Acknowledging and Recognizing my Physicians and health care professionals who provided my care

 August 6, 2020

Dear Dr. Verna Yiu, President of AHS.

Hello. My name is Laura Jean Rutherford, I am 49 years old and I am currently a resident on 6W Martindale Long Term Care (LTC) wing at AgeCare - Skypointe facility in Calgary, Alberta. I am writing this letter to recognize and acknowledge the care provided to me for almost 4 years now. I will be sharing about my hospital admissions: 

PLC Sept 9, 2016 to Sept 21, 2017   

FMC Sept 21, 2017 to April 5, 2018

PLC April 5, 2018 to Aug 5, 2018 

SHC Jan 9, 2020 to Jan 11, 2020 and

PLC Apr 24, 2020 to May 13, 2020. 

Many times we see in the news or read the paper on the negativity or what is wrong towards our healthcare system. I would like to share some positivity about the care I received from your AHS employees - doctors/specialists, nurses (RNs, HCAs), Allied Health Professionals (your rehabilitation teams) and your supportive staff (housekeeping/porters). 

My story begins in September of 2016 after HealthLink 811 informed me to get myself to hospital as soon as possible. Upon arriving to the Peter Lougheed Emergency Room on the afternoon of Friday, September 9, 2016, with symptoms of numbness, pins & needles and tingling in my hands, as well as to my legs and by this point I could no longer walk into the Emergency. 

It was in the Emergency Department where I first met Dr. Dan Zuege (PLC Critical Care Internist) and in describing my symptoms he was able to make a clinical diagnosis of Guillian Barre Syndrome (GBS). I had a CT of the head to rule out any other conditions. He asked for a spinal tap, which is one of the diagnostic tools to confirm GBS, but unfortunately they found no proteins in my spinal fluid. By this time, my breathing was becoming laboured, so I was admitted to PLC ICU to be intubated with the clinical diagnosis of GBS. 

In honesty, the next 5-6 weeks I have no memory of my time in ICU except from what I have read in my chart and from what family and friends have told me who were there from the beginning supporting me. Three days after my admission, an EMG confirmed I had a severe case of GBS of variant AMSAN (Acute Motor Sensory Axonal Neuropathy) with severe autonomic dysfunction (severe bradycardia requiring a temporary external pacemaker for 2 weeks; diaphragm dysfunction; and neurogenic bladder & bowel). The damage made to my peripheral nerves lead to complete paralysis from head to toe. The initial weeks I could only communicate I am told by movements of my eyebrows. I do remember hearing Dr. Zuege’s encouraging words as I became conscious enough to give him a smile; which was a feat as my facial muscles had been paralyzed from GBS. 

In November 2016, when I was more conscious, I learned about the severity and complexity of my GBS condition as I lay in my bed paralyzed from the neck down and unable to speak as I was being kept alive through a tracheostomy with a medical ventilator and a feeding tube. Those early weeks it was touch and go as I experienced a cardiac arrest, blood clots in both lungs and lower legs, pneumonias and infections from my PICC lines. My stay in the PLC ICU was basically a year in length due to mainly being unable to wean off the ventilator. Dr. Zuege was my primary internist during this period, but Drs. Berthiaume and Lord also took care of me during my time in ICU. 

As GBS is a rare disorder (1 in 100,000 people per year), my family and friends helped me research so I could have a better understanding of what I was dealing with. When I asked Dr. Zuege about another treatment for GBS which was plasmapheresis, he told me that in the early weeks he had called Foothills (FMC) about being transferred there but due to my fragile condition it was not recommended and decided in the consult that the plasmapheresis treatment would not have changed my recovery. I remember in December 2016, mouth speaking my frustration to Dr. Zuege about my situation - he told me “If you don’t give up and you keep fighting, then I won’t give up and keep fighting for you”. Do you realize how powerful it is to hear from your doctor when your outcome for recovery is poor, that he has your back? It was for me. He was true to his word, when I was having difficulties talking while attached to my tracheotomy, Dr Zuege found a tracheostomy from Germany which would allow me the opportunity to speak. I want to thank Dr. Dan Zuege for his professionalism, his kindness and his encouragement to myself and to my mom who was there every day throughout my hospital days. 

