For those who are unable to naturally maintain this rhythm—or those who have difficulties breathing, resting, or staying asleep—there are a growing number of new technologies that aim to make the process of resting well more accessible.

Sunnybrook is home to a state-of-the-art research, education, and sleep laboratory that combines brain science-based clinical abilities, teaching, and research, as part of the Clinical Neurophysiology program.

At the most recent edition of our Speaker Series community education session, “A Good Night’s Sleep,” Sunnybrook experts Dr. Andrew Lim (highlighting circadian rhythms), Dr. Mark Boulos (focusing on restless legs syndrome), and Dr. Anu Tandon (sharing about sleep apnea) presented to community members about a range of sleep-related health issues and also had the opportunity to provide real-time feedback and information to participants in the live webinar moderated by Dr. Brian Murray.

A common topic and point of interest: the use and benefits of positive airway pressure therapy.

CPAP, APAP & BIPAP

There are three main types of positive airway pressure therapy:

• CPAP: Continuous Positive Airway Pressure delivers consistent pressure maintained throughout the respiratory cycle to improve oxygenation.
• APAP: Automative Positive Airway Pressure automatically adjusts to meet each person’s specific needs, changing throughout the night to constantly measure resistance.
• BIPAP: Bilevel of variable Positive Airway Pressure is low-range pressure, that delivers higher air pressure when you breathe in.

In addition to these familiar therapies, there are also dental and nasal options, surgical alternatives (nasal or jaw), and nerve stimulation.

Technological sleep innovations

Sleep technologies that collect information while resting in a natural environment and recording information over an extended period of time can also include various pedometers and related trackers. Fitbit® (for example), or similar devices can measure metrics like heart rate, temperature, oxygen levels, and assesses quality of sleep and physical activity.

To assist in discovering sleep abnormalities, Sunnybrook’s Dr. Lim highlighted a few innovative wearable technologies, including:

• MUSE is a brain sensing headband that uses real-time biofeedback to help refocus during the day and recover overnight; it determines when psychology and physical problems arise within the body, with guidance for combatting stress and overcoming fatigue.
• The ANNE^TM ONE system, for the diagnosis of obstructive sleep apneas in adults, is worn over multiple nights in a row, monitoring and predicting when breathing stops during sleep.
• WRIST ACTIGRAPHY devices are wrist-worn monitors that record movement and sleeping or talking patterns over an extended period.

How is your sleep hygiene?

“Healthy sleep is paramount to a healthy lifestyle.” Dr. Mark Boulos, Sunnybrook Neurologist

Here are a few things to consider when monitoring and improving your sleep hygiene:

1. Establishing a fixed wake up time
2. Prioritizing your sleep over other activities
3. Making gradual adjustments to your routines
4. Limiting the amount of naps taken during the day
5. Winding down before going to sleep
6. Dimming lights for a quiet and relaxing sleep environment
7. Unplugging from electronics before bedtime
8. Getting as much daylight exposure as you can
9. Optimizing your bedroom (limiting use for sleep and sex only)
10. Refraining from eating or drinking before going to sleep

Sunnybrook’s Sleep Disorder Clinic

For those who would like to visit Sunnybrook’s Sleep Disorder Clinic, ask your family doctor for a referral if you are experiencing symptoms of concern, including:

• Sleepiness or features of narcolepsy
• Loud snoring or stopping of breathing in sleep
• Restless legs syndrome
• Abnormal sleep behaviours

Have your family doctor fax a brief request to “assess sleep” to 416-480-6092, to arrange clinical assessments and necessary sleep studies: click here for our Outpatient Sleep Assessment Request Form.

Coming soon from the Hurvitz Brain Science program

Sunnybrook’s Hurvitz Brain Science program is growing, with a new Circadian Rhythm Lab on the horizon. To learn more about sleep research taking place within the Hurvitz program, or if you are interested in supporting fundraising efforts, please visit link here for more information.

The post Healthy lifestyle, healthy sleep appeared first on Your Health Matters.

“If you had to get a cancer, this is the one you’d want to get.”

This is a statement that most thyroid cancer survivors are familiar with. A harmless phrase of intended comfort, clinical psychologist Dr. Kimberly M. Davis believes that (along with subtle stigmas and silent burdens) these few words are often uncomfortable and even hurtful to those in various stages of treatment and/or recovery.

