Florida mind tumor affected person performs guitar throughout his surgical procedure: ‘That is wild’


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The concept of getting mind surgical procedure whereas awake may appear superb sufficient — however one Florida man took it a step additional and performed the guitar whereas medical doctors eliminated his tumor.

The neurological workforce from the Sylvester Complete Most cancers Heart on the College of Miami Miller Faculty of Drugs wished the affected person, Christian Nolen, to play notes on the instrument so they might consider and defend his handbook dexterity whereas being as aggressive as doable in eradicating the tumor.

The surgeon and affected person each spoke with Fox Information Digital in regards to the expertise.

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Nolen, who’s an avid guitar participant, had a tumor on the suitable frontal lobe of his mind that was beginning to trigger signs.

“Christian was having points with the left aspect of his physique, significantly his left hand,” Ricardo Komotar, M.D., director of the mind tumor program at Sylvester, advised Fox Information Digital by way of Zoom. 

“He was noticing points together with his dexterity that affected his potential to play the guitar.”

The neurological workforce from the Sylvester Complete Most cancers Heart on the College of Miami Miller Faculty of Drugs requested Christian Nolen to play guitar throughout his surgical procedure in order that they might consider and defend his handbook dexterity. (Sylvester Complete Most cancers Heart on the College of Miami Miller Faculty of Drugs)

Nolen wanted surgical procedure to substantiate the analysis and decide the kind of tumor — as each tumor has completely different therapy choices, Komotar famous — and in addition 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 close to a essential a part of the mind — one thing that controls the power to talk or perceive language or transfer — we wish to do the surgical procedure awake to repeatedly monitor the affected person, so you realize in the event you begin to violate regular mind capabilities,” Komotar mentioned.

Dr. Richardo Komotar

Dr. Ricardo Komotar of Sylvester Complete Most cancers Heart is director of the mind tumor program on the College of Miami Miller Faculty of Drugs. (Sylvester Complete Most cancers Heart on the College of Miami Miller Faculty of Drugs)

When the affected person is asleep, the physician mentioned, the surgical procedure workforce would not have the power to get suggestions.

“The surgical procedures really turn into way more harmful as a result of you possibly can take out a tumor that includes regular mind operate and trigger actual hurt with out understanding it,” he mentioned.

Given the significance of guitar-playing in Nolen’s high quality of life, Komotar mentioned there was “no higher approach” to watch his handbook dexterity and the impact of the tumor than to have him take up the instrument within the working room. 

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When the medical doctors posed the choice to Nolen, he mentioned that at the beginning it “didn’t appear actual.”

“I’d solely actually heard of procedures of that nature being achieved in reveals and flicks,” he advised Fox Information Digital in an e-mail. “I felt prefer it was such a singular expertise that I couldn’t cross up — particularly with my motor expertise being on the road.”

He added, “The chance of being sedated for the complete process outweighed any worry or anxieties across the process itself.”

Christian Nolen playing guitar

Given the significance of guitar-playing in Nolen’s high quality of life, his surgeon mentioned there was “no higher approach” to watch his handbook dexterity and the impact of the tumor than to have him take up the instrument within the working room.  (Sylvester Complete Most cancers Heart on the College of Miami Miller Faculty of Drugs)

Previous to the process, Nolen mentioned he was launched to members of the surgical workforce and was advised in-depth about what to anticipate. 

The anesthesiology workforce put Nolen to sleep for the start of the open craniotomy, however he was woke up throughout a fragile a part of the two-hour process. As soon as he was oriented on what was occurring, the care workforce gave Nolen a guitar and requested him to play.

“Upon awakening, it was fairly overwhelming to see the whole lot round me and to combat the pure response to sit down up,” Nolen recalled. 

“I felt prefer it was such a singular expertise that I couldn’t cross up — particularly with my motor expertise being on the road.”

After one of many members of the care workforce positioned a “reassuring hand” to stop Nolen from sitting up, he mentioned it took solely a second for him to recollect what was occurring.

“I simply needed to breathe and keep calm,” he mentioned.

Throughout surgical procedure, he tried his greatest to play by means of a number of the songs he had been working towards, together with tunes by artists just like the Deftones and System of a Down.

Christian Nolen's brain scans

Nolen had a tumor on the suitable frontal lobe of his mind that was beginning to trigger signs. (Sylvester Complete Most cancers Heart on the College of Miami Miller Faculty of Drugs)

Because the surgeons eliminated the tumor, they repeatedly monitored Nolen’s hand operate whereas he performed the guitar.

“As we have been ending the case on the very again of the tumor, we seen that his hand operate began to say no,” mentioned Komotar. “The tumor was touching and interfacing with the a part of the mind that controls hand motion. Luckily, we have been capable of take away the complete tumor and never injure his hand.”

“That is wild,” Nolen mentioned in the course of the surgical procedure.

What to find out about awake procedures

Whereas a affected person taking part in guitar throughout surgical procedure isn’t an on a regular basis incidence, Komotar advised Fox Information Digital that he and the remainder of the specialised neurosurgical workforce carry out awake surgical procedures a number of instances per week, for a complete of a few hundred instances a 12 months. 

