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The truth about vaccinations

This article was written by Lindsey Bunin for the Fall 2014/Winter 2015 issue of Izaak Magazine – an in-depth, behind the scenes, all-access publication highlighting the incredible, everyday happenings at the IWK Health Centre. World-leading IWK immunization expert, Dr. Noni MacDonald, shares insight on a complex and timely topic.

The digital age in which we live has greatly changed the way we gather and process information. If we have a question these days, most of us just “Google it!”
While the convenience of immediate information can suit our desire for instant gratification, it’s not necessarily the most accurate approach. This is especially true when it comes to the often-controversial topic of vaccines.

vaccinationsDr. Noni MacDonald is a professor of pediatrics at Dalhousie Medical School with an appointment in Pediatric Infectious Diseases at the IWK Health Centre, and her expertise has afforded her opportunities to teach and practice in countries around the world. One of MacDonald’s major research interests is vaccines, particularly in the areas of safety, hesitancy, pain mitigation and policy issues. She is a key member of the research team at the Canadian Center for Vaccinology at the IWK, has published more than 300 papers on such topics and has long been recognized in Canada as an advocate for child and youth health and as a leader in pediatric infectious disease.

In an effort to help clarify vaccination information for families, MacDonald has provided insight into some commonly asked questions.

Aren’t my children safe if everyone else’s children are vaccinated?
“Some vaccines work better when everyone is vaccinated,” MacDonald says. “This is called ‘herd’ or ‘community’ immunity. If everyone is vaccinated for measles, for example, the virus will stop circulating. However, herd immunity doesn’t work for other diseases, such as tetanus, because the tetanus bacteria are in the environment, in soil and dust.

“Besides, you don’t know if everyone around you is vaccinated, and people travel far and wide in our mobile society. You’re taking a huge risk if you’re depending on everyone else to be vaccinated to protect you or your child from measles, for example.”

Aren’t vaccines only for infants and children?
“Most vaccines are for infants and children because there is no natural protection from many serious vaccine-preventable diseases such as pertussis, tetanus, diphtheria, measles, some strains of influenza, meningitis, etc. While a mother transfers some of her antibodies to the infant during pregnancy, these do not last very long after the baby is born. Similarly, the antibodies in breast milk are not enough to protect the infant from many of these diseases.

“An increasing number of vaccines are being developed for adults so they will be protected into old age, the shingles vaccine is one example. It’s also been proven that immunizing adults can help protect infants and children. For example, re-immunizing adults (a booster) for whooping cough prevents infected adults from passing this terrible disease to infants: parents and grandparents take note!

Wouldn’t natural immunity be better?
“Immunity induced by vaccines is effective and much safer than natural infection.
Vaccination is a better choice because it avoids the risk of getting some terrible  disease complications, like brain damage with measles, deafness with mumps, death with tetanus and pertussis, and more,” MacDonald explains. “We’re also learning more about boosting childhood vaccinations with repeat vaccinations later in life, to ensure immunity doesn’t wane as we get older.”

Now that major illnesses have largely disappeared, we really don’t need vaccines anymore, do we? 

“The success of vaccines makes it appear that many infectious diseases have disappeared, but sadly that’s not true,” she clarifies. “There are outbreaks of measles and whooping cough throughout North America, and a resurgence of polio in Asia, Africa and the Middle East. Vaccination rates must be very high (over 90 per cent) to stop the spread of these viruses and bacteria, so when not enough people are vaccinated outbreaks can occur. Today, people travel far and wide and may not be aware that they’re not just bringing luggage with them.”

Do vaccines cause autism and other disorders?
“Vaccines do not cause autism. The increased rates of autism are in part the result of changes in the way the condition is assessed or recognized. Autism is known to be a genetic disorder with other contributing factors, but vaccines are not a factor. There is no proof that vaccines cause autism or any other diseases, like multiple sclerosis, but
there’s plenty of proof that vaccines prevent very serious infectious diseases.”

