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00:00in the heart of liverpool okay let's go is an operating theater like no other
00:09doctors are the pinnacle of their profession ah big nest of vipers that's all totally abnormal
00:20fight to save lives are you all right buddy a bit of pain there yes down my face in neurosurgeon
00:28being able to change lives for the better there's no other job that i'd rather be doing it's high
00:34stakes surgery this is amazing i've not seen anything like this before ready steady go if
00:40you cause an injury to the brain or the spinal cord you can't repair it that's it forever using
00:46groundbreaking technology making life or death decisions oh yes a sea of blood if we don't do
00:55anything should die he needs to wake up i think it's gone well it feels really good i love it when
01:02a pond comes together this is trauma room one
01:17the walton center in liverpool
01:19carries out some of the country's most complex and high-risk brain surgeries
01:3147 year old david needs an urgent operation
01:37what brought me here was i i i went numb down the right side of my face and i thought that can't be
01:43good so i took myself off the way and they did a brain scan on me said unfortunately we found a
01:49lesion in your brain we think it's a tumor
02:00the hospital treats around 500 brain tumor patients each year
02:04david's tumor needs to be removed immediately
02:13how comfortable are you like that uh yeah no more i think that that won't come for you
02:20consultant neurosurgeon mr farooq olabaju is preparing for surgery
02:27today we're going to be doing a craniotomy for david a craniotomy is making a window in the skull
02:32and removing as much of the tumor as we can safely without disturbing the normal functioning brain
02:47the walton center performs roughly 450 craniotomies every year all good buddy yes
02:55david's will be carried out whilst he is fully conscious
02:58why are we doing it awake well what we want to try and do is we want to try and preserve
03:05his function and more specifically his speech function and so this is a 3d reconstruction that
03:12shows the tumor the abnormality in green and some important fiber tracks that are involved with speech
03:20so the one in purple is involved with making sounds whereas the one in yellow is to do with the meaning
03:26of things so the tumor you can see is closely related to those fibers and the team's job today is to
03:33try and help take out the tumor and leave all those critical fibers and structures intact and when he's
03:41awake we can assess his speech and his language
03:43so i'll try and stick around here now so that when we put everything up we know that we can see
04:02each other properly he seems really settled and calm which is brilliant and start so i just need to make
04:08sure that i'm setting everything up so i'm in the best position to be able to talk to him do the
04:12assessments and also speak to farouk as well at the same time
04:18the tumor sits just millimeters from the brain's language pathways
04:24you're doing really well david's stress could distort david's responses
04:29and the slightest slip could leave him unable to speak
04:36you're doing brilliantly very calm
04:40okey dokes let's do it with everyone in position it's knife to skin sharp scratch
04:48we've got thick skin that's a good thing that's a good thing yeah
04:58never attracted no pain yeah no pain
05:05next step a cut through the scalp to expose the skull
05:08how's that perfect good man
05:20i am about to do the bony window mate okay this is the bit you were dreading the most i guess
05:26yeah doing amazing okay okay this is when you hear the drill okay it's it's just like a dentist
05:33drill it's not much louder than that so i'm just drilling now
05:38okay
05:45it's going to be loud because it's just above your ear
05:48a drill creates burr holes in the skull to remove the bone
05:54it's not going to be long take a time
05:55it's not going to be long take a time
06:03A bit of pain.
06:05Mr. Ulabaju and Hannah work in tandem.
06:08I'm holding through here.
06:10Keeping David calm and comfortable.
06:13Doing really well.
06:16Hannah and I have done quite a lot of cases together,
06:19and she's talking to me all the time,
06:21and sometimes she'd be like, Farouk, I think,
06:23you've taken me to the limit.
06:29Okay, fruit, pain there. Pain?
06:31Yeah, pain.
06:33Yeah, stroke down my face.
06:52In the UK, someone has a stroke every five minutes.
06:56For one in three, it's fatal.
07:02What's her name? Maureen. Maureen.
07:0574-year-old Maureen has been rushed in as an emergency.
07:09Squeeze my hand, Maureen.
