pumphead

[hensylee]

Because of a recent post about mind fogginess, I decided to post this and ask for comments.

in the original news about pumpheadedness, they told us that after 5 yrs from surgery, it might become more pronounced. How would one know if one's memory is slipping if one can't remember??

For several years now, I do some mind teasers every single morning to see what my day might be like. Some days, I seem to have a bit harder time getting things as right as I want, than other days. I do a jigsaw puzzle, a word puzzle, a spades game, hearts game, and a numbers game. It seems to give me a heads up as to how things are functioning for that day. If it seems not to bode well, I am more careful of decisions that day and I might just stick round the house. Does anyone else check out your brain function? What do you think about this.

Have to add that now and again I find that I have made a misstatement or mistake in something that, at the time, I was very sure about. Embarrassing to find I was so wrong. That happens to everybody at times, tho.

Too, I am old, as you know, and old people begin losing cells along the way. What about us who have had the operation?

 

[Nancy]

I enjoy doing very hard crossword puzzles, and find that there are some days when I cannot get anything, and other days, I just whiz through them. I haven't had OHS, and I've found this to be true throughout my life.

I guess the old saying that "some days are better than others applies". We all have days that have many distractions and when our biorhythms are not all going in the same direction.

 

[Teresa UK]

What a coincidence...

What a coincidence...

Just this afternoon I was discussing this with a colleague following yet another loss of memory on my part - (as I finished saying something I was asked to repeat it - and I couldn't remember what I'd been talking about!). I might mention that I'm the grand old age of 45. There are quite definitely some days where you discover your brain is not ticking over properly, for no particular reason. Over the years we've blamed forgetfulness/ fogginess/ ditziness mostly on our hormones in one way or another (love/ motherhood/ PMT/ menopause, whatever). Mostly we never realised we were having "one of those days" until elbow-deep in some problem caused by our fuzziness. Whereas, one thing I would say about most of the folk on this forum - they're definitely more in touch with what their body (or mind) is doing than is the average person, and so you're reading the signs and adapting your behaviour accordingly. Very wise. I've not had OHS (yet), but when I do, it's incredible that I may get even more forgetful ... Now then, what was I doing ......

 

[Marguerite53]

hope this might help....

hope this might help....

Hello Ann. I hope this might be helpful. My father and my best friend's father both had triple bypass surgery in the 90's ('98 and '94).Both men were in their late 70?s. It is entirely possible that these fine gentlemen were headed toward dementia anyway, but the similarity in their behavior makes me suspect that the machine may have contributed. I'm certain it was before precautions were put in place for the pumpheadedness. Both of these men were quite brilliant (at one time Princeton and Stanford professors) and it is quite frustrating to watch them change so.

For us, the first thing that was noticeable was the repeating of things. Not just repeating a story a few days later to someone who you want to share it with, but repeating the story immediately after having told it! Gradually, they were dealing with reduced short term memory -- they have significant trouble forming new memories. Particularly with the mundane things. (an incredibly intense and exaggerated instance of this is depicted in the movie Memento ).

Then there were little things like, well, we all went on a trip together (summer 2001) and he threw his stuff all hodge podge into a suitcase ? not the orderly neat guy I had known. He showed up once for a birthday celebration all sweaty and weird and had a nasty infection on his leg that he hadn?t attended to. All personal judgement issues.

Shortly thereafter, it became clear that they ccould no longer take care of themselves because they couldn't remember to pay their bills. OR if they started to, something could have interrupted them, and they never were able to finish. When I cleaned out my father's house I found evidence of so many things he started to do over and over and over and never got done. He just couldn't "turn a corner" -- couldn't quite get there. Eventually, he wasn't even able to remember how to finish writing a cheque. It would take 20 minutes to get the numbers on because he kept having to start over, what was the amount, who exactly was it to be made out to, etc.. Obviously, I took over at that point (well, and to get his garbage pick-up started up again, and uh, pay his taxes!!). Fortunately for me, I am his only child and we have the most unique closeness. He trusts me implicitly and had me all set up to do just what I had to do for him.

