Health
Florida brain tumor patient plays guitar during his surgery: ‘This is wild’
The idea of having brain surgery while awake might seem amazing enough — but one Florida man took it a step further and played the guitar while doctors removed his tumor.
The neurological team from the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine wanted the patient, Christian Nolen, to play notes on the instrument so they could evaluate and protect his manual dexterity while being as aggressive as possible in removing the tumor.
The surgeon and patient both spoke with Fox News Digital about the experience.
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Nolen, who is an avid guitar player, had a tumor on the right frontal lobe of his brain that was starting to cause symptoms.
“Christian was having issues with the left side of his body, particularly his left hand,” Ricardo Komotar, M.D., director of the brain tumor program at Sylvester, told Fox News Digital via Zoom.
“He was noticing issues with his dexterity that affected his ability to play the guitar.”
The neurological team from the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine asked Christian Nolen to play guitar during his surgery so that they could evaluate and protect his manual dexterity. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
Nolen needed surgery to confirm the diagnosis and determine the type of tumor — as every tumor has different treatment options, Komotar noted — and also to remove as much of it as possible.
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The surgery was scheduled for 10 days after the tumor was discovered — and Nolen was surprised when the doctors asked if he’d be willing to remain awake and play the guitar for the procedure.
“When a tumor is involving or near a critical part of the brain — something that controls the ability to speak or understand language or move — we want to do the surgery awake to continually monitor the patient, so you know if you start to violate normal brain functions,” Komotar said.
Dr. Ricardo Komotar of Sylvester Comprehensive Cancer Center is director of the brain tumor program at the University of Miami Miller School of Medicine. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
When the patient is asleep, the doctor said, the surgery team doesn’t have the ability to get feedback.
“The surgeries actually become much more dangerous because you can take out a tumor that involves normal brain function and cause real harm without knowing it,” he said.
Given the importance of guitar-playing in Nolen’s quality of life, Komotar said there was “no better way” to monitor his manual dexterity and the effect of the tumor than to have him take up the instrument in the operating room.
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When the doctors posed the option to Nolen, he said that at first it “didn’t seem real.”
“I’d only really heard of procedures of that nature being done in shows and movies,” he told Fox News Digital in an email. “I felt like it was such a unique experience that I couldn’t pass up — especially with my motor skills being on the line.”
He added, “The risk of being sedated for the entire procedure outweighed any fear or anxieties around the procedure itself.”
Given the importance of guitar-playing in Nolen’s quality of life, his surgeon said there was “no better way” to monitor his manual dexterity and the effect of the tumor than to have him take up the instrument in the operating room. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
Prior to the procedure, Nolen said he was introduced to members of the surgical team and was told in-depth about what to expect.
The anesthesiology team put Nolen to sleep for the beginning of the open craniotomy, but he was awakened during a delicate part of the two-hour procedure. Once he was oriented on what was happening, the care team gave Nolen a guitar and asked him to play.
“Upon awakening, it was quite overwhelming to see everything around me and to fight the natural reaction to sit up,” Nolen recalled.
“I felt like it was such a unique experience that I couldn’t pass up — especially with my motor skills being on the line.”
After one of the members of the care team placed a “reassuring hand” to prevent Nolen from sitting up, he said it took only a second for him to remember what was happening.
“I just had to breathe and stay calm,” he said.
During surgery, he tried his best to play through some of the songs he had been practicing, including tunes by artists like the Deftones and System of a Down.
Nolen had a tumor on the right frontal lobe of his brain that was starting to cause symptoms. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
As the surgeons removed the tumor, they continuously monitored Nolen’s hand function while he played the guitar.
“As we were finishing the case at the very back of the tumor, we noticed that his hand function started to decline,” said Komotar. “The tumor was touching and interfacing with the part of the brain that controls hand movement. Fortunately, we were able to remove the entire tumor and not injure his hand.”
“This is wild,” Nolen said during the surgery.
What to know about awake procedures
While a patient playing guitar during surgery is not an everyday occurrence, Komotar told Fox News Digital that he and the rest of the specialized neurosurgical team perform awake surgeries several times a week, for a total of a couple of hundred times a year.
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“Most patients are intrigued by the process,” he said. “We tell them that they’re going to be able to speak and move their hands or limbs so we can constantly examine them.”
The doctors also reassure the patients that they won’t feel any pain, likely won’t remember the entire procedure, and will remain very comfortable — “which is the result of our world-class neuroanesthesia team,” added Komotar.
Research has proven the benefits of doing procedures with awake anesthesia instead of deep general anesthesia, the doctor noted.
