Brain surgery while awake protects speech functions (video)

Life has a way of throwing a one-two punch. Fortunately, advanced medicine gives us the chance to get up off the mat — literally and figuratively for married couple Ryan and Amy Gamble.

Ryan and Amy had just opened their dream business: a martial arts studio in San Diego. It was a passion born from Ryan’s 28 years of training and competing in the sport. Top that off with their second child having recently arrived, and life was going in the right direction. A major health setback was the furthest thing from his mind.

“I’ve been active my whole life, never had any chronic health issues, and never dealt with anything but a cold,” says Ryan.

Yet, just a few days into being new business owners — and after the day’s last student had walked out the door — Ryan, then 34, felt something was wrong. Within seconds, he collapsed to the floor. Wife Amy, who had been a nurse at Sharp Grossmont Hospital and worked on the neuro and stroke units, immediately thought it might be a seizure or, perhaps, a stroke because of the difficulty he was having when trying to speak.

Ryan was quickly taken to the Emergency Room at Sharp Grossmont Hospital, where they determined he was having a seizure for the first time in his life. Imaging results showed that the seizure was caused by a brain tumor, which would require immediate surgery.

Surgery for a ‘southpaw’

In the ER, Ryan met Dr. Sunil Jeswani, a neurosurgeon with Sharp Community Medical Group and affiliated with Sharp Grossmont, who would map out a careful plan to remove the tumor, which presented challenges because of its location — and because Ryan is left-handed.

“Ryan’s tumor was located on the right side of Ryan’s brain, which is also the side where the speech centers are typically located for left-handed people,” says Dr. Jeswani. “This means the surgery had to be precise and delicate enough to not disrupt any parts of the brain that could have an effect on his speech long-term.”

Dr. Jeswani turned to a state-of-the-art answer to this dilemma. He would perform the surgery while Ryan was awake.

Awake brain surgery allows the surgeon and his team to monitor and protect brain functions while removing a tumor. With the help of a specialized test using a technology called magnetoencephalography (MEG), doctors can determine where things are located in the brain. In Ryan’s case, it turned out that his tumor and his speech center were very close to one another.

During the procedure, Dr. Jeswani and others on the surgical team could talk to Ryan, ensuring his speech was intact despite the delicate procedure taking place inside his brain.

Back to the mat

Swelling in his brain post-surgery, which is common, temporarily impacted his speech but was almost fully regained the following week. Several months of speech therapy improved his speech function even more, and he still continues to work on regaining other functions as well.

“Reading and writing isn’t quite there yet, but still heading in the right direction,” says Ryan. “Trying to get better with my four-year-old and learning to read with him is a fun experience.”

He’s back to teaching most of his classes and says he was recently even able to do spinning kicks.

Amy says they are grateful for the care they received and the team that cared for Ryan from the beginning through his rehab and recovery. “From the surgery center to the cancer center, everyone was just so nice and aware of what we were feeling and going through emotionally,” says Amy. “Each person radiated competence and compassion, which was incredibly reassuring. I was a nurse in the hospital for 10 years and always tried to give my patients this sense of peace. It was so nice to be on the receiving end.”

Ryan agrees. “I needed a surgery that very few hospitals can provide and not many surgeons can perform,” he says. “Dr. Jeswani and his team at Sharp are the reason I’m with my wife and kids today.”

Watch the video above to learn more about Ryan and his experience with awake brain surgery at Sharp Grossmont Hospital.