Pumpheadedness?

[Raverlaw]

Well, this can't be a coincidence- First I was reading a news article today on "off pump" surgery which mentioned memory loss, confusion and lack of concentration as a side effect of OHS with a heart lung machine; then both Georgia and Al mention it in messages to me while discussing timetables for returning to work.

So: How many of you have experienced this? How long did it last? How bad was it? Is it irritating or actually debilitating?

And why didn't my surgeon mention it to me?

 

[Nancy]

Hi Bill-

One of the best things you can do is to do a search on this site using the phrase, pumphead.

There are a ton of posts on the subject, and that will pull them out of the archives.

It's a very common problem, and one which is getting lots of research attention.

I think the folks who have had their surgery very recently have fewer problems with it, so they must have found some ways to mitigate it somewhat.

 

[Ross]

I would call it very irritating. It's not debilitating, just a big nuisance. The length of time varies from person to person. I'm not really sure it is pump related. I still feel it's the effects of the anesthesia, which seems like lingers inside you for a long time afterwards.

 

[hensylee]

When Dr Rich, from about.com wrote his article (which I put somewhere in these archives), one of his first statements was that there is much discussion among doctors about this and they have not come to real conclusions. You should do a search for it - as Nancy says. Hardly anybody has had really big problems with memory - seems it's suspected to set in about five yrs after the surgery, but I haven't got there yet so I can't relate. I think most of us have some memory lapses but many of us had those before surgery anyhow. Not to worry, it shouldn't cause you any big problems.

I am glad we revive this one from time to time for new folks who might not know about it or are concerned about it.

 

[JimL]

It is very frustrating not to be able to remember simple words and terms, but it is not debilitating, since memory does return. Sometimes memory returns in the middle of the night, when you can't sleep anyway, but it does return.

I had a fair amount of pumpheadedness before surgery -- I've always been forgetful, I've always had an innate ability to put my foot in my mouth. The big change after surgery is that it takes me longer to realize that I've just put my foot in my mouth again.

But now, after surgery, I have an excuse! I am delighted to read Ann's post that pumpheadedness sets in five years after surgery. That means my excuse will last a long time yet. I'm sure to need it.

 

[ALCapshaw2]

I noticed the effects more after my first surgery than my second. I specifically asked my second surgeon about cognitive effects from the pump and he told me that the quality of the filters is one factor and they 'used the best'. Seems to have helped. Time on the pump is another factor.

I often 'forget' where I put things or remember there was something I wanted to remember, but can't remember what it was! Hope this makes sense Of course it could also be a normal part of um..er.. aging.

The biggest problem is remembering casual things that just pass by. If I make a point of remembering something I usually do.

To compensate, I make lists of Things to Do or what to pick up on trips to the store and make more of an effort to 'remember' things I need to remember.

'AL'

 

[ALCapshaw2]

I forgot to mention that Beating Heart Surgery is only used on 'some' Bypass Patients (mostly those who need bypasses on the front of the heart).

It's pretty hard to replace a VALVE in a beating heart !

'AL'

 

[hhardt]

I definately have it. The memory recovered rapidly after the avr, but started downhill at about year 2. It continues to get worse. I have trouble remembering common, familiar names and terms. I understand this will continue to worsen until year 5. I hope to report on it at each 5 year interval for a long time. But, I still look down at the grass.

I have a new problem. A nodule growing in my thyroid. It was small after the avr, but is bothersome now. I'll find out what next next week. The ultrasound fine needle aspiration was inconclusive. This I wish I could forget.

 

[catwoman]

Bill:

I had problems recalling very detailed information for about 3 or so months post-op. Even forgot name of the street I live on at one point, but was able to remember my house #.

Fog lifted sometime in early October, I think.

I asked a CRNA who works at a St. Louis MO hospital about it. He attributed it to the heart lung machine and the various anesthetics given for heart surgery. Don't know if he works with many OHS cases -- he said he does everything but OB.

