Hope Spring 2015 Commemorative Issue by Venture Publishing

SPRING 2015

COMMEMORATIVE ISSUE

THE LOIS HOLE

HOSPITAL FOR WOMEN

CELEBRATES 5 YEARS OF EXCELLENCE

BEDSIDE STRENGTH Maternal-fetal specialist DR. RADHA CHARI is one of three research chairs improving care for Alberta women

AGILE ARMS

Meet some sponsors of HOPE on page 6

FERTILE GROUND

A happy couple bridges the gap to make a family

The da Vinci robot extends the reach of women’s surgery

SPRUNG A LEAK? You’re not alone in urinary incontinence. Help is here!

UNWELCOME INHERITANCE Women can weigh their options in the presence of breast cancer predictors PM#40020055

PLUS

MEN IN G THE MATERD N a study AL MIND: scre anxiety ens for a depressiond n

ART IN THE AISLES: The hospital as a gallery

These moments. 101 Riel Drive, St. Albert â&#x20AC;˘ holesonline.com

Contents

HOPE

Features 12 Rule of Thirds

Three academic chairs take research from the lab bench to the bedside

18 Patients First

WCHRI supports research excellence in women’s and children’s health

20 Healing Arts

The Lois Hole Hospital for Women knows that art is medicine

26 Royalty and Rubber Galoshes

Meet the first lady behind the name of the Lois Hole Hospital for Women

32 Women’s Advocate

Philanthropist Dale Sheard: the driving force of the Lois Hole Hospital for Women

36 A Home for School

Take a closer look at a leader among teaching facilities

40 The Real Deal

Noelle talks, sweats and bleeds – and delivers an education

44 High Tech, High Touch

Serving a diverse demographic with state-of-the-art technology and genuine caring

50 Unwelcome Inheritance

The Allard Hereditary Breast and Ovarian Cancer Clinic navigates genetic markers for families

54 Maternal Minds

A new study screens for anxiety and depression during and after pregnancy

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20 58 Hope for the Future

One couple’s tragic loss bound them to the Lois Hole Hospital for Women

60 The Cutting Edge

A new surgical robot allows surgeons to create better care options for patients 5 Years of Caring

26 The Lois Hole Hospital for Women

Spring 2015

Departments 7

Out Front:

News and numbers

48 Top Tips

A gynecologist shares wisdom

57 Strike a Cord

Why umbilical cord donation matters to you

64 Under One Roof

The Lois Hole Hospital for Women is a one-stop resource for care

68 What to Expect

“My journey to creating a family took many turns.”

72 A Life of Spirit

Creating meaning in times of illness includes the spiritual side

76 Flood Relief

Help is here for incontinence

78 In Good Company

Styled by Jessica Clark, Radha is wearing Theory, courtesy Holt Renfrew and shoes courtesy Gravity Pope

Meet a generous corporate giver and community supporter

80 Will Power

Planned giving makes sense beyond just making you feel good

82 No Small Matter

The impact of the modest donation is enormous to women’s health

12 ON THE COVER

68 www.loisholehospital.com

32 5 Years of Caring

Dr. Radha Chari is the model of professional excellence. She is the women’s health zone clinical department head at the Lois Hole Hospital for Women, and chair and associate professor in the department of obstetrics and gynecology at the University of Alberta. PHOTOGRAPH BY PEDERSEN

Spring 2015 • Hope

Welcome Volume 01 • Issue 1 • Spring 2015 Publisher

Ruth Kelly

Executive Editors

Sharlene Rutherford Elise Cerny

Director of Custom Content

Mifi Purvis

Associate Editor

Shelley Williamson

Production Manager

Betty Feniak Smith

Production Technicians

Brent Felzien Brandon Hoover

Circulation Manager

Karen Reilly

Vice-President Sales

Anita McGillis

Advertising Representative

Kathy Kelley

Sales Assistant

Julia Ehli

Art Director

Charles Burke

Associate Art Director

Andrea deBoer

Graphic Designer

Ben Rude

Contributing Writers Caroline Barlott, Colleen Biondi, Lyndsie Bourgon, Sydnee Bryant, Lisa Caterall, Caitlin Crawshaw, Martin Dover, Mike Hingston, Jen Janzen, Robbie Jeffrey, Lani Lupul, Sam Macdonald, Lindsey Norris, Cory Schachtel, Seamus Smyth, Shelley Williamson Contributing Illustrators and Photographers Buffy Goodman, Cooper + O’Hara, Jessica FernFacette, Anthony Houle, Heff O’Reilley, Pedersen, Darryl Propp, Kelly Redinger, Cindy Revell HOPE is published by Venture Publishing Inc. for Royal Alexandra Hospital Foundation. Venture Publishing Inc. 10259-105 Street, Edmonton, Alberta T5J 1E3 Tel.: (780) 990-0839 Fax: (780) 425-4921 admin@venturepublishing.ca www.venturepublishing.ca Royal Alexandra Hospital Foundation 10240 Kingsway Ave. NW, Edmonton, Alberta T5H 2V9 Tel.: (780) 735-5458 www.loisholehospital.com The opinions conveyed by contributors to HOPE magazine may not be indicative of the views of Venture Publishing Inc. or Royal Alexandra Hospital Foundation. While every effort is made to ensure accuracy, neither Venture Publishing Inc. nor Royal Alexandra Hospital Foundation assume any responsibility or liability for errors or omissions. Canadian Publications Mail Product Agreement #40020055 Copyright © 2015 by Royal Alexandra Hospital Foundation. No part of this publication should be reproduced without express permission of Royal Alexandra Hospital Foundation. Printed in Canada by Transcontinental LGM Graphics HOPE is printed on Forest Stewardship Council ® certified paper

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Lois’s Legacy THE LOIS HOLE HOSPITAL FOR Women is now five years old. And there’s no question that the woman for whom it is named would be immensely proud. For Lois, that sense of pride first began the day she gave the Royal Alexandra Hospital Foundation her emotional approval that, yes, she would be delighted to have the hospital carry her name. As we continue on with our mission of building the best women’s hospital in Canada here in Alberta, we think about this iconic Albertan often. The staff and physicians think about her, too. We can’t help but wonder what she would say about this hospital, had she lived to see it completed. We think she would be very pleased by the interior design, the selection of art within, and there’s no question she would have delighted in the abundance of natural light that cascades through the halls and waiting rooms on each and every floor. The rooftop healing garden would have been a favourite spot for her, and the cantilevered staircase, encased in glass and offering magnificent views, would have taken her breath away. But we think what would impress Lois the most – and really, really touch her heart – is the support that Albertans have shown for “her hospital” through their kind and generous donations. Lois was known for her practical hand, her kind heart, and her generous spirit. She also had an enduring search for knowledge. She was a proud Albertan. And her early years as a farm girl informed her ability to make a little go a long, long way. She would be so impressed by the people who care enough about this hospital to want it to succeed. And in doing so, they enable the people who work here to go above and beyond for patients and families. It’s fitting that during the fifth anniversary of the Lois Hole Hospital for Women, we capture and collect this community spirit by showcasing how patient care is reaching new and exciting heights.

5 Years of Caring

Amazing things happen at this hospital; donors from every corner of Alberta have made it so. In that sense, Lois Hole is still very much here. She’s the generous spirit in every donor. She shines in every caregiver. And she lives in every woman who, as a patient at the Lois Hole Hospital for Women, finds that special kind of hope – that real, uplifting hope – that things will turn out OK. Thank you for supporting Alberta’s own Lois Hole Hospital for Women.

THANKS! Hope magazine is here to drive donorship, to thank donors and report to them, to engage with community served by the Lois Hole Hospital for Women, and to celebrate five years of better health care for Albertan women. Special thanks to some important sponsors of this publication: • Cavarzan Inc. • Shoppers Drug Mart • Hole’s Greenhouses & Gardens • Syncrude Canada • Alberta Blue Cross Sincerely, Andrew Otway, President and CEO Sharlene Rutherford, Vice President Royal Alexandra Hospital Foundation

The Lois Hole Hospital for Women

Out Front

7,000 the new record high number of births at the Lois Hole Hospital for Women, 2014

Thanks for Helping The Lois Hole Hospital for Women is proud to serve the community, proud to be part of the fabric of life in Alberta and proudest to be created by Albertans. Donations large and small, given by private or corporate donors once or on an ongoing basis, foster and attract excellence in care to our home. Donations care for Western Canadian women: our sisters, mothers, aunts, and daughters and infants, from the tiniest preemies to the women at the end of their lives. Support means everything to us and allows us to create the level of care that is setting new standards and catching the world’s notice.

HOPE NOTES Official opening day of the Lois Hole Hospital for Women:

April 8, 2010

On the Menu

The Lois Hole Hospital for Women offers a variety of subspecialized services and programs

• Gynecologic Oncology: This is the largest gynecological services centre in Alberta. The colposcopy clinic provides diagnoses and treatment to more than 2,500 patients every year. The gynecology inpatient unit has 33 inpatient beds and 13 day surgery beds. • Maternal-Fetal Medicine: A subspecialty of obstetrics, it provides care for pregnant women with concerns regarding their health or the health of their unborn babies. A national leader, the Lois Hole Hospital for Women offers specialized care for high-risk pregnancies and multiple births. • Reproductive Endocrinology and Infertility: This clinic works to increase the chances for couples who are trying to conceive, helping more than 800 every year. Specialized prenatal classes support women expecting multiples. • Urogynecology: This program is a national leader in the treatment of incontinence, developing and offering the latest surgical treatments and therapies for women suffering from urinary or fecal incontinence problems.

www.loisholehospital.com

• Women and Children’s Health Research Institute: WCHRI comprises some 350 leading researchers, clinician-scientists, academics, health-care professionals and service providers from various academic and community settings. Funding partners support groundbreaking multidisciplinary and transdisciplinary research through grant competitions, ongoing research funding, professional development and expert resources.

5 Years of Caring

Spring 2015 • Hope

Out Front

Don’t Pause for Menopause If you have been exercising for years, chances are you won’t stop when menopause arrives. But the fatigue and meandering aches and pains might put a wrinkle in your routine. If this happens, you can switch gears and try a new regimen until you get used to the new normal. But now, more than ever, you need to stay active. If you have not been, then now is the time to get active. An exercise regimen, even of as little as a half-hour of moderate activity a day will benefit you in many ways. Most of us can work two 15-minute brisk walks into the schedule. • Stay light on your feet. This time of life often brings weight gain. Inactivity now will exacerbate the tendency to lose muscle, and gain fat around the belly. • Protect the twins. Keeping the excess

weight off will help you reduce your risk of breast cancer. • Bone up. Impact exercise such as walking, running, light-impact aerobics, stairs, or biking on hills keeps your bones stronger longer and slows bone loss, reducing the chance of osteoporosis. • Work out the wobbles. Menopause makes you clumsy. Incorporating some balance and stability into your routine can help reduce this effect and keep you upright and smiling. • Heart your heart. Even with little or no weight loss, an exercise regimen will improve your heart health and decrease your odds of acquiring diabetes. • Turn that frown upside down. Menopause increases your risk of suffering from depression. Lucky for you, exercise decreases it. No Rx necessary.

Each OR room is equipped with

state-of-the-art features specific to women’s health procedures

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the number of labour and delivery rooms, including two with infant resuscitation areas to provide the most advanced care

The Smallest Thank-Yous Donors bought two new breast pumps and related software and materials last summer for the neonatal intensive care unit (NICU) to enable mothers of premature babies to initiate and maintain breast milk production – a boon for the health of baby and mother. The pumps’ purchase was thanks to a $4,700 gift from the St. Albert Community Foundation. The NICU is located at the Royal Alexandra Hospital and supports babies born at the Lois Hole Hospital for Women who need specialized care or surgery due to conditions that are often exacerbated by low birth weight. At 69 beds, this is one of the biggest NICUs in the country.

The Lois Hole Hospital for Women

Lois Hole Hospital for Women’s valued partner Shoppers Drug Mart had heart, and a good deal of foresight, when it gave a $7,000 gift to the Lois Hole Hospital for Women and CK Hui Heart Centre. The facilities used the donation in December 2014 to buy a specialized heart monitor for use on women in labour who have the complicating factor of an existing heart condition. Called the IntelliVue MP2, doctors wanted

the monitor as it lets women in labour move more freely while still watching their hearts closely. This movement may shorten labour and definitely helps with pain. “The Lois Hole Hospital for Women is the centre for high-risk labour and delivery and when this involves cardiac concerns, there is often high collaboration with the CK Hui Heart Centre, also located in the Robbins Pavilion,” says Janie Tyrrell, interim executive director at the Lois Hole Hospital for Women. Tyrrell says the technology is light and easy to wear, and can sound the alarm if a woman’s heart readings change suddenly.

Slow and Steady A new study has found that female athletes run at a more even pace than men, when training and competing in marathons. The study, from the journal Medicine & Science in Sports & Exercise, followed runners in 14 marathons around the world, and found that women consistently pace themselves better than men. What this means is still up for debate. It could reflect a difference in physiology, but it could also point to psychological differences in risk taking and competitiveness. Since even pacing plays a key role in distance running, the researchers note that this places women at an advantage. Women’s marathon times have been improving in relation to men’s, which – while still improving – have levelled off significantly since 1985.

www.loisholehospital.com

the number of operating rooms dedicated to women for complex inpatient, day surgery and caesarean section births 5 Years of Caring

Breast Check: a How-to Don’t wait for your yearly mammogram – check your own breasts every month. The best time is usually a week after your period starts. If you’ve stopped menstruating, do your examination on the same day every month. If you’re breast feeding, do your exam after your baby nurses. Here’s how it works: 1. Lie flat on your back, naked above the waist. 2. Use your left hand to check your right breast and your right hand to check your left breast. 3. Press the flat pads of your three middle fingers on your breast. Start at your nipples, and work your way out in a spiral. 4. At each finger placement, first press lightly in a circular motion, to check tissue close to the skin. The press a little harder to feel deeper tissue. Finally, press firmly to feel tissue close to your breastbone and ribs. 5. Note any lumps, thickness or changes. 6. If you feel a lump but aren’t sure, check the same spot on your other breast. It the same thing is there, too, it’s probably fine. 7. You can also check your breasts standing up, with one arm raised over your head. See your doctor if you find: • A new lump, painful or not. • Places that feel thicker than usual. • Sticky or bloody discharge from your nipples. • Changes in the skin of your breasts or nipples, puckering or dimpling. • An unusual increase in the size of one breast. • One breast looks lower than it used to.

Spring 2015 • Hope

Source: myhealthalberta.ca

Listen to the Heart

Out Front 80,000 the number of outpatient visits per year

Tackling Cancer May marks the seventh-annual Edmonton Eskimos Women’s Dinner in support of ovarian cancer research at the Lois Hole Hospital for Women. A group of past and present Edmonton Eskimos and club employees conceived of the dinner as a tribute to the memory of 21-year Eskimos employee Pam Monastyrskyj, who died of ovarian cancer. Funds the group raised were the genesis of the Edmonton Eskimos Women’s Ovarian Cancer Research Endowment Fund – set up to provide longterm, sustainable funding for researchers at

the Lois Hole Hospital for Women. “When we think of outstanding community support for the Lois Hole Hospital for Women and the cancer research and surgeries that take place here, there is no better example than this one,” says Sharlene Rutherford, vice-president of the Royal Alexandra Hospital Foundation. “The Eskimos created a wonderful evening that not only showcases our football team, it fundraises for ovarian cancer research right here in our city.” Looking forward to the next annual dinner? Call 488-ESKS or visit esks.com to get involved.

HPV and Me HPV is short for human papilloma virus. It is a family of sexually transmitted viruses that 70 per cent of sexually active adults will get in their lifetime. Your body will often clear the virus and it will not usually show any symptoms or require any treatment. But some strains of HPV can cause abnormal changes to cells lining the cervix in some women. These changes will lead to genital warts and cervical cancer in some women. (HPV is also a cause of some other types of cancer in men and women.) Women can protect themselves from most cervical cancers with a vaccine against HPV given before they become sexually active. Girls and more recently boys in Alberta are able to get this three-dose vaccine free of charge in schools. It prevents the strains of HPV that are behind 70 per cent of cervical cancer cases. It’s still important to get regular pap tests throughout your life, as it’s the only way to identify changes leading to cervical cancer. The HPV shot doesn’t protect against all cervical cancer. To find out more about screening for cervical cancer, Albertan women can visit screeningforlife.ca.

Hope • Spring 2015

A national leader

in the care of high-risk pregnancy, labour and deliveries 5 Years of Caring

The Lois Hole Hospital for Women

Clickable HOPE NOTES All human wisdom is summed up in two words: wait and hope. - Alexandre Dumas

PHOTO COURTESY: THE EDMONTON ESKIMOS

Seeds of Hope Dr. Dawn Kingston, assistant professor at the University of Alberta, is teaming up with Dr. Peggy Sagle for a rare look into the mental health of women – and men – undergoing fertility treatment. The study, out of the Regional Fertility and Women’s Endocrinology Clinic at the Lois Hole Hospital for Women, seeks to understand how many women and men undergoing fertility treatment experience anxiety, depression and stress – and for those who do, how severe and long lasting their symptoms are. It will also look at what type of help they would prefer to have to deal with anxiety, depression or stress, and who is most at risk for developing these while in fertility treatment. Kingston says it is the first study of its kind to include a look at how men deal with the trials and tribulations of fertility treatment, and her findings will be used to “develop and test some psychological therapies that would be effective for this group.” She also says that any research into how women struggle during fertility treatment has been limited, at best. Kingston hopes the study’s findings will be threefold: to help identify women and men who have symptoms; identify women and men at risk of developing anxiety, depression or stress; and finally learn what types of psychological care would be appropriate for the group.

www.loisholehospital.com

Cancer Support Women looking for support following their treatment of gynecological cancer will be able to net access to like-minded survivors online, thanks to a study now open in Alberta, led by Dr. John Robinson, a psychosocial oncologist at the Tom Baker Cancer Centre, and Dr. Erika Weibe, department of radiation oncology at the Cross Cancer Institute in Edmonton. Participants will be part of a 12-week online professionally moderated group, that’s designed to provide a safe space for women to learn about the

Run for Women Lois Hole Hospital for Women recognizes the connection between mind, body and spirit in women’s health. On Saturday, May 30, 2015, strong supporter Shoppers Drug Mart is sponsoring the Run for Women at Edmonton’s Laurier Park in support of women’s mental health. Funds from the run will support the reproductive mental health pro-

5 Years of Caring

after-effects of treatment and explore the impact of gynecological cancer on their body images, sexuality and intimate relationships. To be eligible, participants must live in Alberta, be 18 years of age or older, have undergone surgery, radiotherapy, or chemotherapy for any kind of gynecological cancer within the past five years, be disease-free for three months and not be currently in treatment. Those interested in participating can email yvonne.brandelli@albertahealthservices.ca or call (toll-free) 1-888-998-8148.

gram at the Lois Hole Hospital for Women. Statistics say that one in three women will suffer from some type of mental illness in her life. The Lois Hole Hospital for Women and Shoppers Drug Mart invite participants to work toward better care and cure for these women. Find out more or register for the run at runforwomen.ca

Spring 2015 • Hope

THE EXPERTS ARE HERE: (L-R) Drs. Radha Chari, Sue Ross and Lynne Postovit have created an environment of excellence.

