In early November a dental team will start providing services to residents with urgent dental needs within Providence Health Care.

We are delighted to confirm that the funding is now in place for the establishment of a dentistry service for our residents.

• In early November a dental team will start providing services to residents with urgent dental needs within Providence Health Care. The first priority will be residents included in the pilot study (St. Vincent's Hospitals and Youville). Services will, wherever possible, be provided to residents at the bedside. Residents may be transported to the Specialty Dental Clinic at UBC for more complex services. This is an interim step to address urgent needs.
• Between January and June 2002 , the service will be expanded. A satellite will be established at both Brock Fahrni and Langara. In addition, our partners at UBC will establish facilities for IV-sedation at UBC and the OR at SVH will be set up to do dental surgery. The team will be expanded to include more dentists. Dental hygenists will start to provide services. By the end of April 2002 we anticipate that a comprehensive dental service will be available to St. Vincent's Hospitals and Youville and an urgent/emergency service will be available to MSJ and HFH.
• By January 2003 the service will be expanded to include a comprehensive service to MSJ and HFH. This will likely include the establishment of a satellite at Mount Saint Joseph Hospital.
• Throughout the implentation process and as part of the ongoing operations, the service will be developing links with other agencies in the region.
• The team is currently working with the Residential Care Leaders to develop details of how access to the service will work. We will provide further details as they are worked out.

The service will form a key part of the Centre in Aging and Health which is committed to finding ways to enhance the quality of care being provided to elders. The service will play an important role in shaping standards of care for elders across the region. The team aims to create benchmarks for service that will be used across the province and Canada.

This is wonderful news for the residents and for the teams that serve our residents. Once the Geriatric Dentistry Service is fully operational it will be providing direct service to over 900 residents.

I'd like to take this opportunity to thank the members of the Geriatric Dentistry Team (consisting of representatives from UBC and PHC) for their commitment to creating this service and to the Vancouver Richmond Health Board, the St. Vincent's Hospitals Foundation and the UBC Specialty Dentistry Clinic for their generous financial support.

A cardiac surgeon at St. Paul's Hospital's has co-invented a technique that utilizes magnets instead of conventional hand stitches during coronary bypass operations.

The use of magnets eliminates the need for hand stitching which reduces surgery time and minimizes the risks to patients in one of the most invasive operations.

Dr. Sam Lichtenstein, professor and head of cardiovascular surgery at St. Paul's Hospital, worked with a California biomedical company to develop tiny, biocompatible, gold-coated magnets that connect graft blood vessels to the coronary artery.

In a coronary artery bypass surgery (CABG), diseased or obstructed arteries are bypassed by healthy ones to improve blood flow. Coronary bypasses usually involve stopping the heart with a chemical solution and connecting it to a heart-lung machine. However, studies have shown that this technique poses several risks to the patient including strokes, confusion and memory loss. The greatest advantage of using magnets is that the surgery is performed while the heart is still beating.

"It's incredible really. Once the surgeon has guided them into place [under a thin layer of tissue], with their magnetic force, they just align," Lichtenstein said. The use of magnets allows CABGs to be completed ten times faster because surgeons no longer have to spend time doing intricate sutures.

The use of magnets in CABGs is part of a world-wide trend towards less invasive surgeries. The first human trials using this technique were recently completed in Europe. Approvals for trials in the US and Canada are pending.

On October 7th, 2001, Mother Emilie Gamelin, foundress of the Sisters of Providence at St. Paul's Hospital will be beatified in Rome, Italy.

To become beatified and eventually recognized as a saint the following three things need to happen:

1) Declaration of Venerability - Be recognized by the Catholic Church as having lived a saintly life and practiced the virtues of Faith, Hope and Charity to a "heroic degree."

2) Declaration of Beatification - Before a person is beatified, the church must determine that God has worked a miracle through the intercession of the Venerable one. Beatification is the second step of the formal process by which a deceased person may be named a saint (canonized) in the Roman Catholic Church. Once beatified, the Pope gives the person the title "Blessed."

