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Awake Craniotomy


Awake brain surgery, also called awake craniotomy, is a type of procedure performed on the brain while you are awake and alert. Awake brain surgery is used to treat some brain (neurological) conditions, including some brain tumors or epileptic seizures.
If your tumor or the area of your brain where your seizures occur (epileptic focus) is near the parts of your brain that control vision, movement or speech, you may need to be awake during surgery. Your surgeon may ask you questions and monitor the activity in your brain as you respond.

Very impressive if you ask me.

In my first consultation with the incredible Mr Dunfold (Neurosurgeon) where we discussed my diagnosis, he explained that if we opted for surgery, they would perform an awake craniotomy and advised me to watch a YouTube video to explain the prceedure.

This isn't the one I watched but I've chosen one that's not thats not so graphic.

So following a pre op MRI and a neuropsychological assesmemt on the Thursday, I was told that my surgery would be on the following Monday.

I don't scare easily but it certainly caused a bit of anxiety. Not because of what they were going to do to me but because I have a young family.

Regardless of how confident the medical teams were about my procedure, there was always that

What if

Rattling around in my thoughts.

The Neuropsychological assesmemt is a series of tests and questions that basically give the teams an understanding of the normal function of your brain. Your level of grammar, mathematics and image recognition. It's not a pass/ fail test.

It felt a bit like the bit in James Bond, Skyfall when he does a psych analysis to determine if he's fit to come back to work and save the world.

I wasn't quite as smug as Mr Bond but it was about 1.5hr of just questions.

I knew what it was for so stuck with it.

And that was it for the weekend.

I had an event to host with my team over the weekend which would completly distract us from what was coming. After a bit of staff managment, i had the right staff in the right place, and the event went without hitch.

Minimum stress maximum results.

Monday April 3rd 2023. 0715hrs. Sitting in the waiting room in the D NEURO department, it was a case of just sit and wait to see where on the list for surgery you were. It was a very somber environment.

People from all walks of life waiting for similar procedures. Just waiting and waiting.

One poor guy was sat for so long that when they finally called his name, he got up and just collapse on the floor.

I jumped to assist and between me and nurse (Edd) we helped the guy to a bed and got him settled. I'm sure if the guy had got up to stretch his legs now and again he would have been fine.

Then there was the lady who had sat there for 6 hours waiting just to be told that due to her high blood pressure her surgery was cancelled. I shed a tear for her. The look on her face said so much.

A quick debrief from my Lady surgeon (Dr Roach) and I was invited to take a bed on the ward.

This was it. 7 months of waiting in complete limbo was up. With instructions to the nurses to stay in contact with Carol they began to prep me for surgery.

I wasn't scared at all by this stage. I think sometimes in life you just need to accept that certain things are way above your pay grade and you just need to trust the people around you.

And we were off. Wheeled off to the operating theatre and met by the anesthesia team. They talked me through what they would be doing throughout the procedure. Basically they will be bringing me in and out of different levels of consciousness at different stages of the op.

My first injection was like the best night out all in one little syringe. Soooo chilled.

Now I think the world could blow up or someone could cut a hole in my head and I wouldn't have cared.

The next four hours we probably the strangest four hours of my life so far. Being awake while having your brain operated on isn't unpleasant and in a very odd way, I enjoyed the process. KIZZY the psychologist was talking away to me throughout the whole thing repeating tests and monitoring how I was reacting to the surgery.

They knew I was a keen runner and there was so much emphasis on my leg movements. I had to report when I felt different or when I was twitching.

I talked a lot about running and the benifits to both mental and physical health.

They assured me it was all quite funny but I'm sure they were just being their very sweet selves.

My last memory of the surgery was a massive twitching fit of my right leg and that's the point they decided to stop.

Off I went to sleep 😴 to be slowly woken up in the recovery ward. I have never felt so hungry

They couldn't bring biscuits quick enough, all washed down with the nicest tasting coffee ever.

I run on coffee don't you know.

Back to the ward where Carol was waiting for a very long awaited hug. The strain in her face was very clear but we talked and reasured each other that all was going to be fine.

Zero sleep that night as I kept demanding coffee. Edd the nurse from the day before was on duty and had to carry out observations every 30 minutes so ordering a fresh coffee was easy.

One thing that was becoming apparent through the night was the lack of sensation in the right side of my body. Completly numb from the armpit down. I decided not to worry too much about it for now and discuss things with Dr Roach in the morning.

Good morning Mark. How are you feeling?

I must have dosed off a bit as I was woken by Kizzy, Beth and Sam. The psychology team from the op. It was lovely to see them if not little emotional. We had a bit of a chat and a few laughs and off they went. Such lovely ladies.

Dr Roach was next with her colleague whose name I just can't remember. The first thing they said was.

You will in time be able to run and it should not effect you coordination or balance.

The numbness, I have been assured will mostly pass and I will learn to live with whats left but two weeks on and there is no change. I can walk about fine but really have to think hard about where I put my foot.

It's like the feeling you get just after pins and needles. You know your leg is there but have no idea what to do with it. I'm sure it's early days and things will improve.

So home within 24 hours of my surgery and getting on with life. I can't really do a lot at the moment as fatigue is a major factor so just chilling and recovering and planning mad goals for the future.

Stitches out and healing nicely.

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