Hope â&#x20AC;˘ Spring 2015

5 Years of Caring

The Lois Hole Hospital for Women

Rule of THIRDS

Three academic chairs at the Lois Hole Hospital for Women work collaboratively and tirelessly to take research from the lab bench to where it matters – the bedside BY LYNDSIE BOURGON • PHOTOGRAPHY BY COOPER + O’HARA

HE LOIS HOLE HOSPITAL FOR WOMEN – AND ITS CLINICS, PATIENT

rooms and hallways – are where many of Alberta’s women experience the most difficult moments of their lives. But this is also a place of hope and change, where developments and commitments in research are improving maternal and women’s health in direct ways. Of these developments, none is more significant than the addition of three research chairs, led by three remarkable women who bring a revelatory focus to women’s health and set new best practices in the field, garnering national attention at the same time they are increasing the depth of local care. Committed to advancing findings in women’s health, these researchers are Dr. Sue Ross, Dr. Lynne-Marie Postovit and Dr. Radha Chari. All three have been working to bring about change in women’s medicine and how it is delivered to patients.

www.loisholehospital.com

5 Years of Caring

Spring 2015 • Hope

“THE GOAL IS TO CONSIDER PATIENT

SUE ROSS Grew up in: Cheshire and Helensburgh, in Western Scotland Studied at: Heriot Watt University, Robert Gordon’s Institute of Technology, the University of Aberdeen and the University of Glasgow Spends her free time: Gardening, backcountry skiing and white-water canoeing. Speaks fluent pika (pikas are rock rabbits that live high in the Rocky Mountains)

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experience,” says Dr. Ross, chatting over tea at the kitchen table in her weekend home. All around her is a mess from a remodelling project that Ross is hoping to see the end of soon, but for now, it’s a work in progress. At work, it’s the tangible effects of research on the lives of women that matters most to Ross. “To me it doesn’t matter if you provide perfect clinical treatment, the research doesn’t matter if it doesn’t help women to feel better in some way, shape or form.” Dr. Ross made her way to Alberta and the Lois Hole Hospital for Women via her upbringing and education in Scotland where she originally trained as a pharmacist. After earning her PhD in health services research, studying how patients access health care and how they respond to treatment, she began doing clinical trials in surgery and family medicine. Since moving to Canada in 1999, her research has focused on obstetrics and gynecology. She now spends the majority of her working time in Edmonton, with three or four days a month in Calgary, maintaining research projects in both cities. “My goal is to lead Alberta- and Canada-wide research,” says Ross, adding that the Cavarzan Chair in Mature Women’s Health Research at the Lois Hole “has been the most fantastic experience I could have imagined in many ways.” She was awarded the chair in 2012, and until then she had been balancing her time between research and teaching responsibilities. Her position at the hospital means she is able to focus on research and writing full time. Ross’s research aims to ensure that clinical treatments are safe and effective for problems that commonly affect mature women, such as pelvic floor disorders (including leaking urine and feces) and pelvic organ prolapse (where the uterus or other pelvic organs bulge into the vagina), and problems associated with menopause. These disorders cause women significant distress and adversely affect quality of life. Ross’s goal is to help women and their doctors to make the best treatment decisions. Ross has led clinical trials, testing the efficacy and safety of new treatments for pelvic floor disorders, but her work is now The Lois Hole Hospital for Women

taking a different approach “I want to look at the prevalence, cost and impact of pelvic floor disorders in Canada,” she says. “There are some vague numbers, but you cannot get an idea of how widespread pelvic floor disorders really are, and people feel stigmatized if their symptoms are severe.” This is also a work in progress for Ross. Recently, she and her multidisciplinary research team were given access to national data from family physician clinics across the country in regards to this research. “When you work at a hospital, you get the impression that it’s a really big deal, but of course the people who come in are only the tip of the iceberg,” she says. The study helps target treatments and provides estimates of increase to the clinical workload as the population ages and the number of women with these disorders increases. Ross and her team have been working with the multidisciplinary menopause clinics in Edmonton to introduce a quality of life measurement, adding this to existing symptom measurements. The added questionnaire will provide insight into if and how much menopause impacts a woman’s quality of life. The measurement builds on the team’s other research to explore the best types of treatment for women with difficult menopause. Dr. Ross currently has a number of papers in development with various other researchers and scholars across Canada, and she is designing studies and guiding them through to funding, research and publication. “It’s the writing that takes the time,” she says, noting that she’s interested in learning more about communicating her work with the public. She says her time at the Lois Hole Hospital for Women has been eye-opening. “I get to work with lots of interesting people and learn new things every day,” she says. She makes sure that researchers ask questions that generate novel and useful answers. “It’s important that I’m present at the hospital interacting every day with clinicians and patients.” While it might seem that Ross is stretched thin between projects, it’s this all-encompassing work ethic that makes her work stand out. “Sticking to your passions against all the odds can really pay off,” she says. www.loisholehospital.com

RADHA CHARI Grew up in: Swift Current, Saskatchewan Studied at: The University of Saskatchewan, with internships and residencies at the University of Western Ontario, University of Alberta and the University of Tennessee Spends her free time: Hanging out with her husband Ravi and her two sons, Keshav and Nik.Drives her family crazy by setting clocks and watches 20-30 minutes ahead so that she’s not running late

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Spring 2015 • Hope

FOLLOWING YOUR PASSIONS IS A

LYNNE POSTOVIT Grew up in: Whitby, Ontario Studied at: Queen’s University Spends her free time: Running, rowing and cooking. Likes to play music loudly in her car and sing along to whatever’s on the radio

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sentiment that everyone at the Lois Hole Hospital for Women can get behind. The foundation’s research chairs all conduct their work from the hospital, and they are all dedicated to women’s health, and bringing to the forefront a field that has been traditionally underfunded. Part of how they stick to their guns is through a commitment to community, and working together to create an atmosphere that embraces multidisciplinary solutions. “When we’re asking big questions, the only way we’ll get answers is by working as a team and bringing all of our expertise into the fold,” says Dr. Lynne-Marie Postovit. Dr. Postovit has done groundbreaking research in the field of tumour progression, and has been the Sawin-Baldwin Chair in Ovarian Cancer at the Lois Hole Hospital for Women since taking up the post in 2013. She also holds positions at the University of Alberta, the Cancer Institute of Northern Alberta and is the Alberta Innovates-Health Solutions Translational Health Chair in Cancer. Postovit has a PhD in anatomy and cell biology, and has spent her time considering how the environment surrounding a tumour might promote its progression. “We’re trying to understand what causes that, so that we can get in there and prevent it,” she says. As her career progressed she moved her lab from London, Ontario to Edmonton, and started looking at how the stem cell system and cancer cells share similarities. “The focus of our entire program is understanding how an environment can push cancer progression,” she says. Postovit’s work focuses on ovarian and metastatic breast cancers because often they are the hardest to treat successfully. In her ovarian cancer research, Postovit is hunting for a way to diagnose the disease earlier – most ovarian cancers go undetected until they are diagnosed in stage three or four, and at that point they have a low cure rate. “So we need a way to be able to detect this earlier, at stage one, for example. One of the things we’re doing is trying to find biomarkers for ovarian cancer,” she says, noting that it’s a team of researchers working together on this work. “We’re doing this by looking at patient samples and using highThe Lois Hole Hospital for Women

end techniques to try to discover what these cells might be secreting into their microenvironment so we might detect it as an early marker.” She also notes that, for now, there will always be women who have their cancers detected too late. “We’re trying to find targets that might prevent recurrence,” she says. It’s the teamwork that Dr. Postovit finds most imperative. “When you’re asking large questions, the only way to get answers is by working as a team and bringing our expertise into the fold,” she says. “This ranges from understanding the progression of the disease to surgically removing it to analyzing it and designing clinical trials.” She is motivated by her patients, and she enjoys interacting with them through her findings. “It’s a reminder of how much needs to be done,” she says. “I want the work we’re doing to make a difference. That might mean finding a eureka moment, or it might mean slowly improving outcomes.”

me, it’s a real growing opportunity, also working with neonatologists and pediatricians in Edmonton and Calgary,” she says. Collaboration is key to Dr. Chari’s work. She recently began working with researchers from the University of Alberta’s physical education and recreation faculty, considering the effects of exercise on fetal growth. “This is beyond the faculty of medicine, which I am finding exciting,” she says. As a vice-president for the Society of Obstetrics

ent areas of interest, which I think is a really great thing,” says Dr. Chari. “Obstetrics and gynecology is vast and covers a broad area. It’s becoming more important that we link our research to clinical practice.” She believes that when everyone works together, from basic scientists to clinicians, the findings are stronger and more relevant than research that exists in isolation. The goal is to apply their knowledge to patient care, improving the work that happens at the hospital. “There are things that are going to be relevant to clinical practice,” says Chari. Working that knowledge into practice is her goal. “It’s connecting across a continuum, taking research to the bedside.” The support that an institution like the Lois Hole Hospital for Women can give to researchers like Drs. Ross, Chari and Postovit is invaluable. “We hope that we can be one of the leading centres nationally, and even internationally,” Postovit says. All three researchers are deepening the expertise of the institution and the field. Postovit says she was excited to come to a community that demonstrates leadership in valuing women’s health. They want to make a difference. “We’re representing early discovery all the way through to translation,” says Postovit. “We come up with a lot of great ideas and leads, but eventually we need to be able to help the patients.”

“When you’re asking large questions, the only way to get answers is by working as a team and bringing our expertise into the fold.”

SLOWLY IMPROVING OUTCOMES seems to be the case. And because it’s the kind of work that takes a long-haul commitment, all of the researchers associated with the Lois Hole Hospital for Women need to be incredibly self-motivated, each of them wearing so many hats (or occupying so many positions) that it can be hard to keep them straight. Dr. Radha Chari has taken on so many projects that she keeps them in a bullet point list. She is the women’s health zone clinical department head at the Lois Hole Hospital for Women, and chair and associate professor in the department of obstetrics and gynecology at the University of Alberta. Her work stretches across northern Alberta and into the Northwest Territories, and she has numerous research projects underway. A maternal-fetal medicine specialist for two decades, high-risk pregnancies are Dr. Chari’s realm, and she has worked to develop consultation programs in northern and central Alberta with cardiology, urology and neurology experts in pediatrics. “To www.loisholehospital.com

and Gynecology of Canada, Chari is helping to revamp the process the society follows when it comes to implementing guidelines for its ob-gyn members. She sees this as a way to contribute directly to women’s health, as it targets not only ob-gyns but also family physicians, midwives, nurses and administrators. “I have always had a real interest in women’s health, and am hoping to contribute to it,” she says. “I want to make a difference in improving how we do things.” It’s this quest for new knowledge that she hopes to apply directly to advancements in patient care. Chari was involved in applying new technology to determine fetal prognosis, and was part of a team that developed MRI reference ranges to help predict newborn lung function. She has also been the lead researcher on a national trial looking at the management of preterm pre-labour rupture of the membranes (PPROM) in patients between 32 and 37 weeks’ gestation, and its impact on neonatal outcome. She currently works with basic scientists in pediatrics to evaluate perinatal management and pediatric health outcomes. Working together at the Lois Hole Hospital for Women will give the research chairs an opportunity to strengthen their research and collaborate at the regional and provincial level. “We’re all different, we all have differ5 Years of Caring

HOPE NOTES There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something better tomorrow. - Orison Marden

Spring 2015 • Hope

Women and Children First WCHRI supports research excellence in a field that has been neglected in the past WOMEN AND CHILDREN HAVE LONG been overlooked and underfunded when it comes to health research. That fact is behind the 2006 genesis of WCHRI. Short for the Women and Children’s Health Research Institute, insiders pronounce the acronym Wick-ree, and there are a number of funders behind it, namely the Royal Alexandra Hospital Foundation, Stollery Children’s Hospital Foundation, the University of Alberta and Alberta Health Services. WCHRI is the only combined research institute in Canada focusing on women’s (including maternal and perinatal) and children’s health. With a web of research and care professionals at the Lois Hole Hospital for Women, the Stollery and the University of Alberta Hospital, it boasts 350 members devoted to women’s and children’s health concerns, ranging from chronic pediatric illnesses to mature women’s health.

Women’s worth in health care exists apart from the realm of maternal health Its director, Dr. Sandy Davidge (also a professor in the departments of ob-gyn and physiology, and a tier-one Canada Research Chair in Women’s Cardiovascular Health) says WCHRI represents just the tip of the iceberg of the potential depth and breadth of women’s health, especially at the Lois Hole Hospital for Women. “With a researchoriented hospital – which is what we’re striving for – women get the best care. We’re at the forefront of knowledge and the

Hope • Spring 2015

forefront of clinicians working hand-inhand with scientists for the best available medicines and procedures,” says Davidge, who’s also the Canada Research Chair in Maternal and Perinatal Cardiovascular Health. “Research saves lives and gives hope, and we want to do that for our women and children.” In addition to three endowed chairs in women’s health, WCHRI supports research excellence through grants, ranging from graduate work to summer studentships. WCHRI also supports the recruitment and retention of the best and the brightest minds in research. And it translates to better health care for Alberta women. “Through our research and our programs, we have been able to look at better ways to improve the health of women in the community,” Davidge explains. “We have three endowed chairs in the areas of mature women’s health, women’s health focusing on maternal, and ovarian cancer. We need to see the research behind women’s health to understand the best way to treat or prevent disease.” Recent initiatives to receive WCHRI support include Davidge’s own study looking at the link between babies who have complicated births and who later in life experience obesity, diabetes and cardiovascular disease. Acknowledging this potential connection may help prevent chronic diseases down the road. But that’s just one of myriad WCHRI studies focusing on pregnancy. “One of the things we’ve been working on in general is looking at healthy pregnancies and health outcomes,” Davidge notes. “To lead to better therapies, we are looking at how the body adapts to pregnancy and what can go wrong in conditions such as preeclampsia.” Other research includes Drs. John Mackey and Ing 5 Years of Caring

AT WORK: Dr. Sandy Davidge is the director of Women and Children’s Health Research Institute. Swie Goping’s work towards personalizing chemotherapy for breast cancer patients. More than just a health consortium, WCHRI is a medium designed to bring bench work to the bedside and the community and back, says Davidge. “If you are sick, where do you want to go? You want to go to a research-intensive hospital for up-to-date, current care. Because we have WCHRI, we are able to make sure we focus on the health needs of women.” Women’s worth in health care exists apart from the realm of maternal health, so recent WCHRI research encompasses all aspects of women’s health. “We actually do research in all women’s health issues, whether that is mental health, mature women’s health issues, or urogynecological issues,” says Davidge. “We are the only women’s health research institute of its kind. We’ve been able to cover the spectrum because of the vision and the partnership.” The Lois Hole Hospital for Women

THE

LOIS HOLE HOSPITAL FOR WOMEN

and so much more

By understanding and meeting the unique health needs of women, we also support newborns, families and communities.

Our thanks to those who do more for patients and families at the Lois Hole Hospital for Women: our dedicated staff, physicians, volunteers and donors of the Royal Alexandra Hospital Foundation.

celebrating 5 years of care & innovation

Hope â&#x20AC;˘ Spring 2015

5 Years of Caring

The Lois Hole Hospital for Women

Lois Hole Hospital for Women has placed an importance on its art collection from the beginning BY LISA CATTERALL • PHOTOGRAPHY BY DARRYL PROPP

HOTOGRAPHS, PAINTINGS, SCULPTURES AND DECORATIVE TEXTILES

sound like items likelier to adorn an art gallery than a hospital. Patients and families don’t often expect to find unique pieces of artwork in every hallway, much less in every waiting room or at the foot of every patient bed. In an August 18, 2014 article she wrote for the Wall Street Journal online, Laura Landro details the efforts of many American hospitals to incorporate art into hallways as a way to boost patient care, citing studies to support the claim that art can encourage healing by reducing stress and anxiety levels. Nature-inspired artwork, she says, can create a warm environment that allows patients, families and staff to feel secure. With more than 700 pieces of art, the Lois Hole Hospital for Women has created this kind of environment, one in which patients, families and staff can thrive.

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5 Years of Caring

Spring 2015 • Hope

The hospital’s art collection is valued at more than $1 million and features a range of Canadian artists. The majority of these artists come from Alberta, with the remainder coming from the surrounding provinces and territories that patients call home. Local art consultant Susan Pointe was a part of the hospital’s development from its early stages. She honed her expertise in the healing power of art and its ability to strengthen a community through years of working with local artists and hospitals. When she began work on the Lois Hole Hospital for Women, she looked to other facilities well-known for their art collections, such as Oslo’s Rikshospitalet, home to Norway’s largest collection of public art outside of its museums, as sources of inspiration. She wanted to create a similar public venue for art in Alberta, reflecting on the province’s talent and beauty.

HOPE NOTES Hope is the thing with feathers that perches in the soul - and sings the tune without words and never stops - at all. - Emily Dickinson

“This project was evidence of a flourishing creative spirit. It was original, local artwork. And if it wasn’t local, it was from other regions from where we drew patients,” Pointe says. “It was evidence of the thriving creative community that was around this facility.” When plans for the Lois Hole Hospital for Women began more than a decade ago, very little was known about the final outcome and what role, if any, art would play in the space. So before Pointe could begin curating the collection, architects and designers had to build the facilities with art in mind. Lead interior designer Michelle Sigurdson of Dialog Design (then Cohos Evamy) first became

Hope • Spring 2015

involved with the project in 2002, and spent the next several years working to save spaces for the collection Pointe was developing. “We had to keep all of the devices off of certain walls,” Sigurdson says. “To keep those walls preserved without anything on them is a feat in itself.” “A tremendous amount of credit is owed to the Royal Alexandra Hospital Foundation for the tenacity to hang on to the budget for original art on a project of this size,” adds Pointe. Each day, as patients, families and staff move throughout the hospital, they experience a range of emotions. From the happiness of a new life to the anxiety of the 5 Years of Caring

unknown, hospital walls are witness to the complete gamut of human emotion and interaction. The belief behind the hospital’s design was that nature could provide an outlet for people to better cope and heal. “The art becomes another window to look out,” Sigurdson says. She and Pointe both stress that nature, light and humour were all very important elements in the art selection process for the hospital, as these elements encourage healing and well-being. The hospital focuses on wellness as a whole, rather than treating environment and health as separate aspects of well-being. While the hospital is not the first of its kind in North America, it is the first in the provThe Lois Hole Hospital for Women

ince to place an emphasis on including art throughout all aspects of the design. Art installations are featured both inside the hospital and out, with pieces that can be viewed from a number of different angles. One of the most prominent pieces, a steel bird’s nest precariously perched on a beam outside the Robbins Pavilion, was designed to create a hopeful focal point from the long corridors on every floor of the hospital. “It looks so different from every level. It’s for people that are going to be there more than once,” Sigurdson says. “You see somewww.loisholehospital.com

thing different every time you’re there.” Each floor, waiting room and unit of the hospital features a different artist and style. In addition to providing places of reflection and beauty, the intent was to create a series of landmarks for visitors, patients and families. The result is a delightful roadmap. People can take the stairwell near a giant beaded bracelet or turn left at a three-part painting that looks like a window into a summer scene. They might orient themselves to take the hallway with the bright painted poppy at the end. 5 Years of Caring

“We put fewer signs up for way finding because the art is memorable,” Sigurdson says. When the project began, Pointe set out curating the work from the roster of artists she had come to know through her work as an art consultant. She put out a call for submissions and worked to find pieces that would fit with the hospital’s needs. Once they received the submissions, a committee of designers vetted the pieces. Staff and foundation members wanted to ensure that the art would fit well with the hospital’s Spring 2015 • Hope

needs and would remain on permanent display on the facility’s walls. “There were artists that spoke to a very diverse committee, and everybody had their favourites,” Sigurdson says. “Having that diversity in the committee really spoke to how things change after you live with them after a while.” Pointe’s choices for the pieces in the collection were governed by wit, humour, whimsy and lightheartedness. Many of the artists took these criteria into consideration when submitting pieces to the committee. Artists like St. Albert’s Akemi Matsubuchi were excited with the opportunity to participate in a project of this scale. “It was a big project to be involved in, and a great one,” Matsubuchi says. She had previously worked as a photographer with Hole’s Greenhouses and Gardens, and was happy to have her work placed on

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permanent display in the hospital’s postpartum ward. In order to ensure the group of artists featured was as diverse as the patient base itself, the committee turned to aboriginal artist Sharon Rose Kootenay to curate the hospital’s collection of aboriginal women’s artwork. She gathered the collection from a wide range of artists and crafters, encouraging them to submit their best work. An

5 Years of Caring

artist herself, Kootenay and her husband Camille contributed two pieces to the hospital’s collection. “It was a watershed moment for a lot of people in their careers. Speaking on behalf of the artists, it was a privilege for everybody to be involved,” Kootenay says. In the end, it has been the work of the foundation, designers, consultants, artists and the greater community that has shaped

The Lois Hole Hospital for Women

True Originals

The Lois Hole Hospital for Women counts among its collection a number of pieces that Sharon Rose Kootenay curated and recommended. The committee responsible for selecting the hospital’s art wanted pieces that represented the entire patient base, including aboriginal women from the city and far-flung communities. This included artwork from: • The Aboriginal Women’s Art Collection, featuring the work of 15 aboriginal artists, ranging in age from 13 to mid-90s • Communities encompassing Plains Cree, Woodland Cree, Dene, Métis, Aseniwuche Winewak, Blackfoot, Nakoda and Inuit art from around the Northwest Territories, Alberta, Saskatchewan and Manitoba • A range of art mediums and methods. They include beadwork, quill work, paintings, fabric, drawings, leatherwork and birch bark biting.

the Lois Hole Hospital for Women to its present state. The interactions of these stories have woven a web around the hospital – a masterpiece in itself. “I think stories are so important, and how we tell our stories – and how our buildings, our art, our interiors tell stories – is how people connect,” says Sigurdson. “It’s so much more than the built environment – it’s got to have a story.” Ultimately, the art collection in the hospital is now a small part of the stories of the thousands of women, children and families passing through the halls each day.

www.loisholehospital.com

5 Years of Caring

Spring 2015 • Hope

BLOOM: Renowned as much for her garden savvy as her compassion and dedication to the community, Lois Hole left a legacy.

