Comments on: Post-operative Cognitive Dysfunction

By: Renee

Renee — Wed, 02 Feb 2011 21:21:49 +0000

My mother had very minor bunion surgery last year and within a day of the surgery she experienced significant memory loss as well as delusions. The initial disfunction lasted 3 months. Her GP thought she might have been allergic to the anesthesia due to a breathing complication from a previous surgery. We have thought this all along until recently. It has been 7 months since the last surgery and she still has “foggy days” every 4-6 weeks. They can last as a long as several hours to several days. She is scheduled to have a cardiac catheterization next week and I am terrified that she will go into another period of intense POCD. Are there any treatments? Have there been any cases of relapses with additional surgeries? Has the drug Versed used as a local anesthetic been shown to have this affect? Can you point me in the right direction for any help. I am finding nothing but resistance from her GP and the anesthesiologist.
Thank you.

By: Kathy

Kathy — Sat, 18 Dec 2010 15:07:32 +0000

My brother had a hernia operation on 12/13/10. He is 61 years old, and I think was suffering from mild depression prior to surgury. He worked hard all of his life, he is a very organized person and has always been extremely frugal with his money. He is out of work on a workman comp. claim that is complicated. The problem is he is not dealing with the responsibilites of this, he is in jeopardy of losing his job, his income and his medical benefits. I have offered to help sort out the paperwork and find the resources to help him and he has no desire to do so. He doesn’t have a plan at all to counteract his situation. When I ask him questions, he doesn’t respond for a long time (dead silence), and his continuous response is “its too overwheming”. Also, he did say his job is making him pay for his full medical payments (their portion and his) , so made 2 medical payments of over $1,400. This is very out of character for him. Do you think he is suffering from POCD?

By: Jared Tanner

Jared Tanner — Mon, 25 Oct 2010 03:14:52 +0000

I’m sorry to hear about your cognitive struggles amplexus. Yes, you could have POCD but it also might not be POCD especially because it is very rare for someone as young as you to have any cognitive problems after any surgery – that doesn’t mean it does not happen, it’s just very rare and unpredictable. Actually, the only thing we’ve found so far that reliably predicts who might develop POCD is age (people over 60 are at more risk). Even then, only a small portion of older adults develop POCD following major surgeries with very few of those having any lasting problems. Formal neuropsychological evaluation, if you haven’t had it, can be helpful in answering some of your questions. The surgery might have been a factor in your problems but it also might not be. I’m sorry I cannot give a more definitive answer than this but there are many things that can affect our cognitive abilities and a lengthy clinical interview and hours of testing often are required to start to understand what is going on.

By: Jared Tanner

Jared Tanner — Mon, 25 Oct 2010 03:02:24 +0000

Sorry for the delayed reply Paul. Your comment unfortunately got lost in the shuffle somewhere.

I, unfortunately, really cannot answer your question. Your cognition could improve but it also might not. Some people take up to a couple years to fully recover from surgeries. But, like you said, your cognition problems might not even be a result of the surgery.

Keep seeing your neuropsychologist for assessments and/or a neurologist if you continue to have struggles. Often clinically, we will assess people 3-4 times to see any progression of cognitive changes either good or bad. That’s really the only way to get more solid answers. I’m sorry I cannot be more helpful than this but hang in there!

By: Jared Tanner

Jared Tanner — Mon, 25 Oct 2010 02:28:52 +0000

I’m sorry to hear about your father’s cancer Kimmy. The forgetfulness could be any of what you said – anxiety, caused by the cancer and treatment, or POCD. If your father continues to have some forgetfulness that is interfering with his life or is distressing to him, I’d advise getting him a neuropsychological evaluation. The severe anxiety and panic attacks are treatable by psychologists with usually very good results. There are panic attack treatment protocols that have close to 90% success rates. If he has POCD, it can take up to a year for his cognition to return to normal. At the least, I’d recommend waiting until at least 6 months post-operation before a neuropsychological evaluation (although it might take a while to get in to see a neuropsychologist). He could certainly see someone sooner, especially about his anxiety.

But yes, his anxiety could be causing the forgetfulness as could his cancer and treatment; it is not a simple answer. I hope things go well for you and your father.

By: Kimmy

Kimmy — Fri, 22 Oct 2010 23:18:36 +0000

My Dad was diagnosed with stomach cancer. He had more than half of his stomach removed. The surgery had complications. That was 11 weeks ago. Now he is getting prep. for his chemo and radiation. He seems worse now than when he came home from the hospital. He cannot focus on anything for more than a few minutes. He has episodes where he completely forgets how to do simple tasks. He also moves more slowly and almost shuffles when he walks. The doctors have told us that the surgery was a success and that he is doing great…My Dad is 62 yrs. old and it is very upsetting to see him this way. The forgetfulness is causing him severe anxiety….and he has had panic attacks. This is new as he has never had them before. I had thought these may be attributed to the cancer. The doctors feel this is just anxiety. I am wondering…do his symptoms sound like P.O.C.D.? I have only just learned of this condition.

By: amplexus

amplexus — Sat, 09 Oct 2010 04:39:59 +0000

I am 47yr old female who had a hysterectomy at age 39. Went into surgery with a perfect memory and came out with severe short term memory loss and cognitive impairment. I was told it should go away in a few days. Then I was told it would be a few weeks. Then it became years. It has slowly been getting better but I still have moderate impairment. 8 yrs later and I am at a loss. The short term memory loss is slightly better but the cognative is a huge struggle. What happened? There is no other reason for this problem. Could it be POCD?

By: Paul Cartwright

Paul Cartwright — Thu, 29 Jul 2010 21:53:34 +0000

I am a 47 year old former Library Director. I am not sure from what That I have cognituion problems. I have PTSD from my previous job due to harrassment from a board member.
I have a rare homoplasmic variant of Mitochindrial Disorder. I has a surgery from which I awaoke from asenthesia upset and disoriented in March 2009. My Neuropsychologist has done
cognitive testing and I have about 20% loss in executive abilities. I continue to have staring spells with mouth open etc. MY question is will my cognition get better?

By: Gene Etter

Gene Etter — Wed, 09 Jun 2010 21:33:44 +0000

6/9/10
I have hip replacement surgery scheduled for 6/15/10, and I am very concerned about POCD. Have there been POCD studies since you wrote about it? Also, is there memory loss with POCD? I am 70 years old and am a high school teacher/coach. If I go through with the surgery, I would like to test myself before and after. If the “after” test shows POCD, I would like to periodically test myself. I am finding it difficult to find tests for this purpose. Do you have suggestions? Part of my concern is my mother has Alzhiemer’s, and when she had hip replacement surgery two years ago, she had a decline of cognitive skills. I test her once a week with reading names of people in her life, a 5-piece jigsaw puzzle, and three photos (of herself, me, and her other son), each of which are cut in half for her to try to push together. In other words, I had something concrete to go on. After a few weeks, she regained enough cognitive skills for me to say she got back to normal, for her, although these activities are not thorough enough for me to be sure. Enough about Mother. I’m wondering about the possibility of new studies coming out within the next year or so, which would prevent or bring down the % of decline of POCD. Is it possible to find out if studies are planned in the future?

By: Cassa

Cassa — Thu, 11 Feb 2010 19:40:49 +0000

Thanks so much. I know you’re right in saying it’s too soon to be worried. The issue may be that we weren’t properly informed about possible post-op scenarios — parameters for “normal” during the recovery. I intend to share this observation with our medical provider, Kaiser.