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cath procedures? brain fog?


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Lisa Inman Find out more about Lisa Inman
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  • cath procedures? brain fog?

    Okay--here's two questions:

    Several people mention cath procedures immediately before myectomy? Who gets that and why?

    There's casual reference to brain fog after myectomy, maybe blamed on the heart-lung machine during surgery? Mention of a year or more.... A friend who had open heart surgery for triple bypass (age 68) says she still comes up at a loss for words, etc. over a year after the surgery and attributes it to the surgery somehow... I am definitely confused enough already (just ask my trusty teaching assistants --I think they are more worried about this potential "brain fog" thing than me--I at least have them to cover for me!) So, any factual or anecdotal info here?

    Really digging up the bad stuff, huh? Oh well, I am the sort that does much better if I know what to expect, even if it isn't great.

    Thanks folks, and thanks for all the well wishes and offers of help with my upcoming surgery--Lisa I.

  • #2
    Hi Lisa!

    Here are my comments on the cath before myectomy and the infamous 'brain fog'...

    Cath before myectomy - very common to have one just prior to surgery so that your heart can be reviewed as closely as possible before the surgery. It's much better for them to be able to map out the heart and see if there are any other 'issues' they need to be 'proactively' aware of before they get into the heart then to have to be 'reactive' on the spot - doctors don't like surprises!

    Brain Fog - Some folks notice it, others don't or very little. It can come from various things some of which might be (but certainly not limited to): the heart/lung machine can be a contributer as even though your oxygen and blood is continued to be moved through your body quite certainly it is at a reduced oxgenated level to the brain which in turn can impact our mental 'sharpness' temporarily, the medications which you will receive during and after surgery certainly are retained in your system far longer than you feel the actual medicinal impact from them, the overall stress to the brain during open heart surgery also impacts it.

    My experience was that after the initial recovery of a couple of months the majority of my brain fog lifted. During the time I experienced it I was recuping and spent time sleeping anyhow and had just mentally 'let myself off the hook' of needing to stay on top of everything anyhow and asked my family to assist me as my body was working overtime to heal and regain strength. During the remainder of that recuperative year (and even still to this day) if I have trouble remembering something or a word, etc. I just say tongue-in-cheek, "it's the drugs man, it's the drugs...". Most folks can sympathize if you can add a touch of comical relief to the situation!

    You'll do great and I understand wanting the details in advance, I think it helps a great deal after the surgery so that you know a symptom might be irritating but you can identify it and say, "this is normal for a post open heart surgerical patient".

    Take care and hope this helps!
    Lynn Stewart
    HOCM 4/2002
    Cleveland Myectomy Crew 8/2002


    • #3
      As a teacher, you've scheduled your Myectomy, after the school year ends & you have the entire Summer to "fog out", B4 you need to worry about being sharp in the classroom. Allow yourself, the time during the summer to allow your body to do whatever it needs. You'll be GREAT when you're in front of your students again!
      The weeks following my Myectomy I found myself just staring into space, for long periods of time-I let myself do that & I don't have that problem any more. Many of my friends & family, forget words or loose their train of thought & they did not have "open heart" surgery!
      A Cath is important, because it allows the Drs to get a "sneak preview" of what they will see. It also insures that there aren't any blockages & if there is a blockage it's no big deal to fix, while you are open on the table. Honestly I was so relaxed about the Cath, because I was so focused on the Myectomy the following day. Since my Myectomy I've had 5 more Caths (in a year & a half) and you can do this easily.
      We all understand your fears & concerns-keep your questions coming-we're here to support you.


      • #4
        Hi Lisa,

        It has been 6 1/2 weeks since my myectomy and I am still very foggy in my brain (I also teach at a university and lived a long time in WA state!). However, I should say that I've had this brain fog thing for a few years now and so its not just the surgery. I think it began around the time I stated taking beta blockers in 2001/2002?? It feels like my consciousness is impaired and my thinking is foggy - like I am experiencing the world through a bubble.

        The degree of this foggines varies from day to day- sometimes it feels as though I am barely experiencing reality and at other times it is not so bad. When the level of this 'fogginess' is at its worst, I also have a tightness in my head. I've often wondered if other HCMers have this...is it related to the medication? Blood pressure issues? Or do I have some other neurological problem?? It would be interesting to see the responses.

        Good luck with your upcoming myectomy!

        Age 38, dad of two young children, dx 1996, myectomy March 2005, a-fib issues, due for ICD soon.


        • #5

          Over the years I have experienced that brian fog bubble thing and like you experienced it prior to my myectomy as well. I do believe that some are more sensitive to BB's then others. You realize that BB's are used in helping individuals to balance their moods as well as for heart problems. The potential difficulties or reversal of positive effect can be effected by dose titration. What I mean is the dose that works well for one problem can effect another problem. When I was at 400mgs of Atenolol , wham!! it was as if I had a room away from the planet . I found myself feeling more and more isolated even though I was around others. I talked to my cardiologist about it and discussed with him my feelings in regard to the mood interference. I felt strongly that this was related to the doseage and that my brain was reacting negatively to it. We agreed I should decrease the dose and went to 300mgs and, whala !! the fog dissipated.

          Now I know you are saying 400mgs!!! Who could tolerate 400mgs? Well answer , I can but not mentally. Post myectomy I am at 250mgs with a recent addition of Dilitiazem for persistant chest pain. Now the chest pain became better but with the added med, I have noticed an increase in clouded sensorium. So I have started to decrease my Atenolol by 50 mgs to see if my brain fog will reverese and if the CCB will continue to handle the chest pain problem.

          Many times we require tweeking of doseages and additions to maintain our current status. Of course I have doctors who has confidence in my skill to manage and report all negative / positive findings. Being a nurse helps my case also. For me I have been able to use what I have learned and stay away from critical care needs. I always let them know what I am trying and seek support/ advise.

          I do not personally think that it is entirely a fluke that most HCMer's have a positive mental attitude. I do personally believe that we garner some benefits from the positive effect that beta blockers have on inhibiting serotonin reuptake in our neurotransmitters. And of course our chemicals and balances in our entire body vary daily and are influenced by multitudes of factors.

          Discuss these possibilities with your doctor and he may decide some adjustment is in order.

          Dx @ 47 with HOCM & HF:11/00
          Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
          Lead failure,replaced 12/06.
          SF lead recall:07,extracted leads and new device 2012
          [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
          Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
          Genetic mutation 4/09, mother(d), brother, son, gene+
          Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin


          • #6
            Hi Pam,

            Yes, we certainly seem to be experiencing the same type of thing. You always seem to come up with great analogies and that one about living on another planet is so right on! Beta blockers do have a nasty impact on me. I took them for 4 months when I was first diagnosed back in 1996 and I became very detached and out of it (and a bit depressed). I decided to stop taking them and within a week I was back to my normal happy self. Maybe now that I've had my myectomy I can stop taking them. I guess I will work that out with my surgeon on Monday.

            Take care,

            Age 38, dad of two young children, dx 1996, myectomy March 2005, a-fib issues, due for ICD soon.