3 months post-op and problems with public speaking

[Ella4hubby]

Hello All,

Have perused the various posts on here related to concentration, pump-head and such, but wondering about a specific problem. My husband is 3 months post surgery (mitral valve replacement with tissue valve). He was 60 yrs old at time of surgery, working full-time (and more sometimes ) in a fairly demanding job. He was in relatively good health with no other medical conditions except for the defective mitral valve. He has progressed very well physically with very little pain overall. His surgery was uneventful and the surgeon said DH was on the by-pass pump for about 45 mins. with the whole procedure lasting only about 1 1/2 hrs. My DH did have issues at first with concentration and some short-term memory loss - one day in particular he constantly repeated the same question over and over, as if the brain was not recording what just happened. DH had a few doses of narcotic meds on days 1-2 post op, but after that he was on regular Tylenol every 4-6 hours - amazingly enough. So not a lot of heavy meds other than anesthetic to cause issues. He could not really read anything heavy, or light actually, for awhile but all that has improved.

DH has been back to work pretty much full-time since week 11 (with a gradual easing in over several weeks before), and is finding it a bit challenging as the pace can get hectic. The main concern he has is to do with public speaking. He was asked to speak to a small group of important leaders (about 20 people) this past week - first time public speaking since surgery. Afterwards he couldn't remember what he said! He had notes and he remembers bits and pieces but feels he may have been scattered in his presentation...but he can't actually remember...This is very disconcerting for him as he has always been a very good public speaker - he enjoys it and it is a big part of his work. He is going to check in with one of his colleagues who attended the presentation to see what this person's perception of DH's performance was. Unfortunately this has shaken my DH's confidence and now he is wary of taking on any commitments for teaching or public speaking at least for the time being...

Anyone else with a similar experience? I know many have shared that these types of problems can be transient, but how long will it take to improve? Or will this be an ongoing problem?

Should we be talking to a medical professional about this? Which professional to consult?

 

[Jkm7]

Sorry to hear of your DH's struggle.
One question comes to mind and that is if he has been prescribed any new meds since his surgery?

Is he taking anything he did not take before?

 

[carolinemc]

He sounds like he is suffering "pump head". I went through that myself when I went back to work. What it is when someone is on the heart/lung machine for a certain length of time, this is a sideaffect from the machine. It takes time and concentration to get through it. I had to take notes on things I had done a million times before surgery and could not remember how to when I went back to work. He will get better in time. It is like being in a fog like state. It will get better. Just takes some time and work. He will be better soon. Hugs for him and you today.

 

[yotphix]

I have to admit occasionally, when talking to family members about the first three months post surgery, that I don't have the faintest recollection of the things they are telling me I said, or did. I do have some memories of that time of course, and I have told and retold some parts too, which have become a sort of memory. The thing is that I normally have a very good memory for fine details such as names and places and dates and times of day. My family usually turn to me for that sort of stuff, but there is a three month (or so) hole there where I have a hard time recalling many specifics at all. Like your husband, I've had rather large pieces go missing completely.
I was on bypass for over three hours, mind you, and had a 4.5 hour surgery but I don't know if it really makes much difference how long it was.

 

[Ella4hubby]

Sorry to hear of your DH's struggle.
One question comes to mind and that is if he has been prescribed any new meds since his surgery?

Is he taking anything he did not take before?

Thanks Jkm7 for the questions. Before surgery my DH was on no meds. No other medical conditions. Even for the prolapsed mitral valve, he had no symptoms - but tests showed severe multidirectional regurgitation and a totally incompetent valve. The cardiologist felt it better to do the replacement now rather than wait 5 years down the road for more symptoms and more chance of weakening the heart. Anyway, all that to say no meds before surgery.

After surgery, he was put on Coumadin for 3 months, Pantoloc (stomach acid inhibitor supposedly to protect the stomach lining while on Coumadin), Coated Aspirin (on that for life), and a Beta Blocker (Sotalol) for some mild atrial fibrillation which appeared 3 days after surgery. The cardiologist discontinued the Beta Blocker at 6 weeks, and DH's last dose of Coumadin was May 28th (almost one week ago now). Stopping Pantoloc now, so all that is left is the coated Aspirin...

Don't think any of these could be related to the memory lapses. As I mentioned it was quite bad at first - he was foggy and had difficulty with remembering things - when to take what, what to do in his daily schedule. But that all has improved progressively. By about week 5-6 DH was reading emails, reading books and doing some light interactions with work-related stuff.

I do think that the speaking element is trying for the brain on several fronts: needing to organize thoughts (mind you he had notes and none of the info was new), staying on track, and being aware of the time, as well as the stress of speaking in front of some "high-powered" leaders. DH seemed to struggle with all of these elements. And all of this was not a problem for him in his pre-surgery life.

