Anesthesia for ftd person

michiganpat

My husband is early stage, entering middle stage dementia and is scheduled to have dupytrens contracture (outpatient surgery) on his hand with general anesthesia. I am worried how the anesthesia and recovery after will affect him. He doesn’t do well with change in general. He needs the surgery but I am concerned how this might affect his progression. Any insight or personal experience on this would be greatly appreciated. Thank you

harshedbuzz

Wait, what?

This isn't generally a painful condition although there can be some tenderness associated and of course some loss of the ability to do fine motor tasks. My mom (she of many medical conditions but at 85 has no dementia) has this along with carpal tunnel, so I am familiar. We would not elect surgery for the contracture, and we chose to brace for the carpal tunnel as a first option. Is this really necessary?

That said, are you certain they will be doing full-on general anesthesia? My bestie had hand surgery for 3 trigger fingers on her non-dominant hand a few months ago. (She a rabid quilter and an semi-pro baker so the procedure was important for her) She was not given general anesthesia-- her procedure was done under sedation instead. Is this an option for your DH?

I expect the aftercare would be an issue as well. Bestie came home with a bandage that was almost a soft cast which had to remain in-place and dry for about 2 weeks. Will your DH be able to comply with leaving the bandage alone and in place? He'll probably have restrictions about using the hand for another several weeks once the bandage is removed. This is likely stage-related, but when my aunt broke her wrist in stage 5-ish she could not recall the need for the soft cast and would not leave it alone. You may need to watch him like a hawk to make sure he doesn't lift anything heavy or use his hand to assist in rising from a chair for some time.

HB

Denise1847

My DH had a knee replacement a year ago. They used conscious sedation and a block. He was disoriented for a couple of days and had to stay in the hospital longer because of BP problems. His primary care later told me that anesthesia of any kind can cause dementia to temporarily worsen.

michiganpat

My mistake. It is not general anesthesia but light sedation. It takes an hour so I wrongly assumed it would be a general. To answer harshedbuzz, it is not too painful but the finger bends almost to the palm and interferes with daily chores as it gets in the way. 9 years ago he had the xylaflex med injected which is a nonsurgical procedure but it came back worse than ever. I still worry how he will react in relation to his dementia. He can still work with tools and such. I want him as independent as possible for as long as he can.

Lills

My DH had FTD (and ALS). He was in mid-stage when his appendix ruptured. Sadly, he experienced a sharp decline. Although he did 'come back' but not 100%.

Ed1937

My wife had a fall, and broke her wrist. She had a cast that the doctor said she would not be able to remove. So after she picked at it until there was next to nothing left, they had to replace the cast. She still continued messing with it until she did the same to that one. After that she was allowed to just use a splint for a while. If she got that loose, I was able to wrap it back up until she finally healed to the point where she no longer needed it.

I'm not saying he shouldn't have the procedure done, but I do think you need to weigh the pros and cons.

harshedbuzz

@michiganpat

That's great that it's sedation and not general anesthesia and that he'll be headed home soon after. I would be frank with the doctor and person managing his sedation about the dementia.

This may be useful reading for you-

Anesthesia, Surgery and Dementia (alz.org)

It can be difficult for members to offer opinions without a good sense of the PWD's stage and presentation. I am all about maintaining whatever independence and meaning a person can muster but I would have concerns about some tools as the disease progresses. Before he was diagnosed, I helped my dad jump a battery and he knocked me clear across the garage. Not 20 minutes later, he put his fork in the plugged-in toaster. I'd reassess this from time-to-time.

HB

michiganpat

Thanks for the above comments. Surgery at this time makes me uneasy. Harshedbuzz, I am having safety concerns re tools my husband is using. I often think of a phrase I read on this site, " he was ok until he wasn't". He does fine but for how long? It is really tough as I want him to have his independence as long as possible. Many things to think about. Our kids are aware of what's happening and we have been watching him closely but I see the most. It is time to have another conversation with them. He has anosognosia and is still mad at his doctor for wanting to do a "brain test". I guess I have a lot of decisions ahead.

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