Toronto Rehab Magazine Summer 2008

H U M A N L Y

Amazing comebacks!

From injury or illness to rehab and recovery

P O S S I B L E

SUMMER 2008

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Contents

4 A new twist on rehab

Low tolerance long duration

6 Losing control

When dementia affects behaviour

8 Second chances

Patient applauds trauma service

10 Toronto Rehab news

Awards, Paralympics and more

12 Being the best we can be

Triumphant comeback stories

15 Monster Ride for rehab

Record amount raised

16 Post script

Michael Yermus rides with heart

The Toronto Rehabilitation Institute is at the forefront of one of the most important and emerging frontiers in health care today—rehabilitation science. As the University of Toronto’s fully affiliated teaching and research hospital in adult rehabilitation, complex continuing care and long-term care, our goal is to advance rehabilitation and enhance quality of life for the 4.4 million Canadians who experience disabling injury and illness.

Toronto Rehab magazine Summer 2008, Volume 8, Number 2 Inquiries and requests to reprint/ return undeliverable Canadian addresses to: Marketing & Communications Toronto Rehab 439 University Avenue, 5th Floor Toronto, Ontario, Canada M5G 1Y8 Telephone: 416-597-3422, ext. 3425 E-mail: communications@torontorehab.on.ca Web site: www.torontorehab.com

Editor Writers Design Photography

Jennifer Ferguson Annie Atkinson, Lynn Woods, Isaac Stein wymandesign.ca Jim Atkinson/MediMedia Group Mark Ridout/Toronto Rehab Meghan Rose/Strategic Objectives istockphoto Digital image modification Ron Giddings Printing TI group

Growing up

By Isaac Stein Growing up with a disability wasn’t easy, but I had committed parents to support me. I have a form of cerebral palsy called right hemiplegia, which affects the movement, sensation and coordination in the right side of my body.

Participating in sports was nervewracking and difficult but my parents encouraged me to enroll in youth soccer and hockey leagues, and came to support and watch me play many of my games. I couldn’t tie shoelaces so I was given velcro shoes. When I had a hard time cutting my meat, Mom or Dad was always there to cut it for me. My parents were determined to help me feel as ‘normal’ as possible. “You’re just like any other kid,” they told me affectionately. “Nobody notices the difference.”

It was only years later that I was finally able to articulate why my younger self felt so frightened every time my parents told me that “nobody notices.” It’s important for me to qualify that I am not writing this to criticize my parents, who I am lucky to have. My parents and the rest of the caregivers orbiting around me—teachers, coaches, camp counsellors—none of them ever told me, “You are disabled. You cannot, will not, live a full life.” Quite the opposite: I was loved, cared for, and consistently told: “You can, you will, live a full life.” But like the rest of the general population, my parents were subject to powerful social distortions and stereotypes about what it means for someone to live and grow up with a disability in a world designed by able-bodied people. My doctors, my teachers, my friends, my parents: like everyone else in this culture, the message they themselves have received over and over again was, “If you are disabled, you cannot, you will not, live a full life.” What happens when a disabled child then, is born into an able-bodied culture that propounds—that manifests—this message? If they

with a disability love the child, those who care for him will do whatever they can to help the child live (what they perceive to be) a full life. What else can that mean but minimizing, obscuring, denying the child’s disability? When my parents squeezed my shoulders and told me confidently that “nobody notices,” the unspoken subtext was as clear and present to my 8-year-old mind as the stiff fingers of the right hand at which I gazed uneasily. The message swirling around and underneath my parents’ reassuring words was: “You can, you will, live a full life as long as nobody notices.

The second somebody does notice, you’re in trouble.”

Feeling that you’re safe as long as nobody notices half your body is not the most secure way to grow up. It can lead to denying, pretending, avoiding; it can foster shame and border on self-negation. Even the most successful pretender climbs into bed exhausted by the effort and is haunted at night by the fear of exposure. Growing up, I did a lot of pretending and felt my share of shame around my disability—and I was lucky enough to have supportive parents, encouraging teachers, gentle coaches. But the societal and cultural perception of disability as defect remains so strong in 21st century Canada that even the most supportive parents and the gentlest teachers still often and unintentionally transmit this perception to the disabled children in their care.