 

[Enudely]

my father was doing some research and said that in Japan, they have been injecting large amounts of abscorbic acid (vitamin C) into the patient right before the surgery for five years now. It seems to really speed up the recovery and helps with the effects of the anesthesia. I don't know about this pumpheadedness but my father is going to talk to the surgeon about it......

 

[Marge]

I think that after any major surgery, especially if preceded by illness or a seriously weakened condition, you are going to have some of the same effects as have been discussed here.

I've mentioned in other threads that some years ago I had my left arm and most of my shoulder amputated following some very serious consequences of an arterio-venous fistula. I was ill from approximately February that year; went into the hospital in March or April; was released after a couple of weeks but the condition kept worsening; was finally hospitalized again in August & had the amputation. By that time I had been in excruciating pain for months and was on so much pain killer and tranquilizers (all of which blurred the pain a bit but did not really lessen it) that I couldn't eat and was seriously weak. The surgery, as it turned out, was quite epic.

When I got home (10 days in hospital that time) my mind was total mush and remained so for months. No memory, no ability to concentrate or to do even simple things. I remember I paid my credit card bills several times over (kept sending in checks on accounts I had already paid). Forgot to pay my bar dues and had to grovel to get my bar membership back without having to pay penalties. Couldn't read. Could only follow the simplest TV programs ( Sesame Street and Rainbow Reading Room became my favorites). I gradually came out of the fog and by December was able to go back to work. But I lost about a year out of my life. When I looked at things I had written during that period -- like those checks to the credit card companies! -- it looked like the handwriting of a completely different person, not me at all.

 

[Nancy]

Hi Marge-

What you have said is very true, at least from what I've observed with Joe.

He's had 5 thoracic surgeries, and has also had about 5 life-threatening and extended medical episodes during which he spent a long time in the hospital and came home debilitated and a very ill man. It took months and months for him to recover from each of these. There was a lot of confusion and memory lapses during these healing periods. I think the body summons all of its resources to keep the core things going, and most of the circulation is sent to the vital organs, leaving other areas on "stand-by".

 

[ccrawford]

Bill - I had my surgery in April. A couple of months later, I was still a little fuzzy. I love historical novels and read a bunch. I could only read for a few minutes and my concentration would go out the window. I was also concerned that my ability to play the keyboard might be impaired. I'm happy to report that I'm burning up half a book per night and my playing has resumed to former levels. I'm also a lot more comfortable around all the power tools in my wood shop - for awhile, I was overly cautious and rightfully so. Be sure and check out the many posts on this - I think I even did a survey, and there are results from several studies that are quoted. Do you know how to get to the older posts ? Chris

 

[Raverlaw]

Well,

I guess I am somewhat reassured that it will go away after a time, but it's not something I am looking forward to. I also love to read, and the thought of not being able to concentrate enough to read for an hour or two is really scary. I'm not a TV watcher; reading is my way to stay informed and to relax or pass time.

I also like to do woodworking, Chris, and I was already planning on being cautious, because of the Coumadin. I'll make sure Im not fuzzy before I start that up again.

 

[Granbonny]

Paying bills

Paying bills

I have always paid our bills..Married to hubby 38 years. so what I did, after my surgery..was to look at due date. take out of envelope and write due date on their return envelope...File in order...due 2nd. 7th. 15th. ect...Phone calls were bad for me. couldn't talk. And hubby calls me..The Mouth of the South. Worse was day QAS called for info for my getting a Protime.. Trying to answer their questions. Now, almost 2 years later...when relatives change their phone numbers, addresses...Hard to get them in my mind. Have to keep a book handy for all numbers.Had to get a new ATM card. and trying to remember my pin number. Have to have it in a safe place..and then..I live in a gated community..and they change codes every Jan. 1st. Have to have that written down Thinking about having them all tattooed on my hand. Also, after surgery..be sure and write down all doctor's numbers, drugstores..for you will be having to call for appointments, meds ect. Post them on fridge or a wall.. because you may lose your address book. Bonnie

 

[Marge]

Of course, Bonnie, at this point in time I find I am already, pre-surgery, having a lot of those same types of mental lapses due to effects of extreme fatigue induced by my beta-blocker, coreg.

