Your Health Matters - fall 2018

 

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ROYAL COLUMBIAN HOSPITAL FOUNDATION MAGAZINE Your Health Matters FALL/WINTER 2018 EDITION IN THIS ISSUE + CYTOGENETIC TESTING Royal Columbian’s far-reaching role in the study of chromosomes + LIVING TO INSPIRE Twelve years after a traumatic brain injury, one man’s quest to help others + MASS CONCERN Surgical specialty offers a chance against challenging pancreatic cancers + REPORT TO DONORS What your support this past year has meant for patient care THIS MAGAZINE BROUGHT TO YOU WITH GENEROUS SUPPORT FROM

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BUILDING EXCITEMENT It doesn’t seem that long ago that excavation started on the first phase of Royal Columbian Hospital’s redevelopment. Take a look now, and you’ll see the new Mental Health and Substance Use Wellness Centre increasingly taking shape. It’s remarkable to see how construction has progressed in the last year and a half. Of course, the new mental health facility is just the start of the transformation that is underway. Still to come is a new 10-storey Acute Care Tower that will become the centre of activity for many of the critical care programs that are so essential to the most seriously ill and injured British Columbians. All it takes is a glance at the construction to see how much work is being put into completion of the mental health centre in time for its opening in 2020. Behind the scenes, much is also happening to bring excellence and innovation to the care we provide at Royal Columbian. We have captured some of that excitement in a special article on redevelopment in this issue of Your Health Matters. You will learn what all the buzz is about from some of the key partners in this $1.35 billion project. Also in this edition of the magazine, you will meet the lead physician for redevelopment and find out the change he envisions upon completion of the hospital’s expansion. As always, we are also grateful to share stories of people who have received exceptional care at Royal Columbian. Their experiences remind us how suddenly a health crisis can come, and how fortunate we are to have such a dedicated and highly skilled team ready to help us in our time of need. Doug Eveneshen Chair, Royal Columbian Hospital Foundation 2 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION Jeff Norris President & CEO, Royal Columbian Hospital Foundation

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CONTENTS VOLUME 4 • ISSUE 2 EDITOR Jason Howe CONTRIBUTING PHOTOGRAPHER Jerald Walliser LAYOUT & DESIGN Gary Slavin COVER DESIGN Paula Heal PUBLISHED BY New Westminster Record Royal Columbian Hospital Foundation Board of Directors Chair: Doug Eveneshen Vice Chair: Tom Corsie Treasurer: Steve Osachoff Secretary: Colin Galinski President and CEO: Jeff Norris Directors: Cameron Belsher, Dr. Sukh Brar, Frank Butzelaar, Meldy Harris, Jennifer Podmore Russell, Farid Rohani, Catherine Ruby, Dr. William Siu, Emily Taylor, Norm Taylor, Rana Vig, Fred Withers We welcome your comments on Your Health Matters magazine. Please email info@rchfoundation.com or write to us c/o Royal Columbian Hospital Foundation, 330 East Columbia Street, New Westminster, BC V3L 3W7. Established in 1978, Royal Columbian Hospital Foundation raises millions of dollars annually to purchase medical equipment, fund innovative programs, and support training and research. To donate, please visit www.rchfoundation.com or call 604-520-4438. 6 8 11 2 Greetings Royal Columbian Hospital Foundation Chair Doug Eveneshen and Foundation President and CEO Jeff Norris 4 Inspired giving Behind-the-scenes briefs 5 A family’s farewell Royal Columbian facilitates a peaceful end to a long union 6 Seizing the spotlight Royal Columbian Hospital is now buzzing over its unprecedented and transformational redevelopment 8 Report to donors With the help of donors like you, we are able to purchase life-saving equipment each year 10 Living to inspire Twelve years after a traumatic brain injury, one man’s quest to help others 11 Mass concern Surgical specialty offers a chance against challenging pancreatic cancers 12 Cytogenetic testing Royal Columbian’s far-reaching role in the study of chromosomes 14 Backbeat Injury sends Port Moody musician’s health on downward spiral 15 Internal medicine, external growth Dr. Matt Bernard serves as physician lead for Royal Columbian’s redevelopment project 3ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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INSPIREDGIVING Pacific Blue Cross is helping to shine a light on mental health at Royal Columbian Hospital. The benefits provider is contributing $100,000 towards the new Mental Health and Substance Use Wellness Centre. Royal Columbian Hospital Foundation is working with donors to raise $9.1 million in support of the new 75-bed facility. With leadership from Dr. Arun Garg, the Foundation has introduced a new Special Purpose South Asian Health Fund, with an initial focus on mental wellness. The fund was created to build leadership in South Asian health and was unveiled at the Canada India Networking Initiative 