To truly combat the stubborn perception of disability as shameful defect, as thing-to-be-hidden-away, change must occur at the cultural as well as the individual level, at the political level as well as the personal. Bloorview Kids Rehab and Toronto Rehab’s LIFEspan program, designed to help people with childhood-onset disabilities to make the transition from pediatric to adult health services, is an example of the way respected institutions

To truly combat the stubborn perception of disability as shameful defect, as thingto-be-hidden-away, change must occur at the cultural as well as the individual level, at the political level as well as the personal.

can do their part to create a new social culture around disability. This new culture can help children view their disabilities as differences, not defects—and allow them to feel not only safe but proud when their disabilities are noticed.

Isaac Stein, a doctoral student in counselling psychology at the University of Toronto, plans to pursue a career in counselling clients with disabilities. A member of Toronto Rehab’s Team Optimize research team, he is a recipient of Toronto Rehab’s Research Training Award for Students with Disabilities, which was made possible through the generosity of TD Bank Financial Group.

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Sylvia Udale-Clough

Low tolerance long duration: Sylvia Udale-Clough has had more complex health problems in the past five years than many people face in a lifetime. While the 56-year-old former Bay Street executive has proven to be resilient—she was critically ill with SARS in 2003 and spent a year in hospital—she did not fare well with high-intensity rehabilitation following surgery to repair a hip fracture suffered in a fall after a snowstorm in February.

Admitted to Toronto Rehab’s musculoskeletal rehabilitation program at Hillcrest Centre for “intensive daily occupational therapy and physiotherapy, I just couldn’t do it,” says Sylvia. “I was exhausted, angry, struggling with pain and feeling like a failure. I kept asking, ‘Why me?’ The staff was concerned that I wasn’t going to rebound adequately to live on my own.”

That’s when Sylvia’s rehab team called in colleagues from the hospital’s E.W. Bickle Centre for Complex Continuing Care, where a new approach to rehab for selected patients was launched in the spring of 2007. Called low tolerance long duration rehabilitation, the program provides a longer course of treatment than traditional high-tolerance rehab and is delivered in shorter therapy sessions. After two months as In the Bickle Centre’s kitchen with Alissa an inpatient in this specialized program, Sylvia is now Tanenbaum, occupational therapist 4

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back on her feet using a cane and is going home to live independently with a few new supports in place.

“No doubt about it—this was the right program for me,” says Sylvia. In fact, she is so impressed with the innovative approach to rehabilitation that she plans to return to the Bickle Centre as a volunteer and peer mentor.

Low tolerance long duration rehab is in its infancy and Toronto Rehab is an early innovator, according to Dr. Ken Uffen, Medical Director of the complex continuing care program. The low tolerance long duration rehab program is for patients whose health is compromised by several illnesses or injuries that cause them to be medically complex and lack the strength and endurance for regular rehab.

“Our aim is to make people strong enough so we can rehab them to the point where they actually improve function,” says Dr. Uffen. “We are trying to get patients back home, to assisted living in the community, to a nursing home or to the point where they can tolerate high-intensity rehabilitation. Without this opportunity for rehab at a level and pace they can tolerate, many of these patients would remain indefinitely in hospital or a chronic care environment.”

To qualify for admission, patients must be medically stable and demonstrate the potential to learn and improve function, explains Helen Wong, Program Services Manager.

“You need to accomplish things within your boundaries. That’s probably the most important thing to realize in our type of program.”

“They must be able to tolerate 30 minutes of therapy in one session and be able to sit outside of bed for a minimum of one hour daily. A discharge plan must be in place before a patient is admitted. The inpatient program is offered for up to 120 days with 150 minutes of therapy provided each week.”

Some of the therapies are delivered at the bedside or on the patient unit. Patients can also participate in a variety of activities available through the Bickle Centre’s wellness and volunteer programs.

To date, most referrals have come from acute care hospitals and other Toronto Rehab programs. Home care professionals have also referred several people. At any given time, inpatients range in age from their early 20s to their early 90s.

Twenty-eight beds at the Bickle Centre are designated for neuro-physical patients, whose diagnoses include stroke, spinal cord injury, brain injury and degenerative disorders. Another 10 beds are for patients in the functional enhancement stream—those who have experienced recent physical deterioration due to acute illness or injury.

Following renovations to the Bickle Centre, 10 beds in a secure environment will be added for people with neuro-

a new approach to rehab cognitive problems from brain injury, stroke, degenerative disorders and some types of dementia.

Low tolerance long duration rehab is provided by an interprofessional team including physicians, nurses, physiotherapists, occupational therapists, speech language pathologists, pharmacists, an advanced practice clinician, service coordinator, social worker and other health professionals.

Sylvia relaxes with patient Rolf Roehrle.

