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Effects of elective surgery, anesthesia on MCI due to Lewy Body diseas

Posted by nelms @nelms, 4 days ago

My husband, 73, has MCI due to Lewy Body disease. He is a candidate for abdominal hernia repair surgery. He is currently physically active, and the risk of not repairing the hernia is (at least) a reduction in vigorous exercise, which has as much—or more—positive effect as the Adderal and Donepazil. He also has autonomic problems, including loss of smell and urinary incontinence, and I wonder if there may be risk to bowel function without repair. But, there is risk of MCI- related decline and adverse events with and after surgery and anesthesia. If we wait until the hernia is intolerable, he may be in a worse cognitive state, and cooperation, adverse events, and decline could be worse than if we did it now. There is also the issue of surgeon and anesthesiologist understanding risks and management due to MCI/LBD. Anybody have experience with this?

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jan83404 | @jan83404 | 1 day ago
In reply to @nelms "Thank you! How long was you LO confused? And it sounds like you have had more..." + (show)
@nelms

Thank you! How long was you LO confused?
And it sounds like you have had more hospital experience with your LO…? Any general advice?

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nelms, You asked how long my LO was confused. He was confused for about 2 hours. Fortunately, he came home right after surgery. What confused him the most was his catheter. Keep in mind, he had only been diagnosed 5 months earlier. But I had learned a lot about the interaction of meds and LBD, so I was able to discuss this with the anesthesiologist. Now, nearly 5 years later, I won’t put him through another surgery unless it was vital.

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Becky, Volunteer Mentor | @becsbuddy | 21 hours ago
In reply to @nelms "Thank you! And in reply to your prior response, my husband is still a (usually) well-functioning..." + (show)
@nelms

Thank you!
And in reply to your prior response, my husband is still a (usually) well-functioning MCI due-to-Lewy-Bodies person. He will not be confused going into a surgery or hospitalization, but I am concerned the surgery, pain, and anesthesia might push him into a lower functioning state. I have read that potential responses for surgical patients with Lewy Body disease differ from those related to other causes, such as Alzheimer’s. I figure I would need to be there to distinguish between LBD-related RBD and delirium, which could happen post op with any MCI or dementia. As a long time nurse, did you observe anything like this?

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@nelms We had confused patients all the time!! But we never made a distinction between types of dementia. We just treated them all the same: insure their safety, have them talk with their spouse, and even have someone they know come and sit with them.

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