Is this normal after valve replacement surgery?

[Meggedy]

Just looking for some input from folks that have either gone though open heart surgery or supported a loved one in this process.  This is really hard.

My grandmother (84 years old) had an infection which went septic and into her heart.  

Last thursday morning, she had mitral valve replacement surgery (open heart).  About 8 hrs after surgery, she was incoherent and in a lot of pain.  We attributed her strange speech and lack of true consciousness to the high levels of morphine she was on.

Now, 4 days later, she is not in much pain anymore, and her morphine is at minimal levels.

She is still incoherent.  She drifts in and out of consciousness.  She doesn't know you're there a lot, or she'll greet you several times over the course of an hour.  We can't understand 90% of the things she says; the rest are just noises.  She can't understand instructions and she has been put on a feeding tube because she isn't aware enough to eat or swallow.

She is still in the ICU (doctors were expecting she'd be out by Sat/Sun), and she will be there indefinitely at this point.  

The surgeon literally used the word "stumped" with us when discussing her mental condition yesterday, and I am starting to get concerned about stroke, etc.

Anyone go through this, either themselves or with a relative?  Can you give me some idea of how abnormal (or normal) this is?  

[Candlelight]

I reread all your statements again before choosing to comment further. Several things leaped out at me:
1. Four days after surgery your loved one is on a feeding tube.
2. After the surgery you say she bleed a lot and it took an hour to get under control. That sounds like a huge complication to me. I assume she was bleeding from the drainage tubes placed in the body.
Did her hemoglobin and hematocrit go to dangerous levels?
Was she given packed red blood cells?(Transfusion)
3. What is the surgeon telling you about what he is finding?
If she suffered oxygen deficit because of blood loss that would explain a great deal.
Is she getting any better?
I hope my concerns are unfounded and that all will be well but I feel concern.

[Meggedy]

From Meggedy...

Thank you both for your input.  To give a little relevant background, the surgery was 3 hours, there were no complications during surgery.  However, she was bleeding too much afterward, which they got under control after about an hour.  I believe he said that she was on the heart/lung machine for about an hour or an hour and a half.  

She was VERY sharp before the surgery.  No frailty, no speech or memory problems, and no underlying medical conditions - diabetes, other heart problems, Alzheimer's - none of that.  In fact, the doc said that she was a great candidate precisely because of the absence of other conditions.

I will talk to the doc about analyzing brain wave activity.  Thanks again for your input and thank you in advance for any more.

[Candlelight]

It is difficult to determine the level of your loved ones' incoherence not having known her before the operation but I
think her doctor said it best when he said he was "stumped."
Some questions you might want ot ask her doctor are:
How long was the operation?
Were there any complications during surgery?
How long was she on the heart lung machine which allows the heart to be stopped while the operation is performed?
                 Her age and level of strength and health before the operation may play a part in post operative recovery but incoherence does not, sound normal to me.
Is the doctor evaluating her cognitive function? Has her brain wave activity been assessed? Some people are very sharp at 84 and others are not. If she was very sharp before the surgery It worries me that she is not now. Keep talking to her and keep asking the doctor relevant questions.If your doctor is truly stumped perhaps a second opinion is possible if her insurance will allow it or if you can afford it.
                  Hopefully she will be completely fine by the time you read this. Best wishes.