New to forum with medical/mental request for help

G

Gto

New Member
Guess I’m seeking wisdom from the group. A79 year old retired schoolteacher with no previous mental issues recently had pacemaker and knee replacement almost back to back. Did fine with surgeries but in a few days became lethargic, blank stare, no blinking and consumed with worry over even the smallest item I.e. bills, money, hygiene, etc. Minimal communication. Previously she drove, shopped good hygiene. Been almost two months and no change. All bloodwork, mri, etc are normal. Or local doctors seem to not even have a hint. No improvement thus far and our own mental state is suffering. Don’t know what to do.
Any thoughts from the group…this is destroying our family who she lives with?
 

Gto said:
Guess I’m seeking wisdom from the group. A79 year old retired schoolteacher with no previous mental issues recently had pacemaker and knee replacement almost back to back. Did fine with surgeries but in a few days became lethargic, blank stare, no blinking and consumed with worry over even the smallest item I.e. bills, money, hygiene, etc. Minimal communication. Previously she drove, shopped good hygiene. Been almost two months and no change. All bloodwork, mri, etc are normal. Or local doctors seem to not even have a hint. No improvement thus far and our own mental state is suffering. Don’t know what to do.
Any thoughts from the group…this is destroying our family who she lives with?
Click to expand...
Oh my, this sounds like a real problem, I can't help you with this, but we have some very wise people here, I'm sure they'll see this and give some advice...
 
Gto said:
Guess I’m seeking wisdom from the group. A79 year old retired schoolteacher with no previous mental issues recently had pacemaker and knee replacement almost back to back. Did fine with surgeries but in a few days became lethargic, blank stare, no blinking and consumed with worry over even the smallest item I.e. bills, money, hygiene, etc. Minimal communication. Previously she drove, shopped good hygiene. Been almost two months and no change. All bloodwork, mri, etc are normal. Or local doctors seem to not even have a hint. No improvement thus far and our own mental state is suffering. Don’t know what to do.
Any thoughts from the group…this is destroying our family who she lives with?
Click to expand...
Some of these symptoms are akin to the those mentioned on the near death thread. I wonder if a significant change in life routine (such as hospital stay) could put a 79 year old into a mental crisis. I suggest a visit to a genealogical psychiatrist. My prayers are for you all.
 

I am so sorry for your suffering. If I put your post to a trusted AI it says:

I'm sorry to hear about the difficulties your family is experiencing with your 79-year-old relative. Based on the information you've provided, it appears that she may be experiencing postoperative cognitive dysfunction (POCD) or delirium, which are common complications in older adults following surgery.Postoperative cognitive dysfunction is a decline in cognitive function that can occur after surgery, particularly in older patients. The symptoms you describe, such as lethargy, blank stare, minimal communication, and excessive worry, are consistent with POCD or delirium
1
4
.Some key points to consider:

  1. Prevalence: Among patients aged 65 years and older, up to 65% experience delirium and 10% develop long-term cognitive decline after noncardiac surgery
    4
    5
    .
  2. Multiple surgeries: Your relative had two surgeries (pacemaker and knee replacement) in close succession, which may have increased her risk of cognitive complications
    3
    .
  3. Time frame: While many patients improve within weeks to months, some may experience longer-term effects. It's been almost two months in your relative's case, which is concerning but not necessarily unusual
    1
    3
    .
  4. Normal test results: It's common for standard tests (bloodwork, MRI) to appear normal in cases of POCD or delirium
    7
    .
Recommendations:
  1. Seek specialist care: Consider consulting a geriatrician or neurologist specializing in cognitive disorders in older adults
    7
    .
  2. Cognitive assessment: Request a comprehensive cognitive evaluation to determine the extent of the decline and track progress over time
    1
    .
  3. Supportive care: Maintain a calm, structured environment, ensure proper nutrition and hydration, and encourage gentle physical activity as tolerated
    7
    .
  4. Family support: Consider seeking support for yourselves as caregivers, as this situation can be emotionally taxing
    7
    .
  5. Patience: Recovery from POCD can be slow, and improvement may still occur over time
    1
    3
    .
Remember, while this situation is challenging, there is hope for improvement. Many patients do recover cognitive function, though the process can be gradual. It's crucial to work closely with healthcare providers and consider seeking additional opinions if you feel your concerns are not being adequately addressed.