Rolf practices standing up under the guidance of physiotherapist Kimberly Carey.

her to regain her strength, stamina and confidence so she can once again live independently. “You need to accomplish things within your boundaries. That’s probably the most important thing to realize in our type of program—that people need to work at their own pace and participate as a member of the rehab team.”

LIFE after rehab “We’re very goal-oriented,” says Helen. “When a patient arrives, the team works with them to establish some mutual goals and we track the success rate of these goals—that’s one of our outcome measures.”

“You won’t see the drama of high-intensity rehab where significant changes occur in a shorter time,” adds Dr. Uffen.

“Progress is slow by nature of the type of patients we are working with. But when a patient’s function improves over time, that’s exciting.”

For Sylvia, low tolerance long duration rehab has allowed

In the 2007 Hospital Report: Rehabilitation, it was recommended that “hospitals could invest in activities that enhance continuity and transition, particularly with respect to providing clients with the information they need to manage their (often) chronic condition after discharge.”

Toronto Rehab is undertaking a series of new initiatives, including low tolerance long duration rehabilitation, to help address this need. This article is the second in a special series on transition initiatives.

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When demen tia lea ds to c hallen ging b ehavio ur

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“We can’t manage your mother’s behaviour any longer. Something needs to be done!”

Eileen Young was pleased when she found a small, quiet nursing home for her 87-year-old mother, Beryl Crichton, to live in; but as her Mom’s

Eileen Young and her mother Beryl Crichton

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Alzheimer’s progressed, she realized that the woman who had once been her confidante and best friend was slipping away. In recent months, she had become more agitated, rocking back and forth and screaming and yelling night and day. The nursing

home staff, while warm and caring, felt her escalating behaviour was disturbing to other residents and beyond their control. So what now?

With 450,000 Canadians over the age of 65 living with Alzheimer’s or a related dementia, Eileen’s dilemma is one that is all too real for thousands of families across the country who have family members living in longterm care. And as the baby boom generation ages and the prevalence of dementia increases, the challenges that family caregivers and long-term care staff face in caring for these patients is only expected to grow.

Toronto Rehab’s inpatient geriatric psychiatry service is striving to make a difference in the lives of patients with dementia and their caregivers.

The service specializes in assessing behavioural challenges specific to dementia, including verbal and physical aggressiveness, agitation, resistance to care, restlessness, pacing, wandering, and yelling and screaming.

“The key to managing people with advanced dementia is adapting as

much as possible to their world and reality rather than having them adapt to ours,” says Dr. Ron Keren, a geriatric psychiatrist and Clinical Director of the geriatric psychiatry service.

“The more we’re able to break the regimented care that is so common in health care settings and adapt to a person’s needs, the less problems we’re going to have with aggressive behaviours.”

That’s the guiding principle behind life on the geriatric psychiatry service’s 20-bed secure inpatient unit at Toronto Rehab’s University Centre. From the moment a patient is admitted, the members of the interprofessional team make a point of learning everything they possibly can about the person entrusted to their care.

“Their initial assessment of my Dad was very thorough,” notes Harvey Gorewicz whose 87-year-old father, Zelman (Sam), spent three months on the unit following a massive stroke and lengthy stay in hospital last year.

“They took time to find out about his cultural background, his family, what kinds of things he liked to do before his stroke, what his food likes and dislikes were. They really took the time to find out who my Dad was as a person.”

That information becomes vital to the individualized care plans developed for each patient. “We discovered that a lot of Mr. Gorewicz’ frustration stemmed from not being able to speak following his stroke and have his needs understood.

The more of an effort we made to understand those needs, the easier he was to manage,” says Dr. Keren.

The team includes an attending physician, consulting geriatric psychiatrists, a consulting neurologist, a chaplain, a dietitian, nurses, an occupational therapist, an occupational therapy assistant, a pharmacist, a physiotherapist, a physiotherapy assistant, social work, speech-language pathologist,

therapeutic recreation, and volunteers. Following a thorough assessment, the team seeks strategies that minimize the triggers for the patient’s behaviours while developing approaches that allow for the safe provision of care. These strategies are

at night, they had her screaming under control, and we were able to communicate with her.”

Concerned that the nursing home Eileen’s mother had come from was no longer the best fit for her, Cecelia worked with Eileen and her family

!

A tender moment between Zelman (Sam) Gorewicz and his wife Wanda

then shared with long-term care home staff through care conferences and care tips to support them in better managing the needs of the patient.

“We look at everything from pain issues, mobility issues, leisure and social activities, to swallowing, communication and cognition, dietary issues and the right balance of medications,” notes social worker Cecelia Marshall, who helps support family members through the often emotional process. “While time consuming, seeking this level of understanding can make all the difference, whether someone is aggressive or resistive to care.”