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“Most sufferers are intrigued by the method,” he mentioned. “We inform them that they’re going to have the ability to communicate and transfer their palms or limbs so we are able to always look at them.”

The medical doctors additionally reassure the sufferers that they received’t really feel any ache, doubtless received’t keep in mind the complete process, and can stay very snug — “which is the results of our world-class neuroanesthesia workforce,” added Komotar.

Analysis has confirmed the advantages of doing procedures with awake anesthesia as an alternative of deep common anesthesia, the physician famous.

Dr. Komotar with patient

Previous to the process, Nolen was launched to members of the surgical workforce and was advised in-depth about what to anticipate. (Sylvester Complete Most cancers Heart on the College of Miami Miller Faculty of Drugs)

“Surgical procedure with steady neurological examination results in higher purposeful outcomes and fewer neurological deficits,” he mentioned. 

There are additionally enhancements in discharge and restoration.

“The much less anesthesia you employ throughout your process, the higher the affected person wakes up,” he mentioned. “The quicker they get up, the earlier they’re up and strolling round, and the earlier they go house.”

Komotar added, “And inherently, the longer you are within the hospital, the extra problems you’ve got.”

“Surgical procedure with steady neurological examination results in higher purposeful outcomes and fewer neurological deficits.”

Guitar-playing isn’t the one exercise that sufferers can do throughout an awake craniotomy. 

Something that doesn’t enhance stress within the head, akin to taking part in the violin, is truthful sport, Komotar mentioned. 

Some sufferers sing throughout mind surgical procedure, which permits the surgeon to watch their potential to type and perceive phrases as they take away tumors in areas that contain language.

Doctor with patient and family

Earlier than awake surgical procedures, the medical doctors reassure sufferers that they received’t really feel any ache, doubtless received’t keep in mind the complete process, and can stay very snug. Nolen is proven at left; Dr. Ricardo Komotar is at proper.  (Sylvester Complete Most cancers Heart on the College of Miami Miller Faculty of Drugs)

There are some dangers concerned with awake cranial surgical procedure, Komotar acknowledged.

“Seizures can undoubtedly be worsened by doing awake surgical procedure,” he advised Fox Information Digital. “If somebody has a historical past of seizures, we attempt to keep away from electrical mind stimulation, which is a part of the approach.”

The most important danger of doing awake mind tumor elimination is that about 5% to 10% of sufferers don’t “tolerate” being woke up, Komotar mentioned. 

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“Even with world-class anesthesia, they may get up both too startled or too in ache to be examined,” he mentioned. “They may be confused, agitated or unable to observe instructions.”

If that occurs, the care workforce places the affected person again to sleep and proceeds with a extra conservative tumor elimination. 

“He went house the day after surgical procedure. He says his high quality of life is healthier than it is ever been, so I feel his restoration has been exceptional.”

With out having steady suggestions from the affected person, the surgical workforce can’t be as aggressive with the tumor elimination, Komotar famous. “We solely take out what we all know is certainly secure, and we go away something that is questionable.”

The highway to restoration

Nolen’s surgical procedure went easily and the complete tumor was eliminated.

“Christian did terrific,” Komotar mentioned. “He went house the day after surgical procedure. He says his high quality of life is healthier than it is ever been, so I feel his restoration has been exceptional.”

Sylvester Cancer Center

“The workforce at Sylvester Complete Most cancers Heart in Miami has been very informative and has not left a lot to the creativeness in the easiest way doable,” the affected person mentioned. (Sylvester Complete Most cancers Heart on the College of Miami Miller Faculty of Drugs)

The primary couple of weeks after surgical procedure have been a bit of robust for Nolen, the affected person mentioned, primarily resulting from post-surgery restrictions. 

“The times have been actually dragging,” Nolen advised Fox Information Digital. “Nonetheless, with a powerful help system, I’ve been capable of deal with the positives.”

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He’s now again to figuring out on the health club and taking part in the guitar, with vital enchancment in his left hand.

“A case like this spotlights the worth of multidisciplinary care.”

He is awaiting the ultimate pathology outcomes, with follow-up therapy doubtless consisting of six weeks of radiation and chemotherapy.

Each Komotar and Nolen emphasised that the success of the surgical procedure hinged on the collaboration of the complete care workforce.

“The workforce at Sylvester Complete Most cancers Heart in Miami has been very informative and has not left a lot to the creativeness in the easiest way doable,” mentioned Nolen. “They’ve additionally supplied me with fairly just a few applications for emotional help.”

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“A case like this spotlights the worth of multidisciplinary care,” added Komotar. 

“It is not doable to take away a tumor like this and get the affected person house so rapidly and in such good well being with out a whole complete workforce — neuro anesthesiologists, nice intensive care specialists, nurses, techs, nice oncologists — all working collectively.”

For extra Well being articles, go to www.foxnews.com/well being.



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