He never completed the word. A car ahead of him had stopped to turn left. Steve swerved into oncoming traffic, colliding head-on with another vehicle.

Paramedics concluded the 28-year-old had suffered a severe brain injury, and that one of his thighbones was broken in two places. With his life on the line, Steve was airlifted to Sunnybrook’s Tory Regional Trauma Centre.

The trauma centre, now celebrating its 40th anniversary, was Canada’s first regional trauma centre and it remains the country’s largest. The centre’s expert team cares for over 1,600 injured patients annually, many of whom are at risk of losing life or limb, usually from a motor vehicle collision, shooting, stabbing, severe fall or industrial incident.

While patients with injuries like Steve’s are a rarity at many hospitals, they’re a daily reality at Sunnybrook. Tory Regional Trauma Centre’s success at saving lives place it amongst the top 10 per cent of all North American trauma centres, according to a recent report by the American College of Surgeons.

Sunnybrook’s trauma team saves 94 per cent of the most severely injured patients who come through the centre’s doors. They can do so because they harness the latest advancements in trauma care, some of which have been spurred by their own cutting-edge research.

This state-of-the-art care was there for Steve when it mattered most. Comatose and bleeding, he was rushed to the trauma bay and treated by a multidisciplinary team of surgeons, anesthesiologists, nurses, respiratory therapists, imaging specialists, blood bank technologists and others.

They stabilized him over the course of nearly three hours by getting the bleeding from his leg under control and treating his life-threatening brain swelling.

Steve had won the opening round of his long fight to return to his daily life. He went on to spend the next 52 days in the Intensive Care Unit. Next came in-patient rehab, and then more from home.

Steve is still living with the residual effects of his permanent brain injury, which has prevented him from pursuing his career path, but he feels fortunate to be alive. “The trauma centre saved my life. I owe so much to them,” he says.

A history of innovation

The advent of computed tomography (CT) imaging – a technology that was crucial to Steve’s care – is one of the major ways trauma care has improved since the Tory Regional Trauma Centre opened four decades ago. CT imaging can visualize nearly all parts of the body, and it is particularly well-suited for rapid evaluation of brain injuries and internal bleeding.

With the introduction of this technology, Sunnybrook developed protocols for its optimal use to assess injuries and come up with effective treatment strategies. A recent addition to the team – dedicated emergency and trauma radiologists who conduct CT imaging – is yet another Sunnybrook innovation.

Advancement in blood transfusion science is another area where trauma care has improved in recent decades, thanks in part to contributions by Sunnybrook. For instance, the hospital’s Massive Hemorrhage Protocol is a comprehensive, multidisciplinary protocol that has been used as a model for hospitals worldwide.

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Sunnybrook’s trauma team saves 94 per cent of the most severely injured patients who come through the centre’s doors

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Developed by Dr. Jeannie Callum, Sunnybrook’s director of transfusion medicine and tissue banks, and Dr. Barto Nascimento, a trauma specialist, the protocol stipulates how and when blood products – for instance, red cells, platelets, plasma – should be transfused in cases of massive bleeding. It also speaks to the use of medications to stop bleeding, and advises on various factors that can impact bleeding such as maintaining normal body temperature, using blood warmers for all blood products and frequent tests of clotting factors.

Dr. Callum’s team reviews every resuscitation involving massive transfusion. Their goal is improving the protocol and saving lives, while carefully and efficiently using scarce blood products. Many patients who survive the early hours and days of a trauma can die later because of a blood clot in the legs or lungs. This is because immediately after trauma, the blood clotting system goes into high gear to stop injury-related bleeding. This process can also lead to abnormal blood clots. Sunnybrook’s Dr. Bill Geerts has led research to enhance prevention and treatment of such clots.

Dr. Geerts, director of the hospital’s Thromboembolism Program, leads a team that assesses every trauma patient for this risk, often prescribing low doses of clot-preventing drugs. His team has dramatically reduced deaths and is considered a world leader in this aspect of trauma care.

