What you need to know before any surgical procedure

It’s the surgical complication that doctors have known about for over 60 years… yet somehow kept a deep, dark secret.

That’s why you’ve probably never heard about postoperative cognitive dysfunction (or POCD).

Even if a loved one appears confused and forgetful in the weeks or months after an operation, you might never put two and two together – after all, it wasn’t even on that book-length release form!

But POCD is a significant and common problem after surgery – especially where seniors are concerned.

And now, after decades of hemming and hawing over what’s causing it and what to do about it, doctors and researchers are finally putting their collective noses to the grindstone and attempting to figure it all out.

In the meantime, however, there are some important things you need to know before you or any of your family members go under the knife — because patients still aren’t being told a thing about the possibility that it could happen to them!

A long-kept secret

You would think that doctors would be able to tell us a lot more about POCD by now!

The condition was first described in full in a series of articles published in The Lancet back in 1955.  During the following decades, various theories as to why it occurs have been proposed – including some blaming it on anesthesia and other drugs, damage to special cells in the brain, or even a kind of “fast-forward” of looming dementia.

The two most popular ideas right now involve inflammation and a long-lasting effect from the anesthesia itself.

As one expert explains, most kinds of surgery trigger “peripheral inflammation.”

When you’re young, the brain is isolated from that by the protective “wall” called the blood-brain barrier. But that can become “leaky” as we age and activate a “whole cascade of events” in the brain.

Another possibility, proposed by researchers at the University of Toronto four years ago, is that the effects of anesthesia – which, of course, prevent you from remembering the trauma of surgery – can cause the “exquisitely sensitive” memory receptors in the brain to continue to be blocked long after any anesthetic drugs have left your system.

Anesthesia doesn’t actually put you to sleep. It induces a “pharmacological coma,” the researchers said, adding, “We shouldn’t take these drugs lightly.”

The good news is that POCD usually goes away on its own.  But it could take weeks — even months — before you’re back to normal.

This June, doctors and researchers will be holding a POCD summit and releasing a detailed paper on the topic in six scientific journals.

But unless some startling new findings are announced, these are the main things to keep in mind before – and after — any surgical procedure:

• If you have sufficient time to prepare for an operation, try to be in the best shape possible by eating well and doing whatever exercise you can. The healthier you are, the better the chance that you’ll bounce back sooner.
• Don’t make important decisions for at least a month after surgery. Experts advise that you put off tasks that require a clear head and have friends or relatives step in with some help during that time.

You should also talk with your surgeon about this “secret” side effect and find out what he thinks will lessen your risk.

Of course, the surest ways to avoid POCD are preventing anyone from putting you “under” and staying out of the operating room! But while skipping surgery isn’t an option in many cases, you should make sure that the benefits of any elective procedure outweigh the risks – and find out what alternatives might be available.

For example, as we’ve told you in the eAlert, some back, shoulder, and knee operations are no more effective than physical therapy!

“What we know and don’t know about memory loss after surgery” Judith Graham, April 12, 2018, Kaiser Health News, khn.org