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Health
New stroke treatment helps more Canadian patients return home to their normal lives
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The Current19:05Calls for greater access to life-saving treatment for stroke
When Marleen Conacher was taken to a hospital for major stroke treatment for the second time in a week in 2021, she wasn’t treated with a clot-busting drug like she was previously given at North Battleford Hospital in Saskatchewan.
Instead, she was transported directly to Royal University Hospital in Saskatoon, where a stroke team performed an endovascular thrombectomy (EVT).
The procedure involved passing small devices through one of the arteries in her groin, and then using suction, or tubes called stents to pull the stroke-causing blood clot out.
“I don’t recall when they, they put the little claw-like thing up through my groin and it went up through the artery and, and into my brain,” she said. “But I do remember feeling when they had got to it and were pulling it out.”
“It was a great deal of pressure. It did not hurt, but it was a great deal of pressure,” she told The Current‘s Matt Galloway.
Within a few days of the stroke, Conacher was out of the hospital, walking on her own and ready to go shopping.
She said she doesn’t think about the stroke much these days.
“I don’t spend a lot of time, you know, thinking about having a stroke or whatever or that time,” she said. “I just thank the good Lord that I am here.”
EVT procedures are a relatively new option in the field of ischemic stroke treatment. In 2015, a study known as the escape stroke trial led by the University of Calgary’s Hotchkiss Brain Institute found that, overall, positive outcomes for stroke patients increased from 20 per cent to 55 per cent thanks to EVTs.
Today, EVTs are used in about 25 to 30 major hospitals across Canada — and according to the senior study author and stroke specialist Dr. Michael Hill, it’s had a “massive treatment effect.”
“People would come in and they were paralyzed on one side, they couldn’t speak or they were severely affected, and they were leaving the hospital in two or three days,” he told Galloway.
“That was a visible change … whereas [before] people would have stayed many days and weeks for their recovery and rehab, if they survived at all.”
Speed is critical
Hill said the key to this procedure’s success is speed, as “10 or 15 minutes makes a difference.”
That’s why a patient is often greeted at the door by a team of emergency department nurses, physicians and the stroke specialist.
“When we’re alerted to a stroke or suspected stroke syndrome and we’re meeting somebody in the emergency room, we’re hustling to get there and be there before the patient or just after the patient arrives,” said Hill, who is a neurologist at the Foothills Medical Centre in Calgary.
Dr. Michael Mayich at the London Health Sciences Centre’s University Hospital explains how a new medical device from Vena Medical is used to remove clots in the brain that cause a stroke and reverse those symptoms.
From there, medical personnel conduct a clinical and imaging assessment to confirm if a patient has a blood clot and where it may be.
If the clot is in a location that is “amenable to a vascular treatment,” then an EVT will be offered.
Sedation can be approached in two ways, he said.
“Sometimes, patients are completely co-operative and we can do it completely awake. Sometimes they require some degree of sedation to keep them still.”
“You can imagine it’s important to do this procedure with your head relatively still. You can’t have them thrashing around.”
A game-changer
Hill said EVTs have a lot of potential in improving stroke treatment, as positive outcomes are a lot more frequent.
“So it’s terrific, right? We get people back to their lives,” he said.
In an ideal world, of course it’s available everywhere because you don’t have a stroke just because you live in the middle of Calgary or the middle of Toronto, right?-Dr. Michael Hill, stroke physician
At the moment, EVTs aren’t available for all Canadians. Hill said the procedure is usually reserved for patients with the most severe forms of ischemic stroke, which occurs when the blood supply to part of the brain is interrupted or reduced.
“It’s a tertiary-level procedure. You’re not going to see it in a small, rural hospital,” he said.
But part of that has to do with the volume of cases needed in order to develop expertise in this field, and it’s big hospitals in major cities that tend to see the most patients.
“So if you’re just doing one a year, you’re more likely to have complications than you are to be successful,” he said. “Whereas if you’re doing 150 a year … everyone’s ready for these things to occur because you’re doing it so frequently.”
Still, it’s important to balance that expertise with availability.
“In an ideal world, of course [EVT is] available everywhere because you don’t have a stroke just because you live in the middle of Calgary or the middle of Toronto, right?” He said.
For the time being, Conacher is content with how the procedure turned out — it’s been nearly two years and the only major impact the stroke has had is a bit of memory loss.
Furthermore, as someone who saw her dad suffer paralysis in his left side due to stroke, she’s pleased with the way stroke treatment is evolving.
“If they had things like this, I think he would have been just as fine as I was,” she said.
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The freshness of spring is giving way to the languor of summer. It’s also that time of year when I step up my health and fitness habits, with the help of a wellness weekend getaway. Check out these ten wholesome ways to experience Whistler.
