, the T-cells are collected and reprogrammed in the lab to recognize and destroy the cancerous cells.
Dr. Natasha Kekre is a hematologist and associate scientist at The Ottawa Hospital. She is leading the development of Canada’s first CAR-T research platform in collaboration with the BC Cancer Centre. “This type of immunotherapy research is groundbreaking, and it’s never been done in Canada before. This is a therapy that uses a patient’s own immune system. It’s personalized medicine — it’s very individualized to each patient,” explains Dr. Kekre.
The Ottawa Hospital is one of the first hospitals in Canada to participate in nationally-led CAR-T trials, and as one of Canada’s top research and treatment centres, the hospital is ideally positioned to play a lead role in bringing an innovative CAR-T research program to Canada, and to Canadian patients.
Going for the Pac-Man effect
In late June 2020, Owen went through apheresis which is the process of withdrawing the T-cells in his blood. “They put an IV in my right arm, and ran the tubing through the machine, and the machine processes the blood and pumps it back through the tubing into my other arm. I lay there on the bed for three or four hours, without moving I should add.”
“It’s just like Pac-Man, the modified T-cells ran around in my blood stream, chomping away at the lymphoma.”
– Owen Snider
Those T-cells were then sent to a lab in BC, re-programmed, and then returned to our hospital two weeks later. Then the T-cells were re-administered just like a blood transfusion. “It allows for that new immune therapy in these cells to go and find the patient’s cancer cells, attack them, and kill them. And it also stimulates the immune system in that patient to further go attack and fight their cancer,” explains Dr. Kekre.
On July 2, Owen received a PICC line and then went through three days of chemotherapy. Four days later he was re-injected with his T-cells and they got to work. “It’s just like Pac-Man, the modified T-cells ran around in my bloodstream, chomping away at the lymphoma.”
His re-programmed T-cells were specifically looking for cancer cells to kill. Owen would need to wait to find out if it was working.
Owen Snider
Did the CAR T-cells therapy work?
One month later, Owen and Judith received some exceptional news. “At my check-up 30 days after getting my T-cells back, I was almost clear of cancer. The scan showed that there was almost nothing left. I was gobsmacked,” he says.
By the three-month mark, Owen says he was as “clean as a whistle.” Eighteen months later, there is still no sign of lymphoma.
For Dr. Kekre, giving patients like Owen new hope for the future is what inspires her. “For the first time, I think in a long time, Owen felt that the lymphoma might actually be disappearing. He’s had multiple scans since then that show the same thing. And so now, I think he’s starting to believe it. And I think that’s the reality of why I do this, because patients like him who had no options before, could soon have the option of CAR-T therapy. That’s what happened for Owen and that’s what we hope will happen for many more patients,” says Dr. Kekre.
Dr. Natasha Kekre and Owen Snider. Owen was treated for lymphoma as part of a CAR-T clinical trial.
What’s next for the clinical trial?
Dr. Kekre and her team are monitoring all patients enrolled in the trial and published preliminary results in June 2022. The purpose of the clinical trial is to provide proof to Health Canada this therapy is safe. “The reality is that we have a data safety monitoring board, which watches for the safety of the trial, and they’ve had no concerns. So, from a safety point of view, we’re very happy with the trial. And that’s why we are still open and we’re still able to enroll more patients,” explains Dr. Kekre.
Why is The Ottawa Hospital unique in its CAR-T therapy?
CAR-T therapy needs to be individually manufactured for each patient using the patient’s own cells combined with large amounts of highly pure virus to deliver the chimeric antigen receptors (CAR) gene. The Ottawa Hospital’s Biotherapeutics Manufacturing Centre is ideally positioned to manufacture the clinical grade virus needed to create CAR T-cells for clinical trials. In fact, we have the only facility in Canada that has produced this kind of virus for clinical trials.
The hope is that one-day CAR T-cell therapy may also be a treatment for a variety of cancers. “The world is watching us,” explains Dr. Kekre. “We’ve had a lot of attention from Denmark, and a few other European countries are reaching out. They believe in a system similar to ours, where patients all have the right to access healthcare. If CAR T-cells are here to stay, they have to be done in a sustainable approach for our patients. And that’s a big part of what we are building — this is only the beginning. And that’s what people are looking at us to see how we do it.”
“Without philanthropy, we wouldn’t have a Biotherapeutics Manufacturing Centre or a Methods Centre at The Ottawa Hospital, and we wouldn’t be able to do innovative clinical trials like this.”
– Dr. Natasha Kekre
This made-in-Canada CAR T-cell research platform will give Canadian patients more access to innovative clinical trials. “Canadian cancer patients shouldn’t have to wait for the research to be done elsewhere but be able to participate in innovative clinical trials here at home,” says Dr. Kekre.
Grateful for each day and philanthropic support for research
Today, Owen appreciates each day and a good quality of life thanks to the clinical trial. He feels strong and can’t wait for the day when he and Judith can travel again — grateful for the lifesaving research. “It was an honour and a privilege to be chosen for the trial.”
