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.

The post Gene-based treatment for Vision Loss appeared first on Your Health Matters.

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

The post New Hope in Brain Tumour Treatment appeared first on Your Health Matters.

With the days getting warmer and the May long weekend quickly approaching, many of us are getting ready to enjoy some fun activities, like a trip to the cottage, hikes, or the first camping trip of the season. While it’s a great time of year to get outside, it’s also when we see many traumatic injuries take place.

Actively preventing injury is always the main objective, but being ready to respond when an incident occurs is the next best option. It helps to be prepared by carrying a first aid kit with a few essential items. We often think about packing disinfectant and ice packs, but did you know large bleeding incidents (which could be caused by a fall or using home improvement tools, for example) benefit from some specific items. A person can bleed to death in as little as 5 minutes, so it’s important to be equipped with the tools necessary to control critical bleeding before help arrives.

What to pack:

• Gloves. A few pairs of gloves provide a great barrier between you and the individual you’re helping.
• Gauze. A great material to use when applying pressure or packing a bleeding wound.
• Extra clothes or t-shirts. If you run out of gauze, an extra t-shirt or two can be used to pack a bleeding wound or apply pressure.
• A high quality tourniquet, such as the Combat Application Tourniquet (CAT). This is perhaps the most important item to include. A tourniquet can be extremely effective at stopping a life-threatening bleed and can be on for many hours until help arrives. Sunnybrook highly recommends receiving formal training in how to apply a tourniquet before adding one to your first aid kit. You can take training by registering for a STOP THE BLEED® course. A CAT Gen7 Tourniquet can be purchased when registering for our course or during class.
• A permanent marker. This can be used to mark the time of tourniquet application, which is handy if you are in a rural area where it might take longer to get help.
• A whistle. Use this to signal for help and assist first responders in locating you.

Remember, if you’re in rural or remote areas where cell coverage or WIFI is unavailable, emergency calls can only be made through a satellite phone. Check to see if your cell phone has the capability to make a satellite call. Always be sure to tell someone where you’re going and your planned schedule.

Sunnybrook wishes you a safe and happy long weekend!

The post Your first aid kit can help STOP THE BLEED® appeared first on Your Health Matters.

When Diana Drake was injured in an ATV accident, she assumed her hopes of becoming a parent were over.

“I was paralyzed and broke my back in two places,” says Diana. “My life was turned upside down.”

Five years after the accident, Diana did become pregnant, and learned about Sunnybrook’s Accessible Care Pregnancy Clinic. The clinic is the first in Canada to care for patients with physical disabilities of all types during their pregnancy, delivery and postpartum phases.

“Patients with disabilities are often highly overlooked in terms of medical care and specifically pregnancy care,” says Dr. Anne Berndl, Director, Sunnybrook’s Accessible Care Pregnancy Clinic. “There is a significant amount of bias towards people with disabilities regarding reproductive care, and stigma when people interact with the health care system.”

The clinic at Sunnybrook was designed to be not only accessible, but welcoming, with the correct equipment and space available to care for patients. Most importantly, the hospital offers a collaborative team of people who are familiar with the concerns a person with a disability may have during pregnancy and birth. This core team pulls in specialists from other areas of Sunnybrook – such as anesthesia, neurology, hematology – to ensure a healthy pregnancy and delivery.

“The vast majority of people with physical disabilities can have a healthy pregnancy,” says Dr. Berndl. “If growing a family, and becoming a parent is your dream, having a physical disability does not mean this is out of reach. You can become pregnant. You can become a parent. For most people, this is a safe choice.”

Dr. Berndl strongly recommends patients have a pre-pregnancy consultation and notes it is not always a smooth road for everyone. There are some increased risks across the spectrum, but she notes going into a pregnancy with your eyes open, and a supportive care team, is key.

The clinic has cared for people with spinal cord injuries, like Diana, as well as little people and those with severe arthritis, spina bifida, a history of traumatic physical injuries, cerebral palsy, multiple sclerosis, a history of amputations, and myasthenia gravis.

“Patients sometimes feel apprehension and trepidation, and wonder ‘is this an okay thing I’ve decided to do…to become a parent and to start a family’,” says Dr. Berndl, who has cared for hundreds of pregnant patients with disabilities. “When you see a new parent, holding a baby in their arms for the first time, it’s a wonderful moment.”

Hear more from Diana about her journey in the video above.

The post Inside Sunnybrook’s Accessible Care Pregnancy Clinic: Diana’s story appeared first on Your Health Matters.

