Volume 5, Number 3 University of Ottawa Summer … 5, Number 3 University of Ottawa Department of Anesthesiology ... Case Discussion – Peri-operative Medicine

Gary Johnson Anesthesiology Research Day

● For Upcoming

Events, see page 17.

Newsletter

Summer 2006

Volume 5, Number 3

University of Ottawa Department of Anesthesiology

Our annual Gary Johnson Research Day was held on Friday, May 12. This year, presenters included 6 resi-dents, one fellow and 4 attendings representing each of the 4 sites (see page 2 for program details). Our featured guest speaker was Dr. C. David Mazer, from Toronto, whose thought-provoking talk was entitled “Cardiovascular Anesthesia Re-search: Have all the questions al-ready been answered?” The meeting was chaired by Dr. Howard Nathan, from the Ottawa Heart Institute. The adjudicators, who had the diffi-cult task of judging this year’s pres-entations, were Drs. David Mazer, Calvin Thompson and Desiree Per-saud. A very special thank you goes out to the administrative and support staff, who tended to every aspect of the day. Everything went smoothly, as usual, due to their diligence and attention to detail. The research projects themselves would not have been possible without the efforts of the research nurses and associates of the University Department, as well as the many attending anesthesiolo-gists who supervised the projects. Finally, the residents and fellows are to be commended for all of their hard work in completing the pro-jects. The Research Day was followed by the annual Dinner and Awards Cere-mony. It was once again held at the Château Laurier Hotel and the atten-dance this year was excellent. More photos and the award results can be found on page 2.

Lucie Filteau

Inside this issue:

Gary Johnson Research Day 1-2

CAS Annual Meeting 3-4

Chairman’s Report 5

Program Director’s Report 6

News from the General 7

Web Initiatives 7

Anesthesia Directions 8

Heart and Stroke Award 8

Women in Anesthesia Night 9

News from the Civic 9

Trivia Question 10

Education Director’s Report 10

Farewell to Heidi 11

Chief Resident’s Corner 11

F!ghtF!ghtF!ght 11

Announcements 12

Alumni Announcements 12

Wedding Announcements 13

Congratulations PGY-5’s 13

Meet our New Staff 14-5

A Word from the Editor 17

List of Contributors 17

Upcoming Events 17

Regional Report 15

Sanjiv’s Elective 16

Above: Dr. Gavin Gracias presenting Dr. David Neilipovitz with the Teacher of the Year Award. Below: Dr. Paul Bragg receiving a very well-chosen piece of folk art as a thank you for his years as Resi-dency Program Director.

More from Gary Johnson Research Day

Page 2 Volume 5, Number 3

PRESENTERS Dr. Jordan Caveno (PGY-4) The analgesic effects of an intravenous lidocaine infusion in abdominal hysterectomy. Dr. Joann Kawchuk (PGY-5) PPART - Peri-operative pressure in anesthesiologists and resident trainees.

Dr. Abeer Arab (PGY-3) Continuous femoral nerve block accelerates mobilization following total knee arthroplasty.

Dr. Ian Ozard (PGY-5) Postoperative nausea and vomiting prophylaxis practice audit. A quality assur-ance study.

Dr. Kevin Gagné (PGY-5) Esmolol use during electroconvulsive therapy at the Royal Ottawa Hospital.

Dr. Jennifer Backstrom (PGY-2) Hypomagnesemia-induced intraoperative myoclonic movements: A pediatric case presentation.

Dr. Wilton VanKlei (Fellow in Perioperative Medicine) Effects of transfusion on the incidence of postoperative myocardial infarction in patients on beta-blockers.

Dr. Greg Bryson (Anesthesiologist, Civic Campus) Neuroprotective strategies in the elderly: Does Apolipoprotein E genotype predict delirium and cognitive dysfunction following abdominal aortic aneurysm repair?

Dr. Dermot Doherty (Anesthesiologist, CHEO) The anti-inflammatory effects of Anti-CD18 therapy after transient global ischemic brain injury in the mouse.

Dr. Calvin Thompson (Anesthesiologist, General Campus) Thoracic epidural adrenaline and meperidine (TEAM) trial.

Dr. Bernard McDonald (Anesthesiologist, The Ottawa Heart Institute) The protective effect of sevoflurane on diastolic cardiac function in patients un-dergoing aortic valve replacement for aortic stenosis.

Dr. C. David Mazer (Visiting Professor, University of Toronto) Cardiovascular Anesthesia Research: Have all the questions already been an-swered?

AWARDS Research Presentations: Drs. Abeer Arab, Wilton VanKlei and Joann Kawchuk Teacher of the Year: Dr. David Neilipovitz Undergraduate Teacher of the Year: Dr. Robert MacNeil Dave Roberts Award: Dr. Desiree Persaud

Top(L to R): Dr. Howard Nathan and Dr. Abeer Arab Middle: Dr. Joann Kawchuk and Dr. Howard Nathan Bottom: Dr. Robert MacNeil and Dr. Lucie Filteau

CAS Annual Meeting—Ottawa’s Participation


Dr. Donald Miller Residents’ Day Program: Tips to Successful Publication

Co-Chair: Richard Knill Research Competition Co-Chair: Poster Discussion – Economics/Health and Ambula-tory Dr. Desiree Persaud Residents’ Day Program Moderator of Case Discussions Dr. Anna Wyand Residents’ Day Program Case Presentation: A funny (“humerus”) thing happened on the

way to the liquor store. Dr. Gregory Bryson Case Discussion – Peri-operative Medicine Patient for major vascular surgery with CAD: To revascularize

or not?

Dr. William Splinter Introducer and Chair: Pierre Limoges Pediatric Lecture Chair and Presenter: CPSA Pediatric Section and Breakfast The difficult airway in infants and children.

Dr. Kimmo Murto Richard Knill Research Competition A survey: Technology in a pediatric day care setting.

Dr. Dermot Doherty Richard Knill Research Competition The neuroprotective effects of ANTI-CD18 therapy after tran-

sient ischemic brain injury in the mouse.