 

[Ella4hubby]

He sounds like he is suffering "pump head". I went through that myself when I went back to work. What it is when someone is on the heart/lung machine for a certain length of time, this is a sideaffect from the machine. It takes time and concentration to get through it. I had to take notes on things I had done a million times before surgery and could not remember how to when I went back to work. He will get better in time. It is like being in a fog like state. It will get better. Just takes some time and work. He will be better soon. Hugs for him and you today.

Thanks carolinemc. It is encouraging just to know that others have dealt with similar issues. I too am assuming it will get better in time. Just hard to see DH struggle and because in the past he has always been able to do just about whatever he wanted, this has been quite the learning experience for him - the whole surgery and recovery process in fact.

I know that it is not necessarily a bad thing in the big picture, as I do see that this experience has made him more compassionate and aware of how people can suffer. That was not really a part of his thinking in the past, at least not in the same way, now that he has experienced such a traumatic surgery and all the symptoms and stuff he has had to face and deal with going through recovery.

Thanks for the thoughts and hugs. They are greatly appreciated!

 

[Ella4hubby]

I have to admit occasionally, when talking to family members about the first three months post surgery, that I don't have the faintest recollection of the things they are telling me I said, or did. I do have some memories of that time of course, and I have told and retold some parts too, which have become a sort of memory. The thing is that I normally have a very good memory for fine details such as names and places and dates and times of day. My family usually turn to me for that sort of stuff, but there is a three month (or so) hole there where I have a hard time recalling many specifics at all. Like your husband, I've had rather large pieces go missing completely.
I was on bypass for over three hours, mind you, and had a 4.5 hour surgery but I don't know if it really makes much difference how long it was.

Thanks yotphix for sharing your experience. Wow! A three-month hole in your memory, now that would shake me up. I too am the one who remembers details, names, dates, etc - though some of that fine memory is getting a few holes here and there...and that is the aging process no doubt! Can't imagine having to accept the loss of that memory, but I assume your memory is better now?

I do think that it scares my husband to not remember what he said. Never had any issues like that before. But as I said, generally it was worse at first, right after surgery and we have seen good progress on all fronts up to now. This was the first time since surgery and being back to work that he had to do this kind of presentation, so it really was a new kind of "brain experience" for him...

Thankfully he will actually be going on vacation by the end of this month (so really only about a month back to work), as things shut down for most of July. I think that will give him a break and more time for recovering of his concentration and memory issues...that's the hope anyway.

 

[AZ Don]

With a setback as severe as open heart surgery, it takes time and exercise to get back into shape physically. For anyone with some cognitive impairment, I would think mental exercise could help speed recovery as well. I suggest your husband participate in a practice speaking group, such as toastmasters. I expect his skills as a speaker would return quickly with practice, and he can use his performance in practice as a gauge for when he is ready for a more important commitments, and to give him confidence in such commitments.

 

[Ella4hubby]

With a setback as severe as open heart surgery, it takes time and exercise to get back into shape physically. For anyone with some cognitive impairment, I would think mental exercise could help speed recovery as well. I suggest your husband participate in a practice speaking group, such as toastmasters. I expect his skills as a speaker would return quickly with practice, and he can use his performance in practice as a gauge for when he is ready for a more important commitments, and to give him confidence in such commitments.

Hello AZ Don. That is an interesting suggestion - participating in a practice speaking group... will consider this. And yes it may be a question of practice just like the need of exercise for physical improvements. Thanks for your input!

 

[tom in MO]

Tell your DH that just because he forgot a stressful situation does not mean he didn't handle it perfectly. Your brain likes to forget stressful things in order to cope and "forgive." It is a blessing and maybe not really an "impairment."

Also, tell him that other people don't really notice, so it's best to not ask if you've done OK. Why clue in your coworkers if they are clueless in the first place? However be pro-active when it comes to asking someone's name etc. if you forgot. Everyone does this, even if you've never had surgery.

I too had/have simple lapses of information since surgery 16 months ago. It gets better with time.

I almost missed a few bills in the last 16 months, which I've never really doen before. Key thing, is I didn't miss the bill and even if I did, the consequence would be minimal (particularly compared with OHS.) Keep it in perspective and it is really minor.

I've rented movies I've seen before. However, I remembered within the first couple of minutes. Now if I didn't remember until the end, then I'd be worried

 

[mwd100]

Ella4hubby,
I am having similar memory problems since my AVR on Feb 25, 2013. I had a TIA (mini-stroke) during surgery but all stroke symptoms went away within 48 hrs. except perhaps the memory problem. I spoke to a neurologist about it and she said it may get better and it may not. She also gave me a list of games to play for mental exercise, which I didn't think were worth much. I am retired so I don't have to worry about the professional aspect of it, but I do find that it effects my ability to socialize. Good luck to you and HD.