Beware of Post-Operative Cognitive Dysfunction

I found out about POCD when it happened to my mother. She went in for a routine colonoscopy and was given a new medication with her anesthesia. Mom jokingly told the nurse she wanted something so she’d forget she was there. The nurse told Mom that the medication would help wipe her short-term memory, so she probably wouldn’t remember much of anything of the procedure. That sounded good to Mom. She had the colonoscopy, and everything seemed fine. But it wasn’t.

When Mom went back for her post-op visit a week or so later, she told the surgeon that she had been noticing problems with her memory, sort of a sluggishness. Mom had always been very sensitive to medications and if there was a side effect, she would get. It Mom was also really in tune with her body and knew almost right away that something wasn’t quite right. The surgeon told her that this sluggishness was due to the anesthesia and that it would work its way out of her system in a month or so.

Four weeks later, when Mom went back to see the doctor, things weren’t any better. In fact, Dad told the doctor that Mom’s memory loss was worsening instead of improving. Again, the doctor told them to give it time.

Ultimately, by the time the anesthesia “worked” its way out of Mom’s system, her memory had so many holes in it, they couldn’t be filled. Of course, then we were told mom had dementia and that it wasn’t related to the anesthesia.

But I was there. I saw it happen. I knew her before the colonoscopy and I knew her the day after and the week after that… and she was never the same.  I really lost my mom that day – she just didn’t pass away. We got to watch her fade for nearly 3 years. It was the POCD.

I didn’t know much about POCD before it happened to my mom, but it affects a substantial number of older adults after surgery. Most patients are not told of the post-surgical risk of POCD during the process of informed consent. But they should be.

POCD can involve subtle, difficult-to-recognize symptoms that develop days to weeks after surgery. Some patients with POCD experience memory problems; others have difficulty multitasking, learning new things, following multistep procedures or setting priorities.

Most of the time, POCD is transient and patients get better in several months. But sometimes — how often hasn’t been determined — this condition lasts up to a year or longer. In my mom’s case the condition was permanent and may have contributed to the onset of her dementia.

Mom’s story just goes to prove that when you’re caring for elderly loved ones, you must be prepared be their advocate. Ask questions and don’t be afraid to irritate the doctors. Sometimes that means putting the boxing gloves on. The last time dad had surgery, I nearly got into a yelling match with the anesthesiologist who kept badgering me and Dad because Dad wouldn’t allow the drug that had caused Mom’s POCD to be used. Fortunately, we won that argument. But only because we persisted.  

If you have questions about an elderly loved one’s care, Takacs McGinnis may be able to help. Just give us a call.

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