Difficulty talking 3 days after valve replacement - normal?

[tjs0329]

My mother had one valve replaced and two repaired on 1/21/03. Her surgery lasted 8.5 hours with her heart restarting well after the procedures. Our concern is that it is now four days after her surgery and she cannot say more than 1-2 words at a time. She is alert and wants to say a sentence but can't. She will say a word or two and then stop. It appears that she knows what she wants to say, but just can't form the words. We have been told that this is normal and her speech will return. Is this a 'normal' part of the post-operative recovery for open heart surgery? To me it sounds like she may have had a small stroke. And we are being told it is temporary to keep us from getting upset. Your feedback would be greatly appreciated. Thank you in advance for your help.

 

[JimL]

It sounds to me like the standard pumpheadedness after surgery. All the information is still there in the brain, but the connections are a little slow. Give her time, and it will improve.

 

[Christina]

tjs0329

tjs0329

Hi,

What you are describing sounds to me like your mother has had a small stroke.
I have been coming to this forum for several years, and I have not seen anyone put this problem to the forum for answers. The problem with your mother appears more serious. You are telling us that your mother is only able to speak a word or two and than stops. That she knows what to say but can't form the words. I personally think this is not normal and that something is wrong.
What some of us are experiencing after surgery is what we call "pumpheadedness". I am not convinced that this so called pumpheadedness is caused by the heart/lung machine, but some of us think we are more forgetfull after surgery. I personally believe I did the same things before surgery, and had to write stuff down if I didn't want to forget them. I still have to do this if I want to remember to do/buy stuff.
I hope things will get back to normal with your mother.
Please keep us posted!

Christina

_________________
AVR's 8/7/00 & 8/18/00
TMC, Tucson, AZ.
Dr. Gulshan Sethi (surgeon)
Dr. Lou Lancero (cardiologist)

 

[Ross]

It's difficult to say. It could be the drugs, small stroke, throat soreness from the trach tube, or just about anything. It doesn't sound right to me either, but when I was at that point, I wasn't coherent either, so maybe she will be alright. Please let us know the outcome.

 

[sylviayasgur]

dear tjs,
so sorry to hear your mother seems to be having difficulty putting all her words together and speaking fluently.
as the others said, i don't remember joey being that "off". a little immediately following surgery, yes, but not several days after. he was still groggy and tired and in pain, but he was walking around and talking up a storm.
please let us know what you find out. hoping your mom gets well soon.
all the best, sylvia

 

[Johnny Stephens]

Doesn't sound normal to me, but then 8.5 hours is quite a long surgery (even with 2 mechanical replacements, mine was only 4). I would not speculate what the problem could be, but if it's an inability to come up with the right word mentally, and not just a mechanical speaking problem (due to tubes, vocal injury, etc), then I think you should push for a more thorough workup and explanation. Your suspicions sound valid.

I'm sorry your mother is having this problem, and offer all my best wishes for a speedy recovery.

 

[hensylee]

I agree with the others that this isn't normal sounding. It's been long enough for her throat to clear up enough to speak. Course it could be drugs, but usually they just make you say silly things. If she is alert enough to speak, in your opinion, I think I would want a consult of some kind and maybe test. And be insistent so that they HEAR you!

 

[Nancy]

Well, My husband has had 3 valve surgeries and he did have difficulty speaking after surgery. He also has had problems speaking after a TEE which wasn't so artfully done. The problems were injuries to the vocal chords or throat from the breathing tubes and of course from the transducer used during the TEE. The breathing tube is pretty large so it's easy to understand how temporary injuries can occur.

But what you have said about your mother doesn't sound like what my husband has experienced. He didn't start talking and then couldn't form the words. He just had a whispery voice.

It could be the pain meds. They can cause all sorts of things from hallucinations to just drifting off, to any other thing related to heavy duty pain stuff. My husband slurred his words, and didn't make any sense. He thought he saw a dust storm in the hall. He fell asleep talking. It all went away when the drugs used were not so heavy duty. But they want your pain to be under control, so these drugs are necessary, for the first few days.