“What they did for my mother was remarkable,” says Eileen Young.

“Within a short period of time, they had her on a minimal combination of medications, she was sleeping

“The key to managing people with advanced dementia is adapting as much as possible to their world and reality rather than having them adapt to ours.”

to find her Mom a long-term care home that was in a better position to respond to her needs. “I have trust and faith that when I’m not visiting, they’re taking good care of my Mom there.”

Cecelia also helped place Zelman Gorewicz in the same nursing home as his wife of more than 60 years, Wanda, had been living in for many years after being diagnosed with progressive Alzheimer’s. “Dad visited Mom there every day for years to help her with her meals, and despite facing his own challenges now connected to strokerelated dementia, he continues to take great pleasure in joining her for meals each day,” says son Harvey.

Dr. Keren hopes the success of the geriatric psychiatry service will eventually lead to greater understanding in the treatment and care of those with Alzheimer’s and related dementias, eliminating the need for the types of phone calls Eileen received.

“By understanding the root of these behaviours, we can all help people like Mr. Gorewicz and Mrs. Crichton to enjoy a better quality of life.”

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When the physically active 28-year-old was hit by a car while riding his bicycle to work last summer, he didn’t know if his life would ever be the same again. The young man, who had never before broken a bone, suddenly found himself lying in a hospital bed with a broken collarbone, a fractured right thigh bone, broken ribs and injuries to his right shoulder. He could barely move.

“It was very scary at first. My brain wanted to do things, but my body couldn’t respond,” says Jose Costa-Velasquez.

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The once-active soccer player, cyclist and surfer was looking forward to joining his girlfriend on a trip to Peru in the fall.

Now he lay in bed both physically and emotionally devastated wondering if any of those activities were still in his future.

That’s where Toronto Rehab’s multiple trauma service stepped in. Transferred to the service’s inpatient unit following treatment and surgery at St. Michael’s Hospital, Jose met an interprofessional team of physicians, nurses, physiotherapists, occupational therapists and social workers whose sole focus was to help him regain the physical and emotional strength needed to return to his life in the community.

As part of Toronto Rehab’s musculoskeletal rehabilitation program at Hillcrest Centre, the multiple trauma service responds to the need for specialized inpatient and outpatient rehabilitation for people, like Jose, who have experienced multiple injuries due to a car crash, fall or work-related accident. The team, which also includes a dietitian, 8

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pharmacist and geriatrician, supports individuals facing multiple fractures of the upper and lower limbs, spine, ribs, pelvis and skull as well as those experiencing associated complications such as peripheral nerve and soft tissue injuries, mild traumatic brain injuries and spinal cord injuries.

Other Toronto Rehab specialists in physiatry, brain injury and neurology are available for consultation, as needed.

“Many of the patients we see can’t walk or physically take care of themselves at first,” notes Dr. John Flannery, Medical Director of the musculoskeletal rehabilitation program. “They worry about how this will impact their roles as mothers, sole financial providers for the family or as caregivers for elderly parents. Our goal is to help them return to a quality of life as close as possible to what they had before they sustained their injuries.”

For Jose, rehabilitation started on the multiple trauma service’s eight-bed inpatient unit where the average length of stay is four to six weeks. Here, the focus is on getting patients to a point where they can safely manage at home.

“We help patients manage their pain, cope with the emotional effects of what has happened to them, set realistic recovery goals and develop the strategies that will help them reach those goals, by leveraging the strengths of each member of the team,” says Dr. Flannery.

“Sometimes the things that most of us take for granted, like putting on a pair of socks, is a remarkable milestone for a patient who could barely move when they first arrived on the unit,” says Mary-Grace Grossi, Manager of the multiple trauma service inpatient unit. “Our therapists work with patients, like Jose, to restore their ability to perform

activities of daily living like dressing, bathing, doing laundry and making meals, all in preparation for a return home. Once they’ve achieved these abilities, you know they’re ready to move on.”

Due to the extent of his injuries, Jose was among the more than 50% of inpatients who continue on with multiple trauma service outpatient rehabilitation therapy following discharge.

Over a six-month period, he worked closely with an occupational therapist who helped him regain arm function while a physiotherapist worked with him on mobility,

ond chances strengthening, range of motion, balance and stamina. He gradually increased his cardiovascular endurance using an elliptical trainer, stationary bicycle and treadmill.