In her presentation, “Adjusting to and coping with thyroid cancer: what does this mean and look like for me?” at this year’s 25th International Thyroid Cancer Survivors’ Virtual Conference, Dr. Davis noted that many of her therapy clients have actually expressed distress that their journey with thyroid cancer is often dismissed, invalidated, and seldom empathized with, because of the widespread assumption that this is a “good” cancer.

What’s so “good” about Thyroid Cancer?

Thyroid cancer’s reputation of being a “good” cancer may be because:

• The prognosis is generally promising–this depends on the type of thyroid cancer and the stage it is detected, but if found early, most thyroid cancers can be treated.
• Many patients do not experience symptoms, especially in the early stages.
• It requires a lifetime of monitoring, however, the rate of recurrence (it can spread to other parts of the neck, lymph nodes, and throughout the body) is minimal, even decades after the initial diagnosis.

Dr. Davis recommended support groups specifically tailored for this patient demographic as a beneficial part of the healing process for survivors, helping to cope with lifestyle changes, fears, and other common emotional and mental effects many cancer patients and survivors experience.

Facts about Thyroid Cancer

It is 3x more common in women than in men.

It is the most common endocrine cancer.

It is now the #1 cancer among young people (ages 15-29) in Canada.

There are several types of thyroid cancer: papillary or follicular (the most treatable kinds, representing about 90% of all thyroid cancers); medullary (about 3-4%); anaplastic (the least common and most aggressive kind, at 1-2% of cases); and there are also variants.

For signs and risk factors of thyroid cancer, and additional information about diagnosis and treatment, visit our Sunnybrook Head & Neck Cancer webpage.

Head & Neck Cancer at Sunnybrook

Sunnybrook has the third largest head and neck program in Canada, within the Odette Cancer program’s Head and Neck Cancer Care department–in collaboration with the Neuroendocrine Tumours (NET) department–providing pre-screening assessments, diagnostics, and minimally invasive treatment options. Published thyroid cancer-related clinical trials have included:

• Ultrasound-Guided Fine Needle Aspirate of Thyroid Nodules: The Sunnybrook Experience
• Waiting for Thyroid Cancer Surgery: A Prospective Cross-Sectional Study of Psychological Morbidity and Determine of Health Associated with Long Wait Time for Patients with Thyroid Cancer
• Thyroidectomy and Informed Consent: Do Pamphlets Enhance Post-Operative Recal

Sunnybrook Innovations in Thyroid Cancer

Sunnybrook affiliate scientist and surgical oncologist Dr. Kevin Higgins has an academic focus on “outcome-based head and neck oncology research, with an emphasis on best practice, meta-analysis and microvascular surgical functional outcomes.” In 2016, his team conducted the largest Canadian study in fine-needle biopsy (listed above).

He is currently researching radio frequency ablation of benign nodules and low risk cancers, and Dr. Higgins is also using “next generation sequencing for very advanced, poorly differentiated, and anaplastic cancers, for targeted therapy interventions.”

Resources

• Thyroid Cancer Survivors’ Association, Inc.
• Thyroid Cancer Canada
• Canadian Cancer Society – Thyroid Cancer

The post September is Thyroid Cancer Month appeared first on Your Health Matters.

When Tony Kim is discharged from St. John’s Rehab this week–after a month-long hospital stay at Sunnybrook–he will be leaving as a freshly declared newlywed.

Tony was looking forward to marrying his college sweetheart Irene on the morning of September 3—the day of their ten-year anniversary—but a motor vehicle collision in early August temporarily disrupted his plans. The civil ceremony (planned prior to the car accident) was to take place at Toronto’s City Hall, however, with the support of St. John’s staff, Tony arranged to have the ceremony in the hospital gardens instead.

A pharmacist, Tony met Irene while they were studying in their hometown of Vancouver, at the University of British Columbia. It was his dedication to community pharmacy that had Tony driving home to Toronto from Muskoka (where he was providing coverage) at night, during a heavy rainstorm.

Tony’s car hydroplaned on the slick roads, and spun out of control. His right femur and hip were injured, as well as his jaw. While the early details of his hospitalization and surgeries were difficult to recall, his final days of recovery at Sunnybrook would prove to be extremely memorable.

