A little more than a year ago my mother had a small surgical procedure, and was effected by the anesthesia in an unexpected way. During a (relatively) short surgery, she had developed a form of temporary dementia that is not uncommon to patients in poor health. Unfortunately, this condition was not brought to our attention prior to surgery. This week when my mother (featured on the left) had another short procedure, I shared her last experience with her current anesthesiologists, who concurred that the possibility of post-surgical dysfunction should be brought to the attention of the frail elderly and their caregivers more often. After our discussion, my mother’s doctors made a slight change in the course of her anesthesia as a preventative measure. Though she was still at risk for a re-occurrence, ‘mom’ came out of this procedure with her memory intact. (Phew!) I am sharing this story from last year, so you can be more prepared with the right questions to ask prior to surgery…
When my 76-year-old mother had recent back surgery my siblings and I had a zillion questions and concerns that we shared with her orthopedic surgeon. It turns out we should have saved a few of those questions for the anesthesiologist…
My mom slept most of the day following her procedure, and was in and out for most of the night. When I arrived in her room the next morning, she was sitting upright in bed, with a plate of eggs and bowl of fruit resting on her tray. My mouth dropped open in surprise as I watched my glassy-eyed mother pull the straw out of her drink, and begin stabbing her cantaloupe cubes with it, as if it was a fork. Given the oddity of the situation, all I could think of doing was putting the straw back in the drink, and handing my mom her fork. Robotically, she repeated the entire incident, and appeared to be in some type of fog. Anxiety rose in my chest, as I smashed at the “NURSE” button for help.
Six months’ prior my mother had experienced a moderate stroke, which she had largely recovered from. Based on her actions, I couldn’t help but fear that she had suffered a recurrence. My mother still maintained her table manners even during the lowest moments following her stroke, and her level of confusion had me not only concerned, but pretty freaked out. A neurologist was called in, and was equally concerned, not only about her lack of etiquette, but also because she was unaware of the date, month, year, or even the name of the President. While my mom was never that great with the calendar, she knew her politics, and never missed her “Morning Joe” on MSNBC.
A series of scans showed that her brain was “unremarkable”, which apparently is a good thing. Seemingly, she had not suffered a further incident, so what accounted for her current fogginess? The doctor explained that she most likely was suffering from post-operative cognitive dysfunction (POCD), a temporary fogginess with dementia-like qualities that effected some patients (mostly seniors) after surgery. I “googled” this phenomenon, which I had never heard of, and immediately dozens of sites with information popped up. As Marketing Director of the Jewish Pavilion, I am lucky enough to have a Senior Resource Specialist on speed dial. I reached out to my friend and colleague, Emily Newman, from the Pavilion’s helpline, The Orlando Senior Help Desk, to help navigate my way through the pile of information.
Though I spoke to Emily long distance from Chicago where I had traveled for the surgery, her reassuring voice calmed, as if it was coming from the office next door. She listened intently, and took a moment to take in my mother’s story. In times of crisis, a listening ear can be invaluable. Emily was familiar with POCD, and shared that it was more likely to occur to patients and seniors with compromised health. We discussed a few of the websites I had found. After reading through several of them, I put together some basic facts on the subject, learning that the fog could last a few days to several weeks. According to what I had read, the length of my mom’s suffering was anybody’s guess, as the phenomenon was not fully understood.
I had planned on staying for just a few days to help my mom after her relatively minor procedure, which typically involved less than a full day of hospitalization. On day four, my mother was transferred to rehab, where she stayed an additional two weeks. Today, I’m happy to say my mom is back in her assisted living home, recovered from her procedure, with her quality of life restored. Additionally, she is enjoying an overload of her daily dose of politics given the current political climate, and reports that even Miss Manners would be proud of her correct use of cutlery.
I wish a medical professional had discussed the possibility of POCD with my family prior to surgery, and that is why I am sharing this story with you now. Before the procedure, we had asked the doctors about anticipated complications, but should have asked about complications specific to her age group and her health history. By the way, I am not the only one with The Orlando Help Desk available on speed dial. Our senior helpline is a no cost resource for anyone with an issue concerning aging and older adults. Call 407-678-9363 Monday through Friday and our Senior Resource Specialist will be waiting for you on the other end, or will return your call ASAP. Call during a crisis, or just to ask a simple question.
Oh, yeah. Say “hello” to Emily for me when you call, and tell her that Pam sent you.