Is it true that vaccines have damaging and long-term side effects that are yet unknown?
“Vaccines have been used over many decades in millions of people around the world.
Extensive global networks track reactions to vaccines known as ‘adverse events following immunization,’ to find out which events are due to vaccine, and which are just coincidence (not caused by vaccine).

“There are now many years of data that prove the safety of vaccines. The global networks alert health professionals to any new concerns about a vaccine. The most commonly reported reaction is a sore arm. The risks of serious complications from contracting diseases like measles, whooping cough and hepatitis are much more common and can be far more serious than any adverse event from a vaccine.”

Why don’t we consider vaccine preventable childhood illnesses as just an unfortunate fact of life?
“They used to be, and millions of children died from diseases that are now prevented
with vaccination,” MacDonald says. “Thousands of children still suffer from these diseases because they don’t have access to the range of vaccines we have in North America. We’re privileged to live in a country where so much serious illness, disability and death can be prevented with a few doses of vaccine”

Can’t the flu vaccine give you the flu or make you sick?
“The flu vaccine cannot give you the flu. The flu virus used in the vaccine is killed or broken when the vaccine is manufactured. The flu vaccine is given when many flu-like illnesses are already circulating in the population so, if you get sick following your flu shot, it isn’t from one of the infl uenza strains contained in the vaccine. The ‘real’ influenza is a very serious illness and not to be confused with a cold or stomach illness.”

Do you think the flu vaccine is really effective?
“Influenza is a very sneaky virus that changes its outer coat every year. This is why a new version of influenza vaccine has to be made and given each year. Sometimes the experts are able to make the vaccine match well to the new influenza strain, other times the match is not so good. When the match is spot on, the vaccine is very effective; when it is less well matched, it is less effective BUT still far better protection than if no influenza vaccine is taken.

“Antivirals and other off -the-shelf medications are not very effective against influenza, so the treatment for influenza is simply bed rest and lots of fluids. Influenza is quite contagious. If you’re not protected by vaccine when exposed to someone incubating or having influenza, you easily become infected and then spread it to others who are not immunized in your family, at work, at school, etc. For many people, the extreme fatigue from influenza is very debilitating and disruptive to their lives, even if they do not get one of the more serious complications. It’s so much easier to just get a flu shot.”

This story and many exciting others are available for FREE though the online version of Izaak magazine.

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Change Makers – Jacob

This article is a series of three, written by Tom Mason for the Fall 2013/Winter 2014 issue of Izaak Magazine – an in-depth, behind the scenes, all-access publication highlighting the incredible, everyday happenings at the IWK Health Centre. A stay at the hospital can be tough, but for some exceptional young people, it’s also a time to grow , gain strength and learn about who they are. 

Jacob Hamilton

Jacob Hamilton

For Jacob Hamilton, paying it forward means finding strength in his own life. At 19, Jacob has been through more than most people his age. He’s already struggled with mental illness, and the stigma that surrounds it, for several years.

Jacob spent four months in the IWK inpatient mental health unit starting at age 17. He endured weeks of difficult medication changes, missed out on family and school events, even spending his birthday and the days leading up to Christmas in the hospital. Through it all, the IWK staff was there to help him, at times becoming almost part of his extended family. “They even took part in Christmas activities with me,” he says.

Today Jacob uses his own experiences to help other young people suffering with mental illness. He volunteers with the IWK Foundation and has worked to raise money for a new inpatient mental health unit for the hospital that will offer much improved care space for those with acute mental illness requiring hospitalization at the IWK. He speaks out to help improve adolescent mental health care in Nova Scotia, and he advocates for young people, to help them overcome the stigma that so often goes with mental illness.

“Mental illness is a disease like any other,” he says. “There’s nothing to be ashamed of, and there’s always hope. There are a lot of youth out there dealing with these issues. They need to know how they can access mental health care.”

