Can memory loss continue? (long sorry

[Guest]

Lulabelle,

I agree with Anna...definitely an inspiration .

I'll have to keep your experience in mind as I have my review this coming week (Thursday).

*sighs*

If only we didn't have to work...LOL

 

[Georgia]

Lulabelle, it sounds like you really set them back on their ears. Good for you.

In most current corporate environments reasons to let older folks go without appearing discriminatory are being sought. (Older folks being those with higher salaries, more vacation time, old pension plans - just generally less-preferred people )

I'm glad things went as they did - you sure can't tell me that your mental capacity is reduced if you handled this situation this way - creatively, assertively, and with a sense of humor.

Continue to document everything, however; just because you called their bluff this time doesn't mean you're off their radar just yet. And all this boloney about not needing to correct the score is wrong - and document that also. Otherwise it may be revisited next year.

You're a treasure, Lulabelle - you're really set a great example for us.

 

[RobThatsMe]

Informative Article

Informative Article

Hi Lulabelle,

Here is some informative information about Memory Loss and the Heart Lung Bypass Machine.

Link: http://abcnews.go.com/sections/GMA/DrJohnson/GMA010208_HeartSurgery_BrainFunction.html

ARTICLE:


A new study just out suggests heart bypass surgery might have adverse side effects on the brain. Your Heart and Your Head
Bypass Sugery and Mental Decline


Feb. 8 ? Heart bypass surgery helps to save lives, but researchers are finding that the procedure often leaves patients with a new problem ? a loss in brain power.
STORY HIGHLIGHTS Memory, Mood and Math Man and the Machine


The surgical procedure may have long-term adverse effects on the brain, according to a new study. Doctors have known for some time that people often lose some of their mental sharpness immediately after a heart operation. But many seemed to recover fairly quickly. The new study, featured in The New England Journal of Medicine, found that this recovery is short-lived.
Memory, Mood and Math

The study looked at 261 patients who had undergone bypass surgery while on a heart-lung machine. Five years after the operation, 40 percent showed a 20 percent drop in mental ability. The subjects showed changes in their ability to follow directions, to perform mental arithmetic, and to plan complex actions. Doctors also noted changes in the patients' memory and mood.

ABCNEWS' Dr. Tim Johnson told Good Morning America that the study is important because it's getting doctors focused on how to prevent the loss of mental function that might occur due to bypass surgery. Johnson also points out that there is more research to be done.

"I want to point out two things in this study. One, there was not a control group, so we don't know for sure how much of this was due to natural aging in this group, but it's a larger number than we would expect," said Johnson. "Secondly, we don't know exactly how this translates into real life function. In other words, it's one thing to do tests in a laboratory setting. How it affects people in real life is another matter. But it raises, obviously, a red flag."

Man and the Machine

Doctors do not know what causes the loss. It might be that people whose arteries need to be replaced already have damaged brain blood vessels. The loss might also have something to do with being put on a heart-lung machine.

An estimated 400,000 people a year are put on heart-lung machines for a bypass operation in the United States. The findings suggest that 160,000 of them risk losing some of their mental ability.

Dr. Mark F. Newman, who led the Duke University study, said other research appears to indicate that there are fewer problems with the brain after bypass operations done without the heart-lung machine. Newman said the operation helps people live longer and that it's now just a matter of fine-tuning the operation "to improve the quality of life as well as the length of life," he said.

Participants in the latest study took tests in memory, attention, concentration and manual dexterity five times: before the operation, when they left the hospital, and six weeks, six months and five years later. The bypass operations took place from 1989 through 1993, and the last five-year tests were given in 1998.

Of those patients tested in the study, 56 percent did significantly worse when they were released from the hospital than when they were admitted. Those who did not show any loss in brain power immediately after the operation were in equally good shape five years later.

Doctors involved in the study say the new research will help them improve bypass techniques that will reduce neurocognitive dysfunction. Some doctors are currently looking into the possibility that it might be better to perform bypass surgery without using the heart and lung machine.


Now save this, like I did... So you don't forget it.

Rob

 

[RobThatsMe]

Another Article - duke University

Another Article - duke University

Hi,

Here is another article on memory loss..


http://www.eurekalert.org/pub_releases/2001-02/DUMC-Cdab-0602101.php

Public release date: 7-Feb-2001
[ Print This Article | Close This Window ]

Contact: Richard Merritt
[email protected]
919-684-4148
Duke University Medical Center

Cognitive decline after bypass surgery predicts five-year cognitive deterioration


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A photo of Newman is available at http://photo1.dukenews.duke.edu in the Duke News Service folder as "Newman02.jpg."

While coronary artery bypass graft surgery has saved the lives of millions of Americans since its inception decades ago, physicians have long noticed a nagging problem -- many patients, while restored to good health, have noticed declines in their cognitive abilities. In the largest study of its kind, Duke University Medical Center researchers have now measured this loss and shown that five years after surgery, more than one-third of the patients will have measurable cognitive decline. It has been generally accepted that many bypass patients exhibit some cognitive defects shortly after surgery and improve over the ensuing months, and now the long-term effects of the surgery on cognition are becoming better understood.

