Retinitis Pigmentosa is a genetic form of vision loss. While rare, its impact on day-to-day living can be devastating, especially as symptoms usually start in early childhood. Now, an important advance in gene-based treatment is offering new hope to many patients.

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View more information about this trial, including frequently asked questions »

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The Cochlear Implant Program at Sunnybrook Health Sciences Centre is the largest adult program in Canada. Test your knowledge about these devices, which an increasing number of Canadians are receiving.

Time's up

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Learn more about Sunnybrook’s Centre for Independent Living

Read more about Elijah’s story

More resources:

• Amputee Coalition of Toronto (ACT)
• War Amps
• Ontario Association for Amputee Care (OAAC)

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As growing numbers of people in our community become infected and recover from COVID-19, how do they rebuild their health?

At Sunnybrook’s St. John’s Rehab, an expert team of specialists works together to develop unique care plans for their patients. In this video, they share the approaches that can help patients both in the hospital and at home rebuild strength after prolonged bed rest.

– Video by Monica Matys

View more tips for continued recovery from COVID-19 »

Rehabilitation is essential to recovery – during and after COVID-19

– Story by Katherine Nazimek

Large numbers of people are predicted to become critically ill with acute respiratory distress syndrome (ARDS) as a result of COVID-19, and will require rehabilitation to recover, according to a paper published in the American Journal of Physical Medicine & Rehabilitation.

“Given the high proportion of hospitalized patients requiring ICU level care, it is likely that in the weeks and months following the surge in patients being admitted to acute hospitals and critical care units, there will be considerable number of critical illness survivors requiring rehabilitation,” says lead author Dr. Robert Simpson, physiatrist at Sunnybrook Health Sciences Centre.

Critical illness for any reason has major long-term side effects, prompting the characterization of “post-ICU syndrome” where patients experience physical, cognitive and mental health impairments following a stay in the intensive care unit (ICU).

“We commonly see a range of bio-psycho-social impairments following critical illness,” explains Dr. Simpson. “These can include muscle weakness following prolonged immobility, impairments of attention, memory and higher order cognitive processes, besides anxiety, depression and post-traumatic stress disorder. Left untreated, these issues can persist well beyond discharge from the hospital and can be profoundly disabling.”

The paper suggests rehabilitation should begin in the ICU and can involve assessing and treating pain, minimizing time on a ventilator with frequent sedation breaks, pre-emptively screening for delirium, promoting early mobilization, and involving the patient and family in care as much as possible.

Because the disabling effects from critical illness are typically both complex and long-lasting, follow-up with inpatient and outpatient multidisciplinary rehabilitation is likely needed. Rehabilitation services have been actively planning to receive large numbers of such patients and are exploring innovative care models to meet demand, including providing virtual rehabilitation.

“Rehabilitation is a key component of the continuum of care for people surviving critical illness,” says Dr. Simpson. “We will have a pivotal role to play in helping patients and their families recover, make sense of their experiences and help them re-integrate back into the community.”

Read the paper in the American Journal of Physical Medicine & Rehabilitation »

The post Recovering from COVID-19: ways to rebuild strength, and why rehab is essential appeared first on Your Health Matters.

It’s one of the most common questions dermatologists hear: what is the best moisturizer? Two of Sunnybrook’s leading dermatologists, Dr. Neil Shear and Dr. Kucy Pon, weigh in with their advice and expertise on this, and other common queries.

Why is moisturizing important?

NS: The skin has its own natural humectants that keep moisture in, but there are many reasons why that skin barrier can break down. Some of the most common include disease, older age and weather. You need to take steps to keep moisture inside the skin.

What happens if you don’t moisturize properly?

NS: You can get rashes, and itchy scaly skin. And if the skin becomes irritated and inflamed, there is a higher risk of infection and scarring.

What is the best moisturizer?

KP: There’s no such thing as the “best” moisturizer for everyone, and picking the right one depends on your skin type, preference for consistency and what you are comfortable spending. So for more oily skin, an oil-free moisturizer, something noncomedogenic and maybe more lotion-based may be preferred. If you have very dry skin or are prone to eczema, a thicker cream or ointment may be better.

NS: The best moisturizer is really the one you will use every day, and that may be very different for everyone depending on their preference, skin type and budget. There’s no scoring system for moisturizers, so it’s the one you are most comfortable with.

Is it better to moisturize as soon as you get out of the shower?

KP: A good way to make sure your skin is moisturized is to put it on right after your daily shower so that it becomes a regular habit. If you suffer from really dry skin, maybe moisturize one or two more times during the day.

NS: You can really moisturize anytime, as long as you do it regularly. In the long run, your skin will look younger and feel better. Just remember that anytime is better than next time!

If you spend more money, will you get better results?

