Driving after major surgery with confusion issues - stunorthants26
My dad came home today having just had a heart bypass and valve replacement.
He cant drive for 8 weeks anyway but he is also suffering from confusion and short-term memory loss ( known as POCD apparently covering a wode range of odd behavior post OP ).

Has anyone here had this problem as we are not sure if my dad is fully aware how away with the fairies he sometimes is and Im wondering if he will be able to make the right judgement on when he is ready to drive again.

Apparently this condition is quite common so Im hoping someone here has some insight into how we should approach this with him as he is somewhat irritable so do we hide the car keys until we are sure, or will he know?

Any advice much appreciated.

{typo in header corrected}

Edited by Dynamic Dave on 09/06/2009 at 22:32

Driving after major sugery with confusion issues - FotheringtonThomas
Tell him that he's got to check with his doctor that he's OK to drive after the 8 weeks. This time does not seem to me to be very long - however, he will have been kept "inside" for a while after the op. I know someone who had an unplanned similar operation - they're OK to drive short distances (about 6 months after), and were not ever told by the quack "do not drive" - merely that it wasn't a very good idea. I have been in their car, & it's OK at least for up to 20 miles, subject to the normal vagaries of age.
Driving after major sugery with confusion issues - oilrag
I would get a home visit from your Dads GP Stu. Get him to give advice, medically and on the confusion and driving. Then back that advice up as a family and keep reminding him.

It`s likely that his Doctors advice will be more acceptable and removes you all from the firing line - as it were.

Hope he`s better soon.
Driving after major sugery with confusion issues - barneybear
After major surgey it is very common to feel dizzy and confused for some time afterwards. It can take a good 3 weeks for the effects of the gas to be completly emptied from the lungs, and not driving for at least 4 weeks is usual, longer if he still feels at all odd. A common issue is that people will start to feel much better very quickly, but then "relapse". Its not a relapse, but just the effects of the gas kicking in again. As previous advice, if in doubt arrange to see a GP. Shouldn't need a home visit - but later this week take him down to see a GP or experienced nurse who can test reflexes etc.
Driving after major sugery with confusion issues - William Stevenson
The 'confusion' is due to toxic effects on the brain, related to anaesthetic agents, low blood oxygen during the operation or afterwards due to lung disease etc., or worst of all: sleeping tablets administered on the ward, which should never be given but, sadly, sometimes are. The 'gas' neither hangs around in the lungs or 'kicks in' again later.

The GP will not be amused by the idea of a home visit for what is a social reason. Clearly the households concerned have more than enough cars available and can take him to the surgery for 5 minutes discussion, although even that trip is questionable. What he certainly doesn't need, and won't get, is any testing of 'reflexes'.
Driving after major sugery with confusion issues - Aretas
I went to a talk given by an elderly doctor. He had previously had a major operation and explained how the brain can be affected. He said that fairly recently after the operation he was driving and suddenly realised he had no idea where he was or where he was going.

Apparently this happened twice, but any problems gradually got better.

Best of luck. Time may solve it.
Driving after major sugery with confusion issues - scouseford
Stu

A critical issue is the age of your dad. My own father took me completely by surprise back in 1995 when he suddenly announced that he was packing in driving (something that had given him immense pleasure during his life). He was 84 at the time and seemed to be as alert as he had always been but he obviously realised that he wasn't quite up to it any more.

Your dad will almost certainly improve as he gets over his operation but whether he becomes fit and able to drive is something that you will need to monitor very closely.

I hope that he makes a good recovery and is able to resume his driving.
Driving after major sugery with confusion issues - stunorthants26
>>A critical issue is the age of your dad<<

70 a few weeks ago.
Driving after major sugery with confusion issues - stunorthants26
Well he's been in hospital for 6 weeks and came home today, but he only had his sugery Thursday - they kick you out quick these days!
We have quizzed the docs at the hospital about all of this but they dont seem to be bothered about it - its only when you know the person pre-op that you realise how weird they are behaving.
Since we have had the brush off from the NHS, its hard to know where to go as he wont go to the docs unless he thinks something is wrong - rather difficult when you feel well in yourself but others around say you arent!

It would be great if anyone here who has suffered with this problem has any insight.
Driving after major sugery with confusion issues - stunorthants26
Thanks folks, all stories/info appreciated, my mums going spare worrying about what he will do next - today on the way back from hospital he didnt stop talking about how roundabouts and dual carriageways all look the same - for an hour!
I just nodded and agreed which seemed to placate him, but its unnerving to say the least.
Driving after major sugery with confusion issues - barneybear
Stu
Your dad will continue to feel funny for some time. He will often be unaware of what he is saying. Some people can get very angry/frustrated and do stuff they are not used to like swearing etc (similar to stroke patients) whilst the brain starts to make sense of what has happened. Idealy he shouldn't be left alone for long periods, especially early on. Keeping a diary might help you and your mum keep track of any episodes as you can start to see they get less frequent, and if they don't you can share with healthcare professionals who can then help further.
Main thing is not to worry, take things slowly and appraciate the fact that you have him at home - 10 years ago you might have not been so lucky...
Driving after major sugery with confusion issues - Old Navy
My BiL had similar surgery and displayed similar behaviour, irritable, short term memory loss, general odd behaviour. Just go with the flow, accept that they have temporarily changed, and avoid confrontation. He is now back to his normal grumpy self. I had major abdominal surgery and was not affected in this way. I am probably too thick to notice the anaesthetic. My doc told me I could drive when I could put full force on the brake pedal without feeling any pain.
Driving after major surgery with confusion issues - ole cruiser
I would have thought it's a bit too soon to try to disentangle the actual heart condition post-op from the fuzziness that follows any deep anaesthetic, and that the time to really get to grips with the driving issue is when the 8 weeks will shortly be up. I imagine the surgeon will be following the case up anyway, so there's your entree. Our next-door neighbour had the same treatment and the word was that he still felt faint when driving for many months afterwards; perhaps he still does but risks it anyway, though only I guess for short journeys in favourable traffic.
Driving after major surgery with confusion issues - stunorthants26
Well we have elected to hide the car keys for the time being as he seems to think his abilities are way beyond reality - he picked up a dinner plate just now and nearly fell over with it!
Driving after major surgery with confusion issues - MikeTorque
Your dad needs to be assessed before he's able to drive again. In the meantime ensure all car keys are securely unavailable and his car is disabled for his own safety, a mechanic steering lock (Disklok) is a good idea.