Spending a year in the ICU, you don’t only get to know your doctors, but also the nurses, therapists and housekeeping who cares for the well-being of their patients. They became a part of my circle of encouragers cheering me on each day, especially when I was having a bad day. A nurse named Morgan knew my faith was important to me and when I had bad days on her shift, she would take a few minutes and pray with me which gave me strength to face the day again. There was a nurse named Kiwi who always made sure I had a smile on my face. The ICU physiotherapist Maureen gave me encouragement to look past the pain when doing our exercises in my room. In April 2017, a lady from housekeeping collected monies and made me a small Easter basket of goodies. Such a thoughtful and touching gesture to give a patient. Definitely felt loved by those who were caring for me - I felt safe. My primary respiratory therapist, Scott made a difference in my recovery and care through his positivity and encouragement during my whole time in ICU. 

After spending a year in ICU, it was natural to be hesitant to leave. The PLC Critical Care Unit has an Outreach Program which helped me to transition from PLC ICU to PLC Unit 39 (respiratory unit) and ensured I would be well taken of on this unit. And I was. The same care I had received in ICU carried forward by the nursing staff on PLC Unit 39. As I was unconscious for my birthday the year before (September 17), my RN, Michelle on Unit 39, on that day while I was asleep decorated my room with a “Happy Birthday” sign and streamers. It is an excellent example of your nursing staff - showing kindness and compassion for their patients. It made my birthday all the more special!

It was on Unit 39 where I met my PLC primary hospitalist, Dr. Scott Samis. From the first time I met Dr. Samis he reminded me of Dr. Zuege - he showed me he had my back and was an encourager in my recovery. Just before transferring to the Foothills Acute Intense Rehabilitation Unit 58, realizing I will probably need continuing care afterwards, Dr. Samis told me he told Dr. Serge Soolsma (my FMC hospitalist) that he could always send me back to PLC and continue my care while waiting transfer to a continuing care facility; which Dr. Soolsma did 6 months later. 

Dr. Samis took great care of me for the 5 months on PLC Unit 54 (Transition Unit) before transferring me to AgeCare - Skypointe Community Care facility on August 5, 2018. As AgeCare-Skypointe’s medical care was being looked after by a group of PLC Hospitalists, he made sure I would be taken care of. His promise was kept, as my PLC Hospitalist who is providing my medical care is Dr. Sumeet Bhatia. This year Dr. Samis cared for me at AgeCare - Skypointe during Dr. Bhatia’s paternal leave (Mar 2020 - June 2020) in which I had to be admitted unexpectedly due to acute appendicitis. With AgeCare - Skypointe on Covid outbreak, the EMS called ahead asking where to bring me in the PLC emergency department. As EMS described that I was a 49-year old female from Skypointe, the nurse said, “Is her last name Rutherford?”. Here Dr. Samis had called ahead to the ER to notify I was going in. After having my CT scan of the Abdomen confirming that I had acute appendicitis, he arranged for me to be admitted to PLC Unit 39 to await my surgery as well as called ahead to ICU to reserve a bed postoperatively. Before leaving the ICU in August 2018, we discovered I have an A-frame trachea probably from a tracheotomy complication, therefore having any intubation increases my risk of postoperative respiratory complications following surgery. This was the reason for sending me to PLC ICU postoperatively. To help put my mind at ease, Dr. Samis called my mom in Ontario and notified her of my situation (she was an ER RN for over 40 years ). In addition he knew as a quadriplegic, my iPad and cellphone were my lifeline to the inside and outside world. So knowing I couldn’t go back to AgeCare - Skypointe until the Covid outbreak was cleared, once I was discharged from the ICU, he personally went to AgeCare - Skypointe to retrieve my iPad and holding devices and brought them to my room on PLC Unit 54. This was huge for me, knowing I could stay in contact with my family and friends who have been my foundation in recovering from GBS. Another example of the kindness and compassion he has shown me during my care with him.