Hope â&#x20AC;˘ Spring 2015

5 Years of Caring

The Lois Hole Hospital for Women

Meet the lady behind the name of the Lois Hole Hospital for Women and find out how she managed to unite and delight Albertans BY LANI LUPUL • ILLUSTRATION BY RAYMOND REID

HE MET THE QUEEN OF ENGLAND ONCE AND SHE WAS ROYALTY

herself, kind of. People called Lois Hole the Queen of Hugs. A woman who carried multiple titles in her lifetime, Lois was like none other. A wife, a mother, professional gardener, author, businesswoman, farmer, chancellor, and in her final years, Lieutenant Governor of Alberta, Lois brought grace and warmth to each role. That grace and warmth now live on in the legacy of the Lois Hole Hospital for Women. Born in rural Buchanan, Saskatchewan on January 30, 1929, Lois Elsa Veregin was twin to brother Ray, and older sister to brother Lorne. Their father was a cattle buyer and their mother a housewife with an avid interest in gardening. Lois grew up with a feverish interest in music, books and learning, and had a natural gift for speaking. At one Sunday morning church service in her early teens, the minister was delayed and the congregation sat fidgeting in their seats as they waited. Lois took note of the crowd’s need for leadership and rose to the pulpit. She shared a little about Jesus, and a little about some other things and, though she wasn’t particularly religious, it put her fellow parishioners at ease until the minister arrived. There was just something about young Lois, even from an early age, that set people at ease.

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5 Years of Caring

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It was a time when Saskatchewan had no universal health care. Lois’s aunt, her mother’s twin sister, nearly died of a burst appendix, and she never forgot that moment and how important it is to have health care for all. “I would say that is one of the most formative moments in her life,” says her son Jim. “It stuck with her until the day she died.” When she was a teenager, Lois’s family moved to Edmonton for better opportunities in the cattle business. Lois continued her education and worked towards her Grade 10 level in piano from the Royal Conservatory of Music. But it was when she met Ted Hole in her early 20s that the future Mrs. Lois Hole began to blossom.

ONI HENDIP: Dr. Luptat Vulputpat lamet prat landis henit nulputp atincil luptat. Ud exes duplo catavat.

HOPE NOTES Hope is being able to see that there is light despite all of the darkness. - Desmond Tutu

In her book, I’ll Never Marry a Farmer, Lois credited her parents for giving her the good sense to know when the right man came along. “Ted turned out to be a pretty handsome guy – I thought he looked like Charlton Heston,” she wrote. “He spoke with such passion that I found myself being caught up in the romantic notion of marrying a handsome farmer – despite my childhood vow.” Ted and Lois married in 1952 and bought 185 acres east of St. Albert. Ted had an insatiable love for the earth, and trained in agriculture at the University of Alberta but had little practical knowledge of how to run a farm. They had some lean and educational first few years. They tried everything from pigs, chickens, turkeys and cattle, with mixed success. They were not afraid to try

Hope • Spring 2015

and fail, and were unembarrassed when things didn’t work. Not bound by convention or stressed by any ideas of how things had to be done, Ted and Lois were able to experiment and navigate farm life. As their family grew, so did their garden. Bill and Jim were born in 1955 and 1956, and became young students under the tutelage of their parents. From learning to debate with visitors around the kitchen table to mastering how to grow colorful marigolds, the Holes cultivated open minds in their family. The future changed for the Holes when one hot summer day some passersby noticed their cucumbers. The visitors offered to purchase some of their garden produce, and Ted and Lois realized they might just have something good going. “She was always prepared to take on new challenges,” Jim says. “She and Dad said they didn’t know a lot about this business of growing vegetables, so they didn’t have any preconceived ideas, and that gave them a lot 5 Years of Caring

of freedom to try new things.” The Holes decided to start a market garden at their farm, selling produce under the trees by the garden. Incorporated in 1979 as Hole’s Greenhouses & Gardens Ltd., the market garden eventually took over their barn. Experimentation was always part of the business and family life at the Hole house. But so was fun. Lois could transform herself from a farmer into a citified woman when she and Ted set out to the opera or a movie. “She didn’t worry about material stuff,” Jim says, “but when she did get dressed up, she looked like a million bucks.” Lois served several terms as trustee on the Sturgeon School Division. Her natural way with the public caught politicians’ eyes more than once, but despite their urgings Lois was never interested in running for office. In 1991, as urban development expanded to their property fence line, the Holes decided it was time to leave farming and focus on the greenhouse and garden centre business The Lois Hole Hospital for Women

in St. Albert – Hole’s Greenhouse – that has since grown into one of the largest retail greenhouse operations in Western Canada. Albertans know it today as the Enjoy Centre, which opened in 2011. With her vast knowledge of gardening, Lois became a contributor to CBC radio, the Globe and Mail, the Edmonton Sun and the Edmonton Journal. She began to write, and published her first book, Northern Vegetable Gardening (later rereleased as Lois Hole’s Vegetable Favourites) in 1993. It was soon followed by five more books in the Favourites series. This series now has sold more than a million copies and continues to be among the top-selling gardening books in Canada. “Lois Hole” became a household name. With her warmth in her public speeches, she made people feel like they were in her living room as she weaved in stories of family and gardening. In 1998, Lois widened her influence again, becoming Chancellor at the University of Alberta. That role would eventually open the door to her final post, as lieutenant-governor in February 2000; she was the second woman in Alberta’s history to carry this honour. “She respected that position to the highest degree,” Jim says. “She was the Queen’s representative.” The Government of Alberta was rebuilding in the aftermath of economic uncertainties of the 1990s. Lois saw it as an opportunity to lend her voice to change and add some humour, understanding that she was there to represent the Crown. “She was first and foremost a people person,” Jim says. “She had an incredible ability to relate to anyone. I have yet to see anybody that could match that.” She got as many hugs as she gave. Even as lieutenant-governor, Lois made it a priority to get home to the farm and join her boys at lunchtime. With three family houses on the property, the extended family would gather around Lois’s kitchen table – a mealtime that was always precious to her. “She was still worried, in the back of her mind, that we wouldn’t feed ourselves,” Jim says with a laugh. Unfortunately, during her term in office, Ted died of prostate cancer in 2003. Lois her-

self was diagnosed with abdominal cancer, and began treatment that same year. Any opportunity she had, Lois still spoke of her passion for education and health care. “Both

Kereliuk wanted to help Lois to learn the value of saying a gracious “no” occasionally. Once, when Kereliuk was running to meet Lois at the greenhouse for some important business, she found Lois still clad in her green galoshes and her heavy work coat, looking like one of the workers. As Lois and Kereliuk walked by a payphone, the customer using it recognized Lois and hailed her, asking if she’d speak to the woman’s sister – a big fan – on the phone. Lois obliged happily, speaking to the stranger at length while Kereliuk waited. Even with declining health, it was Lois’s way with people – her listening ear and how that left them feeling heard – that made Kereliuk realize she was the one who’d been taught. “Rather than me teaching her the importance of saying no,” Kereliuk says, “she taught me the importance of saying yes. She was extremely kind, compassionate and caring. She was also an extremely strong

“Rather than me teaching her the importance of saying no,” recalls Sandy Kereliuk, “she taught me the importance of saying yes.”

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mom and dad were optimistic through their illnesses,” Jim says. “Mom just never seemed to get down.” Sandy Kereliuk was Lois’s private secretary for many years, including the last year of her life as lieutenant-governor, and the two developed a strong bond. “Those passions came out in most everything she did,” Kereliuk says. When Kereliuk first began working with Lois, she noticed the way she never said no to anyone and – with her busy schedule – 5 Years of Caring

Spring 2015 • Hope

woman, even when she was going through the illness and death of her husband. There were only two times I ever saw tears in her eyes.” One of those times was when Dale Sheard and Grant Ericksen, board members from the Royal Alexandra Hospital Foundation, along with foundation President and CEO Andrew Otway arrived at the office of the lieutenant governor to ask if Lois would allow a new women’s hospital to be named in her honour.

HOPE NOTES We must accept finite disappointment, but never lose infinite hope.

– Martin Luther King, Jr.

“We knew of Lois Hole’s reputation and we knew if we could apply that preeminent image to the new women’s hospital it would be hugely meaningful. We also knew it would galvanize community support for the hospital,” says Dale Sheard. “Mrs. Hole knew this too, and she was happy and honoured that her name would help garner support.” Lois was visibly moved, and she shed some tears. “If any hospital had asked me to do this it would’ve been an honour,” Lois told the group. “But the Royal Alex has always been my family’s hospital and it’s where my husband went, and where I’ve been treated. I’m just so thrilled to do this. I can’t wait to tell my boys about this!” The formal announcement of the hospital naming was made in November, 2004 and was attended by dignitaries and media. By this time, Lois, who had been ill with cancer as lieutenant-governor, was now hospitalized at the Royal Alex. Despite being gravely ill, Lois insisted on attending and, after a

Hope • Spring 2015

FARM TEAM: Ted and Lois Hole weren’t afraid of new ideas and took failed ideas as lessons on the road to success.

visit from hair and makeup, she took her place on the stage in a wheelchair. Lois mustered the strength to stand and take the podium to deliver her address. She was radi-

the housekeeper to the CEO of the hospital. It made no difference to Lois where you went in life or what kind of person you were.” Burgess reports that Lois maintained her Queen of Hugs title effortlessly while she was in hospital, doling out her warm embraces to those who needed to get or give one. “I definitely felt honoured that I had come into her life at that time when ant and her emotional speech centred on she needed the support.” one word: Hope. As she lay in her hospital bed at the Royal “So my hope is that when people come to Alex in those final days, Lois looked out her this new hospital and see my name, they’re window towards the future site of the Lois going to have a little extra hope – that real, Hole Hospital for Women. As friends and uplifting hope – that things will turn out family came, she would say, “Did you OK.” It was her last public appearance, and know they’re going to build a hospital two months later, Lois died in hospital on out there and put my name on it? Can January 6, 2005. you believe that?” Today, her words of hope inspire patients Whether it was her bright marigolds and and staff every day. juicy tomatoes, her husband and sons, the Isabelle Burgess, a nurse who cared for guests who ate and debated around her Lois during her time in hospital says, “She kitchen table, or every parent she eased with was an exceptional, one-of-a-kind lady. her personal campaign for education, Lois She treated everybody exactly the same from Hole was invested in life to the very end.

“We knew of Lois Hole’s reputation,” says Dale Sheard. “We also knew it would galvanize community support for the hospital.”

5 Years of Caring

The Lois Hole Hospital for Women

Dad was wrong. Money does grow on trees. Thanks to Shoppers Drug Martâ&#x20AC;&#x2122;s Tree of Life campaign, the Lois Hole Hospital for Women has benefited by nearly a half million dollars. To those stores who selected us as their charity of choice, and to all the women who popped in for lipstick and put down a donation too, we thank you. Your generosity has helped us advance care for hundreds of thousands of women since we opened our doors just five short years ago.

Weâ&#x20AC;&#x2122;ve only just begun.

DRIVING FORCE: It was Dale Sheard who first pitched a “hospital within a hospital” idea to the foundation.

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5 Years of Caring

The Lois Hole Hospital for Women

Women’s Advocate Edmonton philanthropist Dale Sheard played a major role in the creation of the Lois Hole Hospital for Women BY CAITLIN CRAWSHAW • PHOTOGRAPHY BY ANTHONY HOULE

HEN DALE SHEARD WAS IN HER EARLY 20s, SHE LOST A GOOD

friend to cancer. An apparently healthy young woman, her friend had few symptoms until being diagnosed with late-stage ovarian cancer. “It was called the silent killer – and it still is,” she says. “By the time you find out you have it, it’s often too late to beat it.” Sheard was living in Toronto with her husband and children. The couple’s IT business was doing well and life was good. But seeing her close friend cut down in the prime of youth shook Sheard to the core – and it made her realize the importance of women’s health care for the first time. When she moved to Edmonton with her family in 1986, Sheard thought it a shame that there wasn’t a women’s hospital in the city. But over the next few years, she watched with interest as women’s health care evolved. It began in the mid-1990s, when women’s health-care services in Edmonton became centralized at the Royal Alexandra Hospital. Then, a few years later, Sheard received a brochure in the mail from the Royal Alexandra Hospital Foundation requesting donations to renovate a new women’s area for the hospital. She immediately picked up the phone and became a donor. When the renovations were finished in 1999, Sheard was invited to come for a tour, led by Andrew Otway, CEO and president of the Royal Alexandra Hospital Foundation. “We had some interesting conversations that day about women’s health,” says Sheard, who left feeling inspired by the work that the foundation was doing. So when she was asked to join the foundation’s board of directors two years later, she was thrilled. Having sold her

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Spring 2015 • Hope

PHOTO: DARRYL PROPP

WALL OF FAME: Sheard mobilized a team that drove the donorship that helped make the hospital happen.

company in 1995, Sheard finally had the time to roll up her sleeves and make a difference in women’s health. But she wanted to do it right. “I thought, ‘If I’m going to sit on the board and provide advice, I want to have the education to do that,’ ” she says. To that end, she enrolled in the MBA program at Royal Roads University, focusing on public relations and strategic communications. For her thesis project, she chose to do a study on the Royal Alexandra Hospital Foundation. “I really got to know the organization very well. I studied the financials, history, the size of the donations,” she says. “I studied its public profile.” Her study revealed that Edmontonians had limited knowledge of what the hospital did. Few people knew the Royal Alexandra Hospital was a teaching and research hospital,

nor that it was a centre for a number of specialized health services, including women’s health, ophthalmology and mental health. “There were so many great things about the Royal Alex the public didn’t know,” she says. In her thesis, Sheard argued that each of the

“Why can’t this be a women’s hospital?” She approached the board’s public relations committee, of which she was a member, and pitched the idea of a hospital within a hospital. “That’s when the idea of a women’s hospital was really born,” says Sharlene Rutherford, vice-president of the Royal Alexandra Hospital Foundation. The board loved the idea and created a new committee to fundraise for and promote the new hospital, with Sheard at the helm. She chaired the capital fundraising campaign, called “A campaign about caring,” and helped raise more than $20 million. “Dale led a team of very talented volunteer fundraisers and staff to set the stage for success for our women’s hospital and bring a new focus to women’s health,” says Rutherford. Sheard credits the A-team of wellknown Edmontonians, Grant Ericksen, Bunny Ferguson, Debby Carlson, Maureen

Few people knew the Royal Alexandra Hospital was a teaching and research hospital, nor that it was a centre for women’s health.

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hospital’s specializations needed to be promoted individually to the public – including women’s health. So when the province approved the construction of a new tower at the Royal Alexandra Hospital in 2002, with five floors dedicated to women’s health, Sheard wondered, 5 Years of Caring

The Lois Hole Hospital for Women

McCaw, Lynn Mandel, and Joe Thompson, who made the fundraising campaign a major success. “It was a dream team – no question about it,” says Sheard. Sheard was also part of the Royal Alexandra Hospital Foundation’s public relations committee that carefully considered a list of stellar Albertans for whom the committee might name the hospital. Lois Hole was the name the committee found to be preeminent. At the time, the garden centre maven and community leader was serving as lieutenant governor, and it took months to get a meeting to ask her permission to use her name. When it finally happened, “she was just speechless and her eyes welled up in tears,” says Sheard. At the time, few people knew that the lieutenant governor was gravely ill with cancer; sadly, she died in January 2005 – long before the April 2010 grand opening of www.loisholehospital.com

the Lois Hole Hospital for Women. But only months before her death, and on the advice of her two sons who knew their mother’s situation was worsening, the foundation held a formal naming ceremony. Lois – who was being cared for at the Royal Alexandra Hospital – left her hospital bed to speak about the initiative. Sheard was moved by her delight in being able to see the future site from the window of her hospital room: “It was gratifying for me to know that she knew she would be leaving this legacy. ” Although Sheard is reluctant to talk about her achievements, she’s creating quite a legacy for herself, too, says Rutherford: “For a woman who’s done as much as she has, she’s quite content to remain under the radar. But she’s a powerful voice in our community.” In addition to her leadership, Sheard has contributed financial resources, too. After donating to the Royal Alexandra Hospital for decades, she became a founder-level donor (contributors of $1 million or more) of the women’s hospital. Most recently, Royal Alexandra Hospital Foundation named Sheard a patron. In fact, her contributions established a research position at the hospital (The Cavarzan Chair in Mature Women’s Health Research at the Lois Hole Hospital for Women). Named for Sheard’s private investment firm, the chair focuses on mature women’s health issues that the public rarely has the opportunity to support, such as urinary incontinence or uterine prolapse. These are health issues that are just not as appealing to donors as, say, prenatal health research, “but you have to support women beyond their childbearing years,” Sheard says. After all, the hospital has always been about supporting women in all stages of life. It’s part of a holistic philosophy in which the hospital cares for women’s minds, bodies and spirits. That’s why Sheard and others involved in the project raised funds for research, new programs, and enhancements to the hospital both large and small, from a rooftop healing

HOPE NOTES When we are no longer able to change a situation, we are challenged to change ourselves. - Viktor E. Frankl

garden to beautiful art throughout and even hairdryers and makeup mirrors in every patient room. “We wanted it to be a place of comfort,” she says. Nearly every aspect of the hospital – from its vision to its outward appearance – has been influenced directly or indirectly by Sheard. It’s why former Royal Alexandra Hospital board member and chair Anne McLellan calls her “the heart and soul of the

Nearly every aspect of the hospital – from its vision to its outward appearance – has been influenced directly or indirectly by Dale Sheard.

