pog's picture

pog

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Post Surgical Delirium

Does anyone know anything about this?

In another thread I spoke about my father who is 81 and broke his hip in September, requiring a major emergency hip replacement. His surgery was the day after his accident.

Since the surgery his personality is totally different. He is very confused ( at times he didn't even know my sister and I although that, thank God, has cleared) and is so forgetful he literally cannot tell you what he had for breakfast.

It is hard to describe the agony of losing a parent this way. It feels like a long, slow goodbye.

The doctors don't know if this will clear in the coming months and he will return to normal or whether this is the beginning of long term dementia.

Any experiences anyone could share would be most appreciated.

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Dandarii's picture

Dandarii

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Pog, I'm so sorry to hear about your father. I can only imagine how difficult this is. I have never heard of post-surgery delirium. Is it possible he might have had a mini-stroke during surgery?

My grandmother had a couple strokes last year and since then her memory is almost exactly as you have described.

My thoughts are with you and your family.

Dana

nestingtree's picture

nestingtree

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I had something similar with my own father. He was only 69 then and had lung surgery. Came out of surgery and was entirely bonkers! He was seeing little men on his window sill and other delusions. He couldn't write his name. He was confused about dates and times. It freaked us out. They called in the psychiatrist who explained it to us but wouldn't give us a sense of when it would clear. He implied it was not uncommon in old people (my dad wasn't that old but his body was). I thought I knew a lot about what to expect, but no one had told us about this! How could I have not known about this before?

Anyway it did clear up thankfully. Totally back to normal after about a month in his case. It was gradual (he would go in and out of it). It was, however, very scary at the time.

I hope you have the same experience and I wish you luck in days ahead.

nestingtree's picture

nestingtree

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Here is a link I just found on it. The good part was the word near the outset which reads "Transient":

http://www.asahq.org/clinical/geriatrics/posto.htm

linus73ca's picture

linus73ca

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We believe my Dad had the same experience. It happened in January 2002 and it was a very long recovery. He does happen to have some other health issues that complicated things.

We were told in November 2002 that he would never live at home and would have to go into a personal care home. He has never been back in hospital since and is now living on his own. Still not quite the same, and does tend to forget some things, but for the most part okay.

Good luck.

sighsnootles's picture

sighsnootles

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good lord, pog, i am so sorry to hear that...

i used to work as a nurse on a neurology ward, and we would see that kind of thing with people who had strokes... one in particular was just awful. the guy was a very religous man, and had a very religious family. after the stroke, he punctuated all his sentences with four letter words, and constantly masturbated in front of everyone. his wife and family were absolutely mortified by his behaviour, and any of his friends who came to visit him left after 5 minutes.

he was transferred off my floor and sent to the rehabilitation ward, and to her credit, his wife was standing beside him. but i've always wondered how they did after that. talk about 'in sickness and in health'... wow.

anyways, my point in telling that is that there may be some kind of support group that may be able to help you, pog... if you talk to someone about support groups for family members of stroke victims, they may be able to give you some information and help to get through this.

hope you find some help and solace somewhere, and you are all in my prayers, pog... peace.

stardust's picture

stardust

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Hi again Pog

I have a very sad story to tell. My mother-in-law, age 89, had been living on her own with no outside help except for grocery shopping. She did her own housework, washing etc. and went to the hairdresser alone. She didn't have any disease or serious physical problems. Her mind was typical of her age group except she feared her sister would put her away. She was my husband's step-mother.

3 yrs. ago just before xmas she apparently broke a glass in the kitchen and cut her leg; small cuts. Her sister had been seeking a way to have her put into a home. She put her into hospital as a means of accomplishing this. I'll never know what happened to her but within 3 days she lost her mind. I believe it was due to drugs they were giving her. They did 2 cat scans which turned up nothing. She would take every article in her room including the bed sheets and stuff them into a pillow case saying she was packing to go home. She was talking nonsense saying she had often visited the Nile (Egypt). Personally I think she had a drug induced nervous breakdown re her prior fear of hospital etc.

Finally, I presume she wouldn't stay alone in her room. She became very aggressive and ill tempered with the staff insisting on going home and trying to run away. They strapped her into a wheelchair out in the hall almost 24/7. She wasn't allowed to move. I figure they were afraid she would fall and the hospital didn't want the expense should she break a hip. It was very sad and inhumane. She refused food and drink for almost 2 months. The staff seemed to be laughing and making fun of her.

She had always vowed she would commit suicide if her sister put her away. She was due to be placed in a nursing home the next day when the hospital called at night saying she had taken a bad turn, heart attack maybe; medics working on her. She was in intensive care with no hope. They removed life support and she died the next afternoon.

The nurse phoned me to tell me it wasn't a heart attack. They said she had choked on her food. She had no dentures. She was served frozen dinners, big chunks of chicken etc. She may have been yelling at the nurses while trying to eat or she choked herself on purpose. I believe the latter. It was like : "Oh well...she choked "....and nobody cared.

Pog....I was totally horrified throughout her whole hospital stay. My psychic is scarred to this day. I lived far away and couldn't visit often. My husband was working and couldn't deal with the emotional turmoil it caused him. It was his step Mom. They had not always enjoyed a good relationship. I know many families stay at the hospital with their elderly parents round the clock to prevent the hospital from drugging them excessively.

My mother-in-law had loved to walk. I wondered why the hospital couldn't have some kind of railings in a room so she might walk. Her legs became totally swollen up and her toes rather infected with rashes etc. Presumably she wasn't able to manoever a walker. Yes, her sister took her for a walk in the hall when she visited her. It wasn't enough.

