Were you a Pump Head? ( memory / sleep / pumphead)

[LubDubLubDub]

I had Mitral valve replacement Oct 13, 2009, age 55. Medtronics porcine valve. Piece of cake. These days I'm swimming more than a mile each morning.

What WASN'T a piece of cake was my 12 month struggle with what the docs call "Pump Head".

My short term memory and reasoning ability was shot. The best way I can describe it is like someone messing with and deleting lots of random files in your computer - that's what 6 hours on the heart/lung machine did to my brain. As a musician in a band, I found myself having to re-learn almost my entire repertoire. A real nuisance.

Anyone about to have surgery, research this, ask about it, and be prepared for it. I found it very troublesome and depressing. It seemed to resolve after 12 months.

 

[normofthenorth]

I went into my recent (5 wks ago) OHS worried about two kinds of mental/neurological problems, the one you discuss, and a possible increase of frequency or intensity of migraines, which I grew up with and have largely outgrown.

I discussed both worries pre-op with several doctors, mostly every anesthesiologist I met who was going to be involved (or sometimes not!) with my surgery. I ended up "negotiating" a lower-than-average exposure to benzodiazepines, a class of drugs that's administered to OHS patients largely as a stress reliever, but also is known to cause retrograde amnesia. Originally, we agreed that I'd have NO benzodiazepines, but the "real" anesthesiologist convinced me to let him use SOME. He swore that the retrograde amnesia would normally only begin at the moment of the injection, and not affect my prior memories (although SOMETHING clearly messes with prior memories of many OHS patients).

For the migraines, one of the first anesthesiologists I spoke to said that he'd respond to my concern by emphasizing the IV anesthetics and downplaying the inhaled "vapors", since they were more associated with migraine complications than the IV ones. I don't know if he was joking, or testing me (If so, I failed!), or what, but I have trouble imagining being treated with inhaled vapours while my lungs are collapsed and my "breathing" is being done by the pump. . .

My bottom line was that I emerged from the sleep/fog of the surgery feeling just like me, more or less 100% the whole time and ever since, with no significant (or even noticeable) mental deficits. I have no idea if I just got lucky, or if those pre-op discussions or the lower doses of benzodiazepines actually made a difference -- but I'll take it, either way! (When I started using my computer on day 2 or 3 post-op, my rate of typos was elevated, but it dropped back to normal in maybe another 2 or 3 days. Other than a ~1-hour episode of partial aphasia ~2 days post-op, which I've described elsewhere, that is ALL for me!)

BTW, my impression (admittedly vague) of the studies on "pumphead" is that the drugs are a more likely cause of most neurological/mental effects than the pump.

 

[ALCapshaw2]

There have been several threads in the past about cognitive impairment following surgery.
You can probably find many of them by doing an "Advanced Search" for keywords "cognitive", "pump head", "memory", etc.
Be sure to scroll down on the options block and select "Any Date".

Thank you Norm for your excellent and informative response to this thread.

Other means of reducing cognitive impairment that have been discussed on these forums include
(1) using the Highest Quality Filters in the blood lines from the Heart-Lung Machine and
(2) slowing the rate at which the body is re-warmed following surgery (by just a few minutes).

Bob H (a.k.a. Tobagotwo) has written about item 2 above.

'AL Capshaw'

 

[RobThatsMe]

Hi,

I have had this issue with memory ever since my first open heart surgery. I looked for information about this condition, and found that there have actually been several documented studies regarding it. Duke University did several studies on the topic.

Here is a brief overview of some of their findings.

http://dreamcampaign.duhs.duke.edu/duke/patient_care/memory.htm

Google around and see if you can also find further documented information regarding this condition.

Rob

 

[Lily]

I'm glad you're better, and now doing so well. The first thing I did when I came home from the hospital after valve replacement was to sit down and play my piano (namely, Lecuona's "Cordoba" from the Anadalucia Suite) to be sure that I still could. I was relieved

Personally, I have never had a terrific memory and have always had some random experiences with poor memory, or something; and still do. I think I suffered with some pump head for a few months post-op also.

Take care

 

[normofthenorth]

The info in that Duke page that Rob linked is way scary:

Up to 80 percent of patients who undergo heart surgery experience some type of memory decline at hospital discharge. Forty-two percent of heart surgery patients continue to experience memory deficits five years after surgery. In non-heart surgery patients, 59 percent experience memory decline at hospital discharge and 42 percent continue to experience memory loss two years after surgery.

!!

