Monday, February 27, 2006

Toronto transplant doctor teaches patients how to live a full life

This inspiring story recently posted on is a further example of how an organ transplant can transform one's life in so many ways.

TORONTO, Canada (MedPage Today) -- Dr. Heather Ross, medical director of the cardiac transplant program at Toronto General Hospital, doesn't just recommend rehab, she lives it with her patients.

What could be better rehab for a heart-transplant patient than cross-country skiing? So Ross just spent a winter weekend teaching Aaron Knox, who has a new heart, how to cross-country ski.

But there's a lot more to the story than that. Ross, 43, and Knox, 30, are going mountain-climbing together. The skiing lesson was just the first step in a challenging -- and chilly -- adventure.. full story

Friday, February 24, 2006

Another Organ Donation System Proposed for Ontario

Following Ontario's New Democrat MPP Peter Kormos' introduction of a private member's bill last week calling for presumed consent for organ donations unless the potential donor has "opted out" by previously signing a document to that effect, Conservative Frank Klees proposed a bill February 22nd that would deny driver's licenses and health cards to people 16 and older unless they signed a donor card indicating yes or no to organ donation.

So the debate on organ and tissue donation continues. My position has not changed. I believe we should give Ontario's new system, implemented by Trillium Gift of Life Network (TGLN) this past January, a chance to show that it will dramatically increase the rate of donation in our province from the present almost 13 per million population to hopefully near the rate of 33.1 per million enjoyed by the Philadelphia area. Ontario's new program is very similar to the successful Philadelphia system.

Ontario's new system is called Routine Notification and Request (RNR) and is designed to maximize organ and tissue donation. It is a provision of the TGLN Act passed in 2000, with the implementation of the RNR program this year.

Under RNR guidelines, designated facilities report to TGLN when a patient has died or death is expected by reason of disease or illness. Once eligibility has been determined, the hospital then approaches the patient or the patients' family to discuss donation options.

Do you have an opinion on this? Leave a comment below.

Tuesday, February 21, 2006

More Thoughts on Organ & Tissue Donation in Ontario

The new system that went into effect in Ontario this January, (See recent post) is very similiar to the one that's been in effect in the Philadelphia area (with a population about the same as Ontario). They have a donor rate of 33.1 per million population compared with Ontario's 13 per million. It's the most successful program in the U.S. and is called the Gift of Life.

Many readers responding to the recent post about a new system of Presumed Consent proposed for Ontario said they liked the idea, mainly because there is a shortage of tissues and organs and too many people are dying while on the waiting list for a transplant. Some quote Spain's example where over a 10 year period organ donation in Spain rose 146% to 33.6 donors per million population. People automatically assume that Spain has an "opt out" system similiar to the one proposed for Ontario. But Spain's "presumed consent" system is not enforced. In fact, Spain’s laws and practices respecting organ donation are similar to those in the U.S. and Canada. Following brain death, organs can only be retrieved after obtaining consent from the family, and no compensation can be provided for donated organs.

The increase in organ donation in Spain was not driven by statutory changes, and there has not been an increased reliance on living donors to fill the donation gap as in Canada and the U.S. Almost all – 99 percent – of organ donations in Spain are from deceased donors. Spain’s success can be attributed to the creation of the National Transplant Organization (ONT) in 1989, and its network of specially trained physicians who are paid to work as hospital transplant coordinators. These physicians work part-time as transplant coordinators while they maintain their medical practices –primarily as intensivists or nephrologists. These physicians are responsible for identifying potential donors, managing donors and approaching families.

The law in Pennsylvania stipulates that every death in a hospital must be referred to Gift of Life in order to determine if the person's organs are suitable for transplant. It is not up to medical staff – doctors and nurses – to persuade families to allow relatives' organs to be used for transplants. If there is a suitable donor, a trained co-ordinator from Gift of Life visits the hospital to seek the family's approval, but only after the attending physician has told the family the patient is dead.

The "presumed consent" or "opt out" system being proposed for Ontario doesn't sound very ethical to me. What if someone for religious reasons, for example, does not want their organs removed? They may not know of the requirement to sign a document saying they do not want their organs removed in the event of their death.

Now that Ontario's organ and tissue donation agency, Trillium Gift of Life Network, has in place a program similar to Philadelphia's in many ways, why not give it a chance to become successful with the potential to achieve the same organ and tissue donation rates? This way, families will not be taken out of the decision making and can still be involved in the donation of their loved one's organs and tissues. I think it's a win-win situation for all concerned.

Thursday, February 16, 2006

The ethics of presumed consent

A private member's bill introduced in the Ontario provincial legislature on Thursday by New Democrat MPP Peter Kormos, says that Ontario hospitals should be able to freely harvest organs unless a dying patient objects beforehand. Kormos says the aim of his bill is to reduce the number of people who die awaiting transplants.

The policy advocated in the above bill is known as Presumed Consent. Presumed Consent as public policy means that a clinically and legally indicated candidate for cadaveric organ and tissue recovery is presumed to have consented to organ and tissue recovery if he or she had not registered a refusal. Also, there is no allowance for the donor's family to be involved in the donation process.