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Lois Hole Hospital for Women.” As a longtime politician, McLellan has worked with countless community leaders and says the best ones are like Sheard – eager to see a project succeed, but patient enough to lay the groundwork needed for success: “Her commitment to the hospital was so strong and never wavered.”

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PHOTO: JESSICA FERN-FACETTE

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The Lois Hole Hospital for Women

Higher Learning

The Lois Hole Hospital for Women embraces its place as a leader among teaching facilities

BY MICHAEL HINGSTON

HEN YOU PICTURE A

learning environment, chances are you don’t see scenes of comfort. For many, the word “studying” conjures memories of uncomfortable chairs, rigid rows of wooden desks, and harsh fluorescent lighting. And even in a hospital setting, this assumption often isn’t far from the truth: the rooms can be cramped, the equipment out-of-date, the space generally not built with education in mind. Things are different at Edmonton’s Lois Hole Hospital for Women. Here, education and the teaching process play primary roles in everything that happens under its roof. Even a utilitarian space, such as a stairwell, has the power to brighten a student’s day – literally. “One of the things I love is this staircase on the north side of the building,” Sara Ilnitsky says. She’s a third-year medical resident, and among the first wave to have

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done the entirety of their residencies at the Lois Hole Hospital for Women. “It’s all windows, the whole staircase. When you’ve been on call for 24 hours, and you’re up at 5 a.m., if you have a chance to take the stairs between floors, you can see the sunrise.” In fact, this staircase has become so well known for its restorative powers that residents from all around the hospital make a point of using it at some point during the day. “It has a huge effect on your mood, and your learning day overall.” Creating a space that’s conducive for learning has been a top priority at the Lois Hole Hospital for Women since day one. With more than 70,000 patient visits and over 6,000 deliveries each year, it’s an ideal training ground for the next generation of physicians, nurses and other medical staff in Edmonton. That’s why there are approximately 65 students on site at any given time, learning disciplines ranging from medicine and nursing to psychology,

Spring 2015 • Hope

PHOTO: DARRYL PROPP

HOPE NOTES Man is a creature of hope and invention, both of which belie the idea that things cannot be changed. - Tom Clancy

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physiotherapy, and emergency medical services – all in an environment that’s dedicated to women’s health. The bulk of those learners are medical residents and students, and many of them come from the University of Alberta’s department of obstetrics and gynecology, whose clinical department has operated in the hospital since it opened in 2010. (Before that, it was based in the main Royal Alexandra Hospital site.) Much of the department’s faculty and administrative leadership, too, are based at the hospital, and that proximity leads to more hands-on experience for the students themselves.

“Easily two-thirds to three-quarters of the residency time is here, just because we have the tertiary care services and all the subspecialty rotations,” says Dr. Radha Chari, an associate professor and chair of maternal-fetal medicine at the Lois Hole Hospital for Women and head of the department of obstetrics and gynecology. Chari has worked in maternal-fetal medicine for the past 20 years, and she agrees with Ilnitsky that the quality of life at the Lois Hole Hospital for Women – for students and patients alike – begins with the design of the space itself. “The building is beautiful,” Chari says. “You don’t get the same feeling that you would compared to the old hospital. The layout, the amount of natural light exposure, the way that the building has been designed – it’s really good for patients, and it’s also really good for staff. Even when you wait in waiting rooms, you’re exposed to a lot of sunlight and a lot more space. It’s a huge difference.” The shapes of the rooms themselves have also been modernized. Chari says that in maternal-fetal medicine, patients are now able to watch their own ultrasounds as they’re happening, which wasn’t previously possible. There’s more space for a partner or family members to be present. “It leans more towards patient-centred care than we were able to provide at the old hospital.” There’s also more room for the residents to move around. The resident lounge at the Lois Hole Hospital for Women, for instance, has plenty of windows and a kitchenette, while the resident library includes classroom space and a bay of computers for

The Lois Hole Hospital for Women is an ideal training ground for the next generation of physicians, nurses and other medical staff.

5 Years of Caring

research at the back. “It’s lovely,” Ilnitsky says. “I have not been to a program anywhere else in the country that has that kind of resident space for learning.” Another key to a modern learning environment is the range of facilities on hand. The Lois Hole Hospital for Women

The hospital has several specialized clinics in which students can gain experience, including fertility, urogynecology, gynecologic oncology, and maternal-fetal medicine, which is a national leader in the treatment of high-risk pregnancies. The hospital’s Robbins Learning Centre contains a 181-seat auditorium and three classrooms, each equipped with highdefinition videoconferencing technology (see sidebar). Even more exciting is the state-of-theart simulation centre, which allows residents to practice all of the steps of a labour and delivery – with all of their attendant complications – on advanced mannequins that are designed to mirror the actual responses of both the mother and infant. Other settings for the program include simulating premature births, even twins. The centre, which opened in November 2014, is the first of its kind in Canada. (See a story about the sim centre on page 40.) “Historically, the way people have learned is basically going onto the wards directly. This is a step before that,” says Chari. “This allows for people to get some confidence going through those steps in a structured, protected situation.” Likewise, students can learn a lot from observing skilled surgeons at work, as they operate using the hospital’s dedicated da Vinci surgical robot. (For more on da Vinci, see page 60.) Of course, the most important factor in any educational setting is who’s doing the teaching. And here the Lois Hole Hospital for Women more than measures up. “The nurses that we work with are phenomenal,” says Ilnitsky. “All the other staff are really great to work with as well. They’re great teachers. They’re available. They’re supportive.” Even, she adds, at the end of a 14-hour shift. “It’s hard work. But it’s always a joy to go to work.”

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The Robbins Learning Centre When the Robbins Learning Centre opened to the public in February 2012, then-health minister Fred Horne announced that the high-tech training centre would “enhance health-care teaching” in a way that would “benefit patients across the province.” In fact, that’s an understatement. With its 181-seat auditorium and three classroom spaces, each equipped with audio-visual technology that allows them to digitally connect to other facilities, the Lois Hole Hospital for Women, which is housed in the same building as the Robbins Learning Centre, now has an instant connection not just to the rest of the province, but also the country and even the continent. “We’ve never had anything of that size on the Royal Alex campus at all,” says Dr. Radha Chari, chair of maternalfetal medicine at the Lois Hole Hospital for Women and head of the department of obstetrics and gynecology. She adds that the Robbins Centre isn’t strictly reserved for the women’s hospital, either. “Anybody who works on our site can book the area and use it. That’s been really helpful.” The goal of the centre is, ultimately, to share what happens at the Lois Hole Hospital for Women with other health-

5 Years of Caring

care facilities. Presentations and lectures can be delivered around the continent instantly. Chari already broadcasts her rounds across Western Canada, when the topic is of wider interest to other hospitals, as well as operating suites and classrooms. There are even opportunities for the public to get involved: the centre hosts the Royal Alexandra Foundation’s public-lecture series Speaking of Health, where physicians speak about various health issues in a way that’s accessible to the general public. The centre benefits students within the hospital, too – especially those who remember the old meeting spaces. “We used to go to a tiny little classroom in the old women’s building for the rounds,” says Sara Ilnitsky, a third-year medical resident. “Having them in the Robbins auditorium has made a big different to attendance, and to our ability to learn – it’s just a better set up for our uses.” With its cutting-edge technology, the Robbins Learning Centre has the potential to improve not just the way hospitals communicate with one another, but also the way residents and even the general public learn how the health-care system works. The president and CEO of the Royal Alexandra Hospital Foundation, Andrew Otway, put it best when he described the centre, at its opening, as the “place where learning and health care intersect.”

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GENTLY NOW: The simulation centre allows students to practice before they attend a delivery.

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The Lois Hole Hospital for Women

Noelle talks, sweats, cries, responds to medication and can even hemorrhage – all while she delivers an education BY ROBBIE JEFFREY • PHOTOGRAPHY BY JESSICA FERN-FACETTE

’M HAVING CONTRACTIONS!”

shouts Noelle. “Please help me!” Seven medical students huddle around the hospital bed, eagerly watching the nurse do her best to comfort the loud mother-to-be. “You’re going to have a baby!” the nurse tells her, placing a hand on her shoulder. “DON’T TOUCH ME!” Noelle snaps. The nurse gestures to one of the students, Krystyn Popowycz, to put on gloves and a scrub top, and she drapes a gown across Noelle’s abdomen. This is the student’s first time in a delivery room, and while Popowycz knows what she’s doing, her movements are a little tentative, her approach cautious. “I really have to go to the bathroom,” says Noelle.

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5 Years of Caring

Suddenly, Noelle’s cervix starts to dilate. “The baby is coming!” she yells. Popowycz readies herself, and the nurse tells her to get closer. “You’ll only know how to do this when you actually do it yourself,” the nurse says. Popowycz prepares to cradle the baby as its head emerges. Noelle wails like a banshee. Then Noelle goes quiet, as if her whole body is shutting down.

WHEN YOU WALK INTO ROOM GS212 in the Lois Hole Hospital for Women in Edmonton – “a hospital within a hospital” at the Royal Alexandra Hospital – turn right, and you’ll see a piece of paper stuck to the wall with Scotch tape. “Fiction contract: Participants make a sincere effort to immerse

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themselves in the simulation, in spite of any gaps in realism,” it reads. “In turn the Simulation Team will strive to eliminate those gaps in realism by thorough participation and delivery of simulation.” GS212 is the hospital’s newly built simulation lab, where students, physicians and nurses participate in recreations of medical events. The star actors – of which Noelle is one – are robotic mannequins, or “simulators,” and the lot of them cost the hospital $650,000. They are expensive, but the hospital was able to keep the investment to a relatively low $1.2 million, (raised through community support) using existing space in the building rather than renovating. Now, the hospital boasts Canada’s premier simulation centre tailored for women’s health. No one will mistake these simulators for real patients, though with her characteristic shouts and snowflake-pattern pyjamas, Noelle certainly has a personality. But these simulators are not overpriced dolls; they are technological marvels. Noelle blinks, she has a pulse, she has measurable blood pressure, she accepts a feeding tube, her chest rises and falls as she breathes and she can go into shock. She can faithfully replicate disease states. She has blood reservoirs in her side and can be hooked up to an IV, and perhaps most impressively, state-of-the-art drug recognition software means she responds to drugs just as a real-life patient would. And all of the equipment connected to Noelle is identical to what you’d find on the hospital floor. Noelle also gives birth to a simulator baby. (The dual-simulator birth is the lab’s most talked-about attraction.) Her stomach opens up to reveal what looks like a mechanical spool, which slowly pushes out the infant. The students today are getting used to the procedural aspects of childbirth – putting on gowns and gloves, saying the right things to the mother, and using the proper equipment. Andrew Otway, president and CEO of the Royal Alexandra Hospital Foundation, says the idea for the simulation lab was proposed by the hospital in 2011, as part of a two-stage approach. “Initially, there was the concept of the education centre,” he says. “As a foundation, our board was really supportive

of the educational component of the simulators.” The hospital houses renowned teaching facilities. “Then the idea grew to providing a permanent home for the simulators, one that enhances educational capacity, providing the technology to record and debrief on the

asset,” he says. Traditionally, the aviation industry and the military have been leaders in simulation technology. Otway wants to make women’s health a contender. The simulation lab’s benefits are many. Students get first-time exposure to common procedures, while doctors and nurses run through situations they might otherwise experience just once or twice in their career. “Exposure to these scenarios in a controlled setting allows you to develop reflexes for what you’ll be doing when you encounter that situation,” says Dr. Venu Jain, an associate professor in obstetrics and gynecology at the University of Alberta and a staff physician in the maternal fetal medicine clinic at the Lois Hole Hospital for Women. “Almost any scenario you can think of can be simulated – whether obstetrical, gynecological or more general.” Dr. Jain says that prior to the centre’s opening in 2014, the simulation programs

“Simulation is about trying to recreate not only the medical parts,” says Dr. Venu Jain, “but communication and interaction as well.”

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process as well.” The foundation believed that there’d be an uptake in use – with everyone from nursing students to staff physicians – if the lab were a permanent fixture. And while the lab is relatively new, Otway has received encouraging feedback from almost everyone involved. “Even for very experienced practitioners in women’s health, this is seen as a valuable 5 Years of Caring

The Lois Hole Hospital for Women

Rhonda VanThournout

Dr. Venu Jain

were spread throughout different locations in the hospital. The facility needed a centralized and streamlined simulation site, “where all different aspects of simulation are available and it’s dedicated specifically to women’s health care.” Today the centre comprises three rooms under one banner. There’s a prep room filled with torsos, bottles of Altered FX blood and stretchers on which spare full-body mannequins lie; a control room, from which someone can speak through a microphone and control an array of variables; and the main lab room, where a group of students watched Krystyn Popowycz deliver Noelle’s baby. “The difficult part is learning new techniques and procedures to keep patients safe,” says Popowycz, after prodding Noelle’s uterus and dabbing the placenta for blood. Proving the nurse’s point, she adds, “It’s valuable to practise your steps – you can read steps one through 30, but until you actually do it, it’s not the same.” After the students leave, Rhonda VanThournout opens a keypad-entry door to the www.loisholehospital.com

control room, which hides behind the lab’s one-way mirror. The room looks like a makeshift radio studio, complete with monitors and a mixing board for several microphones. VanThournout, a nurse at the hospital who has been overseeing the “birth,” explains the behind-the-scenes adjustments that make each session different from the last. “I can actually have someone with a script controlling her voice and actions,” she says of Noelle. “She can be as real as we want her to be. We can even make her turn blue.” The lab is outfitted with three video cameras that redirect to the control room, where VanThournout records them for review. She can add actors into the fray to mimic the mother’s partner or parent. She can even direct the sessions to focus on a specific objective: Today, for example, she had the students learn a normal vaginal delivery. Tomorrow, she could customize a session to focus on teamwork or professionalism. And she can command an overhead microphone – the “voice of God,”as she says – to give advice. 5 Years of Caring

But lest anyone feel overwhelmed, everyone is briefed before they begin so they know how much control VanThournout has over the session. “We’re putting experienced professionals through a high-stress situation, which can be uneasy for people,” she says. “Part of the brief is to make them feel safe.” It gets to the heart of the simulation lab’s purpose: a productive suspension of disbelief that aims to educate. “Essentially, simulation is about trying to recreate not only the medical parts but the communication and interaction parts as well, whether it’s low-tech or high-tech” says Dr. Jain. The fiction contract that is taped to the door can seem redundant – Noelle is fooling no one – but at the same time, student participants become engrossed despite the “gaps in realism.” It is a reminder of the cognitive dissonance that’s crucial to learning these kinds of skills, the kind of belief and disbelief that makes you think, if only for the briefest of moments, that once the lights are turned off and the door is closed, Noelle still blinks. Spring 2015 • Hope

High Tech High Touch BY CAROLINE BARLOTT • PHOTOGRAPHY BY BUFFY GOODMAN

The Lois Hole Hospital for Women serves a diverse demographic with state-of-the-art technology in an atmosphere of genuine caring

EVERAL LARGE APOTHOCARY JARS IN

various colours are lined up in the lower level courtyard at the Lois Hole Hospital for Women outside a bank of windows lining an airy corridor. But look closer and the real purpose of the art installation becomes apparent. The spaces between the jars look like the silhouettes of women, demonstrating an attention to detail that’s found throughout the hospital, celebrating its fifth anniversary this year.

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5 Years of Caring

The Lois Hole Hospital for Women

ALL FOR ONE: Nurse manager Nomagugu Moyo understands that as varied as the circumstances of her patients are, their desire to improve their lives is universal.

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The 33,450-square-metre facility on the Royal Alexandra Hospital campus was built with the details in mind – in terms of technological advances and the latest in medical services that help women from all cultures and backgrounds. State-of-the-art equipment is in place for women facing high risk pregnancies, gynecological surgeries, fertility problems, cancer treatments and many other medical situations. “We are located in the heart of downtown Edmonton and are fortunate to serve a population of women with varying cultural and socioeconomic backgrounds, ” says Nomagugu Moyo, nurse manager at the Lois Hole Hospital for Women. “The women may be faced with financial difficulties, challenging family dynamics, childcare concerns, or are facing homelessness. They may be new to the country trying to learn a new language and struggling to figure out how things work here. ”

HOPE NOTES People will forget what you said, people will forget what you did, but people will never forget how you made them feel. - Maya Angelou

But regardless of the situation, Moyo says, the women have similar needs and desires – and the hospital strives to not only meet their immediate medical situations, but to improve their lives overall. If a woman comes to the centre for a specific medical concern, but she is also struggling with issues related to immigration, for example, staff at the hospital find resources to help. Moyo says that the hospital also reaches out to the community. Last year, she went to the Africa Centre to provide health information, and simply to ensure that the women she met at the centre are aware of the ser-

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vices offered. Moyo comes from Zimbabwe herself, and says she understands the challenge of moving to a different country and immersing into a new culture. Visiting a hospital can be especially stressful for those unable to articulate their needs clearly due to language challenges. But the Lois Hole Hospital for Women has technology to help – a three-way phone service allows non-English speakers to speak with an interpreter, who then relays the information to a nurse and vice versa. Meanwhile, on-site interpreters in many languages are also available, along with a resource centre that has a variety of materials – including the Canada Food Guide, books and journal articles of interest to patients – in many different languages. Aboriginal culture liaisons can perform ceremonies of all kinds, and provide social and emotional support. And the hospital works with several other groups in Edmonton, so that it can connect patients with the resources that they need even after leaving the hospital. But, Moyo says, the most important way that the hospital helps its patients is through its caring, family-like atmosphere. Kelsey Thiemer agrees; she’s a former patient who, due to complications that had already caused three late miscarriages, was in the hospital for three months prior to giving birth to her son. “The nurses were absolutely amazing. Some of them felt like sisters; some of them felt like best friends,” says Thiemer. “One of them felt like the best aunt in the world.” The hospital itself is set up in a way that’s conducive to connection and comfort. There’s colourful artwork hanging on many walls, floor-to-ceiling windows providing natural light in many areas, and even the hallways sound different from those at most hospitals. The halls are quiet, without any of the jarring and barely intelligible overhead announcements common in older hospitals. Like most hospitals, patients can call for a nurse by pressing buttons on the side of their bed, or even speak directly to them. But unlike many hospitals, the call goes directly to a mobile phone carried by the specific bedside nurse, creating a more personal model of care that extends to the 5 Years of Caring

“We are located in the heart of downtown Edmonton and are fortunate to serve a population of women with varying cultural and socioeconomic backgrounds,” says Moyo.