Prior to the procedure, Nolen was introduced to members of the surgical team and was told in-depth about what to expect. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
“Surgery with continuous neurological exam leads to better functional outcomes and fewer neurological deficits,” he said.
There are also improvements in discharge and recovery.
“The less anesthesia you use during your procedure, the better the patient wakes up,” he said. “The faster they wake up, the sooner they are up and walking around, and the sooner they go home.”
Komotar added, “And inherently, the longer you’re in the hospital, the more complications you have.”
“Surgery with continuous neurological exam leads to better functional outcomes and fewer neurological deficits.”
Guitar-playing isn’t the only activity that patients can do during an awake craniotomy.
Anything that doesn’t increase pressure in the head, such as playing the violin, is fair game, Komotar said.
Some patients sing during brain surgery, which allows the surgeon to monitor their ability to form and understand words as they remove tumors in areas that involve language.
Before awake surgeries, the doctors reassure patients that they won’t feel any pain, likely won’t remember the entire procedure, and will remain very comfortable. Nolen is shown at left; Dr. Ricardo Komotar is at right. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
There are some risks involved with awake cranial surgery, Komotar acknowledged.
“Seizures can definitely be worsened by doing awake surgery,” he told Fox News Digital. “If someone has a history of seizures, we try to avoid electric brain stimulation, which is part of the technique.”
The biggest risk of doing awake brain tumor removal is that about 5% to 10% of patients don’t “tolerate” being awakened, Komotar said.
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“Even with world-class anesthesia, they might wake up either too startled or too in pain to be examined,” he said. “They might be confused, agitated or unable to follow commands.”
If that happens, the care team puts the patient back to sleep and proceeds with a more conservative tumor removal.
“He went home the day after surgery. He says his quality of life is better than it’s ever been, so I think his recovery has been remarkable.”
Without having continuous feedback from the patient, the surgical team can’t be as aggressive with the tumor removal, Komotar noted. “We only take out what we know is definitely safe, and we leave anything that’s questionable.”
The road to recovery
Nolen’s surgery went smoothly and the entire tumor was removed.
“Christian did terrific,” Komotar said. “He went home the day after surgery. He says his quality of life is better than it’s ever been, so I think his recovery has been remarkable.”
“The team at Sylvester Comprehensive Cancer Center in Miami has been very informative and has not left much to the imagination in the best way possible,” the patient said. (Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine)
The first couple of weeks after surgery were a little tough for Nolen, the patient said, mainly due to post-surgery restrictions.
“The days were really dragging,” Nolen told Fox News Digital. “However, with a strong support system, I’ve been able to focus on the positives.”
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He is now back to working out at the gym and playing the guitar, with significant improvement in his left hand.
“A case like this spotlights the value of multidisciplinary care.”
He’s awaiting the final pathology results, with follow-up treatment likely consisting of six weeks of radiation and chemotherapy.
Both Komotar and Nolen emphasized that the success of the surgery hinged on the collaboration of the entire care team.
“The team at Sylvester Comprehensive Cancer Center in Miami has been very informative and has not left much to the imagination in the best way possible,” said Nolen. “They have also provided me with quite a few programs for emotional support.”
“A case like this spotlights the value of multidisciplinary care,” added Komotar.
“It’s not possible to remove a tumor like this and get the patient home so quickly and in such good health without an entire comprehensive team — neuro anesthesiologists, great intensive care specialists, nurses, techs, great oncologists — all working together.”
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Health
Holiday heart attacks rise as doctors share hidden triggers, prevention tips
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The holidays are known to be a source of stress, between traveling, preparing for family gatherings and indulging in lots of food and drinks.
The uptick of activity can actually put a strain on the heart, a phenomenon known as “holiday heart syndrome.”
Cardiothoracic surgeon Dr. Jeremy London addressed this elevated risk in a recent Instagram post, sharing how heart attacks consistently rise around the holidays.
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“Every year, like clockwork, we see a spike in heart attacks around Christmas and New Year’s,” the South Carolina-based surgeon said. “In fact, Christmas Eve is the highest-risk day of the year.”
This is due to a shift in behavior, specifically drinking and eating too much, moving less and being stressed out, according to London. “Emotional stress, financial stress, the increased pace of the holidays, increased obligations,” he listed.
Cold weather also causes vasoconstriction (narrowing of blood vessels), according to London, which increases the risk of plaque rupture and the potential for heart attack.
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Dr. Glenn Hirsch, chief of the division of cardiology at National Jewish Health in New York, noted in an interview with Fox News Digital that holiday heart syndrome typically refers to the onset of an abnormal heart rhythm, or atrial fibrillation.