Staff on A2 shared Tony’s excitement leading up to the big day, and reviewed the morning’s preparation and dressing with him. “I still can’t wear both shoes,” Tony said, laughing, the day before the wedding, proud to be able to stand for ten minutes with the support of a walker, and his nurses close by. “But the trees here are awesome, and the forecast looks good,” he said, excited to proceed with his long-time plans.

With the majority of Tony and Irene’s family members residing in Vancouver, the ceremony was small, with participants including St. John’s Spiritual Care Coordinator Joanne Davies, and Sister Suzanne Marie, the Spiritual Care Provider for A2.

“Tony’s sister came as a surprise for him; that was delightful,” said Joanne Davies. “In fact, the lovely wedding dress (which had been his sister’s) was also a surprise. I think that moment was the best and most poignant for me…Tony’s reaction when he saw Irene coming down the path to the spot for the wedding under the Anniversary oak tree on the grounds. Truly a fairy-tale moment, and happy tears for all of us.”

Tony was grateful to have the support of the health care team, and the manicured gardens and picturesque backdrop as the location for his wedding. As a special gift, staff on A2 temporarily discharged Tony for the evening to spend time with his new bride.

“This has been a helpful learning experience for me, overall,” Tony said, sharing praises for the various interactions he had. “Being able to talk with–and learn from–the nurses, doctors, the pharmacist Grace [Jong], the physiotherapists, and staff like Martha [Agelopolous, the unit PAA], has really broadened my spectrum of understanding, as a pharmacist.”

“Experiencing this holistic approach has been great,” he continued. “Once I started feeling better, I started writing diaries in my phone to record all of the moments and lessons I had while I was a patient.”

Tony looks forward to implementing these new lessons into his community pharmacy interactions and processes.

With A2 staff expressing optimism for his continued recovery and healing—and the ability to proceed with his full wedding ceremony and reception in April, walking his bride down the aisle with their family members in attendance—Tony is leaving his time at Sunnybrook not only as a married man, but also feeling strengthened, inspired, and professionally enlightened.

The post A Weekend Wedding at St. John’s Rehab appeared first on Your Health Matters.

For Ontarians, the holiday also falls around the time of one of Canada’s most vibrant and revered cultural celebrations. The Toronto Caribbean Carnival began in 1967, and like the numerous Caribbean carnival celebrations that take place around the world throughout the year, it is historically rooted in the celebration of freedom.

Sharing the Spirit of Carnival

Aaron Hope

Aaron Hope presented an opportunity through the Sunnybrook Employee Classifieds, inviting colleagues to join him in the return of this year’s carnival. A PAA on C6, Aaron was eager to connect his personal passion with his staff community.

After the cancellation of festivities in 2020 and 2021, Aaron is ready to celebrate carnival again with his design team–Carnival Dollz–and excited to finally present their costumes on the parade route this coming Emancipation Day weekend, at the July 30th parade, downtown Toronto.

“We missed carnival; we missed two years of this release, and we are ready to have a good time,” said Aaron. Along with his partners Phylicia Carmona and Kamania Parris, they have over 150 registered participants to construct, organize, and distribute individually-fitted costumes for at the Toronto Revellers’ costume production site (mas camp).

Freedom of Expression

“Osaka” by Phylicia Carmona

Nurse Practitioner Kamania Parris has worked in health care for 19 years, and spent many of those years (through nursing agencies) working at Sunnybrook. For Kamania, Carnival is all about celebrating joy and freedom; however, as a nurse, she was often apprehensive about participating in the event.

“Being a nurse, you’re supposed to hold yourself to a certain standard. There’s a fear attached to wearing the revealing costumes, which is why many don’t want to participate,” she explained. “They love the idea of dancing in the street and having a good time, but they’re afraid that their patients or co-workers might see them and pass judgement. This is a common roadblock that happens with many of the nurses and professionals I’ve come into contact with. I feel if we raise more awareness of the ‘why,’ that they might let those fears go, and feel comfortable doing what they love.”

Carnival Dollz team and models

Kamania works towards changing this stigma by bringing light to the beautiful and liberating experience. Sharing her culture with classmates, neighbours, colleagues, and peers has been a lifelong commitment.

