Healthy.Together.Markham.Stouffville - Fall/Winter 2018

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MSHF.ON.CA

FALL/WINTER 2018

MARKHAM.STOUFFVILLE.

TM

Comfort & Joy A GRATEFUL FAMILY’S MSH CHRISTMAS TO REMEMBER See P. 32

MEN ON

THE MEND UROLOGY TALKED INTO THE SPOTLIGHT

See P. 27

SLEEP CLINIC AWAKENS HOPE See P. 25

CLIMB EVERY

MOUNTAIN

CELEBRATING HOPE

OUR BREAST HEALTH CENTRE TURNS 10 See P. 20

MSH’S TREK EVEREST BEGINS ITS ASCENT See P. 7

ANSWERS TO YOUR HEALTH QUESTIONS • A WORD WITH THE PHARMACIST • MEET OUR LATEST MSHEROES




MSH

FALL/WINTER 2018

20 The Breast Health Centre celebrates 10th anniversary.

CONTENTS NEWS & COMMUNITY

FEATURES

HEALTH & MORE

4 MSH NEWS What’s new at the hospital and in the community.

18 FINDING ORDER Shining a spotlight on bipolar disorder.

30 HEALTH TIPS A word to the wise from the pharmacist.

6 SIGNATURE EVENTS Trek Everest, 32nd Annual MSH Foundation Golf Tournament and the seventh annual CIBC Night at the Races.

20 CLOSER TO HOME Breast Health Centre celebrates 10th anniversary.

31 ASK THE SPECIALIST A few things you should know about nosebleeds and urinary tract infections.

8 FUNDRAISING EVENTS Your community, your hospital, your support. 10 CALENDAR Upcoming events and fundraisers to add to your busy schedule.

25 REST EASY, BREATHE WELL MSH sleep clinic addresses respiratory health issues. 27 LASER SHARP Examining the benefits of non-invasive surgeries.

32 A CHRISTMAS TO REMEMBER One family’s unforgettable MSH experience. MSHF.ON.CA

FALL/WINTER 2018

MARKHAM.STOUFFVILLE.

TM

Comfort & Joy A GRATEFUL FAMILY’S MSH CHRISTMAS TO REMEMBER See P. 32

MEN ON THE MEND

UROLOGY TALKED INTO THE SPOTLIGHT See P. 27

12 MSHEROES Recognizing the heroic accomplishments of our staff and friends.

SLEEP CLINIC AWAKENS HOPE See P. 25

CLIMB EVERY

MOUNTAIN

CELEBRATING HOPE

OUR BREAST HEALTH CENTRE TURNS 10 See P. 20

MSH’S TREK EVEREST BEGINS ITS ASCENT See P. 7

ANSWERS TO YOUR HEALTH QUESTIONS • A WORD WITH THE PHARMACIST • MEET OUR LATEST MSHEROES

MSH Healthy Together Magazine Fall_Winter 2018 Cover.indd 1

2017-11-03 1:29 PM

Cover: Dr. Mitesh Mehta, Trek team member. Photo by: One Tree Studio Inc.

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Markham Stouffville Hospital Foundation


CEO LETTER

MSH

MARKHAM.STOUFFVILLE.TM EDITORIAL DIRECTOR Sarah Moore EDITOR Sean Deasy ART DIRECTOR Angela Iori SENIOR GRAPHIC DESIGNER Ryan Izokaitis CONTRIBUTORS Vawn Himmelsbach, Dawn Ritchie, Rachel Naud, Maggie Welt SPECIAL FEATURES DIRECTOR Jeffrey Hoffman PROJECT MANAGERS Anne Cuiry Suntharalingam, Melanie Anderson PHOTOGRAPHER Brian Hamilton MARKHAM STOUFFVILLE HOSPITAL, EDITORIAL ADVISORS Lisa Joyce, Suzette Strong VICE PRESIDENT SALES, STAR METRO MEDIA Carolyn Sadler PUBLISHER Star Metro Media PRINT & INSERTING SALES MANAGER, STAR METRO MEDIA Robert Wildbore ADVERTISING SALES Melanie Anderson, meanderson@msh.on.ca Star Metro Media, adinfo@thestar.com Healthy.Together.Markham.Stouffville.™ is published twice a year by Star Metro Media Content Solutions, in partnership with the Markham Stouffville Hospital Foundation. Copyright 2017. All rights reserved. No part of this publication may be reproduced without the consent of the publisher. The material in this publication is intended for general information purposes only. While every effort is made to ensure the accuracy of the material, it does not constitute advice or carry the specific endorsement of either Star Metro Media or Markham Stouffville Hospital. Readers are encouraged to consult their doctor to discuss their health concerns.

H

ealthy. Together. Stronger. Together. Better. Together. The common theme is together. We can accomplish more working together than we can on our own. This is especially true in healthcare. While some visits to the hospital can be very straightforward, others can be much more complicated. Many times, to best care for our patients we need to work with our community partners. Whether it’s other hospitals or local providers, the primary goal is always getting you healthy and keeping you healthy. Partnership is also critical when it comes to working together with our community. There are many ways that we currently engage our community — through our advisory councils, through our community education sessions and through the many special events dedicated to raising awareness and money for the hospital’s clinical priorities and needs. Because the government doesn’t fund everything; MSH must rely on our community for ongoing partnership and support. Healthcare seems to change at the speed of light. New technologies are constantly advancing the way we care for our patients. Change is the new constant. Our team works hard to stay on the cutting edge of technology and strives to be innovative to ensure we continue to lead the way. This enables us to provide excellent patient care from the moment you enter the lobby at MSH. With so much change, it’s hard to imagine what hospitals will look like five, 10 or even 20 years from now. And although we know technology will change the way healthcare looks in the future, we are confident that it will always be dependent on our greatest resource — our people. It has been said that healthcare is a ‘high touch’ industry and that human interaction is really what makes an experience great. We’re proud that our entire team, including staff, physicians and volunteers, remain consistently focused on providing excellent care with a personal touch — that is what differentiates MSH from other hospitals. It’s also reassuring to know that even as our hospital grows and changes one thing that will remain constant is the generosity of our community, keeping us on the leading edge of technology, enabling us to be innovative and collaborate with new partners. We are truly fortunate to have you as partners in your care. At the end of the day, healthcare is a business focused on people: Our people, caring for our community, enabled by our donors. It’s a great full circle that we are so proud to be a part of. Thanks for taking the time to read this magazine and showing your interest in our hospital. We look forward to sharing some great stories with you. Best,

Suzette Strong CEO, Markham Stouffville Hospital Foundation

Jo-anne Marr President & CEO, Markham Stouffville Hospital Healthy.Together. Fall/Winter 2018

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MSH NEWS

MSH NEWS

WE’RE SOCIAL! We love hearing from our community. Tell us about your experience and why you love MSH. @MSHospital

MSH recognized by Osteoporosis Canada Like every department at Markham Stouffville Hospital (MSH), the fracture and osteoporosis clinics do tireless work to help bring world-class care to their patients. The clinics are comprised of professionals who do their work for precisely that reason, and not for the recognition. Still, the hospital was recently presented with a national award for its ongoing efforts in this particular field. In September 2017, Osteoporosis Canada visited MSH to present the hospital with a national recognition award for its work around the Fracture Screening and Prevention Program. This honour is bestowed on Canadian hospitals that have implemented and demonstrated a commitment to the principles of identification, investigation and initiation of treatment, which will ensure fracture patients receive the care they need to help prevent future fractures.

(L-R) Patti Hubert, Nurse, Osteoporosis Canada, Jennifer Weldon, Program Manager, Osteoporosis Canada, Liz Lalingo, Clinical Manager, Clint Atendido, Senior Clinical Operations Director.

And that’s a considerable number of people. Each year the MSH’s fracture clinic sees more than 18,000 patients, many of whom are referred to the fracture clinic from the Emergency Department. The clinic provides post-operative follow-up for orthopaedic patients and

is supported by an orthopaedic technologist, nurses, occupational therapists and physiotherapists. Meanwhile the osteoporosis clinic is where patients can visit with a rheumatologist or endocrinologist for diagnosis and treatment. Congratulations team!

Give a bear on Giving Tuesday Giving Tuesday is here once again. It’s the day set aside for charities, companies and individuals around the world to join together to share commitments and rally for good causes. This year, the Canadian-based movement for giving and volunteering reaches its crescendo on Tuesday, Nov. 28. This year, the overarching theme of the event will incorporate the

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Markham Stouffville Hospital Foundation

hospital’s Buy a Bear Campaign, which has brought warm and fuzzy comfort to so many young patients. Giving Tuesday is your chance to make a real difference at MSH. This year, you can double your impact! Local company Ravenshoe Group has graciously agreed to match every bear given to a patient with a second bear (up to 100 bears). Visit lifesavinggifts.ca to give a bear and show you care.


