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My sister in law is 87. She has had some health issues, has COPD after years of having it called "asthma", uses oxygen from a concentrating machine, and takes some other medication. Last week she had to have an emergency surgery to repair a hernia that was compromising her colon... She lives in Austin with her oldest son now so we were not involved--just got phone calls and some texts from the son when they had taken her to ER to have problem assessed.
He said the doctor said surgery went well--no problems with her COPD--and she was released from hospital the next day. She was there less than 30 hrs....so maybe it was hernia repair done with laparoscopy ---
So she has been home for 3 days---had one bad panic attack the day after where she thought she was having heart attack and they took her to ER...they live north of Austin so getting to hospital takes time and getting an ambulance is expensive... Supposedly it was panic attack--her other signs were ok.
She went home. Had one good day but last night was bad--she was confused, didn't know where she was.
Now her son says that could be from her bladder infection---first time we heard she had one but she has had them before...so they are taking her to Doctor. To confuse the issue, she recently moved in with her son and DIL--she was living in Victoria, TX and doesn't have a personal doctor in new location...so everything w/the hernia was done with first-time doctors via the ER. The hernia apparently was an existing condition which became an acute threat and had to be dealt with. Not sure about the issues after the surgery.
I am starting to wonder if maybe she had a mini-stroke or another issue with her breathing during the anesthesia and had some loss of oxygen -- causing cognitive problems...
How do you check for problem like that? What tests? Specialist?
Due to her age, it is possible she could be having onset of dimentia or similar problem...
We have noticed that over past couple of years she has had some times when we talked to her on phone and she would be kind of "drifty", a little out of it...but we live 5 hrs away and didn't see her in person very often.
Her mother lived to be 90, died from heart attack--and had no signs of mental cloudiness really...
Any way to tell if this is something resulting from the surgery--or if it might have been something lurking in the background
It is very, VERY common for an elderly person to have some mental confusion after general anesthesia, and frankly her doctor should have shared this with whoever is on her HIPAA paperwork. And here's the not so good news - sometimes they come out of it, and sometimes some mental confusion is permanent or it exacerbates dementia that may have been mild to start with - it can sort of kick start it if that makes sense. It can push dementia to the forefront.
Also, bladder infections definitely can cause dementia type symptoms or mental confusion in the elderly.
My recommendation is that she be screened for a bladder infection, which can be done by a general practitioner anywhere. IF that's a possible issue, she needs to take meds to clear that up and then you can see what you're really dealing with - get that out of the equation if it's there.
Then just be sure she's getting plenty of rest and water and good food and give it a few weeks to get the anesthesia and all that completely out of her system. What is left after about a month is what is left to deal with.
Good luck. You may want to post this in the Caregiving section as well, since so many folks there (myself included) deal with this exact sort of issue regularly.
A dear friend of mine (72j had knee replacement rurgery a couple of years ago. Now her short term memory has been compromised. They point the fingers to anesthesia.
I asked a friend of mine, who is a carreer anesthesiologist., about this. He says the “best” way to alter the health of seniors? Yes...anesthesia. It happens. It can compromise the health of otherwise healthy people. Sad but reality. Risks.
This is one of the reasons older people need to proceed with caution when having surgery. My husband is 81 and just 2 weeks ago had semi emergency to repair a hernia similar to what the op is referring to. He actually had 11 small incisions as they found 4 hernias. Prior to this he had 4 different hernia operations. His surgeon, who has had in the past said to be very careful and yes, the anesthesia did leave him more confused than in years past. Now, after 2 weeks he is doing fine. I do know he isn't about to undergo anymore surgeries unless it is a matter or life and death. In this case it could have been because the hernias were interfering with his intestines and causing him not to be able to hold food down.
That's why I say if you need a hip or knee replacement or any sort of surgery, even mild surgery, that requires general anesthesia, do it sooner rather than pushing it out till you're elderly, hoping it will just correct itself or whatever. The elderly and anesthesia really don't mix well together. Sometimes it's inevitable or totally necessary to do surgery on an elderly person but if it can be avoided, avoid it.
I appreciate both responses--
Didn't think about the care-giving forum--
Don't go there much but that is good to know
I have learned that for almost anyone the riskiest part of a surgical proceedure--day surgery or more serious--is the anesthesia aspect....and most people don't know who will do that until after the proceedure---a real "weak link" in my opinion and often a blind-side hit too...
She has had problems with bladder infections, dehydration, and cognitive issues before
She refused to find a new GP in the area when she relocated--wanted to stay with her known doctors--but that is a long drive for an acute problem...and she really needs someone locally for consistent oversight IMO...
Personally doing information exchange via text vs phone call or in person is never satisfactory
My husband isn't really asking any questions either---he doesn't want his nephew/her son to think he is too critical or second guessing their decision making...
That would not be my choice---but she is HIS sister--so I am trying not to be intrusive--
He knows every time I ask him a question I would want more clear explanations/insight...
The son's daughter is in her 40s and is a nurse/midwife in Austin--she is one they called when they found "Granny" lying on the floor because of the pain from the hernia---
daughter convinced them to get her to ER ASAP which was a god-sent because her colon wasn't damaged...didn't need resection.
Could have been lot worse if they had delayed seeking treatment...
This is one of the reasons older people need to proceed with caution when having surgery. My husband is 81 and just 2 weeks ago had semi emergency to repair a hernia similar to what the op is referring to. He actually had 11 small incisions as they found 4 hernias. Prior to this he had 4 different hernia operations. His surgeon, who has had in the past said to be very careful and yes, the anesthesia did leave him more confused than in years past. Now, after 2 weeks he is doing fine. I do know he isn't about to undergo anymore surgeries unless it is a matter or life and death. In this case it could have been because the hernias were interfering with his intestines and causing him not to be able to hold food down.
For my SIL it was life or death--the hernia apparently had gotten worse and started to bind the colon--why she was in such pain--
If it had not been repaired her colon would have necretized and led to gangrene
I was just surprised she was released from hospital so quickly--I think she was really there less than 24 hrs
And when you deal with ER doctors/surgeons you often get very little personal contact--
The nurses do most of the information providing
People have to be pro-active in seeking information too and I don't know how these people (her son and his wife) act around doctors....some people just don't ask lot of questions at all
It is very, VERY common for an elderly person to have some mental confusion after general anesthesia, and frankly her doctor should have shared this with whoever is on her HIPAA paperwork. And here's the not so good news - sometimes they come out of it, and sometimes some mental confusion is permanent or it exacerbates dementia that may have been mild to start with - it can sort of kick start it if that makes sense. It can push dementia to the forefront.
Also, bladder infections definitely can cause dementia type symptoms or mental confusion in the elderly.
My recommendation is that she be screened for a bladder infection, which can be done by a general practitioner anywhere. IF that's a possible issue, she needs to take meds to clear that up and then you can see what you're really dealing with - get that out of the equation if it's there.
Then just be sure she's getting plenty of rest and water and good food and give it a few weeks to get the anesthesia and all that completely out of her system. What is left after about a month is what is left to deal with.
Good luck. You may want to post this in the Caregiving section as well, since so many folks there (myself included) deal with this exact sort of issue regularly.
Keep us posted!
Kathryn explained this well. (except my husband's doctors said that it could take three to six months for effects of the anesthesia to dissipate, with the vast majority of change in the first few weeks, but that may have been specific information for his medical situation)
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