He’s also attending Dalhousie University, working on a science degree and planning to major in neuroscience, microbiology and immunology. Jacob recently received a $40,000 scholarship to help him pay for university and he’s doing well with his studies, but he still deals with his illness every day. “I have good days and bad days,” he says. The hours he gives back as a mental health volunteer are one of the ways he copes. “I do it as a way to give back to the IWK. I lost a lot of time in my life because of my illness. I lost a year of school. The IWK helped me get better. They helped me get back to real life.”

Jacob says that people with mental illness need someone in their corner to help them get proper treatment in their most difficult days. That’s what motivates him to work so hard. “They need to fight for the right care, and the irony is they really aren’t equipped to fight,” he says. “There are a lot of patients who can’t speak about their problems, but I don’t mind speaking out.”

This story and many exciting others are available for FREE though Izaak Magazine’s fully interactive mobile app, available for download on the iTunes Newstand and Google play. You can also read Izaak magazine online through your desktop computer.

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Change Makers – Sonja

This article is a series of three, written by Tom Mason for the Fall 2013/Winter 2014 issue of Izaak Magazine – an in-depth, behind the scenes, all-access publication highlighting the incredible, everyday happenings at the IWK Health Centre. A stay at the hospital can be tough, but for some exceptional young people, it’s also a time to grow , gain strength and learn about who they are. 

Sonja Weilgart-Whitehead

Sonja Weilgart-Whitehead

At the age of 18, Sonja Weilgart-Whitehead is already an old hand at talking to the media. The Herring Cove teenager was just 15 when she spearheaded a media campaign that focused attention on evacuation policies at Halifax Schools – a campaign that changed those policies for students with mobility issues.

Sonja has quadriplegic cerebral palsy, a condition that comes with significant mobility challenges. “My high school had an evacuation policy that said they couldn’t carry disabled persons out of the building because it would risk injuring the person responsible for carrying the,” she says. “Instead, we were supposed to go to a designated safe area and wait for the fire department.” But the designated safe room in Sonja’s high school was located right above a propane tank, with furniture blocking the only window that rescue personnel could use to access it. “I know that if my school ever wet up in flames, I was going to be toast.”

I was a situation that Sonja had no intention of ignoring. She and her mother contacted the media and began a series of interviews to shed light on the topic. The campaign immediately caught the attention of Nova Scotia cabinet ministers Ramona Jennex and Marilyn Moore who offered her an apology and set out to change the school policy. “They changed it for everyone in the province,” she says. “It means a lot, even though I was almost ready to graduate. With the old policy, it was like they were saying my life wasn’t as valued as the other students.”

Sonja is used to overcoming challenges. Her first extended stay at the IWK began the day she was born, when she was 18 months old. She’s made many trips to the hospital since then. “Over the last six years I’ve been getting a lot better because of a phenomenal surgery that the IWK gave me. Now I can walk without tangling by feet, without being crumpled over. I can swim a lot better too. It’s forever changed by life.”

Today, Sonja is studying for her Bachelor of Arts (honours) degree at Carleton University in Ottawa, and received the Robbie and Jean Shaw Scholarship. She plans to go on to become a lawyer advocating for people with disabilities. She chose the university because of its unique program for physically challenged students – a program that includes 24/7 attendant services and full wheelchair accessibility. She is also nationally-classified para-swimmer on the Carleton varsity swim team and involved in horseback riding, sailing, skiing and rock climbing.

This story and many exciting others are available for FREE though Izaak Magazine’s fully interactive mobile app, available for download on the iTunes Newstand and Google play. You can also read Izaak magazine online through your desktop computer.

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Made-to-Order Independence

This article was written by Debra Wells-Hopey for the Spring/Summer issue of Izaak Magazine – an in-depth, behind the scenes, all-access publication highlighting the incredible, everyday happenings at the IWK Health Centre.

11-year-old Taya and occupational therapist Julia Gates

11-year-old Taya and occupational therapist Julia Gates

How a customized wheelchair program provides quality of life for hundreds of kids.