3) Declaration of Canonization - A declaration by the Pope that a person who died as a martyr and /or who practiced Christian virtue to a heroic degree is with God and is worthy of honor and imitation. The Pope gives the person the title of "Saint."

As you can see, it's a lengthy and intense investigation conducted by the Vatican's Congregation for the Causes of Saints once you've died.

Who was Mother Emilie Gamelin?
Mother Emilie Gamelin was born in 19th Century Montreal when the Industrial Revolution was at its height. Despite booms in commercial development, this time was also strife with much political unrest, mass immigration, cholera outbreaks, worker exploitation and unemployment. Mother Gamelin grew up in a family that was accustomed to tending to the needs of the poor. This tradition endured when Emilie married a successful Montreal businessman, Jean-Baptiste Gamelin. In addition to family and social demands she continued to spend time helping those in need. When she was twenty-eight years old, her stable life changed tragically when her husband and three young children died. Instead of withdrawing into herself, Gamelin began a life dedicated to helping others. On September 23rd, 1851, Mother Emilie Gamelin died in Montreal, Quebec of cholera. The Pope will distinguish Emilie Gamelin as "Blessed" on October 7th, 2001.

Mother Emilie Gamelin's Cause of Beatification
In 1983, Mother Gamelin was attributed to the miraculous healing of a young boy in Montreal who was diagnosed with leukemia. Having no immune system, this boy was highly susceptible to viral infections. The boy's grandmother along with other relatives and friends prayed to Mother Gamelin for divine assistance. On December 21st, 1983, during a bone marrow examination, doctors discovered no traces of the disease and he was sent home from the hospital. Subsequently he completely recovered his health. The Pope accepted this divine intercession as authentic in December 2000 and as a result Mother Gamelin will be beatified on October 7th, 2001.

It is possible that Mother Gamelin will someday be canonized, and recognized as a saint for the universal church; this would require documentation of another miracle worked through her intercession. Many who are beatified are never canonized, but this does not diminish their role as models for people of faith.

On August 17, a number of changes took place at St. Vincent's Hospital, Heather as it began a transition from a community hospital to Providence Health Care's principal geriatric and ambulatory care facility. These changes are designed to improve the organization's delivery of health care services and meet the needs of the growing senior population.

As part of this plan, Urgent Care - a relatively new model of emergency care that has been successful in other parts of Canada - replaces the previous emergency services, known as Priority Care. Staffed by emergency physicians and nurses, Urgent Care offers one-stop outpatient services for those requiring a higher level of care than a doctor's office or clinic can provide. This includes a wide range of on-site diagnostics such as x-rays, ultrasounds and laboratory tests. The centre will be open each day from 8 a.m. to 8 p.m.

Dr. Dan Kalla, physician leader at St. Vincent's, Heather and Mount Saint Joseph Hospital, says the major advantage of Urgent Care is shorter wait times for individuals with minor illnesses and injuries.

"In a traditional emergency room, patients with life-threatening illnesses understandably get top priority," says Dr. Kalla. "As a result, people with 'minor' emergencies - cuts, broken bones, infections, abdominal pains, etc. - sometimes wait for hours before seeing a physician. At the Urgent Care, our focus is on minor emergencies, with the goal of rapid assessment, treatment, and discharge."

However, if critically ill patients walk in or are brought in by family, Urgent Care does have the capacity to resuscitate and transfer such patients to an appropriate emergency department.

The switch from priority to urgent care means that St. Vincent's, Heather will no longer receive emergency ambulances or admit critically ill patients (approximately 15 per cent of its former priority care caseload). These patients will be redirected to other emergency facilities including St. Paul's Hospital (SPH) and Mount Saint Joseph Hospital (MSJ) — both Providence Health Care sites.

