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Sunnybrook Campus Editor: Christine Henry 2075 Bayview Avenue Visit us online at: www.sunnybrook.ca , ON M4N 3M5 About Sunnybrook: P: 416.480.4040 Sunnybrook Health Sciences Centre is transforming healthcare through the dedication of its 10,000 staff members, physicians and volunteers. An internationally F. 416.480.5556 recognized leader in research and education and full affiliation with the University of Toronto, distinguishes Sunnybrook as one of Canada’s premier health sciences E-mail: [email protected] centres. Sunnybrook specializes in caring for critically-ill newborns, adults and the elderly, treating and preventing cancer, cardiovascular disease, orthopaedic and arthritic conditions and traumatic injuries. Sunnybrooknews

Commemorate, celebrate, and commit Night of Stars raises over $800,000 for the Volume 6 No. 4 June 2010 Veterans celebrate 100 years of the Canadian Navy Holland Centre Collaborating for

By Sally Fur By Sarah Barker pregnant patients with

On May 18, a large group gathered in Warrior’s Hall at the With its dark red velvet blooms, the Navy Lady is a symbol In closing and in Navy tradition, everyone stood and sang On Monday, May 17, Canada’s top comedians, dancers, kidney disease Sunnybrook Veterans Centre to share memories, recall of the Navy’s centennial and the sacrifices of the men and an old favourite: the official song of the Navy called Heart musicians and theatre performers joined together for their “Navy days” and commemorate one hundred years women who served at sea, ashore, and continue to serve of Oak. A commemorative plaque is located near the Night of Stars, in support of the Holland Orthopaedic & Sunnybrook’s new Division of Obstetrical of history. in the Navy today. Cultivated in St.Jean-Sur-Richelieu, group of 20 Navy Lady rose bushes on the east side of Arthritic Centre. and grown in St.Catharines, Ontario, the Navy the K-Wing garden. Next time you visit the garden be sure Medicine looks at a new approach for Veterans with family members, Navy Officers from the Lady is available through selected nurseries or J.C. Bakker to smell the roses! The event, which featured , The care Canadian Forces College, members of the Women’s & Sons Ltd. National Ballet of Canada, comedians and 1) 2) Royal Canadian Naval Service (Wrens), members of the Ron James, violinist James Ehnes, Glass Tiger’s Alan Frew, By Marie Sanderson the Nathaniel Dett Chorale, The Gryphon Trio and stars Sunnybrook Volunteer Association (SVA), students from Daphne Tully, a Wren and also a 27-year Veteran of the Although it affects millions of people worldwide, kidney Leaside High School and representatives from Veterans SVA, spearheaded the journey of the Navy Lady rose to from Rock of Ages, was produced and hosted by Ross disease can be particularly problematic during preg- Affairs Canada bonded together to mark the Canadian Sunnybrook. It was last fall and the garden was winding Petty. nancy. For a growing number of pregnant women in the Naval Centennial. down for the winter when Daphne first mentioned to Phil Toronto area, kidney disease has become a part of their Spring, Creative Art Therapist, that the SVA would like to Comedian Jessica Holmes, portraying her infamous im- pregnancy. Created on May 4, 1910, and after its third and final read- donate 20 Navy Lady shrub rose bushes for the Veterans personation of Liza Minnelli, had the crowd in stitches 3) 4) ing, the Naval Service Bill received royal assent and Prime Therapeutic Garden behind K-Wing. with her confusion over the event name – why would 1) Eva Avila, , The kidneys perform vital tasks to keep the body run- Minister Wilfred Laurier realized his dream of creating the anyone name an event that supported a centre for hip and Kurt ning smoothly, including removing waste from the body, Canadian Navy. Across Canada, there have been many cel- With Daphne a talented artist, and instrumental in the and knee replacements “Night of Stairs”. L to R: Anne Wood, Second World War Veteran; Daphne Tully, Browning relax backstage. cleaning and returning blood, maintaining water and ebrations from east to west marking the anniversary and hospital’s ceiling tile project, her idea quickly grew to Sunnybrook Volunteer Association and Barry McLellan, President 2) “Liza Minnelli” aka mineral levels and producing hormones. & CEO unveil the ceiling tile interpretation of the Navy Lady rose The night even included a surprise appearance by skat- in Sunnybrook’s Warrior’s Hall it was a grand afternoon. include not only the rose bushes but also the creation Jessica Holmes entertains painted by Anne Wood. ing superstar Kurt Browning, who joked with host Ross of three new ceiling tiles for the Royal Canadian Legion the crowd. Petty about their shared connection – both are married to 5) “Two of the sickest groups in pregnancy are women The program included Charlotte Bastien, Regional Physiotherapy and Stroke gym located in K-Wing. 3) Piotr Stanczyk and Sonia Director General for Veterans Affairs Canada, who paid Canadian ballerinas. with cardiac problems and those with kidney disease, Rodriguez of the National Ballet of Canada. especially those who became pregnant with pre-existing tribute to the Wrens for their willingness to serve their Anne Wood, Second World War veteran and resident of 4) A special performance choreographed by Cirque du The night was a huge success, raising over $800,000, for kidney disease,” says Dr. Michelle Hladunewich, ne- country and help the war effort. She also congratulated L-Wing was asked to paint an artist’s interpretation of the Soleil’s Debra Brown. the construction of a new operating suite for the Holland phrologist and head of the recently created Division of the Wrens on their vision and dedication in developing Navy Lady, which would then be used in the final designs 5) Marilyn Wright, co-chair, Ron