Dr. Robert Elliott Co-chair: Poster Discussion - Critical Care Medicine and Equipment

Dr. Homer Yang & Dr. Jean-Yves Dupuis Co-Chairs: Residents’ Competition Dr. Ibrahim Abu-Shahwan Case Discussion – Pediatrics 3-year-old child with insulin dependent diabetes mellitus

(IDDM) for outpatient bilateral myringotomies.

Dr. Edward Crosby Airway Symposium Lessons learned from the ASA closed claims review of airway

cases and the CMPA review.

ABSTRACTS Dr. Ashraf Fayad - Coronary sinus lactate concentration during myocardial

reperfusion.

- Hemodynamic changes during off-pump coronary artery by-

pass grafting.

- Valve repair is feasible in complex mitral pathology.

Dr. Robert MacNeil Mini-dose spinal bupivacaine for caesarean section.

Dr Ibrahim Abu-Shahwan - Ketamine and the incidence of emergence agitation in children

undergoing dental repair.

- The effect of subhypnotic doses of propofol on the incidence of

vomiting in children undergoing strabismus repair.

ANNUAL MEETING COMMITTEE Dr. Donald Miller Core Member and Abstract Reviewer Dr. William Splinter Section Chair and Abstract Reviewer Dr. Howard Nathan Abstract Reviewer

Dr. Desiree Persaud working out a deal with the Braun reps...

This year, the CAS held the first ever Residents’ Day session on Friday, June 16th. This was a full day resident-only session. The day was a huge success with over 100 resident attendees. The University of Ottawa was well represented with 14 resi-dents. Lectures ranged from medico-legal advice to billing practices to a pro-con session on 16 vs. 24 hour call. I helped moderate a Case Discussion. One of the resident presenters with me was our own Dr. Anna Wyand. The Ottawa gang did us proud with active participation in the discussion and Anna cer-tainly showed signs of being the future Tuesday a.m. rounds leader!!

Desiree Persaud

CAS Annual Meeting—Ottawa Award Recipients


Dr. Jean-Yves Dupuis Dr. Earl Wynands Research Award in Cardiovascular Anesthe-sia and/or Peri-operative Blood Conservation The protective effect of Sevoflurane on diastolic cardiac func-

tion in patients undergoing aortic valve replacement for aortic

stenosis.

Dr. Bernard McDonald Baxter Corporation Canadian Research Award in Anesthesia Airway pressure release ventilation versus conventional positive

pressure ventilation in cardiac surgical patients requiring pro-

longed mechanical ventilation.

Dr. Michael McMullen Winner of the Residents' Competition Biologically variable ventilation improves oxygenation and res-

piratory mechanics in a porcine model of one-lung ventilation.

Dr. Kimmo Murto Best Paper in the Ambulatory Anesthesia Section. A Survey: Technology in a pediatric day care setting.

Dr. Dermot Doherty Richard Knill Prize for Best Paper at the Scientific Meeting The neuroprotective effects of ANTI-CD18 therapy after tran-

sient global ischemic brain injury in the mouse.

Dr. John Cowan CAS Gold Medal Award In recognition of his extraordinary contributions to anesthesia,

both as a mentor to residents and students and by dedication to

his profession through his leadership role in organizations lo-

CAS Annual Meeting—Residents’ Day

Above, Right

(L to R): Drs. David Skene, John Cowan and Renwick Mann Left: Drs. Dermot Doherty and Kimmo Murto

Right: Drs. Jean-Yves Dupuis and Bernard McDonald

Chairman’s Report


The CAS Annual Meeting was a success both for the Society and for Ottawa. The meeting was well attended and the Toronto Harbourfront continues to be a beautiful place to visit. The Ot-tawa contingent was strong, winning a number of awards. There was also an "Ottawa" dinner on Saturday night, where a good time was had by all. Dr. John Cowan deservedly was awarded the CAS Gold Medal, recognizing all of the contributions that he has made to the Society and to Canadian Anesthesia. I would like to echo the recognition given by the Society and congratu-late John for his great contributions. For the Richard Knill Com-petition, Dr. Dermot Doherty at CHEO was the winner for his work on "The neuroprotective effects of ANTI-CD18 therapy after transient global ischemic brain injury in the mouse." A sincere congratulation to Dermot. I am looking forward to see-ing the results of his further research. For the Residents' Compe-tition, Michael McMullen was the winner for his work with Alan Mutch entitled "Biologically variable ventilation improves oxy-genation and respiratory mechanics in a porcine model of one-lung ventilation". Michael will be joining us as one of the Pe-rioperative Medicine Fellows in July. Of course, there were others who presented papers including Dr. Kimmo Murto, Dr. Abushahwan (2 posters), Dr. Ashraf Fayad (3 posters), and Dr. Anna Wyand. Kimmo also won the best paper in the Ambulatory Anesthesia Section. Congratulations Kimmo. A number of us also chaired various functions during the meeting. I would like to take this opportunity to thank eve-ryone who has supported our colleagues; they represented Ot-tawa well! During this meeting, TOH again hosted a booth. It was very nice to have such a focal point at the meeting and a great many alumni dropped by. There were some suggestions to continue having some sort of activity in the future for the Ottawa faculty and trainees, past or present. If anyone has any suggestions please feel free to give me an e-mail so that we can start plan-ning for next year. I don't believe we will have a booth next year but is a hospitality suite a reasonable idea? Thanks to Drs. Jack Kitts’ and Geraint Lewis' hard work, the OAC negotiations have now been concluded. After the OAC negotiations, every academic center in Ontario is gearing up and planning for the Anesthesia Care Team. Algonquin College is also putting together an Anesthesia Assistant training program, aiming to start in Jan 2007. Our Department is forming a group, with Dr. Patti Murphy as the lead person, to liaise with Algon-quin College in setting the curriculum. We also aim to include input from CHEO to ensure appropriate pediatric components in the curriculum. Please feel free to contact me if there are any questions about this initiative. Dr. Ashraf Fayad has recently received word from the Heart and Stroke Foundation that his grant application to study Isolated Systolic Hypertension was successful. The details are still forth-

coming, but I would extend my sincere congratulations to Ash-raf. As most researchers would say, "now the real work starts!" Finally, Dr. Jim Robblee has completed his second term as Chief for the Division of Cardiac Anesthesia. He has done a great deal of good work in the last ten years and the Division continues to thrive as the premiere centre of Cardiac Anesthesia in Canada. An external review was recently held. While we await the exter-nal report, I have asked Dr. Robblee to continue as Acting Chief and he has kindly accepted. Thank you, Jim, for all of your hard work and contributions. Please accept my sincere best wishes to everyone and a great summer: it is shaping up to be an excellent summer weather-wise.

