Wednesday, June 9, 2010

The Partially Awake Craniotomy

Ok, here it is, the story of my first brain surgery.

On Tuesday, April 27th at 4:30am my family squished together in my dad's truck on our way to UW for my 5:00am appointment for surgery. I sat between my parents, and in the back seat Jessica Abu Dhabi was sandwiched between Kaal and Danny. We knew where we were headed, but we had no idea how intense the journey would be.

Along the drive I joked with my dad that he was torturing with me with his coffee. I had been on the no-liquid or food diet from midnight on due to the surgery restrictions. I LOVE black coffee, thick as mud, just the way my dad makes it, and I was really wishing I could steal his cup. I could see that my mom was nervous, and there was definitely strained humor along the car ride as we tried to joke around. It was almost as if everyone was trying to pretend that we weren't headed to the UW, that maybe we were heading to the airport for a family vacation. I remember thinking that I was caught between two different worlds, excitement for my surgery because I was going to be awake while having doctors work on my exposed brain, and the other world of the unknown.

Once we arrived at the surgery pavilion at the UW, I checked in and we sat for a few moments before I was whisked away to surgery prep. When I changed into the hospital gown, and the assistant shaved the areas of my skull I got even more excited for the next leg of my journey. Next, they placed electrodes (don't know if "electrode" is the proper term, but I'm just going to use it anyway because I think you get my point) around my head and drew circles via marker around each one of them to mark the proper locations for the mapping (thanks for that! It took weeks to remove the permanent marker!). The computer calculates the location of the incision, but the electrodes are placed by hand. Below is a photo of me with the computer electrode thingies all over my head. My pre-op nurse Daisy, was pretty angry at the assistant for doing such a crappy job of shaving my head (you can see in the 2nd photo the shaved hair on my pillow). She basically kicked him out of our room because she knew (I was clueless) that I would have to be in the same gown for a few days and all that hair would itch like crazy. Gotta love nurses, they really take care of you! That's Daisy's hand cleaning me up in the top photo.

After a quick consultation with my anesthesiologist, my family quickly came back in to say goodbye I was headed out the door for surgery.

Once I was wheeled into the operating room, I remember saying hello to my smiling surgeons, and the technicians from my consultation from the previous week, and seeing about a dozen other faces that I didn't recognize, but they were all really kind. I remember feeling completely comfortable, despite the cool temperature. They gave me a run-through of what I should expect and before I knew it my mouth was covered with what looked like an oxygen mask and someone was counting down.

The next thing remember, I was laying on my right side on the operating table as I heard someone calling for me, "Jessica?" The anesthesiologist was right, once I woke up I didn't feel groggy at all. I was completely awake, and ready to go. I had been waiting for this moment, anticipating this portion of the surgery like a test. I was ready to do everything I could to aid the surgeons. To keep the mood light, we had some small talk and joked around a little bit and they told me that they were going to go through a sample of images on the computer screen and I was supposed to name the image (for example if it's an image of an apple, say "apple"), while they stimulated different locations in my brain.

As the image series was conducted, they were probing my gray matter to discriminate between healthy gray matter and tumor matter. Throughout the image series, as I was naming the images, every once in awhile my body would involuntarily jerk. I remember at one point, my torso spasmed, and I said to the surgeons, "Oops, guess I need THAT section!" They laughed, and said something along the lines of, "Don't worry, we'll keep that."

When they were done with my image series I said a variation of, "Thanks guys, that was really fun!" And I went back to sleep with the help of the anesthesiologist. For the remainder of the surgery while I was asleep, the surgeons weeded out the groups of tumor cells as best they could. It's impossible to remove the bad cells. In the size of the tip of a pin is a million cells. As you can imagine, it's impossible to differentiate between every single cell, or even small groupings of cells. Also, there is no visual difference between tumor cells and brain cells only a difference in density so they used an ultrasound machine to discriminate between the unhealthy and healthy sections. As one of the UW neurosurgeons explained to my family and me, the tumor cells in my brain are like a bucket that has had a handful of sand tossed into it. Although most of the sand is concentrated in one location, there's sand all throughout the water.

The next thing I remembered I was awake and a little hazy. I vaguely remember smiling at the surgeons as I was being wheeled out the door and I gave them two thumbs-up signs (which was later confirmed by the Chief Neurosurgeon when he spoke to my family and friends in the waiting room - it's almost too cheesy, right?! A double thumbs-up?? I've never been good at playing it cool. One thumbs-up sign would have sufficed). At that point I remember feeling exhausted, but at peace. Little did I know what was in store for the next 24 hours. I thought I had made it through the hard part, but the really frighting reality was my continued mental deterioration and the emergency surgery the next day. I had no idea it wasn't ALL just fun and games as I had been hoping.


  1. You continue to take us all on this journey with you with your descriptive narratives. Your ability to tell this story with vivid details sure indicates that you are processing and progressing!!! Just know that you get two thumbs up (and big toes too if that counts)for your spirit, compassion, drive, humor, beauty, positive attitude.... Thank you for showing us your amazing strength. We continue to keep you all in our prayers. Eatons

  2. I'm sitting here (at work right now) with tears in my eyes reading this. It's kind of like going back to ground zero. Smashing into that wall called reality. Now that all of that really scary part is in the past it is so easy to push and push so hard at the better future. But this is what happened to you only weeks ago. Wow, Jess. You are so brave and amazing. Thanks for sharing and giving me the chance to kind of be there, too. And to relive this experience that is still hard to believe really happened. Love you , think about you always, want to stop in and drop off a gift and snag a hug . . . Let me know whenever you're ready!! :)

  3. Wow! Thanks for the post! You are an amazing writer! So do a great job of being so descriptive....I feel as if I was right there through it all
    You are doing a great job at recovering!

  4. Hi Jessica- I live in Southern California and have been following your blog from the beginning! I found it in The San Juan Islander as I check it every week due to the fact that my Mother lived in Friday Harbor as a young girl. My thoughts and prayers have been with you throughout your journey! You are a beautiful young lady (I'm 61 years old) and so brave and creative! Out of every challenge something good comes and I really think writing is your calling! Thank you for giving me another reason to look forward to, and be thankful for, every day!!! Be Blessed!

  5. You are amazing, beautiful, creative and brave. Thank you for writing this blog.

  6. Stumbled upon your page(picture) as I was searching for some kind of scalp skin condition I seem to totally random post, but just had to comment! You have such talent as a writer, you sucked me right into your story=) U are extremely brave and funny. Chin up girl! You are defiantly gonna be someone! I'll be keeping an eye out for your book ;)



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