As well, complex surgeries will now be handled at SPH and MSJ while some less complex surgeries (ambulatory or outpatient) will move from these facilities to SVH. All critical care will be consolidated at SPH and MSJ — Providence's two acute care sites.

Carla Gregor, vice president, says these changes are designed to reduce duplication of services and create a centre of expertise at each of Providence's eight sites. In the coming months and years, St. Vincent's, Heather will expand it's focus on geriatric medicine, geriatric psychiatry and research on health and aging.

St. Vincent's Hospital, Heather is part of Providence Health Care — a group of eight Catholic health care facilities in Vancouver. It is located at 749 West 33rd Avenue (at Heather).

As a result of The Province story "Cash strapped hospital to lose miracle machine" that ran earlier this year, 121 readers donated money to help buy the Computer Assisted Surgical System (CASS). In total, St. Paul's Hospital Foundation raised more than $300,000 in contributions from 305 individuals and a $200,000 gift from the Mr. and Mrs. P. A. Woodward Foundation.

The CASS, an imaging machine that uses stealth bomber technology to enable sinus specialists to perform intricate surgery, helped the woman featured in the story avoid a major brain operation. The first of its kind in Western Canada, the machine was at St. Paul's on loan from the supplier and the hospital did not have the funds to buy it.

Now the machine is here to stay, specialists from across the country will have the opportunity to come to St. Paul's to learn more about using this technology for sinus surgery.

On Wednesday, July 18 at 11:30 a.m more than 50 people who lent their support had a unique experience. With the help of a mannequin "patient" and computer simulation, guests had a hands on opportunity to get a feel for how the machine works and its value as a tool for sinus surgery specialists. The event took place in Conference Room Seven at St. Paul's Hospital.

Emergency Services are Changing at St. Vincent's Hospital, Heather

On August 17, 2001, a new Urgent Care Centre opens at St. Vincent's Hospital, Heather, located at 749 West 33rd Avenue in Vancouver.

Staffed by emergency physicians and nurses, the centre will provide care for people whose medical problems are not life threatening, but require a higher level of care than a doctor's office or clinic can provide.

The centre replaces the previous emergency services department, called Priority Care.

• broken bones or sprains
• minor burns
• cuts that may require stitches
• skin infections
• asthma
• persistent headaches
• nosebleeds
• allergies
• eye problems
• abdominal pain

How is Urgent Care different from the previous emergency (Priority Care)?
Urgent Care will not receive emergency ambulances and will not admit patients to St. Vincent's Hospital, Heather.

Walk-in patients will either be treated and released or, if the condition is more serious, stabilized and transferred to another facility. (Currently, eighty-five percent of visits to Priority Care are for minor emergency needs, so the impact of this change on other emergency departments in Vancouver is not expected to be significant.)

Benefits for Patients
Urgent Care is a relatively new model for emergency care - one that has been very successful in other parts of Canada. A key advantage for patients is the one-stop service, as the centres have access to a wide range of on-site diagnostic services, such as x-ray, ultrasound and laboratory (e.g. blood tests). Also, because Urgent Care Centres don't treat critically ill patients, wait times tend to be shorter than emergency departments.

Focused on What We Do Best - Care for the Aging
While Urgent Care will enable St. Vincent's to continue providing emergency care to people of all ages in the community, the hospital will focus on what it does best - specialized care for the aging.

In the coming years, the hospital will continue to focus on geriatric medicine, geriatric psychiatry and research on healthy aging. It will also expand on the current range of outpatient services.

• Comprehensive geriatric centre: non-acute geriatric medicine,
geriatric psychiatry and research (including the largest dementia treatment program in Canada)
• Development of a Centre for Excellence in Health and Aging
• Extensive outpatient services: osteoporosis, falls & fractures, diabetes education, foot and ankle, podiatry, geriatric day hospital, bladder cancer clinic, opthalmology, surgical/medical daycare
• Residential Care: 75-bed extended care unit
• Urgent Care Centre: emergency services for all ages

Be a Part of our Future
Do you want to contribute to the exciting future of St. Vincent's, Heather? We rely on the support of the community to fund ground-breaking research into the aging process and to purchase specialized medical equipment. For more information on how you can help, call the St. Vincent's Hospital Foundation at 877-3193.