In my opinion, your best bet for getting a reading on yourself is to ask someone who knows you quite well, whether or not you repeat yourself often. And how is your judgement. Are your decisions still in line with the ?same old you everyone knows?. Pay attention, also, if you feel like your life is starting to go in circles -- do you get somewhere and not know why you went there in the first place? Frequently? (I mean we all look in the fridge for our car keys once in awhile!!) (don't we?? )

I think stress plays a huge role. My father was very stressed because he was getting so confused. Now that he is in a retirement community he is finally beginning to be able to form new memories again. They are an odd assortment, though. I have 2 caregivers who take him on errands, fill his pillbox (pills, what pills? Do I take pills?), clean, laundry, etc. (he has a wonderful pension, thank goodness!) They have worked for him for over 2 years. He recognizes them as soon as he sees them (we think!) and yet if you ask him who Danielle is in simple conversation, he has no idea. You can walk him back to understanding who she is just fine, but he just cannot call it up in his mind (even if she has just left!). So, while he is not good at labels, he is now remembering what he did yesterday, where he?s been, what he saw, just never really who he was with (but he was never good with names!). We?ve had him on Aracept for over a year now. Frankly, it?s expensive and I?m not sure whether that, or simplifying his life and keeping it constant has been more helpful.

The fact that my name was on all of his important papers (deed to his house) and money related (all accounts) items made it possible for me to re-organize his life. I knew where he wanted to ?go next? (he?d had a friend at this particular retirement community and was familiar with it and liked it -- continuing care -- this is a very practical man). I was able to act on his behalf and in his best interest. Of course he misses his home in the woods. Of course he misses driving (oh my ? what an odyssey that was! Getting his license taken away) But he is safe and those around him are safe.

I did have him tested psychologically before I started to move. I had to. I couldn?t just do it without some degree of measure of his condition. There are people out there who do this kind of work. There is a mini-mental test that can be administered to gauge a person?s level of competence. A gerentologist will have resources, info. He had a complete physical by a doctor trained in gerontology. It was discovered that he had also had numerous little strokes. I suspect that those arose from his need for a bypass (not at all like us valvers, I think) and blockages due to lifestyle and heredity. Anyway, a few phone calls in your area and you can probably get some info. Trust me, you do not sound like you need any of this!!

I?m hoping as you?ve read this that you?ve said repeatedly (I want you to repeat yourself here!) oh! That?s not ME! No, that?s not me either. I can?t believe that you are having serious problems. You sound fabulous. And I think there is huge merit in the mental exercises you are doing. Perhaps we should have a forum on mental exercises!! We can all benefit from the ideas you have put forth.

But if you are concerned that down the road things could change, I urge you to get some things in order so whomever you?ve chosen to look after things can do just that for you. My father made it very easy for me to take care of him. Even so, it was tough on me. If those simple measures weren?t in place it would have been awful. Maybe even impossible.

I have learned so much taking care of my father. I?d be happy to respond in any way further, but if I don?t stop talking NOW, Ross may banish me!!

Marguerite

 

[catwoman]

Because of a recent post about mind fogginess, I decided to post this and ask for comments.

in the original news about pumpheadedness, they told us that after 5 yrs from surgery, it might become more pronounced. How would one know if one's memory is slipping if one can't remember??

You've got 5 years of more memories that your brain is trying to access, too! We upgrade our computers with more memory, but we can't do that to ourselves...

 

[hensylee]

I'm not having problems. Believe me, my children are on top of all this and keep track. They would know immediately if there was a problem. Didn't mean the post to sound as though I am in trouble. I do those mental exercises because I believe all of us over 60 should do them to keep mentally active and alert, besides it's a great way to check ourselves. When we can't do them at all, then there's a problem.

Since the original pumphead reports came out, 'they' mentioned that 'after 5 yrs pumpheadedness could set in more'....... my 5 yrs was up in March. Many in VR don't even believe in the pumphead syndrome. I just don't know for sure. We do a lot of kidding about it. We have quite a few in VR that are now past their 5 yrs and I wonder if anyone has found that 5 is any sort of magic number; if they are better, worse, affected at all. We can have our own VR history of what happens 5 yrs after surgery.

Sounds like those two gentlemen above must've been headed towards Alzheimer's or dementia anyhow. Doubt that bypass would have caused that much forgetfulness.

BTW, those legal things were taken care of before I had surgery long ago.

 

[Marguerite53]

Yes,

Yes,

As I expected, Ann, you are "all over it" and well prepared. And yes, it is possible that we are dealing with Altzheimer's, though that was actually not definitively, professionally diagnosed with either of them. It's the short term memory thing that makes me wonder about the pumpheadedness.

Here's the first thing that popped up on Google. Old. Initial finding. This study did not go past 5 years.....

Pump Head - Cognitive Impairment After Bypass Surgery
From Richard N. Fogoros, M.D.,
Your Guide to Heart Disease / Cardiology.

A study from Duke University, published in the New England Journal of Medicine in February, 2001, confirms what many doctors have suspected, but have been reluctant to discuss with their patients: A substantial proportion of patients after coronary artery bypass surgery experience measurable impairment in their mental capabilities. In the surgeons? locker room, this phenomenon (not publicized for obvious reasons) has been referred to as "pump head."
In the Duke study, 261 patients having bypass surgery were tested for their cognitive capacity (i.e. mental ability) at four different times: before surgery, six weeks, six months, and five years after bypass surgery. Patients were deemed to have significant impairment if they had a 20% decrease in test scores.

This study had three major findings

Cognitive impairment does indeed occur after bypass surgery. This study should move the existence of this phenomenon from the realm of locker room speculation to the realm of fact.
The incidence of cognitive impairment was greater than most doctors would have predicted. In this study, 42% of patients had at least a 20% drop in test scores after surgery.
The impairment was not temporary, as many doctors have claimed (or at least hoped).
The decrease in cognitive capacity persisted for 5 years.
The mental impairment was not due to the patients' age (which averaged 61). The results from the Duke study were compared to results from a similar study among patients of the same age who did not have bypass surgery. The decline in mental capacity in those who had bypass surgery was 2 -3 times higher over five years than in patients who did not have surgery.

The authors could not say what, exactly, caused the impairment in mental capacity. The most common speculation is that the mental changes are due to the showering of the brain with tiny particles (microemboli) related to the use of the bypass pump (the heart/lung machine, that oxygenates and pumps the blood while the heart is stopped during surgery.) If this is the case, then newer surgical techniques such as ?beating heart surgery? (in which the bypass pump is not used) should help to minimize the problem. The Duke study was completed prior to the use of such procedures.

Doctors have reacted to the Duke study with mixed feelings. While most believe the Duke study was extremely well designed, many criticize it saying that "in my hospital we don't see this," or that surgical techniques have improved in the 5 years since this study was done, or that publicizing this study will discourage patients from getting necessary surgery.

What should patients think about this study?
When making major decisions ? such as whether or not to have a major procedure like coronary artery bypass grafting ? you want a doctor who will take into account all the potential risks and benefits.
The Duke study is the best information available right now, and must be taken into account. So when considering bypass surgery, make sure you have the answers to the following questions:

Is the surgery likely to prolong my survival, or is it being done electively, simply to relieve symptoms?
Are there any other viable alternatives, such as medication, angioplasty, or stenting? (This question is becoming particularly relevant, with stent technology advancing as rapidly as it is.)
If I must have bypass surgery, is there any reason I can?t have some form of minimally invasive surgery where the bypass pump is avoided? (While it is not proven that the bypass pump causes the cognitive problem, it does seem to be the leading suspect at this point.)
If you do need to have bypass surgery, keep in mind that the majority of patients in the Duke Study had no significant deterioration their mental capacity, and further, of the ones who did, many never noticed it in their day-to-day lives.

Nonetheless, if you are told you ought to have bypass surgery, unless it is vital that bypass surgery be performed immediately, the Duke study ought to provide one more reason to seek a second opinion before choosing this option.

 

[Randy & Robyn]

You guys are scaring the heck out of me. One of my greatest fears is not being myself after the surgery, if you know what I mean. Kind of like I might not be quite the same person personality-wise but since I won't remember what I was like before I won't realize it. Does that make any sense?

I'm not worried about the psychotropic effects of the pain medication since they are temporary. I doubt I will need large doses of analgesics anyway, except perhaps for sleeping, since I routinely pop my shoulder back into position when it dislocates, much to the amazement of my doctor. I worry more about the long-term deficits of the heart-lung machine being discussed here.

I am hoping to finish up a novel yet this year. After reading about the cognitive deficits associated with the typical postop experience I have come to the realization that I will not be capable of that for quite awhile after surgery. I just hope I get all of my nuts and bolts back eventually.

Randy

 

[hensylee]

Randy, not to worry. Didn't mean to scare you. We have had this discussion before and if you search, you will find it. In fact, I posted the above article by Dr Rich when it first came out some 4 yrs ago (about); its in the archives here in VR somewhere. He has a site and a forum; I was an active member on that site. It's a great site in about.com heart disease/cardiology; you can go visit it and ask him any questions you may have. He is a cardiologist/EP and answers personally. Maybe I need to go back to ask him about any updates on the supposed pumphead syndrome since then to see if the medical folk have dropped the entire idea.

We have not had even one member have memory loss since I have been a member here (5 yrs). We do, however, revisit subjects from time to time and that is what I intended with this thread. Never know when a VR member comes across a question that needs to be brought up and discussed again.

Please don't worry about this; it is a simple, minor thing that might not even exist at all.

I feel that as people get older, there should be some personal testing, such as my morning mental exercises, to assure ourselves that we are ok. or not I am pretty sure I am ok -

 

[tobagotwo]

There was a trial done to determine if the reheating process was the cause, and it was determined to be a/the major contributor.