What prompted me to write this piece was several e-mail's I received about an interview by radio personality Andy Barrie with the CEO of Trillium Gift of Life Network, Dr. Frank Markel. I did not hear the interview but was given to understand that Mr. Barrie was an advocate for the private member's bill and opposed to existing Ontario government policy.

I personally do not advocate Presumed Consent but instead like the new strategy of Trillium Gift of Life Network (TGLN) in effect in Ontario, Canada since January of this year (RNR). RNR helps identify potential donors and ensures patients/families are given the opportunity to make an informed decision about donation, thus improving current donation rates and saving more lives.

Routine Notification and Request (RNR) is designed to maximize organ and tissue donation in Ontario. It is a provision of the TGLN Act passed in 2000, with the implementation of the RNR program in January 2006.

Under RNR guidelines, designated facilities report to TGLN when a patient has died or death is expected by reason of disease or illness. Once eligibility has been determined, the hospital then approaches the patient or the patients' family to discuss donation options.

Some countries have increased organ and tissue donation rates through a "presumed consent" policy, such as Belgium, France, Austria, Finland, Denmark and Singapore but their policies approximate "routine salvaging of organs".

Our society assumes that the individual, not the state, should control his or her physical disposition. Our society respects this principle by asking for the consent of the donor before organs are recovered.

This is my opinion. You can find many other opinions elsewhere and the best discussion I've read on this is in "A Report of the Presumed Consent Subcommittee, United Network for Organ Sharing Ethics Committee."

Please go the following link for this in depth analysis: Evaluation of the Ethics of Presumed Consent

Do you have an opinion on this? Leave a comment below.

Saturday, February 11, 2006

Smokers who exercise reduce risk of heart attack

This news release from the University of Texas could be very helpful for those who want to quit smoking but just cannot do so right away.

AUSTIN, Texas—February 8, 2006

Even if you cannot stop smoking, you can lower your risk of cardiovascular disease by exercising regularly, according to a University of Texas at Austin study.

Examining otherwise healthy sedentary smokers and physically active smokers, Dr. Hiro Tanaka, an exercise physiologist in the College of Education, discovered that the smokers who exercised had increased blood flow to the legs.

Cigarette smoking causes a distinct, immediate decrease in blood flow to the legs because blood vessels going to the legs become constricted. Over time, this can lead to peripheral artery disease and increases the risk of heart attack, stroke, amputation or death..Full news release

Thursday, February 09, 2006

Birthday Ball Wednesday, April 26, 2006 (update)

Mark your calendars and be sure to attend the next Birthday Ball to celebrate life through transplant excellence. The Birthday Ball will be held at The Carlu, 444 Yonge Street, 7th floor, Toronto, Wednesday evening, April 26, 2006. (This is the original Eaton Auditorium in College Park that has been completely restored..Carlu web site)

The Birthday Ball is being organized by Team For Transplant under the auspices of Toronto General & Western Hospital Foundation. Last year's event netted $145,000 with about 500 attendees and this year organizers are expecting an attendance of 600.

Funds raised are directed to the Transplant Program and as Birthday Ball co-chairs Brenda Hunter and Pamela Collins say in the web site's welcome message:

"By supporting the Birthday Ball you will be contributing to the efforts of researchers and clinicians who are making new advances in transplantation research and treatment thereby ensuring their patients and future transplant recipients can enjoy the best quality of life and receive a second chance at life."

For tickets and other information: Birthday Ball Web Site
or call Mary-Claire Jankowski at 416.340.4800 ext. 6279.

The above site has a link to photos from last year's ball and there is also a collection of photos on Merv's Birthday Ball Gallery taken by me and other volunteers.

I hope to see you there.

Tuesday, February 07, 2006

Church members brave storm to hear about organ and tissue donation

Merv Sheppard, speaker and Gloria Clarke About thirty members of the Church of The Holy Spirit in Mississauga, Ontario turned out to hear our organ and tissue donation story Monday evening in spite of a sudden winter storm that hampered visibility and made driving tricky. The audience was very attentitive and asked numerous questions. Many said they were unaware there were no age limits to donating organs and most tissues or the types of organs and tissues that could be donated. We distributed donor cards during the meeting and later during the social that followed several people came up to me proudly showing they had filled out and signed their's. Thanks to church member Gloria Clarke (shown with me in the photo) for organizing the event and giving Trillium Gift of Life Network an opportunity to bring our message to their congregation.

Audience I owe a huge vote of thanks to Lynne and Peter Laurence (double-lung transplant recipient due to cystic fibrosis) for their help and support. Not only did they drive me to this meeting from their home in Mississauga and help distribute materials, but they took me home and put me up for the night so I wouldn't have to drive back to Waterloo in the snowstorm. (That's Lynne in white in the last row)

Sunday, February 05, 2006

Another snow day in Waterloo

Here's what greeted me when I looked out my kitchen window this morning. Last week friends were talking about golfing this weekend but the good old weatherman put a damper to that pretty quickly. So I guess I'll either go cross-country skiing or stay in and watch the Super Bowl. Now let's see...hmmmm..