Mount St. Joseph Hospital once a year honours their foundress, Delia Tetreault, during Mission Week.

Who was Delia Tetreault? She was born in 1865 in Quebec, one of eight children. Her twin brother passed away less than a year later, and sickly Delia seemed unlikely to survive. But survive she did: as a teenager she was attracted to the religious life, and worked with the sick in Montreal's poorest neighbourhoods. Because of many events in her life, she almost 40 before she founded the Missionary Sisters of the Immaculate Conception, the first Canadian women's religious congregation whose primary aim was to serve in foreign missions. Delia died in 1941, and was venerated in 1997 (Veneration is the first in the process of the Catholic Church in recognition of a person as a Saint in the Church).

In addition to honouring Delia Tetreault, staff at MSJ also honoured their own spirit that combines care and compassion with a joy for life. As is their way at MSJ, they reflected on their past during Mission Week while also managing to have a lot of fun!

But is it really broken? Providence Health Care held two public information meetings in March to separate the fact from fiction. The following is an overview of the issues discussed. If you'd like to receive a handout with additional information, call (604) 806-8022 or email us your address.

Fiction: The system is falling apart
Fact: Patients who receive care have high levels of satisfaction

An Angus Reid survey last year found that almost 80% of Canadians believe the health care system in their province is in crisis. However, over 70% are confident they would get the health care services they need if they had a serious medical problem, and a large percentage still believe Canada's health care system is one of the best in the world.

The reality is those who receive care report very high levels of satisfaction. This holds true for Providence, where a recent patient satisfaction survey found:

• 91% of patients rated the quality of care they received as excellent or good;
• 97% said they'd return to the Providence hospital where they received care; and
• 96% would recommend the hospital to friends and family.

There's no denying there are serious issues in the health care system, particularly when it comes to access to care. Why? Here are just two key factors:

A severe nursing shortage: At Providence alone, we'll need to hire 1,200 nurses over the next 3-4 years, primarily due to retirements. Right now, we average 100 - 120 nurse vacancies per month. And we're starting to see physician and other professional staff shortages.

The domino effect: To cope with shortages, we must close beds to ensure the staff we do have are able to provide safe, quality care. When we close beds, we then have a difficult time admitting people to hospital from our Emergency departments (causing a backlog), we have to cancel surgeries, wait lists grow and so on.

Fiction: Hospitals are mismanaged
Fact: Provincial referral hospitals, like St. Paul's, must balance the needs of the community and the needs of the Province.

Providence Health Care serves many communities - the elderly, new Canadians, Vancouver, including thousands who work in the downtown core, the Downtown Eastside and people with specialized needs across the province. This isn't an easy balance to maintain, particularly when the funding we receive doesn't cover the actual costs of providing this care.

Some of the communities we serve have very complex needs, such as the Downtown Eastside, where social issues such as poverty, substandard housing and substance use are similar to those in inner cities of the US. Research has shown it costs 35% more to care for someone who is poor than someone who is a middle wage earner. It's also very costly to provide highly specialized heart, kidney and other services to people around BC - care they can't get anywhere else.

Fiction: Hospitals are mismanaged
Fact: Quality care requires quality equipment
Fact: Efficient, effective and safe care requires comprehensive information systems.

Leading edge medical care requires very sophisticated - and very expensive - medical equipment. A great deal of four life-saving technology is worn out, or will be before we can replace it. Based on industry standards, Providence should invest over $15 per year on capital equipment. (This does not cover new technology.) In the last few years, we've received only a small percentage of that.