NEWS

MSH

Summer smarts Bright young minds keep shining — even when school’s out. With that in mind, MSH partnered with Seneca HELIX, the City of Markham, York Region, VentureLAB and IBM to offer the HELIX Summer Institute — a two-week innovation program for young entrepreneurs, which took place this past summer. Participants worked with staff, physicians, patients and families to develop new and innovative ways to improve the cognition and well-being

HELIX students pitch their ideas.

of patients in the Transitional Care Unit. And the results were certainly impressive. A pitch day was held at the hospital back in late August when teams presented their ideas and received feedback from a panel of experts. MSH will continue to work with Seneca and the teams toward

An alliance for tomorrow

(L-R) Shana Betz, mother of patient, Tom Barlow, MSH Board Chair, Dr. Andrew Arcand, Chief of Emergency, Jo-anne Marr, CEO, Mike Apkon, CEO SickKids, Dr. Deepa Grewal, Chief of Paediatrics, Barb Steed, Executive VP, Patient Services & Chief Practice Officer.

It takes a village to raise a child. And it can also take one to ensure she grows up healthy. In that spirit comes a new alliance dedicated to working together to improve the health of children and youth in the community. The Kids Health Alliance (KHA) network — created by The Hospital for Sick Children (SickKids), Holland Bloorview Kids Rehabilitation Hospital and the Children’s Hospital of Eastern Ontario — Ottawa Children’s Treatment Centre (CHEO – OCTC) — endeavours to do just that. MSH will benefit from being the first community hospital affiliated with KHA.

Together with its partners, MSH will have a more coordinated, consistent, high-quality system of care for children, youth and their families. The partnership will initially focus on enhancing paediatric care in the Emergency Department. Then, through continued sharing of specialized paediatric expertise and implementation of best practices, the collaboration will extend to enhancing care in the neonatal intensive care and paediatric inpatient units. To learn more about KHA, visit kidshealthalliance.ca

piloting some of their ideas with hospital staff and patients. HELIX organizers were proud to host William Charnetski, Ontario’s Chief Health Innovation Strategist, as the keynote speaker. To discover the various ideas generated at HELIX, visit msh.on.ca/smartcare_innovation

SHINE

a light on care In the ongoing effort to put patients at the centre of their own care, Markham Stouffville Hospital launched a new partnership in 2016 to create a seamless, shared patient Health Information System (HIS) among three hospitals: Markham Stouffville Hospital, Southlake Regional Health Centre and Stevenson Memorial Hospital. This partnership positions all three organizations to more readily adopt technologies that improve patient care and safety, as well as enhance patients’ experiences while in hospital. It marks the first integration of its kind under the province’s eHealth 2.0 guidelines, released in the summer of 2016. This partnership is called the Shared Health Information Network Exchange (SHINE). With this partnership a patient’s health record, information about past treatments and tests and allergies, will be available through the HIS at any of the three hospitals, improving safety, reducing repeated tests, and streamlining a patient’s visit at any of the partner hospitals. This new shared system will be live in spring 2018.

Healthy.Together. Fall/Winter 2018

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MSH SIGNATURE EVENTS

33rd Annual

Golf Tournament On August 14, more than 160 golfers hit the greens at the prestigious York Downs Golf & Country Club all in support of Markham Stouffville Hospital. The four-person scramble offered prizes for top scores and shots closest to the pin. Golfers enjoyed a perfect summer day filled with lunch on the patio, live entertainment and cocktails. The evening featured a gourmet buffet dinner, cocktails and live and silent auctions. MSH Emergency Physician, Dr. Justin Morgenstern, gave a compelling speech on the importance of rapid infusers — a piece of equipment that is critical when lives are at stake from significant blood loss. “When a patient needs a blood transfusion quickly, this machine is key to saving their life,” he says. His speech sparked an extremely successful equipment appeal that raised $58,000 — enough to buy two rapid infusers for the hospital. Overall, the event raised $225,000. More than 70 businesses, individuals and groups in the community generously sponsored the event. Honeywell returned for the 12th year as Presenting Sponsor and York Downs Golf & Country Club graciously returned to host for the 19th year. Book ahead to sponsor next year’s tournament on Monday, August 13. View photos from the event at golf.mshf.on.ca.

From left: Brad Morris, board chair, MSH Foundation & Golf Committee, Suzette Strong, CEO, MSH Foundation, Barb Steed, executive vice president, patient services & chief practice officer and the 2017 Golf Committee — Kathy Crupi, David Hill, Patrick O’Hanlon and Bill Bachra. (Missing: Mary Eveyln, Michael Froggatt and Shaun Sauve).

7th Annual

CIBC Night at the Races

From left: Eddie Mariani, Chair, MSH Leaders, Colleen Szeto, General Manager, CIBC, Lee Harrison, Portfolio Manager, Investment Advisor CIBC Wood Gundy and Suzette Strong, CEO, MSH Foundation.

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And down the stretch they come! On September 20, more than 300 MSH supporters cheered track-side at a thrilling fundraiser held at Woodbine Racetrack. Each year this event is hosted by the MSH Leaders — a volunteer fundraising committee of young professionals that give back to their community hospital. The event emceed by 98.1 CHFI’s Michelle Butterly featured a fantastic dinner, horse races, auction, draws and a candy bar. Several star jockeys came to meet guests, including Sovereign Award Winning Jockey, Corey Fraser, who gave a speech to the crowd. Thanks to the generous support of Lead Sponsor CIBC and all of the sponsors who made the evening possible. Visit mshleaders.ca for more photos and to learn how you can get involved! Be sure to save From left: MSH Leaders Monika, Vaughan, Jack, Adam, Eddie, Aaron, the date for the next event on Lee, Astrid, Karen and Salmaan. (Missing: Aly, Aurelia, Carl, Jeane, Mary, September 19, 2018. Meg and Rachna).

Markham Stouffville Hospital Foundation


SIGNATURE EVENTS

MSH

Trek Everest

The adventure of a lifetime

PHOTO: CANADIAN ADVENTURE PRODUCTIONS, RICHARD VANDENTILLAART

A group of dedicated doctors, Markham Stouffville Hospital staff and community members is about to take support for their hospital to new heights. About 17,600 feet above sea level, to be precise. This April, with an eye to raising funds for vital new equipment for the operating rooms at Markham Stouffville Hospital (MSH), the group of supporters, which will include a number of physicians and senior leaders from the hospital, will trek 154 km through the Himalayan Mountains from Kathmandu, Nepal, up to the basecamp of Mount Everest. Among the trekkers will be Dr. Mitesh Mehta, who’s keen to join the hike to the highest mountain in the world for a host of reasons — personal and professional. “Markham Stouffville Hospital is important to me. I work here. It’s close to my heart. And I see our need for equipment,” says Dr. Mehta. “Having recently turned 50 and having had multiple injuries over the years, I wanted to do something for me now that I’m healthy. And even though this is definitely on my bucket list, the trek allows me in multiple ways to give back — not just for me but also the hospital and the patients we care for.” Expedition leader and documentarian Ben Webster of Canadian Adventure Productions will lead the team and, along with his film crew, will chronicle Trek Everest as they gather documentary footage to mark the 65th anniversary of Sir Edmund Hillary summiting Everest for the first time. The group will also have the honour of being led by the great climber’s son Peter Hillary, who

now runs the locally based charitable Hillary Foundations. Funds raised by this event will make a significant impact at MSH – notably to open and outfit a new operating room (OR) equipped for fluoroscopy, an important surgical tool for the OR that uses x-rays to obtain real-time moving images and is essential for angiograms, angioplasties, urological and cardiac interventions and many other procedures. The addition of this particular tool will mean increased capacity for surgical procedures and decreased wait times. Although the 15-day trek to basecamp along the “standard route” does not require any technical climbing, it will challenge any moderately fit person, so training for the team has already begun. “I think I’m a little bit scared. I’m sure a lot of people are, but it’ll be exciting to do, and I’m looking forward to it,” says Dr. Mehta. Other itinerary highlights for the team will include an invitation to a sacred temple, receiving a blessing by the Dalai Lama and visiting schools and medical clinics to do work in the communities along the route. “I’ve always wanted to use my training to make a difference in another part of the world,” says Dr. Mehta. “This trek allows me to go to Nepal and work at a hospital beforehand, and, again, give back in a small way.”