Homer Yang

“Dr. John Cowan deservedly was awarded the CAS Gold Medal, recognizing all of the contri-butions that he has made to the Society and to Canadian Anesthesia.”

Homer Yang

Program Director’s Report


Above: Dr. Linda Wynne Below: Tara and Misty

Hello everyone. The end of the academic year approaches – as does my 1st year as PD. It’s been a good year for the department (credit to Paul for leaving it in such good shape) and we were delighted with the recent successes in the exam. We wish them all well in their future endeavours and are delighted that some will be staying with us, at least tempo-rarily. Several new faces will be joining us this year. Carla Lipan has already begun her PEAP. Ahmed ElAlfy, Karolinah Lukkits & Ozgur Demers will be starting theirs on July 1st. Also joining us will be Gregory Krolczyk, Matthew Quon, Chris Pysyk and Robert Sikorski. Jeremie Stewart and Tara Baldisera are joining us in the Northern Stream. Look out for their hopefully smiling, somewhat bemused faces soon!! Anna, Gavin and Rob have passed the reins of power on to Ilia, Abeer and Shawn (Hicks), respectively. They did a fantastic job and hopefully enjoyed most aspects of the experi-ence, though I suspect none is sorry to give up the arduous (and often thankless) task of the call schedule. We had an excellent turnout at this year’s CAS Meeting in Toronto. As well, Education has achieved Section status at the CAS for the first time. As a result, we were able to hold our own seminars and business meeting. Next year, for the first time, a prize will be awarded for the best paper or poster presentation on a topic of education. Start thinking!! Most of the work in Education at the moment is focused on the roles defined in CanMeds 2005 and the shift of emphasis from just Medical Expert to including all the other qualities that make up the excellent physician. We are now trying to determine how best to teach and assess all of these other roles. Portfolios are in our future. The Undergraduate pro-gram in Ottawa is on the cutting-edge with this initiative. Resident portfolios will follow very shortly (projected for 2007) and may be destined to be in the future of all of us. This CAS Annual Meeting also featured the first ever Residents’ Day. It unfortunately conflicted with the ACUDA meeting but both Desiree Persaud and Anna Wyand were pre-senting and I hear that Ottawa had a great turnout. For those of you who like to plan well in advance, the next CAS meeting is in Calgary. On a personal note, the new photo of me that you see is one of a series of black & white photos taken when we brought the dogs (Tara & Misty) for a photo shoot by Helene Anne Fortin in Wakefield. She successfully overcame Tara’s determination not to be captured on film. The example here of the 2 dogs is one of my favourites. The social aspects of the residency program continue to flourish. The end-of-year Resident party, graciously hosted this year by Ilia Charapov was, I hear, a great success despite the weather not cooperating. Next year, I plan to make sure that I am not on-call that night…Arrangements for the camping trip are well under way, with Stephane Moffett leading the organizing committee for that. It’s nice to see so many residents keen to help make the program a success. Following the successful dinner at The Fish House in Stanley Park at last year’s CAS, we held a dinner at Acqua Restaurant in Toronto which, I think it’s safe to say, was thoroughly enjoyed by all. Once again we were able to take advantage of some of the many other skills of our residents – kudos to Greg Bosey for choosing such fine (and affordable) wines!! There are many changes coming to the program as we try to implement the CanMeds 2005 roles. Also, the Resident Log Book is a nationwide initiative that we hope will give us an idea of what the resident experience is across the country in our effort to make sure no-one “misses out”. Stay tuned!!

Linda Wynne

“Resident portfolios will fol-low very shortly (projected for 2007) and may be destined to be in the future of all of us.”

Linda Wynne

Photos by Helene Anne Fortin

has been promised. I am in the process of drafting a list of ex-pectations for how such a recording system and database would work. It is expected to start in the PAU; then it will use the PAU data to set up the intra-op record and then it will capture all monitor/ventilator parameters automatically and allow us to easily annotate our records (intubations, regional blocks, etc.) and enter drugs given. It will carry on into the PACU and I hope will connect with the APS. The end result will be a data-base which will allow us to perform QA analyses, provide data for research, give us instant recall of previous anesthetics, and so on. Hopefully it will make record-keeping less of a chore and also satisfy the CPSO in Toronto! I invite anyone who has an interest in this exciting project to contact me before the end of July. The demo sessions with the vendors are expected to take place in August and I would wel-come comments and suggestions. Bob Elliott