I would like to recognize the following PLC physicians - Dr. Alison Murray (PLC Hospitalist) and Dr. Karen Rimmer (PLC Pulmonologist) who cared for me during my initial PLC admission. Though Dr. Murray only was responsible for my care for few weeks, the kindness and compassion she showed myself and my mom will not be forgotten. Being a stressful time for us just recently being discharged from PLC ICU and quickly being transferred to FMC Unit 58, her actions of allowing my mom to park in her parking pad near Foothills, was so generous and thoughtful. Having my mom not needing to worry about parking at FMC, gave my mom a sense of relief and the freedom to focus on my recovery. We are forever touched by her kindness towards us during this difficult time. Dr. Rimmer has been my primary pulmonologist from my initial admission to PLC and continues to follow me through the Pulmonary Clinic at PLC. She has always been warm and encouraging hoping each time to see any improvements in my recovery. This has meant so much to me. 

I would like to acknowledge the support which Dr. Serge Soolsma (FMC Hospitalist) who cared for me on FMC Unit 58 during my 6 month stay. When we first met, he put me at ease by continuing to be encouraging in moving forward in my recovery. When we had our post-admission family conference meeting about 4-5 weeks later (October 2018), Dr. Soolsma could tell that what I was being told was overwhelming me. After everyone left from the meeting, he stayed behind to reassure me, he had the final say and he had my back. In Feb 2018, he had a Neurologist resident assess me to see if we were dealing with more than GBS. As GBS can mimic other conditions, by ruling them out, we were able to confirm it was only GBS we were dealing with. Again, the compassion and kindness shown to me by your hospitalists at PLC and FMC have been amazing. 

I would like to recognize the FMC Rehabilitation therapists who work with the Unit 58 patients. To begin re-establishing what my life could be like, your FMC Rehabilitation therapists played a major role. Being a patient on Unit 58, I was assigned to be involved in multiple therapies as part of my weekly routine - physiotherapy, occupational therapy, recreational therapy, music therapy and physiological therapy. Though it took me a few months to feel confident to be in an open space with others, like the dining area, gradually with staff and my mom’s encouragement, I began socializing again. In addition, the physiotherapy aides who did my passive exercises began regaining muscle tone in my limbs; the occupational therapists assisted with hand therapy to reduce my hand edema; and the music therapy allowed me to use music as a form of pain management. It was the recreational therapists that played a major role in my recovery and giving me ways to communicate with my family and friends as well as giving me some of my independence back by getting me using an iPad and a mouth stick which occupational therapist Cheryl Oga created for me. With the assistance from Ms. Risha Joffe (FMC Psychologist), I was able to speak out my feelings/concerns about my situation and not bottle them up inside me. This was essential in the healing process from this traumatic event in my life. To this day, I am so grateful for all their efforts to show me even as a quadriplegic (shoulders down), I can still have a quality of life again. 

In January 2020, I had a planned elective surgery (D&C) for ongoing DUB at SHC site. As this was the first hospital admission since arriving at AgeCare - Skypointe; every provision was taken for me as I have poor vascular access for IV insertions and have an A-frame trachea. I was admitted the day before to ensure enough time was given to insert a midline CVC line and Dr. Kayla Nelson (SHC Gynaecologist) came at the end of her shift to make sure I was settled and reassured me everything would be fine the next day. I found out from Dr. Nelson that the Chief of Anaesthesia at SHC had emailed all of his anesthesiologists about my case, so that if they were working the day of my surgery they were aware of my complexities depending on the type of anaesthesia they were going to use. I was incredibly touched that the Chief of Anaesthesia would think of doing something like this for me. I knew I was in good hands for my surgery. The surgery went well and I had no complications. Dr. Nelson had me stay overnight as a precaution and she personally came the following morning to make sure I was okay to discharge. Dr. Nelson’s kindness spoke volumes to myself and my mom. 

