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Re: Dealing with brain damage from by-pass survery

Posted By Don DeCapio on March 25, 1998 at 17:37:37:

In Reply to: Re: Dealing with brain damage from by-pass survery posted by CCF Cardio_MD-DLB on March 25, 1998 at 15:58:01:

: : I am a by-pass patient (7+ years ago at age 42) who is experiencing type II cognitive symptoms (disorientation, confusion,  irritability, lack of ability to concentrate, etc). I have been very glad to see recent acknowledgments of these by-pass surgery related problems as well as research in prevention methods and techniques. These activities will certainly be helpful to future patients. However, I am looking for ways to reduce the current  symptoms I am experiencing. At times they are severe enough to impact my relationships with family and friends as well as job performance. Is anyone aware of any research or efforts in this area. I have discussed this with my cardio but unfortunately, this is not an area he has a great deal of experience in. Any input or comments would be appreciated. Thanks...Don
Dear Don:
Neurological events such as strokes are well-known complications of coronary artery bypass grafting surgery.  Only recently have more subtle degrees of neurological dysfunction been attributed to bypass surgery.  Surprisingly, when sophisticated neuropsychiatric testing is performed, a sizable minority of patients display some degree of dysfunction.  Great research efforts in cardiac surgery and anesthesiology are trying to prevent this problem.  
Certainly, cognitive decline after bypass surgery can be due to the surgery itself.  In addition, medications that a bypass patient (or any patient for that matter) is taking can cause cognitive dysfunction.  Also, depression after bypass surgery is not uncommon and depression can masquerade as cognitive decline.  A number of medical conditions, unrelated to heart surgery, can also cause cognitive decline.  It is important to screen for these different ailments.  If after an extensive medical workup, no other cause for cognitive decline can be found (and if cognitive decline can be objectively demonstrated), and if it is concluded that the cause for the decline is in fact the bypass surgery, there is still hope.  While there is no "magic bullet" to reverse the cognitive decline, neurologists have developed behavioral techniques that allow patients with cognitive dysfunction to compensate for their disabilities.
If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a neurologist.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your doctor.
Thank you for your comments. I understand the points that you make in you e-mail.
Unfortunatley, I do not live in the Cleveland area, but I have been able to identify a facility in the Dallas area. I have contacted them and will be going in for a neuropsychological evaluation in the next few weeks.
Again, thank you for your help....Don

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