Web Initiatives


News from the General Campus

It has been a busy spring at the General Campus. The new O.R.’s and anesthesia offices are progressing nicely. We expect to make the big office move late in Septem-ber this year. The offices will be quite classy with an entry from a glass-fronted atrium and just across the atrium will be a Tim Horton's! We will also finally have a lunch/lounge area separate from our desks. While the O.R.’s will be ready in March 2007, the new SDA unit won't be, so the move into the O.R.’s will be in Sept 2007. The O.R.’s are BIG... and 5 of them will be equipped with all sorts of minimally-invasive state-of-the-art cameras, flat-panel video screens, remote-controlled lights, etc. Of course, the most hyped of all is the 4-foot plasma screen! What will Anesthesia get with the opening of the new Critical Care Wing? The big news is the Periop Information Manage-ment System. This has been a major about-face turn in IT pol-icy. The plan had been to develop an in-house version of vOasis to work in the O.R. and somehow get it adapted to anesthesia recording. I brought I.T. people into the O.R. and showed them how different anesthesia is from other clinical areas and got them to agree that "perhaps" anesthesia just might be better served by a third party, off-the-shelf system. Not surprisingly, they hastened to add that there was no hospital priority for such a system. But fate works in mysterious ways. With all of the emphasis on extra joints and cancer cases, it became obvious to the admini-stration that the current scheduling/management software at all 3 campuses just did not perform. They were dealing with a black box when it came to costing and other analyses to improve effi-ciency. Then the vendor for the software for the General and Riverside dropped the bombshell that, as of March 2007, they would no longer support the software. Suddenly, it all came into focus - the O.R.’s needed a Periop Information Man-agement System and they needed it ASAP! Since May, various committees have been meeting to flesh out something called a Request-for-Proposal. At the beginning of June, the document was posted for vendors to respond, with the deadline being the end of June. Over the summer, the proposals will be examined and 2 or 3 leaders will be chosen to give in-depth demos. The Hospital had only allocated funds for Phase 1 - the O.R. Scheduling Module, and integrating it with equipment manage-ment and tracking. The hope was that this would be ready for the opening of the new CCW and then it would be rolled out to the other campuses. Phase 2 will be the clinical documentation for nursing and for anesthesia. Purchase of the System was to be expanded later to include these other important functions, but when was unspecified. However, late in June the Hospital decided to proceed with funding Phase 2 as well. A timeline has not been decided at this point. What this means is that, finally, an electronic anesthesia record

Dr. Bob Elliott

Central Venous Catheter Website Please check out a new educational website on central line in-sertions: http://www.med.uottawa.ca/medweb/cvc/ This was developed locally as part of a course on central line insertion by Drs. Michael Woo (ER), Jason Frank (ER), Pierre Cardinal (ICU) and myself. The website has a general review of landmark techniques with an introduction to ultrasound-guided central line catheterization and a video on the technique. Our group is piloting the course and we hope to introduce it to students and clinicians in the future. Comments and feedback are welcome. Good luck with your lines!

Calvin Thompson

“...finally, an elec-tronic anesthesia record has been promised... it will make record-keeping less of a chore and also sat-isfy the CPSO in Toronto! ”

Bob Elliott

As many of you will know, the Operative Anesthesia Committee (which formed as part of the 2004 OMA MOHLTC Agree-ment) has delivered its report to the gov-ernment and the OMA. It was a long time in the development and took significant amounts of persistence, diplomacy and "realpolitk". The anesthesia members of the committee were Drs. David Bevan, John Cain, Steven Brown and I, with Dr. Jack Kitts as Chairman. We realised that the main concern of the government was getting more work done to meet the Wait List agenda for cancer and joint surgery, and that they saw the pool of anesthesiolo-gists involved in cataract anesthesia as ripe for change. To summarize the out-come, we have secured the value of these services ($12 million) by reallocating them over time to operative anesthesia codes. The government has also agreed to alternate methods of supplying anesthesia coverage for these cases, under our direc-tion and control, and remuneration for our supervision of alternate care providers. This is essentially what we do now at both eye care centres, except for the method of remuneration. We have recommended the formation of "Anesthesia Care Teams" to provide us with support in the PAU, OR and on the APS with separate funding from the MOH. These support providers will be responsible to us and under our direction. AHSC Anesthesia department funding

Anesthesia Directions


may involve conversion to an APP in an-ticipation of ensuring the appropriate funding mechanism for the team concept to be acceptable. Fee for service changes, to increase OR compensation, will see the introduction of triple time units after 2 hours and ultimately 1.5 hours, effective shortly. On the AFP front, there is ongoing nego-tiation with the MOH, University/Hospital representatives, and other AHSC centres to determine how the current and future funds (totalling $150 million) should be allocated. Under the guidance of the Chair, Mr. Graham Scott, I am hopeful that this will not be a long drawn out affair and that we will see resolution of this mat-ter before the start of the NEXT World Cup of Football. On the home front, I would like to thank all of you who have been supportive of Linda and me over the past year. We are making the most of every day, and this summer plan to visit Linda's father's long lost family in Poland. He has not seen his family since 1940, and has a younger brother and sister he's never met. We’ll be taking the whole family to sample vodka, pierogies and Polish hospitality. Thanks to Tom Polis who has been our translator as we set this up. Na Zdrowie!

Geraint Lewis

“We have recommended the formation of "Anesthesia Care Teams" to provide us with support in the PAU, OR and on the APS with separate funding from the MOH.”

Geraint Lewis

Dr. Geraint Lewis, cheers to our future!

Dr. Ashraf Fayad has just received the good news that he has been awarded a major research grant by the Heart and Stroke Foundation. His project, called the PROMISE Study, will examine perioperative myocardial ischemia in isolated systolic hypertension. Although many applied, Dr. Fayad was informed that his was the only pro-posal to be accepted. The amount awarded is a whopping $360 000. “I believe that this is the largest single grant that our department has ever received!” Ash-raf told me excitedly. His co-investigators in this study are: Drs. Homer Yang, Terry Ruddy, George Wells and James Watters. Congratulations Ashraf!

Lucie Filteau

Heart and Stroke Foundation to Fund Ottawa Anesthesia Research

“I believe that this is the largest single grant that our department has ever received!”

Ashraf Fayad

News from the Civic Campus


As the new Site Chief for the Anesthesia Department of the Civic Campus, I'm experiencing what it's like to be on the other side of the complaints department counter. Rest assured, I haven't yet resorted to using ear plugs! It is shaping up to be a busy summer with several initiatives coming out of the OAC report. Preparation is underway for a submission to the MOHLTC for the Anesthesia Care Team pilot project that is anticipated for the fall. We are also involved with Algonquin College to develop the curriculum for the Anesthesia Assistants Program that is likely to be offered here in Ottawa in January 2007. Despite this high level of activity, I'm confident no one in our department will miss out on enjoying their summer vaca-tion.

