My Mom is 87 and has a stone in her common bile duct. It has flared only once that we know of and it was short lived. They want to do a procedure to remove the stone but she would have to be put under general anesthesia. Do we leave it and risk problems later or do it and risk making dementia worse!
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I would avoid it if at all possible.
If sh currently has no problems and the situation resolved on it's own previously I would opt for the leave it alone course of (in)action.
If there is a flare up I would opt for the least invasive method.
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As a nurse I OFTEN saw dementia after anesthesia. Only a few cases were new onset, sudden and lasting. Many dissipated with time. However some did NOT. There is much controversy about this in medicine with doctors denying it can happen and others seeing it actually happen in the elderly and not without frequency. To tell the truth, an elder in the hospital who has early stages of dementia can become very confused and discombobulated in hospital, and better on discharge.
I would act only if there is pain, danger, and problems, or problems that could occur emergently. Also ask about the surgeon's expectations for removal. A large incision is rare today. This is almost always done by endocopic, and some can now do it through the throat without anything invasive (UCSF able to do this some years ago, was teaching it at the time).
If this was diagnosed due to symptoms, such as nausea, vomitting, pain you really have very little choice.
This was last year. Since then, he's been diagnosed with a stricture and temporary stent placed in the duct to stretch it. He's been anesthetized 4 times in the past year for internal exam for cancer (none), and replacement of temp stents. Dr. will not put in permanent one since there's no cancer (why is that?), so we "look forward" to 2 more procedures within the next two months. All this has produced anxiety. I agree with the guinea pig remark!
His dementia has been showing signs of both progressing and receding alternatively.
He's been declining physically and mentally for 14 years, but seems to rally for months at a time. He's 85, and keeps announcing he'll live 5 more years when he's feeling good (about once every two weeks). If so, that will be the death of me, his caretaker. I love him dearly, but I really need to outlive him to take care of him and then dispose of his thousands of books and tools so the kids don't have to, that he refuses to give up!
I think he was back to were he started after about a month. It was sure not a fun month, but he did recover from it.
If it were me and mom had only had one short lived situation with the stone, I would not do the surgery.
https://www.healthinaging.org/tools-and-tips/ask-expert-prevention-and-treatment-post-operative-delirium
Some antibiotics can reduce dementia since they eliminate the infection that's causing a temporary decline in the mental state. Don't let people talk you out of getting treated.
The author might look at changing the diet to see if it'll reduce or eliminate flare-up's.