He diagnosis came as a cold water jug last year: Raul Gonzalez had a glioblastoma, a malignant cancer of brain. This doctor Hospital de la Santa Creu i Sant Pau (Barcelona) was in the Congo, coordinating the work of the World Health Organization (WHO) in the serious cases of covid-19 from all over Africa. “I was in the jungle and it all started with some tingling on the left arm and leg,” he explains. Initially they believed it was a infection that I had caught in Africa, but a first operation ended up confirming the cancer diagnosis.
A pioneering technique from the Guttmann Institute, practiced before surgery, saves 14 patients from disability
“The surgery At that time it was good. The problem is that that tumor recurred [volvió a aparecer] this year. Glory [Villalba, la neurocirujana que lo operó] I explain where was the tumor and what areas were affected. I was already beginning to have certain symptoms… He told me that there could be neurological sequelae on the left side at a motor level,” Raúl explains naturally. “I am prepared to die, but for me the most difficult thing is to lose my autonomy, make me dependent on someone. And I told him so.” Raúl and Gloria they have become friends as a result of his illness.
Raúl is one of 14 patients who have been part of a clinical trial at the Guttmann Institute of Barcelona that seeks to reduce sequelae in people operated on for a brain tumor. This Tuesday this was presented technical pioneer to journalists, which consists of carrying out a prehabilitation (rehabilitation exercises done before surgery that prevent injuries) to reeducate the brain in how it works and that the consequences after the operation are minimal. More specifically, this prehabilitation consists of apply non-invasive neurostimulation techniques to modify brain activity before tumor surgery. The program is called ‘Prehabilitate’.
“See the light”
Both in Raúl and in the rest of the patients the technique has worked and now the Institut Guttmann hopes that implement in other hospitals because prevent disability of people supposes a savings also for the State. “Participating in this program for me was see the light and I tried everything I could to have the surgery be as successful as possible,” says Raúl, who before being operated on performed two weeks of intensive rehabilitation, morning and afternoon. “The result It was wonderful”, he assures.
“We came to consider euthanasia because he did not want to be left with consequences. So we decided to do the ‘Prehabilita’ study”
Neurosurgeon of the Sea and doctor of Raúl
The aftermath, after surgery, they depend on where the tumor is located. “Raúl had a high probability of losing the mobility in the arm and leg left. He and I even value practicing euthanasia because the He didn’t want to be left with consequences. So we decided to do the ‘Prehabilita’ study”, his doctor explains with him, Gloria Villalba, neurosurgeon at Hospital del Mar and collaborator of the project. Raúl started the prehabilitation on June 4 and on June 14 they operated on him.
“All prevention is cheaper than treatment. It is the number one rule of public health”
Patient of the Guttmann Institute
“As soon as I woke up, Glory to me explored and saw that really “retained mobility,” Raúl relates. On the fourth day was able to leave the hospital and went to the Institut Guttmann so that patients and doctors could see the result of the clinical trial.
Raúl, who is a doctor andspecialist in anesthesia and public health, know the importance of this type of preventive programs. “All prevention is cheaper than treatment. It’s the rule number one of public health,” he responds when journalists ask whether to implement this technique in the portfolio of services It is very expensive. “Chemo or immunotherapy multiply the cost by 10 of this treatment,” says Dr. Villalba.
What did the therapy consist of?
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This prehabilitation consists of about 10 and up to 20 sessions four hours each. Neuromodulation, part of this prehabilitation, It lasts half an hour. It is done through the placement of a neurostimulator in the patient’s frontal area, that for a few minutes inhibits those areas surrounding the tumor. This neuromodulation seeks inhibit for a time this area, so that they are other regions (also involved in language but that act less) those in charge of this function. In other words, the technique consists of reeducate the brain to use regions that until now did not use or used less.
Subsequently, the patient performs coordination exercises, sequencing, balance, memorization or even activities like playing the piano or swimming in the pool. “Was marvelous see that, after the operation, everything “It worked perfectly,” says Raúl, grateful to his colleagues. And, smiling, he concludes: “I want to live”.