James, James Ehnes and Musculoskeletal Program. Obstetrical Medicine in the Department of Medicine at the Navy Lady rose. of the ceiling tiles. Graham Hallward, co-chair, relax backstage. Sunnybrook. “Often these women have had diseases like “Today by planting this beautiful rose, chosen by you and A grade 10 history class from Leaside High School was diabetes or lupus, and because of this have sustained developed by Agricultural Canada, we celebrate and hon- also invited to the stage to present a banner along with serious kidney damage, which in the most extreme cases our all of you. And we pay tribute to one hundred years poems and pictures they had designed for the veterans require dialysis.” of naval service,” said Bastien. “The Wrens were pioneers in honour of the Navy. Intergenerational programs, with L to R: Esther McKinnon, President Sunnybrook Volunteer who never retreated and never surrendered. Not only did local school children, are offered throughout the year and Association; Margaret Haliburton, President Toronto Association Sunnybrook celebrates 20,000 hearts Recruited by Sunnybrook because of her special interest you do your duty but you blazed a trail for those who are an important aspect of many of the recreation and of Wrens; Charlotte Bastien, Regional Director General Veterans in this area, Dr. Hladunewich helps to run several busy followed.” art therapy programming offered at the Veterans Centre. Affairs Canada; Commander Don McDonald, Canadian Forces clinics across the city for pregnant women with kidney College; and Barry McLellan unveil the Navy Lady rose bushes By Laurie Legere disease and is working to provide exemplary collabora- and commemorative plaque. Photos: Dale Roddick tive care for this special patient population.

This collaboration aspect is where Dr. Hladunewich is striving to make a difference, by taking a more city-wide Critical care outcome in the U.S. tied to insurance status approach to women with pregnancy and medical disor- ders, such as kidney disease. She notes that Toronto By Laura Bristow has the patient volume and the exceptional health care resources to create partnerships to offer patients the best Among the general U.S. population, people who are “We found that although uninsured patients were less coverage do not use more resources than the consistently care in the world. uninsured are about half as likely to receive critical care likely to receive critical care services overall, uninsured and long-term insured. services as those with insurance, according to a study by patients in emergency rooms were more likely to require Fortunately the scenario where a woman requires dialysis the American Thoracic Society’s Health Disparities Group. admission to the intensive care unit. This might occur if “Our review indicates that there may be inequalities in the during pregnancy is quite rare, but it provides a good They also found that once admitted to the hospital’s the uninsured delayed going to a hospital until experienc- provision of care to a vulnerable segment, that is, those example of where hospitals can work together. “If a intensive care unit, uninsured patients are less likely to ing a more advanced stage of illness,” wrote Dr. Fowler, who are very sick and in need of care but who cannot woman needs dialysis during pregnancy, she needs it fre- have invasive procedures or pulmonary artery catheter- who is also an associate professor of medicine at the afford care,” concluded the authors. “Even with increased quently. We have pregnant patients who receive dialysis izations and more likely to experience delay in discharge, University of Toronto. “That the uninsured were perhaps access to health insurance, other factors such as poverty, part of the week at Sunnybrook and part of the week at and have life support withdrawn. less likely to use an ambulance to get to the hospital pro- limited health literacy, limited social support, and home- St. Mike’s, so there is real collaboration in terms of caring vides some support for this concept.” lessness will continue to conspire against equitable care. Ladies of the Heart Pillow Project join staff of the Division of Cardiac and Vascular Surgery to present Mr. Sam Jaipaulsingh with the 20,000th for these women,” says Dr. Hladunewich, who currently “Patients who do not have health insurance and become As a society, we should urgently explore options to reduce heart pillow given to surgical patients of the Schulich Heart Centre. Photo: Doug Nicholson sees patients at Sunnybrook, Mount Sinai Hospital and critically ill receive fewer critical care services and may ex- “Although U.S. hospitals are legally obligated to care for such disparities across the population and particularly for the University Health Network. “It’s often the case that perience worse clinical outcomes,” said Dr. Robert Fowler, patients who are emergently ill, they are not obligated those most vulnerable and those most in need.” For the past 18 years, they have come together on chief of Trauma, Emergency and Critical Care, and the one centre just doesn’t have the resources to do every- lead author of the review and Critical Care physician at to be the continuing provider for medically stabilized Monday mornings at the Scarborough Town Centre to CVICU nursing staff to witness the presentation of the thing for these women.” Sunnybrook. “Improving preexisting health care coverage uninsured patients,” Dr. Fowler noted. “The increase in cut, sew, stuff and deliver red, heart-shaped pillows to 20,000th heart pillow to Mr. Sam Jaipaulsingh. may be one mechanism to reduce such disparities.” discharge delay may be due to the “difficulty in finding The new Division of Obstetrical Medicine at Sunnybrook health care providers or facilities to accept these patients.” patients of Sunnybrook’s Schulich Heart Centre who have undergone cardiovascular surgery. On May 28, the