That's how surgeons make the big bucks. Not on office visits. I had a doctor swear I'd probably end up with a major infection if I didn't let him remove a part of my intestine after a diverticulitis attack. I said NO, and he was furious. That was about 6 years ago, I haven't had another problem...and I DID NOT have the surgery. Go figure.
Dear Dazed. I'm really sorry about this. My DH was hospitalized about 5 years ago for 2 days with a TIA. I asked them then to do an MRI or something to see if he had AD but they didn't do it. I know how exhausting that can be. He was so uncooperative. I sat with him the whole time and played cards and other games just to keep him ocupied. I am praying for him and you. You must take care of yourself. You just can't afford to let yourself get to exhausted. Please try and get some rest.
My next door neighbor, with dementia, moved into an ALS on Saturday. The neighbor group that helps me sometimes too was taking very good care of her and not only found the ALS but also organized the move. Her kids are in denial, but they haven't abandoned her. They just don't quite "get it". At least one of them was here all weekend however and actually got the truck and did whatever moving by truck needed to be done, so they are trying.
It is so odd to see that house dark at night. She kept the lights on all night long both in her bedroom and in the bathroom and I could see those lights from my kitchen window.
My point is that this woman has had surgery at least 3 times in the last 4 years. She had the first one (absolutely necessary) before I even met her and just before she moved in. At that point she was still working at a full time job. And she still could work, and did although she never managed to get a full time job again, until after her second surgery for something in her shoulder. After that surgery she no longer could work.
After the third surgery for the other shoulder it all came crashing down. Couldn't drive which brought her to the close attention of the neighbor group. They were also her friends and they realized that her finances were in a mess because she no longer could handle them herself. They took that over and the rest is history.
I talked to her main contact at the neighbor group and she agrees that the last surgery was what landed her in the ALs. She wasn't able to continue with the physical therapy either.
If my husband needs surgery I'm fully aware that he will never come home again. At the stage he is currently at, there is no way I could handle him at home.
I believe it is the anesthesia that causes the mental decline with each surgery. One would think that when an elderly person or someone with EOAD required surgery, they would have a special way of dealing with the sedation that wouldn't put them under so deeply. Does anyone know an anestheist that could enlighten us, or help us understand why this happens. We KNOW this is the after effect in all cases when they have the deep anesthesia, surely they do as well.
Nancy-if discussed beforehand surgery can usually be done with local anesthesia and light sedation. Inhaled gases can be avoided. Of course being in unfamiliar surroundings is a different story.
Nancy B, I've brought a thread to the top for you:
Surgical anesthesia and dementia progression
Many people, including many doctors, believe anesthesia can trigger dementia. I originally accepted this belief, having seen a few recent studies, done with cell cultures, that appeared to point to a causative mechanism. However, one of the people on the Alz Assoc website (FTD patient) was facing surgery, had no choice, and was a very unhappy camper, so I looked into the matter more thoroughly.
There have been many, many, many studies on the impact that anesthesia and/or surgery might have on cognitive function. None of them found reliable evidence that anesthesia triggers, or exacerbates, dementia. They've looked at different drugs that are used to anesthetize, they've looked at the depth of the sedation, they've looked at general vs local. No evidence.
It appears that the problems are caused by:
(1) The hospital environment. Patients who are hospitalized for nonsurgical care can have their dementia symptoms exacerbated. There are steps that can be taken to minimize the impact of the hospital environment on our ADLOs, which I outlined for Dazed. Get that booklet from NIH and plan ahead.
(2) Medicines which are sometimes used for pre- and/or post-operative care. These can simply be avoided -- tell the doctors not to use them. I've listed those in the same post (and elsewhere on this site.)
(3) Difficulties that are sometimes encountered during surgeries, especially cardiovascular surgeries.
(4) Problems encountered after the surgery, such as infections. There are a few things that can be done to try to minimize these, such as trying to avoid catheterization if at all possible.
Sunshyne, If that is the case, and I have no problem accepting it, could it be the morphine they gave him the next four or five days that could have caused his problems.
Nancy, I'd have to do some digging to see if morphine can cause irreversible effects, which I can't right now ... but ... morphine sure isn't for everyone. My mother (who was diagnosed with AD but may have had Lewy body) went haywire on it. Morphine can cause hallucinations; also anxiety, memory problems, and insomnia.
Just in quickly looking for side effects, I found the following:
Morphine is not for treating pain just after surgery unless you were already taking it before the surgery.
You may not be able to take morphine unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it.
Do not stop using morphine suddenly, or you could have unpleasant withdrawal symptoms.
Dangerous side effects or death can occur when alcohol is combined with morphine. Check your food and medicine labels to be sure these products do not contain alcohol.
Sunshyne, I went to the site you suggested and printed out the information about preparing for a hospital visit. Wish I had done that before but didn't know I was going to need it.
I think it was the hospital environment and the morphine that caused the problems with DH. They don't give anesthesia for angioplasty and stints, do they?
All I know is what I know. (Wow! That's a profound statement) My DH fell. He broke his hip. He was taken to the hospital. The next morning at 10, he went into surgery. When he came out of recovery, he was a wild man. He was kicking, screaming, ripping off his hospital gown, pulling out his IV's, kicking off the block that held his leg straight, spitting, cursing, and he stayed like this for about 20 days. He came home after 10, developed pneumonia, went back in 3 days later, and still was hallucinating and even though the day "fits" subsided, they would come back at night (Sundowning). It's been a year and the bad fits are gone, (lasted about 3 months)..but he has NEVER returned to the place he was the day he broke his hip. ... and that's all I know!!!!!!
Something that happened there pushed his dementia ahead at least 2 years faster than it should have progressed. Or was it just a coincidence?
This just sounds awful and I know I sound trite. I've already made up my mind there will be no elective surgeries. If he needs it of course, he'll have it. But, believe me, I will be right on the doctor about the anethia. (sp).
There are 4 blogs written about anesthesia and hospital visits. Log onto the home page - www.thealzheimerspouse.com, and click "previous blogs". Scroll to #91,92, 117, and 118. In #117, there are links to articles about anesthesia and dementia.
I think what we have here is a 'gut feeling" about anesthesia. Almost any of us can tell a tale of someone who "never recovered" - mine is my friend whose memoirs I published. I saw her the week before she broke her hip, and about three months later. Before she broke her hip, she knew me, delighted in the copy of the book I brought her when it was first published, was playing scrabble and I watched her playing hangman with the people in her Assisted Living. After the break she was in a nursing home, couldn't walk (late 80s, so not too surprising) and didn't recognize me when I visited her. Barely could read or identify anyone in her book, though she cherished it. Mostly just sat. And two years later, she's still in that situation (she had no relatives and lives 200 miles away from me; friends do visit.)