All medications can have potential side effects. For patients taking a certain class of antidepressants known as Monoamine Oxidase Inhibitors (MAOIs), a dangerous spike in blood pressure can happen if they eat foods that are high in a substance called tyramine. Tyramine is an amino acid that is found naturally in many foods are that fermented, says Sunnybrook registered dietitian Karen Fung. Now, a new Sunnybrook recipe book is providing these patients with a safe roadmap through the kitchen.

The MAOI Diet Recipe Book is a collaborative project that Karen worked on with a team of experts at Sunnybrook, led by psychiatrist Dr. Ken Shulman. Importantly, it was also driven by a patient living with depression, Connie Reed.  Here, Connie and Karen share their thoughts on this unique resource and the impact it will have on patients worldwide.

Connie

I’ve been living with depression for the past fifteen years. Taking MAOIs has helped improve my quality of life greatly, making it much more enjoyable. Before I was prescribed these drugs, my doctor explained the importance of following an MAOI diet. There just weren’t many resources available on the subject.

During the pandemic, my friend Carol and I worked together sorting through a variety of recipes and adjusting them to MAOI diet requirements. Carol is very close to me and enjoys making meals for me but they have to be adjusted. For example, when making macaroni and cheese, we used a type of cheese that doesn’t contain tyramine. Carol and her husband taste-tested each recipe we worked on.

Karen

Having Connie and Carol’s input was integral to putting this recipe book together. It’s backed by leading Sunnybrook research and it also comes from an actual patient’s experience. Connie and Carol developed a lot of these recipes and provided many cooking tips. It’s easy for anyone to use and understand.

Dr. Shulman’s research has shown the use of MAOIs has declined significantly over the past 10 years, partly due to other medications being available. But many clinicians also avoid prescribing MAOIs because of this interaction with diet, and they may not be confident in what resources are available for patients to tap into. This is a concern as MAOIs represent the best option for some patients with treatment-resistant depression. As Dr. Shulman has noted, this recipe book is a huge step forward in providing research-based recommendations.

The book is easy to navigate and provides some important background and context. Tyramine is an amino acid that is found in various foods, but in much higher concentrations in foods that are aged or fermented. Some common foods that are high in tyramine include aged cheese, air dried sausages, kimchi, miso, sauerkraut and beer on tap.

On the flip side, the safe foods to eat while taking these MAOIs are all low in tyramine, which include fresh products. So fresh meat, fresh produce and fresh dairy products, like ricotta and feta cheese. Red wine is also safe for patients taking MAOIs.

Connie

As a patient, this recipe book has made me even more aware of the importance of the MAOI diet. It’s so helpful because it provides accessible information for patients as well as friends and families of people on the diet. If they want to cook a meal, they have a huge selection of safe recipes to choose from. In fact, it’s dedicated to the families and friends of those of us on MAOI medications, and their loving efforts to prepare delicious meals that are safe for us to enjoy.

Karen

Because there are so many myths and misconceptions out there, it’s important to rely on the experts to get recommendations, especially when people want to use this on an individual basis. From vegetarian options to hearty mains and salads to desserts, there really is something for everyone to enjoy.

The post MAOI Diet Recipe Book provides patients with a roadmap through the kitchen appeared first on Your Health Matters.

February is Heart Month, and one way to care for your heart is by eating well. Dr. Rahul Jain, Family Physician at Sunnybrook, and Karen Fung, Registered Dietitian at Sunnybrook, share some ways individuals and families can incorporate heart-healthy eating habits into everyday life.

Have fun with cooking

Dr. Jain says one way to encourage Canadians to stick to their healthy eating goals is to remind them that eating nutritious foods doesn’t have to mean bland, boring meals. That’s why the Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE), of which Dr. Jain is the co-chair, collaborated with a professional chef from Switzerland, Jaroslav Guzanic, to create a teaching video on how to prepare a delicious, heart-healthy meal (according to Canadian nutrition guidelines). In the video— which you can watch above— Jaroslav prepares a vegetarian version of the Moroccan dish tagine.

“The teaching video aligns with Canadian nutrition guidelines on best practices to prevent and manage cardiovascular disease,” says Dr. Jain. “But it’s about having fun with the food as well. And to pick up culinary skills. [Cooking] can be a fun activity.”

Dr. Jain and Karen say there are some key things Canadians can do to make meals more heart-healthy:

Look for polyunsaturated fats 

One recommendation for heart-healthy eating is for Canadians to reduce the amount of saturated fats they eat and instead opt for unsaturated fats, which include poly- and mono-unsaturated fats.

“Vegetable oils are excellent: sesame, avocado, sunflower seed oil, canola oil, olive oil,” Karen says. “The exception is coconut, which is high in saturated fats.”

