Over the last few days, we’ve all be talking about Gord Downie of the Tragically Hip and his battle with brain cancer. But many of us have questions about just what kind of brain cancer this is and how could he be touring this summer? Neurosurgeon Dr. John Kelly explains Downie has a type of brain cancer called glioblastoma. It’s the most common form of brain cancer and also the most aggressive. It occurs in three in 100 thousand people. It can occur in any one at any age but is most commonly diagnosed in the 60 year old male.
There are reports Downie had a random seizure one day walking down the street. Dr. Kelly explains this is often one of the most common first symptoms of the disease, along with headache and neurological deficit. The location of the tumour in the brain affects what kinds of symptoms a patient will have because various parts of the brain control various parts of the body and mind. Usually what happens is a patient will have a seizure, recover from that seizure and then be taken to the ER to determine what caused that seizure. Imaging tests are done starting with a CT scan and then depending on what is revealed, the patient will get an MRI. The patient will then be put on anti-seizure medication and a treatment plan determined.
Downie has had surgery to remove the tumour followed by chemotherapy and radiation which is the standard form of treatment explains Dr. Kelly. Downie has responded very well to surgery, chemo and radiation, but Dr. Kelly says this is not always the case. Sometimes patients never wake up from the surgery or wake up only to have neurological problems that require care and some patients really struggle following chemo and radiation never returning to their previous life.
But Downie, according to reports, has responded very well to his treatment plan which is why he’s able to tour this summer. Is he cured? No, says Dr. Kelly. With glioblastoma, even though surgery has removed the tumour, it is impossible to get all of the cancerous cells. The cells are simply too small to be seen with imaging and that means another tumour will most likely grow. It’s also impossible to predict when this recurrence will occur.
For now, Downie as any patient at his stage of treatment, will be closely monitored with regular MRI scans so that the next tumour will be found as soon as possible.
For more information on glioblastoma visit this website.
With summer just around the corner, many people with arthritis are looking to get more active. There are over 100 types of arthritis but everyone with the disease can benefit from gentle and regular exercise, says Rheumatologist Dr. Olga Ziouzina.
There are two main types of arthritis. Degenerative arthritis, which is caused by overuse as well as normal aging of the joints, affects about 20 percent of the normal population and the most common kind is osteoarthritis. Inflammatory arthritis, which is caused by a malfunction of the immune system where the body attacks its own joints creating ongoing inflammation, affects about one percent of the population and the most common kind is rheumatoid arthritis. The joints in both types of arthritis cope better when the patient is moving regularly. Dr. Ziouzina explains staying fit ensures the muscles remain strong and the ligaments and tendons remain flexible which, in turn, support the joints better.
However, if the patient has been sedentary over the winter, it’s important to start exercising slowly. Dr. Ziouzina says to expect a little more pain at the start as the body strengthens and to treat the pain with over the counter pain medications as well as heat and ice. She also recommends joint protection devices like walking sticks to offload some of the strain on the joints.
Also, it’s very important to stay in regular contact with your doctor. Dr. Ziouzina says there are new medications being approved all the time for arthritis, so patients need to ask their doctor if there might be a new treatment option for their type of arthritis.
For more information on arthritis visit this website. To support those with arthritis, the annual Walk to Fight Arthritis is Sunday June 5th at Eau Claire Market. Click here for details.
Preeclampsia affects 5 to 8 percent of all pregnant women. For Preeclampsia Awareness Month, we spoke with the Head of Maternal Fetal Medicine at the University of Calgary Dr. JoAnn Johnson about a new study underway that aims to prevent the disorder.
Preeclampsia can have serious consequences for both mom and baby. The disorder is characterized by a sudden onset of high blood pressure in a woman usually after 20 weeks of pregnancy. It’s associated with protein in the urine and can affect multiple organs including the kidney and liver. And in many cases, the only treatment is to deliver the baby prematurely which is traumatic for everyone involved, not to mention incredibly costly to the health care system.
Currently, doctors can determine if a woman has PE by checking her blood pressure and doing a urine test at her prenatal visits. In terms of prevention, doctors can determine which moms are at high risk of preeclampsia by looking at their risk factors: did they have preeclampsia in a previous pregnancy, are they overweight, do they already have high blood pressure…etc. These high risk moms are then given low dose aspirin. But new preliminary research shows if aspirin is given to high risk moms before 16 weeks of pregnancy it can dramatically reduce preclampisa… early studies suggest by as much as 90 percent. But this result needs to be proven in bigger studies.