“Jose had a ‘can do’ attitude that really kept him motivated and on track,” says physiotherapist Josie Tome. “Over time, he

Jose in outpatient program with Josie Tome, physiotherapist

graduated from managing crutches to using a cane, finally mastering the ability to safely use stairs and walk without an aid, bringing him to a pre-accident level of functioning that allowed him to return to his job.” Among those who inspired him to work hard were other patients.

“When I first started therapy, I watched another patient who was further along in his progress break the running record on the treadmill. That roused my competitive spirit, and I was determined to break that record before my therapy was completed,” says Jose.

And he did.

In fact, thanks to support from members of the multiple trauma service team, Jose was Jose has resumed an active lifestyle. able to visit his family in El Salvador and hike the rough terrain with his girlfriend on their rescheduled trip to Peru only two months into his outpatient rehab. “That was really exciting for me. I had just started walking again, and being able to make that trip really lifted my spirits.”

Jose has since revisited El Salvador, and tackled surfing again.

“We’re so fortunate to have a trauma rehab service like this in our city. Thanks to the people at Toronto Rehab, I’ve been given a second chance to live an active life, and I’m making the most of it.”

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news Behind the scenes at the Paralympics Dr. Gaétan Tardif, Toronto Rehab’s Vice President, Patient Care and Chief Medical Officer, will once again provide a behindthe-scenes look at the Paralympic Games in September in Beijing. Dr. Tardif, named the Canadian team’s Assistant Chef de Mission, will chronicle his experience working with the some of the country’s best athletes in a blog on Toronto Rehab’s web site, www.torontorehab.com.

A Paralympic veteran, Dr. Tardif was the Chief Medical Officer for the past two winter games as well as team doctor for the past two summer teams. He wrote about his experience at the 2006 Paralympic Winter Games in Torino in a web diary, The View From Here.

The Beijing Paralympic Games will take place from September 6 to 17, 2008.

New report on rehabilitation research

The Toronto Rehabilitation Institute’s latest annual research report showcases a range of research that is having a significant impact on patient care delivery—or will have an impact soon. The +7 Report on Rehabilitation Research describes how Toronto Rehab researchers are working with clinicians to improve the lives of people affected by disability and aging, and to assist caregivers. Whether it’s an innovative infection control system or a new therapy for patients who have difficulty speaking, the report explains why rehabilitation science is an emerging frontier in health research.

To read +7, visit Toronto Rehab’s web site at www.torontorehab.com. For a copy of the report, contact: Annie Gaddam at 416-597-3422, ext. 7800 or gaddam.annie@torontorehab.on.ca

Living With/Living Well Toronto Rehab’s Living With/Living Well education series continues this fall and winter with a gamut of topics related to rehabilitation. The free public events feature health care experts who provide the latest research and up-to-date information on the topic at hand as well as patients who speak about their own personal experiences. Mark your calendar with the events that interest you. For details, visit www.torontorehab.com Sexuality after Disability

Stroke Risk Factors and Self-Management Falls Prevention

Heart Disease Prevention and Management Managing Chronic Pain / Fibromyalgia

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September 18, 2008 October 16, 2008 November 20, 2008 February 19, 2009 March 19, 2009

BRAVO! to award winners Dr. Milos Popovic, a Toronto Rehab senior scientist and Director of the hospital’s Rehabilitation Engineering Laboratory, has been chosen to receive the prestigious Engineering Medal.

The award is presented jointly by the Professional Engineers Ontario and the Ontario Society of Professional Engineers to association members who have contributed substantially to advancing the engineering profession. Dr. Popovic is being honoured in the research and development category. His research focuses on developing neuroprostheses for people who have had a stroke or sustained a spinal cord injury, brain-machine interfaces, assistive technology and neurorehabilitation. A biomedical engineer and associate professor with the Institute of Biomaterials and Biomedical Engineering at the University of Toronto, Dr. Popovic has made huge progress in designing devices that help to restore or replace functions of the human neuromuscular system when it is damaged.

Margaret Cooper and Elaine Simpson, both long-serving Toronto Rehab volunteers, have been recognized for their commitment with the Governor General’s Caring Canadian Award. The pair began volunteering at the E.W. Bickle Centre for Complex Continuing Care (formerly the Queen Elizabeth Centre) as teenagers in 1944. Over the years, they have been active in patient care areas and participated in special events such as the annual garden party and holiday patient gift wrap event. They continue to be involved in a monthly luncheon at the Bickle Centre. Her Excellency the Right Honourable Michaëlle Jean, Governor General of Canada, will recognize Margaret and Elaine with a certificate and a lapel pin at a presentation later this year.