He also credits the extraordinary care team and those special moments when he visited the hospital. “I can tell you that I always felt more than comfortable. I felt encouraged by anyone I met. The team on 5 West as we know it, is wonderful. I had an occasion to go back there last spring, and it was like walking back into Cheers — everybody knows your name.”
As a longtime supporter of The Ottawa Hospital, and to see philanthropy play an important role in making this clinical trial a reality, he’s an even bigger advocate for encouraging support for our hospital. “All I can say is that the core funding of hospitals doesn’t provide for some of the innovative and cutting-edge things that go on, or maybe some really specialized piece of equipment. And that’s where the community donor can help and contribute to that effort.”
Owen and Judith Snider.
For Dr. Kekre, philanthropy provides the spark for clinical trials like this, and can help to keep them moving forward. “Without philanthropy, we wouldn’t have a Biotherapeutics Manufacturing Centre or a Methods Centre at The Ottawa Hospital, and we wouldn’t be able to do innovative clinical trials like this. We need this kind of research to get to a place where all Canadians can benefit from these therapies. Without philanthropy, we would never get there.”
And to Dr. Kekre, her team, and their collective efforts to give more patients hope, Owen has a simple message: “Thank you. The whole program is outstanding.”
About the Canadian-Led Immunotherapies in Cancer (CLIC) research program
The CLIC research program, established in 2016, brings researchers, clinicians and patients from across Canada together to build Canadian expertise and capacity for innovation in the promising field of cellular immunotherapy for cancer, including CAR-T therapy. The first CLIC clinical trial launched in 2019 at The Ottawa Hospital and at BC Cancer, with support from BioCanRx, BC Cancer, The Ottawa Hospital Foundation and the Ontario Institute for Cancer Research. Core facilities and resources supporting CLIC include The Ottawa Hospital’s Biotherapeutics Manufacturing Centre, BC Cancer’s Conconi Family Immunotherapy Lab, the Ottawa Methods Centre and the Blueprint Translational Research Group. CLIC team investigators include Drs. Natasha Kekre, Harold Atkins, John Bell, Kevin Hay, Rob Holt, Brad Nelson, John Webb, Manoj Lalu, Kednapa Thavorn, Dean Fergusson, Justin Presseau and Jen Quizi.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
Categories: Biotherapeutics, Clinical Trials
For decades, Paula Helmer’s lovely voice carried through the alto sections of several Ottawa choirs. But even after her death following a battle with breast cancer, Paula is still managing to be heard — maybe not through song, but through science.
“That’s what Paula was hoping for from all these clinical trials,” says Jeff Christie, Paula’s husband, “that it would move medical science forward.”
“That’s what Paula was hoping for from all these clinical trials, that it would move medical science forward.”
—Jeff Christie
Jeff and Paula met in university, both studying economics at the University of Waterloo, and both moving to Ottawa, Paula’s hometown, to work for the federal government in fulfilling careers that would span decades. All the while, Paula continued her passion for choral singing, with St. Timothy’s Presbyterian Church and the Ottawa Choral Society. But Jeff says it was family life that centred everything — children, grandchildren, travel, and the family cottage.
Paula (back row, fourth from right) in 2005 with members of the Ottawa Choral Society.
“Five years into retired life, it was discovered that Paula had cancer,” Jeff recalls.
It was a deadly form of breast cancer that had metastasized in her spine and was causing her considerable discomfort. Surgery removed the tumour but couldn’t eradicate the cancer, nor control the pain. That’s when Paula was introduced to Dr. Mark Clemons, a medical oncologist with The Ottawa Hospital.
“We came up with a multipronged plan to not only improve (Paula’s) pain,” Dr. Clemons explains, “but to get her disease back under control.”
“It was patently clear from the first meeting,” says Jeff, “that Dr. Clemons was very capable, competent, and wise. He gained our confidence the first time we met and the treatments he was suggesting for her, they were always so successful. How could you not love the guy?”
A passion to participate in clinical trials
Dr. Clemons is also the lead behind The Ottawa Hospital’s REaCT Program or Rethinking Clinical Trials, launched in 2014 with Dr. Dean Fergusson, senior scientist and Director of Clinical Epidemiology Program, and others. The aim of REaCT is to make enrollment in clinical trials easier, by involving cancer patients and their families every step of the way. Typically, only 3% of patients are involved in trials but with REaCT, that number is closer to 90% since the studies don’t involve extra visits or additional tests. Paula began participating in a series of clinical trials aimed at helping her, but also aimed at improving treatment options for future generations. Jeff says that was her driving ambition.
What is the REaCT Program?
The aim of the REaCT (ReThinking Clinical Trials) program is to make enrollment in clinical trials easier, by involving patients and their families every step of the way.
“Paula played an important role in advancing the treatment of patients across the world.”
— Dr. Mark Clemons
“It was really important to her, to both of us,” he says. “There are more treatments out there we haven’t found yet and we are going to find them through clinical trials. If you don’t participate, nobody gets the new treatments.”
Empowered and making an impact
More importantly, Jeff says, Paula’s participation in these clinical trials gave her a voice and made her an active participant in her treatment.