2018, a quadrennial gathering of health experts led by Dr. Garg. Seren Williams spent five days in Royal Columbian Hospital’s Variety Neonatal Intensive Care Unit when she was born. For her fifth birthday, she asked her friends to each donate $5 to help our newborns. Several cardiac arrest survivors joined interventional cardiologist Dr. Gerald Simkus and St. John Ambulance to raise awareness of the importance of knowing CPR and how to use automated external defibrillators. As BC’s busiest cardiac care centre, Royal Columbian treats more heart emergencies than all other cardiac centres in the province combined. For the latest Royal Columbian Hospital Foundation news, follow us: 1 By subscribing to our monthly e-newsletter at www.rchfoundation.com 2 On Facebook: www.facebook.com/ RoyalColumbian 3 On Twitter: @RoyalColumbian 4 On Instagram: www.instagram.com/ royalcolumbian 4 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION

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A FAMILY’S FAREWELL Colleen and Murray McRae married young and were together for a remarkable 70 years when they were admitted to Royal Columbian Hospital separately in the summer of 2017. When staff learned they were husband and wife, caregivers moved them together in a room that became affectionately known as the “honeymoon suite”. It was a gesture the family appreciated, even more so in hindsight when 87-year-old Murray passed away less than a week later. “You couldn’t have asked for anything better for end of life,” says daughter Linda Cann. Her parents had lived in the same New Westminster home for three decades, but in recent years, Colleen had developed dementia. Murray did everything he could to care for her at home, but a chronic bladder infection led Colleen to be admitted to hospital. “He religiously attended and was absolutely her advocate for making sure she was in the best care,” says Ron Cann about his grandfather’s daily visits to Royal Columbian while Colleen was being treated with antibiotics. But Murray, who had chronic obstructive pulmonary disease (COPD), started coughing blood one day and was taken by his family to the emergency department. There, they received stunning news – he had terminal lung cancer. “He wasn’t surprised,” notes Linda. “He accepted it right away. He knew there was something desperately wrong.” Honeymoon suite Murray was admitted to the same floor as his wife, although they started off in separate rooms. A family member brought the couple’s relationship to the attention of staff, and soon they were together in a room by themselves. “The nurses were calling it the honeymoon suite,” says Linda. “It was wonderful that they could be together, although we didn’t realize at the time my dad was going to go so quickly.” Murray’s health deteriorated a few days after he was admitted, and he passed away less than two days after that. Despite the sudden loss of their loved one, the family appreciates the hospital’s efforts to make the moment as comfortable as possible. “It was wonderful to be able to be there with him, at the very end, and bring my mother to him, right there in the room, not disturbing anyone else, having the space for ourselves,” says Linda. “It allowed the event to go from being in a cold institution to something as if it was happening at home,” adds Ron. “We weren’t expecting grandpa to pass away. In retrospect, isn’t that an amazing way to wrap a very long life and chapter?” Royal Columbian facilitates peaceful end to a long union ABOVE: Murray and Colleen McRae were married for a remarkable 70 years. 5ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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Redevelopment feature SEIZING THE SPOTLIGHT Traditionally BC’s unsung hero of healthcare, Royal Columbian Hospital is now buzzing over its unprecedented and transformational redevelopment Hospital upgrades are always an important undertaking, as well as being elaborate in terms of logistics. But the impact of the three-phase, $1.35-billion improvement for Royal Columbian Hospital is such that it recently prompted Tom Sparrow, the hospital’s redevelopment chief project officer, to remark, “What’s taking place is spectacular and of significant benefit to New Westminster, Metro Vancouver and all of BC.” That’s because the upgrades — which comprise the largest governmentfunded health care redevelopment project ever approved in BC — are for the only hospital in the province TOP: Preliminary design concept (subject to change) of the Acute Care Tower to be built during phase 2 of Royal Columbian’s redevelopment. with Level 1 trauma, cardiac care, neurosurgery, high-risk obstetrics, neonatal intensive care, and acute mental health care services, all on one site. Royal Columbian is BC’s busiest cardiac care centre; it is the only hospital in BC that cares for certain critically ill pregnant women and their unborn children; and it is one of the province’s busiest emergency departments and medical heliports. There are many other distinctions to Royal Columbian, which is also the province’s oldest hospital (established in 1862); but the bottom line is that with it serving