Working miracles, Shriners Hospital for Children in Montreal continues to produce amazing results
Posted Jan 22, 2010 By Ryland Coyne
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Tweet ThisEMC News - A young girl approaches from down the hall, a gentle smile lighting up her face.
"Hello," she says cheerily. "I'm Sarah-Kate, what's your name?"
From the brief encounter, one learns Sarah-Kate is, in so many ways, a typical 12 year-old with a love of arts and crafts, board games and pink nail polish, not to mention a thirst for knowledge of the world and people around her. She enjoys the company of others and sharing stories and interests.
But Sarah-Kate's life has been anything but typical. Her bright outlook belies the painful challenges she has faced, almost since birth. At just five months of age, she was diagnosed with osteogenesis imperfecta (OI) or brittle bone disease, a rare but debilitating disorder. It's brought on by a lack of collagen, causes one's bones to break easily and can result in deformities of arms and legs, bringing with it chronic pain.
Since she was a toddler, Sarah-Kate, who is confined to a wheelchair and has been placed in 'halo traction' to take pressure off her spine, has made regular trips to Montreal from her home in Minnesota. There, she receives treatment at the world-renowned Shriners Hospital for Children, a 40-bed pediatric orthopaedic hospital, research and teaching centre, located on Mount Royal near the campus of McGill University.
"The surgery and research being done here is amazing," Sarah-Kate's mother Joanna Stone says. "The surgeons and researchers' openness to work together with families for the best possible outcome of the child is unmatched in the world."
She has no doubt the work undertaken at the hospital from the ground-breaking research by Dr. Francis Glorieux to the surgical expertise of Dr. François Fassier has saved her daughter's life.
"Both he (Glorieux) and Dr. Fassier have spent their whole lives focusing on this infliction," she says.
"The return isn't flashy but they are amazing," adds Sarah-Kate's grandmother Joanna Hennessey.
Her granddaughter is no less remarkable. Despite having to travel north every few months, her sunny disposition brightens the day for a weary group of visitors from the eastern Ontario-based Tunis Shrine Temple. She is, simply, inspiring.
And as she continues to progress thanks to today's breakthroughs, Frank Nicholson is proof of the hospital's past successes as well. The Smiths Falls resident is one of the oldest surviving patients who first arrived at the hospital back in 1946. The then six year-old needed to have two-and-a-half inches added to his right leg, a testy procedure in 2010 let alone 64 years ago.
While Frank admits the advances made over so many decades is remarkable, the quality of care remains second to none.
"I have nothing but good to say about them," Frank tells the EMC. "As far as treatment goes...what I remember was excellent.
"It's the reason I'm walking."
Frank remained in hospital for 11 weeks and had to make numerous return visits, he recalls. His treatment required seven casts "off and on," but the end result was a new ability to walk, allowing him to return to school and play sports like baseball and hockey.
"Who knows? I would probably have been in a wheelchair" without the Shriners' Hospital, he says.
PASSION FOR HOSPITAL
Frank and Sarah-Kate's stories offer a glimpse into why Shriners are so passionate about their hospital in Montreal. The work being done at this remarkable institution has been helping children since 1925. And thanks to the Shrine organization, all of the youngsters receive treatment free of charge.
Outlining the hospital services to a group of Ottawa and area Shriners from the group's Tunis Temple, administrator Céline Doray explains the Montreal site is one of 22 hospitals in the Shrine system throughout North America. The year (2010) is an exciting one, she explains, marking its 85th anniversary.
The hospital's key mission is focused on orthopaedics.
"We offer care to children (up to age 18) with different types of problems," she told the group.
While the hospital assisted youngsters with chronic diseases from its founding through the 1940s, there were "very few operations or treatments we could offer."
That, of course, has changed tremendously over the past half century, affiliated as it is with McGill University and now being home to many of the world's top researchers in the field of orthopaedics, treating such problems as spine, leg and hand deformities as well as metabolic and genetic bone diseases, not to mention neuromusculoskeletal conditions such as spina bifida and cerebral palsy.
One of the hospital's specific areas of expertise is osteogenesis imperfecta (OI), she says, led by researcher Dr. Glorieux. His work has brought many advancements in the treatment of brittle bone disease, with positive results.
In the past, this has been a particularly cruel and painful condition with bones fracturing sometimes at the slightest touch. "They (patients) get fractures even when not falling," Doray explained. "Even when born, a child with OI could have a fracture to the skull, ribs or lower limbs."
Dr. Glorieux's research has been key to alleviating the pain and strengthening the bones so they don't break as easily.
"Already the patient's quality of life has improved significantly," she told the Shrine group in her presentation. "There's much less pain."
The progress made in this field has resulted in young patients traveling with family to the Montreal site from across North America and abroad for care.
The hospital follows a team approach with researchers, surgeons and other health care personnel working together to assist their young patients.
"The goal is to provide the best care possible for the kids," Doray said.
Breakthroughs have also been made in the treatment of spina bifida and cerebral palsy, she explains. Botox, for example, has been found to be effective in reducing spasticity, allowing patients to better walk and have more control of their movements.
"Twenty or thirty years ago, these children would not have survived. Now they survive and do very well."
Other work to improve the lives of youngsters includes limb deficiencies, hand and hip disorders, leg-length discrepancies and back surgery for curvature of the spine, a condition known as scoliosis.
MORE THAN PATIENT CARE
Being at the forefront of research as well as education, Canada's Shriners Hospital for Children goes beyond patient care.