Expedition Team

Wish to make a real difference? Each trekker is committed to raising a minimum of $10,000. Please visit mshtrekeverest.ca to make a pledge, donate or join the team! n

Ben Webster - Expedition Leader

Clint Atendido Allan J. Bell Karen Chadwick Victoria Cole Tiffany Haidon Carol Heck Dr. Roberta Hood Ronald Hulse Dr. Martin Jugenburg Dr. Dagmar Justa Trisha Lawless Brandon Lougheed Dr. Eileen Lougheed C.H. Craig McOuat Dr. Mitesh Mehta Brad Morris Dr. Iain Murray Stephen Ng Caroline Pope Susan Sheffield Barb Steed Paul Tennyson Rabiah Usman Nicholas Vardon Maryse Wood Peter Hillary - Expedition Host

Melanie Southworth - Expedition Guide

Healthy.Together. Fall/Winter 2018

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MSH EVENTS

Highlights

Our spring and summer community events

Sikh Community Gala

Committee presents $225,000 to Suzette Strong, CEO, MSH Foundation. Photo: VFX Artist Photographer

It takes our entire community to support Markham Stouffville Hospital. We gratefully acknowledge the generous fundraising efforts of our many supporters. Every dollar raised offers life-changing and life-saving potential for a family member, friend or neighbour. Thank you! View more photos at mshf.on.ca Alex Chiu Annual Golf Tournament

Alex Chiu Golf Committee presents $25,000 to Allan, MSH Foundation.

2017 Ride for Mental Health

Neil and the Heavy Rollers cycling team raised more than $27,000 and counting!

Young Artists Fundraiser

Allan, MSH Foundation with artists Madison and Lucas who raised $400 for our community’s health.

6th Annual Councillor Alan Ho Charity Golf Tournament

MSH Board Member Kenny Wan and Allan, MSH Foundation present Councillor Ho with a gift of appreciation for raising $20,000 for MSH.

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Markham Stouffville Hospital Foundation

3rd Annual ScotiaMcLeod Night at the Races

John, Riley, Jan, Colin, Chelsea and Jackson at Woodbine Racetrack raising $15,000 for MSH!


EVENTS

MSH

19th Annual Markham-Unionville Ladies Golf Tournament

Karen, Allan, MSH Foundation, Linda, Bonnie, Sylvia and Mary.

Tim Hortons Smile Cookie Campaign

Local Tim Hortons owner Gillian with Allan, MSH Foundation and Tom of Tim Hortons.

8th Annual Portraits of Giving

Markham recipient Shakir of Flato Developments Inc. with the Cousens family and Karen of Merk Photography.

Howcroft Annual Charity Golf Tournament Dave, Elvis and Sharon.

Mike’s Love Lemonade

Michael raises $7,000 from his annual lemonade and bake sale.

Angus Glen Summer Five Miler

Mom and daughter teams ready to race!

Team Mehdi Au Hadi, Scott and Asim. Healthy.Together. Fall/Winter 2018

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2018

CALENDAR THESE FUNDRAISING EVENTS, ORGANIZED AND SUPPORTED BY OUR FRIENDS IN THE COMMUNITY, DEMONSTRATE A STRONG BELIEF IN THE HOSPITAL’S SERVICES AND PROGRAMS. VISIT MSHF.ON.CA FOR FULL DETAILS.

PHOTO: CANADIAN ADVENTURE PRODUCTIONS, RICHARD VANDENTILLAART

SAT. FEB. 24

Annual Amici Breast Cancer Fundraising Gala, Terrace Banquet Centre, 5:30 p.m. Benefiting cancer care, guests enjoy an antipasto bar, dinner, open bar, silent auction, gift bags and live entertainment. To attend, sponsor, or donate, call 905.307.4141 or visit amicispa.ca

APRIL 21 TO MAY 8

Trek Everest – Adventure of a Lifetime A dedicated group of MSH supporters will embark on Trek Everest “The adventure of a lifetime” — basecamp, Nepal. This exciting expedition will celebrate the 65th anniversary of Sir Edmund Hillary’s iconic first ascent of Mount Everest while funding a new operating room suite at Markham Stouffville Hospital. To learn more about the team or to donate visit mshtrekeverest.ca

HOST A FUNDRAISING EVENT!

Whether it’s a family skate, holiday dance or winter carnival — no event is too big or too small. EVERY DOLLAR COUNTS! Visit mshf.on.ca or contact Joyce at joso@msh.on.ca or 905.472.7373 ext. 6229.

SUN. APRIL 29

SHOPPERS. LOVE. YOU. Run for Women Unionville Benefiting women’s mental health at Markham Stouffville Hospital, register for this 5K or 10K walk/run or the Little Steps 1K for kids under 12 to help end the stigma. Register now at runforwomen.ca

THURS. MAY 31

Planting Seeds & Growing Friends Stouffville Gala, Spring Lakes Golf Club Organized in partnership with Stouffville community leaders and supporters – this gala is sure not to be missed! Sponsorship opportunities available, contact Allan at 905.472.7395 or abell@msh.on.ca

SAT. APRIL 28

MSH Foundation’s South Asian Ball, Festival of Colours Hilton Markham Suites Don’t miss a celebration of fabulous South Asian culture. This glamourous evening offers scintillating entertainment and opulent charm. Sponsorship opportunities available for this biennial event, contact Allan at 905.472.7395 or abell@msh.on.ca

SUN. APRIL 8

Angus Glen Spring Ten Miler Angus Glen Golf Club A unique opportunity to run on the golf cart paths of the renowned Angus Glen Golf Club. This race sells out! Register at angusglenrunningseries.com

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Markham Stouffville Hospital Foundation

SUN. JUNE 3

5th Annual Unionville Festival Funky 5K Main Street Unionville, 8:15 a.m. This race is bringing back tie-dye and all things groovy! Don’t miss this timed 5 km run/walk or family 2 km walk around Toogood Pond Park. Register at funky5k.ca

MON. AUG. 13

34th Annual MSH Golf Tournament York Downs Golf & Country Club Enjoy a day of golf, auctions and great food at the prestigious York Downs Golf & Country Club. Sponsorship opportunities available, contact Allan at 905.472.7395 or abell@msh.on.ca or visit golf.mshf.on.ca



MSH HEROES

Recognizing the heroic day-to-day accomplishments of our people

KELLIE STAJER

MANAGER, NEONATAL INTENSIVE CARE UNIT (NICU)

AKA:“the

advocate”

Kellie Stajer has spent her whole career caring for the “smallest patients.” Her childhood dream was to be a paediatric nurse, and to “make a difference in the lives of families,” and she’s done it. After years at the Hospital for Sick Children (SickKids), Kellie came to MSH in 2009, and loves being part of the close team at MSH. Kellie’s proud of the reputation their department is building. “Families are seeing that they can get exceptional care right in their own community.” She is also truly proud of MSH’s recent involvement in the Kids Health Alliance — a new collaboration with SickKids that will make MSH, “a leader in community paediatric care.” Kellie’s as passionate about sharing her knowledge as she is about continually learning. Last year she returned to school and earned a master’s in health studies. There’s one thing she has learned for certain. “They need specialized treatment, children aren’t just small adults.” She takes her role as advocate very seriously, and appreciates that she is not just caring for the patient, but their whole family at what is often a very stressful time. Her approach for that? “Sometimes you have to be flexible to meet the individual needs of each family.” Kellie says what she’s most proud of is the amazing team of professionals that work together to ensure families are listened to, cared for and connected at all times. This can mean making special arrangements for siblings to visit or a Skype/Facetime call to family at home so they can see their baby and connect with the team. For Kellie it’s all about taking care of one family at a time. n

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Markham Stouffville Hospital Foundation


HEROES

MSH

DR. DAVID AUSTIN CHIEF OF STAFF

AKA:“the

big heart”

Dr. David Austin has an ear for his work. He realized he wanted to become a physician because he was, “fascinated by the prospect of listening to heart sounds.” Turns out that Dr. Austin, one of the first physicians at Markham Stouff ville Hospital when it opened in 1990, has a pretty big heart himself. Dr. Austin spent his early career at Toronto General Hospital, but then became interested in community medicine, which led him to MSH. He describes the group of young doctors who started together at the then

new hospital as, “having grown up together,” and quickly adds that most of them are still there. That distinct lack of staff turnover is one of his favourite things about working at MSH. He finds the work environment “very collegial.” The team, “all work together on patient care and there is a lot of consultation.” Chief of Staff since 2006, Dr. Austin also sits on the hospital and foundation boards. On the MSH Foundation Board, he offers a physician’s perspective on fundraising initiatives, while on the hospital board he’s involved

in long-term strategic planning for the hospital. The highlight of his long career at MSH is the completion of the expansion and renovation project in 2014. The expansion project involved, “advocacy by the hospital board to get approval, and a huge amount of work and fundraising.” Dr. Austin says community members worked hard to get a hospital, and the rightful sense of ownership is palpable. And that, he says, keeps him motivated to continue working hard for them. n Healthy.Together. Fall/Winter 2018

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MSH HEROES

ANDREA FORREST PALLIATIVE CARE NURSE

AKA:“the

Nightingale”

Maybe singing isn’t what you’d expect to hear echoing through a palliative care unit, but nurse Andrea Forrest starts each day with, “Oh, What A Beautiful Morning,” as she walks down the hall at MSH. She is known as the singing nurse, and many patients have asked for a bedside recital from her over the years. And she is always happy to oblige. Andrea became a nurse in 2009, having always dreamed of the job. She comes from a family of caregivers — her mother is a nurse, and two aunts are midwives in Jamaica. She grew up listening to their stories, and seeing her mother care for complete strangers in their home. She knew her life’s work was, “a quest to alleviate suffering.” Her quest has been recognized along the way. Andrea was nominated for, fittingly, the Toronto Star Nightingale Award in 2015, and this year won MSH’s Robert J. Gall Award of Excellence in Nursing. She is flattered by the recognition, but unfailingly modest. “I am just going about my job and always reflecting on my practice as a nurse.” Garnering awards, she says, won’t change who she is. “Palliative care

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Markham Stouffville Hospital Foundation

can be a sad unit, but I am there to serve, and deliver solace.” Andrea characterizes her unit as “a cohesive team, with lots of communication. The team is always cheering each other on, and helping each other with patients.” It’s her unwavering belief that she should stop and show kindness

wherever possible — whether that’s “just holding a hand, making eye contact, or showing empathy.” In return, she is seldom forgotten. In fact, family members of her former patients are invariably checking in with her, either bringing flowers or sometimes just coming to say ‘hi.’ n


HEROES

MSH

BRAD MORRIS

CHAIR, MSH FOUNDATION BOARD

AKA:“the

go-getter”

Brad Morris says he would climb a mountain in support of Markham Stouff ville Hospital. And this April he’ll prove it. He and number of other supporters from the hospital will head to Kathmandu, Nepal, and then to base camp at Mount Everest on a trek to raise funds for MSH. Brad, who has been on the MSH Foundation Board for six years, was appointed its chair in June, and is a passionate supporter of the hospital. He is a long-time community member and the list of reasons he got involved at MSH is long, bookended by the birth of his daughters, and the “compassionate end-of-life care” his mother-in-law and grandfather received. Those experiences are so valued by Brad that he, “couldn’t help but want to help.” And help he has. He has chaired the annual Signature Golf Tournament Committee for the last six years, and proudly shares that last August they netted $230,000 for the hospital. He is also eager to mention that the tournament’s renewal rate is 80-90 per cent each year, which is rare — another special sign of support from the community. He attributes this specific interest in fundraising to his mom, who was a nurse. From her, Brad learned, “what is and isn’t funded by the government, and that the healthcare system will always need more support.” Now, he is passing those same lessons on. In recent years his young daughters have donated their birthday money to MSH, making their dad very proud. It is “worth all the time,” he says, “because more will always be needed.” Brad says he is even more driven to stay involved now than when he got started because of, “the quality of individuals and care at MSH.” n Healthy.Together. Fall/Winter 2017-18

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MARKHAM STOUFFVILLE HOSPITAL FOUNDATION

33rd Annual

G LF Tournament

Thank You to our Supporters 12 YEARS PRESENTING SPONSOR & OFFICIAL GOLFER GIFT DONOR

19 YEARS VENUE SPONSOR

Gold Sponsors

Dinner Sponsors

Silver Sponsors LUNCH SPONSOR

PROGRAM SPONSOR

CART SPONSOR

RECEPTION SPONSOR

Refreshment Cart Sponsor

Frank & Freda Spain The O’Hanlon Group – Private Wealth Management RBC Dominion Securities

Closest-to-the-Pin Sponsor

Crossover Sponsor

Birdie Sponsors

Driving Range Sponsor

Rupinder (Ruby) Sangha

Financial Corp.

Event Sponsors JD Development Group Norman Hill Realty Inc.

$10,000 Hole-in-One Sponsor Bachra Insurance Agency Ltd. / The Co-operators

Beverage Sponsors Coca-Cola Labatt Breweries of Canada Lifford Wine & Spirits Molson Coors Pepsico Profile Wine Group Steam Whistle

Golf Ball Sponsor The Octagon Steakhouse

Car Hole-in-One Sponsors Town+Country BMW MINI Markham

Media Partners Markham Economist & Sun and Stouffville Sun-Tribune Tournament Supporters James Chim John Preston SDA Building Services Inc. Tibanda Investments Inc./ARG Group Vanguard Global Services

Excel Realty Ltd.

Corporate Sponsors Access Rehab Inc. Agfa HealthCare Inc. All-Risks Insurance Brokers Limited Buckley Insurance Brokers Ltd. Cushman & Wakefield Ltd. Grote Industries Co. Ledgemark Homes Lexmark Canada Inc. Markham District Energy Inc.

Bachra Insurance Agency Ltd.

Mattamy Homes OHE Consultants PolicyMedical Inc. RBC Royal Bank Stephen Tar, Century 21 Leading Edge TD Commercial Banking Teknicor Healthcare & DELL EMC The Milestone Group Wilson Vukelich LLP

...and a special thank you to all who contributed to our prizes, gifts, live and silent auctions.

For photos visit golf.mshf.on.ca



MSH MENTAL HEALTH

Shining a spotlight on bipolar disorder

FINDING ORDER BY VAWN HIMMELSBACH

E

sther Herbert doesn’t remember walking into her boss’s office, sitting at her desk and answering her phone, pretending to be her. It’s all a bit of a blur. But she remembers being handcuffed by police and escorted to a waiting ambulance, where she was taken to Markham Stouffville Hospital (MSH). It was a life-altering event: It was then that she was diagnosed with bipolar disorder. For many years, she had been misdiagnosed with depression and given medication that exacerbated her bipolar disorder. She was also an alcoholic and, at times, a workaholic. “I had been diagnosed as depressed, given some anti-depressants, and that just made it worse,” says Esther. “It was an awful, awful, spiraling thing, great highs and lows.” Leading up to that fateful day, she had been working later and later, and became obsessed with cleaning (and hiding it from her colleagues). It all came to a head when she locked herself in her boss’s office. “I was consumed by answering the phone, pretending I was her,” says Esther. “I had this illusion of grandeur that I was her — I lost complete touch with reality.” While this was going on, everyone else in the building gathered in the warehouse while waiting for police to arrive on scene. “I thought I was on a Lear jet off to meet the Queen,” says Esther, as she was transported by ambulance to MSH. “Then I met Dr. Mark Berber and he diagnosed me with bipolar disorder.” After finding the right medication, her life completely changed — and it’s why she now wants to speak publicly about bipolar

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Markham Stouffville Hospital Foundation

Dr. Mark Berber, Psychiatrist, MSH, with patient Esther Herbert.

disorder, a mental illness that is often undiagnosed and untreated. “I’ve had this illness since I was about 15 or 16 years old, but it was not diagnosed until 2000,” says Esther, who is now 54 years old. “Now that I’m diagnosed and committed to the program, I’m so excited to tell people you can live with this and you can manage this and you can be productive.” Six weeks after she was diagnosed and began treatment, she walked back into the building where she had been handcuffed and led away by police.

“I went back to work,” she says. “I can’t let something like that lick me.” On her first day back, her boss — the one she had pretended to be — met her in the parking lot and walked into the office with her, in a show of support. She calls this experience a mixed blessing, underlining the importance of medication in her treatment, which enables her to continue working. “If I didn’t have that drama, I probably wouldn’t have that benchmark [of how bad things can get], so I don’t ever get off that medication,”


MENTAL HEALTH

she says. “That’s why I do it.” Esther has been seeing Dr. Berber, a psychiatrist with Markham Stouffville Hospital every six months for the past 17 years. She says he often refers to her as a “poster child” for bipolar wellness: She’s been sober for 25 years; she’s faithful to her medication and she takes part in MSH’s support services, such as art therapy. Bipolar disorder involves oscillating between two poles: depression and misery on one end, and happiness and utter elation on the other. The aim of treatment is to avoid those two extremes and keep the patient stable, which requires finding the right medication. “Most people who suffer from bipolar disorder live their lives depressed,” says Dr. Berber. “Unfortunately, the anti-depressants classically used for depression are not effective for bipolar depression.” Diagnosis is also difficult because it’s a disease that typically occurs in the late teens or early 20s. “Many times it’s misdiagnosed as ADHD or anxiety disorder, and often it’s complicated big time by substance abuse,” he says. “Experimenting with marijuana or alcohol also makes the diagnosis challenging.” An accurate diagnosis, however, is the most important step for successful treatment. Bipolar disorder occurs in about 1.5 per cent of the population, says Dr. Berber, and of all psychiatric disorders, it’s the one that is most likely to end in suicide. “But, if patients stay on their treatment plan,” he says, “they can live a rewarding, fulfilling life.” As a leading mental health treatment centre in York Region, MSH specializes in community integrated mental health. “As part of the psychiatric care team, I’ve seen [the centre] grow and flourish in a positive way,” says Dr. Berber. “When we started, we had three psychiatrists — I was one of them. Now we have 11 psychiatrists, and we’re seeking to increase the staff.” The centre has grown from a 23bed unit in the original building to a 33-bed unit in the new wing of the hospital. But some things haven’t changed. “The attitude we started with in the department of psychiatry hasn’t changed — it’s very patient-focused,”

says Dr. Berber. “Although we’ve grown, the initial values we pride ourselves on remain the same.” Despite success stories such as Esther, “bipolar disorder is still underdiagnosed and inadequately treated,” says Dr. Berber. “There’s great room for improvement when it comes to a more timely diagnosis and

Canadian Media Icon Lloyd Robertson speaks to crowd of 200 at the MSH education event ‘Bipolar Disorder: from Diagnosis to Wellness.’

