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KarayanMD
KarayanMD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 805
Experience:  Board Certified Neurologist with Subspecialty in Clinical Neurophysiology. Private Practice.
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I had rotator cuff surgery and express my concern about memory

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I had rotator cuff surgery and express my concern about memory loss and the anesthesioligist said he would use another gas which is less effective but would be better. what was that and is there something better when an IV is used.

KarayanMD :

Hi.

KarayanMD :

Thanks for your question.

KarayanMD :

Are you available to chat?

KarayanMD :

I am a board certified neurologist in the U.S. I will be happy to help.

KarayanMD :

Are you there?

Customer:

yes

KarayanMD :

Great. Welcome.

KarayanMD :

So your concern is a very understandable.

KarayanMD :

After surgery, memory problems can be seen in some cases, especially in the elderly.

KarayanMD :

This condition is termed "post-operative cognitive dysfunction", and is an issue that has become recognized more in the last few years.

KarayanMD :

Do you drink alcohol in any excess or smoke, sir?

Customer:

no to smoking and 1 glass of wine daily am in good health and take no prescriptions I experienced memory problems months after a colonoscpy

KarayanMD :

OK. Thanks for this information.

KarayanMD :

How long did the memory problems go on for/

KarayanMD :

?

Customer:

6 to 8 months and then improved somewhat. I had no problems after shoulder surgery, as I said he used another gas.

KarayanMD :

OK. If this is the case, I would strongly advise you to ask the anesthesiologist the exact name of the case that was used, to see if it could be used again for future surgeries.

KarayanMD :

The information we are aware of this day in age do not specify which medications in particular produce less risk for POCD.

KarayanMD :

However, what we do know is that you should request that the lowest effective dose of sedation be used in surgery, to try to have less medication in your system if possible.

KarayanMD :

Also, having conscious sedation or less invasive type of sedation (rather than general anesthesia) may result in lower risk of experiencing post operative memory problems.

KarayanMD :

We also know that infections and breathing complications after surgery will increase the chance of memory loss, so these should be avoided or treated promptly if possible to reduce this risk.

KarayanMD :

One more point would be to have the surgery as short as possible, as longer operation times may increase the risk of this problem too.

KarayanMD :

You should of course talk with any anesthesiologist who will be sedating you in the future, to inform them of the problem you had experienced in the past with the colonoscopy. This will help them take added precautions.

KarayanMD :

There are a few inhalational anesthetics (administered by a gas) which are used these days, and they include nitrous oxide, isoflurane, and desflurane. However, I can not be sure which of these (if any) was used in your particular case, as you can understand.

Customer:

I did tell the anesthesiologist before my colonoscopy but he just brush me off saying the shoulder surgery was with gas and we us IV which resulted in my problem. I need cataract surgery and hemroid surgery which use IV and I need an answer or not have the surgery

KarayanMD :

Both of these surgeries are relatively minor, and my suggestion would be to let the doctors know the issues you had with IV anesthesia. It may have been that they used high doses of medication or a combination of medications which caused your problem. You can always get the medical records of the colonoscopy to know exactly what you received, and to give this information to your future anesthesiologist/treating doctor.

KarayanMD :

There is not one particular IV medication that is "better" than another, for any given person. This is very individual.

KarayanMD :

Again, low doses, shorter surgeries, minimizing complications all will help prevent such a problem in the future.

KarayanMD :

You could ask for a inhalational anesthetic (gas), as it sounds like this worked better for you previously.

Customer:

I had hoped you could tell me what gas to ask for.

KarayanMD :

I cannot possibly know the exact gas you had received, but you could easily find this out. Common ones include nitrous oxide, isoflurane, and desflurane.

KarayanMD :

Simply call the medical records department or doctor's office who did your surgery with the gas, and they will be able to tell you what was used for you in that situation.

KarayanMD :

Shouldn't be a difficult issue.

KarayanMD :

Best of luck. Please keep in mind the various things I mentioned, which should help you with this issue. Please let me know if there are more questions. If this has been helpful, please don't forget to click on the happy face/accept button to acknowledge the time taken to answer your question.

Customer:

Thank you. You answered the best youcould even tho you have told me nothing I didn't already know. I have one more problem with this chat. Right after i authorised the credit card the card company called and asked if I authorised it . I said yes Then then asked if I authorized a $1 transaction and I said no. Then said they was blocking my card and would issue a new one. This hasn't been a pleasant outcome!

KarayanMD :

You are very welcome. I think you understand there are some limitations in terms of what I can realistically answer with any given information, but that I have given you the most complete response possible. I sincerely XXXXX XXXXX the best of luck and hopefully you can read over my suggestions again to make sure you understood all that I have advised. Best wishes!

Customer:

What about the $1 charge.

KarayanMD :

Any questions regarding billing can be brought up with the justanswer site. They will certainly help you with that.

KarayanMD :

They will instruct you on what happened on that occasion, sorry to hear if there was some confusion.

KarayanMD :

Don't forget to click on happy face so I can receive credit for my work.

Customer:

I'm sorry I can't give you a good rating when I get my credit card blocked because I decided to chat whith you. somethings wrong.

KarayanMD :

In that case, simply realize that I spent more than 30 minutes in conversation with you, and hopefully when the credit card issue is resolved, you can return and click on good rating (to not penalize me for the issue you are having with the site). Have a good day and best of luck!

Customer:

I have checked with my credit card company and they said there was no apparent fraud involved and they would unblock my card. That was the only problem I had with the chat and would like to again thank you for the service and change the rating to good. I'm sorry for the misunderstanding.

KarayanMD :

No problem at all. I am glad the situation was resolved. Please make sure to click on the happy face or positive rating, that would be much appreciated.

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