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‘Just like Iron Man’: Calgary surgeon undergoes experimental spinal surgery

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  • CALGARY — Dr. Richi Gill’s life changed in an instant.

    The 38-year-old surgeon, who helped develop Calgary’s bariatric surgery program, was involved in a freak accident on a boogie board during a family vacation in Hawaii one year ago.

    “The wave pushed me down instead of forward in pretty shallow waters. My head hit the ground and ended up breaking my neck,” Gill said following a recent physiotherapy session.

    “I don’t have any movement or sensation below that injury level. I do have some use of my arms but not my hands.”

    Gill described how he embarked on strenuous rehabilitation at Calgary’s Synaptic Spinal Cord Injury and Neuro Rehabilitation Centre, then headed to Thailand in October for experimental surgery.

    An epidural stimulation implant was placed in his lower back. With the use of a small device like a remote control, the implant sends electrical currents to Gill’s spinal cord to stimulate nerves and move his limbs, bypassing the traditional brain-to-spinal-cord pathways.

    The implant can be programmed to stimulate certain nerves mapped out by surgeons and therapists.

    Gill said his middle of three children, Akaash, thinks the implant is cool.

    “He’s very much like, ‘This is just like Iron Man! … We need the suit,” Gill said.

    “He’s only seven so I think he might think there’s a suit that’s out there somewhere.”

    The smile doesn’t fade from Gill’s face as, strapped into a harness, physiotherapists slowly help him walk with the use of a machine on wheels. Gill isn’t able to move his legs on his own, but by concentrating he is able to make his hip muscles flex and help himself along.

    “Right now, realistically, assisted stepping is where I’m at and being able to stand with assistance. Will I be able to walk on my own? It’s a possibility. My main focus is just trying to improve day by day and we’ll see where that gets me.

    “It’s definitely fatiguing because each time you try to take a step you have to really focus and concentrate to get that signal to the right spot.”

    Gill spent $100,000 for the surgery and travel, since they weren’t covered by health care or insurance. He plans to return to Thailand later this year to have a second stimulator placed higher up on his spine.

    His career as a surgeon is over, he said, but he hopes the operations in Thailand will help him regain some hand function and his overall quality of life.

    The spinal surgery is also performed in a few other countries such as the United States and Switzerland, but it’s much cheaper in Thailand.

    Only a half dozen people in Canada have had it done abroad and the number worldwide is about 30, said Dr. Aaron Phillips with the Cumming School of Medicine at the University of Calgary.

    So few procedures having been done makes it harder to get approval from Health Canada or the Food and Drug Administration in the United States, he said.

    Phillips has been involved in assessing the procedure for the last nine years.

    “I’m just really overcautious about selling these things too early. And, although I am extremely excited about the potential of this therapy, it still needs to pass rigorous tests first,” he said.

    “We don’t know if this will work the same way in everyone. We’re still dealing with very small numbers, although the initial findings are promising.”

    Ryan Straschnitzki of Airdrie, Alta., the Humboldt Broncos player who was paralyzed from the chest down when the Saskatchewan team’s bus crashed last April, has become friends with Gill through the Synaptic clinic.

    Gill has inspired the 19-year-old with his positivity.

    “He’s able to do things he couldn’t do before. It’s amazing,” said Straschnitzki.

    The executive director of Synaptic has seen a marked change in Gill’s abilities and has visited the medical facility in Thailand.

    “Given the nature of Richi’s injury, there was no sensory and no volitional movement below his level injuries. This has allowed Richi to regain some of that function and to be able to command voluntary movement below his level of injury,” says Uyen Nguyen.

    “This is not a cure. But from what we can see, this appears to be the most promising procedure for people with spinal cord injuries.”

    — Follow @BillGraveland on Twitter

     

    Bill Graveland, The Canadian Press

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    Health

    Healthy eating obsession can be a sign of mental-health struggles: study

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  • TORONTO — While we should all strive for a balanced diet, York University researchers say the extreme pursuit of healthy eating can be a sign of mental-health struggles.

    Jennifer Mills, an associate professor in York’s psychology department, co-wrote a recent paper on orthorexia nervosa, which she describes as an unhealthy obsession with healthy eating, published in the journal Appetite.

    In reviewing academic literature on the subject, the authors found that people with a history of eating disorders, obsessive-compulsive tendencies, perfectionism and other psychological and behavioural tendencies were at higher risk of developing orthorexia.

    “There is nothing wrong with healthy eating. Healthy eating is something we should all aspire to,” Mills said in an interview. “But (we need) to be aware that mental-health difficulties can manifest through food.”

    Orthorexia has not been recognized in the standard manual psychiatrists use to diagnose mental disorders, and the York study found research on the subject is limited.

    But as so-called clean diets have picked up steam, Mills said there’s been growing interest in medical and research circles about the social and psychological side-effects of a “pathological” preoccupation with healthy eating.

    While there’s overlap between the risk factors for orthorexia and certain eating disorders — such as poor body image, a drive for thinness and dieting — Mills said the conditions differ in key ways, particularly their motivations.

    People with a restrictive eating disorder like anorexia will typically reduce their food intake in order to reach a low body weight or change their appearance. But for those with orthorexia, Mills said the focus on food is about quality rather than quantity.