This occured in a large well known Toronto hospital. If I had to choose a career now I would choose to work on behalf of the elderly in hospitals and nursing homes lobbying the government, the hospitals, and making a big fuss. I hope I don't scare you. Its not a nice story. God bless your father and I pray he gets back to normal health.

Vespagirl's picture

Vespagirl

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Hi Pog
So sorry about your Dad. Unfortunately I have seen this very thing with my Mother.
She paased away 2 weeks ago from a stroke after suffering with a dementis of some sort. (Alzheimers diagnosis cannot be confirmed until autopsy).
About 10 years ago or so my Mom started getting a bit forgetfulll. She otherwise seemed ok and we did not worry too much. About 6-7 years ago my mother had emergency surgery for a ruptured diverticulum in her bowel. Less than a week later back to surgery again for peritonitis. After that my Mom was never the same. She saw things, talked only in the past, kept asking for her parents(both deseased in the early 60"s), and was very upset and did not know why she was in hospital.The Doctors at first attributed it to a post surgery psychosis from the anesthesia.
When she finally did come home she did settle down some and my Dad was able to look after her and she could function pretty well but did not always recognize people and woulf forget things that had just happened. But as time went on Mom only got worse until she finally was placed in a nursing home about 18 months ago.
I think that maybe the dementia would have shown itself at some point but I really think the trauma of 2 difficult surgeries brought things to the forefront a lot quicker.
I hope that this not the case with your Dad and that he does improve.
Take care and Big Hugs

Atheisto's picture

Atheisto

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Did he have a head CT? He could have had a ministroke from a dislodged bloodclot from the surgery.

Just a thought..it's why you are heparinised after a surgery...to try to stop this problem.

sighsnootles's picture

sighsnootles

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hows it going, pog?? is your dad doing any better??

you're in my prayers.

pog's picture

pog

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Hi Sigh - actually things are not going well. On top of everything else, Dad was rushed to hosptial on Monday with heart failure and pneumonia. He keeps hanging in there though - he's tough and we're doing a lot of praying. We're just not ready to say goodbye yet.

There really is not much dignity in this getting old thing.
Thanks for your thoughts and prayers.

Pog

pog's picture

pog

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Hi Atheisto- they have now done 3 CT scans and have found nothing but this new trip to the hospital has added to the confusion and delirium. The doctors said to expect that....

wilmahelen's picture

wilmahelen

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Dear Pog:

I can only tell you of a personal experience. I had major surgery on my spine a number of years ago. I was only in my thirties at the time but, after surgery, I found that I had lost some of my mental capacities. I was a bookkeeper by profession, but I had and still have lost all concept of numbers. I can't even remember my own telephone number. I also lose words and names. I forgot (no it's not even forgetting - it's like it never existed ) the name of a girl I fostered for several years. Eventually, I received a diagnosis of fibromyalgia. I don't know whether I believe it or not. I have found ways around these blocks and having a supportive family is a great help. I will pray for you and your father.

WilmaHelen

Lissimore's picture

Lissimore

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Hi Pog,

I'll keep you, your dad, and your family in my prayers. Tough times.

I have had some experience with post-trauma delerium - not just surgery, but that included. Most of it is anecdotal, but supported by folks in the field whom I respect. It seems that it is not unusual for someone who is older to have a fair cognitive impact after a traumatic event (which includes surgery, but also car accidents etc.). While I was in Prince Rupert, BC, an elderly member of my congregation struck a pedestrian in a situation where witnesses (thank God for them) said that it would have been impossible to see the guy as he darted out into the street very abrubtly (he was drunk). Anyway, the man from my congregation showed very significant cognitive impact from the event. Many folk in the congregation came to me, concerned about the man's mixed up memory, forgetfulnes, and some behavioural changes. Then a wise nurse in the congregation told me not to worry -- it was the body's response to shock and once the shock wore off, he'd be fine. She wasn't talking about his blood pressure returning to normal or any other standard medical definition of shock, but more a psychological one. Sure enough, over the period of about a year, he did come back to being basically his old self again, only a year older. Once I knew about the pattern, I started seeing it in my hospital visiting as well. The sad news is that I have also seen relatively minor "shocks" (such as broken hips) precipitate a downward spiral from which many have not recovered, eventually leading to their deaths. Wish I could tell you how to tell the difference between the two. Part of it is the positive outlook of the person, but that's not all of it. I've seen people with really grim and negative outlooks rally (medically) and walk out of the hospital just as I've seen positive people being the next ones that I've buried. Prayer (including cathartic lamentation), and the nurturing of relationships with God and each other is all I have to suggest (which, I note, you're already doing).

Wish I had better answers for you in this touch time. May God bless you and your whole family with a tangible sense that you are not alone as you walk this path.

Shalom.

easternDiva's picture

easternDiva

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Pog, sometimes a person has what is called a ministroke or a TIA during the surgery process itself or just after. In that age group strokes are a big risk factor.
On the other hand the elderly get confused out of their own environment , especially if they were on the edge of being senile to start with. They cope well at home because it is familiar but in new places they become very confused.
Sorry to hear about you dad and hope this info helps
Diva

Londongirl's picture

Londongirl

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Hi, and sorry to hear about your father. i would check any medications he is on.
Don't be afraid to ask about anything he is on. Hope this helps. My prayers are with.

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