 

[Cooker]

I still have it to a degree .... almost 5 years since surgery ... I'm pushing 55 and that doesn't help:rolleyes2:

 

[bigsidster]

I was home from the hospital 3 days and sat at the computer and it took me about an hour to put 2 sentences together with the correct spelling.It wore off after about 2 weeks.

 

[drivetopless]

Who do you discuss this with- the anesthesiologist? My surgery is next week. I will meet the anesthesiologist that morning.
I'm very concerned about retention of cognitive function. I'm scheduled to give a presentation at a conference in June. It would be so embarrassing if I lose my train of thought.
Good topic!

 

[RobThatsMe]

Hi DT,

Write your presentation down before surgery.
It will be much easier to recall it that way.

When I went back up to CCF in Dec. for post-op tests and a meeting with my surgeon, I forgot my briefcase on at least 4 occasions. I left it at the airport ticket counter, several places in the hospital, and in the waiting room at the car return place at the Nashville airport. It contained my health records, airline info, ID's and my Passport!!!! YIKES!!! Good thing my wife kept asking where it was when she saw that I did not have it!

Scary stuff... for me anyway!! I know that I had memory issues after my 1st OHS, but now... it's ridiculous.

now... forgetting all that above..( hmmm). I really wish you a very succesful surgery and will keep you in my thoughts and prayers as you go through it.

Rob

 

[buncle]

I had the "pump head' for about 3 weeks.I am amazed how some can poat from the hospital! No way I could.It took me 2.5 weeks and I had to retype 1/2 of my e-mails.I thought I was doing good till I re read my letters.It will get better but, it is frustrating.Dont worry it will pass.

 

[Luana]

I had no problems at all. I was able to tell people things that were said to me when I was in ICU shortly after surgery before I had actually woken up, and they said I was spot on. No memory problems at all.

 

[normofthenorth]

Who do you discuss this with- the anesthesiologist? My surgery is next week. I will meet the anesthesiologist that morning.
I'm very concerned about retention of cognitive function. I'm scheduled to give a presentation at a conference in June. It would be so embarrassing if I lose my train of thought.
Good topic!

Yes, almost all of my discussions were with my anesthesiologists. I think I discussed my concerns with my main surgeon, too, and I think he referred me to the anesthesiologists, as the people in charge of the drugs that are most likely to cause cognitive deficits or retrograde amnesia (or, in my case, migraines).

Again, I wish I could tell you that my excellent results were BECAUSE of my pre-op discussions, but I've got no idea really, and there's only one data point in my sample. . .

 

[Guest]

I'm 4 1/2 weeks post op and am experiencing pump head. I'm having trouble with names.

 

[Greg a]

I was just getting over the first two and a half week comas pumphead when I slipped into the second coma ....pumphead lasted a lot longer that time so with the anger AND pumphead I would not have lived with me I have no idea how my family did

 

[marie]

I still have it to a degree .... almost 5 years since surgery ... I'm pushing 55 and that doesn't help:rolleyes2:

Ditto and I'm almost 3 years after surgery and I'm pushing 70

 

[Guest]

I'm now 10 weeks post op and STILL have pump head. I'll start to say something, and have to stop and try to recall what I wanted to say. Frustrating.

 

[drivetopless]

Seems like there is a wide degree of pumphead results. I am happy to report that I had no pumphead issues (to my knowledge). In fact immediately after the surgery, I experienced a feeling of mental clarity and good memory recall. I think my time on the pump was minimal as I only had VR and no additional procedures. Hope the mental clarity lasts.

I did discuss the topic with my anesthesiologist. I gave him printouts of the Duke study summaries and discussed if he uses a "slow warm" techinique. Don't know if it did any good, but it made me feel better. The nurses on the heart floor commented that older patients usually have more mental side effects from the meds and anesthesia than younger patients.

i think some of the pumphead stuff you hear about could also be from the crazy amounts of heart drugs they put you on the first few months after surgery, espescially if you get afib.

 

[OldManEmu]

Drivetopless I agree.

I think some of the pumphead stuff you hear about could also be from the crazy amounts of heart drugs they put you on the first few months after surgery

I was fine post surgery, it was only in the months after surgery that the beta blockers were increased to promote heart remodelling that my short term memory and concentration became poor. Once this class of drugs were discontinued 15 months post surgery after the heart remodelled, my memory and concentration returned to normal.
Beta blockers are a class of drugs I would not want to be on indefinitely from my experience, I do credit them with my heart remodelling.
I went through heart surgery to improve my quality of life not to substitute long term drug induced issues for a heart induced problem.

 

[neil]

defo had a problem with memory etc.but it does get better......so what was the question?