Taya is spirited, bright and patient as she describes the way she gets around in the world.

“When I move my head left, I turn left,” she says enthusiastically, even though she must have explained this to people many times over. “When I move my head right, I go right. And when I move my head back, I go straight forward.”

At 11 years-old, Taya has Cerebral Palsy and is a long time visitor to IWK Specialty Seating, a service within the IWK’s Rehabilitation Service. The service offers assessment and provision of customized seating and positioning equipment, including seating inserts, wheelchairs, special-needs strollers, bath seats, car seats and toileting aids.

Julia Gates, Occupational Therapist in Specialty Seating, and Nancy Cashen, Operations Manager for Rehabilitation Services, have known Taya since she was three years old. “This program is designed to assist children who can’t walk on their own, most often due to Spina Bifida, Muscular Dystrophy or Cerebral Palsy,” explained Gates. “Children are referred to the program as early as 14 months and stay with us until they are ready to transition to adult health care.”

Gates explained that although children this young are able to still use a stroller, it means they are dependent on others to get around — at an age when they want to start exploring the world on their own.

“Independence is an essential part in a child’s growth and development,” added Cashen.

Specialty Seating at the IWK consists of Cashen and Gates, as well as a Specialty Seating Technician, David Beattie, and a Funding Coordinator. Together, along with the family, this team determines what kind of wheelchair would be best for the child.

“We take many factors into account,” says Gates. “For instance, a level of hand mobility is essential for maneuvering a manual wheelchair, but not necessary for a power wheelchair.”

The amount of seating support required is a complex assessment that is completed by the occupational therapist and takes into account the disease prognosis, planned orthopaedic surgeries, maintenance of skin integrity, comfort, functional abilities and wheelchair skills. All children are different, and the amount of support required could be viewed as mild, moderate, or complex. Generally, seating for a mild support is not custom made, and may be arranged through a local wheelchair supplier in the community. The seating for children who require moderate or complex support is custom made by the Specialty Seating Service at the IWK.

There is a workshop onsite at the IWK where Beattie employs his expertise. For specialized seating, an impression is made on a mould that resembles a large bean bag. This shape can then be transferred to a 3D digital model on the computer. These images are sent via email to the United States where the only machine of its kind in North America manufactures the seat. It is then shipped to the IWK for fitting.

As for Beattie, he has been with the hospital since 1989. He was familiar with an Occupational Therapist who suggested he may enjoy the work. Considering Beattie has remained in the program for more than 24 years, it certainly is a great fit.

“This is the perfect job as far as I’m concerned,” says Beattie. “I get to work with my hands and help people simultaneously. The work is challenging and rewarding.”

Beattie’s workshop looks much like any other, yet very unlike anything you expect to see in a hospital. There are various materials stored: pieces of repurposed wheelchairs, three industrial-sized sewing machines, neoprene for upholstering, two band saws, a table saw and a wealth of tools.

“When we first see someone we measure them for a seat using a fitting frame. From these measurements I construct a seat out of foam and plywood and I upholster it. I also adjust and repair wheelchairs as needed. I’d say one of my favourite parts of my job is going on the mobile clinics. Several times a year we go to Cape Breton and the Annapolis Valley. At times we go to schools here in HRM, or even homes.”

Gates explained that the first order of business when a child needs a wheelchair or seating device is to meet with the family and get to know their needs.

“This initial meeting is so important,” says Gates. “It’s when we first get to meet the child; establishing their needs, administering a postural assessment, taking measurements, then making recommendations.”

“Recently we had a child who needed a new power wheelchair. We had two styles and tried them both in the home to see which operated better in that specific environment. It needs to work in the child’s daily life.”

Having the right wheelchair and seating can make all the difference in the world when it comes to quality of life — kids need to participate with classmates, explore their environment and have a sense of independence.

“When a child receives their first wheelchair it is often a period of growth for both the parents and the child,” says Gates.

