Day 4300: Awake Surgery and Things to See.

   

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Patient Awake, Plays Guitar During Surgery

Awake Craniotomy. video, here

All surgeries are serious, but brain surgeries are particularly delicate. Among other things, the patient's abilities to speak and move are at stake. That's why, in many cases, the person is kept awake so doctors can best evaluate and protect their dexterity. For one man named Christian Nolen, things went a step further. Knowing he was a talented guitarist, his doctors requested him to play his instrument on the operating table.

Ten days after a brain tumor was discovered, Nolen underwent surgery at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. The musician was put to sleep at the beginning of the open craniotomy, and was deliberately woken up halfway through. “Our plan going into the surgery was that he would be awake and playing the guitar while we were taking out the tumor,” explained brain and tumor neurosurgeon Ricardo Komotar, M.D. “We’d be examining him to be sure we weren’t injuring the part that controls hand movement, and the testing of hand movement would be done by him playing the guit

Nolen had only heard about such procedures in movies and television shows. But having played guitar since he was 13, he couldn't pass up the opportunity. Doctors talked to him about the procedure before the surgery, preparing him for what was to come; but, when he woke up, Nolen was taken aback. “Upon awakening, it was quite overwhelming to see everything around me and to fight the natural reaction to sit up,” he said.

Luckily, after being handed a guitar, Nolen was ready to do his part during the procedure. He chose to perform some Deftones songs and his guitar playing ended up being key to protecting his brain. “As we were finishing the case at the very back of the tumor, we noticed that his hand function started to decline,” added Dr. 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.”

In addition to safeguarding one's mobility, an awake surgery has other benefits for patients. “It’s shown to improve outcomes, in terms of lower complication rates,” explains Dr. Arman Dagal, chief of Neuroanesthesiology and Perioperative Neurosciences. “Also, patients stay in the hospital for a shorter period of time, and they require less-invasive postoperative monitoring because when they go to the ICU, they’re fully awake, and we can communicate with them.”

Nolen still has some weeks of treatment ahead of him, but it is reported that he has resumed his active lifestyle. Having passed his dexterity tests, he's back to playing his beloved guitar on his own terms.

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