Dr. John Flannery, Medical Director, Toronto Rehab’s musculoskeletal rehabilitation program, was named the 2008 recipient of the University of Toronto’s William Goldie Prize and Travel Award in Education. The award recognizes outstanding contributions in the first 10 years of the recipient’s time on faculty. Dr. Flannery was honoured for his contributions to the Department of Medicine educational endeavours both in rehabilitation medicine and in the Master Teacher program.

Lynne Sinclair, Toronto Rehab’s Director of Education, has been named by the University of Toronto Faculty of Medicine as the 2008 recipient of the prestigious Helen P. Batty Award in Faculty Development in the category of teaching excellence. In addition to Lynne’s leadership role at Toronto Rehab, she is the Faculty Lead in Preceptorship at the U of T’s Office of Interprofessional Education and holds appointments in the Faculty of Medicine and the Faculty of Nursing.

Toronto Rehab’s new cardiac rehabilitation home program won the top award in the category of improving quality and patient safety at Ontario’s Celebrating Innovations in Health Care Expo this spring.

The new program includes the same elements as Toronto Rehab’s regular cardiac rehab program but is designed for people who are unable to attend sessions at the hospital. Pictured receiving the award from then-Minister of Health and Long-Term Care George Smitherman (left) are Toronto Rehab’s Kerseri Naidoo, Chantal Graveline, Anne Marie Shin and Dr. Paul Oh.

Queen Elizabeth Centre welcomes new name A historic milestone in the history of the Queen Elizabeth Centre and complex continuing care program was realized on April 10 as the facility was officially renamed the E.W. Bickle Centre for Complex Continuing Care.

Marking a new era in the delivery of complex continuing care services at Toronto Rehab, the new name honours the legacy of a family that has generously devoted more than 70 years of volunteer and philanthropic support to further enhance patient care at the Dunn Avenue site. Both Judith R. (Billie) Wilder, pictured here with the new Bickle Centre sign, and her late father, E.W. Bickle, served as Chair of the facility’s Board of Directors at different times in their lives, and made annual Christmas Day visits to patients a family tradition.

In the fall of 2007, Billie Wilder further reinforced her commitment to patient care with a $5-million gift to Toronto Rehab Foundation’s Everything Humanly Possible campaign, the largest personal donation ever made to Toronto Rehab.

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Amazing comeback “We’ve all got the potential to be the best we can be.”

They say they are just four ordinary people, who face the extraordinary challenges of disability caused by injury or illness. Chris Bourne, Alfred Carr, Melissa Teehan and Emile DuHamel are at different places in their journeys, but these current and former Toronto Rehab patients share a common trait: a dogged determination to live as fully and independently as possible.

“Deep down inside of us, we’ve all got the potential to be the best we can be—whether that’s becoming Prime Minister of Canada, an NHL hockey player or getting a C on a test,” says Chris Bourne, who has lived with paraplegia since 1990 when his car collided with a train near Orillia, Ontario. “Everybody’s got potential and it’s up to you to dig deep and find it in times when things look pretty grim. It’s all about the attitude you take towards a challenge.”

Chris, Alfred, Melissa and Emile know firsthand that a positive attitude combined with expert rehabilitation can have powerful results. Each in their own way has achieved an amazing comeback—and we thank them for sharing their stories.

Chris Bourne “My life is full and satisfying,” says Chris Bourne, a resident of Manotick, Ontario (near Ottawa) and Acting Executive Director of the Active Living Alliance for Canadians with a Disability. At 40, Chris has lived almost half his life with paraplegia, yet he is at least as active now as he was before his spinal injury at age 23.

“I worked my butt off in rehab,” says Chris of his time at Toronto Rehab’s spinal cord advocate : athlete and rehabilitation program at Chris Bourne Lyndhurst Centre. “My goals were to get back to school and pick up race and 10 km wheelchair race) and silver at the 2002 my life where I’d left off.”

World Duathlon Championships. He also competes at After rehab, Chris finished his business degree, worked the international level in waterskiing for people with for seven years and then completed a Master’s degree disabilities. in recreation and leisure studies. His focus is to promote Through his many volunteer roles with organizations a physically active lifestyle for people with all types of including Paralympics Ontario, Chris visits schools, rehab disability. “Whether it’s a daily outing to walk the dog and fitness centres, and workplaces to do motivational or fly a kite, community square dancing or going to the and educational presentations.

Paralympics as a rugby player, I encourage people to be “Who knows what I would have been doing or who active and to know that there is life after disability.”