ladies “Not only do the heart pillows provide comfort to surgical will coordinate the medical care of pregnant patients The researchers reviewed more than 5,500 citations on Overall, lack of insurance is independently associated with of the “Heart Pillow Project” made an extra special deliv- patients, but they also help in the recovery process,” said as well as education and research in obstetrical medi- critical care and insurance status, ultimately identifying reduced access to care and poorer outcomes. “Developing ery to the Sunnybrook Cardiovascular Intensive Care Unit Dr. Fremes. “By hugging the pillow, the chest cavity is cine within the department. The new Women & Babies 29 observational studies that described the admissions more comprehensive programs and legislation to improve (CVICU) to present one special patient with the 20,000th kept intact and there is less likelihood of stitches tearing.” Program facilities at the Bayview campus will strive to and outcomes for critically ill patients with and without health coverage for patients who are acutely ill would pillow made by hand, with love. provide one-stop shopping for women so that patients insurance. therefore seem a logical avenue for investigation,” the can see both their obstetrician and a specialist during a study’s authors conclude. The Sunnybrook team thanked the ladies for their dedica- “Making heart pillows gives us a chance to visit with tion to the patients of the Schulich Heart Centre and for single visit. The results were published as an official systematic review friends we might not otherwise see regularly and the the comfort they have provided with their healing hearts in the May 1 issue of the American Journal of Respiratory The authors also comment that while increasing access heart pillows we make comfort people who have under- over the years. Dr. Hladunewich is currently working on a plan for identi- and Critical Care Medicine. to insurance inevitably raises concerns about costs, the costs of underinsurance are already borne by society at gone heart surgery at Sunnybrook. It’s a win-win situa- fying who will be involved in medical support for obstet- tion,” says Mary Shinn, Pillow Project originator. “We’re What does it take to make 20,000 heart pillows by hand? rics, an area which will have a representative from every Currently, one-third of the population under the age of large, as uninsured patients rely more heavily on emer- having fun and making a difference in the lives of others!” << 3.6 km of red cotton fabric medical sub-specialty. This new cross-city approach to 65 is uninsured for a portion of any given year, and the gent care, and the responsibility for unpaid bills falls to Bruce Farr, Chief of Toronto Emergency Medical Services, and << 4 tons of fiberfill medical care will also explore developing partnerships costs of critical care are approaching one per cent of the the states and ultimately the tax payers. Furthermore, Barry McLellan, president and CEO of Sunnybrook sign the official Dr. Stephen Fremes, Head of the Division of Cardiac and << 400 spools of red thread with Mount Sinai Hospital and St. Michael’s Hospital. U.S. gross domestic product. concerns about possible over-usage are not substanti- Emergency Department offload agreement on April 28. The agree- ment enables paramedics to get back on the road quicker thanks Vascular Surgery at Sunnybrook was joined by Dr. Bernard << 20,000 “Telco Community Volunteers” labels ated by research. Recent evidence shows that individuals who move from no insurance to more comprehensive to a new offload nurse program. Photo: Dale Roddick Goldman, founder of the Division, Dr. Gordon Rubenfeld, “This process is long overdue,” notes Dr. Hladunewich. “Two lives are at stake with a pregnant patient, and this 4 really brings people together.” The 2010 Schulich Awards Dr. Ron Kodama awarded Fourth annual Bertin Awards for excellence New nurse peer 2010 W.T. Aikins Award in Customer Service leader for eHealth Eighth annual ceremony recognizes clinical and academic excellence By Monica Matys By Laurie Legere Congratulations to Advanced By Laurie Legere Congratulations to Dr. Ron Practice Nurse Ria Spee, Kodama for being chosen as in Sunnybrook’s Veterans On May 27, 10 of Sunnybrook’s nursing and clinical staff Dr. Brian Gilbert, Chief of the Sunnybrook’s Schulich one of the 2010 W.T. Aikins Centre, who was recently members, and three graduating medical students gath- Heart Program, addressed the winners of the Schulich Award winners. The Aikins selected by the Registered ered at the Vaughan Estates for the eighth annual Schulich Awards, providing a brief history of Seymour Schulich committee selected Dr. Kodama Nurses’ Association of Ontario Awards ceremony. Family, friends and colleagues looked and his generous donations in support of the hospital as a winner in the Individual as the new Nurse Peer Leader on as the 2010 Schulich Award winners were recognized and of education. Teaching Performance—Small for the Toronto Central LHIN. for their exceptional nursing, clinical and academic Group category for his “sus- contributions. Also in attendance at the celebration were Marilyn tained teaching performance Reddick, VP of Human Resources, Dr. Catherine Kelly, RNAO is leading the Nurse in the Department of Surgery”. Generously funded by Dr. Seymour Schulich, the awards acting director of the Peters Boyd Academy for the past Peer Leader Strategy in They also noted his remarkable recognize 10 permanent part-time or permanent full-time year and current Director, Dr. Mary Anne Cooper. Veterans Centre Advanced Ontario with funding from Teaching Evaluation Scores, Practice Nurse Ria Spee. employees who work in the areas of diagnostic, therapeu- Canada Health Infoway. The genuine concern for students Photo: Doug Nicholson tic and direct clinical patient care who demonstrate excel- Winners of the