Olive oil is likely the most accessible, but some people might be hesitant to cook with it: Karen says not to worry about that.

“The common misconception is that we can’t cook with olive oil, but we can. We just can’t use it at very high heats like barbecuing,” she says. “If you’re making a stir-fry or frying an egg, you can totally use olive oil.”

In addition, nut, seeds and nut/seed butters as well as avocados are sources of unsaturated fats. For Omega-3 fats, people can eat fish such as salmon, rainbow trout, mackerel. Most white fish does not have significant amounts of Omega-3. Karen recommends fresh, not canned or cured versions.

Up the fibre

“There’s a small percentage of Canadians who meet the fibre requirement on a daily basis,” says Karen. The daily recommendation for fibre intake is at least 25 grams for women and 30 grams for men. Karen says Canadians may benefit from focusing on increasing the amount of soluble fibre in their meals because it’s often overlooked.

Soluble fibre is beneficial for heart health, Karen says, and it can be found in whole grains, oats, barley, lentils, chickpeas and beans. The fibre typically found in fruits and vegetables is known as insoluble fibre.

“We know about fruits and vegetables being a fibre source, but we forget about whole grains and legumes possibly being an even better fibre source,” she says. “Because of the low-carbohydrate fads and trends, people have shied away from whole grains and legumes.”

Both are important, but think about upping the amount of soluble fibre specifically.

Watch the sodium

Hypertension Canada recommends Canadians eat less than 2000 mg of sodium per day, which is equal to one teaspoon of salt. Currently, the average Canadian consumes closer to 2800 mg of sodium per day. Too much sodium increases the risk of high blood pressure, which increases the risk of heart disease and stroke.

Dr. Jain says about one in four Canadian adults have high blood pressure, and about 30 per cent of those cases are related to high sodium in the diet.

“Salt attracts and draws water, and if you have more retention of fluid, you have increased blood volume and that results in increased blood pressure,” says Dr. Jain.

Karen says one of the easiest ways to reduce sodium intake is to cook meals at home and limit the use of processed and canned foods such as frozen dinners or canned soups.

“Replace [salt] with other herbs and spices,” says Dr. Jain, adding the cooking video with Jaroslav is a great example of how to use spices and herbs to create flavour without using as much salt. “For example, adding basil and oregano to soups and pasta, or garam masala and cumin to lentil dishes or stews.”

Progress, not perfection

Making small changes will add up, says Karen, so don’t feel as though you have to make sweeping changes to your eating habits immediately.

“It’s about the big picture,” she says.

These are general guidelines, suitable for most Canadians to prevent heart disease, but Dr. Jain says for individuals who have chronic conditions such as diabetes, high blood pressure or heart failure, it’s important to speak with your family physician or a dietitian because they can provide specific recommendations for your situation and needs.

The post How to cook (and eat) with heart health in mind appeared first on Your Health Matters.

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

The post Sunnybrook advocacy and research leads to improved quality of life for patients with hearing loss appeared first on Your Health Matters.

Nurses at Sunnybrook — and across the globe — have faced immense pressure throughout the COVID-19 pandemic. In this video, Sunnybrook critical care nurse Victoria Boateng takes us inside Sunnybrook’s ICUs, and shows us a first-hand account of what it’s like working on the front-lines during the COVID-19 pandemic.

The post Inside Sunnybrook’s ICUs: A day in the life of critical care nurse Victoria Boateng appeared first on Your Health Matters.

David Onley has lived much of his life in the public eye. As a former broadcaster and serving as Ontario’s 28th Lieutenant Governor from 2007 to 2014. In 2019, however, he made headlines for a very personal reason. After experiencing a two-year steep decline in his health and daily functioning, Onley was diagnosed with a benign brain tumour, which was surgically removed by Sunnybrook neurosurgeon Dr. Leo da Costa in the Hurvitz Brain Sciences Program.

As part of his follow up, Onley is now participating in an ongoing trial called the MOMENTUM (The Multiple Outcome Evaluation of Radiotherapy Using the MR-Linac) study, for which radiation oncologist Dr. Arjun Sahgal is the site lead at the Odette Cancer Centre at Sunnybrook. Here, David and his surgeons look back at what led him to his initial diagnosis, and why he’s chosen to share his current experiences as a patient with others.

When did you first start noticing symptoms that something was possibly wrong?

David Onley: I started teaching after leaving the Office of Lieutenant Governor in 2015 and I was determined to keep meticulous notes. So I taught that first year, and then repeated the cycle in 2016 and 2017, but noticed it was becoming more and more difficult to teach the courses and I was getting very frustrated. It made no sense, as is should have been getting easier.