about one third of the total population of BC, the upgrades — Phase 1 of which is already underway — will take these services to stratospheric new heights. As far as Royal Columbian site medical director and critical care physician Dr. Steve Reynolds is concerned, the upgrades are also drawing much-needed attention to the hospital’s achievements. “I came here eight years ago and was struck by how such a talented team of health care professionals did amazing work and yet weren’t inclined to draw attention to themselves,” he says. “It’s an admirable quality, but unfortunately it tends to compromise Royal Columbian when it comes to advocating for funding or the distribution of resources.” Building blocks So how will $1.35 billion make Royal Columbian better than it already is? For starters, the first phase will add a new mental health and substance use wellness centre to the infrastructure, consisting of 75 beds (an increase from the current 30) as well as a new, more efficient energy plant and an advanced fibre-optic network. Phase 2, which will unfold between 2020 and 2024, will see the construction of a new acute care tower to provide more beds, a new and larger emergency department, four more operating 6 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION

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Royal Columbian Hospital is BC’s busiest cardiac care centre, performing complex open-heart surgery as well as minimallyinvasive procedures to open blocked arteries and replace failing heart valves. rooms, more MRI capacity, plus equipment and site enhancements. The final phase, which will commence in 2023, includes upgrades to areas in the Health Care Centre and Columbia Tower to support the beds and services added in Phase 2. It includes expansion of clinical support spaces, conversion of four-bed inpatient rooms, and improvements and expansions to the pediatric and neonatal intensive care units. The amount of planning and collaboration required to move this project forward is enormous, with the provincial government, Fraser Health, and the Royal Columbian Hospital Foundation responsible for funding — the latter currently fundraising in order to make multimillion-dollar contributions to the three phases. Unfolding future “It’s interesting to think that donations from industries and the community allowed the original Royal Columbian to be built in 1862 for just under $3,400, and here we are relying on benefactors again,” says Foundation president and CEO Jeff Norris. “The response we’ve received is overwhelming; we’ve already raised one-third of the $9 million we set as the Foundation’s goal for Phase 1 of redevelopment, thanks to a $1 million donation from BMO Financial Group to really get the ball rolling.” Sue Paish, the Foundation’s redevelopment campaign cabinet chair, says, “Royal Columbian’s redevelopment teams are being visionary, practical, courageous and confident in planning both the bricks and mortar elements of the new hospital and, most importantly, the service delivery plan.” To which Dr. Reynolds adds, “Our culture, our processes, how we flow patients through the system — everything is being analyzed to create even better efficiencies than we have now.” Paish continues, “This process is vital, because healthcare needs are evolving. To take just one example, the population of seniors we serve will double in 20 years, and there are plenty of other changing demographics we must be ready for.” While various public figures associated with the upgrades expressed their excitement about the project when it was first announced in 2017, New Westminster mayor Jonathan Coté most accurately summarizes the sentiment by remarking, “Finally, the sleeping giant that is Royal Columbian is getting the attention it deserves. We’re very much looking forward to how the future will unfold.” Sue Paish (7th from left) chairs the Foundation’s redevelopment campaign cabinet 7ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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REPORT TO DONORS With the help of donors like you in 2017-18, Royal Columbian Hospital Foundation has been able to purchase equipment for a number of hospital departments, including the following: hundreds of newborns annually. The infant transport incubator is a self-contained, mobile intensive care unit that controls temperature and humidity and allows for quick and easy access in emergencies. This specialized equipment was purchased with the help of donors to the Foundation’s running team during the Scotiabank Charity Challenge. Supporting complex cancer care Surgical retractors help give surgeons the best view possible during complex procedures. The tools are used in hundreds of surgeries a year at Royal Columbian, and the ability to see and act could make the difference in a patient’s life. In particular, retractors were at the top of the wish list for the hospital’s liver and pancreas cancer surgical team, which treats patients from throughout Surgical retractor sets are used in hundreds of complex operations a year at Royal Columbian Hospital, including liver and pancreas cancer cases. the health