Sunnybrook’s chief of surgery, Dr. Avery Nathens, says the Tory Regional Trauma Centre’s innovative care wouldn’t be possible without its talented staff. “We’ve brought in the right people, all of whom are here because of their commitment to the injured patient,” he says.

Sharon Ramagnano is one of those people. She was brought on this year as manager of trauma services and will lead quality improvement and strategic project work in order to make processes better and foster more alignment across all clinical areas that are involved with trauma patient care. She is also focused on patient and family education to both prevent trauma and support those going through the continuum of trauma care.

“We are very proud of the work we do saving lives,” says Dr. Nathens. “We also realize the importance of improving the quality of life of our trauma survivors. This focus – bringing together the experience of our surgical teams, rehabilitation medicine specialists and mental health physicians – to get patients back on their feet to the lives they’ve had before injury – will be our next advancement.”

An important innovation on the horizon is the construction of Sunnybrook’s first hybrid operating room (OR). At twice the size of a standard OR, the hybrid OR will bring advanced imaging and surgical equipment into the same room. This will, for instance, enable one surgeon to operate to stop abdominal bleeding, while another surgeon operates on the brain.

“A hybrid OR means we will never have to compromise in our approach,” says Dr. Nathens, adding that the facility, which will be built with the assistance of donors, is evidence of Sunnybrook’s commitment to inventing the future of trauma care.

For trauma patients like Steve, it’s all quite remarkable. “There’s so much work that goes into saving one person,” he says. “I think it’s just amazing.”

The post Cutting-edge innovations fuel Canada’s largest trauma centre appeared first on Your Health Matters.

Lesley has been doing just that for the last three years in the Trauma, Emergency and Critical Care Program at Sunnybrook. She was brought to the hospital by Surgeon-in-Chief Dr. Avery Nathens, who recognized the need for different perspectives to improve outcomes for trauma patients.

“Anthropologists bring a different perspective to health services research,” says Lesley. She recently studied communication in the Critical Care Unit, interviewing and observing team members for months during their daily routines.

“We wanted to know what it was about working in critical care and surgery that makes communication between staff difficult,” she says. The study findings helped to identify the differences in the way the team communicates, enabling recommendations to be made for appropriate improvements.

While studying for her PhD in anthropology at the University of Toronto, Lesley saw herself on a path to becoming a more traditional anthropologist.

“I got a grant to go and do fieldwork in French Polynesia,” she says. But she discovered the field of medical anthropology just as she was about to leave for the South Pacific. “I cancelled the trip, started doing field work for my dissertation at a hospital and I haven’t looked back,” she says, adding that she enjoys the unique challenge working in a hospital environment brings. “Establishing a good rapport with people is key to being a good anthropologist. Nothing about what I do is judging – it’s understanding.”

Beyond the trauma and critical care programs, Lesley has also worked on strengthening interprofessional collaboration throughout the hospital. In one project, she interviewed staff who had been anonymously identified by their team members as being good collaborators.

“Most of the time, these individuals were very surprised that they had been nominated by their peers,” she says. The findings are being developed into a tool kit and an educational resource for team collaboration. “It was a privilege to talk to and learn from such humble, high-achieving people.”

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Alexis Danford was only 25 weeks pregnant when she went into labour. Born at Sunnybrook almost 15 weeks early and weighing less than two pounds, her daughter Reylene faced a range of serious health problems, including life-threatening breathing, heart, brain and eye issues.

Fortunately for the new mom and baby, the Neonatal Intensive Care Unit (NICU) at Sunnybrook’s Women & Babies Program was running an initiative that brings in breastfeeding peer counsellors to help and encourage families like hers. Breast milk is especially critical in the care of premature infants, as it promotes healing, growth and development and decreases the risk of life-threatening infections and conditions. Yet, mothers of preterm and critically ill infants face unique barriers and challenges to breast-feeding.

