Tuesday, May 29, 2012

Tuesday, August 25, 2009 Concerned daughter asks

Q: does anyone have experience with PTSD after surgery being confused with dementia and delirium?

My father has been in memory care since January after an aorta repair surgery. He came out of surgery fine, but the next day was in complete delirium with vary vivid delusions. After his second visit to the ER, they said he needed 24 hour care. His cognitive abilities are returning. He can figure money (percentages, how old some one is etc in his head again). In May he finally go the how much is a dime, nickel, penny and quarter and thought we were foolish for asking. He now remembers how much money he had in each bank account before sugery, he was happy "working" at his condo and didn't know why he was there but seemed happy after Mom died. I live here now you know, he would say. When they did the cognitive test this month when it got the the math question to count backwards from 100 subtracting by 7's the doctor said he did it so fast he could barely keep track of how many he had completed. He had never see that before. Dad was capable of adding 5 digit columns of numbers in his head before all of this. WELL...just when things were going so well, we were able to take him out for family dinners etc. All of a sudden he is back to the talk about going to jail for raping ladies in the home, there are hit men after him, and he gets me confused with my mother, yet he knows she is dead. Well last Monday he showed me a ping pong ball and said he was now targeted by the hit men and that he had to kill whomever they told him to. He said but I don't want to hurt anyone so if they catch me, I'm not going to let them take me, I will kill myself first before I hurt anyone else. I called the home they reported it to his healthcare provider (NOT). We visit hiim every day and spend time with him so we know when he is upset more than the staff. He wouldn't let his favorite gal even come in his room because he didn't want her to get hurt. Tonight he said, I know you don't take this hitman shit seriously but it is very true and very real to me. He talked about the guards with the dogs, how they were dressed and everything. I was thinking some kind of psychotic break, but he is a WWII veteran and I did some reading onthe web about heart surgery and PTSD. The day of surgery he was fine, the next am he was not....that doens't really click with brain damage from the surgery. This has been a rough year with Dad there and Mom dying in May. BUT NOW I'm very freightened for him. The HMO says it will take 2 weeks just to get the scheduler to look at the schedule. I pleaded with them and said if it was your Dad would you want to wait 2 weeks knowing they may find him dead. He has military training, he is capable of alot. I have to get some rest, I'm hoping someone out there knows something that could help. At this point they are going to do a 4 hour test that the ER doctor said he needed in February. We just sold all his belongings in the estate sale. I would love to get him back, but just getting him back happy will be enough for me. I left crying tonight from his place and that is the second time..the first was the day we put hiim there.

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Answers (5)
Carol Bradley Bursack, Health Guide
8/25/09 7:14am

First of all, what medications does he take? My dad was like that on Haldol. He, too, came out of surgery and seemed okay for a day, and then went into complete dementia. They put him on Haldol and he was far worse. Paranoia was huge. It took days to get them to stop Haldol, and then he was a bit better.

 

I'm sorry to say that he never recovered. He spent ten years in demented hell, though many days were better than the horrible ones like you describe with your father. The war years coming back are not at all unusual. These memories never go away.

 

It's horrible that you have to wait so long just to get him looked at. If he's on an anti-psychotic, I would suggest to the doctor that they take him off and see how he does. If he still needs one, try another.

 

Meanwhile, I wish I could give you more hope. Damage can be done in surgery from the necessary oxygen levels to keep him alive. You may want to read this:

http://timesofindia.indiatimes.com/news/health-science/health/Administering-oxygen-precipitates-Alzheimers/articleshow/4884884.cms and read the posts for this: http://www.healthcentral.com/alzheimers/c/question/232579/82934.

 

Why there is a "good" day before the damage is clear is a mystery to me. Maybe doctors can explain it. I'm just telling you of my experience and that you aren't alone in this.

 

I hope you can get some medical help and some rest. My heart breaks for you. I've been there. Please keep us tuned in to how you are doing.


Carol

 

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8/25/09 8:54am

He was like this after surgery and they put himon seroquel. that toook the scary delusions away. He still had some mild ones but nothinig that frieghtened him so, that it changed his lifestyle.