DID YOU KNOW? MSH provides a full range of mental health services, including emergency and crisis support, adult inpatient services and a full-service adult outpatient clinic including the BRIDGE Day Treatment Program, which helps patients transition from inpatient to outpatient follow-up. It also offers individual, group and family therapy. Next April, MSH will participate in the SHOPPERS.LOVE.YOU Run for Women Unionville as part of a national fundraising event held in 15 cities across Canada in support of women’s mental health programs.

MSH

more adequate treatment.” And he says stigma is still an issue. MSH is providing a counternarrative to stigma through educational events and communitybased initiatives and care, such as ‘Bipolar Disorder: From Diagnosis to Wellness,’ held on October 27. This event, in fact, was Esther’s idea — one supported by Dr. Berber — aimed at educating patients and their families, as well as anyone affected by bipolar disorder. Topics ranged from early recognition of symptoms to substance abuse, treatment options and healthy living. Former news anchor Lloyd Robertson was the keynote speaker. He also signed copies of his memoir ‘The Kind of Life It’s Been’ about growing up with a mother who suffered from bipolar disorder, paranoia and obsessivecompulsive disorder. When it comes to psychiatry, MSH is unique in that it offers continuity of care, says Dr. Berber. “Patients come to see us as an outpatient; if they need inpatient care, they stay under the care of the same psychiatrist,” he says. “This is not often found at other hospitals.” MSH is also developing a dynamic outpatient mental health care team and introducing group programs — such as emotional regulation, interpersonal therapy and cognitive behavioural therapy — to serve more patients and help prevent relapses and recurrences. Funding from the community allows MSH to deliver evidence-based therapy and innovative services and care. It also funds therapeutic supplies and support services ranging from art and music therapy as well as yoga — all of which support a holistic approach to care. Esther wasn’t so sure about art therapy at first. Then she found herself creating projects that gave her more than she’d expected. “I’m painting this thing, it’s not overly attractive but I made it,” she says. “And I just love it.” n Healthy.Together. Fall/Winter 2018

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MSH BREAST HEALTH

(L-R) The Breast Health Centre Team - Wendy Punchard, patient care manager, Diana Salmingo, nurse navigator, Kim Olidis, unit secretary, Pamela Anderson, nurse navigator and Dr. Crystal Pallister, general surgeon.

CLOSER

to HOME Breast Health Centre celebrates 10 years BY DAWN RITCHIE

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Markham Stouffville Hospital Foundation

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n 2005, the notion of a permanent Breast Health Centre (BHC) at Markham Stouffville Hospital (MSH) was a mere twinkle in Dr. Crystal Pallister’s eye. As a surgeon at MSH, her vision was a comprehensive patient-centred care, diagnostic and rapid assessment clinic. A one-stop breast clinic that would move patients from screening and diagnosis through to surgery, chemotherapy, radiation treatment, reconstructive surgery and aftercare. It would be the first of its kind in the region and a gravely needed service for the community. Markham Stouffville Hospital was willing, but the stumbling block was funding. So the hospital looked to the Markham Stouffville Hospital Foundation to help raise the funds needed to make this vision a reality. While MSH waited for Ministry of Health and Long-Term Care approval, in 2005, the Foundation’s fundraising permitted the purchase of a $750,000 digital mammography machine. By 2007, the Foundation provided $3.6 million to open a clinic in a dedicated space. Dr. Pallister’s initiative became a reality with four general surgeons covering the newly minted Breast Health Centre four days a week. “It was a paradigm shift for the hospital,” explains Dr. Pallister. “The concept that care would revolve around the patient’s need, not around department schedules. We had to get


BREAST HEALTH

MSH

The multidisciplinary team from MSH who helped launch the Breast Health Centre, 2007.

three to four departments together to juggle schedules and relinquish personal control for the greater good.” As part of the rapid assessment mandate, patients referred by their family physicians would be seen within a week. “In a morning visit, you will see the nurse navigator, surgeon, get diagnostic imaging — a mammogram and/or ultrasound — and, depending on your case, a biopsy,” says Dr. Pallister. “Within one week, you will get your results.” The whole process, from referral to discharge is coordinated by one of the clinic’s nurse navigators and the medical secretary, Kim Olidis. Unlike the larger hospitals, at MSH, the surgeon you meet in the clinic is the doctor who takes care of you for your entire patient journey — from the beginning with diagnosis through to surgery and even to the five-year milestone after surgery. Dr. Pallister often hears from her grateful patients that ‘they feel like real people and not just another number.’ The ongoing fundraising commitment from the Foundation through events like the Celebration of Hope enabled the clinic to expand patient volumes. In 2013, they moved into a larger space increasing clinic hours from four to five days a week. June 19, 2017 marked the clinic’s 10th anniversary and the growth in healthcare services is momentous. More than $2 million has been raised through the Celebration of Hope over the last 10 years. Four medical oncologists, six surgeons, and three plastic surgeons specializing in reconstruction now work in the clinic. In January 2017, a brand new partnership brought a radiation

Elizabeth LeBel, mammographer, assists patient with breast screening.

Lindsay Chevalier, RN, chemo clinic and nurse navigator gives a comforting hug.

oncologist on site weekly for initial consults, reducing the number of trips patients must make out of the community, bringing their care closer to home. The Pain and Symptom Management Clinic recently expanded from two mornings a week to three, with four palliative care physicians now seeing an average of 33 patients a month. Fifteen to 30 patients move through the BHC each day. And in the last two years the technology to do MRIguided biopsies and onsite radiation consultation was added. “We have also begun offering clinical trials,” says Shellyna Moledina, patient care director of pharmacy and oncology services. “It’s a major step.” In 2016/17 the BHC performed over 13,100 mammograms, 5,800 breast ultrasounds, and 280 breast cancer surgeries with wait time for surgeries significantly reduced. “Our motto is: Take the worry out of the wait,” says Dr. Pallister. “In the

patient’s second visit, the surgeon explains pathology and will go through recommended treatments. Typically, they’ll have surgery within two weeks. Most patients go right to surgery but some may benefit from neoadjuvant treatment [preoperative chemotherapy] up front to shrink the tumor prior to surgery.” Aftercare has also become a priority. “A lot of people transition patients back to the family doctor after treatment,” says Dr. Pallister. “Here, patients are followed for five years post-op. Patients don’t feel abandoned. If there’s anything new. We’re right there for you.” Patient Lee Lawson credits the clinic with saving her life. “They fasttracked me through there,” she says. “I found a lump on my right breast at the end of November 2014 when I was working out. I had an ultrasound and mammogram in early December and a biopsy mid-December. I found out in early January it was breast cancer. I had my mastectomy two weeks later.” Lee underwent four rounds of chemotherapy, followed by radiation. “They have an awesome team,” she says. “I attended the chemotherapy education sessions and the Look Good Feel Better program offered at the hospital. You lose your hair and eyebrows during chemo. They show you how to apply makeup, where to get wigs, and make you feel good about yourself.” Continued on Pg 22

Healthy.Together. Fall/Winter 2018

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MSH BREAST HEALTH Continued from Pg 21

Lee and her husband were so amazed by the care received at MSH that they organized a Texas Hold’em Poker Night as a fundraiser. “We raised $5,000 for the Breast Health Centre,” she says. “I made some good friendships and bonds there. You’re not just another number.” “One of the big things we want to work on for the future is to increase the survivorship program,” says Dr. Pallister. “Taking a multidisciplinary approach of social work, psychology, medical oncology, pain management and a lymphedema clinic. World-class care closer to home is the goal.” The oncology team also has it sights set on offering a peer-to-peer support program where recently diagnosed patients would have the opportunity to meet cancer survivors. Learn more about the MSH oncology department at msh.on.ca/oncology. n Lee Lawson, breast cancer patient.

Breast Health Centre Event

In celebration of the BHC’s 10th anniversary, two events were hosted on Oct. 26 by the Foundation where other breast cancer survivors shared their stories. Mark your calendar, the next CIBC Celebration of Hope will take place on Nov. 11, 2018.

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(L-R) Markham Mayor Frank Scarpitti, Dr. Crystal Pallister, Suzette Strong, CEO, MSH Foundation, Jo-anne Marr, CEO, MSH, Allan Bell, MSH Foundation, Jane Philpott MP for Markham-Stouffville and Minister of Indigenous Services.

Host Beverly Thomson, anchor, CTV News with Dr. Crystal Pallister and the dedicated Breast Health Centre volunteers past and present.

(L-R) Kim Olidis, unit secretary, Sue Kempton, grateful patient, Pamela Anderson, nurse navigator, and Dr. Angelo Vivona, general surgeon, MSH.