The team’s costume was designed by Phylicia Carmona, a graduate of Humber College’s Fashion Arts program. With the support of granting programs–and after successfully designing eco-friendly intimate wear for new mothers, and mothers-to-be–she joined the Toronto Revellers masquerade band (led by Toronto Raptors’ Assistant Coach and Community Ambassador, Jamaal Magloire), to express her talents through costume. Through designing for carnival masqueraders, she has been able to reach large audiences and translate the beauty of her culture in a unique and influential way.

A Family Tradition

“Growing up, carnival was a constant in my life. My dad was a DJ and an instrumental figure organizing the parade in Montreal, and his reach extended to Toronto. Every year he brought my siblings and I along for the ride as he DJ’d at parties, at the King & Queen of the Bands competition, and on the parade route,” said Sunnybrook Research Institute Trainee Coordinator Natalie Hakim.

Natalie Hakim

“Raising children in Canada, my dad made sure this piece of Caribbean culture would be passed down. I’ve participated as a spectator, a masquerader, and as a designer, and now I get to pass this tradition down to my children,” Natalie said. “As a costume creator, when I see someone in my costume I don’t see my craft…I see a visual representation of the importance of my culture. As a masquerader, I feel that as well. Many people just see carnival as a ‘party in the street,’ but it’s so much more than that. Every successful year we have brings us closer to acceptance and understanding.”

Natalie explained how cultural events like the Caribbean carnival also influence her health, wellness, and work/life balance: “I always compare carnival to Christmas. December first hits, and the mall starts playing Mariah Carey’s ‘All I Want for Christmas,’ and it automatically puts you in a great mood! During carnival season, I play music by Machel Montano, and I get that same feeling. The feathers, the music, the dancing, it all gives me so much joy! And the best part is that it doesn’t come in a package or a gift…it’s an energy,” she said.

“I think as Canadians, we often view slavery as an American dark spot in history, however, Emancipation Day in Canada is recognition and a reminder that slavery was a global plague. While there is still much work to be done, Emancipation Day gives me a sense of pride that we as people are constantly growing and learning. On a more celebratory note (and specifically, as a Torontonian) it also means CARIBANA: fun!”

The Meaning of Emancipation Day

While Emancipation Day is new to Canada as an officially recognized holiday, the concept of emancipation has been tied to Caribbean carnival celebrations since inception. A public display of freedom, empowerment, and cultural joy, the earliest 18th century carnivals were developed as a way for African descendants to tell visual stories, exhibit arts–music, costume, and dance–and to revel in the power of their community and heritage.

Around the world, many celebrate Emancipation Day with street processions, or by re-enacting the reading of the Emancipation Declaration.

“Emancipation Day is all about freedom,” said Aaron, who was born and raised in Barbados, before moving to Canada. “Freedom to be who you are, and freedom to live a life without fear–without worrying about what people see you as. Carnival is a way to celebrate all of that freedom…and it’s liberating!”

The Ultimate Feeling

Anne Marie Phillips

“I have enjoyed Toronto’s carnival celebrations since 1970, and all three of my children have participated since they were in their strollers,” said Sunnybrook Phlebotomy Supervisor Anne Marie Phillips. “This is the fifth year that my daughter and I are making costumes for the Carnival Nationz masquerade band.” Led by Marcus Eustace and Bryce Aguiton, the band has received international acclaim, and won over 15 King & Queen titles in Toronto’s carnival festivities.

Anne Marie expressed what the holiday means to her family, including her design partner and daughter, Stacey Barnett.

Daughter of Anne Marie Phillips (designer Stacey Barnett), with excited masqueraders in “Circe” costume pieces

“For my family, Emancipation Day is the culmination of everything carnival, like the steelbands, and the soca and calypso music that just make you want to dance! The costumes with their vibrant colours, features, and gems…the food from various islands, fetes, and the overall vibe. From creating the costume prototypes, to the band/costume launch, and the numerous hours spent creating in the mas camp…to parading across the big stage on Lakeshore Boulevard, carnival produces the ultimate feeling. Through carnival, our Caribbean culture influences a way of life that is being embraced–and enjoyed–by many more cultures now, and it’s a beautiful thing.”