"That's what makes us a Centre of Excellence," Doray said.
Affiliated with McGill University almost from the moment it opened its doors 85 years ago, the hospital assists with the education of residents and fellows who have been able to use what they've learned at Montreal in their own communities.
The orthopaedic-based research starts in on-site laboratories where new treatments are discovered. From there, breakthroughs are brought forward to clinics where they are implemented, then assessed based on their effectiveness.
"We look at what we're doing and measure if it's making a difference," Doray said, describing the work being undertaken as being "from bench to bedside to business."
Beyond the walls of the hospital itself, the Shriners Hospital for Children - Canada has run a number of outreach clinics in Sudbury, Ont., Gander, Nfld., Bathurst, N.B., and Halifax, N.S.
And the hospital's first satellite clinic has just opened in Winnipeg, Manitoba. A Shrine hospital physician travels out west to determine whether patients can be treated there or must come to Montreal.
"It's our expertise that moves out," Doray explained.
Part 2 of this two-part series on Canada's Shriners Hospital will appear next week.
HOSPITAL FEATURES 40 BEDS
The three-storey 40-bed hospital, located along Cedar Avenue on Mount Royal, is a warm and inviting facility where the children are made to feel as comfortable and welcomed as possible, no small feat given their physical challenges and the fear they must feel entering for the first time.
No uniforms are worn outside surgery. The hospital walls are decorated with an array of bright murals and wall hangings, many of them featuring amusing, colourful creatures. The patient rooms are identified not only by number but by a stylized animal emblazoned on the front door such as a smiling elephant, monkey or penguin.
"Numbers don't mean a lot to children but animals do," explained hospital tour guide Edgar Brown of the Shriners' Karnak greeting unit in Montreal.
The ground floor features a reception area complete with a display explaining the Shriners' support of the hospital. There are examination rooms, occupational and physiotherapy facilities, a plastering room where casts made of new material similar to fiberglas are used to stabilize broken bones and a room where bone density can be measured.
A medical imaging/ultrasound facility features state-of-the-art equipment provided by the Montreal Canadiens Children's Foundation following a tribute gala held in honour of legend Jean Béliveau. Here, a beautiful floor-to-ceiling mural designed and painted by a former patient, displays a myriad of forest creatures at rest and play. It serves to soothe any anxieties the child may feel in facing what otherwise could be a very sterile and intimidating piece of equipment.
"It's all for the children," said Brown. "Children just realize it's for them" as soon as they enter. "Our hospital is one of the best in the world."
The third floor is dedicated entirely to research while the second floor offers parents' and family rooms all part of Shriners Hospital's philosophy of 'family-centred care' more areas for physiotherapy, cafeteria, patient rooms, and play room where youngsters can also watch videos. There's even 'Le Parc', a learning area where the children can catch up on their studies they may be missing as a result of being away from home, and participate in arts and crafts as well as other activities.
A total of 1,000 surgeries are performed annually, Doray says, 900 at the hospital itself and another 100 at the Montreal Children's Hospital.
There are more than 12,000 annual visits made to the hospital's outpatient clinic while the in-patient unit accommodates between 15 and 20 youngsters at one time who arrive for surgery, day surgery or other treatment. Where the average stay for patients back in Frank Nicholson's day was between 90 and 120 days, today that's down to an average of 2.7 days. With the advances in medical technology and greater involvement by parents in the provision of care at home, patients can be discharged much sooner then return frequently for treatment on an outpatient basis.
DATE BACK TO 1872
The Shriners organization dates back to September, 1872 when the first temple or branch was formed in the New York City Masonic Hall. This new fraternity, born out of the Masons organization and known as the 'Ancient Arabic Order of the Nobles of the Mystic Shrine (A.A.O.N.M.S.), took several years to take hold. It began to expand quickly in the latter part of the decade, with new temples started in Ohio, Vermont, Pennsylvania, Connecticut, Iowa, Michigan and Massachusetts.
The first Shrine temple in Canada was formed in the 1880s in Toronto and soon after, a move from a mostly social organization to one of philanthropy started to take hold. It was at the Imperial Session of 1920, held at Portland, Oregon, that the membership took the bold step to build a network of hospitals geared specifically to children. (First known as Shriners Hospitals for Crippled Children, the name has since been changed to Shriners Hospitals for Children).
The first hospital was built two years later in Shreveport, Louisiana and welcomed its first patient, a little girl with a clubfoot, on Sept. 16, 1922. Seven more were built over the next three years across the United States before Canada's hospital in Montreal opened its doors on Feb. 18, 1925. A second Canadian site was established in 1952 in Winnipeg, but closed in 1977.
While the focus of Shriners Hospitals has always been on pediatric orthopaedic care, they entered the burn care field in the 1960s. New hospitals were built in Cincinnati, Ohio, Boston, Mass. and Galveston, Texas, and a new burn treatment centre in Sacramento, Calif., opened in 1997. They have also expanded to include spinal cord injury rehabilitation and ground-breaking treatment of children with cleft lip and palate.
Shriners, who total 400,000 worldwide, are still known for their good nature and fun, with different child-friendly units from 'Klowns' and 'Keystone Kops' to mini cars and airplanes. They can be seen all across the region in a myriad of parades, and the world-famous Shrine Circus makes an appearance in the capital region every year. But everything they do has a purpose, raising funds for their hospitals for children, all of which makes it one of the world's greatest philanthropies.
For more information, visit the website at www.shrinershospitals.org