I would have been had I not been injured,” says Chris.

An accomplished triathlete, Chris won gold in 2001, “My injury—while a terrible thing and a real shock—has bronze in 2002 and silver in 2008 at the World Triathlon opened up a lot of doors and opportunities that I Championships (1,500 metre swim, 40 km handcycle otherwise wouldn’t have had.”

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ks!

Alfred Carr with

his Boston Mar athon medal

demands of his job and the need for him to be home in the evenings to care for his wife, who has Alzheimer’s disease. Alfred kept a diary of his exercise routine and heart rate; he e-mailed regular reports to his home cardiac rehab supervisor, Anne Marie Shin, and had weekly phone meetings with her. Anne Marie and the team even suggested that Alfred run a half marathon in Toronto in the fall of 2007 in preparation for the Boston Marathon in 2008.

“My rehab was critical to my recovery and meeting my goals,” says Alfred. “The home cardiac program provided me with a safety net. Having Toronto Rehab there supporting me gave me the confidence I needed to succeed.”

Melissa Teehan Alfred Carr On April 21, 2008, 14 months after suffering a heart attack, 62-year-old Alfred Carr of Toronto crossed the finish line at the Boston Marathon—beating his previous record by 24 minutes and requalifying for the event in 2009.

“I feel I’ve had an amazing comeback,” says the long-time runner and Manager of Systems Development and Support at George Brown College. Alfred’s heart attack was caused by a 99% blockage in a main artery of the heart and blockages of 30% to 70% in other arteries. He underwent an angioplasty and two stents were inserted.

After meeting with Dr. Paul Oh, Medical Director of Toronto Rehab’s cardiac rehabilitation and secondary prevention program and undergoing an assessment, Alfred joined the hospital’s home cardiac rehab program.

Dr. Oh and his team supported Alfred’s goal to run the Boston Marathon in 2008. “That was music to my ears because it was the first time anybody from the medical profession had acknowledged that there was still life after a heart attack,” says Alfred.

The home program was a Melissa Te good fit for Alfred because of the e

“I really believe the mind has a powerful impact on recovery,” says Melissa Teehan, 36, of Toronto. “It’s not my fault that I got sick but it’s up to me to get better.”

The mother of two young boys and a Retail Sales Director with Metroland Media Group, Melissa is doing everything she can to fight her way back from the

physioth han with Kristina era G (right), occ pist, and Chandy uy (left), G upationa l therapis reen t

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effects of transverse myelitis, a rare virus that attacked suddenly on July 13, 2007. The resulting paralysis was so complete that she couldn’t move any part of her body and needed the help of a respirator to breathe.

After seven weeks in hospital, Melissa was transferred to Toronto Rehab’s spinal cord rehabilitation program at Lyndhurst Centre, where she spent seven months as an inpatient before moving to the outpatient program. “When I left hospital, I probably

Emile DuHamel

In November 2007, he was admitted to Toronto Rehab on a stretcher. Paralyzed by a stroke, he couldn’t walk, stand or even sit without falling over.

Less than two months later when he was discharged from the stroke service, Emile DuHamel, 63, of Burlington, walked out of the hospital on his own steam using a walker.

4 , n ia “It was a very emotional and Jill ussell, 2, children R d experience—it felt like n ra g d Hamel an Emile Du a new world,” recalls Emile. Now he uses a cane in the community and walks unassisted at home. Emile’s short-term memory has improved and he is helping out in the house again; he plays with his grandchildren and he’s even practicing his golf swing.

That’s a far cry from the man whose was beset by a rash of complex health problems starting in the summer of 2007 that left his medical team and family unsure if he was going to survive. Emile was diagnosed with several blood conditions and over the fall, he experienced problems from renal failure and pneumonia to acute respiratory distress syndrome. At one point, his heart had about 5% of my function back. With rehab, I’ve function dropped to 20% capacity. Several days after now got about 25% to 30% back,” says Melissa. “I’m surgery to remove his gallbladder and spleen, he aiming at 80% and if I can get there, I’ll be thrilled. suffered the stroke.

