Collaboration among the best

Collaboration between Sunnybrook’s world-renowned Harquail Centre for Neuromodulation and ALS Clinic is giving David Hillyar hope for two neurological disorders at once

In retrospect, David Hillyar says he had an “awful lot” riding on one sip of water.

The 74-year-old father and grandfather had just emerged from a two-and-a-half hour stint in an MRI machine with a unique helmet affixed to his head, when his neurosurgeon asked him to take a drink of water.

That day at the Harquail Centre for Neuromodulation, David had received an innovative procedure developed at Sunnybrook to treat the tremors that had developed in his right hand using focused ultrasound, a non-invasive, image-guided surgical technology with the power to reach deep within the brain and target specific areas with pinpoint precision.

David didn’t feel any different after the procedure, nor was he particularly thirsty. But he had learned over the past few months that when someone at Sunnybrook asks you to do something, there’s a good chance something special is about to happen.

“Lo and behold, something special did happen,” says David. “I could slowly bring the glass up and take a sip – something that had become impossible to do. I had remembered telling the doctor, you’re ‘awfully confident’ when he asked me to give it a go – but it turns out, he was right.”

That critical moment was one of many David has experienced at Sunnybrook, where collaboration between high-performing teams at the world-renowned Harquail Centre and ALS Clinic is giving him a new lease on life.

It is rare to have both amyotrophic lateral sclerosis (ALS) and essential tremor. ALS is a progressive and incurable neurodegenerative disease that affects nerve cells in the brain and spinal cord, leading to muscle weakness and paralysis. Essential tremor is a neurological disorder that causes involuntary shaking, often in the hands.

While it is uncommon, it is the reality for David, who was diagnosed in March 2024 with ALS and not long after with essential tremor in both his hands.

Collaboration among the best

A mechanical designer by trade, David has made a five-decade career based on tinkering with objects in his daily life and fixating on their design.

But the essential tremor David developed had threatened that ability, and taken away his quality of life in the process. It made it next to impossible to complete his sketches for work and his beloved crossword and Sudoku puzzles, or grip a cup of tea – the latter, a daily joy, for the Brit who has called Canada home for half a century.

David says he has always counted on his own skilled hands to “find workarounds for problems.” So it’s fitting he found himself in the care of someone uniquely skilled with his hands, too: Dr. Agessandro Abrahao – the world’s first neurologist formally trained with a focused ultrasound fellowship.

There is no one else in the world quite like Dr. Abrahao, or Dr. Age as he is affectionately called by many patients.

Guided by his mentors – Dr. Lorne Zinman, Director of Sunnybrook’s ALS Clinic, and Dr. Nir Lipsman, Director of the Harquail Centre for Neuromodulation, Harquail Chair in Neuromodulation and the Chief of Sunnybrook’s Hurvitz Brain Sciences Program, Dr. Abrahao is harnessing the power of focused ultrasound and breaking barriers he never thought possible.

For David, Dr. Abrahao’s Collaboration among the best at Sunnybrook has made all the difference. Not only did Dr. Abrahao make the complex diagnosis of both David’s ALS and essential tremor, he ensured David was quickly enrolled into a promising new clinical trial for his ALS and innovative treatment for his essential tremor – both made possible thanks to donor generosity.

Trailblazing patient care

At the Harquail Centre, it was Dr. Lipsman who had offered David his first sip of water. Over the years, Dr. Lipsman and his team have gained attention across Canada and around the world for their trailblazing use of focused ultrasound for a range of brain disorders including cancer, Alzheimer’s disease, Parkinson’s disease, major depression, essential tremor and more.

Meanwhile at Sunnybrook’s ALS Clinic – the largest of its kind in Canada and among the largest in the world – David is now enrolled in a clinical trial where he is undergoing further non-invasive treatments with repetitive transcranial magnetic stimulation (rTMS) to reduce the “hyperexcitability” of motor neurons in the brain.

All thanks to Dr. Age

David is eternally grateful for the care he has received – and so inspired by the innovative technologies, treatments and trials funded by donors that he has decided to become a Sunnybrook donor himself.

That means enjoying the cottage he has built with his own two hands and the beautiful life he has made with his wife of 53 years Lesley, their children Matthew, Benjamin and Kate, and grandchildren.

David recently spent the day using his regained dexterity setting up a volleyball net for his six-year-old grandson, Wyatt, and while it took him a bit longer than it once would have, he loved every moment of it.

“At 74 years old, I know the road in front of me is getting shorter, and the road behind is getting longer, but that’s OK,” says David. “I treat every day as it comes. Obviously, with my diagnosis and what's going to happen – it's not going to be linear, and one day it's going to change. But fortunately, I'm still able to do many things.”

“It’s all thanks to Dr. Age.”