As I mentioned above, Dr Samis made arrangements to find me a PLC Hospitalist to continue my medical care at AgeCare - Skypointe. My physician is Dr. Sumeet Bhatia. From our first day meeting, you could tell he deeply cares for his patients and wants the best for them. He saw the importance of my mom and my friends in my continued recovery from the GBS residuals, such as my tetraparesis. When I had my 6-week post admission family conference meeting, this was evident in the people I asked to join our meeting. Not only did Dr. Bhatia share what he was looking for to happen in the coming year, but he engaged my friends asking what they wanted to see for me too. One of my friends said ‘finding ways to give back to me my independence’. A few weeks later, Dr. Bhatia came for his weekly visits and he brought a couple of packages of Wi-Fi plugs that I could use to plug in my lamp and fan into and control from my iPad; thus not having to ask my HCAs to turn the items on or off. He has been such an encouragement for me and continues to be still today. Similar to what Dr. Zuege said to me before, Dr. Bhatia said “if you don’t give up in your recovery, neither will I.”  From last year’s family conference meeting where my mom and brother were able to attend; seeing and hearing the care I have been given by Dr. Bhatia as well as the AgeCare - Skypointe staff gives them the peace of mind I am receiving the best care I can, especially hearing of my care during the current Covid-19 pandemic. I feel very blessed having Dr. Bhatia on my team to AgeCare - Skypointe. 

As you can imagine, waking up finding you are now paralyzed from the neck down, having no voice to communicate but being able to hear and see what is happening can be quite frightening. It was a scary experience for me especially as I was not able to communicated properly and didn’t know what care was being done to me. Having the staff communicate to me what they were about to do helped to reduce the anxiety when I didn’t know why they were doing their task. When I was able to finally communicate, the doctors and therapists were patient and made me feel comfortable to ask questions and feel engaged in my care. This has been so important to me as it gave me a confidence in feeling a part in the decision-making in my recovery and quality of life. 

The other area is towards a patient having a rare disorder such as GBS. With GBS, there is no known real trigger for GBS other than it seems a virus triggers an autoimmune response in the body.  There is also no known cure for GBS and each individual recovers at different paces depending on the specific GBS variant and severity. In my case, the AMSAN variant tends to have a slow and poor recovery prognosis, even the possibility of death. The one thing that Drs. Zuege, Samis, Soolsma and Bhatia didn’t do to me - they never took away my “hope” from me. Despite knowing I will have a poor recovery, they all echoed the sentiment; “I would love for you to prove me wrong .” It gives one the motivation to fight to stay alive and move forward in one’s recovery. This has meant so much to me. 

I would like to mention a few areas I feel could be improved upon within your system. One area where I feel I did fall through the cracks was my stay at FMC Rehabilitation floor - physiotherapy. When I went FMC Rehabilitation, I was paralyzed from the shoulders down and learned to sit in a wheelchair just 4 days before my transfer. I was told they were taking a chance on me as I didn’t meet all the criteria to be admitted to this floor. After 3-4 months at Foothills, I noticed that my physiotherapy was being reduced from 3 days a week to 2 days a week since I was not showing enough acute recovery in my mobility to continue 3 days a week. The rehabilitation plan for the last 4 months therefore focused more with the recreational therapists on technology (4 days a week for an hour) with physiotherapy only being 2 days a week for 30 minutes, primarily just my arms as they were showing slight increase in movement. I found this discouraging and felt they had given up on me. 

When I returned to PLC (April 2018), I was assigned a physiotherapist aide Tara. She added therabands to our sessions (2 days per week) and I was able to see more improvements in my hands and feet movements in the same amount of time I was at FMC. What a motivation that was for me, keeping my hope alive! She was encouraging and made me celebrate the small victories that were made in our sessions. Today, I have a private physiotherapist who comes twice a week for an hour each session, as there are no physiotherapy resources at my facility. I am still considered a functional quadriplegic but I have begun to gained limited movement in my limbs. This is why physiotherapy is a vital component in anyone’s GBS/CIDP rehabilitation recovery plan. Though I do appreciate them taking a chance on me, as the FMC Rehab floor has only 15 spinal injury beds to serve all of Southern Alberta, I know there is a reason for the criteria made for this floor. The last thing anyone wants is to feel defeated and lose the motivation to participate in ones own recovery, but this is a common occurrence if one feels they have been given up on because they believe you are no longer going to have the acute recovery they are looking for. 