CARE FOR ALL: Moyo ensures that patients have the resources in place to best deal with their situation during and after care at the Lois Hole Hospital for Women.

nurses’ alcoves, located right outside of patient’s rooms, rather than in a centralized location. The hospital aims to provide a new model of care that is more personal and tailored to the needs of each patient. “We are patient- and family-centred in everything we do. And we’ve made great advances not only in the technology and clinical part of hospital care, but in the manner in which we deliver the care,” says Janie Tyrrell, interim executive director of the Lois Hole Hospital for Women. For Thiemer, that care made her threemonth stay away from her husband and two older children more comfortable than one would expect. Thiemer is from Whitecourt, but because the town does not have the speThe Lois Hole Hospital for Women

The Details

cialized services she needed, she came to the Lois Hole Hospital for Women. While there were many difficult moments, she says, the nurses created the opportunity for genuine connection, including movie nights and heart-felt conversations that she still misses. “I remember the spiritual care staff arranged tea parties and I went to one just before my baby was born,” Thiemer says. As she neared her due date, Thiemer was feeling frustrated and decided she was near enough to term – 35 weeks – that she wanted to go home early – a-two hour drive with no specialized hospital at the other end – but one of the nurses convinced her to stay, at least until she was a week farther along and the baby was safer. The following night, www.loisholehospital.com

Thiemer had her baby. “As far as I’m concerned, she saved my baby’s life,” Thiemer says. “She sat me down and made sure I didn’t do something rash.” During her stay, Thiemer received counselling through mental health services, which provided her with treatment to help prevent postpartum depression, something she had suffered in the past and didn’t want to face again. It was a helpful experience, one that continues to benefit her. “I think for women, whether they’re having a baby or coming in for gynecological services or oncology – the reoccurring theme is how positive the staff are,” says Moyo. “We want to give people a sense that there is hope for a better day.” 5 Years of Caring

The Lois Hole Hospital for Women demonstrates its high tech, high touch care in lots of ways, large and small. • Interactive Bedside Terminals: Each hospital room has a bedside unit that’s basically a multipurpose laptop, stored above the bed, and can be swung down to the patient’s level. The units can be used as any laptop can – as a way to watch movies, surf the Internet, talk on the phone or listen to music. • QUIET, PLEASE: Gone are the days of overhead call bells. Instead, nurses are equipped with cell phones and when patients require assistance, they can connect immediately and privately to their nurse. The system is more direct, efficient, and promotes a quiet environment, more conducive to healing. • CuddleCot System: The cooling bassinet allows bereaved families of infants who have died a longer chance to grieve and say goodbye to their loved one. • Hairdryers: Details for personal grooming include hair dryers and makeup mirrors. • Pictures for Pain: On the wall opposite every bed in the hospital, there is an original piece of artwork, easy for the patient to cast an eye to. The paintings serve to lift the mood, and offer a focal point that can help women cope with pain. • Labour and Delivery: Other health facilities require patients to move into a new room for delivery. The Lois Hole Hospital for Women sets up a family in a single room, where they will stay for labour, delivery and recovery.

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Health Tips

A Gynecological Guide An expert at the Lois Hole Hospital for Women sees women at all ages and in all stages

DR. ERIN BADER HAS BEEN WORKING AS AN OB-GYN (OBSTETRICIAN-

gynecologist) at the Lois Hole Hospital for Women since before it officially opened five years ago. As such, she’s a specialist in women’s health at one of Canada’s leading research hospitals. The women she sees have usually been referred to her by a primary care physician. “It’s not like on TV,” she explains. “You don’t call and book an appointment with an ob-gyn. Your doctor refers you.” Bader says that doctors refer patients for a variety of reasons, depending on the patient’s presentation and on their own repertoire and comfort level with women’s medicine. Bader sees woman at all stages of life for a variety of conditions.

STARTING OUT While it’s rare for Bader to see a child in her practice, there are conditions that bring pediatric patients her way. “A lack of estrogen can cause the labia to stick together,” she says. And she sees young patients who have skin conditions that can affect the genital area, causing redness and itching.

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“Sometimes we see girls with precocious puberty, meaning they have started puberty too early,” she says. These patients are often treated by an endocrinologist who uses medication to put the brakes on the puberty process until the child is older. Sometimes the opposite happens, and Bader will meet an older teenager in her practice who has not yet started menstruating. “Generally, if a girl has not started menstruating by age 16, we should investigate,” she says. Bader’s team will order tests in addition to those the teen’s family doctor may have already carried out. Depending on the reason behind the absence, Bader might again enlist an endocrinologist. To protect a woman’s gynecological health, Bader advises families to take advantage of the free HPV shot available for girls (and now boys) in Alberta in Grade 5. It protects again the strains of human papilloma virus that are behind 70 per cent of cervical cancers. “A woman will still need regular pap tests, though,” she says, “starting at age 21 or three years after her first sexual intercourse, whichever comes later.” 5 Years of Caring

THE MIDDLE YEARS Often Bader will see women in their 20s and 30s who want to get pregnant, but haven’t been able to. By the time Bader sees them, most women will have had at least some fertility testing completed by their family doctor. Tests include evaluating hormone levels at particular times during a woman’s cycle to give doctors insight into how the ovaries are working, so women should take particular care to chart their cycles. Other tests include ultrasounds to examine the ovaries and uterus. Bader might order a hysterosalpingogram, a test in which fluid is flushed through the uterus into the fallopian tubes to see if they are open. Sometimes they are blocked by scar tissue. Causes of scarring include a past STD or an inflammatory condition called endometriosis, a disorder of the uterine lining, which is frequently behind women’s fertility challenges. “And I also see fibroids in women in their 20s, 30s and 40s,” says Bader. “These are benign muscle tumours of the uterus.” Women are sometimes referred to Bader because they have menstrual irregularities. “They might have an absence, or sudden change to the pattern of their periods, or a marked heaviness to the flow. Also, disorders of the vulva, vaginal pain, itchiness and rashes are beyond the scope of many family practitioners and these conditions will often engender a referral to Bader. These problems are not limited to the middle years and can happen at any time in a woman’s life. Bader advises women who have any of these symptoms to see their doctor. The Lois Hole Hospital for Women

who have pre-existing conditions such as heart disease, high blood pressure or diabetes. She also sees women who have lost pregnancies in the past due to (for example) a condition such as incompetent cervix that can cause them to deliver too early. The Lois Hole Hospital for Women is a national leader in complicated and high-risk pregnancies, and Bader and her colleagues offer specialized inpatient and outpatient care for high-risk pregnancies and multiple births.

EXPECTANT TIMES The Lois Hole Hospital for Women delivers more than 6,000 babies each year and about half of Bader’s practice is spent on the obstetrics part of her title. “Pregnancy is one of the most common reasons I get a referral,” says Bader. Some of the pregnancies she sees are routine, and many involve high risk pregnancies and premature deliveries. As an obstetician, Bader sees pregnant women with higher medical needs and concerns for their own health and/or that of their baby. For example, she’ll see mothers

LATER YEARS Menopause is ubiquitous, but impacts women differently. Some pass through this milestone with few symptoms. “For other women, it’s debilitating,” Bader says. There are hot flashes, mood changes, vaginal dryness and, for some, profound sleep disturbance. How she treats these women depends on their symptoms, age and risk factors, but treatment may include hormones, sleep aids or other medication. Bader often sees women for urinary incontinence, or prolapse. While these conditions can occur earlier in life, they become more common and symptoms increase as women age. “The number one cause for prolapse is childbirth,” Bader says. Prolapse involves a pelvic organ bulging through the vaginal wall. “It can feel like something is falling out of the vagina,” Bader explains. “Or women can feel a sensation or pressure and pain with intercourse.” Bader and her colleagues can treat prolapse or incontinence surgically or with the aid of a device called a pessary, which women wear internally to support pelvic organs. “Treatment depends on severity, and on the age of the patient,” Bader says. “Physiotherapy helps, and so does estrogen therapy.”

When is it urgent? Many women worry about gynecological cancer. While women of any age can get it, it becomes likelier with age. Regular pap smears monitor the cervix for changes that are a precursor to cancer. Other cancers are harder to spot. Bader says there are some symptoms that should send you to your doctor right way, rather than waiting to see if they resolve. Most women with these symptoms do not have cancer, but they should be investigated.

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1.Vaginal bleeding after menopause. This can be a symptom of a cancer of the uterine lining; don’t ignore it.

2.Abdominal bloating. A sudden expansion of the abdominal girth, with or without pain, or a rapidly increasing girth, is one of few signs of ovarian cancer.

3.Heavy or ongoing bleeding. In pre-menopausal women heavy bleeding (including clots) that requires a woman to change her napkin or tampon every hour or two, needs medical attention.

Health Link

Toll-free: 1-866-408-5465

5 Years of Caring

Spring 2015 • Hope

ONI HENDIP: Dr. Luptat Vulputpat lamet prat landis henit nulputp atincil luptat. Ud exes duplo catavat.

Hope â&#x20AC;˘ Spring 2015

5 Years of Caring

The Lois Hole Hospital for Women

The Allard Hereditary Breast and Ovarian Cancer Clinic helps families piece together the mystery of potentially deadly genetic markers BY JEN JANZEN • ILLUSTRATION BY HEFF 0’REILLEY

LISA WARWICK-MARKOWSKI WAS 38 WEEKS PREGNANT WITH HER

second child when she found a lump in her breast. She wasn’t concerned about it, and neither was her obstetrician – breasts go through many changes throughout pregnancy, and most lumps aren’t a problem – but the doctor sent Elisa for bloodwork and an ultrasound, just to be safe. These tests led to a biopsy. A week later, on a cold Friday in January, her obstetrician called with bad news: the lump was cancerous. The pathology report also indicated the cancer was triple-negative, meaning the cancer cells didn’t contain the estrogen, progesterone or HER2 (human epidermal growth factor) receptors needed for the most common breast cancer therapies to be effective. So instead of hormone-targeting medication, her treatment options were limited to tumour removal followed by chemotherapy and radiation. “They gave me the weekend to process the news,” Elisa recalls. Her labour was induced on the Monday. Eight days later, she had a lumpectomy to remove the cancer in her breast. Then, with a newborn and a three-year-old at home, she began her cancer treatments: three months of chemotherapy and 30 rounds of radiation over six weeks. Those few months were a whirlwind of treatment for Elisa, but she didn’t go through it alone: her mother, Elaine, was diagnosed with a rare form of ovarian cancer just a couple of weeks before Elisa’s breast cancer discovery.

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5 Years of Caring

Spring 2015 • Hope

“My mom and I had our chemotherapy on the same days,” recalls Elisa. The mother-daughter cancer discovery prompted the pair to look back at their family history. At this point, they still didn’t know it was hereditary. But based on the rarity of mom Elaine’s cancer and the fact that Elaine’s sister had had breast cancer in her 40s, the mother-daughter pair were referred for genetic testing. Meanwhile, as Elisa’s sister Shauna Warwick watched her mother and sister cope with chemotherapy and waited for the genetic testing results to come back, she talked about the situation with her doctor, who referred Shauna to the Allard Clinic. “The red flags were there,” Shauna says. “And my physician thought it was prudent to send me to the high-risk clinic,” she says.

HOPE NOTES Hope lies in dreams, in imagination, and in the courage of those who dare to make dreams into reality. - Jonas Salk

The Hereditary Breast and Ovarian Cancer (HBOC) Society says HBOC syndrome “is a genetic predisposition to some types of cancer.” There are several known types of genetic mutations, but the most common are known as BRCA1 and BRCA2. “All cancer is the result of gene mutations,” says the website, adding that the causes of gene mutations include aging, chemical exposure, hormones or other factors. “The cancers estimated to be hereditary are related to a genetic mutation that exists in every cell of the body, and carriers, whether they’re male or female, have a 50-per-cent chance of passing the mutation onto a child of either gender. Funded by generous donors, including

Hope • Spring 2015

the Allard Foundation and the HBOC Society, the Allard Hereditary Breast and Ovarian Cancer Clinic, located in the Lois Hole Hospital for Women, follows about 600 patients, just over half of whom have ovarian and breast cancer in their families but have not yet had genetic testing. The Allard Clinic sees patients who have a suspected genetic link and those who have a confirmation. Dr. Valerie Capstick is a gynecologic oncologist and one of the specialists at the Allard Clinic. She says about five per cent of breast cancers and 10 per cent of ovarian or fallopian tube cancers are caused by hereditary factors (the HBOC Society says this translates into about 1 in 400 women). With a BRCA1 mutation, the risk of breast cancer is in the range of 50 and 85 per cent, whereas the risk of ovarian cancer is generally around 40 per cent. With BRCA2, Capstick says the risks are slightly lower, “but still significantly elevated.” Male carriers of either mutation have an increased risk of getting breast cancer and prostate cancer. Some of the red flags for HBOC syndrome are multiple people on the same side of the family with breast and/or ovarian cancer, developing breast cancer at 40 or younger, and developing triple negative breast cancer at 50 or younger. 5 Years of Caring

Shauna was the first woman in the family to go to the Allard Clinic. She had her first appointment before she had had any genetic testing done for herself. “At that point when you don’t know, your body feels like a ticking time bomb,” she says. “It does weird things to your head.” A month after she visited the clinic, Shauna also found a lump in her own breast. She called the clinic on a Friday and secured an appointment for the following Monday. “They were fabulous – very reassuring,” Shauna says. She had an ultrasound on the spot and the results were instantaneous: the lump wasn’t cancer. “If I went through a physician, there would have been a three- or four-week wait for an ultrasound,” she adds. Four months later, she found another lump and was able to get a biopsy done at the clinic. She had the results in a week. “They know how much stress you’re under,” Shauna says, “and they know their stuff: how this kind of syndrome is different than a generic risk of breast cancer. They know the risk and they treat you accordingly.” There are five women in the Warwick family. Shauna and her sister Kathleen tested negative for the BRCA1 mutation, while The Lois Hole Hospital for Women

Elisa, sister Christina and their mother all tested positive. The three BRCA1-positive Warwick women go to the Allard Clinic every six months (Shauna and Kathleen were released from the clinic since their test was negative), and their diagnostic tests alternate between a mammogram and an MRI. Capstick says one of the strengths of the Allard Clinic is that it brings together experts in both breast and ovarian cancer to provide dedicated focus in a part of medicine that isn’t universally understood. “It’s a very specialized area,” Capstick says. To capture the expertise under a single roof, breast specialist Dr. Kelly Dabbs spends 20 per cent of her workweek at the Lois Hole Hospital for Women, creating the opportunity to learn together, further establishing best practices.

Some women struggle with the choices, worrying about what their partners will say – particularly when it comes to breast removal – but others approach it straightforwardly, either deciding on a total mastectomy or keeping their breasts and holding to a rigorous screening plan. “Counselling someone in this situation can take more time than somebody who has ovarian cancer,” Capstick says. “It’s hugely complicated and nuanced, and then there’s the overlay of what happened in their families.” Since breast cancer is typically more treatable than ovarian cancer, many more women opt for a salpingo-oophorectomy (the medical term for fallopian tube and ovary-removal surgery) and choose to closely monitor their breast health. Although ovary and tube removal obviously comes with a side-effect of no longer being able to have children, Capstick says most women start considering the surgery by the time they’re 35 years old, so “they have lots of time” to decide on their families. The Allard Clinic also has a Menopause Clinic, which Elisa was glad of when she got her ovaries and fallopian tubes removed last year. “I hit menopause cold turkey,” she says. “That’s another struggle you have to go through as a young woman.” But, she adds that the hot flashes and night sweats and continual need to observe her bone health – menopause places Elisa at a higher risk for developing osteoporosis – are a small price to pay for knowing her cancer risk has dropped dramatically. Once an Allard Clinic patient has had preventive surgeries and her cancer risk is reduced to that of the general population, she is discharged from the facility. Capstick says about 10 per cent of the tube and ovary surgeries reveal a small cancer, which is removed and the patient then treated with chemotherapy. Since receiving her negative result for BRCA1, Shauna is no longer an Allard Clinic patient. Once Elisa undergoes the bilateral (both sides) mastectomy she’s got planned for later this year, she won’t be, either. All follow-ups will be with Elisa’s family doctor. Mom Elaine, who is in remission from

Some women struggle, worrying about what their partners will say when it comes to breast removal. “A lot of women in the past may have had different messages about what their risks are,” Capstick says. A gynecological oncologist for 25 years, she remembers when the BRCA mutations were first discovered about 20 years ago. “We just seemed to see families it happened in often,” she says. “In my time, I’ve seen the genes responsible discovered, I’ve seen increasing refinements in what we recommend to people.” And Capstick, Dabbs and the team are at the avantguard of research and treatment. Those recommendations often centre around preventive surgery: mastectomies and ovary/fallopian tube removal. The decisions made by the patient, though, are deeply personal and often influenced by their own family’s history. “We’re able to give people a percentage chance of getting cancer and everybody interprets that differently,” Capstick explains. “If you watched your mom die of ovarian cancer it’s very likely you’ll want your tubes and ovaries gone. If there has been no ovarian cancer, and lots of breast cancer, chances are you’ll want your breasts gone.” www.loisholehospital.com

5 Years of Caring

ovarian cancer, will continue to attend the clinic for regular breast cancer screenings. Elisa says her last appointment at the Allard Clinic will be a bittersweet day. “You don’t want to go back again, but you know you’re being looked after so closely. If there’s anybody who’s going to look after me in this area, it’s those doctors. I trust them completely.”

Celebrate celebrity

In early 2013, gossip magazines exploded with the news that Angelina Jolie underwent a preventive double mastectomy. A carrier of the BRCA1 mutation whose mother died at 56 of ovarian cancer and aunt died at 61 of breast cancer, Jolie’s choice rocked the women’s health news beat. Was she right to get the surgery, or did Jolie just scare women into wondering if they also needed such drastic measures? Dr. Valerie Capstick at the Lois Hole Hospital for Women says the fact that Jolie’s decision is controversial in the first place is proof the Allard Clinic is so important. “That’s the challenge we have with family doctors,” Capstick says, “They’re stunned that women would go to those lengths.” Capstick says the only question in her mind when she found out about Jolie’s surgery was why Jolie didn’t have her tubes and ovaries removed, as well. (Jolie has since had this surgery, too). Her choices were not at all ridiculous.” Plus, says Capstick, plastic surgery has come a long way, and many women are thrilled with their breast reconstruction work.

