Anesthesia may affect memory after surgery

The Baltimore Sun

My mother recently had surgery and now is experiencing significant memory loss. The doctor said anesthesia sometimes affects memory. How long will this last, and is there anything we can do to help her recover?

Surgeons and anesthesiologists are aware that surgery may pose risks to mental function, especially in older people. They call this condition postoperative cognitive decline (POCD).

There is controversy as to whether the problem is brought on by anesthesia or by surgery itself. Some commonly inhaled anesthetics have been linked to dementia in mouse research (Neurobiology of Aging online, March 7, 2007). Gases like isoflurane and halothane lead to accumulation of beta amyloid, a compound that is thought to contribute to Alzheimer's disease. Injected anesthetics such as propofol and thiopental may be less likely to cause such problems (Neurochemical Research, August 2005).

For many surgical patients, POCD disappears within a year. A small number, however, may have lasting memory problems. We don't know of any way to reverse such cognitive decline.

My wife has a sleeping problem, and so do I. She goes to bed and falls asleep about 10 p.m., but wakes up around 2 a.m. or 3 a.m. and is unable to fall back to sleep after that.

She takes prescription sleeping pills, alternating between Lunesta, Ambien CR and temazepam. They have not helped her sleep through the night. I, too, have trouble getting back to sleep.

Most prescription drugs for insomnia are better at helping people get to sleep than they are at helping people stay asleep. There is one, however, that is so short-acting that it may be taken in the wee hours when your wife awakes. She may want to discuss Sonata with her physician.

If your wife is taking other medicines, they should be reviewed to make sure they are not contributing to her sleep problems. A surprising number of drugs can cause insomnia.

I am a healthy 65-year-old woman who's acquired little aches and pains through the years. Recently, I had painful bursitis, for which the doctor prescribed 800 milligrams of ibuprofen three times daily.

The ibuprofen helped with the bursitis during a three-week period, and my aches and pains also improved. I hate to quit taking this wonderful stuff. If the ibuprofen makes me feel so great, can I continue with it forever, in smaller doses?

Ibuprofen, like other nonsteroidal anti-inflammatory drugs (NSAIDs), can help relieve a variety of painful conditions. The downside of prolonged use (even in lower doses) is stomach upset, ulcers and even kidney problems. Blood pressure control also may become more difficult.

The Food and Drug Administration recently approved a topical product containing a powerful NSAID called diclofenac. It is prescribed as Voltaren Gel. This medication is applied to the skin around the painful joint (knees, wrists, fingers, etc.). It is effective and less likely than oral NSAIDs to cause digestive upset (Current Medical Research and Opinio n, April 2008).

You had a reader who wanted to know what to do for vaginal dryness. I'd like to respond.

From my experience, coconut oil is best. It is inexpensive and widely available at health-food stores. It comes in a glass jar. Even though it is a bit solid in the jar, when it is allowed to warm to room temperature, it easily dissolves into the skin. It is harmless and has antiviral and antibacterial properties that are very helpful.

Thanks for the recommendation. We have heard from several women who use olive oil for vaginal lubrication. As coconut oil is edible, it seems it, too, should be safe.

Do keep in mind that oil of any sort is incompatible with latex and should not be used with diaphragms or condoms.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site:

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