Maybe this is what is wrong. A doctor/neurologist would be best to make sure.
 
Great response Paco Dennis(y)

I also googled "can heart surgery and knee surgery back to back cause mental health issues" Quick AI answer:

Yes, major surgeries like heart surgery and knee surgery can cause mental health issues, such as depression and anxiety.
These issues can occur during and after the recovery period.
 
Paco Dennis said:
I am so sorry for your suffering. If I put your post to a trusted AI it says:

I'm sorry to hear about the difficulties your family is experiencing with your 79-year-old relative. Based on the information you've provided, it appears that she may be experiencing postoperative cognitive dysfunction (POCD) or delirium, which are common complications in older adults following surgery.Postoperative cognitive dysfunction is a decline in cognitive function that can occur after surgery, particularly in older patients. The symptoms you describe, such as lethargy, blank stare, minimal communication, and excessive worry, are consistent with POCD or delirium
1
4
.Some key points to consider:

  1. Prevalence: Among patients aged 65 years and older, up to 65% experience delirium and 10% develop long-term cognitive decline after noncardiac surgery
    4
    5
    .
  2. Multiple surgeries: Your relative had two surgeries (pacemaker and knee replacement) in close succession, which may have increased her risk of cognitive complications
    3
    .
  3. Time frame: While many patients improve within weeks to months, some may experience longer-term effects. It's been almost two months in your relative's case, which is concerning but not necessarily unusual
    1
    3
    .
  4. Normal test results: It's common for standard tests (bloodwork, MRI) to appear normal in cases of POCD or delirium
    7
    .
Recommendations:
  1. Seek specialist care: Consider consulting a geriatrician or neurologist specializing in cognitive disorders in older adults
    7
    .
  2. Cognitive assessment: Request a comprehensive cognitive evaluation to determine the extent of the decline and track progress over time
    1
    .
  3. Supportive care: Maintain a calm, structured environment, ensure proper nutrition and hydration, and encourage gentle physical activity as tolerated
    7
    .
  4. Family support: Consider seeking support for yourselves as caregivers, as this situation can be emotionally taxing
    7
    .
  5. Patience: Recovery from POCD can be slow, and improvement may still occur over time
    1
    3
    .
Remember, while this situation is challenging, there is hope for improvement. Many patients do recover cognitive function, though the process can be gradual. It's crucial to work closely with healthcare providers and consider seeking additional opinions if you feel your concerns are not being adequately addressed.

Maybe this is what is wrong. A doctor/neurologist would be best to make sure.
Click to expand...
Excellent!
 
I, too, suggest a neurological exam, including a brain CT. It is very possible she has/is throwing micro blood clots, aka mini-strokes. It is very common in heart surgeries like bypass grafts (aka CABG) and/or heart valve replacements; although she has not had those major surgeries, it is possible she is having those issues with the knee replacement. Edited to add: this may happen even with "normal" blood lab results.

Why did she get the pace maker? Was it A-fib? That, too, can be throwing tiny blood clots.

If it were me, I would request copies of the surgical reports from both the surgeon AND ANESTHESIOLOGIST! What drugs were used? Was there even a small cardiac incident during the surgery? I assume a cardiologist has checked the pacer?

This is so sad; I hope you figure it out.
 