Taya’s mother Christine knows all about it. She has been taking Taya to Specialty Seating and working with the team for eight years. Taya was only three when she received her first wheelchair and met the group at Specialty Seating. She was outgrowing a stroller at this point, not only in a physical way but also as a growing child her needs were changing — she had a desire to be independent, to be able to explore the world on her own.

“Although she was small enough to still use the stroller, it no longer seemed to be the appropriate choice,”explained her mom. “The chair was so much better for her

Izaak#Provincial#05-02-2013#A01posture, and allowed her to be eye level with her peers. Her diaphragm was also better supported which made her breathing and therefore her speaking so much better.”

Taya was born with cerebral palsy. She enjoys her grade five class and likes to read — especially Harry Potter books. She also swims and uses a sit ski at Wentworth ski hill.

“I have both a manual and a power chair,” explained Taya. “I use the power chair at school. Some places are easier to use a wheelchair in than others though.”

Although Taya drives herself around by using head movements, the wheelchair must be steered remotely by a device similar to a joystick when it is being loaded into the family van. Apparently, according to a laughing Taya, dad is an expert at it, while mom, who is quick to agree, isn’t as deft.

Taya was eight when she got her first power chair. She started at six years old “training” with a joy stick, but it was a lot of work and a head array began to make more sense. The family visits Specialty Seating about once a year.

“To a certain extent, the chairs grow with her. Especially the manual chair, which she will have for about eight years,” explains Christine. “The power chair needs changes or replacing more frequently.”

As for cost, the family is fortunate that both Christine and her husband have good health care plans, however, they still certainly incur costs. The head array alone cost $10,000, which is as much as the chair. Then there are the costs of converting the family van with a manual ramp that has to be lifted and unfolded. A power system is even more expensive. This is the reality for families with a wheelchair. Taya gets to continue to visit the team at Specialty Seating until she is ready to transition to adult health care.

“I can’t say enough about the program and the staff,” says Christine. “When your child is first diagnosed, you’re in a daze. You don’t know where to go or what to do. They have helped us immensely, even in emergency situations.”

One such situation was during a weekend when Taya’s chair was accidentally run over, crushing one of the wheels. It meant facing a whole weekend propped up or in bed. Not a great thought for a young, energetic girl like Taya. Christine contacted Gates and Beattie who were more than willing to go into work on a Saturday to get the chair fixed. Says Taya, “Dave and Julia are extremely nice people and I would come to them all my life if I could.”

And there’s no higher praise than that.

To read the full issue of Izaak magazine visit www.iwkfoundation.org/izaak

Make a gift to the IWK Health Centre Foundation.


Breathing Space

This article was written by Tom Mason for the Spring/Summer issue of Izaak Magazine – an in-depth, behind the scenes, all-access publication highlighting the incredible, everyday happenings at the IWK Health Centre.Dr. Laine Johnson brings highly-specialized airway reconstruction surgery to the IWK

Larkin looks at the plastic fish and bubbles

Larkin looks at the plastic fish and bubbles

Larkin Pottle was born four years ago with tracheomalacia, bronchomalacia, and subglottic stenosis of her trachea — conditions that severely restricted her ability to breathe on her own. Her parents, Rhonda and Brent Pottle, struggled with the tracheotomy that allowed her to survive the process. As she grew, breathing on her own started to look

Like a possibility; surgery to allow this to happen was the next step for the Pottle family. Tracheotomies are one of the most vital surgical procedures in modern medicine, but they are actually very old. The surgery is depicted on Egyptian artifacts more than 5,000 years old and described in Sanskrit texts from around 2,000 BC. A tracheotomy involves placing a tube through an incision in the neck to bypass the nose and mouth and allow air directly into the trachea. Every year they save countless lives; but for most young children who have undergone the procedure,

a normal life doesn’t begin until the tube has been successfully removed. That can prove to be difficult.

Dr. Liane Johnson uses a scope to view Larkin's airway.

Dr. Liane Johnson uses a scope to view Larkin’s airway.