Spring 2015 • Hope

Hope â&#x20AC;˘ Spring 2015

5 Years of Caring

The Lois Hole Hospital for Women

Maternal Minds

A new study screens for signs of anxiety and depression during pregnancy and beyond BY SHELLEY WILLIAMSON

ANA BERRY KNOWS WHAT

paralyzing panic attacks and debilitating depression feel like. After being diagnosed at age 16 with an anxiety disorder she hit her depressive low at 26. At her worst, she was unable to hold onto jobs. “And I had panic attacks just sitting at a stop light in the car,” says Berry, now 34. “The depression definitely came from feeling stuck and the thinking I was never going to get better.” In her search for answers and a mental health lifeline, she turned to anything she could. “I tried everything including medication. I saw psychologists, psychiatrists; I even ordered pills off the Internet that promised to help. But the medication actually made me worse. One day, I woke up and realized, for me, it was going to be about making a decision to get up every day and to live a better day and to do one thing today to make myself better than I was yesterday.” Soon Berry was doing better; she found faith, remarried and even learned that she was pregnant. For her the news of her first child was a joyous experience but she also knew there was a possibility of an exacerbation of the symptoms of depression. www.loisholehospital.com

Though she had long felt better, and had stopped taking medication years ago, the pending responsibility of another life stirred some concerns. Despite her medical history of anxiety and depression, she was surprised during her checkups that conversations with her medical team seldom touched on how she was doing emotionally. Then her doctor told her about a pilot study at the Lois Hole Hospital for Women that included online prenatal screening and a cognitive behavioural therapy (CBT) component for mental health. The study, part of the reproductive mental health program, would be the first of two prenatal studies she would participate in led by researcher Dr. Dawn Kingston. “I was lucky because they were just starting the program when I was pregnant with my daughter,” says Berry, who is now a mom to two-year-old Kristen and eight-monthold Josh. “My girlfriends who’d had babies before me, they were all surprised when I told them about the study – because no one had ever asked them or mentioned to them that post-partum depression does happen and if it does, these are your resources. It makes it a little less scary.” 5 Years of Caring

DAWN KINGSTON IS AN ASSISTANT professor at the University of Alberta and lead researcher on two recent studies that she says were prompted by an absence of routine prenatal screening for depression in Alberta. In fact, she adds, no province offers routine screening for prenatal depression or anxiety in pregnant women. “Historically in this group, the focus has always been on post-partum depression, but what we are learning is if a woman has prenatal depression and high stress, she’s much more prone to depression and anxiety in the post-partum period,” Kingston says. “Our work is showing that, rather than focusing on post-partum depression alone, we should be thinking earlier about the prenatal period.” Kingston says Canada, and Alberta especially, could follow the example of Australia, which has run an awareness campaign on the importance of universal mental health screening of pregnant women. “Now we realize that, if a woman has depression in pregnancy, there’s far more risk for her to still have it when her child goes to preschool at age four,” she says. This research has helped her team Spring 2015 • Hope

understand that some women prefer to take responsibility for their mental health care. “At least half of the women who have a positive screening for mental health issues don’t take a referral, don’t get external help,” she says. “In our work, we understand that there is a group of women who’d prefer to at least start with selfhelp. That is another reason why our work focuses on internet-based help.” To that end, Kingston and her team created a study that offered a pilot group of 150 women, including Berry, access to online screening and CBT for their symptoms of depression and anxiety during their pregnancy. The study recently received funding for an additional 800 participants. The team will recruit these women from prenatal classes and primary care clinics during the

about their mental health as a part of their care,” says Kingston. “Of the women who were not asked by a prenatal caregiver about their mental health, 99 per cent said they wanted to be. We don’t even talk about mental health screening and pregnancy, but I think the message is clear that women want support to take care of their mental health.” Kingston says stigma remains one of the prime reasons women do not access prenatal mental health care. “Women reported that they don’t want to be seen as depressed or anxious and therefore treated differently,” she explains. “They don’t want to be seen as an incompetent mother.” Family members telling a pregnant woman she is “fine” can also exacerbate a reluctance to seek help, Kingston adds. “Who’s the first person women go to when they are looking for advice? They ask other women or their families. We need to begin to educate the broader public about mental health and pregnancy.” Berry supports opening the discussion about the connection between pregnancy and mental health, and she lauds the benefits of screening and treatment programs like Kingston’s. “Sometimes you feel like a different person when you’re pregnant; especially when you get to the end of your pregnancy and you just want the baby to come,” says Berry. “The toughest transition is that you think that once the baby comes it gets easier. The program is really good, because it keeps you aware that it’s not easy – but there are people who can help you.” There is still much work to be done, according to Kingston. She would like to see prenatal mental health screening become the rule, not the exception. “We want all women who are pregnant, and after they have their babies, to have routine mental health assessments built in as part of prenatal care. It could be with their family doctor, their obstetrician or their midwife.” She says that efforts would go a long way to helping the 80 per cent of at-risk women whose problems go unaddressed. “We know that routine screening increases the number of these women who will get help.”

“Of the women who were asked, 97 per cent said they were very comfortable being asked about their mental health as a part of their care,” says Kingston. four-year trial, and an additional group of participants will come from the Lois Hole Hospital for Women’s high-risk antenatal unit, beginning in April 2015. (Funders include the Shoppers Drug Mart Run for Women, Norlien Foundation, WCHRI and Canadian Institutes of Health Research.) She likens the tool of online screening and therapy to those who prefer to work out at home over a gym. “Many of our women have young families and therapy can be expensive with long wait times. This type of online therapy can be effective for stress, depression and anxiety. There are even people who use it who have quite severe symptoms that find it useful in conjunction with medication,” she says. In an effort to learn why more pregnant women don’t seek help, Kingston polled more than 500 Alberta women, who her team recruited through doctors and prenatal classes, as to whether prenatal caregivers asked about their mental health. “Of the women who were asked, 97 per cent said they were very comfortable being asked

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5 Years of Caring

Mind your own mind Dr. Dawn Kingston, an assistant professor at the University of Alberta working with the Lois Hole Hospital for Women, wants to spread the message that there is mental health help available for women both during and after pregnancy. She hopes to offer the online cognitive behavioural therapy program to pregnant women who want it. In the meantime, she has tips for maintaining a mentally healthy pregnancy, birth and postpartum period. • Talk to your doctor. “The first step if a woman is concerned about her mental health is to tell her doctor exactly what she is feeling,” Kingston says. “Her doctor will help find support.” • Ask for help. “You don’t have to be at the end of your rope to ask for help,” Kingston says. Mild and moderate depression or anxiety also has an impact on mother and baby. • Eat and sleep well and exercise. “We are seeing a trend in lifestyle medicine as a component of depression and anxiety care,” Kingston says. Lifestyle changes help prevent and treat the symptoms of depression. • Respect your history. “It is important for women who’ve had a past diagnosis of depression or anxiety – even if they were 16 years old,” Kingston says. “These women are more at risk of developing prenatal and post-partum depression. It’s time to take charge of your mental health.” • Treat yourself. “We need to treat depression as a chronic disease, so that lifestyle prevention practices are truly rooted in our lives,” Kingston says. Take steps to introduce positive change in your life: it’s not difficult, but scientific evidence shows it’s critical.

The Lois Hole Hospital for Women

Program Files

BY MARTIN DOVER

Strike a Cord A program to save umbilical cord blood from newborns at the Lois Hole Hospital for Women provides hope for stem cell transplant patients A NEW PARTNERSHIP BETWEEN THE Lois Hole Hospital for Women and Canadian Blood Services has helped make Canada’s National Public Cord Blood Bank a reality. Started in 2014, it’s already saving lives and has the potential to benefit thousands of patients across in Alberta, across the country and around the world. The Lois Hole Hospital for Women has been named as one of four hospitals in the country to serve as a collection site and Edmonton is one of two storage sites. As a woman’s hospital of national importance, the Lois Hole Hospital for Women sees more than 6,000 births annually. “It makes us an obvious collection point,” says Cheryl Parkes, patient care manager, obstetrics. She oversees recruitment of cord blood donors, working with Canadian Blood Services to recruit expectant mothers and obtain their consent to donate their child’s umbilical cord blood – a rich source of blood stem cells. Canadian Blood Services saves and stores it for potential future use by patients who need it for medical treatments. The Canadian Blood Services website says recipients need blood stem cells to treat dozens of diseases, the most common of which are types of leukemia. Blood stem cells used for transplantation can come from bone marrow, peripheral blood stem cells collected from the blood after special treatment, or umbilical cord blood. Cord blood comes from the umbilical cord that anchors and nourishes the growing baby in utero. “If this cord blood is not harvested at birth, it gets discarded anyway,” Parkes says, “So there is no risk to the baby or mother to donate it.” Cord blood is often preferable to bone marrow and peripheral blood that adults donate. www.loisholehospital.com

A cord blood match can be shipped quickly in an emergency. It can take months to find an adult donor and harvest blood stem cells. Complications such as latent viral infection and graft-versus-host disease are less common, less severe and easier to treat when the patient has received a cord blood donation versus adult stem cell donation. “It’s easier to match patients with cord blood than other stem cell sources,” Parkes says, “because you don’t need an exact match.”

Cord blood would be discarded otherwise,” Parkes says, “So there is no risk to the baby or mother. Dr. Graham Sher, CEO at Canadian Blood Services, has said his organization is honoured to partner with the Lois Hole Hospital for Women. “This partnership underscores the collaborative effort our organizations have taken to launch a national public cord blood bank,” he said in a press release, “one that offers more opportunities to find a match and save more lives.” Canada’s National Public Cord Blood Bank improves the ability of Canadian Blood Services to find matches for patients through its stem cell network – OneMatch. This is especially important to patients from diverse populations, particularly aboriginal, African-Canadian and multi-ethnic. “These patients can have difficulties finding a matching donor,” says Parkes. “Cord blood is 5 Years of Caring

easier to match and, coming from a facility like ours that serves an ethnically diverse patient base is especially valuable. We are thrilled be part of the national cord blood bank initiative.” Working with Canadian Blood Services, Parkes was involved with the pilot program in 2014, when mothers delivered babies at the hospital and donated their cord blood to the bank with signed consent. “Most mothers were quick to volunteer,” she says. “It didn’t take much convincing.” About half of Canadian patients who need an unrelated blood stem cell transplant are unable to find a match. Canada’s National Public Cord Blood Bank provides additional opportunities for finding a match, saving more lives. A group of Edmontonians including Dale Sheard and Anne McLellan, were generous donors and organizers who made the national Canadian Blood Services project possible.

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We’ve only just begun! Donate to the Lois Hole Hospital for Women at loisholehospital.com Spring 2015 • Hope

Return to HOPE

One couple’s tragic loss bound them to the Lois Hole Hospital for Women, where they found the resources to help them cope BY BY SÉAMUS SMYTH

YNN SUTANKAYO EXPERIENCED actually hit the radiologist. The doctor had

a real-life nightmare. It was December, 2013, and she was 31 weeks pregnant. She and her husband Billy Smale were excited about the fast-approaching due date of their first child. Sutankayo had some pains in her abdomen, so she visited a medical centre to ensure that nothing was wrong. Her pregnancy had been fairly smooth and neither she nor Billy was worried. The doctor asked if there had been any change to the baby’s activity level. There hadn’t – the baby had never been much of a kicker. The doctor scheduled her for an ultrasound that followed a few days later. When the day arrived, Sutankayo was feeling good and neither she nor Smale were worried. In fact, she left her husband to wait in the car and tinker away at editing their wedding video. So she was alone when the radiologist delivered the news that would penetrate a parent’s deepest worries. “She told me, ‘There is no easy way to say this, so I just will. Your baby has no heartbeat,’” explains Sutankayo. Her baby had died in utero. Sutankayo recalls that she swung her arms violently, lashing out – she

Hope • Spring 2015

already made arrangements for Sutankayo to be admitted to the Lois Hole Hospital for Women and printed out a map for her. Sutankayo climbed in the car and broke the news to Billy, and they set out for the hospital, a long drive from residential Mill Woods on the city’s southeast side to the core of Edmonton. Smale was behind the wheel, and the information gradually seeped in on the journey downtown. “Every time we hit a light, I started to cry. I did that throughout the whole city,” Smale explains. The bad news wasn’t over. Doctors at the Lois Hole Hospital for Women told the couple that because Sutankayo was so close to due, she would have to deliver the baby vaginally despite the fact that the child had died. It would be better for her health and recovery, they explained. “It was the most horrifying thing they could have said. We were in so much shock. And yet, it ended up being a blessing,” says Smale. What could have been a moment that scarred the young couple ended up being a crucial aspect of the healing process. It allowed a beautiful birthing experience and a few last moments to spend with their baby. 5 Years of Caring

CARE FOR PARENTS: Bereavement coordinator Patti Walker shows a CuddleCot, made possible by donors, that enables bereaved parents to stay a little longer with their babies who have died.

Doctors induced Lynn Sutankayo’s labour late that evening. The couple spent the long night in a labour and delivery room, and did not need to worry about moving from one room to another. Sutankayo found a way to escape by staring out the window and watching the colours spill into each other as night shifted into morning. She played meditational music and drifted to her sacred place, surrounded by mountains and a lush forest, as well as a capacious beach for her unborn child, who they named Annie Raya when she was born the next morning. Once Sutankayo delivered Annie, the team at the Lois Hole Hospital for Women immediately went into action. They offered a visit from the hospital Chaplin on duty, who officiated at a naming ceremony. The hospital’s regional bereavement coordinator, Patti Walker, arranged a visit from the organization Now I Lay Me Down to Sleep, a group of professional photographers that donate their The Lois Hole Hospital for Women

FAMILY: Lynn Sutankayo and Billy Smale delivered baby Hue, pictured here, at the Lois Hole Hospital for Women in December. In 2013, they also delivered Hue’s sister Annie there, who was stillborn.

time to take pictures of parents and their baby who died. Lynn says that Patti Walker played a significant role in her recovery through unlimited support and as a source of comfort.

20 weeks or more have passed, either in utero, or during labour or birth. It’s rare in Canada, with just four or five births in 1,000 ending this way. Reasons behind it can range from illness or infection in the mother, injury to the baby in utero or during birth, or genetic illnesses in the baby. Autopsy reports revealed the cause of Annie’s death was a rare metastatic cancer that spread quickly, and was undetectable at a 20-week ultrasound. At the Lois Hole Hospital for Women, Walker and her team aim to give each baby the love and respect he or she deserves. “If you were the mom, how would you want the baby treated?” Walker asks. “There is something beautiful about every baby.” Walker gave the couple a resource package, and one of the most helpful things in it was was a pamphlet to give families and

“You can’t just replace another baby,” Lynn Sutankayo says. “You can’t repeat a child.” “It’s a very supportive environment,” Walker explains of her role. “The values of the hospital are to support families in the circumstances that they’re in. You can’t change the fact that families are at the hospital but maybe we can make a difference during the time that they are here.” Walker says the majority of pregnancy losses are miscarriages that happen before 12 weeks. A stillbirth is when a baby dies after www.loisholehospital.com

5 Years of Caring

friends, Sutankayo says. The literature would help people avoid saying things that would cause the new (and newly-bereaved) parents unintended pain. It was filled with tips and advice on what to say and more importantly, what not to say, to parents dealing with such a traumatic loss. “Don’t say, ‘Well at least God has another angel.’ We don’t want God to have another angel - we wanted to have one,” says Smale. “You can’t just replace another baby. You can’t repeat a child,” says Sutankayo. Although Annie was never allowed a single breath in the world, Lynn says she knew her and loved her in an instant. “You could see her features – you could see she had my lips and Billy’s nose,” she says. After a getaway to Indonesia, a source of escape for the two, they decided that they would not give up hope. Although both admit to being cautious when they were discussing a second pregnancy, baby Hue was born in December 2014. For Smale and Sutankayo, it was an obvious decision to deliver at the Lois Hole Hospital for Women after the support they had received with Annie. “We had the utmost confidence with the staff there and we just felt really good about delivering there again,” says Lynn. As a way of displaying their gratitude and to help others contend with loss, at a memorial gathering they had to mark Annie’s birthday, the couple collected teddy bears for the Parent Care Support Society, a support group for parents who’ve suffered a loss. A teddy bear, or Annie bear as Lynn and Billy referred to it, was another tool that gave energy and salvation to Lynn. “It was so therapeutic. I wanted to hold Annie but we didn’t have her to hold, so Patti gave us this bear. We cuddle this bear to this day,” she says of the gift. Smale says now takes time to process the essence of each moment in his life as a parent to Hue. Sutankayo is similarly reflective. “I think Annie has made me a better person and a better mom,” she says. “You get pregnant and you think you are going to have a baby to take home, but it didn’t work that way for us. We are now blessed to have a healthy baby in our arms, as well as Annie in our hearts.” Spring 2015 • Hope

Hope â&#x20AC;˘ Spring 2015

5 Years of Caring

The Lois Hole Hospital for Women

The

Cutting EDGE

Surgical excellence at the Lois Hole Hospital for Women took a leap with the introduction of a new member to the team BY CORY SCHACHTEL • PHOTOGRAPHY BY EPIC PHOTOGRAPHY

L THE FOURTH MUSKETEER: (L-R) Drs. Valerie Capstick, Tiffany Wells and Helen Steed pictured with the newest member of the team, the da Vinci robot.

www.loisholehospital.com

OIS HOLE HERSELF WAS A PASSIONATE SPOKESPERSON FOR

innovation and excellence, so it’s not surprising that the surgical care at the eponymous hospital embodies these traits too. The hospital’s surgical team enhances the reach of the clinics in fertility, high-risk pregnancies, urogynecology and gynecologic oncology, providing the widest range of women’s health services in the province. Doing so, it has established itself as a national centre of surgical excellence. “We like to be innovative, driving the expansion of where medicine is going, and providing the best possible care,” Dr. Helen Steed says. She’s a Lois Hole Hospital for Women gynecologic oncologist and surgeon, and lately she’s been working with a new surgical partner: the da Vinci robot, a life- and time-saving machine that allows surgeons a versatility they didn’t have before.

5 Years of Caring

Spring 2015 • Hope

Da Vinci is the first tool of its kind in Canada to be dedicated solely to women’s health and its presence is a game-changer. “In the past we shared a da Vinci robot with the main OR at the Royal Alex and had access to it about one day per week,” Steed explains. “With our own dedicated robot we’ve more than doubled the number of surgeries that we can do.” Rhonda Plamondon was one of the first patients to benefit from da Vinci’s precise work. She’s from Plamondon, Alberta, a hamlet three hours northeast of Edmonton (named after her husband’s ancestor). Her doctor found some irregular cells in a pap test in 2013 so he repeated the test in 2014. It showed the same kind of changed cells, so he sent Plamondon’s tissue for a biopsy.

HOPE NOTES Hope is like a road in the country; there was never a road, but when many people walk on it, the road comes into existence. - Lin Yutang

Plamondon followed up with Steed in December 2014 at the Lois Hole Hospital for Women. Steed delivered the worst news: it was cervical cancer. Nobody expects cancer, but at 25, with a husband (Shawn) and two kids under four, it was an especially jarring diagnosis, made worse in that it followed quickly on a fatal experience for her family. A year before her diagnosis, Shawn lost his father to bladder cancer. “We’re a very close family,” she says. “And they had all just lost their dad and husband, so to tell them I had cervical cancer, it was almost not believable. It was just … too soon to rationalize. But any time I needed to talk, or go for a walk, or help with the

Hope • Spring 2015

HANDS ON: The da Vinci’s robotic arms are able to rotate 360 degrees to manoeuvre in ways the human arm and wrist could not manage.

kids – I couldn’t have asked for a better support team.” She couldn’t have asked for better medical care, either. Through tears, Plamondon listened to Steed’s advice and immediately chose to have surgery. It was then that Steed offered her a new treatment option – da Vinci. “She told me it was a new development, something for which the foundation had been fundraising for a year, and they wanted to use it on me,” Plamondon says. “She said the recovery time is faster, and less painful, so of course I took it. To be honest, I was just scared of going under.” Plamondon could easily also have worried about a long-post surgical recovery and the problems it would present to a 5 Years of Caring

busy mother of two young kids. But instead of a lengthy hospital stay, she and Shawn left the hospital the next day – unheard of for such a procedure if it were executed without the help of da Vinci. Plamondon’s pain was less than she had experienced after her caesarian section. “I had little discomforts all over my stomach, but that was it,” she explains. It was the longest she’d been away from her children, who only knew that mommy was going to the doctor to have some booboos in her stomach fixed. After the kids had a sleepover at grandma’s house, and a night at auntie’s, their mom and dad returned to collect them. “When we first saw them again,” Plamondon says, “it was The Lois Hole Hospital for Women

Bedside The Lois Hole Hospital for Women provides the largest gynecological services in Alberta with four gyne operating rooms dedicated to women’s health. The gynecology oncology inpatient unit at the hospital has 33 inpatient beds and 13 day surgery beds, providing treatment to more than 2,500 patients each year. Each room has a computer outside the door where any nurse or doctor can check on a patient’s progress, rather than retreating to a centralized computer at the front desk, and having to pull a file each time.

like Christmas morning, we felt so hopeful and excited.” Plamondon’s surgery was one of the first performed using the da Vinci after its arrival in the Lois Hole Hospital for Women. Couple the new machine with the hospital’s top-line operating rooms dedicated to its patients only, and it means Steed will never again have to postpone a procedure like Plamondon’s. The advancements made in oncological surgery are nothing short of stunning. The last few decades have seen surgeons making smaller incisions, inserting cameras and using new tools to minimize a patient’s pain and hospital stay. But the arrival of the da Vinci robot is the beginning of a new era. www.loisholehospital.com

Steed, who is a frequent user of the da Vinci along with her colleagues Dr. Valerie Capstick and Dr. Tiffany Wells, says da Vinci makes her a better surgeon, and it’s easy to see why. For a surgeon, da Vinci improves steadiness, visualization and dexterity with its tools and 3D imaging. Using it, surgeons can make a 360-degree rotational movement that a human wrist won’t allow when they are operating without da Vinci. Instead of a broad abdominal incision, Steed makes five, eight-millimetre incisions in the abdomen, one for each of da Vinci’s arms. Once it’s docked to the patient, Steed unscrubs and walks across the room, puts on the intuitive operating 5 Years of Caring

glove, looks through the goggles and executes surgical procedures with an exacting precision. Da Vinci also allows Steed to sit, a less obvious benefit to doctor and patient. “Clearly, the patient care is foremost, but the ergonomics are phenomenal – no more straining and turning, and the camera gets as close as I want, from all angles. It makes everything more precise, lessens fatigue and increases the life span of a surgeon’s career,” she says. The $3.3-million base cost of the robot was covered by community donor support from across the province, led by campaign chair Lynn Mandel, with the hospital covering the remaining $500,000 for staff and maintenance. It’s another example of what donors can do, coming together to support the Lois Hole Hospital for Women and ensuring patients like Plamondon from across Western Canada survive and return quickly to their lives. In March, Plamondon was in Edmonton again to see Steed at the Lois Hole Hospital for Women. Steed gave her a clean bill of health and told her to visit twice a year for two years and once a year for five more. Plamondon found the news as delightful as it was reassuring. Spring 2015 • Hope

Facility Profile

SPECIALIZED TREATMENT: Amanda Skaggs’s high blood pressure meant she needed special care when she was expecting baby Landon.