07:11A 74-year-old lady, she was woken up with a left-sided weakness,
07:18which is quite extensive.
07:20She's unable to move her arm or her leg.
07:24She's got some speech disturbances.
07:26She's unable to swallow.
07:28So she's really struggling with the blood flow into her brain.
07:32Maureen, open your eyes.
07:35Maureen, open your eyes.
07:38A stroke happens when the blood supply to part of the brain is cut off,
07:41either by a clot or a bleed.
07:45Stroke is a race against time.
07:47To put this into perspective, every minute with loss of blood supply to the brain,
07:58around two million nerve cells die.
08:02Consultant neuroradiologist Dr Mo Altebi must urgently identify the cause and the location of the blockage.
08:14We can see that there is some fading of contrast, which means that this is the site of the clot.
08:21She doesn't have a blood clot inside the brain, but she has a large blood clot at the neck.
08:29What I'm going to need to do is try to pass a wire through that,
08:34and then hopefully open that blood vessel up.
08:39Just 10% of strokes are caused by blockages in the neck.
08:43Maureen needs a thrombectomy to remove the clot.
08:51A catheter is inserted in an artery via an incision in the groin.
08:55It's moved up through the body into the neck.
09:00The clot will then be sucked out through a tube.
09:08For best chances of survival, it needs to happen within six hours of the stroke.
09:14As we go up in age, our vessels become more tortuous,
09:19and it means that navigating through these blood vessels can be quite difficult.
09:24Her clot is quite large, so the mortality risk is high.
09:31Okay, we're ready? Hopefully it works.
09:36So a bit more drilling now.
09:49Consultant neurosurgeon Mr Ulubadju is removing a brain tumour from 47-year-old David.
09:55Okay, fruit, pain there. Pain? Yeah, pain.
10:02Yes, it broke down my face. Was it? Yeah.
10:05David is fully awake throughout.
10:08Okay, I'll give you some more local... Thanks, Wade.
10:12You okay?
10:14Talking to him is specialist speech and language therapist,
10:17Hannah Jones-Reynolds.
10:19Doing really well.
10:23No pain, yeah? No pain.
10:27It's a critical point in the operation.
10:32Removing a piece of skull.
10:35I'm almost through here.
10:38Squeeze my hand if you want.
10:40You can do it. You can do it. You're amazing.
10:46Done.
10:47Well done. Thanks, mate.
10:50Well done.
10:51Bony window created.
10:52I love the bony window, you know me.
10:57The Dura is revealed.
11:00This is the delicate, translucent membrane that protects the brain.
11:06Is that a bit better? Yeah, that's great.
11:09Operating on a conscious patient poses unique challenges.
11:13Brian, keep the head still as much as you can. You're doing brilliantly.
11:15There's all kinds of risks.
11:19The major, the biggest risk is infection and seizures.
11:24If you, for example, had a seizure during this procedure,
11:27we could abandon it.
11:29And then there's not taking out all of the tumour,
11:32or if I cause a speech deficit,
11:34which is exactly what we're trying to prevent.
11:35So there's lots of risk involved.
11:38Can I? Yeah, please.
11:50With the Dura peeled back, the brain and the tumour are exposed.
11:54The tumour's the right there.
11:56So the bit where it's bulging out is exactly where the tumour is.
12:00All right, Hannah, do you want to start to just get your baseline?
12:05Can you see that all right there, Dave?
12:07Correct. Yes.
12:08This is an eye.
12:10This is a church.
12:14This is a kitchen.
12:16As Mr Ulubarju cuts away at the tumour,
12:20Hannah asks David to name objects.
12:23This is a door.
12:24His responses are a sign.
12:26This is a shoe.
12:27That the areas of his brain-controlling speech are still intact.
12:32This is a kangaroo.
12:34If David pauses or struggles,
12:36This is a car.
12:37Mr Ulubarju is too close.
12:41This is a beard.
12:43If Farouk was to cut a different area of the brain,
12:47one that we weren't supposed to,
12:49the result potentially could be devastating for the patient.