That’s where Dr. Liane Johnson comes in. Dr. Johnson is a pediatric airway surgeon at the IWK, the only doctor in Atlantic Canada to perform a specialized form of airway reconstruction surgery in children. The innovative technique involves using the child’s own rib cartilage to expand the scarred airway to attempt to achieve a normal diameter airway (air passage). Because the technique relies on tissue from the child’s own body, there are no issues with rejection.

Dr. Johnson learned the complex procedure during a two-year fellowship at the Cincinnati Children’s Hospital Medical Center under world-renowned pediatric otolaryngologist Dr. Robin Cotton, who pioneered the technique 30 years ago. She has already performed about 20 of the surgeries at the IWK. She says the procedure offers the patient and family a degree of independence that is life-changing.

“With proper patient selection, they can be very successful surgeries,” she says. “It’s rewarding to see the results.”

Larkin Pottle’s conditions were serious and because she needed constant medical care, Larkin could never be left alone. This left her family with the task of learning how to take care of her properly at home. Any kind of mucus plug or blockage of the tracheostomy tube could also be disastrous. It was a 24-hour-a-day job for Rhonda and Brent,

one that required plenty of professional help. “We had to get professional respite care at night so that we could get some sleep,” says Rhonda.

Rhonda Pottle cuddles her daughter Larkin Pottle as they wait for Larkin's appointment at the IWK.

Rhonda Pottle cuddles her daughter Larkin Pottle as they wait for Larkin’s appointment at the IWK.

Along with the basic skills that every new mother learns — feeding Larkin and changing her diapers — Rhonda quickly became adept at a number of medical techniques, including suctioning a tracheotomy tube and performing mouth to trach resuscitation. If Larkin accidentally removed the tracheostomy tube, the Larkin family had to be prepared to perform CPR.

“It’s not that difficult. Anyone can learn to do it as long as they’re not afraid of it,” says Rhonda. Larkin was approaching her second birthday when doctors discovered she was breathing through her nose and mouth around the tracheotomy tube. It was good news. It meant the airway was growing and the problem was correcting itself. But scar tissue had formed, and Larkin’s airway needed to be repaired before the incision in her trachea could be permanently closed.

This picture was taken at the level of the vocal cords showing complete obstruction of the subglottic airway, just beyond the vocal cords.

This picture was taken at the level of the vocal cords showing complete obstruction of the subglottic airway, just beyond the vocal cords.

Rhonda began the search for a doctor who could do the surgery. She and her husband had already made plans to travel from their Stephenville, Newfoundland home to Cincinnati to meet with Dr. Cotton when they heard about the IWK program. “I heard there was a doctor in Halifax who had studied with Dr. Cotton and was using the same procedure.” The Pottle’s first visit to Halifax was a little disappointing. Dr. Johnson examined Larkin and told the family to come back in three months for reassessment as it was

too soon for the operation. “That’s the hardest thing to say to parents: ‘She’s not ready,’” says Dr. Johnson. “But if you do the surgery too early the consequences can be devastating. The last thing I want to do is set up a spiral of failure. Sometimes it’s just safer to wait.”

This picture was taken just below the vocal cords showing a completely open subglottic airway following placement of rib grafts.

This picture was taken just below the vocal cords showing a completely open subglottic airway following placement of rib grafts.

When the day finally came, it was a long one. The Pottles spent eight hours waiting for Larkin’s surgery to end. Dr. Johnson constructed two rib grafts to expand the damaged airway, placing them carefully in the trachea below the little girl’s voice box. When it was over she was sedated and ventilated in the intensive care unit for nine days, but after stent removal she was soon breathing on her own. It was a success.

There have already been many milestones for the Pottle family. Larkin had a bout of the flu during the winter – a normal rite of passage for most four-year-olds, but one that would have brought on a serious medical crisis before the surgery. This time it was no big deal, says Rhonda. The family left for a Florida vacation in March, the first family trip since Larkin was born that didn’t centre around a medical appointment. Most importantly, Larkin is gaining a measure of independence that she didn’t have before. She’s getting ready to attend preschool and is making friends her own age for the first time. “She loves other kids,” says Rhonda. “Finally she can be a kid herself.”

