memory loss

  My Grandfather recently had a quadruple by-pass heart surgery. His surgery went well and physically he is doing well. His mind has been another story. It's been one week since his surgery and he is still totally confused and has a hard time remembering his family, or what words mean. The doctors say this is normal and because of his age (he is 71) that it may take him longer to recover. We are all very upset that this is going on. The surgeons never told my Grandfather he would lose his memory and have anger fits after his surgery. My Grandmother is a wreck and so is my mother. What information can you give me to help them? And can you explain why it is taking him so long to come out of this?
  PLEASE HELP US to understand, the doctor's won't return my Grandmother's phone calls and she has no idea what to expect.
  Thank you SO MUCH!
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Dear Shannon:
The situation you describe is not that uncommon after bypass surgery.  In the few days after bypass surgery, many patients have some degree of confusion, just from being in an ICU setting.  This usually passes by the time the patient is discharged from the hospital.  The best way to reorient the patient is to have familiar objects in the room, such as photographs of the family.
Fever or infection can sometimes cause confusion, especially in the elderly.  Your doctors have probably looked into this possibility.  Lack of sleep (a common problem in the hospital) can cause confusion.  Certain medicines can cause confusion; examples are sleeping pills and sedatives.
A stroke can rarely present as confusion.  Strokes are an unfortunate, but well-recognized, complication of bypass surgery.  
Sometimes depression after surgery can masquerade as cognitive decline.
Merely going on the heart bypass machine during surgery also seems to affect cognitive function in a large number (about 30%) of patients.  This can range from subtle changes in personality to substantial loss of cognitive capabilities.  There is no specific treatment, but the situation does tend to improve with time, though it can take quite a while.  This side effect of surgery has only been recently appreciated as a real phenomenon.  Many medical researchers are looking into ways to prevent it.
Usually, the cause of confusion in the elderly patient after bypass surgery is a combination of many of the factors I have listed, and the situation does tend to improve with time in most cases.
I hope this has been useful.  I wish your grandfather the best of luck.
Information provided here is of a general nature.  Specific diagnoses and treatments can only be made by your doctor.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at Desk F15.

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