The NICU Peer Counsellor Program aims to increase the percentage of premature infants who are exclusively breastfed on the day of discharge. The program is part of a study through Sunnybrook’s Breastfeeding Centre of Excellence: it opened last year as the first of its kind in Canada. The program’s goal is to promote the exclusivity and infants, with a particular focus on “micro-premature” (born before 26 weeks) infants. The study found that bringing peer counsellors – moms who are themselves graduates of the NICU – into the unit increases breastfeeding rates in new moms who are having trouble breastfeeding.

“Having a peer counsellor to help support me with my breastfeeding experience was integral to achieving my feeding goals,” says Alexis, 25. “I had to pump every two hours for the first three months of Rey’s life. I was getting my supply up for when we were ready to start trying at the breast. During this time I was often exhausted and sometimes felt overwhelmed, but my counsellor would make a point to recognize my efforts and motivated me to keep going. I’m grateful to have had such strong support.

“I’m grateful to have had such strong support,” says Alexis Danford (above), of having a peer counsellor during her daughter Reylene’s time in the NICU. (Photography by Tim Fraser)

“Three days after my daughter was born, still in shock and terrified, I met Ophelia Kwakye in Sunnybrook’s NICU Family Room. She introduced herself to me immediately and invited me to join her and the rest of the NICU moms for the weekly Mom Lunch,” adds Alexis, a freelance multimedia producer from Barrie, Ont. “From that day forward, she made every effort to encourage, support and help me in any way possible. She was someone who truly understood what we were going through and assured us that there was a beautiful and joyful end in sight.”

Kwakye gave birth to her own son 15 weeks early. He stayed at Sunnybrook for almost four months, battling infections and pneumonia, and requiring three blood transfusions. Kwakye credits NICU Parent Support Specialist Kate Robson with getting her through the trying time.

It was Robson who later approached Kwakye to see if she would be interested in becoming a peer counsellor herself. It’s a part-time job for Kwakye, who now spends her days working with moms in the NICU.

“I go in the unit, room to room, and talk to moms about how to pump every two to three hours and how to maintain your milk supply,” says Kwakye. “I also encourage them about what happens around here and how to take care of themselves. I ask them about what they’re doing and share how they can do better.”

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“We truly are blessed and grateful for all that the entire amazing team in the Sunnybrook NICU did for our family.”

– Alexis Danford

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When it comes to preterm babies, and micropreemies especially, breastfeeding is truly life-saving, says Jo Watson, chair of the Breastfeeding Centre of Excellence and operations director of the Women & Babies Program.

Breast milk promotes healing, growth and development, and decreases the risk of life-threatening necrotizing enterocolitis (a condition that affects the intestines), infections and time spent in hospital. It also improves motor outcomes, cognitive skills and neurobehavioural development.

“When a baby is born premature, the composition of the milk actually changes from the characteristics that a full-term baby would receive,” says Watson. “It’s higher in fat, because what that baby needs is a higher fat content to support the final growth of the brain that would have happened in the uterus. Breastfeeding also reduces the risk of sudden infant death syndrome, and premature babies are at higher risk for it.”

Watson developed the program after seeing similar initiatives elsewhere with successful outcomes. “The opportunity came up to apply for funding through the Government of Ontario and the support of the Best Start Resource Centre at Health Nexus to have an improvement project specifically focused on supporting breastfeeding in populations that had lower breastfeeding rates,” explains Watson. “I knew this model had worked in other centres, so we thought that we would introduce peer counsellors into the NICU and see if we could improve breastfeeding outcomes.”

Mothers of complex or critically ill pre-term infants encounter  a variety of unique breastfeeding barriers and challenges that can make it difficult to initiate and sustain breastfeeding. Many have to pump their milk up to 10 times a day for many weeks before the baby can be at the breast, Watson says. “Not only are you pumping around the clock, but you also have a sick baby in an intensive care unit. A lot of women have to travel a long way to get here and get home. They may have other kids at home. There are all kinds of challenges. It’s hard to maintain that routine for weeks and weeks,” she says.

According to Watson, the national average for babies receiving only breast milk on the day of discharge from an NICU is 40 per cent. “Our rate was already at 70 per cent, so we were doing really well in comparison with the rest of the country, but we thought we could do better, and we knew there were still opportunities,” she says.