Gto said:
Guess I’m seeking wisdom from the group. A79 year old retired schoolteacher with no previous mental issues recently had pacemaker and knee replacement almost back to back. Did fine with surgeries but in a few days became lethargic, blank stare, no blinking and consumed with worry over even the smallest item I.e. bills, money, hygiene, etc. Minimal communication. Previously she drove, shopped good hygiene. Been almost two months and no change. All bloodwork, mri, etc are normal. Or local doctors seem to not even have a hint. No improvement thus far and our own mental state is suffering. Don’t know what to do.
Any thoughts from the group…this is destroying our family who she lives with?
Click to expand...
Welcome, Gto.
Talk to the anesthesiologist. The combination of surgery and the drugs he uses can be traumatic for an older person and cause dementia although often temporary. Please keep us posted
 
John cycling said:
The most obvious and likely cause is all the drugs that they've used on her.
Click to expand...
That is what I was thinking, particularly if opioids were prescribed and taken. On every recent surgery I have had, oxycodone was prescribed. I did not take them, however, since they tend to disrupt my sleep a lot. Instead, I managed with ibuprofen and Tylenol.
 
I am so very sorry, how worrying for the family.

My first thought is - no wonder! She has been through so much so quickly. I think she is overwhelmed. Just quiet rest, patience, a solid predictable routine daily and very gentle with her. Having surgery is traumatic, hospital is frightening.
So please don't despair, obviously seek medical opinions and try to stay calm. She may well recover in time.
 
Shock related trauma to the body can really cause issues. When my mother in law moved in with us (coming from Ohio to Texas), a lot of her hair fell out and she had the "blank stares, etc. She finally came out of it. The key was to get her interested in something. She lost a lot of weigh and we got a care helper to drive her where she wanted. She got a whole new wardrobe. They had lunch and for years it gave her something to look forward to each week.
 
Events which would not have bothered us, or just caused a speed bump become major issues the closer we are to 80. The smaller our world the more events cause major issues, even events that are not normally traumatic become traumatic.
 
Paco Dennis said:
I am so sorry for your suffering. If I put your post to a trusted AI it says:

I'm sorry to hear about the difficulties your family is experiencing with your 79-year-old relative. Based on the information you've provided, it appears that she may be experiencing postoperative cognitive dysfunction (POCD) or delirium, which are common complications in older adults following surgery.Postoperative cognitive dysfunction is a decline in cognitive function that can occur after surgery, particularly in older patients. The symptoms you describe, such as lethargy, blank stare, minimal communication, and excessive worry, are consistent with POCD or delirium
1
4
.Some key points to consider:

  1. Prevalence: Among patients aged 65 years and older, up to 65% experience delirium and 10% develop long-term cognitive decline after noncardiac surgery
    4
    5
    .
  2. Multiple surgeries: Your relative had two surgeries (pacemaker and knee replacement) in close succession, which may have increased her risk of cognitive complications
    3
    .
  3. Time frame: While many patients improve within weeks to months, some may experience longer-term effects. It's been almost two months in your relative's case, which is concerning but not necessarily unusual
    1
    3
    .
  4. Normal test results: It's common for standard tests (bloodwork, MRI) to appear normal in cases of POCD or delirium
    7
    .
Recommendations:
  1. Seek specialist care: Consider consulting a geriatrician or neurologist specializing in cognitive disorders in older adults
    7
    .
  2. Cognitive assessment: Request a comprehensive cognitive evaluation to determine the extent of the decline and track progress over time
    1
    .
  3. Supportive care: Maintain a calm, structured environment, ensure proper nutrition and hydration, and encourage gentle physical activity as tolerated
    7
    .
  4. Family support: Consider seeking support for yourselves as caregivers, as this situation can be emotionally taxing
    7
    .
  5. Patience: Recovery from POCD can be slow, and improvement may still occur over time
    1
    3
    .
Remember, while this situation is challenging, there is hope for improvement. Many patients do recover cognitive function, though the process can be gradual. It's crucial to work closely with healthcare providers and consider seeking additional opinions if you feel your concerns are not being adequately addressed.

Maybe this is what is wrong. A doctor/neurologist would be best to make sure.
Click to expand...
 
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