12:51It really could impact the patient's ability to understand,
12:55express themselves effectively.
12:57And that's one of the reasons why it's so important to do this procedure awake.
13:02Yesterday he drank.
13:05Yesterday crawled.
13:07So as soon as I've opened,
13:10see that that is all abnormal tissue.
13:14That's the tumour.
13:18Tumour?
13:20This is a hammer.
13:22Tumour?
13:24This is a castle.
13:26More tumour?
13:29And while I'm here, I'm going to turn the pink light on.
13:33And make sure it all fluoresces.
13:36So let's turn the pink light on and see.
13:38Before the operation, David was given a drink called 5ALA, nicknamed the pink drink.
13:51Absorbed into the bloodstream, it travels to the brain.
13:55And under a blue surgical light, the tumour cells glow a fluorescent pink.
14:00This highlights what needs to be removed and, more importantly, what cannot be touched.
14:09If you look at the screen, you can see some pink.
14:14That pink is tumour.
14:16So Hannah?
14:18Yeah.
14:19And everything's okay?
14:20Yeah, everything's okay.
14:22Mr. Ulabaju and Hannah stay in constant communication.
14:26I'm in the cavity and I'm going to try and go around this.
14:30Okay, yeah.
14:32They're going deeper into the brain.
14:35Right, David, come on.
14:36You can do this.
14:37Okay.
14:38This is a kitchen.
14:39This is a chair.
14:41This is a sock.
14:43This is a frog.
14:45This is a spider.
14:47This is a ruler.
14:49Okay.
14:50I'm going to turn the pink light on and see if there's anything in that depth.
14:56That's tumour.
14:58The heart of the tumour has been removed.
15:00But tendrils are threatening the speech functions.
15:04So all of that is still tumour.
15:09Each last piece must be removed.
15:14Hannah, I'm just in the depth.
15:16Keep a step in.
15:18This is a cheekbone.
15:19It's a temple.
15:22An arrow there, proof.
15:24There's a problem.
15:26So if David starts to get the questions wrong
15:28while we're resecting parts of the tumour,
15:32if you carry on,
15:34you will cause irreversible damage.
15:37Struggling.
15:38What? Hesitation?
15:39Yeah.
15:41Proper arrest.
15:42Proper arrest.
15:43David.
15:44With more than 1,500 spinal operations a year, the Walton Centre tackles the most complex cases in the country.
16:01It's just like a constant pain, like shooting electric pain down my arm.
16:1433-year-old Holly had an accident 11 years ago.
16:18I guess I'm used to just being in daily pain and struggling.
16:27I used to go to the gym quite regularly.
16:30I've had to stop that.
16:31So I can't do my usual role at work.
16:35I've had to be put on light duties.
16:38It does get to you just being in constant pain.
16:42Just hoping that it sort of get my life back to where it should be.
16:46Today, she's here for a cutting-edge procedure.
16:57Here on the scan, you can see her cervical spine.
17:01So this is a side-on view.
17:03You've got the bones in her neck stacked on top of each other with discs here in between.
17:08And you can see there's a little bit of a bulge here at that level.
17:11And that's what's giving her her nasty symptoms.
17:16Consultant neurosurgeon, Mr. Matthew Stouvel, will perform a full cervical disc replacement.
17:23We'll remove the disc from the front, sneak in down natural tissue corridors to the front of the spine.
17:32Yup, that's it.
17:34Fewer than 1,000 of these operations take place in the UK every year.
17:38So we're going to use a disc replacement.
17:42An artificial disc that tries to mimic the movement of the normal discs.
17:47The spinal cord, major arteries, and delicate nerve roots all sit within millimeters of the operating field.
17:54I'm always aware that brain and spine surgery is risky.
18:05You can't repair neurological structures, so if you cause an injury to them, that's it.
18:10You could make them better, or you could make them a lot worse.
18:16Scrubbed in, it's knife to skin.
18:18A knife, please.
18:19Starting.
18:21Okay, that's lovely.
18:23A very thin platysma.