“Paula was always left with the impression that she was in the driver’s seat right beside Dr. Clemons. They listened to her, believed her.”
Dr. Clemons explains that one of the many clinical trials Paula participated in involved looking at how often bone agents should be given for patients with metastatic breast cancer. Traditionally, the treatment is delivered as an injection every four weeks, requiring patients to come to the hospital and spend prolonged periods away from home.
“Paula had a driving ambition to not only improve her own prognosis but also help with the knowledge being gained for future patients.”
— Dr. Mark Clemons
“Because of Paula and many other patients involved,” says Dr. Clemons, “we were able to do a trial that showed that an injection every 12 weeks was just as effective and was associated with fewer side effects.” It also added to Paula’s quality of life, allowing the couple to continue to visit the cottage and travel in between those 12-week injections.
“That was a great thing,” says Jeff. “The care we got was supportive of our lifestyle. It allowed us to travel as we had hoped to.”
Paula’s participation in a REaCT trial added to her quality of life, allowing her to continue to visit the cottage and travel with her husband, Jeff, in between 12-week injections.
Paula’s legacy lives on
Sadly, Paula lost her fight against cancer on February 18, 2021. But Jeff is continuing her work, spreading the word about REaCT among friends and colleagues, raising funds to support this critical work that is helping to shape better treatment options for cancer patients around the world.
“I’ve spoken about REaCT in my social circles,” Jeff explains. “I mentioned Paula has participated in at least dozens of clinical trials and benefited from them.”
“It’s fantastic that Jeff is continuing Paula’s legacy,” says Dr. Clemons. “Paula played an important role in advancing the treatment of patients across the world.”
It’s a role that she embraced with the same fervor she approached everything she did in life, whether as an economist, a wife, a mother, and yes, even a singer.
“There are more treatments out there we haven’t found yet and they are going to find them through clinical trials.”
— Jeff Christie
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
Categories: Cancer, Clinical Trials
Darlene Kulig is an award-winning artist whose paintings are described as bold, joyous, and eye-catching. Born in Ottawa, Darlene now calls Toronto home and brings uniquely Canadian landmarks and landscapes to life through her semi abstracted, spirited art.
When Darlene’s nephew, Craig, passed away in 2016 at the age of 23 from a rare form of cancer, it was a devastating loss for her family. Craig’s father, Bruce Kulig, wanted to do something to keep his son’s memory alive, so he created a fundraising campaign — the Craig Kulig Memorial Fund with The Ottawa Hospital. When Darlene learned about the campaign, she wanted to use her art to have an impact.
Darlene began selling card sets featuring her art, with proceeds donated to our hospital. When the pandemic hit, her campaign took a different twist. She created beautiful masks, and once again a portion of the sales would support the memorial fund.
Today, Craig’s memory lives on through the countless people who have supported his memorial fund and the impact their philanthropy is having on cancer research. The research will help other patients and their families – just as Craig’s family had hoped.
Q: What inspired you to fundraise for The Ottawa Hospital?
A: In 2016, we lost our dear nephew Craig Kulig, at the age of 23, to an aggressive form of rare cancer. Craig received wonderful and compassionate care from the team of doctors and nurses at The Ottawa Hospital. Since Craig’s passing, it has been my brother Bruce’s goal to raise $100,000 in Craig’s memory.
As an artist and an aunt processing through my grief journey, I felt compelled to create a painting in memory of Craig. I painted Dragonfly Ascending into Twilight which depicts Granite Lake where Craig spent his youth. We donated the large giclee print of this meaningful painting and it now hangs in the oncology department at the hospital.
A memorial for Craig Kulig at Granite Lake with candle houses created by Craig’s sister Katrina.
Q: What is your fundraising all about?
A: Early in the pandemic, I was approached by BYOM, a mask manufacturer, to have my Canadian Landscape paintings printed as fine art face masks. Each artist that was approached was asked to align with a charity, so we created a beautiful line of adult and children’s face masks with all proceeds going to The Craig Kulig Memorial Fund. To date, we have raised over $16,000 through the sale of these masks. We also introduced a beautiful wall calendar and holiday boxed card sets featuring my art.
“As an artist and an aunt processing through my grief journey, I felt compelled to create a painting in memory of Craig.”
— Darlene Kulig
Q: How easy was it to set up a community fundraising event through our Foundation?
A: My brother Bruce set up The Craig Kulig Memorial Fund through The Ottawa Hospital Foundation. It has been a great experience working with their team to promote our masks, continue to raise money for Craig’s fund, and raise awareness for the leading research that is taking place at The Ottawa Hospital.
Q: What might you tell someone who is thinking about donating to The Ottawa Hospital?
A: I believe our fundraising efforts are going to make a difference. It is our hope that other individuals and families can and will have better outcomes. This takes time and much-needed donations. The Ottawa Hospital is a leading research centre that we are proud to be partnered with.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
Categories: Cancer, Cancer, Donors
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 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
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, 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 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: Patient Care
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 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.
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.”
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.
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