Former NICU mom Ophelia Kwakye is now a peer counsellor, advising new moms on breastfeeding their preemies. (Photography by Doug Nicholson)

While rates for breastfeeding exclusivity at Sunnybrook for 2013 indicated that preterm infants are less likely to be exclusively breastfed at discharge than their full-term counterparts (68.3 and 76 per cent, respectively), thanks to the peer counselling program at Sunnybrook, that rate has increased to 75 per cent.

“I fiercely believe that Ophelia was an integral part of not just surviving the NICU, but [also] flourishing in it,” says Alexis. “The empathy, insight and information she was able to provide as a graduate mother herself were intrinsic and incomparable.”

Now almost five months old, Reylene is doing phenomenally well, says her mother – thanks, she adds, to Sunnybrook’s Peer Counsellor Program and the centre’s exemplary practices.

“Considering we had prepared for the worst, to now be home with a beautiful, healthy baby girl is both astonishing and humbling,” says Alexis. “We truly are blessed and grateful for all that the entire amazing team in the Sunnybrook NICU did for our family.”

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It was a stressful situation for a new nurse in Sunnybrook’s Neonatal Intensive Care Unit (NICU): A father, upset over a change in the care plan for his premature baby, was becoming increasingly emotional and the nurse – who had been on the job for about six months – was struggling over how to handle the situation.

Enter registered nurse Jo-Ann Alfred, a nurse educator whose advanced education and clinical training gave her the tools she needed to calm the nurse down and help her deal with a potentially confrontational situation.

“The father was emotional, and at the time the nurse wasn’t sure how to properly explain the change in the plan without getting the father more upset,” says Alfred, an 18-year veteran nurse who has been working in the NICU since 2014. “I told her the biggest thing to do in this situation is to use kindness and understanding, and listen, because [for the most part] they just want to be heard.”

The work of Alfred and other nursing mentors is part of Sunnybrook’s emphasis on continuing education, which is proving to be more important as health-care workers adapt to new challenges of increasingly complex hospital settings, an aging population, complex medical conditions and technological advances such as mobile devices and electronic medical records.

“This is about ensuring that we are providing the best care we can for patients and families in a constantly evolving world,” says Elizabeth McLaney, Sunnybrook’s director of Interprofessional Education. “And at the same time, ensuring we can continue to provide that care for future generations.”

In the nursing education department, improving the patient experience comes in many forms – but it all starts with making sure newly hired nurses are comfortable and confident in their roles. Critical to this is mentoring. Following an orientation period, each new nurse is teamed with an experienced colleague, says Beverly Waite, a nursing education leader at Sunnybrook.

As well as benefiting from mentoring initiatives, many of Sunnybrook’s registered nurses pursue a master’s degree and even a PhD, qualifying them for advanced-practice nursing positions (such as nurse practitioner and clinical nurse specialist) and other clinical roles, as well as research, teaching and leadership positions.

So who are these Sunnybrook nurses embracing the never-stop-learning culture? Below are just a few.

Lauren Cosolo

Part-time registered nurse (RN) in the trauma unit and clinical instructor for University of Toronto (U of T) nursing students.

Lauren Cosolo knows through her own experience the value of having a mentor.

“When starting out as a new nurse, you’re not confident in yourself or your skills, but having somebody there to help you through that is so valuable,” says Cosolo, 27. “In the trauma unit, we get people who’ve been seriously hurt from motor vehicle collisions to gunshots and have traumatic brain injuries – they’re complex traumas that involve lots of different systems.”

For the past couple of years, while working part time in the unit, Cosolo has pursued a master’s degree in nursing. By doing so she hopes to become a nurse educator, to teach other nurses in “evidence-based practice” – that is, caring for patients using the best knowledge possible, based on both scientific findings and what has been shown to work in practice.

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“I really enjoy nursing education and being that support system: helping new nurses and nursing students develop skills and confidence.”