18:25So, first of all, we go through skin, and then we go through platysma.
18:27The platysma is a thin sheet of muscle just beneath the skin of the neck.
18:28Okay, hold that.
18:29Next, it's through soft tissue.
18:30Scissors.
18:31Scissors.
18:32Scissors.
18:33We're gently teasing the tissues apart, cutting whatever structure is a little bit
18:34bigger.
18:35Okay.
18:36Okay.
18:37Okay, hold that.
18:38Okay.
18:39Okay.
18:40Okay.
18:41Okay.
18:42Okay.
18:43Okay.
18:44Okay.
18:45Okay.
18:46Okay.
18:47Okay.
18:48Okay.
18:49Okay.
18:50Okay.
18:51Okay.
18:52Okay.
18:53Okay.
18:54Okay.
18:55Okay.
18:56Let's just put this in a little pinch of connective tissue that are resisting you.
19:01Making sure that osophagus and trachea are medial.
19:07Or pulled across in one bundle.
19:08Can you hold that for me?
19:11And the parotid artery is lateral.
19:15That allows you to get there without damaging the tissue planes.
19:22Matthew is working right by the carotid artery, the main vessel that supplies blood to the
19:33brain.
19:34It's got quite tough tissues.
19:39If one were to cut the carotid artery, the patient would bleed to death in under a minute.
19:46So you have to be extremely precise and cautious when you're working around it.
19:53A tiny bit there.
19:54Up.
19:55Slow down.
19:56Gently.
19:57The Walton Centre in Liverpool is one of just a handful of hospitals providing a 24-7 thrombectomy
20:22service.
20:26They carry out around 200 every year.
20:29OK, let's have a look.
20:31The blood clot is removed using a catheter threaded up through the groin.
20:36But it's time critical.
20:3974-year-old Maureen is undergoing this emergency operation to clear a blockage in her neck.
20:47She's got such torturous anatomy.
20:51Consultant neuroradiologist Dr Mo Altebi is trying to reach the clot.
20:58I think there's a small kink.
21:01But it's harder in older patients when blood vessels are narrower and more fragile.
21:07Just be careful as we go into that.
21:09There's a bit of a loop.
21:10So as expected, we see a lot of tortuosities and the vessels are loopy and turny, which
21:19makes access to these vessels quite challenging.
21:22We want to be careful not to scratch the lining of the vessels, which may end up in damage.
21:29So as they always say, you know, slow is fast.
21:33We try to stay calm.
21:35If an artery ruptures, blood will get underneath the skin, cause more swelling.
21:42It could push into the other structures around the neck.
21:47It may cause even more strokes.
21:53Yeah, a bit more.
21:55OK.
21:56Yes, perfect.
21:57So now we're going to see the actual clots in the neck.
22:02Let's do a gentle puff.
22:05Having reached the neck, a dye is injected into Maureen's bloodstream to locate the blockage.
22:18So the occlusion is just right here, completely occluded.
22:22So we identified where the clots is.
22:28We're going to try to bring an aspiration catheter into that clot and take it out.
22:35Every second, thousands of neurons in the brain die.
22:38So we need to be as quick as we can.
22:52Come on, David, last, last bit, last bit.
22:57In the operating theatre, consultant neurosurgeon, Mr. Ulubarju.
23:02More tumour.
23:03And specialist speech and language therapist, Hannah Jones Reynolds.
23:07Come on, David.
23:09Are midway through an awake craniotomy on David.
23:12A whistle.
23:13Yeah.
23:14This is his drum.
23:15They've successfully removed most of his brain tumour.
23:19This is a...
23:21No, he's struggling with reason.
23:25But now, they've hit a critical complication.
23:28Give him a break, a minute.
23:31David's speech is faltering.
23:33The brain's a little bit swollen, which I don't like.
23:41Sometimes there might be a bleed somewhere.
23:46You want to do some assessments, Hannah?
23:48Yeah.
23:49This is a knife.
23:51This is an apple.
23:53This is a beard.
23:55This is a beard.
23:56They are operating just millimetres from the brain's language centre.
