Anesthesia related cognitive decline, specifically dysnomia

This is different but my daughter was sedated for a long time while on a ventilator, following an accident. She had a kind of amnesia where she does not remember about 3 months of the time after the sedation, and at the time scored in the 7th percentile on certain cognitive tests (she has just graduated from Harvard). Her function returned and she got a PhD. For awhile I feared she was going to be cognitively disabled.

Of course at 73 our brains might have less ability to recover quickly but I know friends with COVID brain fog, who are older than 73, have recovered. This must be upsetting.

I totally agree with your experience with doctors by the way. Even my neurologist, who I have seen for 20 years, now says things like "well, you are older now" for symptoms I had at 50, as if they don't matter anymore. It's kind of like "what do you expect." I am not a complainer. But I have noticed a change in MD attitudes since I hit 70.

Thanks. I’m trying to be honest and candid with people I encounter when they see me struggling for a word. I instinctively describe whatever I can’t find the word for in another way and usually if I relax and take
a breath the word will surface. But it’s disturbing. I hope it clears

My 71 yr. old husband had his hips replaced. The first hip no problems but the second hip, 6 months later, was different. First, we didn't think much of it but he would confused words, like micro soft for microwave. He also was having a had time remembering things but worst of all he was having trouble driving. He keep bumping into things like gates, walls trees etc. So we went to the eye doctor who said everything was normal. However, upon doing a google search I found out just what your doctor said that in older people it takes a lot longer to clear the anesthesia from the body. It took maybe 4 months in my husbands case. He is fine now but you would think that in all those discharge papers they would mention it...good luck !

That’s very helpful and I’m encouraged that he is fine. It’s been 7 mos for me and I’m not seeing a change yet - but I’m hopeful. I haven’t read anything that can facilitate that change but I continue to search scholarly publications.
Thanks for replying.

Pam @pb50, You provided an excellent description of the changes you've experienced. Was your surgery very recent? From what you wrote I figure the surgery occurred within the last month or two.

My partner had surgery in both hands for Dupuytren's contracture. The surgeries were a few years apart. He had a nerve block for the first surgery. For the second surgery the nerve block did not "take" so the anesthesia was converted to a general anesthesia. This is a good discussion to have with your hand orthopedic surgeon given your experience with the pulmonary surgery.

Before I retired much of my scholarly work was in the area of cognitive function in older adults. I might add that I started this work when I was in my 30's and now I am one of those "older adults" at age 71. General anesthesia indeed can and does affect the retrieval of words. As you know it is common as we get older to have difficulty retrieving proper names such as the names of people or places or titles. However, I'd like to validate that you've described a word retrieval difficulty that is not typical. I was often frustrated with neurologists and other physicians who passed off these word retrieval difficulties following general anesthesia. After all, if the surgery was successful for say, open heart surgery or the lung surgery that you experienced then their work is done with the exception of the followups.

You've received some good advice here from @windyshores and @casey1329 who suggest that it can take months for naming function to return. In the meantime I'd like to make a suggestion. If you aren't already doing this, you could chart your observations each day. This could get laborious if you chart every naming difficulty you experience so perhaps just chart with a scale of 0-5 on the difficulty you experience each day with 0 being no difficulty and 5 being extremely difficult. If you have a column for a few examples then that's even better. I have found that when I have written records that I can bring to my physician they are often very willing to take a serious look through my charts.

One last question. When you have the naming difficulty, can you bring to mind the first sound (letter), or the number of syllables of the word? If you let the word "go" does it come to you later? If the answer is yes, then this means that you have retrieved the word but it's "stuck" in the lexical (vocabulary) stream and it's on the "tip of your tongue". That's also good information which means that the word isn't lost but rather stuck.

OK - perhaps this is too much information or detail. I'm very happy for you that your lung nodule was followed closely and eventually removed. Will you let me know about the progress of your recovery?

Oh that is marvelous information!! And yes, It always feels like it’s on the tip of my tongue.

Most recent notable example. I’m in initial consult with an oncologist because I was never offered one and I want someone looking to see what could be developing beyond the periodic chest CT screen.

In that discussion I was describing the word retrieval issue and I intended to add that my deepest underlying fear is Alzheimer’s. (My mother and 80% of her 8 siblings all died of or with Alzheimer’s). But in spite of the contextual importance of that word, I could not reach it. I ended up saying ‘brain dysfunction’ and then told the Doc “you just witnessed what I am experiencing”.

As a pure coincidence I have an appointment with a neurologist early next week to evaluate some violent ataxia I am having when I have my head back for a few minutes - like in a shampoo bowl at the hairdresser - and then change to normal position. Anyway I think I will ask if I could schedule visit to evaluate this anesthesia reaction. Thoughts?

One more point - I have never been a person who remembers everyone’s name - even in my young adulthood. So in my 70’s it’s become a standing joke with friends and family. Proper names are commonly out of reach. But it’s different. I don’t feel like they are on tip of tongue. They instead are akin to being behind a closed door I can’t open. But it doesn’t frustrate me like the current situation does. Not sure if that adds insight.

@pbpam Ha, ha. Same with me about remembering names. It did become worse as I got older but I just let it go and try not to let the failure in retrieval of proper names bug me. If it's important enough to me I come up with a strategy or device that will help me to remember.

Yes, I can understand what you mean about the frustration with what's happening at the present.

Just realized I didn’t answer your question - my left Lower lobectomy was May 25th, 2023. So almost 8 mos ago now.

@pb50 Pam, that’s been awhile so I’m wondering if you’d like to talk with an expert in this area. I can certainly sense your frustration and concern.

I don’t have a specific recommendation for an individual but perhaps a neuropsychologist? You know yourself well enough that you can describe your cognitive status before and after the surgery and then track your progress with neuropsychological testing. It could be challenge just getting in to see a neuropsychologist in the near future but it’s an idea if you want to see numbers and objective results that can be followed over time. The other thought I have is a neurologist who specializes in higher cognitive function. I think many neurologists with this expertise tend to be found at academic medical centers. For instance, there are neurologists with this expertise at Johns Hopkins. I copied a link for Dr. Argye Hillis because I knew her when she was a speech-language pathologist who later went into neurology. I’ve often thought what a great combination of skills she has for her patients. She practices at a Memory Disorders Clinic. I’m not suggesting you have a memory disorder. It’s just that many neurologists with this expertise often practice in these centers.

Argye Hillis, MD
— https://www.hopkinsmedicine.org/profiles/details/argye-hillis

Anyway, these are my thoughts. Feel free to write me a personal message on Mayo Clinic Connect.