Hyperbaric machine with Caribbean touch
An award-winning clinician scientist with Caribbean roots is an integral part of a new hyperbaric unit at Rouge Valley Centenary Hospital in Scarborough.
Staff physicians Dr. Hance Clarke, who migrated with his family from St. Vincent & the Grenadines in 1978, and Dr. Rita Katznelson are trained anaesthesiologists with sub-speciality training in hyperbaric medicine at the Mayo Clinic in Rochester,
The team also comprises Dr. Anton Marinov who is the medical director.
The official ribbon-cutting ceremony for the 5,000-square foot unit, that includes six industry-leading hyperbaric chambers and a fully integrated electronic medical records system, took place on Tuesday.
The facility is the only one of its kind east of Yonge St. to Kingston.
Hyperbaric medicine increases blood oxygen that temporarily restores normal levels of blood gases and tissue function to promote healing and ward off infections. The therapy is used to treat several medical conditions, including carbon monoxide poisoning, gangrene, arterial gas embolisms and sudden deafness.
“There are a lot of misconceptions about hyperbaric medicine, but it actually has 14 OHIP (Ontario Health Insurance Plan) indications,” said Clarke who is the director of Pain Services and the medical director of the Pain Research Unit at Toronto General Hospital. “One of the main populations that we treat, which is clearly an issue within our community, is diabetic ulcers and complex wounds. Anytime patients have a complex wound that’s non-healing and have vascular flow issues, we are a potential treatment option.
“The two bigger clinical problems that people are really unaware of are any type of post-cancer treatment that has been radiated. If you have a large prostate that has been removed, you then have radiation treatment and you develop proctitis or a bleeding bladder issue from the radiation.”
Clarke said the hyperbaric medicine is an excellent treatment for this condition. He also pointed out that Jehovah’s Witnesses, whose religious beliefs preclude them from receiving blood products, and individuals suffering from deep bone infections with anaerobic bugs and are on IV antibiotics are also candidates for hyperbaric treatment.
“There is this misconception that you wait until the antibiotics are done before you come for treatment,” he said. “There is, however, good evidence to show a 20-30 per cent improvement in terms of folks that get into these chambers with their IV antibiotics onboard and allow the anaerobic bug to be penetrated.”
Patients can be referred by a physician or self-refer to the clinic located at 2863 Ellesmere Rd. #110. The opening hours are 8.30 a.m. to 5 p.m. Mondays to Fridays and the telephone number is (416) 287-0990.
During treatment, a patient is placed in the closed hyperbaric chamber where the atmospheric pressure gradually increases to the prescribed level and a patient breathes 100% oxygen under the elevated atmospheric pressure for a set amount of time. The treatment lasts about two hours and the number varies from 1-5 remedies for patients with acute conditions and up to 60 for those with chronic diseases.
Clarke’s research interests include evaluating the efficacy of preventive analgesia, identifying novel acute pain treatments after major surgery, the factors involved in the transition of acute post-surgical pain to chronic pain and risk factors associated with continued opioid use and poor health related quality of life after major surgery, and studying the genetics of acute and chronic pain after surgery.
He heads a ground-breaking program that helps patients manage severe post-surgical pain using a range of traditional and alternate therapies, including non-opioid pain medications and acupuncture.
“Chronic pain in our country costs about $60 billion annually,” said Clarke who is an African-Caribbean Board of Industry & Trade founding board member. “Of that, 10 per cent is probably related to post-surgical pain and people who have an intervention – whether it’s perioperative or peri-hospital – continue to have pain after they leave the hospital. In the past, it took anywhere from 18-24 months before you actually could walk through the door of a tertiary care centre and see a pain specialist. What our program does is close the gap. If you walk out of a hospital and you have a pain problem, we have a silo now that you can be seen within a six-month window. Once you hit that six-month period, the data shows you are probably not going to get better.”
Clarke has also partnered with other academic physicians in the Greater Toronto Area to build out an observational platform for medicinal cannabis.
CanvasRx Inc, Canada's leading cannabis education and counselling service, is sponsoring the three-year study that will follow 1,000 medical cannabis patients and seek to assess the efficacy of medical cannabis on chronic pain, sleep and function.
“This is completely separate to recreational cannabis and what is happening on a recreational level has nothing to do with what is taking place on a medical level,” he noted. “With this large scale study, we hope to advance our understanding of the medical uses and efficacy of cannabis and guide the development of further clinical trials.”
Graduating from St. Michael’s College School in 1992 and the University of Western Ontario, Clarke obtained a Master’s in behavioural neuroscience, Doctor of Medicine and Doctor of Philosophy from the University of Toronto where he was a Royal College of Physicians of Canada Fellow in the anaesthesiology residency program.
The 2013 Baxter Corporation Research Award in Anaesthesia recipient and University of Toronto assistant professor was recently honoured with the Canadian Pain Society prestigious Early Career Award that recognizes outstanding achievement in pain research and/or management by an individual at an early stage of their career.