region. With the generosity of donors, the Foundation has been able to purchase four of these sets. In addition to liver and pancreas surgeries, the retractors are used in trauma cases as well as in a number of other surgical specialties. Transporting our smallest patients It takes the right skills and equipment to transport high-risk and critically ill newborns from one hospital to another, or even between departments within one hospital. Our Variety Neonatal Intensive Care Unit, as one of four centres in the province equipped and trained to care for the smallest and most fragile premature babies, supports Gold standard screening Colonoscopes are the gold standard screening method for colorectal cancer, which is among the leading causes of death from cancer for men and women. When found early, colorectal cancer is highly treatable. Royal Columbian Hospital is a major referral centre for screening and treating colorectal cancer. By partnering with football Hall of Famer Lui Passaglia and philanthropist Jack Gin during our Get Behind Lui campaign, donors to the Foundation have added another Donors joined football Hall of Famer Lui Passaglia and philanthropist Jack Gin to purchase a pediatric colonoscope. The infant transport incubator is a selfcontained, mobile intensive care unit to help transport critically ill newborns. instrument to the Gastrointestinal (GI) Clinic’s toolkit: a pediatric colonoscope, which is thinner and more flexible than a regular colonoscope and can be a better choice for some adults. 8 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION

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warming at very specific increments. It allows health professionals to put the patient into an induced hibernation, reducing the demands and needs of the patient at a cellular level, thereby preventing brain and heart cell death. This helps ensure more intact cognitive brain and heart function. Assessing blood vessels Donors to the Foundation have helped open Fraser Health’s first vascular lab for people at-risk of a common but under-recognized circulatory problem. Hundreds of patients at risk of a common but under-recognized circulatory problem can be assessed at Royal Columbian Hospital’s vascular lab, the first in Peripheral artery disease (PAD) is a the Fraser Health region. narrowing of the arteries other than those that supply the heart or the brain. Induced hibernation If left untreated, the condition could This is no ordinary blanket. The lead to amputation. Hypo/Hyperthermia Blanket is used A treadmill exercise test can be used in the Intensive Care Unit (ICU) to to identify narrowed blood vessels. regulate body temperature for patients Donors purchased the diagnostic who are recovering from a severe illness system used in the lab during testing. or traumatic injury. Breast imaging upgrade A key tool in the detection and treatment of breast cancer, MRI involves magnets and It can be used to either heat or cool patients. The blanket’s innovative programming maintains a stable body temperature and provides cooling and radiofrequency waves to produce detailed images. Hundreds of patients each year receive diagnostic breast MRI exams at Royal Columbian. Donors have helped to upgrade the computer- aided diagnosis software that is essential for MRI breast imaging. The system allows the radiologists to detect and characterize breast lesions while they review the images. This system also allows radiologists to perform MRI guided breast biopsies of breast lesions that would be difficult or impossible to see using other imaging modalities such as mammography or ultrasound. Donors have helped to upgrade the computer-aided diagnosis software that is essential for MRI breast imaging. Sim doll The Hypo/Hyperthermia Blanket is used in Simulation mannequins breathe, talk and blink like a real patient. They allow the Intensive Care Unit (ICU) and can help prevent brain and heart cell death while recovering from a severe illness or traumatic injury. healthcare providers from throughout the hospital to practice their life- saving skills during simulated medical emergencies. The technology was pioneered in the aviation industry, allowing pilots to train for rare, critical events in a safe environment. Donors have funded a new sim doll to educate and train students, residents, physicians, nurses, respiratory therapists and others. Simulation exercises help improve long-term retention of skills and bring teams together to practice multidisciplinary care. This sim doll allows healthcare providers to practice their skills during simulated medical emergencies. 9ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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LIVING TO INSPIRE Twelve years after a traumatic brain injury, one man’s quest to help others Michael in a coma in 2006. Michael (3rd from left) with parents Bob and Suzie Coss, twelve years after Michael’s traumatic brain injury. Michael Coss has made it his mission to inspire. Twelve years ago, his future appeared bleak to many after the van he was driving rolled over on the Coquihalla Highway. He suffered a traumatic brain injury and remained in a coma for six months at Royal Columbian Hospital, the health region’s referral centre for brain and spine surgery. While the accident permanently changed his life, the 49-year-old sees lots of opportunity in his remarkable and ongoing recovery. “I don’t feel sorry for myself,” Michael says while at the Langley home he shares with other survivors of traumatic brain injuries. “If I had the choice, I like how I am now. I’m a better person having gone through what I have.” While Michael has no memory of being at Royal Columbian, clinical nurse specialist Trudy Robertson remembers. She was a clinical nurse educator on the hospital’s neurosciences unit when Michael arrived. “His care was provided 100%, in all aspects, by the care team,” Trudy recalls. “He was dependent on us for his survival.” In addition to treating the severe diffuse axonal brain injury, the care team had to work to prevent a number of potential complications. These can include pneumonia, infections and muscle spasticity. “Our job is to put actions in place to prevent complications from occurring,” explains Trudy. “It can be quite a chase, considering how sick people can become and how they respond to treatment. There are so many things we are trying to keep on our radar.” Awakening For months, the progress was very hard to recognize. Michael’s parents Bob and Suzie came from Quebec to be at their son’s bedside every day. “One day, as we were taking Michael out of his room, a close friend of his came out of the elevator,” Bob remembers. “As soon as Michael heard his name, we saw tears coming out of his eyes. That was the first sign of recovery.” A few months after being admitted, with few encouraging signs in his prognosis, Michael’s parents arranged for him to be transported regularly to Richmond for special hyperbaric oxygen therapy treatment. “Paramedics would come, and we would wrap Michael in blankets and put him on a stretcher and take him,” says Suzie. From there, Michael started showing new signs of recovery. His eyes started to focus. His fingers began to move. “I can remember some of the nurses being so full of enthusiasm and so happy for Michael,” recalls Bob. Michael had to relearn everything, from swallowing to sitting and speaking. He eventually progressed from a wheelchair to his own two feet. “I think his recovery was remarkable,” says Trudy. “He and his family really contributed to a great portion of his recovery being as successful as it has been.” These days, Michael seeks many opportunities to share his story and help others who face similar challenges. “It gives me the drive,” he says. “It gives me purpose. It gives me satisfaction. It gives me good joy to do that for others.” 10 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION

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LEFT: Dr. SHAWN MacKenzie performs complex liver and pancreas surgeries on patients who live throughout the health region and even beyond. BELOW RIGHT: Hepato-PancreaticoBiliary (HPB) surgeon Dr. Shawn MacKeNZIE MASS CONCERN Surgical specialty offers a chance against challenging pancreatic cancers Rose Donovan had not been feeling well for weeks. The 52-year-old Maple Ridge woman was dealing with headaches, nausea, hot flashes, and then a pain on her upper right side. She suspected stress as the cause, but her family doctor sent her for a gallbladder ultrasound. The test result was blindsiding – there was a golf ball-sized mass on her pancreas. “You hear that cancer word and it’s like, ‘Oh my God! What does this mean?’” says Rose. “Being a sole parent, it was a hard time.” Pancreatic cancer has a reputation for having a Rose Donovan feels fortunate after undergoing a complex surgery at Royal Columbian to treat pancreatic cancer. high mortality rate. Rose had a threecentimetre neuroendocrine tumour, a rarer form and slower-growing than the more aggressive adenocarcinoma. As a comparison, actor Patrick Swayze died of pancreatic adenocarcinoma. Rose’s case was comparable to the type that afflicted business innovator Steve Jobs. “I honestly spent the first three days feeling sorry for myself,” says Rose. “I cried a lot in private. Then I shook myself out of it, because it wasn’t going to help anybody if I couldn’t stay together.” Walking miracle Since Royal Columbian Hospital performs the health region’s complex pancreas and liver surgeries, Rose was referred to Hepato-Pancreatico-Biliary (HPB) surgeon Dr. Shawn MacKenzie. “Neuroendocrine tumours are easier to handle than adenocarcinoma,” explains Dr. MacKenzie. “They are less likely to spread, and there are potential treatments we can do if it has spread. We have a better chance to cure.” Rose was scheduled for a complex surgical procedure known as a Whipple to remove the head of the pancreas, part of the small intestine, the gallbladder and the bile duct. Reassured by Dr. MacKenzie and supported by her family and friends, Rose headed into the surgery with optimism. “I have always been a positive thinker,” she says. “But you have to push aside any possibility of anything being different than the outcome you want. And that’s what I did.” The surgery was a success, and Rose stayed in hospital for just over a week. A year and a half later, she considers herself a “walking miracle” who is staying focused on the positives even while managing inconvenient side-effects like low energy and gastrointestinal issues. She is also at a higher risk of developing diabetes and will need to be monitored for the rest of her life in case the tumour recurs. “Dr. MacKenzie is my subject matter expert,’ she says. “I felt he was very upfront and honest about what to expect. I feel very comfortable with him and trust him. For me, everything happens as it should.” 11ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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As Royal Columbian Hospital’s cytogenetics medical director, Dr. Monica Hrynchak studies chromosomes for abnormalities that can lead to a diagnosis. Cytogenetic testing Royal Columbian’s far-reaching role in the study of chromosomes It was during Vicki Foley’s 20-week ultrasound that they discovered fetal measurements were about a month behind schedule. Thus began regular monitoring and eventually a planned delivery at 37 weeks. While Royal Columbian Hospital’s Variety Neonatal Intensive Care Unit looked after baby Hope for her first few weeks, it took genetic testing to offer an explanation for the newborn’s small size. She was diagnosed with a rare chromosomal condition known as Wolf-Hirschhorn syndrome. “There’s a huge spectrum of things with this syndrome,” says Vicki, seven months after Hope’s birth. “Some have certain delays or difficulties, and they range from being quite minor to being really significant. We don’t really know where she falls in yet. We are going to find out more as she grows up.” Wolf-Hirschhorn is caused by the absence of part of the short arm in chromosome number 4. It generally causes delayed growth and development and is associated with distinctive physical features. Since the diagnosis, Hope’s parents have been helping her develop through several exercises that target Hope’s upperbody, head support and leg extension. “We are so fortunate to have a diagnosis so early in Hope’s life,” says dad Matthew Annis. “We have put a lot of effort into physical therapy, occupational therapy and really utilize the resources to help Hope.” Hands-on lab work The diagnosis came as a result of work in a part of Royal Columbian that people don’t usually see. The molecular cytogenetics laboratory involves the study of chromosomes, and the hospital conducts testing for the health region, other parts of the province and even as far away as Saskatchewan. “We provide the biggest and most diverse testing of anywhere in the province,” says Dr. Monica Hrynchak, Royal Columbian’s cytogenetics medical director. “We do blood chromosome analysis for couples who have recurrent pregnancy losses. We do mostly chromosome microarray for children who have developmental delay or congenital 12 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION

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RIGHT: Hope, at home with her parents and brother, is about two months behind the usual milestones associated with infant development. BOTTOM: Hope (pictured here at nine months old) was diagnosed with a rare chromosomal condition known as Wolf-Hirschhorn syndrome. abnormalities. We also do bone marrow analysis here.” “Over the years, our ability to provide clinical care and counselling in many cases has been enhanced or made possible thanks to the work of our cytogenetic lab,” says neonatologist Dr. Zenon Cieslak. The work is labour-intensive and in Hope’s case starts with a blood sample. Chromosomes are pulled from white blood cells by technologists using a number of techniques that offer physicians like Dr. Hrynchak an opportunity to search for abnormalities and determine whether they are significant or not. “Cytogenetics is very handson,” explains Dr. Hrynchak. “There’s not much automation. It’s all done manually. The biggest thing the computer does is allow us to digitally manipulate the chromosomes.” Next evolution Cytogenetics has continued to evolve in the three decades since the service was first introduced at Royal Columbian. And next-generation sequencing is poised to increase the role of cytogenetics in patient care. “It’s the next iteration of what’s going to happen in anatomical pathology,” says Dr. Hrynchak. “There are very specific genetic changes that can be identified by next-gen sequencing in specific tumours, and depending upon the change you have, it will determine what kind of treatment you get.” “With new advancements, new techniques and progress available in genetics, its role will only continue to get more and more important in the coming years,” adds Dr. Cieslak. Following the overwhelming emotions of the first weeks after Hope’s birth, her parents are grateful that the work of cytogenetics has focused the family on a plan for their daughter that has already led to good results. “I am glad we know, because we have been able to get on and help her,” says Vicki. “We have already seen big changes in her. She is doing really well. She is a really happy little girl, and we are on top