Although we are optimistic that Jim’s tumor is a low grade, in the brain, even low threat tumors can be dangerous because of the location. Unfortunately, this tumor is located near several important areas of the brain, including those responsible for speech and memory. So, the neurosurgeon must be careful to not cut or remove healthy brain that could impact the patients’ functioning. Our neurosurgeon believes the best way to do this is to keep Jim awake during the surgery. While the neurosurgeon opens the brain, the neuroanesthesiologist will sedate Jim so he will not feel any pain. Then the anesthesiologist will wake Jim and a speech pathologist will ask him questions to help the neurosurgeon determine the functional areas in the region of the tumor. The neurosurgeon will mark the boundaries so he knows where to cut and where not to cut. This process will not be painful. Then the anesthesiologist will put Jim back “under” while the neurosurgeon works to remove as much of the tumor as possible, while keeping Jim safe. They will wake him periodically for additional checks.
The surgery is estimated to last 8 hours. Jim will spend much of it sedated and will get a drug that will make him forget the whole experience. So, the neurosurgeon explained that the 8 hours will seem like 10 minutes to Jim…although he acknowledged it will seem like 2 ½ days to me!
Let’s not kid ourselves…this is brain surgery, and it comes with risks, some of which are pretty scary. The awake surgery should minimize many of them. Having the procedure done by a Top Doc using the best available technology should reduce them further. We’ll rely on prayers and luck for the little bit of risk that remains.
Our very own “McDreamy” (Grey’s Anatomy reference) does awake brain surgery at least once a week; he does more than probably anyone in the DC area. While scary for all of us, this is “where he lives”…this surgery is routine for him. He talks and jokes with patients during surgery and will keep Jim as comfortable as possible. He promised to treat Jim like his brother—and then he reassured us that he likes his brother! We have tremendous confidence in him and (most of the time) feel confident about the surgery.
Simple guide to awake brain surgery: