Abu Dhabi: Patient tells doctors how UAE fulfilled his dreams during 4-hr-long awake brain surgery

Expat Krishna Prasad Rao told doctors his life's story while undergoing an extremely rare procedure



by

Ashwani Kumar

Published: Thu 27 Oct 2022, 10:45 AM

Last updated: Thu 27 Oct 2022, 2:31 PM

In a rarest-of-rare instance, doctors listened to a patient tell his life story during a four-hour-long complex awake craniotomy, or brain surgery while awake.

The operation theatre in Lifecare Hospital, Musaffah, witnessed more thrills and frills, emotions and joy than any Bollywood potboiler.

"I was born in a village near Kathmandu. It was an ordinary place, and I come from a very humble family. When thinking about my childhood, my grandfather's face always comes to my mind. He took me to a lot of places…."

This is how the life story of Krishna Prasad Rao, an Abu Dhabi-based expat from Nepal, unfolded inside the operation theatre. Doctors and nurses, while removing a tumour from his brain, were listening to Rao carefully as the 38-year-old passionately shared his life's success story. He finished his story by thanking the UAE for fulfilling his dreams and providing an opportunity for a simple man from a backward village in Kathmandu to become a manager at a fast-food chain in Abu Dhabi.

The unique 'storytelling' was part of awake craniotomy, performed after diagnosing a large lesion in the left motor cortex and Broca's area – the parts of the brain responsible for speech and motor skills. As the tumour was located in a functional area of the brain, the doctor recommended an awake craniotomy.

The medical team wanted to constantly communicate with Rao throughout the procedure to keep a close look at his brain's functions, and they suggested some tasks for him. Rao chose to tell a story, a task that made the procedure a unique experience for the team as well.

According to Dr Veera Ravi Kumar, a specialist neurosurgeon at LLH Hospital, Musaffah, awake craniotomies are rare.

"It is challenging to operate on the speech and motor area of the brain. In this case, as the tumour was located in such a critical area, removing it under general anaesthesia could have caused permanent neurological deficits, like hemiplegia (paralysis of one side) and aphasia (language difficulties). So, we decided to perform awake brain surgery under neuromonitoring and brain mapping to excise the tumour," Dr Kumar told Khaleej Times.

"Krishna Prasad's life story was very inspiring and listening to such a story during the surgery was a first-time experience for me. He shared his life experiences and how the UAE contributed to his dreams. It was heart-warming. Hearing how struggles lead to happiness made our day."

'It started with a headache'

Rao, who has been living in the UAE for 12 years, first noticed he was having trouble speaking fluently in May. When headaches followed by seizures accompanied the difficulties with his speech, Rao decided to seek medical attention.

He visited Dr Kumar, who conducted investigations that revealed a large lesion. The surgery took place at Lifecare Hospital. It was led by Dr Kumar from LLH Hospital and V Ratnakar, anothe specialist neurosurgeon from Lifecare Hospital. Dr Bhavesh Kumar, a specialist anaesthetist, headed the anaesthesia team.

"I remember getting onto the operating table. I was a little scared, but once the procedure started, I felt comfortable. It was as if I didn't know the surgery was going on. I was happy to share my life story. Everyone listened carefully. My story is similar to other expats who come from a humble background."

"I hail from a small village and used to walk three kilometres to school. I was looking to earn more and improve my lifestyle. Coming to the UAE was a turning point in my life. A man from a backward village is today a manager."

"This country fulfilled many of my dreams and inspired me to dream further. Getting an opportunity to recall my life journey in an operation theatre was unexpected. Doctors and nurses asked me several questions, which made me go into detail and engage," Rao recalled.

Brain mapping done

As the patient's cooperation is a prerequisite during such cutting-edge surgery, the medical team assessed Rao and found him to be a good candidate for the procedure.

The doctors put his mind at ease by reassuring Rao that he wouldn't feel any pain due to the scalp blocks and anaesthesia. They explained to him how the surgery would allow them to test his brain function. With the anaesthesiologist's support, Rao remained calm and free of anxiety during the surgery.

Through brain mapping, the important areas of the brain could be identified and monitored during a surgical procedure.

"When we stimulate an area and the patient has the slightest change in speech or cognition, we can identify it and steer clear of the area that would compromise the patient's neurological function," said Dr Ratnakar.

During the surgery, the doctors performed stimulation mapping of the brain and changed the path of the procedure upon noticing speech or movement disturbances. They removed the tumour and successfully completed the surgery. They could preserve the critical fibres of the brain passing through the area and prevent damage.

Rao is recovering well from the procedure and has found immediate improvements in his speech.

"I feel very happy. I can speak better. My family visits me every day. They are happy to see me doing well. I look forward to recovering completely and getting back to work," Rao said, adding that he is grateful to the doctors who gave him the confidence to undergo such a daunting procedure.

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