Yet another challenge is the substandard state of our key information systems, many of which are 20 years old. Outdated systems affect patients - they lead to inefficiencies, increased medical errors and ultimately compromise the care we can provide.

Fiction: No one wants a career in health care
Fact: For every young person accepted into UBC's School of Nursing, two are turned away

We need to train every qualified young person who wants a career in health care. Period.

Providence has taken a lead role in recruiting internationally, as well as providing specialty training for our nurses. (The largest nursing shortages have been in specialty areas). We're also putting significant effort in improving the quality of worklife for our staff, so they will want to stay at Providence.

An Emerging Issue: Care for the Older Adult
The funding level of staff in residential care facilities has not changed since 1974, despite the fact that the needs of those living in care have increased dramatically. Even with significant medical or mental health challenges, your loved one may receive only 15 minutes of nursing care in a 24-hour period. In some cases, there is only one nurse on a 75 bed unit on the night shift. And it's tough to attract staff to residential care - the work is heavy and demanding, workplace injuries are high and the physician fee structure is lower.

As the largest provider of residential care in Western Canada, these facts are distressing to us. We're working hard to raise awareness of these issues, and we're investing in research and care for the future. Our Centre for Excellence in Health and Aging, now in development, will focus on research that will help people stay healthy and independent as they age.

Solutions
The health care story is not one of doom and gloom alone. As stated earlier, every day thousands of British Columbians receive high quality care that enables them to live productive, healthy lives. Yes, there are challenges. Serious, troubling challenges. But there are also solutions:

• system-wide integration and collaboration
• new ways to delivery care outside the hospital (i.e. ambulatory care)
• capitalizing on the potential of information technology
• a province-wide capital equipment strategy
• support for research and development that will change the way we deliver care tomorrow

Stroke
New diagnostic tests and medications can help you find out if you are at risk of stroke. Even with the best treatments available today, prevention is still the best way to avoid death or permanent disability from stroke. The risk of stroke can be dramatically reduced if you and your doctor know that you are at risk.

• Preventing is still the most effective way of reducing the impact of stroke, the third leading cause of death in Canada and the leading cause of disability in adults.
• After age 55, the risk of stroke doubles every 10 years.
• There are approximately 75,000 strokes in Canada each year - the majority of sufferers will end up with a major disability.
• St. Paul's Hospital specialists have carried out extensive research into the benefits of "clot-busting" drugs that can minimize the long-term effects of strokes, as well as prevention drugs and tests for risk factors of stroke.

• Cardiovascular disease kills more Canadians each year than all types of cancer put together.
• An estimated one in four Canadians has some form of cardiovascular (including heart, stroke and blood vessels) disease — that's about eight million people.
• The incidence of heart failure has increased by 60 per cent since 1970. In B.C. alone, more than 7,500 people are hospitalized for heart failure each year, at an annual cost of more than $38 million.
• Studies show that a healthy lifestyle can prevent or control heart disease
• St. Paul's Heart Centre provides comprehensive care to patients from throughout the province — everything from heart attack rehabilitation to open heart surgery and heart transplants

• The number of Canadians with kidney failure is growing by 14 per cent every year.
• As well as diseases that attack the kidney itself, health problems like diabetes, high blood pressure and heart disease can cause kidney failure.
• Diabetes alone accounts for about one-third of new cases of kidney failure each year.
• St. Paul's Hospital is home to Provincial Renal Agency, which was set up to help administrators and physicians work out the best way to manage kidney disease across the province and the kinds of resources necessary

• More than 1.5 million Canadians have diabetes. Another 750,000 Canadians are estimated to have the disease but be unaware of it — 75,000 of them are in B.C. — worldwide, cases of diabetes are expected to double by 2010.
• Studies show that 20 per cent of people older than age 65 suffer from diabetes
• Early detection and proper treatment can minimize the risk of progression of diabetes
• St. Paul's Hospital has the largest diabetes program in the country.

Increasing numbers of Canadians are diagnosed each year with difficult to treat and often deadly eating disorders. Some experts, including Dr. Laird Birmingham of Providence Health Care's St. Paul's Hospital in Vancouver, say the problem has reached epidemic proportions. "More than 85% of young men and women are concerned about eating and body image," says Dr. Birmingham, also noting that eating disorders are the most common cause of suicide in teenage girls.

Eating disorders include anorexia nervosa, which is characterized as an extreme aversion to food usually resulting in extreme weight loss, as well as bulimia nervosa, the uncontrolled act of repeated binging and purging.

Commenting from his clinic at Providence Health Care's St. Paul's Hospital, Dr. Birmingham cites growing peer and media pressures as two of the reasons for the increased prevalence of these disorders. "For the first time, young people rely more on their peers as authority figures than they do on adults," he says. Still, he points out that anorexia nervosa in particular — just like schizophrenia or alcoholism — is a disease that will develop only in those who carry the gene, about one in 100 women.

In the face of these grim statistics, British Columbians can take some comfort in knowing their province is home to one of the most admired and comprehensive eating disorders programs in the world. At Providence Health Care's St. Paul's Hospital, a renowned program uses a uniquely integrated, multi-disciplinary approach that is serving as a model for the launch of similar programs in Australia and other countries.

Here, adult patients from all over the province have access to a variety of approaches to treatment, determined in part through an assessment of what the patient's motivation is to recover. For many, the question is not, "Do you want to get well?" but "Do you want to have a job and friends? Or do you want to have energy to do the things you love?" Depending on the response, or need, there are in-patient beds for those suffering medical complications, and group homes for longer-term residential treatment - all part of the only rehabilitation program of its kind in the world.

Also on site at Providence Health Care's St. Paul's Hospital is the provincial Eating Disorder Resource Centre, which is available toll-free from anywhere in British Columbia at 1-800-665-1822. If you, or someone you know, would like more information on eating disorders, call your community health office, contact the B.C. Eating Disorder Resource Centre, or visit the clinic's web site: www.eatingdisorders-sph.org

Providence Health Care was recently awarded $1.4 million for new programs to attract and retain nurses, far more than any other health care provider in the Vancouver/Richmond health region.

Funding for the programs, which aim to reduce nurse shortages and improve their working conditions, is part of the provincial government's Health Action Plan.

The grants support innovative recruitment and retention plans and integrate new nurses into professional practice under the guidance of an established registered nurse. Addressing nurses' issues and making nursing a more positive, satisfying experience is seen as an important way of strengthening BC's health system.

Providence initiatives were successful in attracting more than half of the total $2.7 million provided to the entire Vancouver/Richmond region.

• $191,513 for nurse mentoring programs
• $49,921 to hire a service support aide to relieve nurses of miscellaneous tasks at Mount Saint Joseph Hospital
• $934,570 to provide training for 43 nurses in advanced care at St. Paul's Hospital
• $51,744 to create partnerships and local infrastructures to support interdisciplinary practices involving 109 nurses
• $66,318 to provide training in mental health for five nurses
• $90,010 to develop and implement a comprehensive critical incident stress management program for nurses and other health-care workers
• $191,513 for the development and presentation of preceptor/mentor education and workload relief to permit nursing staff to attend workshops and take on mentorship and preceptorship responsibilities

On behalf of the Board of Directors, I am pleased to announce the appointment of Mr. Carl F. Roy as President and Chief Executive Officer of Providence Health Care. He will join us on May 7th, 2001.

Carl is currently President of Caritas Health Group in Edmonton, a multi-site Catholic organization that includes the Edmonton General, Grey Nuns and Misericordia hospitals as well as the Youville Home in St. Albert. Caritas operates in collaboration with the Capital Health Authority, which is a fully integrated academic health sciences centre. Prior to joining Caritas, he was President and Chief Executive Officer of St. Joseph's Health Centre in Sudbury, Ontario.