Women in Anesthesia Meeting

I stepped into the dimly lit entrance of the “Foundation Lounge and Restaurant” and was greeted by some familiar faces looking very unfamiliar. There stood about forty women, usually shrouded by masks, bouffant caps and various shades of ill-fitting muted greens. That night, they looked absolutely smashing. Their cheeks were already rosy from half-empty glasses of red wine and the air was thick with Cuban cigar smoke. A small cir-cle of rowdy, pregnant staff anesthetists arm wrestled in the cor-ner. There was sparkly eye shadow, bare legs and cleavage eve-rywhere. Things only became more unbelievable as a large glaring spot-light focused on a rather dapper Dr. Edward Crosby, wearing his Sunday best. Initially, I was under the impression that Dr. Crosby was going to school us on the perils of “Fatigue in Anes-thesia”, as the invitation had originally stated. So, let’s say I was a bit confused when the two large disco balls were lowered from the ceiling and a bit more baffled at the resounding base of dance music that began to blare. “Take it off!” screamed two frenzied staff anesthetists, who shall remain anonymous. At first a little shy, Dr. Edward “Beefcake” Crosby loosened his tie and then, as though possessed by the repetitive chants of crazed women and 90’s dance hits, his hips started moving and well…let’s say it was a very informative presentation. We then dined on a fabulous meal, fit for queens. We laughed at jesters, brought in for our entertainment, and we discussed who would be our next “presenter” for the following meeting. I was impressed and vowed from that day on that I would never miss another W.I.A. meeting again.

Tania Di Renna

(Ed’s note: Some parts of this story may have been slightly em-

bellished.) Drs. Ted Crosby and Tania Di Renna

Some new and not-so-new faces: Mr. Eric Forgiel joins our administrative assistance core. Dr. Alan Chaput, from the Toronto program, is scheduled to join us in July while Dr. Ben Sohmer, recently back from a year’s fel-lowship in Cleveland, will come on staff in August. I'm also pleased to announce that Dr. Susan Goheen from Barry will be joining us in September. New Fellows include: Dr. Michael McMullen (Perioperative Medicine and Acute Pain), Dr. Jacque-line Kolman (Regional Anesthesia) and Dr. Jay Ross (Simulation). Dr. AlHarbi will be back in August to do Chronic Pain. WELCOME TO ALL.

Michael Curran

As I walked briskly through the downtown parking lot, a crum-pled “Women in Anesthesia” invitation in hand, I imagined a quiet dinner with familiar faces discussing various aspects of anesthesia, motherhood, shopping, recipes, etc… I really was-n’t prepared for what lay ahead.

Report from the Education Director


Well, I’m now 4 months into the Education Director job, and I’ll have to say I’m enjoying it very much. At the moment, the focus is getting core program organized for next year, and getting the Anesthesia Assistant program at Algonquin College underway. Regarding Core Program, we’re having a change-over of many coordinators. Thanks to Mike Curran, Jocelyne McKenna and Linda Wynne for their years of coordinating the Pharmacology, Endocrine and Pain Core Programs respectively. George Dumi-trascu will be managing Pharmacology Core. Simone Crooks is taking over Endocrine. Tammy Barrows and Cathy Smyth are assuming the Pain Core leadership. Thanks to Tom Polis, who is returning as coordinator of the Neuro Core next year. Thanks to all of the lecturers who are contributing to the PGY-1 Core program. Starting again this July, this lecture series is in-strumental in helping our junior residents to “hit the ground run-ning.” Thanks to all of you for the enthusiastic response to my plea for help with developing the Anesthesia Assistant course at Algon-quin. We are now in the early stages of curriculum development. The folks at Algonquin have drafted a list of objectives, which our staff volunteers are currently reviewing. The curriculum will be developed by Algonquin with our feedback in mind. Their

goal is to enroll their first 10 students in January ’07. Now’s the time to envision what role you want AA’s to play in your life, and send your opinions to me please! I’d love to know how you feel about this controversial subject. On the Royal College front, changes are coming to the exam in 2008. These have not been finalized as yet, but it appears that the current MCQ and oral formats will be shrinking a bit, and an SAQ (short answer question) section will be added. The current format of 2 full exams per year is under review due to the small number of candidates participating in the fall exam. It’s possible that this may be the last year for 2 exams. The decision will be announced by September, giving candidates one year’s notice of the change. Thanks for all the positive feedback for the question of the week. It has been a fun project. I’ll be taking a summer break, but will be resuming this in September. You may notice that I’m spending most of my blurb saying thank you! That’s appropriate, as the level of commitment to education in our department makes me proud! Have a great summer!

Patti Murphy

Last issue’s trivia question: What do an anesthesia machine, a rocket, a can of whipped cream and a bag of potato chips all have in common? Answer: They all use nitrous oxide. In some rocket engines, N2O is used as an oxidizer due to its stability at room temperature and ease of safe storage. In aerosol cans of whipped cream, it is dis-solved in the fatty cream until it leaves the can, when it becomes gaseous and causes the creation of foam. Its properties as an inert gas also make it ideal to displace the staleness-inducing oxygen when filling packages of potato chips. Congratulations to Gavin Gracias, who was the first person to answer this question correctly. I am told he has had to forfeit his winnings to his wife, Marie-Josée, who gave him the answer.

This issue’s trivia questions:

How well do you really know the people you work with? Be-low is a list of interesting facts about various anesthesia staff (S)and residents (R). The trivia prize, a $20.00 gift card from Chapters, will go to the person who correctly answers the high-est number of questions. Lucie Filteau

QUESTIONS:

►Who used to make wine recommendations to patrons at one of the top restaurants in Canada? (R) ►Who has bowled in competitions at the world level? (R) ►Who is an active member of an Ottawa choir which regularly per-forms for the public? (S) ►Who used to be a respiratory therapist? (S) ►Who can successfully juggle 3 balls? (S) ►Who has competed nationally in swimming and made it to Olympic tryouts twice? (R) ►Who comes from a family of 14 children? (S) ►Who used to be a professional cheerleader for a Canadian football team? (S) ►Who used to be a competitive figure skater? (S) ►Who started their career as a medical officer on a naval ship? (S) ►How many current residents did their medical schooling in Arabic? ►Who is a competitive race car driver? (S) ►Which two people are past presidents of the CAS? (S) ►Whose singing voice sounds just like Elvis’? (S) ►Who was a martial arts black belt and competed at the world champi-onship level by the age of 16? (R) ►Name 3 anesthesiologists/residents who have a parent who is also an anesthesiologist? ►Name two people who were football stars at Queens? (S) ►Name the 7 pilots amongst us. Who used to be a pilot on an aircraft carrier? (S) Send me your entries by email (listed on Page 17).

