Memory Loss

[Doodle12]

My dad went into the hospital to have a knee replacement. The day after that surgery, he had a heart attack, then another the day following. On the 3rd day after his knee replacement, he had by-pass surgery. He has been in ICU and on a vent for 20 days. They took the vent off today, and he is very confused and he does not seem to remember much. Is this normal? Is there anything I can do to help him?

[Yvette BG]

So sorry to hear about your Dad. Sounds like he's been through a lot and so have you.

It is not unusual for people when they are in ICU to be confused. They sometimes call it ICU Syndrome or ICU Psychosis. It's a form of delirium that can be caused by environmental factors (sleep disruption, being woken up for tests night and day, stress, disruption of light and natural body rhythms, noise and beeping equipment, etc.) as well as many different medical factors, including medication, imbalances in the system, etc. It also takes a while for the body to adjust to the medications; they have to change the medications to wean a person off of the ventilator, from what I understand.

My Dad got confused and agitated in ICU after his heart surgery (triple bypass, aneurysm repair, and aortic valve replacement--all in one surgery.) He was trying to pull out his tubes and climb out of bed, take off his gown, etc. He knew who we/his daughters were, but did not know where he was or why he was in the hospital. It was very difficult to see him in that state, so I feel for you. My sisters couldn't handle it and had to leave the hospital. I think the only reason I was able to stay is I've worked in hospitals and have been around patients that are in that kind of state, so I was able to detach myself from it and pretend he wasn't my father. That might sound weird, but that's how I coped.

Is your father sleeping? We found out that my Dad was sleeping maybe only 1 or 2 hours a day for more than 48 hours straight. Then they tried a medication to calm him down (Ativan) and his agitation got worse. My suggestion would be to ask the nurse if he's been able to sleep and if not, ask if they can try a different sleeping medication (if he's on one already and it's not been working.)  We also brought in calming music and they allowed us to play that continuously by his bedside; it helped drown out some of the noise and he stopped constantly asking, "What's that?" when he heard a beeping of his IV, etc. or another patient's equipment nearby. Once he started sleeping, he really started improving.

Good luck and keep us posted.

---Yvette

[kenkeith]

Yes, that is not an unexpected consequence of by-pass surgery.  Almost always the patient will completely recover.  t how common post-bypass mental changes are, how long they last, and what causes them has never been crystal clear.

Duke University Medical Center:  It indicated that half of people undergoing bypass surgery developed memory or thinking problems in the days following it, and that these problems were usually still evident five years later.

A different viewpoint:  Johns Hopkins researchers who have been at the forefront of this field reviewed the evidence on short-term and long-term mental changes after bypass surgery. They found that short-term confusion, memory loss, and poorer problem solving and information processing are common after bypass surgery, but are usually temporary and reversible. Most people return to their pre-bypass level of function between 3 and 12 weeks after surgery.

Hope this helps and if you have any further questions you are free to respond.  Thanks for sharing your father's experience.  Take care.