Hope • Spring 2015

5 Years of Caring

The Lois Hole Hospital for Women

BY SYDNEE BRYANT • PHOTOGRAPHY BY COOPER + O’HARA

Under One Roof Gone are the days when complex women’s health needs meant travelling around to various facilities for tests and appointments AMANDA SKAGGS WAS IN THE FIRST TRIMESTER OF HER PREGNANCY WHEN her general practitioner referred her to the Lois Hole Hospital for Women. The St. Albert resident, who has high blood pressure, always knew that her condition could cause additional problems while she was pregnant. But it wasn’t until her first visit to the Lois Hole Hospital for Women that Skaggs, then eight weeks along, found out just how many resources were available to her in one place.

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5 Years of Caring

Spring 2015 • Hope

Considered a high-risk pregnancy, Skaggs met with a doctor and nurse practitioner at the hospital at the maternal-fetal medicine clinic. “They looked at my history and developed a game plan on how they were going to treat me,” says Skaggs. She had regular appointments every six weeks early on in her pregnancy, then at four-week intervals as she drew closer to her due date. At each visit, the staff would monitor her blood pressure and do blood work. “The staff were amazing,” says Skaggs. “They were all involved in my care. I can’t say enough positive things about them.” Skaggs’s situation isn’t uncommon. The Lois Hole Hospital for Women’s maternal-fetal medicine outpatient clinic handles approximately 16,000 visits every year. Many of those patients are from out of town. “Patients that are diagnosed with high-risk pregnancies are often referred here,” says Janie Tyrrell, interim executive director at the Lois Hole Hospital for Women.

The interdisciplinary clinics at the Lois Hole Hospital for Women provide services to women of all ages, for a variety of health and wellness needs. The Lois Hole Hospital for Women, which opened in April 2010, is the tertiary hospital for central and northern zones of Alberta, as well as Canada’s northwest. The hospital experiences more than 80,000 outpatient visits every year. Depending on the services needed, patients are referred to the hospital’s outpatient clinics by their family doctors or ob-gyns, and in some cases, they self-refer. “The Lois Hole Hospital for Women is really unique in that it’s an integrated obstetrics and gynecology program,”

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says Tyrrell. It offers a patient- and familycentred model with labour and delivery, antepartum, post-partum, outpatient, operating rooms and gynecology services – all under one umbrella. In many situations, patients are receiving many different services in one location, says Tyrrell. The team consists of both obstetrical medicine providers and cardiac providers working together with the patient to provide integrated and collaborative care in one place. The hospital’s dedication to patient- and family-centred care shows in every aspect. The facility was designed to facilitate a warm and welcoming atmosphere, delivering compassionate and sensitive care for patients and their families. “The whole design of the hospital is very much a natural and friendly environment,” says Tyrrell. 5 Years of Caring

“It’s fresh and bright, with large windows, natural light and artwork everywhere you look – it feels like a home atmosphere.” There’s also a rooftop healing garden and much visited chapel on site. The interdisciplinary clinics at the Lois Hole Hospital for Women provide services to women of all ages, for a variety of health and wellness needs, ranging from reproductive endocrinology and fertility to obstetrical medicine, adolescent pregnancy, urogynecology and menopause. The outpatient clinics, which also include a hereditary breast and ovarian clinic, are not “typical physician-and-nurse clinics,” says Tyrrell. “They consist of a multitude of providers working together to provide care for patients and families.” Since the hospital and its outpatient The Lois Hole Hospital for Women

I wasn’t sure if I would go through more than one pregnancy,” she says. “If I could do it the same way and have the same team around me next time, for sure I would consider trying again.”

We’ve Come a Long Way, Baby

clinics are interdisciplinary, patients such as Skaggs can access several resources in one place. “On my first visit I met with a dietician and she followed up with me several times after,” says Skaggs. She was also diagnosed with hypothyroidism during her time at the maternal-fetal clinic, and was treated immediately. “It definitely eases your mind – you have a whole team dedicated to you,” says Skaggs, who also took part in a study on folic acid at the hospital during her pregnancy. Doctors at the Lois Hole Hospital for Women monitored Skaggs closely throughout her pregnancy. Her blood pressure, which actually decreased enough during her pregnancy that she was able to go off her medication, spiked when she was 36 weeks along. Her doctors put her back on www.loisholehospital.com

blood pressure medication – she was at risk for pre-eclampsia – and induced labour when she was 39 weeks along. Skaggs had an emergency C-section and gave birth to a healthy, eight-pound baby boy on December 2, 2014. Skaggs stayed at the Lois Hole Hospital for Women for five days after giving birth to her son, Landon. She continued to access the hospital’s many resources during that time. A first-time mother, Skaggs received extra breastfeeding support after giving birth. She also continued to meet with the nurse monitoring her for the folic acid study. A positive experience at the Lois Hole Hospital for Women has convinced Skaggs that her condition isn’t a hindrance to pregnancy. “Before getting pregnant, 5 Years of Caring

A lot has changed in the past two decades, particularly when it comes to post-partum care, says Janie Tyrrell, interim executive director at the Lois Hole Hospital for Women. A multidisciplinary, hospital such as this one didn’t exist in Edmonton 20 years ago. “Moms and babies don’t stay as long as they used to in the hospital so they need lots of connection points in the community,” says Tyrrell. “We also have women having babies later in life, which can lead to more complex pregnancies. There’s also increased fertility options and better technology – women who have heart conditions who would never have gotten pregnant can now get pregnant.” But pregnancy is not a woman’s only health issue. Hospital care is also much more focused on patient needs and improving the patient’s experience. Tyrrell points to the hospital’s menopause and incontinence clinics. “Women are living longer and are not as willing to accept those things – they would rather have services that provide a better quality of life.”

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We’ve only just begun! Donate to the Lois Hole Hospital for Women at loisholehospital.com Spring 2015 • Hope

First Person

HAPPY FAMILY: After years of discouragement, Megan Isbister and her husband Marc conceived two girls, Abbey, left, and Sophie, through IVF.

Hope â&#x20AC;˘ Spring 2015

5 Years of Caring

The Lois Hole Hospital for Women

BY MEGAN ISBISTER • PHOTOGRAPHY BY KELLY REDINGER

Expectant Times A few years ago, I had no way of knowing that my journey to creating a family would take so many turns IT WAS A BEAUTIFUL FALL DAY, AND there I was attending yet another baby shower, this one for a friend who already had two boys and was about to have a third. “A mistake,” she said. But all she had to do was look at her husband and – bam – she’s pregnant. Even though I was happy for her, I couldn’t help feeling jealous. Everyone around me and my husband Marc was pregnant and having babies. For us, each month came and went as a disappointment. Every baby shower guaranteed that the topic of our non-existent babies was going to come up.

The next year was hard, and I was constantly trying to find projects to occupy my time. Hopefully one day I could cuddle a baby of my own. “No we are not pregnant yet, I’m sure it will happen soon,” I heard myself saying. What I really felt like saying was, “We CAN’T get pregnant, so stop asking!” My husband and I were married in October 2007 and we were anxious to start a family. I was turning 30 and definitely felt my biological clock ticking. From listening to other couples and talking to doctors we knew it could take up to a year before we finally conceived. I did the math; we would be having a baby by the time I was 31. www.loisholehospital.com

5 Years of Caring

Months later, I still wasn’t pregnant and I was getting discouraged. I went to see my doctor, who ordered some blood work for both of us. Marc got his sperm tested and the results came back normal. My doctor sent me for an ultrasound.

THIS IS TAKING A LONG TIME, I thought, as the ultrasound tech conducted the test, scrutinizing what looked like fuzzy grey blobs on a monitor. If this is routine, then I wouldn’t be here this long. Something must be wrong. Then the tech left the dimly-lit room and said she’d be back in a minute. When she returned, the doctor was with her. This can’t be good, I thought. The doctor told me that there were several cysts on my ovaries, and some of them large masts. “OK,” I said, “what does that mean?” This is when I found out I had endometriosis. I really had no idea what it was or what it meant for us having a baby. At my follow-up appointment I found out the only solution was to have laparoscopic surgery to scrape down the endometriosis. The doctor told me there was only one infertility doctor in the city that did this procedure and we’d have to wait to see him. I was crushed. I had to wait a year before I was even able to see a doctor, never mind getting pregnant. The next year was hard, and I was constantly trying to find projects to occupy my time and keep my mind off of the thought that hopefully one day I could cuddle a baby of my own. In July 2009 I got in to see Dr. Tarek Motan at what would soon Spring 2015 • Hope

be the Lois Hole Hospital for Women. From doing some research and talking to other people I thought I would have this surgery and then be able to get pregnant naturally. But Dr. Motan made it clear that, from the pictures of my ultrasound, I had stage four endometriosis – the most severe kind. “Your chances of getting pregnant naturally are about as likely as winning the lottery,” he told us. He said the only hopes of us conceiving would be through in vitro fertilization (IVF). I was devastated. I went home and cried, trying to make sense of the possibility of us never having children.

We waited, and I was optimistic, but we weren’t so lucky. The pregnancy test came back negative. I was so upset. I had the surgery a couple of months later. At my follow-up appointment, Dr. Motan showed us the pictures from the procedure. My ovaries were the size of tennis balls and pretty much touching each other. The endometriosis was attacking my ovaries, fallopian tubes, even my bowels. Dr. Motan suggested he would put me on a drug for four months to launch me into a temporary menopause, to give my body a break from the endometriosis, then we’d begin the IVF process. The additional months of waiting felt like another setback, but the time finally came. We started our first round of IVF, which brought financial as well as emotional stress. IVF is uninsured by Alberta Health Care and, at the time, each fresh cycle of IVF cost approximately $6,500 for the procedure. (Thankfully, both my husband and I had benefits plans through work that covered the drugs I had to take prior to the IVF procedure. These medications can cost as much as $8,000.) For approximately 10 days before the retrieval of my eggs, I had to give myself three injections in my abdomen each day. I had frequent ultrasounds so the

Hope • Spring 2015

FERTILE GROUND: The Isbisters will welcome their third child this summer – something parents Megan and Marc never thought possible.

doctors could precisely time the retrieval of the eggs. The embryologist told us that a typical procedure retrieves approximately eight or 10 eggs, about half of which are viable. Viable fertilized eggs not used in an IVF cycle can be frozen for future use. The day we went in for the retrieval, I had mixed emotions, nerves, excitement and doubt. After the procedure we found out the team was able to retrieve only three eggs. I was devastated. How would it work if only half of those were viable? The nurses reassured me it’s about quality not quantity. We came back for the transfer three days later and the team implanted two fertilized eggs. They had to discard the third. We went home and waited. Feelings of excitement and fear ran through me, but approximately 10 days later we were cele5 Years of Caring

brating. The longest three years of my life, but I was finally pregnant and we could finally look forward to a family. On November 7, 2010 we gave birth to a beautiful baby girl, Abbey Lena Marie Isbister. We were so happy to have our bundle of joy, but within a few months I made another appointment with Dr. Motan. I wanted to try again soon in hopes of avoiding another surgery or another punishing round of induced menopause. In March 2011, Dr. Motan sent me for an ultrasound, and the results suggested that I would have to have surgery once more before thinking about having a second child. But this time, he suggested I try taking the birth control pill first instead of the drug to put me into menopause. He said the statistics of a successful IVF pregnancy The Lois Hole Hospital for Women

Defining a problem

afterwards is the same. So that’s what we did. Everything went well, the team retrieved and fertilized five eggs transferring two into me. The others weren’t viable. We waited, and I was optimistic, but we weren’t so lucky. The pregnancy test came back negative. I was so upset, I felt like we had just flushed $6,500 down the toilet. I wanted to just jump right back into another cycle of IVF, but Dr. Motan wanted do what worked the first time: four months of drug-induced menopause. So, months later, we tried again. Another fresh transfer, another stress on my body and another $6,500. We were able to retrieve eight eggs – finally some good news. The team transferred two fertilized eggs into me and they froze two. The result: no pregnancy. www.loisholehospital.com

I had a beautiful daughter at home, and I tried to adjust my expectations: we might only have one child. In July, 2012, we decided that we would transfer the last two fertilized eggs we had frozen and then close the book on having more children. The process to prep your body for a frozen transfer is more grueling than a fresh retrieval. I took a drug by nasal spray five times a day for about four weeks. We went in for the transfer at the beginning of August. One of those frozen fertilized eggs took, and we had a second daughter on April 24, 2013: Sophie Gail Marie Isbister. Our family was complete. We are blessed to have two beautiful daughters and are completely thankful to Dr. Motan and his amazing team for giving us the family that otherwise wouldn’t be possible. 5 Years of Caring

Endometriosis affects women during their child-bearing years. It means endometrial tissue that normally lines the uterus is also growing outside it. This does not always cause symptoms. And it usually isn’t dangerous. But it can cause pain, abnormal menstrual bleeding and infertility. Doctors don’t know what causes this disease, but they know that the hormone estrogen made by women’s bodies in their childbearing years makes the problem worse. That’s why one treatment is putting a woman into a temporary, artificial menopause. The clumps of tissue that grow outside the uterus are called implants. They usually grow on the ovaries, the fallopian tubes, the outer wall of the uterus, the intestines, or other organs in the belly. In rare cases they spread to areas beyond the belly. Symptoms can affect women from their teens through their late-40s, and usually subside in menopause. Source: myhealth.alberta.ca

IN OCTOBER, 2014, I CAME HOME from work early feeling slightly nauseated. I feel like I’m pregnant, I thought. There’s no way! But I took a pregnancy test anyway. Negative. Thank goodness, I thought. I was busy with two young children. The next week came, but my expected menstrual cycle did not. I took another test just to be sure. I texted my husband a picture of the positive test and wrote, “Looks like we won the lottery.” It was unanticipated but definitely no mistake. I feel truly blessed and lucky, five years ago I could only dream of having one child and here we are, having a third. Spring 2015 • Hope

Mind, Body, Spirit

Hope â&#x20AC;˘ Spring 2015

5 Years of Caring

The Lois Hole Hospital for Women

BY MARTIN DOVER • PHOTOGRAPH BY DARRYL PROPP

A Life of Spirit STELLA CORMIER STARTED WORK

as the Roman Catholic Chaplain at the Royal Alexandra Hospital on September 1, 1993. She has a wealth of experience caring for the diverse spiritual needs of patients there and at the Lois Hole Hospital for Women. She calls the Robbins Chapel “a very special place.” At its base, the Robbins Chapel is a non-denominational place of worship. “This is a well-attended space,” says Cormier. She had a hand in its inception,

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so she knows it was planned for a full occupancy. “A family can fill this place for a memorial service, or people can come in by themselves. Staff come here, sometimes on a break, for a moment of reflection.” Cormier was part of the organizing committee that had input into the planning of the chapel. “The Robbinses looked at a number of chapels and provided their input along with that of the committee,” Cormier says. That input guided the

5 Years of Caring

Edmonton architectural design firm DIALOG. The Robbins Chapel is simple and elegant in its assembly. As you face the pulpit, there’s a textured, cream coloured wall on the right, that draws the eye forward and invites contemplation. On the left are three stained glass windows. The first one is The Nativity, the second one is called Let the Children Come to Me, and the third is Jesus in the Garden of Gethsemane. The windows add tone and lighting

Spring 2015 • Hope

to the chapel that changes throughout the day and according to the season, depending where the sun hits them. Overhead, wooden beams form a peak over the pews, suggesting a classic church roof. It welcomes all denominations and faiths, but there is a definite Christian sensibility to the space. In consideration of that, the Royal Alexandra Hospital also has an interfaith worship centre that’s open 24/7, a welcome respite for people of other faiths. The chapel is a place to unite spirit with

Hope • Spring 2015

body and mind the quest for health, or in its absence – for peace. “When you are sick or in need, peace is what you hope for,” Cormier says. She assists with many services here, from Roman Catholic mass on Sundays, to the blessing of hands, to memorial services, to naming ceremonies for the babies who died in utero. “People in need come here in search of the mystery,” Cormier says. “And the hope – we don’t know what each person’s hope is.” But Cormier and her spiritual care colleagues support them in the journey. 5 Years of Caring

The chapel is named for Bill and Mary Jo Robbins. Mary Jo trained as nurse, and her philanthropic efforts often focus on education and health care. “She has a special love for the sick and their spiritual welfare,” Cormier explains. The Robbinses, patrons of the Royal Alexandra Hospital Foundation, are the namesakes of this and a number of structures on the hospital campus. The couple has generously supported the Royal Alexandra Hospital for many years. The Lois Hole Hospital for Women

Spaces in the Heart Healing Garden: From the Robbins Chapel, the Walkway of Hope leads patients, families and staff through to a bell tower and to the Ted and Lois Hole Healing Garden. A garden is a way to connect with nature, important for lifting the spirit and opening the mind of grieving or stressed patients and family members. And it’s a natural addition to the hospital’s special spiritual spaces. Hope Wall: Quotes from Lois Hole’s speech at the naming ceremony of the eponymous hospital are inscribed on a two-storey granite wall. Over it cascades water, offering a soothing natural sound and catching the light, allowing it to play across and soften the surfaces. “Women tell us that this is a place of great meaning for them,” says Sharlene Rutherford, vicepresident of the Royal Alexandra Hospital Foundation. “They say that seeing it when they first come in to the hospital provides them with reassurance and comfort.” Soft Spot: While this might seem more appropriate in the arts section, many staff members and patients report that the giant metal bird’s nest and eggs, called “Soft Spot” and visible from so many vantage points in the hospital, offers them solace. Each place you view it from brings a new perspective and patients say the thought of the giant bird that built it, soaring just out of sight, brings them a feeling of lightness and hope.