This can happen after an episode of binge-drinking alcohol, Hirsch said, which can be exacerbated by holiday celebrations.
Binge-drinking at any time can drive atrial fibrillation, a cardiologist cautioned. (iStock)
“It’s often a combination of overdoing the alcohol intake along with high salt intake and large meals that can trigger it,” he said. “Adding travel, stress and less sleep, and it lowers the threshold to go into that rhythm.”
The biggest risk related to atrial fibrillation, according to Hirsch, is stroke and other complications from blood clots. Untreated atrial fibrillation can lead to heart failure after a long period of time.
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“The risk of atrial fibrillation increases with age, but also underlying cardiovascular disease risk factors increase the risk, such as high blood pressure, obesity, diabetes, sleep apnea and chronic kidney disease,” he added.
Christmas Eve is the “highest risk day of the year” for heart attacks, according to one cardiologist. (iStock)
Preventing a holiday heart event
Holiday heart syndrome is preventable, as Hirsch reminds people that “moderation is key” when celebrating.
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The expert recommends avoiding binge-drinking, overeating (especially salty foods) and dehydration, while managing stress levels and prioritizing adequate sleep.
“Don’t forget to exercise,” he added. “Even getting in at least 5,000 to 10,000 steps during the holiday can help lower risk, [while] also burning some of the additional calories we are often consuming around the holidays.”
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London agreed, stating in his video that “movement is medicine” and encouraging people to get out and move every day.
The various stresses of the holidays can have physical consequences on the body, doctors warn. (iStock)
It’s also important to stay on schedule with any prescribed medications, London emphasized. He encourages setting reminder alerts, even during the holiday break.
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“Prioritize sleep and mindfulness,” he added. “Take care of yourself during this stressful time.”
London also warned that many people delay having certain health concerns checked out until after the holidays, further worsening these conditions.
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“Don’t ignore your symptoms,” he advised. “If you don’t feel right, respond.”
Health
‘Aggressive’ new flu variant sweeps globe as doctors warn of severe symptoms
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Flu season is among us, and a new strain has emerged as a major threat.
Influenza A H3N2, or the subclade K variant, has been detected as the culprit in rising global cases, including in the U.S.
In an interview with Fox News Digital, Dr. Neil Maniar, professor of public health practice at Boston’s Northeastern University, shared details on the early severity of this emerging strain.
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“It’s becoming evident that this is a pretty severe variant of the flu,” he said. “Certainly in other parts of the world where this variant has been prevalent, it’s caused some severe illness, and we’re seeing an aggressive flu season already.”
Influenza A H3N2, or the subclade K variant, has been detected as the culprit in rising global cases. (iStock)
The variant seems to differ from prior strains of the flu, with heightened versions of typical symptoms like fever, chills, headache, fatigue, cough, sore throat and runny nose.
Subclade K is the “perfect storm” for an aggressive flu season, Maniar suggested, as vaccination rates overall are down and this year’s flu vaccine does not address this specific strain.
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“The vaccine is very important to get, but because it’s not perfectly aligned with this variant, I think that’s also contributing to some degree to the severity of cases we’re seeing,” he said. “We’re going in [to this flu season] with lower vaccination rates and a variant that in itself seems to be more aggressive.”
“There’s a lot of concern that this could be a particularly difficult flu season, both in terms of the total number of cases [and] the severity of those cases.”
Staying indoors during the colder months increases the risk of exposure to winter illness. (iStock)
Because subclade K is “quite different” from prior variants, Maniar said there is less natural immunity at the community level, further increasing the risk of spread and severity.
Those who are unvaccinated are also at risk of experiencing more severe symptoms, as well as a higher risk of hospitalization, the doctor emphasized.
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In addition to getting vaccinated, the doctor recommends washing hands frequently and properly. While the flu can spread via airborne transmission, a variety of other illnesses, like norovirus, can stick to surfaces for up to two weeks, he added.
The holiday season also boosts the risk of infection, as gatherings, large events, and packed planes, trains and buses can expose people to others who are sick.
The flu vaccine can help to prevent hospitalization and reduce severe symptoms, doctors agree. (iStock)
Those who are not feeling well or exhibiting symptoms should “please stay home,” Maniar advised — “especially if you think you are in that contagious period of the flu or any of these other illnesses that we’re seeing … whether it’s norovirus or COVID or RSV.”
“If you’re not feeling well, stay home. That’s a great way to recover faster and to ensure that you’re not going to get others around you sick.”