The idea is to determine who is at high risk of preeclampsia early on, and then offer them this low dose aspirin. That’s why the research study, called the Prediction study, underway at the University of Calgary first needs to confirm that their assessment tool works here in Canada, if it does, then those women deemed high risk can receive treatment.
Researchers are looking for 1 thousand first time pregnant women, less than 14 weeks, here in Calgary to participate. There’s no risk to mom or baby. All the study would do is add an additional blood test and measurement to the first trimester screening. This additional testing would add about 30-40 minutes to their nuchal. Researchers want women to understand participating in this study would help future moms and babies.
For more information on the study and to find out if you’d be eligible to participate email firstname.lastname@example.org or call 403-943-8382.
For more information on preeclampsia go here.
More and more Fort McMurray evacuees in evacuation centres across the province are coming down with an intestinal illness called Viral Gastroenteritis or viral gastro. The latest numbers of those infected can be found here from Alberta Health Services. This is a viral infection that can be caused by several kinds of viruses… norovirus (the one often associated with cruise ships and daycares,) rota virus, adeno virus and more. These are viruses that are in the community at all times. But Dr. Raj Bhardwaj, an acute care physician, explains the viruses are highly contagious and easily spread through confined spaces like schools and evacuation centres. He says the virus particles can live on hard surfaces for up to two weeks if not cleaned off.
The viruses cause unpleasant symptoms like vomiting and diarrhea, stomach pain and nausea. While unpleasant, the infection usually only lasts about 2-3 days. But because it is so highly contagious, Dr. Bhardwaj says the best defence is good hand hygiene. He says washing hands with soap and water for 15 to 30 seconds, then drying hands with a paper towel and using that paper towel to turn off the taps and open the door is the best practice. It’s critical not to reinfect yourself leaving the bathroom by touching any surfaces. Hand sanitizers are less helpful because they’re often not used properly. Dr. Bhardwaj says with an alcohol based sanitizer, people must wet their entire hands including between fingers and under fingernails and then they must rub hands together until they’re dry. It’s also necessary for patients to isolate themselves as best as they can. They must also not prepare food for others.
And as for treating this infection, do not expect antibiotics. Dr. Bhardwaj explains viral gastro is a viral illness so antibiotics won’t work. The best thing to do is support the body while it clears the infection itself and that means staying hydrated. While it can be a challenge to keep water down, particularly in little kids, Dr. Bhardwaj says aim for just 1 tablespoon of water every 5 to 10 minutes. This is all the hydration the body needs to fight the infection on its own.
For more information on this illness read this fact sheet from AHS.
Lupus affects one in two thousand individuals, 90 percent of them are women. The disease is most commonly diagnosed between the ages of 15 and 45 so this age group presents unique challenges. But first off what is lupus? Dr. Ann Clarke who has started a new Lupus Clinic at the University of Calgary explains lupus is an autoimmune disease where the patient’s own antibodies attack their own tissues. Numerous organs and tissues can be affected but many patients present with a skin rash, arthritis or kidney involvement. So the disease can be tricky to diagnose, hence the nickname “the disease of a thousand faces.”
Typically a family doctor will suspect lupus in a patient and then refer them to a rheumatologist. That doctor will then do a full patient history to try and put together a symptom profile, they’ll do an exam and order blood work where they’ll be looking for specific antibodies related to lupus. Like with many diseases, lupus is easier to treat if it is caught early. Treatments usually involve immune suppressing drugs from steroids to biologics. The goal of treatment is to get the patient into a prolonged state of remission.
And with this group of patients family planning is a huge issue, says Dr. Clarke. Fertility can be affected and the fetus can also be adversely affected by lupus medications. Furthermore, the mom’s condition can become worse in pregnancy so patients who want to become pregnant must come up with a plan with their doctor in order to do so safely.
The good news is Dr. Clarke’s lupus clinic is accepting new patients with lupus. This clinic will provide optimal care for lupus patients. Dr. Clarke has established relationships with other specialists like nephrologists or kidney doctors and a dermatologist with a special interest in lupus. The clinic will also allow for patients to participate in clinical trials for new medications.
For more information on lupus visit this site, for more information on Dr. Clarke go here.
Headaches in children are more common than most of us realize. By the age of 15, three out of four kids has experienced a significant headache. These headaches occur for many reasons… and tension headaches are most common, but migraine headaches are right up there explains Pediatric Neurologist Dr. Thilinie Rajapakse from the Headache Clinic at the Alberta Children’s Hospital.