Saturday, February 04, 2006

Do you care about your doctor's appearance?

I've never really thought about how my doctors look. I guess my main concern has always been dealing with my health problems and getting them taken care of. But this study published in the British Medical Journal seems to indicate that many patients do care about how their physicians look and interract with them. Do you have an opinion on this? If so, you are invited to leave a comment at the end of this post. It will be interesting to see what everyone has to say. I've provided a link to the full study but here's an extract:

Patients preferred doctors to wear semiformal attire, but the addition of a smiling face was even better. The next most preferred styles were semiformal without a smile, followed by white coat, formal suit, jeans, and casual dress. Patients were more comfortable with conservative items of clothing, such as long sleeves, covered shoes, and dress trousers or skirts than with less conservative items such as facial piercing, short tops, and earrings on men. Many less conservative items such as jeans were still acceptable to most patients. Most patients preferred to be called by their first name, to be introduced to a doctor by full name and title, and to see the doctor's name badge worn at the breast pocket. Older patients had more conservative preferences... BMJ full article

Friday, February 03, 2006

Introduction to Molds

From time to time we hear about lung disease patients who experience respiratory problems from living in environments such as damp basements and hopefully this U.S. Enviornmental Protection Agency review of molds and how they develop will be helpful.

Molds produce tiny spores to reproduce. Mold spores waft through the indoor and outdoor air continually. When mold spores land on a damp spot indoors, they may begin growing and digesting whatever they are growing on in order to survive. There are molds that can grow on wood, paper, carpet, and foods. When excessive moisture or water accumulates indoors, mold growth will often occur, particularly if the moisture problem remains undiscovered or un-addressed. There is no practical way to eliminate all mold and mold spores in the indoor environment; the way to control indoor mold growth is to control moisture.

Basic Mold Cleanup

The key to mold control is moisture control. It is important to dry water damaged areas and items within 24-48 hours to prevent mold growth. If mold is a problem in your home, clean up the mold and get rid of the excess water or moisture. Fix leaky plumbing or other sources of water. Wash mold off hard surfaces with detergent and water, and dry completely. Absorbent materials (such as ceiling tiles & carpet) that become moldy may have to be replaced.

How do molds affect people?

Some people are sensitive to molds. For these people, exposure to molds can cause symptoms such as nasal stuffiness, eye irritation, wheezing, or skin irritation. Some people, such as those with serious allergies to molds, may have more severe reactions. Severe reactions may occur among workers exposed to large amounts of molds in occupational settings, such as farmers working around moldy hay. Severe reactions may include fever and shortness of breath. Some people with chronic lung illnesses, such as obstructive lung disease, may develop mold infections in their lungs.

Ten Things You Should Know About Mold

Asthma and Mold

For the full article go to: Mold Resources

Thursday, February 02, 2006

I had a great time in Toronto last night!

Christine & Merv SheppardJust how important family is to someone's life really hits home when you have a chance to get together with loved ones you don't see regularly. It was wonderful to have a visit with my daugher Christine yesterday. She is staying at the Royal York Fairmont Hotel in downtown Toronto this week to attend a convention (she's Executive Director of the Alberta Library Association). Many of my fellow lung transplant recipients and their supports will remember Chris because she flew in from Calgary to be my support for five weeks post transplant. She gives her regards and says hello to everyone.

Bob, Gary, Chris, Fran Chris and husband Gary, my brother Bob (another support person for me) his wife Fran and I went out for a fabulous dinner at Joe Badali's, an Italian restaurant just west of the Royal York on Front Street. The service and attention to our party was terrific and the food was delicious. A good time was had by all except I'm a bit tired today because my head didn't hit the pillow back here in Waterloo until almost 2 a.m..But it was well worth it! (this picture was taken in Chris & Gary's suite at the hotel)

Wednesday, February 01, 2006

Smokers Double Their Quit Rate By Wearing Nicotine Patch Before Stopping

This might be welcome news for anyone who is trying to quit smoking.

DURHAM, N.C.Smokers trying to quit the habit may double their success rate by wearing a nicotine patch two weeks before their actual quit date, according to a Duke University Medical Center study. Currently, the patch's label warns against smoking while wearing the patch.

In a study of 96 smokers attempting to quit, 50 percent of those who wore the patch two weeks prior to quitting had stopped at four weeks. Only 23 percent of smokers who wore a placebo patch two weeks prior to quitting had stopped after four weeks. The same pattern appeared to continue for six months, although many of the study participants were no longer reachable to verify this trend, said the researchers.

If these findings are confirmed by a larger study currently underway, the researchers said the Food and Drug Administration may need to re-evaluate its current warning against smoking while wearing the nicotine patch. Moreover, said the researchers, such confirmation would lead them to advocate a change in clinical practice in smoking cessation programs, to include use of the patches before cessation...Full news release