1. Eat well, be well at a new event series
Making its debut the Nourish Spring Series by Cornucopia celebrates the season every weekend in June with farm-to-table fare, farm tours, lavish wellness dinners, healthy brunches and activities to refresh both mind and body. Sit down to a four-course spring harvest tasting menu (Brome Lake duck breast with Pemberton beets, anyone?), brush up on grilling skills with an expert chef, pick up painting pointers on an art picnic or jump into an outdoor Zumba class. Order tickets online at whistler.com/events/spring-cornucopia.
2. Chill at a spa
With more than 12 spa facilities in town, it could be said that Whistler has everyone’s back. Pop into the Whistler Day Spa for a 75-minute stress relief massage using Swedish relaxation techniques or the Taman Sari Royal Heritage Spa for an 80-minute herbal steam massage using pouches filled with Javanese turmeric, ginger and other spices. Have more time? Dip into the hot-cold-and-relaxing thermal journey at the silent Scandinave Spa Whistler, home to open-air pools, cold-plunge baths, a Finnish sauna, Nordic showers and solariums in a tranquil forest setting.
3. Lace up for new guided hikes
Trek past alpine meadows flush with wildflowers on the way to glacier-fed Garibaldi Lake or meander through a fragrant rainforest before taking a dip in Crater Rim’s warm Loggers Lake. These are just a couple of guided hike options from Mountain Skills Academy & Adventures. Prefer to stay close to town? Sign up for the Whistler Alpine Hike and explore the gondola-accessed terrain of Whistler Blackcomb.
4. Embark on an ebike adventure
Sneak in some good clean fun with an ebike rental or guided tour. Explore Whistler’s car-free Valley Trail, a 46-km network of paved paths and boardwalks linking the resort town’s neighbourhoods and lakes, beaches, parks and viewpoints along the way. Go it alone or hop on a full-suspension electric-assist mountain bike with Whistler Eco Tours for a two-hour guided ride. Prefer an old-school ride or want to hit the alpine trails? Comfort cruisers, cross-country and downhill bikes are also on hand.
5. Expand the mind at an Indigenous exhibit
You have until October to view, the Squamish Lil’wat Cultural Centre’s Unceded: A Photographic Journey into Belonging. Shot at striking locales throughout the Sea to Sky Corridor, the exhibit brings together aspects of ancient traditions, modern Indigenous life, and colonization and development. Behold the bear dancer on Blackcomb Mountain, the cultural chief in the Fairmont Chateau Whistler lobby and the Squamish Nation chair standing in the middle of downtown Vancouver’s West Cordova St.
6. Get down, be healthy at a new café
Boogie back in time to the ’70s and ’80s at the new Rockit Coffee in Whistler Creekside. From the speaker-lined wall and vintage phones, radios and ghetto blasters to menu items like Espresso Greatest Hits and Drinks Just Wanna Have Fun, the colourful café exudes a decidedly retro vibe. Pull up a chair and order a nutritious Aero-Smoothie – choose from the Green Day, Bananarama or Strawberry Fields Forever – and pair it with a Veggie Eilish breakfast wrap or Prosciutto Rhapsody sandwich.
7. Check into wellness
Go for the Fairmont Chateau Whistler’s healthful options like daily yoga classes, guided excursions and access to pools, steam rooms, the fitness centre, tennis court and (soon) new pickle ball courts. But stay for the regionally sourced seasonal menus – complemented by the rooftop garden’s bounty from May to October – and no-proof cocktail selection in the Mallard Lounge.
8. Float down a winding river
Canoe, kayak or stand-up paddleboard along the meandering five-km-long River of Golden Dreams. After putting in at Alta Lake, paddle past riverbanks lined with wildflowers, foliage and forest, all the while keeping an eye out for beavers, otters, eagles and bears. Newbie paddlers are advised to go with a guide, as changing water levels can make for tricky steering and mandatory portages.
9. Connect with nature on a new birding trail
Watch for whiskey jacks, Clark’s nutcrackers and, come summer, lots and lots of swallows along the Sea to Sky Bird Trail. The fifth and most recent route to be added to the BC Bird Trail network along the Pacific Flyway, the new trail takes birders to alpine heights (lift ticket required) where they can spot olive-sided flycatchers and various raptors. Then it’s off to Rainbow Park on Alta Lake to spy common yellow throats and merlins.
10. Wake up beside a lake
Perched along the southern tip of Nita Lake in Whistler Creekside, Nita Lake Lodge checks off all the boxes for a dreamy wellness escape. Start with stunning water and valley views from luxe suites, currently undergoing a modern refresh slated to wrap in time for summer. Then there’s the new onsite restaurant, The Den, where plant-based alternatives share space with meat and seafood items on the seasonal menus. Topping off a salubrious stay at Whistler’s only lakeside hotel is an award-winning spa with rooftop hot tubs.