When you have a young person looking at having to live in a continuing care facility, providing therapies like physiotherapy and occupational therapy to assist in their daily routine; keeps them motivated and contributes to full wellbeing (physical, mental and emotional health). I think it is something important to consider for the future, especially with GBS/CIDP patients. AHS has some great outpatient clinics available once a patient has been discharged from hospital but are all your doctors aware of what could be possibly available for their patients if they need continuous follow-up? It would have been excellent had my physicians or therapists made me aware of this option. 

For example, in September 2017, SHC opened the Neuromuscular Rehabilitation Clinic on the 5th floor on the outpatients wing. At this time, I had just arrived to the FMC Rehabilitation floor and was there from September 2017 until April 2018, and those involved in my rehabilitation care should have noticed I was not being followed by a neurologist as well. So my question is, why wasn’t a referral sent to the Neuromuscular Rehabilitation Clinic so I could have had a neurologist monitor me, while being able to access the rehabilitation therapies associated with this clinic. It was a fluke that while attending a GBS/CIDP Education Session in September 2018, I met Dr. Chris White, a neuromuscular physician from the Neuromuscular Rehabilitation Clinic at SHC. Could there be a reference guide made available for physicians/therapists of outpatient clinics that would be available if their patients are looking for outpatient care to continue their recovery and not take up an acute care bed in the hospital? From my perspective in having a rare disorder, it would have been nice to know there is a GBS/CIDP Organization of Canada where I could reach out to other Calgarians who have firsthand experience on recovery after their diagnosis of GBS/CIDP. I would have been able to receive this information before my discharge from FMC (April 2018), if I had been told AHS has a Neuromuscular Rehabilitation Clinic available to me with a referral from my doctor. 

Dr. Yiu, I would again like to express my gratitude for the wonderful AHS team of doctors, specialists, nursing staff, allied health therapists, and supportive staff like the porters and housekeeping, who made a difference in my recovery since my GBS diagnosis throughout my many hospital admissions. 

I would also like to acknowledge the PLC Hospitalist Team specifically - both as an inpatient and outpatient care at AgeCare - Skypointe.  They have all shown me respect, dignity, kindness and compassion. They truly work as a team, working together to focus on the patient’s health and well-being. It is one of key component in my ongoing recovery of GBS, and I can’t thank them enough for that.And please do thoughtfully consider my concerns and suggestions for what could make the services you offer even better for present and future patients.  

If you have any concerns or follow up questions, please contact me via email : laura2travel@yahoo.ca. 

Sincerely, 

Laura Jean Rutherford 

Cc’d:

Dr. Serge Soolsma - FMC Hospitalist 

Dr. Dan Zuege - PLC Internist 

Dr. Sumeet Bhatia - PLC Hospitalist 

Dr. Scott Samis - PLC Hospitalist 

Dr. Karen Rimmer - PLC Pulmonologist

Dr. Alison Murray - PLC Hospitalist 

Ms. Risha Joffe - FMC Psychologist

Dr. Chris White - SHC Neuromuscular Physician 

Dr. Kayla Nelson - SHC Gynaecologist 

Dr. Sid Viner - Calgary Zone Chief Medical Director   

Dr. Luc Berthiaume, PLC Critical Care Unit Site

Mr. David Weyant, Chair for Alberta Health Services Board

Dr. Rollie Nichol, Associate Chief Medical Officer, AHS - Patient & Family Advisory Group 

Dr. Jim Eisner, Calgary Zone - Medical Inpatient Section Chief

Dr. Marinus Van Westhuizen - Deputy Section Chief of Medical Inpatient