I spoke with the care givers last night and we are tag teaming the HMO. They are calling and faxing today saying to expedite the evaluatino. They love him very much. It ended upthe nurse on duty last night was the one that cared for him when he was first there.I use to call every morning when I went to work to talk to her about how his night was. So she remembers how bad it was 7 months ago and how good it has been. they didn't want to give him a bunch more seroquel because they want the eval to show what is going on. They are the BEST.

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Carol Bradley Bursack, Health Guide
8/25/09 10:06am

I am so happy you have these good people to work with. I, too, was fortunate that my dad was much beloved by the caregivers who helped us, even though many people couldn't understand his situation. I hope this goes quickly for you and he can get evaluated. Drugs can be wonderful or terrible. Combinations can be great or cause a lot of problems. So, your wonderful caregivers and you will get him evaluated, and hopefully some improvement will be possible.

 

Take care and try to get a little sleep,

Carol

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8/25/09 10:49am

Hard to do...get sleep. I will say, when I carpooled last week for the first time in months, I sat back and closed my eyes. I let out a big sigh and said...this is the first time in 7 months the only thing I'm responsible for is.....breathing. Boy did that feel good. I really need a vacation but I have used it all up for my parents needs. AND when my mom died they told me I would lose my job if I missed any more work. I really love what I do and want to keep my job. Thanks again for your constant help Carol.

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Carol Bradley Bursack, Health Guide
8/25/09 11:18am

I know that feeling! It's so seldom you can just "be." Treasure it. I'm glad you are aware. I used all my vacation for parents' doctor visits and such, too. It's so horrible that employers aren't more understanding about elder care. Many larger ones have to give you family leave if you request it, but it's unpaid, and we all know there can still be repercussions, even if they aren't "outright." Maternity leave seems to be no problem, but understanding elder care has some catching up to do.

 

Hang in and keep in touch. We do understand, even if we can't fix it.

Carol

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2/10/10 5:08pm

wow im only 15 and im reading this and im really sorry for you the reason i looked on here was because my favorite girl is very sad because her grandma has alzheimers and i wanted to see if they went away. your story is very inspiring and i dont know if your dad is telling the truth or not it sounds pretty serious though i wish the best of luck

 

sincerely brennan from indiana

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2/10/10 5:08pm

wow im only 15 and im reading this and im really sorry for you the reason i looked on here was because my favorite girl is very sad because her grandma has alzheimers and i wanted to see if they went away. your story is very inspiring and i dont know if your dad is telling the truth or not it sounds pretty serious though i wish the best of luck


sincerely brennan from indiana

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11/ 8/10 12:14pm

Have the Doctors check a complete electroyle panel including magnesium.  Hypo magnesium is sometimes not detected because the M.D.'s have to ask for the test specifically.  If he has low serum magnesium that could make him very confused.

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12/ 4/10 4:20am

Yes, our 80 year old dad had emergency surgery to remove his gall bladder back in February.  Due to the severity of the infection (and his age) the surgery did not go well and at one point his heart stopped and they to "jump-start" it with paddles.  By the grace of God he got through the surgery and was in recovery when I guess things got a crazy. 

 

Our dad is hard of hearing (but won't admit it) and without glasses, can't see well (up until this surgery vision and hearing problems were really the only medical problems he has ever had.)  When he started to come to in the recovery room he couldn't hear the nurse telling him where he was; nor could he see his surrounds well enough to know where he was.  Plus they hadn't let my sister and mom back to see him yet, so everyone was unfamiliar.  So what does he do??  He panics...he tried pulling out his IV, he became loud, and he tried to get up and leave.  According to the recovery nurse he was uncooperative and unruly, which is why she felt the need to have him restrained with leather cuffs, like some crazy person that has just tried to commit suicide.  She said it was so HE didn't hurt himself. 

 

This is a slender 80 year old man that has just had major surgery that he almost didn't make it through, how unmanagible could he really have been??  Needless to say, my sister gave the nurse quite an earful when she saw our poor dad "shackeled to a hospital bed." 

 

I know my dad's problems aren't the same, but sometimes things are always how they seem.  Best of luck to you and your dad, I know it's rough, but stay strong for your dad.  :)  Anne

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By Concerned daughter— Last Modified: 12/27/10, First Published: 08/25/09