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For those who are unsure of their health status or diagnosis, Maniar recommends seeing a healthcare provider to get tested. Some providers may be able to prescribe medication to reduce the severity and duration of the illness.
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“It’s important that everyone stays vigilant and tries to take care of themselves and their families,” he added.
Health
Are you too old to shovel snow? Experts reveal the hidden heart risks
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As snow blanketed parts of the U.S. this week, heart health experts have shared warnings of the physical strain shoveling can take — particularly for older adults.
A 2025 Mayo Clinic review found that just 10 minutes of heavy snow shoveling can push the heart to about 97% of its maximum rate. Exposure to cold air was also found to increase blood pressure and reduce coronary blood flow.
While there isn’t an official age that’s “too old” to shovel, some cardiologists recommend that individuals over 45 should exercise more caution to lower their chances of a cardiac event.
When to take caution
“While there’s no strict age cutoff, generally above the age of mid 40s and above, we tend to be a little more cautious — particularly in people who are less active [without] regular exercise,” Dr. Navjot Kaur Sobti, M.D., an interventional cardiologist at Northwell’s Northern Westchester Hospital in Mount Kisco, New York, told Fox News Digital.
Heart health experts have shared warnings of the physical strain shoveling can take — particularly for older adults. (iStock)
“Certainly in people who are above the age of 65 — and who have risk factors for heart disease, such as high blood pressure, high cholesterol, diabetes, obesity or sedentary lifestyle — we recommend being very, very cautious about shoveling snow,” she advised.
Dr. John Osborne, M.D., a practicing Texas cardiologist and volunteer for the American Heart Association, shared similar guidance for people older than 45, especially males over 65.
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“Unless you are in good cardiovascular shape and conditioned, it may be a good idea to ask someone for help,” he said in an interview with Fox News Digital.
The impact of snow removal is especially concerning for those with existing cardiovascular risks and a history of heart attack or stroke, according to the cardiologist. “People with these characteristics and those who have had bypass surgery or coronary angioplasty simply should not be shoveling snow in any conditions,” he said.
Just 10 minutes of heavy snow shoveling can push the heart to about 97% of its maximum rate, a 2025 Mayo Clinic review found. (iStock)
Osbourne said he often sees cardiac episodes in people who are typically sedentary and sit at a computer most of the day with little or no exercise. “Then once or twice a year, they go out and try to shovel the driveway after a heavy snowfall, and that unexpected exertion can unfortunately lead to tragedy.”
Hidden strain
The stress that is placed on one’s heart while shoveling snow is similar to what occurs during a cardiac stress test, Sobti pointed out, and may even exceed it.
Cold temperatures can cause blood vessels to constrict and blood pressure to spike — which, coupled with existing hypertension and the exertion of lifting snow, can significantly tax the heart, she warned.
“It’s almost like an at-risk person is putting themselves through an unsupervised maximal exertion stress test without a cardiologist actively monitoring them,” Sobti told Fox News Digital.
The stress that is placed on one’s heart while shoveling snow is similar to what occurs during a cardiac stress test. (iStock)
In addition to the exertion of shoveling, frigid temperatures can also strain the heart. Recent research has shown that cold exposure accounts for nearly twice as many cardiovascular deaths as heat exposure, including heat exhaustion.
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That study, published in the Annals of Internal Medicine last month, also found that those over age 65 had higher rates of temperature-related deaths.
“So the risk is very, very high,” Sobti cautioned. “It’s really that sudden rise in blood pressure coupled with the physical stress of snow shoveling itself.”
Safer shoveling tips
The cardiologist said it’s ideal to have someone else help with snow removal — but if you do choose to use a shovel, she recommends pacing yourself and using a “pushing or sweeping” motion instead of heavy lifting.
Recent research has shown that cold exposure accounts for nearly twice as many cardiovascular deaths as heat exposure. (iStock)
To protect against the cold, Sobti also recommends covering your mouth, nose and extremities, wearing a hat and gloves, and using extra caution in windy conditions.
Using an automated snow blower can still raise the heart rate — up to 120 beats per minute, compared to 170 while shoveling, the American Heart Association states on its website.
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It is also important to be aware of any symptoms of a potential cardiac issue while shoveling, Sobti emphasized.
If a person starts to experience warning signs such as chest pain, shortness of breath, a racing heart or palpitations, those should not be ignored.
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Even if the symptoms resolve after a few minutes, a person “could still be experiencing symptoms of a heart attack” and should call 911 for evaluation, Sobti said.
“It’s better really to be safe than sorry.”
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