Trivia Questions

As we bid goodbye to another academic cycle I would like to thank, on behalf of the residents, all of the staff who have been involved in resident teaching throughout the year. It is your enthusiasm for teaching and your encouragement and support of our research projects, rounds presentations, etc. that make our program so strong. Speaking of staff… congratulations to the PGY-5’s, soon to be staff, on the completion of their exams. As we move into the new academic year, the residents will have a new group of people repre-senting them on the residency committee: Ilia Charapov (Chief Resident, Civic Site Scheduler), Abeer Arab (Assistant Chief Resident, General Site Scheduler) and Shawn Hicks (CHEO Repre-sentative and Scheduler). Ilia has already been busy in his new official capacity as he hosted the successful end-of-year BBQ for the PGY-5’s. Upcoming exciting events for the summer in-clude our 3rd Annual Camping Trip, to be held July 14-15th at Fitzroy Provincial Park. As July 1st rolls around, be sure to keep an eye open for our new incoming PGY-1 residents. Have a great summer everyone and we hope to see you out at the Park!

Anna Wyand

Chief Resident’s Corner

F!ghtF!ghtF!ght


Kelly Shinkaruk, now a PGY-3, has certainly been busy on her weekends! Her and her indie rock/dance/punk band F!ght F!ght F!ght have been getting a number of gigs around town and in some outlying areas (Guelph, Oshawa, Toronto). Most recently, they’ve been seen performing at Barrymore’s, Zaphod’s and Babylon. The band also spent time in the recording studio and had an EP release party at the Rainbow Bistro on June 18th. The event received media coverage in both the Ot-tawa Citizen and The Sun. Kelly tells me that, although somewhat timid about the whole self-promotion thing, she will happily sell a CD to anyone who asks her for one. It is entitled “Paper Cranes and Building Things” and is a mere $8.00. You can visit the band’s website for more details: www.fightfightfight.ca.

Lucie Filteau

Left: Dr. Kelly Shinkaruk (photo by Andrew Carver, National Capital Rock)

“The band also spent time in the recording studio and had an EP release party at the Rainbow Bistro on June 18th...The

CD is entitled Paper Cranes and Building Things. ” Lucie Filteau

Farewell Heidi

Right (L to R): Mary Lou Crossan, Judy Dureau, Heidi McBride and Nancy Green

It is with great sadness that we said good-bye to Heidi McBride on June 9th. She has been an administrative assistant with the Civic Cam-pus Anesthesiology Department for the past 5 years. Looking for a new challenge, she has taken a position as the PGY-1 Education Coor-dinator in the Emergency Department. Good luck, Heidi. You’ll be dearly missed!

Dr. Ilia Charapov

Announcements


Engagements/Upcoming Nuptials ►Kim Walton and Dave Eibner were recently engaged. They have no immediate wedding plans. ►Tania Di Renna and Nicholas Guay were also engaged and plan to marry sometime in the new year. ►Lukasz Bartosik and his fiancé Honorata Bittner are to be wed in October in Ottawa, at the Château Laurier. ►Joann Kawchuk and Rahul Mainra are to be wed in Ha-waii this December.

Great Expectations ►Michelle Chiu and Toby Kemp are expecting their sec-ond child in late September. ►Tammy and Craig Barrows are expecting their second child in mid-December.

Births ►Joanne Madden and her husband Dan, along with their sons Jack and Alex, proudly welcomed the arrival Olivia Mary April Madden on June 10, 2006. She weighed 7 lbs, 12 oz and is healthy and gorgeous. Mom and Olivia are home now and doing well. ►Mohamed Al-Ismaili and his wife brought their new son Hadi into the world on June 14, 2006 at the General Cam-pus. Everyone is doing very well.

Recent alumnus Scott Duggan and his wife Lindsay proudly an-nounced the birth of their first child, David Lawrence, on March 26, 2006. He weighed in at 9 lbs, 2oz. In his March email, Scott stated “I never thought that I would be so excited about changing diapers!” (Ed’s note: Funnily enough, when I saw Scottie at the CAS Meeting

in June, he no longer raved about this excitement over diaper

changes….Anyhow, as this is Scott’s third announcement in as many

issues, I am thinking of creating a new newsletter section called “The

Duggan Report”. Let me know what you think…).

Kim Walton and Dave Eibner

Hadi Al-Ismaili

Alumni Announcements

Right: David Lawrence Duggan

Lucasz Bartosik and Honorata Bittner

`

Amy Fraser married Krishna Sharma in a small family ceremony on May 20th, 2006. Some felt that the bride and groom had rushed into things, after only having been together for eight years. Others main-tained that true love would find a way. To celebrate the nuptials, the bride shaved the groom’s head and the hair was donated to charity. The happy couple is also accepting bids on the “before”, “during”, and “after” shots of the shaving process, proceeds to be donated to The Canadian Cancer Society. Krishna is a member of the Division of Respirology at The Ottawa Hospital. Jordan Caveno married Jessica Haussmann on October 15, 2005 on Jericho Beach in Vancouver, B.C. (where they had met on the same day, 14 years earlier). They were surrounded by 50 of their closest family and friends and, by Jess’s report, they had a blast. Jess is a PGY-5 studying Gastroenterology here in Ottawa.

On behalf of the Anesthesiologists, residents and support staff I would like to offer our sincere congratulations to the PGY-5’s on their recent success in passing the Royal Col-lege exams. We are extremely proud of you and wish you the best of luck in all of your future endeavours. Speaking of the future, this is what our new graduates have planned: Ian Ozard will be doing a locum at the Ottawa Hospital, General Campus. Joann Kawchuk will be doing locum work in Ontario and then pursuing a Critical Care Fellowhip in Australia. Kevin Gagné will also be doing locum work in Ontario and then going to Australia. Khaled Tibar will be doing a Fellowship in Thoracic Anesthesia at TOH, General Campus. Due to his time at Harvard doing his Master’s in Education, Samir Ghatalia will be finishing his residency in September.