KP: You can get good results at all price points, so it just depends on what your are comfortable spending. Price does not always dictate quality or results.

Are there any skincare ingredients consumers should avoid?

KP: Generally, we recommend using fragrance-free products because in many cases, fragrances can aggravate skin conditions and can be a potential cause of allergies.

NS: I actually love to read labels, so in a moisturizer, I tend to steer away from known allergens. That’s hard, though, because there are a lot of them out there and for most people, they aren’t a problem. If you are experiencing problems, like rashes or itching, you may be allergic to some of your skincare components. That’s something a dermatologist can test for.

Do you need to wear sunscreen all year long?

NS: Yes, and I would recommend choosing one that contains a Sun Protection Factor (SPF) of 30 or higher.

KP: People should apply an SPF every day. Even in the cold and winter, there can be sunny days and UV rays are present. Also, the snow and ice can bounce the UV rays back, exposing us to reflective UV rays.

What should you apply first: moisturizer or sunscreen?

KP: Moisturizer first, and then sunscreen.  There are also a lot of great two-in-one products that can make the process more convenient. Just keep in mind when applying a sunscreen that you need to use adequate amounts to protect yourself.  We recommend about two tablespoons to cover the whole body, and don’t forget to reapply after a few hours.

Will drinking water hydrate the skin?

NS: Proper hydration is important for overall health, but it’s not going to do enough to moisturize the skin. You need to apply something directly to the skin to do the trick.

Many products claim to reverse aging. Any truth to that?

NS: There’s no reversing aging, but if you keep your skin moisturized well, it will generally look younger and healthier.

KP: Some creams and cosmeceuticals do provide benefits to the skin, like giving it a glow and helping it feel supple. By far the best anti-aging strategy is practicing proper sun protection.

Do you need a separate moisturizer for around your eyes?

NS: The eye cream story is complicated because people have different issues, like puffiness or dark circles. There are also many skin correctors that, if applied too closely to the eye area, may cause burning or irritation to the eyes. I would recommend finding something simple, not too heavy, that addresses your specific needs.

KP: Often a facial moisturizer is good for the whole face, but some people like to have a specific eye cream. It all comes down to personal preference.

Should your skin care routine change as you age?

KP: It might, as the issues you deal with shift at various ages. Even if your products change, though, be consistent with sunscreen at all ages.

What do serums do?

KP: Serums aren’t moisturizers. They are ways to deliver active ingredients to the skin. If you’re going to use one, follow this order: wash your face, then apply your serum, moisturizer, sunscreen and makeup.

Should you change your moisturizer seasonally?

NS: It’s not necessary, but I’d recommend it if you feel your skin needs are different throughout the year.

Are hydrating facial masks effective?

KP: A lot of women like using them because they are relaxing, so there’s value in that. Some facial masks deliver active ingredients to the skin, so as long as they don’t irritate your skin, go ahead and enjoy them.

Any final words of advice?

NS: With online shopping, it’s easy to access products through mail orders from all over the world. Keep in mind, though, that some of these products may contain ingredients that have not undergone proper testing and haven’t been approved for use in Canada, so it’s buyer beware.

KP: In the winter, when many people develop dry, itchy skin, I recommend using a humidifier in your bedroom, opting for gentle cleaners and avoiding itchy fabrics coming in direct contact with your skin.

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Surgeons facing the delicate work of recreating a breast post-mastectomy now have a first-in-Canada training tool: a custom-developed microsurgery training chest simulator that “breathes.” 

Simulators recreate all or portions of the human body to allow surgeons-in-training to hone their microsurgery skills. The more realistic the simulator, the better prepared the surgeon will be. 

This simulator trains surgeons for a procedure called the DIEP flap, a method of transferring a woman’s own abdominal tissue to reconstruct her breast. This challenging microscope-guided surgery requires connecting an artery and vein – each about the width of a piece of spaghetti – deep within a tiny chest incision. To complicate matters, the location over the lungs and heart is literally a moving target as the patient breathes during the procedure.

“We can challenge and prepare our students by varying the breathing rate, which they find very helpful,” says Agnes Ryzynski, Sunnybrook’s Canadian Simulation Centre manager, who co-developed the  simulator with Sunnybrook plastic surgeons Dr. Laura Snell and Dr. Joan Lipa. 

“This is by far the most technically difficult, yet safest and best, method of breast reconstruction for patients in the long term,” says Dr. Snell. “By training a new generation of surgeons, the hope is to make it an option for more women.” 

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For amputees, sockets are a critical part of any prosthesis.

Our St. John’s Rehab team is studying the use of 3D printers to help build these sockets. Compared to traditional manual casting, it could be a faster and easier method for some patients. Watch the video above to learn more.

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