eighth annual Schulich Awards for purpose of this strategy is to and achievements as a great role model and educator. lence in nursing and clinical care, and three fourth-year nursing and clinical excellence facilitate education and knowledge sharing about eHealth graduating medical students who demonstrate clinical • Nancy Boyd, Physiotherapy Assistant, C4, Medicine The W. T. Aikins Award, named after the first Dean of across the nursing community so nurses from all sectors and academic excellence. • Emilie Exconde, Registered Nurse and Team Leader, the Faculty of Medicine, is the most prestigious Faculty gain a better understanding of eHealth and its relation- D2, Medicine award for commitment to excellence in undergraduate ship to quality care and client outcomes. There are 14 To be considered for the Schulich Awards, staff members • Anne Hayward, Social Worker, Burn Unit medical education. It honours invaluable contributions to nurse peer leaders, each representing a LHIN in Ontario. and medical students are nominated by their colleagues, • Lori Holden, Advanced Practice Radiation Therapist, the Faculty of Medicine’s educational mission. Winners physicians and patients. A committee that has no knowl- Radiation Therapy, Odette Cancer Centre The winners of the 2010 Bertin Awards are: Dr. Barry McLellan, Sunnybrook president and CEO (presenter), Allyson Morris, data analyst, of this award are selected from nominees identified in a The key role of a nurse peer leader is to leverage RNAO’s edge of the nominees’ identities reviews the submis- • Juliet Hutchinson, Registered Nurse, Team Leader D3, NICU, Tabor Kidane, parking attendant, Madeline Pimentel, accounting clerk, Holland Centre, Verna Titus, patient administrative assistant, Faculty-wide process. existing eHealth resources and to engage nurses in a sions. Winners are chosen for their clinical and academic Schulich Heart Program B5 ICU, Bertha Effio, administrative assistant, Patient Relations, Quality & Patient Safety and Joe Nunes, porter, Patient Transport. Photo: Doug Nicholson dialogue about eHealth and nursing practice. excellence and for their commitment to Sunnybrook’s • Karen Johansen, Registered Nurse, K1E-K1W, Palliative The criteria for the awards are extremely rigorous, and patients. Care Unit each nomination requires extensive support from both On the evening of April 29, family, friends and colleagues nominee’s identity, the committee reviewed submis- • Caroline Johnson, Registered Practical Nurse, One of the key goals is to have 20 per cent of the nurses peers and students. Documentation, student evaluation gathered at the Sunnybrook Estates for the fourth annual sions and successful candidates were chosen for their Dr. Barry McLellan, president and CEO hosted the awards Operating Room in each LHIN log on to RNAO’s eHealth course, found at: and peer evaluation are carefully reviewed for each nomi- Bertin Awards for Excellence in Customer Service. The outstanding commitment to providing extraordinary ceremony and addressed recipients of the Schulich Award • Barbara Anne Maier, Registered Nurse, Odette Cancer www.rnao.org/eHealth_course. This means that in the nee by a panel of Faculty and students. award recognizes and celebrates the exemplary work of customer service. for Nursing and Clinical Excellence. Centre Toronto Central LHIN, at least 3,400 nurses are being Sunnybrook administrative and service support staff that • Ann Schaedlich, Registered Nurse, Musculoskeletal targeted to complete the eHealth course. “This is such a fitting award for Dr. Kodama, who has put Sunnybrook’s values into action every day to improve Dr. Barry McLellan, president and CEO of Sunnybrook, “This award recognizes and honours the clinical work Program, Holland Site been committed to teaching for the past two decades,” the experience of our patients and their families. Marilyn Reddick, vice president of Human Resources and of individuals who demonstrate in their daily work the • Nisha Chopra Umraw, Occupational Therapist, Burn Sunnybrook nurses are encouraged to log on to complete says Dr. Peeter Poldre, Vice President, Medical Education chair of the Bertin Awards committee, and Paul Bertin values of Sunnybrook, a commitment to learning, exem- Unit & Professional Practice. “In addition to being an out- The Bertin Award for Excellence in Customer Service all spoke at the event and praised the winners for their the course. This type of capacity building within the nurs- plary work with our patients and a talent for innovation,” standing undergraduate teacher, as shown by his two was named in honour of Paul Bertin, who devoted many accomplishments. ing community is a key to successful implementation of said Dr. McLellan. “The winners we recognized tonight Winners of the eighth annual Schulich Awards for Peters-Boyd Academy Awards in 2004-5 and 2007-8, as years of service to the hospital as a board member. With eHealth, including the electronic health record. There are truly contribute to the vision of Sunnybrook, for they are academic excellence his service on various board committees over the years, the postgraduate program director in Urology, he has “We are here to acknowledge their contributions and to several Nursing eHealth Champions at Sunnybrook who inventing the future of healthcare each and every day.” • Robert Goldberg Bertin has dedicated countless hours to the hospital as a inspired and mentored many urology trainees. Learners thank them for the extraordinary service they provide are highly influential in clinical settings in promoting and • James Kennedy Sunnybrook volunteer. at all levels are enriched by his efforts. He truly is an to our patients and other hospital staff,” said Marilyn facilitating eHealth adoption that Ria will be connecting • Joseph Wiley exceptional educator.” Reddick. “Through their acts of kindness, good deeds, with to promote eHealth at Sunnybrook. Patients, family members and colleagues nominated em- and quality work, these staff members have made a dif- ployees from across Sunnybrook. Winners were selected Dr. Kodama has won many undergraduate divisional ference in the lives of our patients and our hospital staff. awards (AW Bruce) and a departmental Bruce Tovee by a committee composed of a cross-section of leaders teaching award. This is also his second Aikins award from the non-clinical areas. Without knowledge of the in the past 10 years in the same category. In addition, Dr. Kodama has been awarded several divisional post- graduate teaching awards and the departmental Bruce Tovee post-graduate award. Interprofessional student placements at Sunnybrook

By Laura Collin, dietetic intern and Adam Michalak, radiation therapy student

We started by learning about each profession repre- tient’s issues pertaining to our profession, and the care sented by our small group: Radiation Therapy, Social plan that we would follow after considering all the issues Work, Clinical Nutrition, Spiritual Care, Communicative Winners of the eighth annual Schulich Awards for Nursing and Clinical Excellence. Photo: Doug Nicholson raised by each profession. Disorders Assistant, and Nursing. To some of us, a few of these were new professions, and to others they have Overall, after working collaboratively with, and learning been colleagues for many years. We spent some time from various professions, we are now better able to un- learning how each profession approaches a patient and derstand the role that other professions play in patient Awards recognize academic excellence at Sunnybrook what they do specifically to assess and make plans in care. We discovered the importance of communication, terms of patient care. This was also a time for reflection Sunnybrook has been teaching some of the country’s CONTINUING EDUCATION AWARDS teamwork, and respect while seeking the input of other as we thought about how we perceive other professions best physicians, researchers, nurses and other health disciplines to enhance the care we provide. in addition to our own. care professionals for more than 30 years. Excellence in course coordination and continuing edu- cation teaching During this student placement, we were given the chance We would like to acknowledge Lisa Di Prospero, Manager, To recognize the outstanding work being carried out at Joseph Kay to request guest speakers to come share with our group Research and Education in Radiation Therapy and Lina Sunnybrook, the Celebrating Academic Excellence Award L to R: Lina Gagliardi (Co-facilitator), Karla Anor (Nursing student), their role as members of an interprofessional team. We Gagliardi, Social Worker in General Internal Medicine, for Ceremony & Dinner was held on May 25 to recognize Excellence in innovation in continuing education Rena Arshinoff (Chaplaincy student), Sarah George (Chaplaincy facilitating the IPE structured placement. the following areas: Professional Advisory Committee, Arun Sayal were fortunate to hear from experts in Palliative Care, student), Adam Michalak (Radiation Therapy student), Kelly Harvey Nursing Education Awards, Continuing Education (Audiology student), Lisa Di Prospero (Co-facilitator). Missing is Radiation Therapy, and the Ethics Centre. Sunnybrook offers three to five structured IPE placements Awards and the Peters-Boyd Academy Teaching Awards. THE PROFESSIONAL ADVISORY COMMITTEE & L to R: Sharona Bookbinder, Art Therapist, Ruth Barker, Director Laura Collin (Dietetic student). Photo: Dale Rodick of Health Professionals and IPE/IPC (award presenter) and Leasa per year. In addition, a flexible, self-directed IPE model is Congratulations to all 2009 – 2010 winners. NURSING EDUCATION AWARDS During the final two weeks, we prepared a concluding Knechtel, Director of Nursing Education (award presenter). The experience with the Interprofessional Education/ presentation of our learning outcomes. We decided to available to accommodate those students who are unable Interprofessional Care (IPE/IPC) Structured Placement was PETERS-BOYD ACADEMY AWARDS Academic/Curricular Teaching Award use a case study as a means to explain to Sunnybrook to participate in a structured placement. For further infor- valuable to our student experience and ongoing learning. Nazlin Allidina staff what we learned from the placement. We each mation on structured IPE placements or the self-directed We met as a group early in April, unaware of what the Clinical Teaching/Supervision Award presented slides about what our profession does, the pa- flexible model, please call Ruth Barker at 5830. next four weeks would teach us about other professions Calvin Law, Neal Westreich Clinical Teaching / Supervision Award and about ourselves. Sharona Bookbinder Dr. A. W. Harrison Scholarship Award Joseph Wiley Interprofessional Education Award Radiation Therapy Clinical Coordinator Team, Resident Teaching Award Krista Dawdy, Michelle Greig, Karen Moline, Upasana Krishnadev, Andrew Smaggus Marnie Peacock