The researchers gave 261 heart surgery patients the same battery of standardized tests of cognition at different intervals during a five-year period and discovered that 53 percent had measurable declines at discharge from the hospital, 36 percent had measurable declines six weeks after surgery, and 24 percent had measurable declines at six months. However, by five years after surgery, 42 percent had measurable declines.

In the study, the researchers tested such cognitive abilities as short-term memory, attention, concentration, language comprehension, abstraction and spatial orientation.

The results of the Duke study, which was supported by grants from the National Heart, Lung and Blood Institute and the American Heart Association, were published Feb. 8 in The New England Journal of Medicine. Dr. Mark Newman, chief of cardiothoracic anesthesia at Duke, led the multi-disciplinary study of heart surgery patients treated at Duke University Hospital.

"Little is more devastating to patient and family than for the patient to have a successful operation that prolongs life, but diminishes the quality of that prolonged life," Newman said. "Our results confirm long-term persistence of cognitive dysfunction and the importance preventing these deficits. They will also help us design strategies to make an already safe procedure even safer."

In addition to demonstrating the cognitive declines, the researchers also found that three factors were important determinants of the five-year decline: age, level of education and the level of cognitive decline at discharge.

"The older the patient, the higher the probability of suffering decline," Newman said. "Age is an important factor, especially since we can safely operate on an older population of patients. Also, the more educated a patient is, the smaller the decline. While we don't know the exact reasons for this, it seems that education confers more of a cognitive 'reserve,' so the loss is not noticed as much."

This study did not compare the study participants with similar people who did not undergo surgery. While studies have shown that cognitive function has been shown to decline gradually with age, the researchers pointed out that study participants who suffered cognitive declines showed a decline more than two times that demonstrated by 5,888 Medicare patients in a recent five-year study.

Coronary artery bypass grafting (CABG) surgery is a surgical procedure performed more than 600,000 times a year in the United States. Typically, surgeons use pieces of blood vessels from other parts of the body to "bypass" clogs in coronary arteries, and thereby restoring blood flow to the heart.

The researchers say it is likely that many factors are behind the cognitive declines, although they believe that the heart-lung bypass machine commonly used in CABG surgery is an important culprit. This machine essentially pumps and oxygenates the blood for the body while surgeons operate on the stopped heart.

"While we have known for some time that the heart-lung machine is probably a cause, we don't know for certain how it might affect cognition," Newman said. "It is likely that tiny emboli, or clots, are formed and go to the brain. Other factors, such as inflammation and the lowered blood pressures, could play a part as well. There needs to be further investigation into operative neuroprotection to allow us to reduce the short- and long-term consequences of cognitive decline after surgery."

The Duke team is investigating many strategies to better understand this phenomenon of cognitive decline with the hope of developing new strategies to protect the brain. These include:

-- Using minimally invasive techniques, surgeons are now operating on beating hearts, meaning that the heart-lung machine is not needed. Preliminary results are encouraging, although the long-term effects are not yet known.

-- Duke researchers have found that temperature has an effect on cognitive decline. During surgery, the heart-lung machine cools the blood to lessen the metabolic needs of the body during the procedure. Duke studies have shown that patients who are rewarmed more slowly after surgery tend to do better on cognitive tests.

-- Duke researchers also have found a genetic component to the decline. Patients with the E-4 variant of the APOE gene (which has also been linked to early onset Alzheimer's disease) tend to do worse than patients with other variants of the gene.

Other Duke members of the team are: Jerry Kirchner, Barbara Phillips-Bute, Vincent Gaver, Dr. Hilary Grocott, Dr. Robert Jones, Dr. Daniel Mark, Dr. Jerry Reves and James Blumenthal. All are members of the Duke Neurological Outcome Research Group and the Cardiothoracic Anesthesiology Research Endeavors group.


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another..

http://www.healthandage.com/Home/gm=6!gid1=3254


Impaired immunity link to cognitive decline after heart bypass



[ Disease Digests > IMPAIRED IMMUNITY LINK TO COGNITIVE DECLINE AFTER HEART BYPASS ]


Impaired immunity link to cognitive decline after heart bypass

Reported by Susan Aldridge, PhD, medical journalist

Older people are vulnerable to infection and inflammation during heart bypass surgery and this may trigger cognitive decline.
It's already known that cognitive decline - memory loss and difficulties in problem solving - may follow a heart bypass operation. One factor seems to be inflammation caused by release of toxins by gut bacteria while the patient is on the heart-lung machine. Normally the immune system can deal with these toxins, but in older people, immunity may be impaired.

Doctors at Duke University have measured the level of antibodies to these toxins in a group of 460 patients undergoing bypass surgery. The higher the antibody level, the stronger the immune system. The patients were aged between 23 and 87 and they also had a battery of cognitive tests before and six weeks after surgery. This showed that 36 per cent experienced significant cognitive decline.

For older people, lower levels of antibody were a factor linked to cognitive decline, the researchers say. The younger individuals had a stronger immune response. Maybe cognitive decline following bypass surgery could be avoided by boosting weakened immunity beforehand.

 

[Bill Hall]

Lulabelle - It sounds like you did well with your review, but be careful. The boss will likely start writing things down and documenting any errors or performance inadequacies. I would still suggest a new job or transfer. Don't forget that this guy can still hurt you.

Rob - Thanks for all the good memory information. I think that some of the five year data may be a result of a person getting five years older.