A woman who underwent a highly specialised brain operation while she was awake, has thanked the team at NHS Greater Glasgow and Clyde who cared for her – and singled out one member of staff who was “like a second mum” to her throughout the process.
Earlier this summer Brooke MacFadyen, 24, from Coatbridge in Lanarkshire, underwent Awake Craniotomy, a procedure used to remove primary brain tumours.
The goal of the surgery is to remove as much tumour tissue as possible while minimising risk of complications or longer-term effects on motor control and cognitive functions, and to do that Brooke was kept conscious during key parts of the surgery, to help ensure the procedure was going to plan.
Traditionally, clinicians rely on very simple, bedside type tests to gauge a patient’s cognitive ability and to monitor for any emerging deficits from the surgery, allowing the surgical plan to be modified to compensate.
However, these tests often lack standardisation and sophistication, and as a result NHSGGC teams have been the first in Scotland to pioneer a different approach.
Teams at the Institute for Neurological Sciences have been using a new system called NeuroMapper – a digital platform that allows monitoring across a wider range of functions such as language, attention, working memory, visuospatial, and executive functions, during the awake stage of the surgery.
The result has been a better experience for patients and more accurate, more consistent data leading to improved outcomes for patients.
Brooke needed to wait a number of weeks after her operation to find out how serious the tumour was, but she has just been given the positive news that she and her family have been waiting for.
She said: “I will be getting looked after with some future treatment to prevent the tumour coming back, but basically I can look forward now with real confidence.”
Brooke’s tumour was discovered earlier this year after she went to her GP following a seizure.
“When I heard about the awake craniotomy, it took me a couple of weeks to get over the shock, but then I decided ‘I’m going to do this’.”
Brooke said the run-up to the operation was difficult, with a lot of ‘what-ifs’ circling in her head, but she said that the support she received from the entire NHSGGC team was critical to her, and her whole family – mum Kelly, dad Graham, brothers Harry and Jack, boyfriend Dillon, and best friend Robyn.
Kelly agreed: “It was such a worrying time – I mean, my daughter needed brain surgery – but I’m so grateful for the preparation we got, not just Brooke but the whole family.
“They supported her so well, and the fact they included us – well I’ll always appreciate that.”
The operation itself took more than seven hours, and during the entire procedure Dr Sharon Mulhern, Consultant Clinical Psychologist and Lead for Regional Neuropsychology Services, was there to support her, holding her hand and keeping her calm during the awake phase of the procedure.
“I’ll never forget Sharon,” Brooke said. “She’s been amazing throughout this whole process, and I have such a clear memory of seeing her there with me during the operation.
“I’d like to thank the whole team for looking after me, but especially Sharon – in fact she was like a second mum to me.”
During the operation, Dr Mulhern and Speech and Language Therapist Jen Bowers operated the NeuroMapper and worked with the rest of the theatre team to gauge Brooke’s reactions and ensure the procedure was going to plan.
In Brooke’s case, the procedure was a success – and it has left her looking forward to life with a new confidence and focus.
“Strangely it’s been a really positive experience. I’ve been through life-changing surgery and now feel completely different.
“Before I doubted myself so much – I’d get into my own head with things, talk myself out of things. But not now – I now know I’m a really strong person, and super-independent.
“Making this decision – something I was so scared of – I’m going to use it as a positive from now on.
“I’ve already booked a holiday to Tenerife with Robyn, and this experience has made it so clear to me that I want to follow my dream to work with children.
“I’ve decided I want to be a primary school teacher. I don’t know when – and I’ll need to get a qualification in maths first – but I’m determined to get there.”
She added: “All I’d like to say is thank you – I’d like to thank every single one of them for everything they’ve done. From the doctors to the cleaners and the nurses on the ward, they are all special people to be able to do what they do – l’ll never forget what you’ve done for me.”
Mum Kelly agreed: “How do you ever repay people like these? They say they were just doing their job, but they did so much more than that.
“It’s been such a rollercoaster for us – from all the worry, to the joy of Brooke getting through the operation – and the team was fantastic all the way through. We’re just so grateful to them and everything they’ve done.
“The NHS gets such a bad rap – it’s sometimes an easy target – but our experience just shows how amazing they all are.”
Dr Mulhern admitted she was touched by Brooke’s good wishes. She said: “I’d like to thank Brooke and her family for their kind words. We really are here just to do our best for our patients, but it’s particularly lovely to hear that the care we provide is appreciated so much.
“Awake Craniotomy is a highly specialised procedure often working to extremely fine margins. It’s early days, but NeuroMapper has real potential to be a revolution in intra-operative brain mapping, bringing real benefits for the surgical team, for the patient – and for longer-term outcomes.”
Consultant Neurosurgeon Mr Likhith Alakandy, who carried out Brooke’s operation, said, “I have found NeuroMapper to be a great addition to awake craniotomies. It provides an accurate and objective assessment of patients’ language and cognitive abilities, comparing it to their pre-operative function.
“By providing constant feedback, it allows the surgeon to push boundaries of tumour removal while preserving important neurological and cognitive function. Maximising tumour removal is known to improve survival in patients with intrinsic brain tumour, so it helps provide a better outcome in these patients.”
Moving forward, the team at the INS will carefully monitor the efficacy of the Neuromapper platform and collate data on the feasibility and success of this approach. They are also involved in a research project examining how patients cope with awake surgery.