Small Group Teaching Award Staff Development Award Pamela Lenkov, Michael Varenbut Veterans Centre Interprofessional Education Steering Committee, Francine de Belchior, Dong Kang, Raina L to R: Leasa Knechtel, Director of Nursing Education (award pre- Student Contribution Award Minler, Winsome Shirley, Ria Spee, Mei Tse, Chris Watson, senter), Dong Kang, Physiotherapist, Raina Milner, RN, PCM K3E, Theodore Christakis, Antoine Eskander Helen Yeung Ruth Barker, Director of Health Professionals and IPE/IPC (award presenter), Francine de Belchoir, Recreation Therapist, Ria Spée, RN, APN, Chris Watson, SLP, Helen Yeung, Clinical Dietitian. Ab- sent: Mei Tse, RN, LFSE and Winsome Shirley, PAA. Photos: Doug Nicholson Sunnybrook News Volume 6 No. 4 June 2010 Sunnybrook News Volume 6 No. 4 June 2010 June is Stroke Awareness Month Fewer Ontarians dying of heart disease Researchers to explore new treatments Walk this way! Health tip: Signs of a stroke By Monica Matys The rate of deaths related CHD deaths, risk factors (smoking, diabetes, blood for fractures to heart disease decreased pressure, cholesterol level, exercise, obesity) and Did you know? If you’re ready to enjoy the warm weather, and get a great by 35 per cent in Ontario changes in the use of treatments. By Jim Oldfield workout at the same time, Nordic Pole Walking is for you! between 1994 and 2005 due Stroke sometimes gives a warning first Sunnybrook was the first Canadian hospital to incorpo- to improvements in lifestyle The researchers found that improvement in risk fac- The work will be an early-stage investigation of feasibil- rate this popular European activity as an official wellness factors and medical treat- tors accounted for about 3,660 fewer CHD deaths Your awareness and timely intervention can make all the ity. “The study is high-risk in the sense that it may not strategy, a concept that has now been picked up by many ments, a new population over the course of the 11 years and new medical and difference work, but if it does work, it could transform how we treat others across the country. study shows. surgical treatments accounted for about 3,280 of the craniofacial fractures,” said Whyne. total of deaths prevented or delayed. A transient ischemic attack (TIA) or “mini stroke” is a Sunnybrook staff can take full advantage by signing Results of the study, warning sign of a future stroke, with symptoms similar to Dr. Margarete Akens, a junior scientist in SRI’s orthopae- up for one of the many weekly classes led by certified published in the May 12, Although reductions in smoking and inactivity each a major stroke. It is usually caused by temporary interrup- dic biomechanics laboratory, will lead the second grant. Sunnybrook instructors at nordixx.com. 2010 issue of the Journal played an important role in the decline in CHD related tion of blood flow to the brain by a blood clot – symptoms Dr. Harindra Wijeysundera Akens, Whyne and their Sunnybrook colleagues will test a of the American Medical deaths, the biggest difference came from a reduc- usually resolve within 24 hours. is an interventional car- new way to improve healing in long-bone fractures, which Nordic Pole Walking is fitness walking using specially Association (JAMA), indi- tion in cholesterol levels and blood pressure - each diologist at Sunnybrook’s account for 25 per cent of extremity combat wounds and designed poles to push your body forward. The activity Schulich Heart Centre. cate that improvements in representing about 20 per cent of overall reductions However, even if the symptoms are temporary, they are a common injury in civilians. These fractures can take burns nearly twice as many calories as regular walking traditional risk factors for in death. should always be treated as a medical emergency as up to one year to heal, and as many as one in 10 don’t (about 400 calories per hour), eases impact on knees they can be a warning flag for a more serious impending coronary heart disease (CHD) such as cholesterol levels mend completely, often resulting in repetitive surgeries The most important change regarding new medical and joints and improves posture. And it’s a wonderful stroke. and blood pressure were responsible for about half of the and long-term disability. and surgical treatments was the number of patients way of reducing stress while working your core muscles. reduction in deaths, while new medical and surgical treat- Drs. Albert Yee (left) and Cari Whyne (right), with Dr. Margarete taking appropriate medications. Numerous studies have supported the health benefits of About 10 to 20 per cent of patients will experience a ments were associated with 43 per cent of the decrease. Akens, will investigate photodynamic therapy as a treatment for The researchers will investigate a combined drug-light long-bone fractures. Photo: Doug Nicholson this simple, yet highly effective, activity. major stroke within 90 days following a warning TIA. Half technique called photodynamic therapy (PDT). This tech- “The primary aim of the study was to take a look at the “Although it was encouraging to see that more of TIA patients will experience a major stroke within 48 The U.S. Army Medical Research and Material Command nique has garnered considerable attention recently as a The sport was invented in Finland as part of summer number of CHD related deaths over the course of 11 people are making the necessary lifestyle changes hours. have granted musculoskeletal scientists at Sunnybrook treatment for cancer and other conditions because it is training for cross country skiers. Athletes soon discov- years to see if we could identify any trends that would and getting the treatment they need to look after Research Institute (SRI) two hypothesis development nonsurgical, minimally invasive and localized: a latent ered the tremendous advantages of Nordic Pole Walking, suggest what we are doing well to prevent and treat heart their heart health, the news is not all good,” cautions For these patients, the faster they can be assessed and awards totaling $288,000 U.S. “photosensitizing” drug is injected directly into the tu- which incorporates 90 per cent of all body muscles and disease,” says Dr. Harindra Wijeysundera, interventional Dr. Wijeysundera. treated, the better chance they have of avoiding a major mour or wound area or via intravenous, then activated increases overall endurance. stroke. It can mean the difference between life and death, cardiologist at Sunnybrook’s Schulich Heart Centre and by laser light. The study results indicate that the prevalence of The grants will fund research on a novel method for stabi- or permanent disability. lead author of the study. “Identifying the underlying diabetes and the rise in obesity has had an inverse lizing traumatic bone injuries of the face and skull, and a “So many people don’t participate in regular physical factors associated with this decline is critical for plan- Scientists are beginning to overcome a long-standing ob- effect on CHD related deaths. From 1994 to 2005, treatment to enhance long-bone fracture healing. exercise because they find it exhausting,” says Dr. Klaus ning future health policy and prioritizing strategies for stacle to implementing the therapy—limited penetration diabetes accounted for a six per cent increase in Schwanbeck, President of Nordixx Pole Walking Canada. prevention.” of tissue by laser light—with new LED technology and cardiac deaths, while obesity accounted for a two per “The funding climate right now is difficult, particularly for “But Pole Walking is a low-impact way to instantly benefit needle-delivery methods, sparking a surge of interest in cent increase. operating grants, so these awards are a nice surprise,” your whole body, and it’s fun to do!” Warning signs of a TIA or stroke In partnership with the Toronto Health Economics and said Dr. Cari Whyne, director of the Holland musculosk- the technique. Technology Assessment (THETA) collaborative, the “What people living with coronary heart disease Here at Sunnybrook, about 250 people regularly partici- • Weakness - Sudden loss of strength eletal research program at SRI, and principal investigator Institute for Clinical Evaluative Sciences (ICES), University should take away from this study is that they have a “In doing work on spinal metastases, one of our unex- pate in Nordic Pole Walking. And results from evaluation or numbness in the face, arm or leg, and co-principal investigator, respectively, on the two of Liverpool, University of Western Ontario and Canadian lot of power when it comes to managing their heart pected findings was that PDT not only kills tumours, but questionnaires find almost all found it easy to learn and even if temporary grants. Heart Research Center, Dr. Wijeysundera and colleagues disease,” adds Dr. Wijeysundera. “Making lifestyle it [also] structurally augments bone,” said Whyne. “And would recommend it to others as an enjoyable way of • Trouble speaking - Sudden difficulty looked at data for people between the ages of 25 and changes like exercising, eating right and not smok- it’s been shown to have a positive effect on infection, staying fit. speaking or understanding or sudden For the craniofacial study, Whyne and her colleagues will 84 who were treated for CHD in Ontario between 1994 ing is equally as important as the medical treatment which can be a problem in long-bone fracture healing. confusion, even if temporary develop a new method for bony reconstruction that may and 2005. The model they used to analyze the data al- they receive so those factors need to be taken just So it’s potentially a great way to help patients with long- Ten training sessions cost $20, which includes the pole • Vision problems - Sudden trouble with provide a unique combination of mechanical strength, lowed them to examine factors such as population size, as seriously.” bone fractures that aren’t healing.” rentals. You can also purchase the poles for your own vision, even if temporary ease and flexibility of application, and cosmetic subtlety. personal use for $50 from Occupational Health. • Headache - Sudden severe and The researchers will then test the biomechanical strength Having recently returned from a Canadian Institutes of If you want to give Nordic Pole Walking a try, contact unusual headache of the implant-bone constructs. Health Research grants panel, where finite funds will Karen Wichert in Occupational Health by email, or at • Dizziness – Sudden loss of balance, likely not cover the large number of good proposals, extension 1621. especially with any of the above signs “Craniofacial surgeons face many complex structural New metabolic imaging method helps better problems, and their methods for dealing with them are Whyne was especially grateful for the awards from south limited, in part because the bones are often very small, of the border. “It’s a great opportunity if your research (stroke warning signs from the Heart and aligns with the army’s priority areas, and musculoskeletal Stroke Foundation) tailor chemotherapy thin and three-dimensionally complicated,” said Whyne, who is also an associate professor at the University of trauma is important to the military,” said Whyne. “That By Natalie Chung-Sayers Toronto. “They can’t use thick plates and screws as they said, they fund research on many different diseases and do with long bones, and current surgical procedures often injury states—and they’re open to anyone, anywhere in For the first time ever, Sunnybrook researchers show in and medical oncologist and co-lead, Locally Advanced fail to sufficiently stabilize the bone, which is necessary the world.” Recognizing and responding immediately to the warning as early as four weeks, breast cancer tumour response Breast Cancer Clinic, Sunnybrook’s Odette Cancer Centre. for healing.” signs of a stroke by calling 911 can significantly improve during patients’ pre-surgical chemotherapy using imag- survival and recovery. ing known as diffuse optical spectroscopy. The study Locally advanced breast cancer involves tumours greater is published in Clinical Cancer Research and tracks than five centimetres in size, involve the skin or chest responses over multiple times during patients’ therapy. wall and include inflammatory breast cancer. Pre-surgical Co-founders of Sunnybrook’s Centre for Spinal neoadjuvant chemotherapy and sometimes radiotherapy Joanne Nevison, age 50, participated in the study. Her are often used to decrease tumour bulk to allow for more The Campaign for Sunnybrook has a fundraising goal Trauma seek cure for devastating spine injuries case was very responsive to the specific pre-surgical che- breast-conserving