Basically, it goes like this: You're cooled down to a very low body temperature for the surgery, to greatly limit possible damage from interrupted bloodflow. However, after the surgery, it was practice to get you back up to temp rapidly, which seemed a reasonable thing to do.

What the dotors found (and someone will chime in with the institution name, please) was that the brain tended to come up to temperature too fast, and it would suddenly have a high demand for oxygen that was not available to it, as the rest of the systems were lagging behind. So part of the problem was, well...anoxia.

Most hospitals take this into account when reheating you (what, are we leftovers?) these days. It wouldn't hurt to ask about it, though.

Best wishes,

 

[McCln]

I do not have the so-called pumphead. I have always had some memory loss at times, like where do it put the house key, where did I last had the checkbook. I am proud to say I am 40 and we all have bouts of little memory loss no and then. I had surgery almost four years ago. So, no matter how old your are, we forget things at times. Selective memory loss, they say. Have a good day.

 

[Guest]

We upgrade our computers with more memory, but we can't do that to ourselves...

*raises eyebrow*

What an interesting statement/concept. I hadn't even thought about that in that sort of way before. Sure makes me wish we COULD upgrade our own personal memory banks .

As for those games, Ann, I sure wish I had time in the morning to get myself going like that...would be quite interesting, I think. In a way, we humans have a lot of things to "keep in working condition" ... our mind, our bodies, etc. Would be nice to have the time to test the brain (games) and test the body (exercise) a bunch each day....

I've noticed that my memory is "selective" in what it remembers and in what it doesn't. The things important to me...kept. The things not so important (sadly, including some work issues) not kept...which frustrates the helk out of me .


Cort, "Mr MC" / "Mr Road Trip", 31swm/pig valve/pacemaker
'72,6,9/'81,7.hobbies.chdQB = http://www.chevyasylum.com/cort/
MC Guide = http://www.chevyasylum.com/mcspotter/main.html
"You better not try to stand in my way" ... J Paycheck ... 'Take This Job & Shove It'

 

[geebee]

Well, I am long past the 5 year mark and I have not gotten worse. In fact my "worst" was the few weeks after surgery and I improved from there. I believe I returned to normal, whatever that is.

What was the question?????????

 

[hensylee]

Dr Rich, who wrote the pumphead article ab ove, he also has a webside besides his participation in about.com heart disease/cardiology. Here it is:

http://www.yourdoctorinthefamily.com/DrRich.htm

 

[gadgetman]

Don't think (or at least don't remember) if I've experienced.................................................

 

[lance]

Right on

Right on

Well, I am long past the 5 year mark and I have not gotten worse. In fact my "worst" was the few weeks after surgery and I improved from there. I believe I returned to normal, whatever that is.

What was the question?????????

My sentiments/experience exactly.

Cheers

 

[Granbonny]

My Daddy

My Daddy

Who turned age 90 last Oct......Has a great memory....No OHS..but still,......Due to his failing eyesight..I can call him and tell him the Atlanta Braves schedule for 3 days in advance. Time, who they are playing and which station they will be on... Cannot not write it down but can remember. Also, he knows if I tell him anything concerning his family up here (lives in Alabama ) and we are all in Ga. and S.C....Anything and he will ask me several days later about family. Did my Hubby finish his sidewalk, planting flowers, ect...How are the Great Grandchildren doing with their doctor appointments, ect. and calls them by name. When my brother takes him to a doctor's appointment..he will tell me when he has another one. He lives alone..gets up at 5 a.m...makes his coffee, watches the local news and then turns to Fox for all day news. Then goes outside and walks a mile...comes back, cuts his grass with a pusher, plants flowers and waters them... No health problems..Just a b/p pill that he remembers to take. He also knows every penny he has..in several CD's..and how much interest they make a month. He pays a neighbor..$50.00 a month to take care of his bills, look up repair numbers for him, ect. Lordy, I hope I got his Genes. Back to me at age 65 soon... My only problem is the small print that comes with mail. Just finished filling out Medicare forms How confusing....All their instructions to do this and that..because it will be read by a computer. Is the Government crazy or what?We are age 65...Not age 20... I really feel sorry for those reaching our age and not having someone help to fill out these forms. I had to take out my NEW medicine card from UnitedHealth. The print for group numbers, ect. on the card was so small....Could barely read them.......and, Yes, I just got new glasses a few months ago.... ..Just a hint for people near my age. when I get a bill, Insurance for cars, ect. I take the bill out..put it in their envelope and write due date on the front..Then file in order to dates.Check them every few days.... Ann..I do not worry about you..My Avatar buddy.... You are still a beautiful Lady...and I'm sure you will keep on... keeping me and Ross, walking the line. Bonnie