24:02This is a tyre.
24:04A dense network of neural pathways that control speech and comprehension.
24:10This is a clown.
24:12A wrong move could have life-altering consequences.
24:16This is an ear.
24:18This is an ear.
24:19Is it?
24:20Sorry.
24:21Spectacles and eye.
24:24There's some hesitation.
24:27Mistakes in David's responses are a warning sign that they are edging dangerously close to areas that must be preserved.
24:35Keep going.
24:37This is a sock.
24:38Good man.
24:39Come on, David.
24:40You can do this.
24:41This is a frog.
24:42Well done.
24:43This is a spider.
24:44It's quite pink there.
24:45At the moment, I'm just chasing the pink.
24:54Three hours into the surgery, Mr Ulubadju has taken David as far as he can, operating deep to remove every last trace of tumour.
25:05So we can't see any more pink anywhere.
25:08Are you alright, buddy?
25:11But then, another setback.
25:13David, come on.
25:14Just show me you're okay.
25:17Can you have a little rest now?
25:19The team have no choice but to pause.
25:25We are always trying to push as much as we can to get the best possible outcome.
25:30But yeah, there will always be a point where you're not doing any good.
25:34You're not progressing this operation and actually what you're doing is you're now in an unsafe area where you don't know whether your patient's just tired or whether you're actually causing harm.
25:47David?
25:48How are you?
25:49David?
25:50How are you?
25:51How are you?
25:52Are you alright, David?
25:53Any issues?
25:54No.
25:55Do you know where you are?
25:56Yes.
25:57What's my name?
25:58How are you?
25:59How are you?
26:00Perfect.
26:02I'm happy.
26:03I'm going to start closing.
26:07They've made it through the most critical part of the operation.
26:10The tumour fibres are out and David is still talking.
26:15So what do we rate David in terms of the awake craniotums we've done?
26:19He's been amazing, hasn't he?
26:21Ten out of ten, David.
26:23Yeah, I think so.
26:25I think so.
26:26See, there were some times when we thought that maybe he was producing some errors and after the testing's gone on for a little time it can be quite difficult to determine what's a real error versus something related to fatigue.
26:37You know, he's been through a lot.
26:39The surgery has been a success.
26:44David is stable and recovering.
26:48I'm obviously a little bit tired but feeling good.
26:52It's absolutely crazy that I was having a tumour removed just an hour ago and now I'm here talking to you.
26:59Yeah, crazy.
27:01And then, you know, the next thing is biopsy results and see what's next but that's for future David.
27:08I'm just dealing with this today.
27:12David did really well.
27:14It was quite reassuring that there was no functional tissue in that corridor that we were going to.
27:19So we were able to go through and even in the depths it was all negative.
27:24I'm hopeful that I've got it all.
27:26Removing the tumour should ease David's symptoms but a biopsy must determine if it's cancerous.
27:35In radiology, consultant neuroradiologist Dr Mo Altebi has managed to reach the site of the blood clot in Maureen's neck using a catheter.
27:57So we have the catheter all the way to the clot.
28:04It's time to try and remove the blockage.
28:07Okay, let's have the aspiration tubing.
28:09So this is a canister which is like a suction engine.
28:17If there is a blood clot at the tip of the catheter that will suck the blood clot out.
28:21The suction apparatus has engaged with the blood clot and it can now be removed.
28:33So now I'm going to try to take the stent out.
28:35And I'm doing that slowly and carefully to make sure that the clot is captured in the stent.
28:51Now the stent is out.
28:53We're going to inspect it and hopefully see a blocked clot in there.
28:58Yes.
28:59So this is a quite a fresh clot, quite a large chunk of blood clot that was in the blood vessel.
29:10But Maureen isn't out of the woods yet.
29:13We aim to take the clot out in just one single chunk.
29:20Sometimes part of the clot can be broken down and that can be sent deep into the brain arteries.
29:27And the more likelihood that we can cause a brain hemorrhage.
29:48Perfect.
29:49Yeah, it's free flowing. That's good.