surgery. Locally advanced breast can- of $470 million and the community has invested $294 motherapy she was on. This was very apparent from the cer represents up to 20 per cent of all newly diagnosed By Sandeep Punia Dr. Klaus Schwanbeck, President of Nordixx Pole million to date. Here’s what the money will pay for: diffuse optical spectroscopy scans taken of the tumour. breast cancers in women in North America. Walking Canada. “It’s worth a lot to know that much sooner, the type of Over 20 years ago, Barry Munro broke his neck in a div- care and spinal cord injury. Munro is delighted about chemo I was on, was right for me,” says Joanne. The researchers performed diffuse optical spectroscopy ing accident. Becoming a quadriplegic changed his life CSRO’s participation in the groundbreaking new Centre. scans with ten women diagnosed prior with locally ad- forever. “We have evidence at multiple times during pre-surgical vanced breast cancer. Five scans per patient were taken “Sunnybrook’s reputation as the number one trauma cen- chemotherapy that shows significant differences between up to three days before treatment and at one, four and Today, as the chairman of the Canadian Spinal Research tre in the country actually positions the Centre for Spinal patients responding and those who were not, at four eight weeks after pre-surgical chemotherapy. Responders Organization (CSRO), he is a tireless advocate for research Trauma as the place to learn more about spine care,” he weeks after starting therapy. An accurate, faster read to treatment and non-responders were significantly dif- in spinal cord injury and neurotrauma. adds. Facilities $212M means better potential to individualize treatment,” says ferent, for all functional activities at the four-week scan. Progress to date: $112M Dr. Gregory Czarnota, lead investigator and radiation “Sunnybrook saved my life,” Munro says. “The neu- Committed to reducing spinal cord injuries by building oncologist, Sunnybrook’s Odette Cancer Centre and as- The device used in the study is the SoftScan system by rotrauma staff took such good care of me. They are never awareness, the CSRO’s mission is a natural complement sistant professor, departments of Radiation Oncology ART Advanced Research Technologies Inc. The study satisfied with status quo because they keep striving for to the Centre for Spinal Trauma’s mandate - to find a cure Research $116M Progress to date: $84M and Medical Biophysics, University of Toronto. was funded by a Cancer Care Ontario Research Chair in excellence.” for paralysis caused by spinal cord injury. Experimental Therapeutics and Imaging, Natural Sciences Diffuse optical spectroscopy: and Engineering Council of Canada, Ontario Institute for As the largest centre for orthopaedic surgery in Canada, The CSRO also supports public events like the Run, Walk Technology $100M • Shows strong promise over traditional imaging Cancer Research and the Odette family. Sunnybrook already treats more than 150 spinal fractures and Wheelathon, which will be held on July 15 this year at Progress to date: $64M • Provides functional imaging to better monitor tumour every year. To meet the growing needs of patients in the the Honda Indy Toronto, the day before the official race. activity e.g. changes in oxyhemoglobin, deoxyhemo- Greater Toronto Area and across Ontario, Sunnybrook will The Run, Walk and Wheelathon will combat road racing “Cancer Can’t Dance Like This” is a comedic globin, lipid and water content create a facility where staff can conduct more research to and raise funds toward a cure for paralysis. Sunnybrook Fund $42M one-man show performed by Daniel Stolfi, Progress to date: $34M • Uses risk-free near infrared light save more lives, and to ultimately find a cure for spinal • Does not require the patient to be injected with a con- cord injuries. For more information about CSRO and how they are who was diagnosed with Acute Non-Hodgkin’s trast agent reducing spinal cord injuries through public awareness Lymphoma at age 25. The show vividly • Is relatively less expensive than MRI (magnetic reso- That’s why, Munro insists, the time to build the research programs, visit csro.com. portrays Daniel’s experience during chemo- nance imaging) and PET (positron emission tomography) capacity for spine care at Sunnybrook is now. • Can be used more readily in smaller settings therapy treatment while embracing his own And they’re setting the pace. Munro and his fellow part- saving grace – the fine art of comedy. Join us “With traditional imaging it is many months of chemo- ners at the firm Falconeri Munro Tucci LLP have teamed up on July 22! Proceeds will fund the expansion therapy before one might better tell how a patient is re- with the Canadian Spinal Research Organization to make Submission deadline: sponding and whether to change the treatment approach. a milestone gift of $5 million to create Sunnybrook’s new The Canadian Spinal Research of the chemotherapy unit at Sunnybrook’s June 30, 2010 Centre for Spinal Trauma, the first of its kind in Canada. Organization, in partnership With this new, more functional imaging, we can see more Odette Cancer Centre. The Centre launched on May 27, 2010. with Falconeri Munro Tucci LLP, tumour activity early on which means a better therapeutic has made a milestone gift of $5 ratio (reduced toxicity while keeping the chemotherapy Dr. Gregory Czarnota is the lead investigator of the study and a million to create Sunnybrook’s The Centre for Spinal Trauma will unite Sunnybrook’s effective) and better chance there will be no cancer after radiation oncologist at Sunnybrook’s Odette Cancer Centre. new Centre for Spinal Trauma, surgery,” says Dr. Rebecca Dent, study co-investigator Photo: Dale Roddick expertise in orthopaedic spine care, trauma and neu- the first of its kind in Canada. 2 rotrauma, conducting research and clinical trials in spine 3