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When patients arrive in the trauma unit, she says, “usually they’re from the Intensive Care Unit (ICU) and they’re acutely ill. A newly hired nurse in the ICU may struggle at first with addressing the concerns and fears of distraught families of these patients. But the mentor helps by giving valuable advice and recommending resources to help the new nurse deal with the needs of the patients’ loved ones.”

Under the early guidance of her mentor Melanie Santos at Sunnybrook, Cosolo learned to hone her nursing skills. “Melanie was very much the one who would give me confidence. She was always there for support when I needed her, but also pushed me to be independent, which is important,” Cosolo says.

After taking a nurse preceptor workshop (which educates nurses on how to guide and work with students), Cosolo mentored her first student last year and takes pride in seeing her now working in the trauma unit.

“I really enjoy nursing education and being that support system: helping new nurses and nursing students develop skills and confidence, handle a full patient load and practise confidently, ethically and safely,” Cosolo adds.

Craig Dale

Advanced-practice nurse (APN) in the ICU and assistant professor at the Lawrence S. Bloomberg Faculty of Nursing at U of T

Craig Dale has seen his career as a nurse go through quite an evolution over his 22-year tenure at Sunnybrook; through it all, he’s constantly reminded of the importance of learning from the patient experience.

Dale, 51, has been an APN in the ICU for the past decade, with specialties in qualitative health research and critical-care nursing. He has been an assistant professor at the University of Toronto since January 2015, two years after earning his PhD in nursing.

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“A lot of people entering the profession don’t realize that you can have a rich career that advances patient care from more than one vantage.”

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“One thing I didn’t realize at the start of my career,” he says, “is, you can become a scientist at the same time as being a nurse clinician. A lot of people entering the profession don’t realize that you can have a rich career that advances patient care from more than one vantage. In my case, I’ve done this through my clinical role, my academic work, my research and as a mentor to other nurses at Sunnybrook.”

Dale’s research focuses on improving hygiene practices for intubated and mechanically ventilated adult patients. For his doctorate, he studied the practical challenges of providing oral care and how to improve it. It’s an essential life-saving skill; for instance, he discovered that pneumonia starts with bacteria in the mouth.

He believes nurses play a crucial role in the health-care system internationally, including in leadership positions, “because they understand what’s happening at the point of care: they know how things work and how they break down. They’ve also been trained to communicate with people in distress which is one of the most important skills clinicians can bring to the patient-family encounter.”

One young trauma patient, who suffered extensive orthopaedic and facial fractures in addition to a life-threatening pneumonia, was particularly memorable for Dale.

“He couldn’t speak while on the ventilator and his eyes wouldn’t open because of his facial swelling,” he says. “Assuming he was able to hear and understand me, I guided him during his care and offered encouraging details about his recovery. Many months later he walked into the ICU to thank me. He didn’t know what I looked like but said he could recognize my voice.

“Despite the high-tech focus of ICU life-support, I have learned how patient survival is undeniably conditioned by empathetic support and communication.”

Desiree and Drew Lewis

Staff RNs, Neonatal Intensive Care Unit (NICU)

Born several weeks early, it seemed fraternal twins Desiree and Drew Lewis’s destiny that they would end up working with other premature babies. They have been doing just that in Sunnybrook’s NICU since September 2015.

The sisters, who turned 26 in May, say their experiences in the NICU after getting nursing degrees have been “amazing,” in large part because they weren’t just thrown into the nursing pool to sink or swim.

Drew, the older twin by five minutes, always wanted to be a nurse. Desiree earned an accounting diploma before realizing she, too, would rather work in health care.

After graduating last year, they joined the NICU staff and entered an orientation program with in-class learning for two weeks, then received one-on-one training by nurse preceptors over a three-month period.

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“I am lucky that I can come to work every day and feel inspired by all those around me.”

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Their own background as premature twins helps fire their enthusiasm for their work in the NICU. “I am inspired by [preterm babies’] strength, resilience and fight, and by how strong and hopeful their families are,” says Desiree, who says these young patients motivate her every day to want to learn as much as possible about her profession.