Wellness & Inclusivity

With time to plan, the restrictions of the pandemic lifted, and the ability to gather with the community-at-large, Aaron is excited to be able to encourage colleagues and friends to join him as he celebrates Emancipation Day. He hopes to continue to promote wellness and inclusivity at work by introducing cultural traditions.

“When I first thought about sharing this year’s costumes, I thought of my co-workers at Sunnybrook, because we have a lot of Caribbean people at work,” Aaron said. “And those who didn’t know much about carnival, are now ready to embrace it, and hopefully join me next year and experience this wonderful combination of freedom and the arts!”

The post Staff wellness & inclusivity through Caribbean carnival traditions appeared first on Your Health Matters.

Jagger Smith, Mindy Oiffer (Photo: Doug Nicholson)

On the afternoon of Tuesday, June 28 at North Toronto’s Baycrest Park, steps away from Baycrest Arena, volunteers, healthcare providers, and administrators of the Englemount-Lawrence Vaccination Clinic (ELVC) gathered to celebrate and reflect on the experience that brought over 20 organizations together to help protect their community from the spread of COVID-19.

Sunnybrook Care Navigator Kay McGarvey

Just over a year earlier, the COVID-19 landscape was very different, with vaccine doses newly released to the public. Each neighbourhood posed its own set of unique challenges, and vaccination teams had to adjust swiftly to ever-evolving policies around the vaccination process.

“In the face of several challenges, we came together as a team to vaccinate our community,” said Jagger Smith, Director of Ambulatory Clinical Services at Baycrest Health Sciences. “We delivered highly successful collaborative care at the ELVC, and that deserves to be acknowledged.”

Baycrest was charged with coordinating and leading clinic operations, along with the member organizations of the North Toronto Ontario Health Team (NT OHT).

Scott Ovenden, Stacy Landau, Dr. Jocelyn Charles, Dr. Karen Fleming, Dr. Yoel Abells, Dr. Dan Cass (Photo: Doug Nicholson)

Across the City of Toronto, healthcare and community partners rallied together to create an easily accessible and seamless experience for clinic patients, especially those from marginalized and vulnerable communities. Participation was broad throughout the clinic, including approximately 200 physicians, 60 representatives from Red Cross, 100 staff and leaders from NT OHT partners and 100 contributors from collaborators like North York Community House, Toronto Community Housing, and Liberty Pharmacy.

Together, they administered over 29,000 doses during the ELVC’s months of operation.

The ELVC appreciation picnic gave NT OHT co-leaders Stacy Landau (SPRINT Senior Care CEO), Dr. Dan Cass (Sunnybrook Health Science Centre EVP and CME) and Scott Ovenden (Baycrest Hospital President and CEO), the opportunity to present certificates of appreciation to the contributors on behalf of the NT OHT and Baycrest.

Gail Gordon, Mindy Oiffer (Photo: Doug Nicholson)

Gail Gordon, a site manager for Red Cross, recalls how volunteers from across the city came to assist with clinic operations. OR surgeons and community family doctors—with cancelled procedures and appointments—pivoted to administer vaccine doses at the clinic. SPRINT Senior Care was readily available to provide transportation services for elderly residents. Raquel Heayn (a volunteer coordinator with Reena at the time) drove members to and from Reena and the ELVC.

Bryce Watson and Emmanuel Kiplimo from Paladin Security provided security services at the clinic; they would often arrive to community members gathered outside the clinic before it opened, eager to receive their first or second dose of the vaccine.

Emmanuel Kiplimo and Bryce Watson (Photo: Doug Nicholson)

“It was overwhelming sometimes,” Emmanuel acknowledged. “We were the first point of contact to everyone arriving at the clinic. There were always many questions, and we were the people the community encountered first.”

“We would seek advice from the health professionals, and make sure we were communicating the right information at all times,” Bryce added. “We knew how important the vaccine was to people, so we had to do our best to keep everyone calm and help the process move smoothly.”

Oiffer received a call from the Canadian Red Cross requesting her volunteer services less than 24 hours after she got the first dose of the vaccine herself. Mindy became a familiar voice, a welcoming face, and another committed contributor to the ELVC mission to vaccinate as many community members as safely and efficiently as possible.

(Photo: Doug Nicholson)

Excited to reunite with the leaders, staff, and other healthcare and community workers at the ELVC, Mindy and Emmanuel reminisced about the days they spent together at the clinic.