I make lists for everything these days. When I have to phone, I write down ahead of time what I'm going to say. I never lock my front door or my car without checking several times that I have my keys so I can get back in. And all kinds of other things I never did before. A friend, observing this the other day, said to me: What's the matter, when did you start developing these obsessive compulsive behaviors?

They tell me I'm going to have to stay on this beta blocker the rest of my life, even after surgery. The combined effect on my mental abilities of "pumpheadedness" and beta-blockers could be ... interesting.

 

[Harpoon]

Oh boy oh boy oh boy oh boy.....


Lots of sarcasm there.


This is one of the things I've gotten to deal with my entire life, it's a happy little thing....


More sarcasm.


The difficulty with open heart surgery (one of them anyways) is that it's rather difficult to cut and sew a moving target so they generally like to stop the heart from beating before working on it. There are some instances, usually during "minor repairs" where they've tried working on it in motion. Back in the day (when I had my first surgery, in the 70's) the best way they had to stop the heart was by packing you in ice, lots of it, head and torso usually, to bring down your core body temperature inducing hypothermia which stopped the heart. It works ok and all, but the problem is the brain isn't getting the oxygen it needs (the the amount needed is reduced) so you have to move quickly. The big downside to this is it causes brain damage (more or less) and most kids that survive the surgery end up with something like a mild learning disability or whatever. I can't do rote memorization (suck at math and art history) and I can be easily distracted at times. I work around it easily enough most times, I'm not a mathematician....

Along comes the heart/lung by-pass. Operations can last longer and more can be done, however when you run blood through plastic tubing and such, you damage the blood cells and that can decrease how much oxygen is getting to the brain over a period of time after surgery (generally the oxygen depletion during surgery isn't as bad as the ice method, as is my understanding)

So there may be some temporary memory loss or decreased mental function. You might wander around feeling a little "dumber" than you used to be for a while, but generally it gets better.

I still have some "dull moments" but they aren't as bad as when I first got home.


There's also a memory loss associated with the medications they have you on in hospital. I can't remember about five weeks or so worth of my stay in Cleveland. Part of that is because I was essentially in a coma and there just wasn't anything to remember and part of that was medication induced.

I have a few vague impressions, like dreams, of an altered reality. I remember someone who was my girlfriend/fiance, but she wasn't Erica. I remember a different room that I was in, odd drapes and an elderly couple in the next bed, but I KNOW that never happened because I spent all of my time in children's wards. I remember my extended family taking me on a special trip after surgery, with medical care on hand and a train ride....

I even had some kind of a dream about being on a space ship....


I was on some REALLY good drugs man.


I think most impaired brain function from the heart/lung machine comes back after a while. It's different for different people and it's probably related to how well your body can replace those damaged red blood cells with new ones.

It's temporary.

 

[hensylee]

I had another sort of surgery last May and they put me on dilaudid and I could push the button myself - that is a horrid medicine. I am a gentle person always, but my dear daughter suffered at my hands - I became mean, she said and that's not me. I remember nearly nothing of that hospitalization and slept for a week in the hospital. So, yes, medicine is definitely a problem sometimes. After heart surgery, they just gave me pills and I could refuse if I wanted - and did. Got over it much faster that last year's surgery. The dilaudid must've left some effects because it took me quite a long while to get past the mental stuff.

 

[ALCapshaw2]

"I never lock my front door or my car without checking several times that I have my keys so I can get back in. "

After leaving my keys in my truck and locking the door a couple of times, I made a spare set and keep them in my wallet. This has saved me MANY times.

'AL'

 

[Raverlaw]

I'm already not as good at remembering some things as I used to be, which I thought was age related but now can blame on my AV, right?

But, seriously, I started using a Palm device about two years ago, which I keep a LOT of information in; addresses, phone numbers, to-do lists, passwords, you name it. I'd recommend this to anyone as it is small, portable and easy to use. If you're using a computer a lot (I bet most people on this board are) it syncs to your computer and makes updating really easy.

BUT - you have to REMEMBER where you put it and can't forget to bring it with you!! And please - don't even try looking up a phone number while driving!