Lyndhurst has a really great team and it’s a great “I had heard stories of Toronto Rehab and I didn’t facility. If I didn’t have rehab and the support of my think I could do the stroke program—I thought it family, I don’t know how I’d get through this.” would be too hard,” says Emile. “But when I got there, In addition to intensive rehabilitation, Melissa takes it was wonderful. The occupational therapist, speech botox injections, which she hopes will improve the function of her arms so that she can care for herself and pathologist, physiotherapist, the doctors and the nurses—they were unbelievably helpful.” her family. She is just starting to use a walker with the Emile is doing his outpatient rehabilitation at a help of two people. “I hope to keep getting better and hospital closer to home, but he recently returned to better,” says Melissa. “I think my recovery so far is great Toronto Rehab for a follow-up appointment with his but my comeback isn’t as amazing as I think it will be. doctor. “I went up to see the rehab team and they just “Life is a journey. It’s not always the life you wanted or expected but it’s a journey and you do have to see it swarmed around me. They couldn’t believe how well I was walking. They thought I was doing great!” through.”

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Rallying for the cause!

Several InnerWeb Monster Bike Ride participants surround Dr. Doug Richards (centre) and father-in-law Eli Drakich (cloth hat).

Fundraising was always a secondary focus for this group of 15 “very active, fit, rakishly handsome, talented 50-something” friends who gather each spring to do a 200 km InnerWeb Monster Bike Ride from Niagara Falls to Toronto. That’s until this year’s Grand Marshall Dr. Doug Richards selected Toronto Rehab’s stroke service as his charity of choice in tribute to the care received by his father-in-law, Eli Drakich. Suddenly the usual $6,000 raised by the event—which this year was held on Sunday, June 8—spiked to over $19,000!

With Doug “pumped about the charity,” the InnerWeb riders—most of whom have cycled together several times weekly for more than a decade and have been friends for nearly 40 years—rallied behind the cause in support of the Richards/Drakich family.

Eli suffered two strokes in rapid succession in early November 2007. After arterial surgery and post-operative care, he was transferred to Toronto Rehab’s stroke service on December 6. He was unable to walk or care for himself. But when Eli was discharged at the end of February, “he walked out on his own power,” according to Doug.

“It was unbelievable to me—and I’m a physician,” says the Director of the David L. MacIntosh Sport Medicine Clinic at the University of Toronto. “In the past, the medical emphasis was entirely on trying to prevent recurrences. It was an eye opener for me that stroke rehab has come as far as it has since my school days, and is as effective as it is.”

Each year, the Toronto Rehab Foundation invites members of the community to host fundraising events in support of the hospital’s mission to advance rehabilitation and enhance

quality of life for the nearly 4.4 million Canadians who experience disabling injury and illness. In 2007/2008, community groups raised close to $125,000 to support Toronto Rehab programs including complex continuing care and cardiac rehabilitation. Events included dinners, hockey games, golf tournaments, walks, runs and more.

“We are pleased to welcome back to our 2008/2009 program the Scotiabank Toronto Waterfront Marathon and the Rick Hansen Wheels in Motion events and we’re delighted to welcome new community groups including the InnerWeb,” says Tannis Walker, Development Associate, Events and Corporate Sponsorship, Toronto Rehab Foundation.

As for Doug, Eli and family, “Words cannot easily express how wonderful the staff and programs are at Toronto Rehab.

It is in gratitude for and support of this wonderful program that we designate the stroke service as charity of choice for this year’s ‘Monster.’”

For more information about hosting a community event in support of Toronto Rehab, contact Tannis Walker at the Toronto Rehab Foundation at 416-597-3422, ext. 3967 or send an e-mail to walker.tannis@torontorehab.on.ca TORONTO

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Post script For Michael Yermus (in black pants on Ricksycle, a combination of

a tandem bike, tricycle and rickshaw), recovery from a stroke in February 2007 has been about hard work, dedication and meeting a series of goals he set for himself. The 49-yearold’s most recent success was to cycle the 25 km course at the Becel Heart & Stroke Ride for Heart in June. Accompanied by his Goodfellas team of family and friends including his wife Janice, Michael and long-time friend Brian Stal rode the distance on this side-by-side cycle-fortwo. The team raised over $15,000 for the Heart and Stroke Foundation. Michael’s stroke affected the left side of his body and left him struggling with his speech and some cognitive skills. He credits his rehabilitation at Toronto Rehab’s inpatient stroke service at University Centre and outpatient risk factor modification and exercise program for stroke survivors at Rumsey Centre for getting him on the road to recovery. “Rehab has been very important to me,” Michael says. “The team at Toronto Rehab did a great job—they were fantastic. I have nothing but good things to say.” Married for 20 years and the father of three, Michael is already busy working on his next major goal—returning to work as an insurance broker. “After the stroke, I couldn’t read or do work but now I’m working with a speech-language pathologist and I’m continuing physiotherapy. I’m improving quite a bit. I’ve got to do it slowly and my talking has to get a little better, but I’m getting there.”

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