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The concept of getting mind surgical procedure whereas awake may appear wonderful sufficient — however one Florida man took it a step additional and performed the guitar whereas medical doctors eliminated his tumor.
The neurological group from the Sylvester Comprehensive Cancer Center on the University of Miami Miller School of Medicine wished the patient, Christian Nolen, to play notes on the instrument so they may consider and shield his guide dexterity whereas being as aggressive as doable in eradicating the tumor.
The surgeon and patient each spoke with Fox News Digital concerning the expertise.
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Nolen, who is an avid guitar participant, had a tumor on the best frontal lobe of his mind that was beginning to trigger signs.
“Christian was having issues with the left side of his body, particularly his left hand,” Ricardo Komotar, M.D., director of the mind tumor program at Sylvester, advised Fox News Digital through Zoom.
“He was noticing issues with his dexterity that affected his ability to play the guitar.”
The neurological group from the Sylvester Comprehensive Cancer Center on the University of Miami Miller School of Medicine requested Christian Nolen to play guitar during his surgical procedure in order that they may consider and shield his guide dexterity. (Sylvester Comprehensive Cancer Center on the University of Miami Miller School of Medicine)
Nolen wanted surgical procedure to substantiate the prognosis and decide the kind of tumor — as each tumor has totally different therapy choices, Komotar famous — and likewise to take away as a lot of it as doable.
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The surgical procedure was scheduled for 10 days after the tumor was found — and Nolen was shocked when the medical doctors requested if he’d be keen to stay awake and play the guitar for the process.
“When a tumor is involving or near a critical part of the brain — something that controls the ability to speak or understand language or move — we want to do the surgery awake to continually monitor the patient, so you know if you start to violate regular mind features,” Komotar stated.
Dr. Ricardo Komotar of Sylvester Comprehensive Cancer Center is director of the mind tumor program on the University of Miami Miller School of Medicine. (Sylvester Comprehensive Cancer Center on the University of Miami Miller School of Medicine)
When the patient is asleep, the physician stated, the surgical procedure group does not have the power to get suggestions.
“The surgeries actually become much more dangerous because you can take out a tumor that involves normal brain function and cause real harm without knowing it,” he stated.
Given the significance of guitar-playing in Nolen’s high quality of life, Komotar stated there was “no better way” to observe his guide dexterity and the impact of the tumor than to have him take up the instrument within the working room.
When the medical doctors posed the choice to Nolen, he stated that at the beginning it “didn’t seem real.”
“I’d only really heard of procedures of that nature being done in shows and movies,” he advised Fox News Digital in an e-mail. “I felt like it was such a unique experience that I couldn’t pass up — especially with my motor skills being on the line.”
He added, “The threat of being sedated for the complete process outweighed any worry or anxieties across the process itself.”
Given the significance of guitar-playing in Nolen’s high quality of life, his surgeon stated there was “no better way” to observe his guide dexterity and the impact of the tumor than to have him take up the instrument within the working room. (Sylvester Comprehensive Cancer Center on the University of Miami Miller School of Medicine)
Prior to the process, Nolen stated he was launched to members of the surgical group and was advised in-depth about what to anticipate.
The anesthesiology group put Nolen to sleep for the start of the open craniotomy, however he was woke up during a fragile a part of the two-hour process. Once he was oriented on what was occurring, the care group gave Nolen a guitar and requested him to play.
“Upon awakening, it was quite overwhelming to see everything around me and to fight the natural reaction to sit up,” Nolen recalled.
“I felt like it was such a unique experience that I couldn’t pass up — especially with my motor skills being on the line.”
After one of many members of the care group positioned a “reassuring hand” to stop Nolen from sitting up, he stated it took solely a second for him to recollect what was occurring.
“I just had to breathe and stay calm,” he stated.
During surgical procedure, he tried his greatest to play by a few of the songs he had been practising, together with tunes by artists just like the Deftones and System of a Down.
Nolen had a tumor on the best frontal lobe of his mind that was beginning to trigger signs. (Sylvester Comprehensive Cancer Center on the University of Miami Miller School of Medicine)
As the surgeons eliminated the tumor, they constantly monitored Nolen’s hand perform whereas he performed the guitar.
“As we were finishing the case at the very back of the tumor, we noticed that his hand function started to decline,” stated Komotar. “The tumor was touching and interfacing with the part of the brain that controls hand movement. Fortunately, we were able to remove the entire tumor and not injure his hand.”
“This is wild,” Nolen stated during the surgical procedure.