“I am lucky that I can come to work every day and feel inspired by all those around me,” she says, adding she wants to further her education and inspire future nurses “the way I was inspired by many throughout my journey.”

Desiree says she and her sister continually experience what it means to be part of a teaching hospital. They’re grateful they can collaborate with other nurses, doctors, pharmacists, dietitians, social workers and other professionals who are passionate about their jobs and enthused to teach and “clarify their piece of the patient puzzle,” while trying to return that to their colleagues at Sunnybrook.

Although she’s not certain what her career future holds, Drew says she, too, will one day pursue additional education, and her experience at Sunnybrook will prepare her.

“I will be ready for the journey.”

All photography by Doug Nicholson

The post The importance of a never-stop-learning nursing culture appeared first on Your Health Matters.

After an angiogram found blockages, Angelo underwent triple bypass surgery that same month. “Since I’ve worked at Sunnybrook for so long, I was confident the surgery would go well. The Schulich Heart Program has a good reputation, and I knew I was in very good hands,” he says.

The surgery was a success, and he was able to return to his job at Sunnybrook as a medical laboratory technologist. As a patient, Angelo gained a new perspective on just how important the work is that he does in the lab.

“When physicians want to know what’s causing an infection in a patient, we test the bacteria sample and identify the organisms, which helps them figure out which antibiotic should be used to treat the patient,” says Angelo. “I really enjoy working in the lab because there’s never a dull moment. Bacteria and organisms are constantly changing and evolving, so there’s always something new to learn.”

Angelo discovered his passion for microbiology early in life. “Growing up, I loved playing with the microscope, doing experiments and pretending to be a scientist,” he says. He is now teaching the next generation of medical laboratory technologists, working part time as a lab instructor at the University of Ontario Institute of Technology.

In addition to teaching, Angelo recently went back to school. After studying part time for five years, with a brief interruption for his heart surgery, he graduated this year with a bachelor’s degree in allied health science. “Learning, teaching and making improvements have always been an important part of my life,” he says. “I’m forever grateful to the cardiology team for helping me get back to doing what I love.”

Photography by Doug Nicholson

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As a patient services aide (PSA), Greg’s role is essential. It includes housekeeping duties, putting fresh linens on the beds, delivering food trays and some portering. “We feel very valued as a part of the care team. A big reason I’m here is because I get to work with great people,” he says.

Greg has worked at St. John’s Rehab for 29 years. His mother worked in the admitting department at St. John’s Rehab for 25 years, and Greg says, “When I started here, I began having such a good time I never left!” He has held many positions over the years, starting as a porter. Greg later worked in shipping and receiving, then groundskeeping, but he missed getting to know patients. He feels that being a PSA is the best fit for him.

Greg says the best part of his job is interacting with patients and making them smile. “People really enjoy making a connection with someone, and laughter helps you do that. Putting people at ease with silly jokes and stories helps with healing and getting through the day,” he says. “Patients in rehab are often dealing with the biggest life changes you can imagine. If I can bring a bit of joy to their day, it’s an honour.”

Greg has been happily married for 20 years, with two sons he is extremely proud of. He loves getting away to the family cottage in the summer, which has been a part of their tradition for decades. In his spare time, Greg plays the drums with his blues-rock band, which supports charitable organizations through their gigs. “Music and giving back is very rewarding for me.”

At the end of the day, it’s the little gestures for which Greg is known. “It’s amazing how much of a difference you make just by helping patients open up their [dresser] drawer or by asking how their day is going. People call me ‘The Smiling Man,’ and that is the biggest compliment.”

Photography by Doug Nicholson

The post The patient services aide: Greg Karman appeared first on Your Health Matters.

Ohannes lived in Aleppo, Syria’s economic centre and once its most prosperous city. Aleppo is now one of the most dangerous cities in the world, where thousands of civilians are caught in the crossfire of the Syrian civil war.