Lucie Filteau


Wedding Announcements

Drs. Krishna Sharma and Amy Fraser

Drs. Jessica Haussmann and Jordan Caveno

Congratulations to the New FRCPC’s!!

L to R: Drs. Khaled Tibar, Joann Kawchuk, Ian Ozard and Kevin Gagné (missing: Dr. Samir Ghatalia)

Left: Mr. Eric Forgiel

Meet our New Staff


Dermot Doherty Dermot joined the group at CHEO last summer. He completed his undergraduate medical studies and anesthesia training in Dublin, Ireland. Following that, he did Fellowships in both Pe-diatric Anesthesia and Pediatric Critical Care at the University of Toronto. He then came to CHEO to do more Fellowship training in PICU/Pediatric Trauma. Throughout all of this, he has been an active researcher in the area of ischemic brain injury and has submitted his MD Thesis in Dublin this year. His work has been recognized both in Canada and Ireland and he has been the recipient of several prestigious research awards. His most recent accomplishment was winning the Richard Knill Prize for Best Paper at the CAS Annual Meeting in Toronto. Dermot and his wife Lara have two children: William (2½ yrs) and Rebecca (11 months). He is also an aspiring musician (rock bass and drums) and loves sports although he admits to not hav-ing much time to pursue them (Ed’s note: no…really?). Dr. Dermot Doherty

Joanna Nawrocka Joanna joined the staff at CHEO in October 2005, after completing a Pediatric Anesthesia Fellowship there. She attended medical school in Poland, where she later became board certified in both Anesthesiology and Internal Medicine. She went on to Philadel-phia, to do an Anesthesiology Residency in the US. Joanna has a 24 year old daughter, Cathrina, who recently graduated from medical school at the University of Montreal and is start-ing her Internal Medicine Residency. She also has an 11 year old son named Alex. Joanna’s hobbies include French literature, clas-sical music, tennis and gardening.

Lucie Filteau

Eric Forgiel Eric joined the administrative team at the Civic Campus in late June of this year. He is relatively new to the hospital scene, having spent several years as a banker at various financial insti-tutions. His responsibilities have included financial planning consultation, mortgage development director and assistant branch manager. Prior to studying Investment Portfolio Man-agement, Eric obtained diplomas in Modern Photography and Computer Technology. Eric is also a professional drummer. He has been on the music scene for 15 years and will be heading into the recording studio this fall with his rock band, called Last Mile. Physical fitness plays an important role in Eric’s life. He obtained his black belt in Tae Kwon Do in 2000, became a certified personal trainer in 2005 and is an avid bodybuilder who works out 6 days/wk. He and his wife Desirée have two children: Jeremi, age 4, and Alexis, age 2.

George Dumitrascu George joined the Civic Campus group in April, 2006. He grew up in New York, where he completed his BSc. in Biology. He then went on to study medicine at McGill University in Montreal. He completed his anesthesia residency training at Stanford University, in California. Since then, George has been very busy work-ing as an anesthesiologist in San Antonio, Texas. For the past couple of years, he has held the position of Co-Director in Obstetrical Anesthesia, as well as Director of the Anesthesia Simulator Program. In 2003, George won the award for the Best Scientific Exhibit at the ASA Meeting for “Three dimensional virtual model

of the upper airway as a teaching tool for fibreoptic intubation”. He has also been extensively involved in undergraduate education, giving regular lectures and simulation sessions to the medical students (Ed’s note: As far as I’m concerned,

this makes him a “salt-of-the-earth” kinda guy...). In case you residents out there were wondering, he has supervised EIGHT senior resident research projects and one fellow in the past three years (in the areas of obstetrical anesthesia and the use of simulators in medical education/evaluation). While in Texas, George wrote four textbook chapters in “Decision Making in Anesthesiology”, 4th Edi-tion. This book is still in press, but those in training who use this very popular study guide should feel free to get his autograph when it comes out. So how did we convince George to come to Ottawa? We didn’t. His lovely wife Teresa happens to be an Ottawa native who missed her home and we just got very lucky! George and Teresa are the proud parents of Buddy, a golden retriever, and Taz, a german shepherd (short for Tasmanian devil). On their spare time, they enjoy motorcycling and an annual sea kayaking holiday.

Meet our New Staff


Dr. George Dumitrascu

The Regional Core Program spanned 8 weeks. For the first time, 100% of the lectur-ers were videotaped and all of the notes were posted in a timely fashion on the resi-dent website. This was thanks to Dr. Patti Murphy, webmaster Dr. Ken Fong and our dedicated lecturers who put up with my occasional nagging. Core Program highlights included a lively game of Regional Jeopardy and another outstanding session at the University of Ottawa Health Sciences Centre Anatomy Lab. Thirty-three of our resi-dents attended this Saturday session, knocking down all previous attendance records for all of the academic sessions this year!! We have to acknowledge George D’An-gelis and Astra-Zeneca for their continued generous support of this session. In keep-ing with tradition, the regional core program book prize was again given to the top mark on the core program exam. This year, the prize was the atlas: Peripheral Nerve Blocks, edited by Admir Hadzic and Jerry Vloka. Dr. Hadzic graciously sent a letter congratulating the winner. The top mark went to Gavin Gracias. Congratulations Gavin!! The other highlight of this period was our new Fellow, Maan Kattan. Maan will be completing his 4 month mini-Fellowship with us at the end of June. Finally, this was my third and last time as Regional Core Program Coordinator. It was a great 6 years and I will shortly be asking for a “volunteer” to replace me for the 2009 core!!

Desiree Persaud (Editor’s note: Desiree was a Guest Lecturer at the Can-Am conference hosted by

Buffalo, McMaster and UWO on May 6, 2006. Her talk was titled: “Upper Extremity

Blocks: Tricks of the Trade.”)