To read the full issue of Izaak magazine visit www.iwkfoundation.org/izaak

Make a gift to the IWK Health Centre Foundation.

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On the front line

This article was written by Elizabeth Patterson for the inaugural issue of Izaak Magazine – an in-depth, behind the scenes, all-access publication highlighting the incredible, everyday happenings at the IWK Health Centre.  Through the lens of a microscope, laboratory technologists are often the first to uncover the diagnoses that will change lives.

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Even in a job featuring some of the world’s most up-to-date technology, there’s nothing like old-fashioned human contact to put everything into perspective.

“A child who has been sick for weeks may come into the emergency department. They’ll have blood work done and when we look under the microscope, we’ll find abnormal white cells count and see leukemia,” says Randy Veinotte, Manager of the Core Laboratory, Pathology and Laboratory Medicine at the IWK Health Centre.

Laboratory technologists use microscopes to examine different body fluids, blood, and tissues. For example, when a patient has blood drawn for a CBC (complete blood count) and it is run through the analyzer, a blood smear is made and stained for review when results are abnormal. When reviewing a blood smear with a microscope the technologist is looking at the number and types of cells present.

“The technologist can be the first person to see abnormal cells,” explains Veinotte. “Abnormal cells can be caused by different conditions like infections, malaria, sickle cell, or could reflect abnormalities in the bone marrow, pointing to Leukemia. So, you can see why this is such an important step … the earlier the diagnosis the quicker the treatment for the patient.”

Medical lab technician Terri-Lynn Lawrence analyze patient samples for indicators of illness.

Medical lab technician Terri-Lynn Lawrence analyze patient samples for indicators of illness.

For Veinotte, information like this is a call to action for the hospital’s medical staff. Every day, his team of laboratory technologists, assistants, and Licensed Practical Nurses (LPNs), are on the front lines, meeting with patients who require tests that can unearth every type of ailment imaginable. While some results may not be good, it’s still better than not knowing.

“When you’re in a position of caring for patients, understanding your boundaries is important. Yes, we’ve found something, but you have to believe maybe we’ve caught it in time,” says Veinotte.

Veinotte says that this is what keeps everything at a very human level.

“We’re lucky here at the IWK,” says Veinotte. “When we do the collections, we see the patient — what’s contained in that tube is the patient — it reminds you that every specimen is important.”

As a teaching facility, the IWK labs host students from the Medical Laboratory Technologist program at NSCC, as well as laboratory assistants, and residents from different medical programs.

“They all use our laboratory to help train their students and prepare them for life in the real world,” Veinotte says. “What makes our laboratory so different is that we get to see samples from women, children and babies all under one roof — a very challenging setting, but also extremely rewarding.”

The Core Laboratory looks after chemistry and hematology is open 24 hours a day, every day of the year. It has a staff of about 30 people who provide test results on a daily basis to ensure patients get proper care.

Izaak - SMALL.pdf - Adobe Acrobat ProBesides tracking down illnesses, working at the IWK presents a unique set of challenges. The patients range from infants to elderly women and that means using different techniques. For example, collecting a blood sample from a newborn isn’t the same as getting one from a 35-year-old woman. For one thing, you need smaller tubes to collect the samples and you can’t take as much of a sample. If the samples aren’t taken properly at the beginning, it won’t necessarily yield a proper result. It all means that the staff must always operate at the top of their game.

“We have individuals here who are very skilled at what they do,” says Veinotte. “It takes a special person to do this type of job.”

Compassion and understanding for patients and their families are the most important aspects of the job. Veinotte says that seeing a patient get properly diagnosed, treated and then recover is one of the benefits of his position. “We are there for their care and we do get to see them get better. We get to see the full circle.”