(L-R) Host Beverly Thomson, anchor, CTV News, Dr. Hedy Boutros, breast cancer survivor, Brad Morris, MSH Foundation board chair.

Markham Stouffville Hospital Foundation


Financial Tips

Charitably Speaking Tax Smart Giving

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s the end of the year approaches, many will be contemplating year-end donations, re-assessing their estate plans and looking for ways to reduce their tax burden. The federal government provides incentives in Canada’s Income Tax Act that facilitate philanthropic giving. While tax benefits are not

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the primary reason that individuals donate, the financial benefits can play a major role in the timing, size, structure and assets that are used to fund charitable donations. There are numerous strategies that have favorable tax treatment. Here are just two easy and tax-smart ways to make a difference with your tax dollars.

Donation of Appreciated Securities Most people simply give cash to a charity without thinking twice about it and receive a tax credit. In many cases this is the best approach. However, a more tax advantageous strategy would be to gift some securities that have significantly appreciated in value over time. In donating the shares, you pay no tax on the capital gains and you receive a receipt for the full fair market value of the securities.

EXAMPLE: Assume you have $100,000 in securities with an Adjusted Cost Base (ACB) of $70,000: If you sold your investment: Sale proceeds: $100,000 Capital gain: $30,000 ($100,000 minus $70,000) Taxable gain: $15,000 ($30,000 times 50%) Tax on gain: $6,511 ($15,000 times 43.41%) Net after tax proceeds: $93,489

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If you donated your investment: Capital gain: $30,000 Taxable gain: $0 Tax on gain: $0 Donation receipt: $100,000 Credit at 41% combined rate: $41,000 Net cost of donating stock: $52,489 ($93,489 minus $41,000) Based on the above, the cost of the gift is only 52% of the stock’s value!

Name your favourite charity the beneficiary of your RRSP You may choose to start taking distributions from your RRSP immediately upon retirement or you can defer payments as long as possible if you do not need the money immediately. However, an RRSP must mature by the end of the year when you turn 71 years of age. By that time you must elect either a retirement annuity or an RRIF. The one thing many people overlook is that when you die, assuming you have no spouse to transfer the assets to, your estate will be liable for a huge tax bill. This is because your RRSP will be taxed as income in the year of death.

Almost half of the RRSP assets will need to be paid back to Revenue Canada. This can be resolved in a matter of sixty seconds by obtaining a change of beneficiary form from the plan administrator and naming your favourite charity as beneficiary of all or a percentage of the RRSP/ RRIF account. The end benefit to you is that you retained full access to the retirement funds during life, at the end of life the tax credit offsets the tax on distribution, the entire amount passes to the charity tax free and the gift is very simple to arrange.

For decades, Canadians have benefited from substantial tax savings through well thought out estate planning and philanthropic giving. Working with a trusted financial advisor will ensure you can develop

your philanthropic and legacy plans in a way that ensures financial security and peace of mind while reducing or eliminating the tax liability and leaving a lasting impact not only now but well into the future.

Contributor: Rick Page is a Senior Financial Advisor with Page and Associates Family Wealth Management www.askpage.com. Healthy.Together. Fall/Winter 2018

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SLEEP CLINIC

MSH

REST WELL,

breathe easy

Sleep clinic uncovers respiratory health issues BY VAWN HIMMELSBACH

C

arole Nelles didn’t notice anything was amiss. But when her daughter came to visit, she told her, “Mom, you’re snoring, and it’s the middle of the day!” What neither realized at the time was that — in addition to unusual behaviour such as afternoon naps and snoring — Carole would also stop breathing while asleep. Carole never used to snore, but something had changed. “Even my husband mentioned it,” she says, “and he has a hearing issue.” When she told her doctor, she was referred to the Sleep Disorder Clinic at Markham Stouffville Hospital’s Centre for Respiratory Health. Before proceeding

with a scheduled knee surgery, her doctor needed to know if she had any sleep-related issues that could affect the surgery. At MSH, Carole underwent a sleep study — also known as an overnight polysomnogram — which monitors brain waves, eye movements and muscle movements, as well as breathing and oxygen levels, to determine sleep stages, heart rhythm, leg kicking and breathing problems. A week later, the results were in, and they were scary: Carole had stopped breathing 88 times during the night. She was diagnosed with sleep apnea, a sleep disorder that involves pauses in breathing lasting from

a few seconds to a few minutes. She was sent to the clinic’s respiratory care services to get a CPAP (continuous positive airway pressure) device that would help her breathe throughout the night – and address her snoring. “When I went back for a followup about six weeks later, the results were unbelievable,” says Carole. The number of times she had stopped breathing during her sleep study went from 88 down to 2.1. Since then Carole’s numbers have been as low as 0.2. Those are typical results for her now: Each morning, her CPAP device will tell her on her smartphone how many hours she slept and Continued on Pg 26 Healthy.Together. Fall/Winter 2018

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MSH SLEEP CLINIC Continued from Pg 25

how many times she stopped breathing. “I feel so much better, I have no periods of sleepiness during the day, I go right to sleep at night,” she says. “I also sleep right through the night.” Thanks to getting a good night’s rest — and enough oxygen — her blood pressure has dropped, she’s able to focus at work and she’s even eating healthier. “I was so tired and hungry all the time so I’d grab the fastest, easiest thing,” she says. “Now I have the energy to prepare better meals and make healthier decisions.” Increased energy has also been a boon to her career as a musician and singer with the Amadeus Choir — a career that requires diaphragm breath control. Wearing a CPAP device each night, however, is a big change. “I know some people might have issues with first putting it on,” says Carole. “But the alternatives aren’t pretty, so the best thing is to stick with it, and after a couple of nights to two weeks you get so used to it and enjoy having such a solid night’s sleep.” She was surprised her CPAP device doesn’t make a sound and is small enough to be taken on an airplane. As in Carole’s case, many patients are alerted to the fact they have a sleep disorder by a partner who says they’re snoring loudly or making choking sounds during the night. The Sleep Disorder Clinic offers diagnostic and treatment services for adult patients with symptoms that could include nighttime snoring and gasps, limb movements during sleep, inability to fall asleep or stay asleep, daytime excessive sleepiness and morning headaches. “We have six respirologists, four of which are sleep trained, and the ones that are sleep trained will do sleep consults, interpret sleep studies and recommend therapy,” says clinic manager Liz Lalingo. With sleep apnea, therapy varies depending on its severity; for mild to moderate sleep apnea, it could involve losing weight or requiring an oral appliance or positional sleep aid. As for patients with severe sleep apnea? “The real gold standard is CPAP therapy,” says Liz. “These days they’re very small and they’re very quiet; often we set them up in the

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Markham Stouffville Hospital Foundation

clinic based on your sleep study results and prescription provided by the sleep specialist, your doctor.” There are a variety of CPAP devices to suit different sleep styles, from a small nasal pillow to a mask that fits over the nose to a mask that fits over the face. Comfort means compliance, so, while some conditions do apply, patients can test out a device and, if it doesn’t work for them, they can bring it back and try another one. “When [patients] use it consistently, they talk about a complete change in their life,” says Liz. “If you’re always

Now I have the energy to prepare better meals and make healthier decisions.

sleep deprived, there are other systematic effects. Low oxygen levels in your blood start to put a strain on your heart, your blood pressure goes up. Our body naturally shuts down our peripheries when we don’t have enough oxygen … a lot of people who have strokes or arrhythmias may have underlying sleep apnea.” Sleep apnea is often associated with other health issues, such as heart disease, diabetes or stroke. That’s why the sleep clinic works hand-inhand with primary-care doctors and hospital departments. Cardiologists and neurologists often need to rule out sleep apnea; nocturnal high blood pressure, for example, can be exacerbated by sleep apnea. The sleep clinic also sees patients with narcolepsy, restless leg syndrome,

nocturnal seizures and other sleeprelated disorders. “There are lots of disease processes that intersect with sleep apnea,” says respirologist Dr. Althea Burrell. Since sleepiness is a non-specific symptom, “our role is to rule out sleep-related disorders.” When it comes to sleep studies, “there’s a bit of an art to it.” Patients sleep overnight in the lab, in a private room with a bed that mimics a bedroom (rather than a hospital room). Sensors are placed on the scalp, chest, legs, finger probe and a nasal sensor to capture data, monitored by a registered polysomnography technologist (RPSgT). “We see and treat a ton of sleep apnea, and we’re really good at doing that because we do it all day,” says Dr. Burrell. “We don’t know if someone has it until we do a sleep study to diagnose it. Even if a person has it, you need a specialist to dig down [into the data], because people have different symptoms.” The sleep lab has expanded to include seven beds; the hope is to add three additional beds,” says Liz. “We’ve also expanded the number of days the sleep lab operates; we now run seven nights a week while we were at five prior.” These days, there’s more public awareness of sleep disorders, particularly sleep apnea. “We definitely see an increased demand,” says Liz. “I do believe it’s because doctors like to send patients to a hospital-based sleep clinic. We have a reputable group of respirologists and quality of care is consistent.” It’s also a one-stop shop for patients. “They can come see the doctor, get testing done and get treatments in the same location,” says Dr. Burrell. The sleep clinic also has a portable sleep study device, she says, for urgent inpatient sleep studies. It’s been more than a year since Carole was diagnosed with sleep apnea and started using a CPAP device. It’s changed her life — and her health. She sleeps through the night and feels full of energy the next day, having a positive impact both personally and professionally. “And,” she says, “It has had a very positive effect on my golf game!” n


MEN’S HEALTH

MSH

LASER SHARP

MSH’s non-invasive laparoscopic surgeries mean fewer incisions, and quicker recoveries BY RACHEL NAUD

Urologist Dr. Adeel Sheikh speaks at Men’s Health Education Night at MSH.