What to learn about awake procedures
While a patient enjoying guitar during surgical procedure is not an on a regular basis prevalence, Komotar advised Fox News Digital that he and the remainder of the specialised neurosurgical group carry out awake surgical procedures a number of instances every week, for a complete of a few hundred instances a yr.
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“Most patients are intrigued by the process,” he stated. “We tell them that they’re going to be able to speak and move their hands or limbs so we can constantly examine them.”
The medical doctors additionally reassure the sufferers that they gained’t really feel any ache, seemingly gained’t bear in mind the complete process, and can stay very comfy — “which is the result of our world-class neuroanesthesia team,” added Komotar.
Research has confirmed the advantages of doing procedures with awake anesthesia as a substitute of deep common anesthesia, the physician famous.
Prior to the process, Nolen was launched to members of the surgical group and was advised in-depth about what to anticipate. (Sylvester Comprehensive Cancer Center on the University of Miami Miller School of Medicine)
“Surgery with continuous neurological exam leads to better functional outcomes and fewer neurological deficits,” he stated.
There are additionally enhancements in discharge and restoration.
“The less anesthesia you use during your procedure, the better the patient wakes up,” he stated. “The faster they wake up, the sooner they are up and walking around, and the sooner they go home.”
Komotar added, “And inherently, the longer you’re in the hospital, the more complications you have.”
“Surgery with continuous neurological exam leads to better functional outcomes and fewer neurological deficits.”
Guitar-playing isn’t the one exercise that sufferers can do during an awake craniotomy.
Anything that doesn’t enhance stress within the head, akin to enjoying the violin, is honest sport, Komotar stated.
Some sufferers sing during mind surgical procedure, which permits the surgeon to observe their capability to kind and perceive phrases as they take away tumors in areas that contain language.
Before awake surgical procedures, the medical doctors reassure sufferers that they gained’t really feel any ache, seemingly gained’t bear in mind the complete process, and can stay very comfy. Nolen is proven at left; Dr. Ricardo Komotar is at proper. (Sylvester Comprehensive Cancer Center on the University of Miami Miller School of Medicine)
There are some dangers concerned with awake cranial surgical procedure, Komotar acknowledged.
“Seizures can definitely be worsened by doing awake surgery,” he advised Fox News Digital. “If someone has a history of seizures, we try to avoid electric brain stimulation, which is part of the technique.”
The largest threat of doing awake mind tumor elimination is that about 5% to 10% of sufferers don’t “tolerate” being woke up, Komotar stated.
“Even with world-class anesthesia, they might wake up either too startled or too in pain to be examined,” he stated. “They might be confused, agitated or unable to follow commands.”
If that occurs, the care group places the patient again to sleep and proceeds with a extra conservative tumor elimination.
“He went home the day after surgery. He says his quality of life is better than it’s ever been, so I think his recovery has been remarkable.”
Without having steady suggestions from the patient, the surgical group can’t be as aggressive with the tumor elimination, Komotar famous. “We only take out what we know is definitely safe, and we leave anything that’s questionable.”
The street to restoration
Nolen’s surgical procedure went easily and the complete tumor was eliminated.
“Christian did terrific,” Komotar stated. “He went home the day after surgery. He says his quality of life is better than it’s ever been, so I think his recovery has been remarkable.”
“The team at Sylvester Comprehensive Cancer Center in Miami has been very informative and has not left much to the imagination in the best way possible,” the patient stated. (Sylvester Comprehensive Cancer Center on the University of Miami Miller School of Medicine)
The first couple of weeks after surgical procedure had been somewhat powerful for Nolen, the patient stated, primarily because of post-surgery restrictions.
“The days were really dragging,” Nolen advised Fox News Digital. “However, with a strong support system, I’ve been able to focus on the positives.”
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He is now again to figuring out on the fitness center and enjoying the guitar, with important enchancment in his left hand.
“A case like this spotlights the value of multidisciplinary care.”
He’s awaiting the ultimate pathology outcomes, with follow-up therapy seemingly consisting of six weeks of radiation and chemotherapy.
Both Komotar and Nolen emphasised that the success of the surgical procedure hinged on the collaboration of the complete care group.
“The team at Sylvester Comprehensive Cancer Center in Miami has been very informative and has not left much to the imagination in the best way possible,” stated Nolen. “They have also provided me with quite a few programs for emotional support.”
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“A case like this spotlights the worth of multidisciplinary care,” added Komotar.
“It’s not possible to remove a tumor like this and get the patient home so quickly and in such good health without an entire comprehensive team — neuro anesthesiologists, great intensive care specialists, nurses, techs, great oncologists — all working together.”
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