To read the full issue of Izaak Magazine visit www.iwkfoundation.org/izaak.

Make a gift to the IWK Foundation.

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Depression detective tackles the genetic code.

This article appeared in the inaugural issue of Izaak Magazine – an in-depth, behind the scenes, all-access publication highlighting the incredible, everyday happenings at the IWK Health Centre.  Dr. Kathleen Pajer and her team have developed a unique blood test in an attempt to pinpoint how and why this form of mental illness occurs.

“Intriguing and provocative” is how Dr. Kathleen Pajer, Chief of Psychiatry at the IWK Health Centre, describes her research with long-time collaborator Dr. Eva Redei of Northwestern University in Chicago. Dr. Pajer’s arrival in Halifax last year did not happen by chance. After vacationing in Nova Scotia six years ago, Dr. Pajer decided it was a place she’d love to live and pursued professional opportunities in the province. The rest, as they say, is history.

DepressionNow, in her role at the IWK, Dr. Pajer continues her compelling research, trying to determine how and why depression occurs. If she can do so, she and her international research colleagues will truly be leading in mental health research that can change the world.

Through their extensive work, Dr. Pajer and her research team realized that the current method of diagnosing depression is subjective. So, they sought to find a blood test that could serve as an objective tool to determine depression. Their pilot study involved 28 patients — half of whom had early onset depression and half who showed no symptoms. This study resulted in the development of the first blood test to diagnose major depression in teens.

“Right now depression is treated with a blunt instrument,” explained Dr. Pajer’s research associate, Dr. Redei, in a release about their findings. “It’s like treating type 1 Diabetes and type 2 Diabetes exactly the same way. We need to do better for these kids.”

“This is the first significant step for us to understand which treatment will be most effective for an individual patient,” added Dr. Redei. “Without an objective diagnosis, it’s very difficult to make that assessment.   The early diagnosis and specific classification of early major depression could lead to a larger repertoire of more effective treatments and enhanced individualized care.”

Their findings were published in the spring and were widely cited because it demonstrated that they found 11 genes that differentiated the two groups. To help explain the research, Dr. Pajer compared a person’s genes to an electrical panel in a house.

Whether the genes — or the switches — are there indicate whether a person has a predisposition for something. Then, at some point in a person’s life the genes can be turned on or turned off. When genes get turned on or off, they either make proteins or don’t. This highly depends on an individual’s environment and includes many factors.

“We discovered 11 genes in a panel that were  able to mark early onset depression,” Dr. Pajer says. “This was an incredible discovery — one that we didn’t expect due to the complexity of the disorder.”

Dr. Pajer’s research is critical to the mental health treatment underway at the IWK. In fact, her work will have a meaningful impact on treatment of children and youth now and in the years to come, in the Maritimes and around the world.

“Everybody, including parents, is wary of treatment, and there remains a social stigma around depression, which in the peer-pressured world of teenagers is even more devastating,” Dr. Redei said. “Once you can objectively diagnose depression as you would hypertension or diabetes, the stigma will likely disappear.”

Having a blood test that can detect depression earlier is significant because the  mind is like clay. The longer you wait, the more it sets and it becomes less pliable. In her research on depression, Dr. Pajer has discovered that the longer she follows adults who have not been successfully treated, the closer the depression cycles get and the harder they are to break. “We want to try to treat it early and identify it early,” Dr. Pajer said. “Early onset depression is the worst kind you can have. The earlier the onset, the more likely for a chronic course, the more likely that you’ll continue throughout the rest of your life to cycle into depression.” Early onset means the depression is diagnosed before the person is 26 years old.

The next step is to compile a larger group of child participants. The research team will then measure the gene expression level of those who show symptoms against those who do not. “This next step will bring us closer to our goal of early intervention,” says Dr. Pajer. “We then anticipate more effective treatments and enhanced individualized care.”

To read the full issue of Izaak Magazine visit www.iwkfoundation.org/izaak.

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