In addition to being a memorable experience for all participants, the main objective of the ELVC—protecting the community—was clearly achieved, with over 29,000 doses administered during the ELVC’s months of operation.

“The reunion gave us a moment to appreciate the connections we made to each other as contributors to the ELVC, as well as to the people we served,” said Jagger Smith. “Seeing one another again, e-mailing with those who could not attend, and hearing a thank you from a passer-by in the park during the picnic really brought home the importance of the work we achieved together.”

In a sunny Baycrest Park, overlooking the arena, the ELVC reunion was an afternoon to feel the joy of accomplishment and professional collaboration, and to celebrate what was possible during challenging times.

The NT OHT thanks all who were involved in the ELVC for their critical work in helping to protect our community against COVID-19.

With contributions from Kimberly Taylor, Baycrest Health Sciences.

The post How the North Toronto community united to administer COVID-19 vaccines appeared first on Your Health Matters.

Rates of lung cancer are decreasing, and strategies such as enhanced screening and detection methods can lead to an earlier diagnosis, which can result in better patient outcomes. Recognizing these improvements (in addition to decreased incidence of cigarette smoking), enhanced treatments, and the latest forms of radiation technologies, Sunnybrook experts recently reiterated the White Ribbon Project’s message that it is indeed “time to change the lung cancer story.”

The White Ribbon Project’s advocacy is based on promoting lung cancer awareness, in addition to altering the public perception of the disease rooted in years of misleading campaigns. At the last Sunnybrook Speaker Series event, guest presenters Surgical Oncologist Dr. Calvin Law (Chief of the Odette Cancer Centre), Radiation Oncologist Dr. Alexander Louie, Respirologist Dr. Harvey Wong, and Thoracic Surgeon Dr. Negar Ahmadi highlighted the advances in treating lung problems and malignancies that have contributed to a significant improvement in outcomes over the past few decades.

Innovations in Lung Cancer Treatments

Innovations in cancer treatment include various new trials taking place at Sunnybrook that involve SBRT (Stereotactic Ablative Body Radiotherapy). New surgical approaches for treating early cancers are also available, and becoming more minimally invasive, including robotic surgery, and removing smaller portions of diseased lung (i.e., segmentectomy rather than lobectomy).

At Sunnybrook, outpatient Interventional Pulmonology programs such as LDAP (Lung Diagnostic Assessment Program), are helping to expedite the work of patients with suspicious findings for lung cancer. This in turn results in quicker cancer treatments for patients, resulting in better patient outcomes. Minimally invasive methods are now available to confirm the diagnosis of lung cancer (i.e., scopes with ultrasound capabilities, in conjunction with navigation software, result in a painless and incisionless tissue sampling). While these innovations are currently in use, there are also newer technologies (i.e., Robotic Bronchoscopy) that are not yet available in Canada, but are being actively investigated and explored internationally.

Minimally invasive interventions are also available to manage complications related to lung cancer such as airway dilatation and the debulking of tumors from central airways. Another outpatient Interventional Pulmonology program, the EPIC (Effusion Procedural Interprofessional Clinic), inserts indwelling catheters so patients can have the fluid that forms around the lung drained in the comfort of their own home, rather than requiring frequent visits to the hospital.

Positive Outcomes from New Lung Cancer Innovations

• Enhanced treatment for patients
• Improved patient support and home care collaboration
• Faster treatment of cancer complications
• Increase in minimally invasive removals
• Enriched patient experience

Early Screening Saves Lives

Those between the ages of 55 and 74, with a current or former history of smoking (or who have quit smoking within last 15 years), are advised to talk to their primary care physician to see if they quality for lung cancer screening via CT scan. Lung cancer screening saves lives, and Sunnybrook continues to ensure that patients have the latest and most successful options.

Recommended Readings from our Experts

Offering perspectives from lung cancer patients, physicians, and on navigating the Canadian health care system.

• “The Emperor of All Maladies” by Siddhartha Mukherjee
• “When Breath Becomes Air” by Dr. Paul Kalanithi
• “Taking Charge of Cancer” by Dr. David Palma

The post Advances in Lung Cancer Treatment: Changing the Lung Cancer Story appeared first on Your Health Matters.