29:52The vessel is open in the neck and it's open up in the brain vessels.
29:56It looks pretty clean. So I think I'm going to stop here.
29:59That's the best result that we can get.
30:05Typically patients who have a fresh clot, they tend to do better when they wake up.
30:11So sometimes we see that they start moving their legs and sometimes they start talking.
30:15We're hoping that her symptoms have improved.
30:19Maureen is taken to recovery.
30:20Maureen?
30:21Can you say hello?
30:22Hello.
30:23Hello, Maureen.
30:24Wiggle your toes.
30:25There we go.
30:26Yeah.
30:27She's definitely moving her left leg now which she wasn't doing before.
30:29So, again, that's a good success.
30:30Maureen is taken to Aintree Hospital to recover on a ward before being discharged.
30:37Maureen is taken to Aintree Hospital to recover on a ward before being discharged.
30:43In the midst of complex spinal surgery.
30:44It's a bit, she's got quite tough tissues.
30:45It's a bit, she's got quite tough tissues.
30:46Maureen is a consultant neurosurgeon.
30:47Maureen is taken to Aintree Hospital to recover on a ward before being discharged.
30:52In the midst of complex spinal surgery.
30:53It's a bit, she's got quite tough tissues.
30:54Maureen is a consultant neurosurgeon, Mr. Stovell, who was performing a full cervical disc replacement on 33-year-old Holly.
30:55That's a bit, she's got quite tough tissues.
31:11Maureen is a consultant neurosurgeon, Mr. Stovell, who was performing a full cervical disc replacement on 33-year-old Holly.
31:20year old holly he's accessing her spine through the front of her neck navigating past the carotid
31:29artery one of the body's most vital blood vessels okay should be fine
31:43so we've done the approach to the spine and we've placed a tiny needle in the vertebral body and
31:54we're going to take an x-ray with that needle in to make sure that we are where we think we are
32:06holly's neck needs to be perfectly positioned
32:09there's no margin for error when you're this close to the spinal cord
32:18two three four five six exactly where we want to be that's lovely jubbly
32:28so important before we do any disc ectomy that we mark the midline
32:40the midline is an invisible vertical line that runs down the center of the spine
32:48i'm just trying to make absolutely sure of where this midline is
32:55identifying it is critical to ensure the implant is centered and stable
32:59there would you agree yeah cool okay fine thank you quite
33:08with the midline confirmed the surgery can continue
33:12so the deeper part of the disc ectomy i'll do microscopically because we'll be approaching
33:16the spinal cord and the nerve reach
33:21this is some disc i'm removing here
33:27there we go there's the speaker
33:30worn disc removed
33:35next step chisel two grooves into the bone
33:38to hold the artificial implant in place
33:48i'm preparing the vertebral end plates
33:53very carefully
33:54the vertebral end plates are the strong bony surfaces that anchor the implant
34:03number two please
34:05if they're damaged the new disc could shift or collapse
34:11one thing that you've got to be aware of with the disc replacement is you've got to protect
34:15the top and bottom of the vertebral bodies either side of the disc
34:21protecting them is essential as they'll bear the full weight of holly's head and neck
34:28come on
34:30you've got to be forceful enough but you can't damage them
34:35this is causing us a bit of issue
34:44the walton center liverpool one of the busiest neurosurgical hospitals in the uk
35:00carrying out 6 000 surgeries every year just wondering about that there
35:07consultant neurosurgeon mr stovale is nearing the final stages of holly's operation
35:14the damaged disc has been removed
35:20and the compressed nerve root is exposed
35:26it seemed inflamed flattery around the nerve root
35:30launch up please
35:33you have to make sure that the decompression of the nerve root is achieved
35:37you can directly decompress it by nibbling away little bits of bone another soft tissue that's around it
35:45and by decompressing it it causes a little bit of ooze from tiny veins
35:55bleeding from the surrounding veins must be stopped
35:58we don't want any collection of blood around the spinal cord or nerve root
36:10to cause compression of them after the operation
36:14so i'm just making sure we mop all that up wash please
36:17the new artificial disc can now be inserted
36:31okay right so i'm just sizing different sizes to see what fits her perfectly
36:36that's a four feels snug it feels right
36:44i have the kill cutter please
36:51okay hammer please