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5 Years of Caring

Spring 2015 • Hope

Health Works

BY COLLEEN BIONDI • ILLUSTRATION BY CINDY REVELL

A Flood of Relief Urinary incontinence sends women rushing to the bathroom. But help is here AS AN ARTIST, TEACHER AND MOTHER of two teenagers, Marilyn Porter (not her real name), 49, manages a busy life in Edmonton. She also manages a condition not uncommon to her peer group – urinary incontinence. “I’ll be working in my office. I’ll feel the need to go and run for the bathroom, but I won’t make it,” she says. “I probably pee my pants on a daily basis.” It’s been an issue for Porter since childhood. She consulted doctors, but they could find no physical cause. Porter was embarrassed that her body was betraying her and was too humiliated to talk about it. Then, about 20 years ago, something

Hope • Spring 2015

shifted. She and a friend were giggling during a visit, her bladder let go and she wet her pants. “There was no way she could not see what had happened, so I came clean. She told me her sister did that all the time.” “It was at that point that I lost the shame,” says Porter. “I learned I wasn’t alone and it wasn’t my fault. It was a turning point.” Today, she wears maxi-pads, voids whenever she can – up to 20 times a day – and makes sure she’s close to a bathroom at all times. Women like Porter are the kinds of patients Dr. Jane Schulz sees in her position as divisional director of urogynecology at the Lois Hole Hospital for Women. 5 Years of Caring

“We get peed on every day,” she says. But she is nonplussed. “Body fluids do not faze us in any way. We want to see what is going on so we can help people.” Schulz is not only frank and funny, she is also setting the bar high and leading opinions in treating urinary incontinence. She says it’s a common problem that doesn’t commonly get talked about. Schulz and her team at the Lois Hole Hospital for Women are creating new best practices that have the attention of other clinical centres, and she says that acknowledging the universality of the problem is the first step. It happens frequently in women over 60 due to age and menopausal changes. The Lois Hole Hospital for Women

“Urinary incontinence can impact one in four women over her lifetime,” Shulz says. It can occur in elite athletes and in women who are pregnant or have had children. Many athletes have low body mass index, which is associated with lower estrogen levels and weaker connective tissues. Add in high impact activities like jumping or running, which put extreme pressure on the pelvic floor, and you are at risk for dribbling. Schulz estimates up to 70 per cent of high-level athletes like Olympic gymnasts and weight lifters will have unwanted leakage during their training or competitive activities.

Schulz’s leadership in the field means help is at hand. During pregnancy, women can leak due to hormonal changes and pelvic organ prolapse. “Fifty per cent of women who have had children will have prolapse, where the bladder drops and pushes against the vagina, or herniates through the vaginal wall,” says Schulz. After pregnancy, damage to the nerves or tissues of the urethral sphincter can result in unexpected peeing. Other professions are not immune. Construction workers, farmers and health-care personnel are vulnerable due to the pressure on the bladder from the lifting and bending associated with their work. “Women who cough frequently – those with chronic obstructive pulmonary disease (COPD) or asthma – are at increased risk,” Shulz says. Schulz’s leadership in the field establishes that, for some women, incontinence and its companion urinary frequency present more than an inconvenience. “Pervasive disruption in sleep from the need to get up and go can lead to anxiety and depression,” she says. Approximately 25 per cent of women experience mental health problems as a result. “But not everyone is bothered by urinary incontinence,” says Schulz. “If the leakage is just a spritz, you might just wear a light sanitary pad and call it a day.” But if you are active and, for example, you spend time on www.loisholehospital.com

the golf course or on the tennis courts and the leakage is significant, it could be bothersome. “Jumping on the trampoline with your kids and wetting your pants,” says Schulz, “that is a huge issue.” For some women, urinary incontinence makes them feel like a wreck. “The good news is it’s highly treatable,” says Schulz. The first line of attack is to discuss the situation with your family doctor, who may make suggestions or refer you to an expert like Schulz. (This is not as obvious as it sounds; many women have not told their spouses about this let alone their primary health care professionals.) At the Lois Hole Hospital for Women there’s a multidisciplinary team consisting of surgeons, nurses, urologists, a family doctor, pharmacist, physiotherapist and a dietician – nurses will take a history and do a physical exam. They will suggest you avoid bladder irritants like alcohol, caffeine, citrus, tomato and aspartame. “They’ll will ask you to keep a bladder diary to record how often you go for a pee,” Schulz says, “and note how much you are peeing and what you are drinking.” Next up is help with urge suppression to increase the time between voiding; Kegel exercises, for example, strengthen the pelvic floor and help contain urine in 60 per cent of cases. Vaginal estrogen – taken twice a week and typically by cream or suppository – helps temper an overactive bladder. If necessary, you can get a ring-like device called a pessary inserted that will support the pelvic organs – the uterus, bladder and rectum. If these conservative management efforts don’t do the trick, there is surgery – bladder slings, prolapse repairs, hysterectomies or vaginal vault suspensions. Schulz and her surgical colleagues are in the operating room four days a week to help women stem the flow. And research is ongoing. Some of the most promising leads involve exploring more effective bulking agents to inject into the bladder neck and developing more resilient graft materials for pelvic floor repairs. For now, the message is clear: women do not have to suffer in silence. “This is a very common condition,” says Schulz. “There are lots of treatment and resource options. You do not have to live with this.” 5 Years of Caring

Squeeze and relax “Imagine you’re sitting on a wooden bench next to the Queen of England and you feel the urge to pass gas,” says nurse practitioner Julia-lin Ding. “Now squeeze that muscle,” she says, putting the emphasis on the word “that.” “If you can do that, you are probably doing a pretty good Kegel right now.” Ding works with Dr. Jane Schulz at the urogynecology wellness clinic at the Lois Hole Hospital for Women. A Kegel is an exercise that she, Schulz and a team of physiotherapists and nurse continence advisors teach women who suffer from urinary incontinence. “A Kegel is the conscious contraction of muscles that support pelvic organs,” Ding says. But the opposite is equally important. “Sometimes my patients with leakage or prolapse have problems relaxing the pelvic floor,” she says. Ding says that women with incontinence or pelvic organ prolapse should be assessed by a physical therapist like the ones in the urogynecology wellness program who have specialized training. These therapists and the specially trained nurses who work with them manually check the ability of the patient to use these muscles before they prescribe a Kegel exercise regime. A typical prescription is 10 quickflick Kegels followed by three slow ones with 10-second holds, performed twice a day. Ding says that healthy women can also benefit from doing Kegels as a preventative measure. If imagining a fart in the presence of royalty doesn’t scare you into a good Kegel, Ding has another metaphor. “OK, your vagina is an elevator,” she says. “Now close the doors, and imagine you are slowly bringing the elevator up to your belly button. I’ll bet you are doing a Kegel right now.”

Spring 2015 • Hope

Corporate Donor

The Responsible Thing What drives a for-profit company to donate money? For Canadian Natural Resources Limited, the answer lies close to home THIRTY-FIVE YEARS AGO, J. CLAYburn La Force, the dean of the Graduate School of Management at the University of California, declared the idea that corporations should behave with social responsibility as a “political fad.” In this speech, given to a group of business executives, he said that proponents of this fad wished to turn the corporation into “an instrument for attaining somebody else’s ambitions, euphemistically called the ‘wider goals of society.’” At the time, the term corporate social responsibility had only been around for a decade or two, and opinion was sharply divided about the role that for-profit companies should have in doing good:

Hope • Spring 2015

La Force’s speech, while reprinted in The Wall Street Journal, was scathingly reviewed by The New Yorker. Today, no one can call corporate social responsibility a fad. However, the intricacies of a for-profit company devoting corporate profits to good deeds remain a tricky business. How much can a public company donate before it alienates the shareholder? How many hours should it encourage its employees to spend on volunteer projects? Do companies with a strong corporate responsibility policies risk having the warm fuzzy feelings engendered by doing good deeds encroach on the bottom line? For Canadian Natural Resources Limited, being a good corporate citizen doesn’t 5 Years of Caring

mean keeping an eye on the wider goals of society, as La Force put it. Instead, its focus is on the communities where employees live and work. Recently, the Calgary-based oil and gas company made a six-figure donation towards the robotic da Vinci Surgical System for the Lois Hole Hospital for Women. This new surgical tool turns a radical surgery with a long recovery time into a minimally invasive surgery that allows more women access to better treatment with shorter recovery times. These women may be valued employees, or the mothers, daughters, or wives of employees. “It’s an initiative that aligns well with Canadian Natural’s focus on health and The Lois Hole Hospital for Women

BY LINDSEY NORRIS

wellness initiatives,” says Julie Woo, a public affairs advisor from the company’s investor relations department. Woo says that the technology will benefit the company’s employees, their families, and the communities in which Canadian Natural operates. Sharlene Rutherford, vice president of the Royal Alexandra Hospital Foundation, noticed a trend towards increased transparency in corporate giving. “The corporations want to truly understand how that donation can make a difference to patients,” she says. “It isn’t enough for a company to say, ‘The da Vinci surgical system will benefit all Albertans.’ They will need to know which communities benefit, where patients are coming from. And they want to be able to communicate that value to stakeholders.” If communication around corporate giving is an important aspect to a successful campaign, Canadian Natural has a lot of good news to communicate: in 2013, the company’s total investment reached $10.8 million, and included programs in more than 50 communities. www.loisholehospital.com

Its donorship benefits more than The Lois Hole Hospital for Women. “Canadian Natural supports diverse opportunities for employees to play a role in helping build stronger, healthier communities,” Woo says. She points to the company’s other beneficiaries, which include the United Way and Habitat for Humanity. Between all

Canadian Natural Resources Limited made a six-figure donation to the Lois Hole Hospital for Women towards the cost of the da Vinci robot. of Canadian Natural’s varied efforts, hundreds of volunteers have logged thousands of hours that benefit organizations in the community financially and materially. Canadian Natural’s rebuilding projects now go much farther afield: its international 5 Years of Caring

division, Canadian Natural Resources International, conducts operations off the coast of the western African nation Côte d’Ivoire, and the management and staff located in that country are currently involved in projects to rebuild schools and hospitals in the southern city of Abidjan, which was affected during the 2011 humanitarian crisis. So, from hospitals in western Africa to the Lois Hole Hospital for Women in central Edmonton, Canadian Natural has its hands in lots of initiatives. In the increasingly transparent environment Rutherford has witnessed over the years, it becomes more important for companies to be clear about where their CSR dollars are going, and Canadian Natural has built consultation and shareholder engagement into the corporate responsibility process. This may be an era in which few people doubt that corporations have some responsibility to behave in a socially responsible manner, but it is also the era in which everything from a Facebook post to a newspaper flier is expected to produce a measurable return on investment. There is research that tries to pinpoint the value of charitable giving – motivated, productive employees, lower turnover, improved reputation – but these benefits remain stubbornly difficult to quantify. What is not difficult to prove is that most employees want to feel that their work has value, and that they work for a company that supports their values. A survey by the Conference Board of Canada found that 71 per cent of employees want to work for companies that commit to social and community concerns, and in the highly competitive job market in Alberta, that is no small benefit – it just happens to benefit the recipient as well as the donor, and in this case, it makes life-changing technology available to Albertans. “It’s support from individuals and corporations that allows us to take our diagnostics to the next level, to offer ground-breaking technology that maximizes our ability to deliver high-quality, compassionate care,” Rutherford says. “We’re so fortunate to have support from Canadian Natural and the corporate community here in Alberta. They help us do amazing things.” Spring 2015 • Hope

Donor Files

BY ROBBIE JEFFREY • PHOTOGRAPH BY BUFFY GOODMAN

Leading with Legacy After the Royal Alexandra Hospital gave the Nakatsui family peace of mind, they gave back NATALIE NAKATSUI IS 10 YEARS old, learning Mandarin, and reading her father’s old science fiction novels. Her father, Thomas, is a dermatologist in Edmonton, and her mother, Melanie, is a well-known volunteer with organizations like The Works Visual Art Society and the Royal Alexandra Hospital Foundation, the latter of which she joined after Lynn Mandel asked her to become involved. They look like a model family – two successful, radiant parents with their exemplary daughter, who is as curious and bright-eyed as she is well-behaved. But Thomas and Natalie’s decision to have a child was fraught with anxiety. Almost two years before Natalie was born, Melanie had been pregnant but had a stillbirth. “I wasn’t sure we should have another child after that,” Thomas says. “It’s really traumatic because you’ve built up a relationship with that child. You feel the baby moving, you’re talking to them – and then something unbearable happens.” Still, they tried again. But Melanie had protein in her urine, often a marker of toxemia of pregnancy, and both feared a second trauma. Six months into Melanie’s pregnancy, her obstetrician identified potential obstacles and sent them to the Royal Alexandra Hospital, now home of the Lois Hole Hospital for Women, where they had access to 3-D imaging technology. It was a blessing. “We looked at the screen and saw our daughter’s face; she was moving around, and she had her thumb in her mouth,” Melanie says. “We could even see her hair.

Hope • Spring 2015

For me, as a mother, I felt such a relief that she was OK, that she looked healthy. That had a huge impact on me emotionally and mentally.” And in 2005, Natalie was born. As Natalie grew up, Thomas and Melanie became more and more involved with the Royal Alex. They were donors to the Lois Hole Hospital for Women during its capital phase. They took tours of the hospital, continually impressed by the calibre of the technology and the staff. Melanie joined the board.

There’s nothing more personal or intimate,” Terry Tobin says, “than how a person decides to allocate the wealth they’ve accumulated throughout their life. Then they met Terry Tobin, senior development officer at the foundation. In 2013, he made a presentation to the hospital’s board about bequests and planned gifts. Shortly after, the Nakatsui family made a monumental commitment. They put the foundation in their will. Tobin is both a consultant and an agent. He provides prospective donors with information or sample wording of how they can include the hospital in their estate plans; he also administers and directs those gifts. But he quickly dispels 5 Years of Caring

any notion that he persuades people into gift-giving. “There’s nothing more personal or intimate than how a person decides to allocate the wealth they’ve accumulated throughout their life,” he says. “No one can convince you to make a gift in your estate – it always comes from the donors’ hearts and minds.” A gift in a will can be customized. Sometimes donors are specific in where they’d like their money to go, while others are content to give to whatever the hospital needs. They can request that their name be public or private. Sometimes Tobin is surprised to find that people who have donated small amounts throughout their life leave to the hospital a considerable bequest. And sometimes, someone leaving a bequest will also end up getting more involved in the hospital during their lifetime. The choice is up to the donor, whose wishes are paramount. With Tobin’s guidance, the Nakatsui family earmarked $50,000, an amount they’ll add to over time, in their will for the Royal Alexandra Hospital Foundation, to go toward whatever needs funding at the time. Tobin cautions donors about getting too specific with choosing a specific program or area – some areas are well funded, while others need more attention. Some programs may change in years to come. “Terry made it very easy for us,” Melanie says. “He explained to us in a very understandable way, and we decided from there.” Tobin underscores the importance of telling the donors’ stories. “Gifts from strangers are beautiful, but we’d like to know from whom we get our gifts so we can tell their The Lois Hole Hospital for Women

WHERE THERE’S A WILL: Thomas and Melanie Nakatsui have made a lifelong commitment to the Lois Hole Hospital for Women.

stories,” he says. “If someone prefers to remain anonymous, we can tell their story in a way that protects their identity, but we like to share stories. There’s usually a connection between what the donors think is important and what the foundation does.” Malcolm Burrows agrees with Tobin. As head of philanthropic advisory services at Scotiabank’s Private Client Group, he is happy to discuss the logistics of planned giving and talks about the importance of consulting an expert. And of course he speaks enthusiastically about the benefits of leaving part of your estate to charity, and how people can gift a charity and eliminate tax on those funds. But he, too, circles www.loisholehospital.com

back to the importance of storytelling. “One of the great mistakes in the area of planned giving is that we focus too much on the mechanics and not enough on why people want to give back. It’s not so much a question of ‘Will I do it if I find the right way to do it? Will I do it if I save enough taxes?’” Burrows says. “Planned gifts are driven by life experiences – putting it in that context is the first thing to grapple with.” It’s no surprise then, that another motivating factor behind the bequest of the Nakatsuis was reading the story of Kazimierz (Kasey) Kozak, who left a gift to the Royal Alexandra Hospital Foundation to honour his late wife. Not only do the Nakatsuis have their own 5 Years of Caring

incredible story to tell – they were inspired by someone else’s story. And as Natalie Nakatsui reads her science fiction novels, it’s clear that the power of telling these stories will carry on.

TO GIVE A GIFT

A bequest in your will supports compassionate, world-class patient care at the Royal Alexandra Hospital and the Lois Hole Hospital for Women. To learn more, contact Terry Tobin in Bequests and Planned Gifts at the Royal Alexandra Hospital Foundation, 10240 Kingsway NW, Edmonton AB T5H 3V9, 780-735-5061, bequests@royalalex.org

Spring 2015 • Hope

Donor Files

BY SAM MACDONALD

The Modest Donation When donors band together and pool their resources, the results are as powerful as any corporate gift

THE LOIS HOLE HOSPITAL FOR Women is flourishing from community support. Donations from thousands of contributors run the gamut of amounts, and most come from close to home. “We have valuable donors who make major transformational gifts to the hospital,” says Sharlene Rutherford, vice-president of the Royal Alexandra Hospital Foundation. “We certainly couldn’t make the changes we do without those.” But Rutherford says there is also power to create enormous progress, fuelled by modest donations. “Community support turns a good hospital into an outstanding hospital,” she says. Modest donations might include one-time gifts of the proceeds from children’s bake sales and birthday parties that ask for donations in lieu of gifts. They also include one-time or regular, recurring donations from adults. Anne Fry, a realtor with Remax Excellence, is one such contributor, who has signed up for a monthly donation. Fry was inspired to donate after seeing first-hand what charitable giving, even in small amounts, can accomplish. She cites the kindness of her mother, Susie Fry, and Lois Hole, the activist after whom the hospital is named, as her inspiration. “Lois Hole inspired many of us, and in donating, I also

Hope • Spring 2015

remember my mother. Both were vibrant, giving people.” And a little at a time over time adds up. “Let’s put it this way – there’s a room in the hospital named after my mother,” Fry says. Rutherford says that donors often take an active role in their contributions. “They’re interested in learning whether the hospital is leading in the areas they donate,” she says. “Oftentimes, we are.” An example of the power of small donations is a piece of game-changing technology called the da Vinci Robotic Surgical System. (Read more about da Vinci on page 60.) Rutherford says da Vinci was purchased in part thanks to some large donations. But a campaign led by Edmontonian Lynn Mandel energized thousands of donors who stepped up to make it a reality with small gifts specifically for this project. Modest donors, most of whom are women, have contributed more than $100,000 towards daVinci, Rutherford says. But so many other features at the hospital are likewise made possible by the multitude of modest contributions. CuddleCots, cooled bassinets to allow more time for grieving parents to spend time with deceased infants, are an important bereavement program resource fuelled by 5 Years of Caring

small donations. Other items include breast pumps for the mothers of premature babies in the neonatal intensive care unit, and blood pressure monitors for mothers with highrisk pregnancies who need close monitoring. “Not everything is really high-tech, but it’s certainly an enhancement to the hospital that provides special care for families,” Rutherford says. Fry agrees, and says that gathering and donating funds to enhance the hospital has been personally very important to her. A special moment that recognized her efforts was the naming of a room after her mother. “When I was first asked to be on the committee raising funds, I didn’t have that much awareness of the importance of small donations,” she says. “I was just one person among a big number of people.” That’s when she realized that harnessing the power of the individual meant harnessing the power of the group.

A Little Goes a Long Way To donate any amount, modest or otherwise, donors can give with the click of a button. Visit royalalex.org/loisholehospital and select the “Donate” button. It will take you to a secure page where you can enter an amount and indicate if it’s a one-time gift or a recurring gift, and also select a campaign or leave comments. You can also indicate if your gift is a memorial gift or one that marks a special occasion. To donate over the phone, call 780-735-4723.

The Lois Hole Hospital for Women

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