Experience with Postoperative Cognitive Dysfunction?

Anonymous
OP here. She had a bowel obstruction. There is no UTI, we’ve stopped any oxy. She wasn’t delirious after surgery—she was great and improving for 10+ days. It’s so weird.
Anonymous
One of the PPs here: my dad's delirium began after a fairly routine ER visit for an allergic reaction. No painkillers involved, just an Epipen which he'd had before. They kept him overnight for observation and then longer because he was clearly not right. In his case the delirium manifested as unresponsiveness; for some people, it can be more like mania.

He wound up getting pneumonia and staying in the hospital 6 weeks. He had early stage Alzheimers and had been living independently (with some support) but after this episode his mental and physical condition had degenerated so much that we had to move him to memory care.

Our experience was that the doctors didn't understand delirium very well, they kept insisting that it would dissipate quickly and he'd bounce back. I don't know if it would have made a difference but in retrospect I would have pressed to find someone with real expertise on delirium in hopes of doing something other than waiting for things to improve. Good luck OP.
Anonymous
OP here. Thanks for sharing that. In all my research about this, there really isn’t a treatment anyway. They’ve tried certain anti-inflammatories but there doesn’t seem to be consensus that any of it works. I think it’s similar to the issues of long COVID or any post-viral syndrome where your body mounts a response and overdoes it.
Anonymous
Unfortunately doctors do not like to tell people that anesthesia can cause this. It’s a big risk with older people, and one of the reason why surgery is so dangerous. I’m really sorry.
Anonymous
Anonymous wrote:Unfortunately doctors do not like to tell people that anesthesia can cause this. It’s a big risk with older people, and one of the reason why surgery is so dangerous. I’m really sorry.



But wouldn't that impairment have been evident immediately after the surgery rather than coming in 10+ days afterwards?
NP
Anonymous
I think it may be less important that the onset was later and more that it’s coming with a bowel obstruction that left her hospitalized for a week. It sounds like her body is declining pretty quickly. She may just be good at masking and was holding it together during the “crisis” hospital phase too.
Anonymous
Is there any chance they are secretly drugging her in some way? I’d try to get her out of this home as well.
Anonymous
Did they actually culture her urine for awhile? And any new meds post surgery other than oxy? Even antibiotics? My elderly parent has had some disturbing side effects like this with random meds (even ones not known cause such issues) but they go away when the meds are changed.
Anonymous
Anonymous wrote:Did they actually culture her urine for awhile? And any new meds post surgery other than oxy? Even antibiotics? My elderly parent has had some disturbing side effects like this with random meds (even ones not known cause such issues) but they go away when the meds are changed.


PP here. Also note that false negatives are very common even when there is a UTI.
Anonymous
Anonymous wrote:Unfortunately doctors do not like to tell people that anesthesia can cause this. It’s a big risk with older people, and one of the reason why surgery is so dangerous. I’m really sorry.


It was only after I had heart bypass surgery that I learned that postoperative cognitive decline was a thing. Guess I'm glad I didn't know, because it would have been one more thing to worry about and I had no choice about having the surgery. Fortunately as far as I know, it didn't happen to me.
Anonymous
Anonymous wrote:She may never recover from it. Hopefully it will improve but don't expect her to return to pre-surgery. To be blunt, prepare for this to be the begining of the end. I know that isn't pleasant to hear, but it's better to deal with the truth. Don't drag her to doctors and subject her to test to find a "cure"


OP, hate to agree here, but do. This happened with our 85 y.o. dad - physically and cognitively so sharp before his fall, but never cognitively recovered from the surgery. Regrettably languished for another 14 months with no progress. Do what you can, but don't necessarily stress her.
Anonymous
I know she's been taken off the opiates, but what about other drugs? Is she on trazodone or any kind of med to help her sleep? Those can definitely cause mental alteration.

And I second the statement that UTIs are often not properly diagnosed. Ask which diagnostic tests they ran.
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