36:53i'm cutting a small groove so that the final implant sits exactly where i want it to sit
37:10doing it very gingerly i'm hammering something
37:13towards the cervical spinal cord i don't want to go too far x-ray
37:20millimeters from the spinal cord
37:22find a bit more precision is essential
37:34got it lovely okay let's go
37:39time to fit the new disc so this will go into space and mimic the movement of a normal disc
37:50you want to get the disc replacement the prosthesis right in the middle central of the spine
37:58we've already cut our keels but
38:01it's tricky because you've got the trachea and oesophagus the windpipe and the food pipe in the way
38:09so you have to come slightly from the side which can make
38:13getting the implant absolutely in the middle tricky but also really important
38:18okay a little hammer please yeah um
38:26x-ray there
38:27an x-ray will confirm if the implant is correctly aligned
38:37lovely here's the implant we've got the implant here right in the middle of where we want it to
38:43be on the lateral view and also right in the middle here from left to right i'm happy very happy
38:52the operation is complete but only time will tell whether the surgery has been a success
39:03so
39:19how are you i'm feeling yeah a little bit sore
39:23have you noticed any changes in the symptoms down your arms yet there's definitely been
39:28an improvement in the nerve pain sort of down there and sort of the top half of my arm
39:35yeah the left arm was a big improvement great i'm delighted that your symptoms are starting to
39:40get better it did really well well done so she's already seen some improvement um that's what we hope
39:48and that's what we've achieved so very happy
39:53less than 24 hours after arriving for life-changing spinal surgery
39:58holly can now go back home good to go it's all a bit of a blur but yeah it's
40:05crazy that i've been suffering for so many years i'm so pleased that
40:10i went through with it because it's going to change my life
40:2911 days after his surgery to remove a brain tumor david is back at the hospital
40:34i'm here for the biopsy results from the tumor that was removed from my brain
40:41i obviously hope that that's going to be a benign result
40:47big man how we doing hi dude hello hello hello
40:54so how's things things are good things are remarkably good consultant neurosurgeon mr
41:01ula bardu specialist speech therapist hannah jones reynolds and clinical nurse alison rodway
41:08have come together to deliver the news we do have some results um so you're right with me telling you
41:14that yes okay so it's come back a high grade primary brain tumor um which means it's something that we can
41:24treat but it's not something that we can necessarily cure okay okay and so the evidence is that it will
41:38recur regardless of the treatment and unfortunately this is a disease that will shorten your lifespan yeah
41:46i i i was prepared for either outcome um obviously you you hope for the best um we're not getting
41:55no no no we're not we're not getting the best but we'll do the best with what we've got and and that's
42:00that's that's that's what we'll do so you've all been amazing though so you know we've it's been it's
42:07been it's been a um it's been a team effort very much i know you said at the beginning it would have to
42:11be a team effort and you were right it was everybody's been fantastic so i can't thank you enough
42:21i am there for people during some of their hardest times i'm there for people through some of their
42:28happiest times it's something that i i in a way i'm proud to be involved in it's enriching
42:37and that's why i became a doctor being a part of someone's journey and trying to assist them through
42:47the probably the most darkest scariest times of their lives is extremely important to me
42:53you know being able to help those patients is i would say the best job in the world
42:59david's treatment will begin in the coming week
43:12it's only just really sinking into me but the hardest part for me um i've now got to tell
43:19my friends this diagnosis um however i won't be having um any upset um not on my time and they're
43:30there now to help me have a good time and that's what i want from them and i'm not sad so i don't
43:38need them to be sad the only thing i can say from somebody who's been given this diagnosis is this can
43:46all be over very quickly and appreciate the time that you've got appreciate the people that you've
43:51got and have a couple of parties along the way
44:11so
44:21so
44:35so
44:41so
44:47Transcription by CastingWords
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