Ohannes had just graduated from university when the conflict reached his city in 2012. Only a few years earlier, Syria’s growing economic potential had inspired him to study finance and banking. But Ohannes moved to neighbouring Lebanon once war hit, continuing his education with a master’s degree in business administration.

“We thought the war would be over in a few months – a year, even,” says Ohannes. “But the war raged on, and we had to go,” he says. “We couldn’t stay in Lebanon because it was illegal for us to work there.”

Ohannes and his family applied for refugee status in Canada when the opportunity came to resettle. Their new life began six months later.

“Finding a job was difficult, even though I was educated,” admits Ohannes. He is now gaining Canadian work experience as a finance and donor relations assistant with Sunnybrook Foundation.

“I’m grateful for my managers’ trust and confidence,” he says. “Getting this opportunity at Sunnybrook made me feel like I can do this, that I will be OK.”

He’s proud of the work he does. “We don’t have these kinds of [non-profit] organizations in Syria. Even though I am only an assistant, and doing a very small job compared to what the doctors and others are doing in the hospital,” he says, “I believe I am doing something to benefit the whole of society.

“When I open donations and read messages from donors thanking Sunnybrook for the care they received here, that’s enough for me. Wherever I go I will say with pride, ‘I work at Sunnybrook.’”

Photography by Doug Nicholson

The post The finance assistant: Ohannes Tchamichian appeared first on Your Health Matters.

As many as two million young people are struggling with mental illness in Canada, yet only one in five receives the help they need. “Knowing that there are always more families in need that can benefit from navigation is the most demanding part of my job,” says Katie.

Navigation is the key word here. In a complicated, ever-changing mental health system, families are often not aware of what help is available or they need support finding their way through the maze of programs, services and treatments.

“As a navigator, I provide information and offer a unique bridge that connects families with medical and clinical resources. I am always amazed at what can be accomplished – and how much stronger we are – when we all work together.”

Katie’s academic training has served her well. With a deep-rooted love for the fields of education, mental health and psychology, she studied psychoanalytic thought at the University of Toronto and then completed her graduate degree in education, counselling psychology.

“I feel an immense sense of pride and commitment being part of Sunnybrook, and I think of my work as my passion and not just a job.”

Spending time with her three children is Katie’s other passion. She coaches her children’s soccer and swim teams, hosts a boot camp and recently took up running. Beyond the physical health benefits, she also exercises for mental health and stress relief.

“I have been trying to make a point of carving out time for me, which then fuels my energy for my work and family.”

In September 2016, Katie will take part in the 15-kilometre run in the RBC Race for the Kids, a family event and fundraiser for youth mental health and the Family Navigation Project.

Photography by Doug Nicholson

The post The clinical navigator: Katie Wicik appeared first on Your Health Matters.

The couple pledged to one another that if they became financially able, they would give back to the country that had provided them with a safe refuge. The Nanjis have made good on their promise.

Respected and admired within and beyond their Ismaili community, the Nanji family’s legacy of philanthropy is remarkable. They have donated millions of dollars to causes that are close to their hearts. Sunnybrook is one of the fortunate recipients.

Mr. Nanji is president and CEO of Belle-Pak, one of Canada’s Top 50 Best Managed companies. He has also been recognized as one of Canada’s Top 25 Immigrants, was awarded Male Entrepreneur of the year by the Indo-Canada Chamber of Commerce and won the Positive Aging Award in 2015.

The Nanjis’ generosity is likely to touch the lives of many patients who visit Sunnybrook.

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“My passion is to help youth who struggle with serious mood disorders that make everyday life a challenge”

– Pyarali Nanji

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Their most recent donation means that more patients will be rapidly diagnosed by some of the most advanced magnetic resonance imaging (MRI) machines available. Once installation is complete, Sunnybrook will have four state-of-the-art MRIs, one fully paid for by the Nanji family.

“MRI impacts patients throughout the hospital every day,” says Dr. Masoom Haider, chief of Sunnybrook’s Department of Medical Imaging. “We use MRI to detect life-threatening conditions. We use it to guide precision treatments, like cancer surgery and radiation. And its importance only continues to grow as we conduct research that pioneers new uses for MRI.”