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Manitoba researchers looking for people to take part in a national HIV Stigma Index project are only about halfway to their goal of hearing from at least 75 people living with a positive diagnosis.
The international peer-driven research project helps understand the stigma associated with HIV and supports those living with a diagnosis.
“I wouldn’t say that anybody ran out and said ‘I’m gonna go get HIV today and see how that happens.’ Things happen to people and it’s our duty as human beings to support people no matter what they’re going through,” research co-ordinator Arthur Miller told CBC Information Radio Wednesday.
The Canadian HIV Stigma Index is a community-led and community-based research study, part of the international implementation of the People Living with HIV Stigma Index project
Participants are interviewed by another person living with a positive diagnosis. Interviews are about an hour-and-a-half long and can be done in person, by phone or through a video conferencing platform, said Miller, a Mi’kmaw HIV activist based out of Nova Scotia and research co-ordinator of the project with REACH Nexus, under the MAP Centre for Urban Health Solutions at Unity Health Toronto.
The national project has been done in Ontario, Quebec, Atlantic Canada and British Columbia, and this is the second time it’s being done in Manitoba, with an updated survey.
Researchers collect information related to stigma, discrimination and human rights, with the aim of better understanding the social determinants and stigma across systems like health care, schools and legal fields. The research aims to help people develop supports and policies at both local and national levels.
Peer-driven aspect crucial
Jared Star, a research manager at Winnipeg’s Nine Circles Community Health Centre, which specializes in HIV prevention and care, said the HIV Stigma Index’s peer-driven aspect is crucial for participants.
“They know that they won’t be judged,” he said. “They won’t have to explain situations and details that come naturally for them, because they’re talking to somebody with the same experience.”
Star is also a research consultant and PhD student with expertise in sexual health, alongside his work with Nine Circles, which is working closely with Miller on the project.
“It’s better for the study if we can collect the data in a shorter period of time, but because it’s qualitative research, it tends to take longer than a survey,” said Star. “But the more we can get up front and faster, the better.”
Star said the information gained from the project will help people move from a place of supporting and sustaining stigma to actively challenging and resisting it.
“I think if we do a good job and we’re able to get that information and then develop interventions that target stigma, we will be able to contribute to a reduction in HIV infections in Manitoba,” he said.
Education key to understanding
Much more is known about HIV now than 30 years ago — like how to prevent transmission and that it’s no longer a death sentence.
With proper care, people who are HIV positive can lead long, healthy lives.
Miller said education is key and pointed to the fact that many don’t understand somebody with an undetectable viral load who adheres to treatment can’t transmit HIV through sexual intercourse.
“This is big for people with HIV,” he said. “For me, it felt like I got part of my life back.”
Manitobans willing to share their experiences through the HIV Stigma Index project can contact Miller at arthur.miller@unityhealth.to or by phone at 1-877-347-1175 to begin the process.
“The great thing about this study is we’re building this network of people living with HIV,” Miller said. “You’re going to be talking with someone living with HIV, so they can relate and share some experiences.”
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This is Oakville’s coronavirus update for Saturday, May 27, 2023. New, active cases of COVID-19 in Halton have nearly doubled for the second week in a row, and outbreaks at local long-term care homes are growing.
Oakville is reporting 22 new cases this week, about the same as the week before. But these last two reports from Halton regional health are the highest numbers of new cases in months – and active cases are now trending upwards by 50-100% weekly.
The outbreak that opened earlier this month at Oakville’s West Oak Village long-term care home has been contained to the Harbour floor. But there are two new outbreaks that have opened this week in other parts of Halton, including one at Oakville’s Northridge home on the Chisholm floor.
Halton continues to fall behind on our booster shots: only 1 of every 10 people in Halton have a full series of immunization, and the percentage of residents with outdated immunization has grown every week since the start of 2023. Among those 40 and under, those fully immunized is now below 5%.
The United States this week has said they and the CDC will no longer be tracking new, aggregate daily COVID-19 cases and deaths or new nationwide testing data.
The World Health Organization (WHO) has declared that after more than three years, the COVID-19 global health emergency is now over. WHO has determined that “COVID-19 is now an established and ongoing health issue which no longer constitutes a public health emergency of international concern (PHEIC).”
765 million cases of COVID-19 have now been recorded worldwide since the start of the pandemic; 6.9 million people have died.
**Vaccine booking: Fourth doses (second booster doses) of vaccine are now available for anyone in Halton age 5 and up, though fourth doses must be at least five months since your last dose and 90 days since having COVID-19.
Halton continues to book first and second-dose vaccinations for all residents age six months and older, plus third-dose boosters for anyone age 5 and up.
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