PHOTOS: BRIAN HAMILTON

B

rock Burrows was understandably nervous when it was time for his surgery. The 19-year-old student and Junior A hockey player had never had surgery before. He was nervous about going ‘under the knife’ but due to MSH using leading-edge technology his surgery was done laparoscopically. Markham Stouffville Hospital (MSH) is fitted with technology that allows urologic surgery to be done laparoscopically and non-invasively — services usually found only in hospitals

within large academic centres, including Toronto, Ottawa or London. Urology is surgery of the kidneys, bladder, urinary tract and male reproductive system. MSH provides open, laparoscopic and cystoscopic services to diagnose and treat urinary tract illness. Dr. Adeel Sheikh, a minimally invasive urologic surgeon at MSH, says the hospital is able to treat conditions across the board in terms of bladder cancer, kidney cancer, kidney stones, prostate cancer and

prostate enlargement, to name a few. MSH offers various laparoscopic surgeries for the adrenal glands, the kidneys, the ureters and the prostate. “We also deal with the male reproductive system, including erectile dysfunction and testicular cancer,” says Dr. Sheikh. And while many hospitals offer services to treat the same conditions, MSH is able to offer non-invasive treatment options, which can make a world of difference to patients undergoing the procedure. Continued on Pg 28

Healthy.Together. Fall/Winter 2018

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MSH MEN’S HEALTH Continued from Pg 27

THE BENEFITS OF LAPAROSCOPIC SURGERY

The laparoscopic surgical services provided by MSH are probably one of the biggest advancements the hospital has seen in the last three years. In general, Dr. Sheikh says, the known or demonstrated benefit of laparoscopic surgery is that the procedures are less invasive. This means, as opposed to making one big cut in a patient’s body, the surgeon will make two or three small, subcentimetre incisions and use cameras to pinpoint the exact issue. “The advantages with laparoscopic surgery, are shorter stays in hospital, less pain medications required and less pain after the procedure,” says Dr. Sheikh. Brock, who underwent laparoscopic pyeloplasty in April 2016, was expecting a long and painful recovery. Instead, a short six weeks later, he was back on the ice playing the sport he loves. “My recovery was a lot better than I

expected,” he says. “I was a bit worried because it was my first surgery but it was a lot easier than I thought. After the first couple of days, I didn’t have a lot of pain. And, about a week after surgery, I felt good. I felt normal.” Today, Brock says the operation has been life-changing. “On and off the ice, I feel like I have a lot more energy,” he says. “Before the surgery, I felt tired. I didn’t have as much drive to do things. Now, that I don’t have pain in my side anymore, I’m able to play hockey no problem… if I ever have another problem, I would definitely go back to MSH. It was a really good experience.”

LOOKING FORWARD

Now that laparoscopic surgery is available at MSH, Dr. Sheikh is looking to the future and is hopeful that the hospital may be able to get a GreenLight laser. “This technology is used for treating the enlargement of the prostate,” says Dr. Sheikh. “Traditionally, we

do a procedure where we shave out the inside of the prostate, but now that newer technology is available, which I also have training with, I can use a GreenLight laser to vaporize the prostate tissue. The advantage here is less blood loss for patients as well as a shorter stay in hospital. They could actually go home the same day.”

REACHING OUT

While the future holds a lot of exciting technological advances, Dr. Sheikh does want to highlight the exceptional services the hospital has to offer its male patients in the community. Dr. Sheikh was a featured speaker at a men’s health event on Oct. 12 at MSH that focused on urology. (See “Let’s talk: a session promoting men’s health,” below.) “We thought it would be a good way to connect with the people in our community and advocate a proactive approach to health via patient education,” he says. “We can

Let’s talk A session promoting men’s health “We’re going to need more chairs.” That was the immediate realization by Markham Stouffville Foundation (MSHF) staffers at a recent open-door information session on men’s health. And as the fourth-floor auditorium continued to fill up, it was clear: There is no shortage of community members eager to learn how to maintain their own good health. And that, say the experts, starts with talking — something men are typically reluctant to do. In fact, all too often, men don’t visit their doctor unless they suspect something is wrong with their health. To help mitigate that, the mid-October event gave people from the community, notably the gents, an opportunity to learn directly from the specialists. Organized in partnership with MSHF and urologist Dr. Adeel Sheikh, the evening featured two other urologists — Dr. Avidis Boudakian and host, Dr. John Di Constanzo — as well as MSH’s Chief of Psychiatry, Dr. Rus Sethna and Chief of Family Medicine, Dr. Alan Monavvari. Each physician delivered a short overview of a particular topic, and time was allotted at the end of the session for individual questions from the floor. “Sessions like this are a great opportunity for us to connect with the community, and to talk to you about health and to make sure you stay healthy,” Dr. Sheikh told the attendees. “You certainly know we’re here for you when

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Markham Stouffville Hospital Foundation

Dr. John Di Constanzo hosts Men’s Health Education Night at MSH.

you’re sick or unwell. And we also want to partner with you to keep you well and alive for many more years to come.” Close to 150 attendees were on hand to learn more about some of the more common conditions related to men’s health, including erectile dysfunction and prostate cancer, as well as the treatment options available and the lifestyle choices required to maintain good health. The overwhelming popularity of the event will lead to similar sessions being offered in the future.


MEN’S HEALTH

(L-R) Presenters: Dr. Adeel Sheikh, Dr. Avidis Boudakian, Dr. Alan Monavvari, Dr. Rus Sethna and host Dr. John Di Constanzo at Men’s Health Education Night at MSH.

inform patients about the common conditions related to men’s health, promote awareness and highlight what treatment options are available. All of this while establishing a connection with the community — to give back and allow the patients to have the opportunity to learn something directly from specialists.” Another message Dr. Sheikh has for

men is: Be proactive when it comes to your health.

PREVENTION IS KEY

“If we can work to inform men so that they are educated in prevention and early detection, that is certainly beneficial,” says Dr. Sheikh. “It’s important to be aware.” For Dr. Sheikh, this means being

MSH

involved in your health and trying to work from a proactive standpoint in terms of prevention and early detection of conditions. For many, this may translate into an annual checkup. “Yearly checkups are typically done by family doctors. As a urologist, based on what we know about urology conditions, there are certainly instances where yearly checkups should be done. If not yearly, then sometimes every two years.” But even if men aren’t going to the doctor on a regular basis, Dr. Sheikh advises men have open and frank discussions with their family doctors about various types of men’s health issues. “It’s important to initiate conversation,” says Dr. Sheikh. “ Even if you’re not having yearly or bi-annual checkups, at least start a conversation when you are there. Don’t be afraid to say, ‘Hey, what do you think about erectile dysfunction or prostate cancer.’ If a patient has any concerns, they should bring them up early.” n

There’s no place like

Home

We can help your loved one remain independent in the comfort of their own home. Meal Preparation Light Housekeeping Personal Care Medication Reminders Joyful Companionship Supplementary Care – Hospital, Retirement & Nursing Homes Call us for a FREE assessment

905.918.0103 www.LAServices.ca

Healthy.Together. Fall/Winter 2018

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MSH HEALTH TIPS

A word with the pharmacist:

JUST WHAT THE DOCTOR ORDERED Ian Walker is a pharmacist with 29 years’ experience – 14 of them at Dale’s Pharmacy on the grounds of Markham Stouffville Hospital. He provides tips for managing medications, his team’s advice on side effects and the pharmacy’s ever-changing role. What does your pharmacy do? We ensure the needs of people entering the pharmacy are addressed. As well as dispensing prescription medicines we sell many other items including blood pressure monitors, diabetes blood glucose meters and many over-thecounter medications including vitamins, cough and cold product and analgesics. We also sell many home health care items and have staff that are trained to fit braces and support stockings. How has the role of pharmacy changed? The main role of the pharmacist and technicians is really not just simply putting pills in a bottle anymore. Our focus is to ensure what has been prescribed is appropriate and the dose is correct. There are so many other health care providers involved in the healthcare system today; people may go to their family doctor and get a referral to a specialist, whether a cardiologist, oncologist, urologist, gastroenterologist, dermatologist to name a few. Many times a new medication is prescribed to replace or be in addition to existing therapy. The patient may have been told