The Nanjis’ involvement with Sunnybrook stretches beyond their gifts. They strive to better understand the hospital’s needs by making regular visits and talking to doctors, researchers and hospital staff.

It’s a dynamic established more than a decade ago, when they first learned of a growing need to support adolescents living with mood disorders. Their donation toward brain sciences acknowledged an area of health care that, at the time, wasn’t getting much philanthropic support. Other donors soon came forward, helping turn Sunnybrook’s youth psychiatry division into the largest in Canada.

“My passion is to help youth who struggle with serious mood disorders that make everyday life a challenge,” Mr. Nanji says.

The Nanji Family Foundation continued to support Sunnybrook, contributing to the expansion and renovation of the emergency department and creation of the Nanji Emergency Response Centre, which serves patients with acute needs and provides dedicated space for emergency psychiatric patients.

The foundation next made a major investment in two critical areas: the Nanji Ambulatory Centre, which occupies 30,000 square feet and is the location of Sunnybrook’s out-patient clinics for dermatology, ophthalmology and vision sciences, plastic surgery and rheumatology, and the four-floor expansion of Sunnybrook’s main wing. This helped to complete the world-class Women & Babies Program facility.

Many life-saving and patient-care improvements at Sunnybrook over the past 12 years can be traced back to the promise Mr. Nanji made to himself as he arrived at his new home in 1972.

“Giving back to a community that has given so much to us is just the right thing to do,” Mr. Nanji says.

Photography courtesy of North York General Foundation

The post Sharing the wealth of their new life appeared first on Your Health Matters.

By viewing the tomosynthesis slices (panels 2 to 4) the radiologist can be assured that there is no cancer present, but only normal tissue structure at that location.

Looking at a regular mammogram, explains Dr. Martin Yaffe, senior scientist at Sunnybrook Research Institute, is a lot like looking through the glass at an aquarium. “You don’t see the little fish behind the others.”

That incomplete view is challenging when the patient is a younger woman who typically has more dense tissue and less fat in her breasts, meaning small cancers may lurk unseen.

Dr. Yaffe and his Sunnybrook colleague Dr. Roberta Jong, a radiologist specializing in breast imaging, are Canadian pioneers in advancing new techniques and technology for mammograms for younger women and those with dense breasts.

They led the Canadian contribution to the landmark study – D-MIST (Digital Mammographic Imaging Screening Trial) – that compared the diagnostic accuracy of film and digital mammography.

They found that, for women 50 years old or younger and for women with dense breasts, the digital mammography was significantly more accurate. Digital mammography has now all but replaced film mammography.

Now Dr. Yaffe and Dr. Jong are again advancing the field, leading the first Canadian clinical trial comparing three-dimensional breast imaging (3-D tomosynthesis, or TMS) with the current standard of digital mammography.

T-MIST (Tomosynthesis Mammographic Imaging Screening Trial), initiated at Sunnybrook, will be the first, large randomized, multicentre study comparing the two techniques.

Dr. Yaffe describes the newer technique as “looking slice by slice.” Instead of taking just two digital views of the breast, TMS takes up to 15 images that are layered into a three-dimensional view. “It’s less likely that structures would be hidden,” explains Dr. Yaffe.

The 3-D view not only finds more abnormalities, but it also reduces the number of false alarms.

Preliminary studies suggest that TMS reduces the chances of false alarms by about 30 per cent.

When TMS finds cancers that may otherwise not have been recognized until later, it can result in less aggressive treatment, meaning breast conservation and increased survival rates, he says.

Or, as is often the case with prostate cancer, testing a tiny malignant tumour found in the breast may indicate that it poses no risk and requires only “watchful waiting.”

The researchers are currently recruiting more than 6,000 women at four sites in Canada for T-MIST, while looking to extend the trial to 148,000 women across 14 more sites in North America.

Images courtesy of Dr. Roberta Jong & Dr. James Mainprize

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