Expert: Dr Ian Jackson - please note UK based - 12/30/2009

Question
Just 5 weeks ago i had a cystectomy, urinary diversion, illeal conduit and my cervix removed. I had a eneral ansaesthetic and an epidural which worked on the third attempt. I breezed the surgery, had 6 days in hdu, had 8 days on a ward, got out and 4 days later ended up back in with a septic pelvis which wasnt so nice as i had a roaring temp of 39.9 for 2 days which would then come down but shoot back up again. I had metradinazol and gentamicine sorry for poor spelling on that one!) IV for ten days with copious amounts of fluid and had another 2 and a half weeks in hosp. After a few more issues im out but not coping very well. Im having the most terrible bad dreams at night, not settling at all through the day and people and things are getting right on my wick!!! Whats bothering me nost is the tiredness that comes over me in waves and my memory is really bad. I can have the same conversation with people twice in the same day!! I dont trust me at all. my surgery was 8 hours long. I was only sick because of the amount of anti histimine they were pushing because or the itch i had thru the epidural morphine and di hydracodeine. What is going on?? im wondering if the anaesthetic has anything to do with my memory loss! Help...!!!  

Answer
Hi Nancy
I sometimes think that we are not very good at explaining to people what happens after they undergo major surgery. Your body has suffered a major insult - not just the original operation but also the severe infection you had afterwards.
Your body is now in the repair phase and is using up your own muscle mass as part of the healing process. This makes you tired and less able to cope with the normal things and will go on for some months yet.
Now as to the rest - there is no doubt that anaesthesia can have an effect on people with over 10% of those over the age of 60 having problems with memory, mental agility etc for a long period afterwards. This appears to be a permenant issue for certain subgroups of the population.  The surgery/healing process can also contribute to the problem.
There is nothing you can do except ensure you are eating well and gently exercising. That can be as simple as taking a walk each day and gradually increasing the distance each week. (I know difficult with the current weather.
I hope the above helps a bit.
Dr Ian Jackson