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verbally by the other health care provider why but often doesn’t remember. So it is our job to make sure the whole puzzle is put together properly and the patient is taking the correct medication. We also provide scheduled one-onone medication reviews called a MedsCheck, where a pharmacist sits down with a patient to review all the medications the patient is taking. Technology has made medication histories and profiles easily retrievable. But it still requires someone with the knowledge of the medications purpose to determine if the therapy is appropriate: Does it duplicate something the patient is currently taking? Are there any drug interactions? These are some of the issues the pharmacist may address. In addition, pharmacies now administer flu shots and other vaccines not publicly funded that aren’t available at the doctor’s office. Instead of having to buy the vaccine and take it to the doctor’s office to be administered, people now have the option of buying it and having it administered at the pharmacy. What do patients need to be mindful of when it comes to their medications? Some people have memory issues, take many medications or their regimen becomes too complicated. For these patients we suggest and many physicians will order the medications to be dispensed in weekly blister packs which can be delivered on a weekly or monthly basis. So visually the patient or

caregiver can see exactly what medication is in the pack since the name and description of each medication is listed. If other family members are involved, all they had previously was a bottle to look at, now they can look at a date on the pack and say: “Well, your morning medication is still here, obviously you haven’t taken it.” What else should patients keep in mind? People should know what the medication has been prescribed for and the duration of the therapy – whether it is important to complete the prescription. There are many times where you assume the physician has told the patient exactly what has been prescribed and why. But many times this is not the case, for instance a patient may go to the Emergency Department for acute back pain and be prescribed pain medication and the patient often does not know if they are to complete all the medication or just take it until the symptoms subside. Again we try, to the best of our ability, to ensure the patient leaves knowing the reason the medication has been prescribed and for what duration and suggest following up with a family doctor if the condition does not improve. What should patients understand about side effects? This can prove challenging at times since printed information given to the patient when the medication is dispensed lists all possible side effects, even the ones that are extremely rare. We reinforce which ones are common and more likely to occur and what other ones to be aware of. I’ve seen it before: If we dwell on the potential negatives, people can be afraid to take the medication, and they don’t comply. Then they end up back at the doctor’s office or worse because the condition that they originally presented with hasn’t been treated. There are times though where we make suggestions and offer to call the physician to have a prescription changed if another medication may be better tolerated and provide the same end result. n


ASK THE SPECIALIST

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MSH

What is a UTI?

ANSWER: The urinary tract is a set of organs

Ask the Specialist OUR DOCTORS ANSWER YOUR HEALTH AND WELLNESS QUESTIONS

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What causes nosebleeds and how are they treated?

ANSWER: Epistaxis, also known as nosebleeds, result from a bursting blood vessel within the nasal cavity or nasopharynx. This can occur in the front of the nose (anterior epistaxis) or from the back of the nose (posterior epistaxis). Nosebleeds can be either spontaneous or be caused by local and systemic factors. Local factors include direct nasal trauma, nasal picking, surgical complications, upper respiratory tract infections (colds) and/or tumours within the nose. Systemic factors include high blood pressure, the use of blood thinning medications (e.g., aspirin or Plavix), history of bleeding disorders and pregnancy. The majority of nosebleeds can be treated by yourself by applying nasal pressure (i.e., pinching together the soft portions of the nose). If your nose bleeds last longer than one hour or if at anytime you start to feel lightheaded, you should seek medical attention. Some nosebleeds require the help of a physician to burn the bleeding vessels with cautery or shrink the vessels by packing the nose. For severe cases, the entire blood vessel needs to be blocked off using embolization or ligation techniques. Dr. Dupe Oyewumi is an otolaryngology – head and neck surgeon at Markham Stouffville Hospital and lecturer at the University of Toronto.

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in the body that carry our urine. A ‘normal’ tract includes two kidneys (organs that filter the blood to make pee), the bladder (ball shaped organ that warehouses urine), two ureters (muscular tubes that carry urine from the kidneys to bladder) and urethra (the tube where the pee comes out). Urinary tract infections or UTI’s are infections that affect the organs and tubes listed above. They are more common in women than in men. Bladder infections are more common than kidney infections and occur when bacteria (certain type of germ) get into the urethra and travel up to the bladder. If the bacteria travel higher you can get a kidney infection. The symptoms of bladder infections may include needing to urinate more often, having to urinate suddenly, having pain or burning when you pee or having blood in your urine. If the infection involves the kidney you may have fever, back/side pain and/or nausea and vomiting. If you think you may have a UTI you should see a health care provider and they can test your urine. There is a simple urine test that can be done at the bedside. Sometimes the urine will be sent for a ‘culture’ test to check for bacteria, and this can take up to two days. Most urinary tract infections are treated with antibiotics although some just get better on their own. Your health care provider may give you an antibiotic for anywhere from three — 14 days. It is important that you take all of the antibiotics otherwise the infection may come back. If you are getting frequent bladder infections, keep track of them and follow up with your primary care provider. This is a summary of simple UTI’s — the rules and approach can be different for patients with complicated medical histories, neonates, older men and seniors in long-term care facilities. Don’t hesitate to ask a trusted health care provider if you or a family member may have a UTI. Dr. David Austin is an Emergency Department physician and Chief of Staff at Markham Stouffville Hospital.

HAVE A QUESTION? IF YOU HAVE A QUESTION FOR A SPECIALIST AT MARKHAM STOUFFVILLE HOSPITAL, EMAIL: myhospital@msh.on.ca

Healthy.Together. Fall/Winter 2018

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MSH DONOR

A Christmas to remember One family’s life-changing brush with the true spirit of the season BY DAWN RITCHIE

Kostantina Diakanastasis spends a memorable Christmas at MSH.

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he days before Christmas mark the last frenzied rush of preparations for the most cherished holiday of the year. But for the Diakanastasis family, December 23, 2016 was spent in the ER of Markham Stouffville Hospital (MSH) with a very sick child. Ten-year-old Kostantina was fighting an eye infection, and it was getting progressively worse at an alarming rate. “It started out as a little bump,” recalls father, Steve Diakanastasis. “Then grew and grew. Nobody knows what caused it.” MSH physicians diagnosed the infection as cellulitis, a potentially lifethreatening infection if it were to enter the bloodstream. Most concerning was the dangerous proximity of the infection to the brain. Kostantina was admitted to paediatrics immediately and administered intravenous antibiotics. The hospitalization threw a monkey wrench into the close-knit family’s

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plans. Steve’s wife, Helen, slept in the room overnight while Steve returned home to tend to their other daughter. “The tree was up, presents wrapped. We have a large extended family. Everyone was coming for dinner. We hoped she’d be out by Christmas Eve.” But all hope was dashed when physicians explained that Kostantina wasn’t going home for the holidays at all. “The little one lost her mind,” Steve remembers. “She loves Christmas so much. But we decided to make the best of it. The staff were so caring. They were phenomenal. They let us bring in a mini Christmas tree and decorate the room. We even put up lights.” This patient-centred approach to care is part of the paediatric unit’s Child Life Program — a mandate to alleviate the stresses children and their families encounter during hospitalization. “They had local school children make up little care packages for kids who were in the hospital over the holidays,” says

Steve. “Kostantina got a package every morning. A book and stuffed toy. Small arts and crafts, made by other school children. It was amazing.” Family members were also allowed to pour in, keeping the mood light, bringing pies and desserts. “We did crafts all day. Kostantina got the most attention she’d ever gotten. She loved it.” Come Christmas Day, the entire Diakanastasis clan, friends, cousins and grandparents arrived with turkey and all the fixings for their traditional Christmas meal. Hospital staff allowed them to set up in a closed section of the cafeteria. “There were 14 of us. We had a great time,” he says. And Kostantina was finally recovering under the vigilant care of MSH nurses and physicians. She was released on Boxing Day. But so remarkable was the family’s experience with MSH staff, they decided they wanted to honour this generosity of spirit and give something back in return. As the owner of a metal fabrication business, Steve had recently built a new shop and taken the opportunity to order an extravagant fixture from Asia for his office. That’s when it struck him, “Just because I can afford this thing doesn’t mean I have to have it. Why do I need this useless thing when the money could go to a much better cause and do so much good?” Steve cancelled the order and donated the $13,800 instead to the paediatric unit of the hospital. A most welcome donation that helps to ensure MSH’s excellent care for future patients. “It was actually a relief,” remarks Steve. “That I didn’t spend that money on something stupid. The feeling was night and day. The money was going to a good cause, towards helping others.” The Diakanastasis family are strong believers in giving back. They sponsor four children in Ecuador and donate regularly to other healthrelated charities, but this was by far their biggest personal donation to date. “It made me feel a lot better,” he insists. “The caregivers were beyond wonderful. Beyond accommodating. And even though it wasn’t the normal Christmas we had planned, it was memorable. Maybe the most memorable Christmas ever.” n



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