Regional Report

Dr. Gavin Gracias, avoiding the media attention from his most recent accomplishments (see right and Page 10)

An Exciting Elective Experience


The beginning of this calendar year was marked by a very stimu-lating sojourn in Singapore and Melbourne. I decided to use my 3 months of elective time to get some international insights into the practice of anesthesia. On my way across the Pacific, I stopped over in Hawaii for a 5 day vacation in an effort to pre-pare myself for the challenges ahead. The wonderful shores of Waikiki, the impressive Diamond Head Crater and the sobering Arizona Memorial were the highlights of my visit to the island of Oahu. The sunny January weather, with temperatures in the mid 20's and a pleasant ocean breeze, was a perfect transition from the -20°C weather that I had left behind and the humid +35°C that lay ahead in Singapore.

Singapore airlines is a great way to fly. My own personal enter-tainment system offering numerous movies, television shows, games and documentaries combined with many Singapore Slings made the 15 hour flight feel way too brief! The airport itself was a marvel with free internet, local calls, arcade and cinema for the traveler stuck with a long layover. The city-state is 20 x 40km, with 4 million people calling it home. I arrived just in time to celebrate Chinese New Year. Some free advice: do not go to Chinatown on Chinese New Year’s Eve! The food was varied, exotic, spicy, tasty and abundant. Hawkers’ stalls can be found on every corner and mouth-watering cuisine is fast and cheap. Kwai teo, fried carrot cake and chicken rice were some of my favorites. Singapore is also a shopper's paradise. At times, the whole city feels like one big shopping centre. Besides eating and shopping, I also spent some time learning about anesthesia. I worked at Tan Tock Seng Hospital, which is the second largest hospital in Singapore. Isoflurane and atracu-rium were widely used. The Narkomed machines were most

Dr. Sanjiv Gupta on the Clarke Quay along the Singapore River

commonly used, although there were a few Drager Cato’s. Our familiar Datex-Ohmeda’s were rare. Any patient with an epidu-ral had to go to the ICU! Anesthesia nurses do the machine check, prepare all the lines and airway equipment. Induction rooms helped with the turnover. Many senior trainees were double booked and ran their own lists. The worst part of the whole experience was the working hours. An elective list ran till the list was complete. That could be until 7 or 8 pm at night. Almost every room was a late room because surgeons had a tendency to overbook. The health care is subsidized by the Sin-gapore government but since the patients were directly charged for their care, cases were rarely cancelled. The health care in Melbourne is a public-private system and the care provided in the two systems is by no means equal. One is not better than the other but each system has its plusses and minuses. I worked at the Austin, which is a public hospital. It also had anesthesia nurses, induction rooms and senior regis-trars running their own lists. After working for four weeks at the hospital I was surprisingly offered the chance to run my own lists, which I gladly embraced. Making decisions inde-pendently with no one looking over your shoulder, but available at a distance, is a great learning experience. Vecuronium and atracurium were the staple muscle relaxants. Rocuronium was rarely used because of the belief that anaphylactic reactions to rocuronium are relatively common. A BIS monitor is standard for every general anesthetic with muscle relaxants. Intra-operative and post-operative ketamine infusions were more common than epidurals. Tramadol was also used fairly often. Spinals, epidurals and central lines all required a full scrub. The anesthesia department was very sociable, with sushi lunches on Wednesdays and wine and cheeses on Friday after-noons. I enjoyed the anesthesia but with the Commonwealth Games being held in Melbourne, I also got to experience the best the city had to offer. The games were celebrated with many free festivals and concerts. Giant screens were setup around the city to broadcast the Games live. One of the best venues to enjoy the Games' atmosphere was Federation Square. To top it off, the weather consisted of clear sunny skies and 30°C for the

duration of the Games. Once the Games were over the Foster's Grand Prix rolled into town. The footy season followed. I caught one of the pre-season footy games at the Telstra Dome. My last weekend in the city was spent exploring the Great Ocean Road. The 12 apostles, the tree-top walk, koalas in the wild and the breathtaking scenery along Australia's southern coast were some of the highlights of my trip. Finally, it was time to come home. A 5-day stopover in Cal-gary helped me recover from the jet lag and tribulations of my trip. Despite all the fun I had globe-hopping over 14 weeks it was good to be back home. Unfortunately, back in Ottawa it was mid-April and still 10°C!

Sanjiv Gupta

On this lovely Sunday afternoon in the middle of July, I was presented with a choice: write an editorial for this newsletter or go to Wakefield to show our boys a real steam locomotive. Well folks, the choice was simple. See you in the Fall!

Lucie Filteau

University of Ottawa

Department of Anesthesiology

Ottawa Hospital, Civic Campus

1053 Carling Avenue, Box 249-C

Ottawa, Ontario K1Y 4E9

Phone: 613-761-4940

Fax: 613-761-5032

Email: [email protected] or

[email protected]

Newsletter

The University of Ottawa Department of Anes-thesiology Newsletter is published 3 times per year (Fall, Winter/Spring and Summer).

Contributors to the Summer 2006 Issue:

Drs. Desiree Persaud, Homer Yang, Linda Wynne, Bob Elliott, Calvin Thompson, Geraint Lewis, Tania Di Renna, Mike Curran, Patti Mur-phy, Anna Wyand, Amy Fraser, Sanjiv Gupta, and Lucie Filteau.

The next issue will be published in Octo-ber 2006. Submissions are welcome at any time!

Next Core Program:

Pharmacology Start Date: Sept 7, 2006

A Word from the Editor

Fall Journal Clubs Sept 18, 2006 Royal Room The Ottawa Hospital General Campus October 16, 2006 Kaminski Room The Ottawa Hospital Civic Campus

Upcoming Events...

Annual Mentor Dinner September 7, 2006 (tentative) Location: to be determined

Visiting Professor October 4, 2006

Dr. Gregory Hare Assistant Professor Department of Anesthesia and Physiology, University of Toronto The Ottawa Heart Institute Foustanellas Auditorium H 2348-C

Documents

Volume 5, Number 3 University of Ottawa Summer … 5, Number 3 University of Ottawa Department of Anesthesiology ... Case Discussion – Peri-operative Medicine