He has a Master of Health Science, Administration from the University of Toronto and is a Certified Health Executive (Canadian College of Health Service Executives).

As President of Caritas, Carl brought a renewed focus to organizational culture and deepened the understanding of faith-based mission and values within the organization and with key stakeholders and publics. He also strengthened and developed strategic alliances with the Capital Health Authority and was able to build mutually respectful, inclusive and collaborative relationships throughout both organizations.

I am confident that Carl's deep personal faith, his energy and his unwavering commitment to faith-based care, combined with his considerable skills and experiences, will make him an exceptional leader for Providence Health Care. He is dedicated to creating a vibrant organization where the vision is articulated, the values are lived and people find meaning in their work. With his guidance, we also look forward to continued collaboration and mutually beneficial partnerships with the Vancouver/Richmond Health Board, the Ministry of Health, the University of British Columbia and our other partners in care and service.

Janet L. Brown
Chair, Board of Directors
Providence Health Care

Thanks to a machine now in use at St. Paul's Hospital, Christine Stadler no longer needs to worry about keeping a plentiful supply of Kleenex at her side.

The Burnaby resident had a tiny hole in her skull that caused fluid from her brain to leak out through her nose. Without a high-tech imaging machine that helps sinus specialists perform intricate, minimally invasive surgeries, she would have faced major brain surgery to correct her problem.

Instead, using a Computer-Assisted Surgical System or CASS (currently the target of a fundraising campaign by St. Paul's Hospital Foundation), sinus specialist Dr. Amin Javer was able to repair the hole using instruments and a telescope threaded through Christine's nose.

"With my nursing background, I know what having brain surgery means. I was so glad that the machine was available at St. Paul's," she said. "On my first visit to church afterwards people found it hard to believe that I had had surgery at all."

Procedure first in B.C.
Christine is the first person in the province to have this procedure done. The CASS shows a detailed "road-map" of the patient's sinuses and skull on a computer monitor screen in the Operating Room. Special instruments that register on the map enable the surgeons to see precisely where these instruments are located at all times in three-dimensions, supplementing the view they see through the telescope.

The hole in Christine's skull developed for no apparent reason; fortunately, her condition is rare. The majority of patients who can benefit from this machine have sinus problems - not uncommon at all. St. Paul's three sinus specialists treat people with severe sinus problems from communities throughout B.C. For some, surgery to relieve frequent or constant sinus pain would not be possible without use of the CASS technology.

"Sinuses are the important structures located near the nose to warm and humidify the air we breathe," says Dr. Javer. "If you have ever suffered from sinus headaches or pain associated with flu or allergies, you can appreciate the kind of discomfort suffered by patients who have chronic sinus problems severe enough to need surgery."

CASS helps relieve severe sinus problems
Some of the patients who are benefiting from the CASS at St. Paul's have had many prior unsuccessful surgeries and suffer frequent or constant sinus pain. Dr. Javer explains that chronic sinusitis or previous surgeries often change the structure of the sinuses. Patients who would not otherwise benefit from conventional surgery are able to gain relief when surgeons are able to use a CASS, which provides better visibility and precision during surgery.

"The CASS is an essential navigational tool for patients whose sinus problems have changed the anatomy of the area. This machine also means the difference between major and minor surgery for patients who have skull-base problems that can be reached and corrected through the sinuses, Dr. Javer says. "However, it's important to note that this is also a machine that can be used in almost every sinus surgery to provide better results for our patients."

St. Paul's Hospital currently has a demonstration model CASS on a temporary basis. St. Paul's Hospital Foundation is trying to get enough fund to purchase the $250,000 machine to enaable the hospital to keep the machine and own the first CASS in Western Canada.

Christine hopes that the hospital will be able to buy one soon - her condition has a 20 per cent chance of recurring. Her options would be brain surgery in Vancouver or a trip to the U.S., where CASS machines are more plentiful.