    Many people with orthorexia are proud of their bodies, she said, but are decidedly picky about what they put in them.

    This often involves eliminating certain types of food from their diets, such as sugar, saturated fat, gluten, animal products, artificial flavours and preservatives.

    For some, she said, the list of forbidden foods can grow so long that their diet may be lacking in essential nutrients, which in severe cases can lead to health hazards such as anaemia, vitamin deficiencies or excessive weight loss.

    But Mills said one of the reasons orthorexia tends to go overlooked, including by medical professionals, is that many people with the condition are physically healthy, even though they may be suffering psychologically.

    “When people go to their doctors and say, ‘I eat really healthy,’ the most typical response they’ll get is, ‘That’s great… Keep doing what you’re doing,'” said Mills.

    “But they may be struggling more privately with just this sense that they’re starting to lose control, that this is actually taking away from their life.”

    For individuals with orthorexia, eating foods that conflict with their diets is likely to cause extreme guilt or anxiety, said Mills. This distress is usually bound up in perceived risks of disease or physical impairment. But in treating their bodies as temples of health, some may lose sight of their mental welfare, she said.

    They may spend a lot of time and money planning and preparing meals, and can find it difficult to eat food made by others, Mills said.

    Some strict dieters find these sacrifices are worth it given the health benefits, Mills acknowledged. But people with orthorexia may feel their fixation on food is so all-consuming that it interferes with their work, family and social activities, she said.

    “When we’re extremely stressed or overwhelmed, we look for ways of coping. And for some people, having very, very tight control over their eating is a way for them to feel like they’re in control, but then the irony is that they’re not,” she said.

    “Being healthy mentally means having flexibility, and having time and mental space freed up for other kinds of things, and not having your world revolve around food.”

    Mills said one of her research team’s most surprising findings was that orthorexia occurs in relatively equal rates between men and women. This suggests the condition may be less like an eating disorder, which disproportionately affect women and girls, and more like anxiety or obsessive-compulsive disorder, which are similarly prevalent across genders, she said.

    She said diagnosing orthorexia can be slippery, because it isn’t defined by specific eating habits, but rather, a pattern of problematic thoughts and behaviours that detract from a person’s quality of life.

    Mills hopes the study increases awareness about orthorexia, a condition she believes is on the rise, fuelled by a culture that prizes healthy eating and wellness among its ultimate virtues.

    “It’s all around us: messages about how we should be doing better; we should be eating better; we should be constantly striving to improve ourselves,” she said.

    “I think it has a way of encouraging black-and-white thinking about food … and (that) can make people feel worse about themselves.”

    Adina Bresge, The Canadian Press

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    Ontario researchers invent way to store vaccines at higher temperatures

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  • Ontario researchers say they’ve come up with a simple way to store vaccines at higher temperatures for weeks at a time, potentially solving a major problem in the fight against preventable diseases around the world.

    The cheap technology from the team at McMaster University involves the use of a sugary gel that allows for easier, longer shipments of vaccines that typically need to be consistently stored at cold temperatures.

    “If we can make vaccines easier and more accessible through technology, then we can save a lot of lives,” said Vincent Leung, a chemical engineering professor and the lead author of the study that was published Tuesday in the journal Scientific Reports.

    Most vaccines require the “cold chain,” an uninterrupted refrigerated supply chain where they’re stored at temperatures between 2 C and 8 C at all times. Otherwise, the effectiveness of vaccines can be greatly affected, the study notes.

    Leung worked for four years on the project as part of his doctoral research and had help from other disciplines, including biochemists and immunologists, he said.

    The solution the researchers devised is simple.

    McMaster chemical engineers had previously created a sugary gel for use in various applications, including an edible coating that can prolong the shelf life of fruits and vegetables.

    The research team mixed two sugars — pullulan and trehalose — with the vaccines and let them dry, either by air, or vacuum to speed up the process. The gel seals in the vaccine, which can later be reconstituted with water by clinicians in the field and given to patients.

    “It’s easier to think of Listerine breath strips because that’s the main material,” Leung explained. “It will form a film like that, then (is) put into a vial for deployment.”

    For the study, the research team stored mixtures of the sugary gel and numerous vaccine types at various temperatures for different lengths of time and then tested the vaccines.

    They found, for example, that “enveloped DNA vaccines” that usually require consistent cold storage, such as the herpes simplex virus type 2 vaccine, retained their efficacy for at least two months of storage at 40 C with the use of the sugary gel. The team also showed the inactivated influenza vaccine remained effective after three months of storage at 40 C.

    “This can really improve deployment and give easier access to those that don’t have refrigeration or access to electricity,” Leung said.

    The fact that the dried gel vaccine can easily be reconstituted by clinicians in the field could make the storage and transportation method invaluable in certain situations, such as the delivery of Ebola vaccines in remote areas of Africa.

    “Part of our goal was to have a very simple and cost-effective solution to address this accessibility issue for vaccines,” Leung said.

    The research team is now looking at partnerships and more funding to further develop the technology, and is also going through the proper regulatory procedures to be approved by the likes of Health Canada and the U.S. Food and Drug Administration.

    “The good thing is the sugars we’re using are already used in the food and drug industry and approved by FDA and Health Canada,” Leung said. “On that end, it should not be as hard to get it approved.”

    Liam Casey, The Canadian Press

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