Then came the physical decline. I started to fall more and my family noticed the changes. My wife told me my voice was getting weaker, and I took great umbrage at that because I’m the broadcaster of the family! It was really bothering me. Then it got to the point where I literally had trouble sitting up and walking. Where it really hit the wall was when I nearly drowned in my bathtub because I couldn’t get out and I wasn’t mentally processing the fact that my life was in danger. We all knew something was wrong, but didn’t know what it was.

What did you do at that point?

David Onley: My family doctor referred me to Sunnybrook, where I underwent a series of tests to try and find an answer for my rapid decline. Those included ALS tests, CAT scans and an overnight sleep lab study. During this time, I experienced a series of falls. After having an MRI, I emerged thinking I’d be told to make an appointment to see my neurologist Dr. Sandra Black. Instead, the technician told me with real urgency that I needed to get to emergency immediately, where we met Dr. Black. It’s important to remember that everyone’s situation is unique, but in my case, she said she feared that if I sneezed the bottom of my brain would drop out.

A benign brain tumour called a meningioma was found on my right frontal lobe. It was the size of an orange and it needed to be surgically removed right away by Dr. Leo da Costa because my condition was so dire. Instead of being panicked or devastated or crushed, I was actually relieved because I thought, oh, they’ve diagnosed it. It was a relief after going through the better part of two years of decline and frustration and not being able to figure out what was happening to me.

It was at that point, down in emergency, that I was heavily sedated and I have no memory at all until the next morning being rolled into surgery.

Dr. da Costa: When he came to see me, he already had and MRI scans showing the tumour. It was sizeable, but luckily amenable to being removed surgically.

David Onley: As part of my follow up after my surgery, I would come in to Sunnybrook every few months to be monitored. When a small change was eventually detected, I had a discussion with my medical team about best next steps.

It was decided that I would start a regime of ongoing radiation to get rid of the area that had been left behind after the actual surgery. These are minute amounts of the tumour and not malignant, but the only way to guarantee they’re not going to become malignant is to eliminate them through radiation. I decided to move forward with treatment on the MR-Linac as part of the MOMENTUM (Multiple Outcome Evaulation of Radiotherapy Using the MR-Linac) study.

Dr. Arjun Sahgal: The MR-Linac Elekta Unity is the first machine in the world to combine radiation and MRI imaging, meaning every day you come in for treatment, the team uses that day’s image of your brain to plan exactly where to focus the radiation. Because the MR-Linac is a new device, every patient treated on it is enrolled in this global trial. Sunnybrook was the first site in Canada to have the MR-Linac and we are the only study participant in the country right now. We share our data, so we’re learning about this technology as a global community. 

As a patient, what does treatment on the MR-Linac feel like for you?

David Onley: I’m just laying down and laying still. They create a plastic mask that covers my face and secures my head to the table. The only discomfort I’ve experienced is that it totally secures my head to the table and after a half hour or so, it would be nice to move. But really, it’s not bad, and I’m given ear plugs to protect against the noise inside the MRI. It’s quite amazing when the radiation gamma beam is released because a number of patients, including myself, get gentle flashes in their eyes, almost like a flash of lightening. It’s not painful, but it’s a reminder of the technology that’s at work.

Dr. Arjun Sahgal: Thirty to forty percent of the time, we’re either making a change in the medicine or the actual radiation treatment plan because we can see the tumour each day.

David Onley: I took time to learn more about the MR-Linac technology before my treatments. I can say I would far rather go for something that was being seen effectively live, or almost live. That’s really quite amazing. Totally amazing.

Dr. da Costa: Many treatments being offered to Sunnybrook patients now are much more personalized and image-guided platforms. We’re getting busier and busier. For patients, it’s important that they are aware that things can happen, and sometimes we can change outcomes thanks to these advances.

Why are you sharing your story now?

David Onley: Maybe it’s the old newsman in me looking to tell the story, but this is an incredible piece of machinery. And if it raises awareness about potential treatment for somebody else, then fantastic.

This interview has been edited for length and clarity.

Learn more about..

• The MR-Linac
• Sunnybrook’s Centre For Neurovascular Intervention
• The Hurvitz Brain Sciences Program
• The Odette Cancer Centre

The post Undergoing treatment with the MR-Linac: Former Lieutenant Governor David Onley’s story appeared first on Your Health Matters.

After a patient receives a COVID-19 test, the swab is sent to a laboratory to be processed and analyzed. At the Shared Hospital Lab at Sunnybrook, 5,000 COVID-19 tests are processed each day. Take a behind-the-scenes look at how it works.

The post How a COVID-19 test is processed appeared first on Your Health Matters.