of trying to get her strengthened and doing all these things that are going to help her progress more.” 13ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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Terry about the start of his troubles, which he attributes to some heavy pulling at work. “As all these other symptoms started to come along, the pain sort of shifted over to more of the middle of my lower back. It felt like my intestines were being twisted.” Over a number of weeks, his symptoms included constipation, Terry Banks is grateful for the care he received at Royal Columbian and wants to use his talents as a musician to give back through the Foundation. BACKBEAT Injury sends Port Moody musician’s health on downward spiral Back pain by itself can be debilitating. For Terry Banks of Port Moody, a nagging lower back sprain was only the start of his problems. By the time he made his way to Royal Columbian Hospital’s emergency department weeks later, he was struggling with a number of complications. Now shivering and desperate for help, Terry wondered what was happening to him. “Originally, the pain felt like it was on the lower left side of my back,” recalls frequent urination, elevated blood sugar levels, weight loss and constant discomfort. A course of antibiotics for a prostate infection didn’t bring relief. Disc danger After finding blood in his urine, he was referred for a CT scan. That’s when Terry went to Royal Columbian’s emergency department. It was there he started shaking and had to be wrapped in warm blankets. “When I looked at him, you could see his pulse was quite fast, but there was no (unusual) temperature,” says emergency physician Dr. Joe Haegert. “He was alert but obviously in a lot of distress and was having a hard time moving.” Dr. Haegert suspected an infected disc, and testing revealed it was a Staph aureus infection. Terry was admitted to hospital and put on a new antibiotic. “The concern with the Staph aureus discitis is that if unchecked, untreated with antibiotics or other treatments, it can continue to swell and cause an abscess,” notes Dr. Haegert, “which can compress the spinal cord and could eventually lead to paraplegia. Terry was fortunate that he came in time.” Three months later, and Terry wells up as he thinks about all that happened. “You don’t come that close to being that sick and not be grateful to the people that saved your life,” he says. “Everybody just seemed to really care and really wanted to see me get better. I feel pretty damn lucky.” 14 YOUR HEALTH MATTERS I ROYAL COLUMBIAN HOSPITAL FOUNDATION

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Internal medicine, external growth When Dr. Matt Bernard had his first up-close look at the amount of work going into Royal Columbian Hospital’s redevelopment plans, he found it eyeopening. An internal medicine specialist with a deep interest in clinical teaching, Dr. Bernard has also now taken on the role of bridge-builder between the hospital’s doctors and the physical transformation that’s taking place around them. Foundation: What are your responsibilities as the physician lead for the redevelopment project? MB: I think my key role is to engage the physician body, bring them into the conversation, ensure they have opportunities to have their opinions heard, and make sure we are all working towards the best possible hospital for our patients. Foundation: Redevelopment is a massive project. What’s your take on what it’s going to mean for Royal Columbian? MB: I think this is going to be a huge opportunity for the Royal Columbian Hospital community to redefine our future. There is so much energy and effort being put forward by so many people. I hope we build a facility that enables and reinforces the existing culture of patientfocused care, hard work, and professionalism that really does permeate through the hospital. Certainly if you practice at enough different places, you will realize just how special this particular place is. Foundation: What will redevelopment mean for patients and patient care? MB: I would hope right now that patients would recognize how hard people here do work, in what can sometimes be a difficult physical environment, to ensure that their care is excellent. I think the patient experience in the new building will be vastly better in terms of singlepatient rooms, built-in space for family members, and the flow between different areas of the hospital. I think it’s also important for patients that the facility reflects the level of care they will receive. Foundation: Will the redevelopment be a significant attractor of new talent? MB: Absolutely. It’s already been identified that we need to have the right people here to support the enhanced services that we will have. I think this is going to transform certainly this whole campus and the surrounding area. By building an outstanding new facility and allowing people to do the things they have been trained to do, we will enhance our ability to recruit the best people in the province, country, and world. 15ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS

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