In fact, at the ACH they have three thousand children with chronic migraines that get these headaches 15 times or more a month. These headaches are very disabling says Dr. Rajapakse and usually start with vague symptoms like yawning, carb cravings and moodiness which is then followed by a pounding headache, nausea and vomiting as well as a sensitivity to light and sound. A third of these kids will also experience an aura which is a wave of electricity that move across the brain from the back to the front that causes dramatic symptoms like seeing flashes of light, difficulty speaking and losing the ability to feel one side of the body. While these symptoms are very scary for parents, Dr. Rajapakse says they’re very common and usually subside within an hour and are then followed by that pounding headache. These migraines can last for one hour or up to three days.
Dr. Rajapakse says treatment usually begins with lifestyle changes like drinking more water, getting better sleep and then painkillers like ibuprofen and acetaminophen. If the child is not getting enough relief there are several medications that can help including preventative medicines that can be used that work on reducing the nerve excitability in the brain. These drugs do have side effects that include sedation and changes in appetite, but Dr. Rajapakse says these medicines work quite well and only need to be taken for a short time and that any side effects can usually be well managed. Other vitamin and herbal therapies are also used to help.
The good news is exciting new treatment options are being researched right now. Dr. Rajapakse says they’re looking into injections into the brain like nerve blockers and they’re also exploring brain stimulation to help with these headaches.
For more information on children and headaches visit this website.
About one in every three thousand babies is born without an ear. And one in 1500 is born without an ear because of syndrome like the one 13 year old Alassandro Manzoni was born with. Alassandro’s syndrome affects five parts of his face including his ear. His case is one of the worst his reconstructive surgeon Dr. Ryan Frank has ever seen. But Dr. Frank has made great progress making Alassandro a new ear. The process began a couple of years ago. And it’s a big one. To create a new ear, Dr. Frank says it usually takes three surgeries over a year and a half.
The first surgery is the biggest one. Dr. Frank says this surgery is usually six to eight hours in the operating room. Children typically undergo this surgery after the age of 6 when the good ear is 90 percent formed. Dr. Frank makes a model of the good ear, reverses it then uses it as a model for the new ear. He then takes part of the rib cartilage out of the child, bends it and forms it to match the model ear using tiny wires to hold the pieces of cartilage together. He then implants the cartilage ear under the skin and lets the child recover. A month or so later, with the second surgery, Dr. Frank will lift that cartilage ear to give it some projection and make it look more like the good ear. The third surgery usually involves inserting fat into the new ear to make it look as natural as possible.
Dr. Frank says the best results occur when using the child’s own tissue. He says there is a better chance the ear will get a blood supply and less of a chance of infection or of the body rejecting the ear.
Alassandro likely has a couple more surgeries to go before his ear is completed. But he’s already very pleased with the results. He says his new ear is “cool and pretty awesome.” He explains it’s much better “than everyone staring at me.” And that’s what it’s all about says Dr. Frank. Creating the ear is not about helping the child hear better, they can hear well with one ear and with the help of a hearing aid. It’s a cosmetic procedure to help the child look and feel as normal as possible.
For more information on microtia or small ear defect visit this site.
Last year in Alberta there were 272 overdose deaths involving the drug fentanyl. Now we know there is a street drug in Alberta called W-18 that is 100 times stronger than fentanyl. That’s why parents are very concerned right now about these drugs and their children. David Hodgins, Head of the Department of Psychology at the University of Calgary who specializes in addictions, says it’s a terrifying time for parents.
He suggests parents talk to their kids right now about drugs. He says it’s not one conversation but it’s several conversations that establish an open line of communication between parent and child. He says using a news story about fentanyl or W-18 would be a great springboard for a conversation. And parents must be prepared to listen without judgement to try and get an understanding of where their child is coming from. Hodgins also suggests parents educate themselves about what’s out there, so in this case, about fentanyl and W-18. And these conversations need to happen sooner rather than later. Hodgins says research shows children as young as age 11, 12 and 13 have the opportunity to access drugs and that the average age of initiation is 15, so the earlier the better to talk about drug use.
Hodgins says there are many reasons why kids choose NOT to do drugs, but one of the main reasons is because drugs are not compatible with what the child might be doing or want to do. For example if the child is a hockey player or a dancer, being on drugs won’t allow them to do that successfully. This is a point parents should articulate clearly to their kids.
And if parents are concerned their child is already using drugs, parents need to step in and not take a relaxed approach. Hodgins says a child is not going to ask a parent about drug counselling or treatment. These options need to be suggested by the parent.
The good news is once most parents have the conversation about drugs with their kid, they’re often reassured that their child will make safe choices.
For more information about fentanyl and W-18 visit this website, for more information on talking to your kids about drugs visit this site.