A Rare Case
In a rare case, doctors listened to Krishna Prasad Rao, the patient who shared his life story while performing a four-hour complex awake craniotomy or brain surgery while awake.
More excitement, emotion, and joy were felt in the operating room at Musaffah’s Lifecare Hospital than in any Bollywood blockbuster.
The Story of Rao
“In a village not far from Kathmandu, I was born. I’m from a very modest family, so it was a regular place. My grandfather’s face is the first thing I picture when I recall my early years. He showed me around a lot of places. In the operating room, the life story of Krishna Prasad Rao, a Nepalese expat living in Abu Dhabi, started to take shape.
While removing a brain tumour, doctors and nurses paid close attention to Rao, 38, as he passionately recounted his life’s accomplishments. In his closing remarks, he thanked the UAE for helping him realise his goals and allowing him to work as a manager at a fast-food restaurant in Abu Dhabi, even though he was a simple man from a poor village in Kathmandu.
The unusual “storytelling” happened during an awake craniotomy, performed after discovering a significant lesion in the left motor cortex and Broca’s area, the regions of the brain in charge of speech and movement. The doctor advised an awake craniotomy because the tumour was found in a functional part of the brain.
To keep a close eye on Rao’s brain functions throughout the procedure, the medical team suggested some tasks for him to complete. Rao told his life story, making the process memorable for the entire team.
Awake Craniotomies
Awake craniotomies are a rare type of surgery, according to Dr Veera Ravi Kumar, a specialist neurosurgeon at LLH Hospital in Musaffah.
He said that surgery on the speech and motor areas of the brain is complex. Due to the tumour’s critical location, in this case, removal under general anaesthesia could have resulted in long-term neurological deficits like hemiplegia (paralysis of one side) and aphasia (language difficulties). Thus, they chose to remove the tumour while awake and monitored by neurologists and using brain mapping, according to Dr Kumar, who spoke to the Khaleej Times.
The Doctor’s Experience
It was Dr Kumar’s first time hearing a life story like Rao’s during surgery, and it was very inspirational. Rao talked about his life experiences and how the UAE helped him achieve his goals. It was comforting. The medical team enjoyed learning how happiness can come from hardships.
“It Began With A Headache.”
Rao has lived in the UAE for 12 years, and in May, he first noticed that he was having trouble speaking smoothly. When Rao had difficulty speaking and started having headaches and seizures, he went to the doctor.
“I remember getting on the operating table,” Rao said. I was nervous, but I enjoyed telling my life story and didn’t notice the surgery. Everyone listened intently. My experience is comparable to that of other immigrants from low-income backgrounds.”
“UAE made many of my dreams come true and encouraged me to dream bigger. It was unexpected to have a chance to reflect on my life’s journey in a surgical setting.” Rao added, “the doctors and nurses questioned me several times, prompting me to elaborate and interact.”
Brain Mapping Done
As the patient’s cooperation is needed for this advanced surgery, the medical team evaluated Rao and decided he was a good candidate.
The doctors reassured Rao that the scalp blocks and anaesthesia would prevent pain. They told him the surgery would test his brain function. The anaesthesiologist helped Rao stay calm during the surgery.
Brain mapping can identify and monitor critical brain areas during surgery.
Dr Ratnakar said that if the patient has any change in speech or cognition, they can identify it and avoid the area that would compromise neurological function.
The surgeons used brain stimulation mapping during the procedure and diverted from their original plan when they encountered problems with speech or movement. The surgery was successfully finished after the tumour was removed. They could protect the vital brain fibres that pass through the area and stop damage.
Rao is doing well after the procedure, and his speech has already improved.