I would speak with the surgeon and get his advice. If you are not satisfied, then ask for a neurology consult.

You could also bring a pad and pencil for your mom and see if she can write down her sentences and explain what she's feeling.

 

[Ross]

I was going to suggest the pencil and paper, but thinking back, I couldn't even write a coherent anything, so I don't expect that she'll be able to either. I hope I'm wrong.

 

[tjs0329]

Thank you for your helpful responses and kind words. They have been a great help. My Mother has made some big physical improvements today. She was up walking three times and sat in a chair most of the day. She is eating solid food again and is off the morphine. Before I went to the hospital today I called to check on my Mom's condition. The nurse said she was doing well and her speech was 'alot better'. I said I was concerned about her speech and asked the nurse if my Mom had had a stroke. The nurse replied that she had not and that they were watching closely for any signs. The nurse reiterated that the speech problems were not unusual given the length of her surgery (8.5 hours). I hope they are right. When I got to the hospital I thought her speech was somewhat improved, not 'alot better' ad the nurse said. She was able to say a five word sentence this morning, but she really struggled to get the words out. Most of her communications are 1-3 words at a time. Hopefully tomorrow will bring greater improvements and she will get out of ICU. Thank you all again for your responses. It is a comfort to know there are people like you willing to take the time to help.

Thank you,
Tom

 

[Ross]

Please keep us posted Tom.

In my case, the drugs had me so messed up that I couldn't write, speech was very impeded, and I myself thought that I had had a stroke. When they all wore off, I started improving. I hope this is the samething with your mom.

 

[hensylee]

We will be interested in hearing how your mom progresses. It is good news today!

Please continue to update us. This site provides much needed information for others and we are always ready to support those who come through our doors. Any new information or experiences that we are able to relate to others is always helpful. Thank you for telling us.

I pray that your mom will continue to improve - and expect that she will. God bless

 

[sylviayasgur]

hi tom!
glad to see that your mom is up and walking and doing better.
please keep us posted and let us know how she is doing and if her
speech improves.
wishing you all the best, sylvia

 

[Bob]

Cant speak

Cant speak

I am ten days out from valve repair and still having trouble speaking. For me it was the trach tube and the effect of medications. Hope it clears up.

 

[hensylee]

It will clear, Bob - you will continue to get better every day. God bless

 

[tjs0329]

Update (1/27/03)

Update (1/27/03)

Greetings,
I just wanted to give a quick update on my Mother's condition and thank everyone for their responses. My mother was released from ICU last evening. Her speech has improved considerably. She is now saying 5+ word sentences fairly consistently. But she is far from being fluent and does 'lock up' at times where she can't complete a sentence. It seems like her situation is similar to yours Bob. It was probably a result of several factors - trach tube being in for so long (25 hours) and the medications she was on. We are hoping she continues on this track of improvements.
Thank you all again for your replies. They help give us perspective on the situation.

Thank you,
Tom

 

[sylviayasgur]

hi tom!
i was so glad to read that your mom is improving with every day. must have been such a scare for you when she had trouble speaking.
please wish her a continued smooth recovery and let us know how she does.
be well, sylvia

 

[Nancy]

Hi Tom-

I so glad to hear that things are moving forward. Even if the forward movement is slow, it's a very good sign. She'll be fine in a few days.

Wish her the best from all of us.

 

[cookie]

Boy does all that bring back memories! When I was being discharged from the hospital they asked me to sign my name on the release papers. Geez! I knew my name and knew where to sign but couldn't get the message from my brain to my fingers! Very scarey! I kinda just sat there a few minutes with my fingers not moving! Don't want to experience that again! Your Mom was in surgery a long time so give her body time to regroup. It's a very "big" surgery!

 

[Ross]

I knew my name and knew where to sign but couldn't get the message from my brain to my fingers!

Isn't that aweful? Combine that with being addicted to Ativan and having withdrawal shakes and it makes for one heck of a picnic. I agree, I never want to experience that again either!