When the time comes it's a good idea to go out with him a few times to assist & monitor his driving rather than letting him go out alone. This will help rebuild his confidence as well as his loved ones.

Check with your doctor regarding anything you are concerned about, good communications between all parties is always a positive.
Driving after major surgery with confusion issues - stunorthants26
I was thinking of disconnecting the battery on his car - its an old one so no electrical systems likely affected and simpler than hiding keys in an obvious way - he will only ask where they are thinking about it.

Driving after major surgery with confusion issues - Kevin
>known as POCD..

This explains something we never understood at the time.

My FiL was in hospital for an unrelated illness when his aorta burst. He was on the table for a few hours.

After being discharged he suffered from short term memory loss and was a bit grumpy. We just assumed it was the concoction of NHS Smarties. That assumption was reinforced when he left a dose of tablets on the coffee table and the dog ate them.

The symptoms disappeared gradually and he was back to normal after six months or so.

>Well we have elected to hide the car keys for the time being..

Be careful. He might not forgive you.


Kevin...
Driving after major surgery with confusion issues - rtj70
Be careful. He might not forgive you.


But if he's not up to driving (sounds like it may take a little time) they need to do something. Would he be happy if a passenger in the car being driven.

This is all new territory for me.
Driving after major surgery with confusion issues - Kevin
>But if he's not up to driving..

I don't think it will take long before he realises that he's being deceived.

Kevin...
Driving after major surgery with confusion issues - billy25
Stu,
The problems you describe are as you say classed as "common" because they are! but that doesn't mean you shouldn't be concerned, the short-term memory loss for example, affects different people differently. After my quad-bypass four years ago, i was driving after three weeks! nobody told me i couldn't, (until i went to the 8wk check-up, and the consultant told me i could start again!) and to be honest, i literally could have driven myself home from hospital after the op, such was the improvement physically!. However on the other hand, i still have trouble remembering simple things, names can be a nightmare!, i tend to forget things arranged for a couple of days ahead unless i write them down, and i still find myself in various rooms in the house wondering when i get there, what i went for! until i get back where i started from then i remember!!! - but my immediate thinking skills, such as you use for driving, and my long term memory, childhood, school lessons, and quiz fact/trivia retention remain totally un-affected.
So basically, it's early days, i wouldn't worry too much, certainly some things will improve, and certain things will have gone, but he'll learn to adjust, and like me will be almost as good as new!!
As an aside, they discovered that the short-term memory loss is caused by clamping the arteries to and from the heart, the clamps shatter and splinter plaques (athersclorosis) off the inside of the arterys/veins and these travel up to the brain and clog the tiny capillaries.
An Anesthesiest once invented a "plaque-counter" that clicked every time a potentially dangerous-sized piece passed it, to alert the surgeons to the possible increased risk of surgery induced secondry trauma, eg stroke etc, but according to reports, surgeons found it so worrying and upsetting during ops that they have largely stopped using it!

Billy
Driving after major surgery with confusion issues - Dwight Van Driver
What does the 'small' print of his Insurance policy state?

dvd
Driving after major surgery with confusion issues - jc2
Most people on here seem to be worrying about him and his passengers!What are you going to do when he runs over a child?
Driving after major surgery with confusion issues - stunorthants26
Im pretty sure that without keys, his only transport is a wheelchair and I think kids will see him coming, not that he can wheel it at the moment anyway as he is still very sore!

Interesting info about the bits going to the brain - id read something similar.

Luckily his main reason for driving was going to the tip and going to B&Q/garden centre, for reasons of DIY and gardening, neither of which he is going to be doing for quite a while. He only did 1500 miles per year anyway before his op so its not like he needs to go anywhere. Ive disconnected the battery on his car now so its not going anywhere.
Driving after major surgery with confusion issues - Brentus
Stu its early days yet. Billy has a good take on this. Like me he had a quadruple heart bypass 4 years ago. Me i had mine Nov 2007 so thats 18 months ago. What you describe is normal for this most serious type of operation. I like Billy have had memory loss still do a little. As time has gone by i have nearly got all my strengh back. The main problem i have is when excercising i get out of breath very easy and thats because of the medication the beta blockers and ace inhibitors. What i would say is if your concerned about dad get him back to the docs to get checked out. But believe me this operation is a life saver and in time he will improve and lead a normal life, with a life expectency far greater than he could have imagined a few weeks ago. Good Luck.
Driving after major surgery with confusion issues - Brentus
Stu forgot to say. You cannot drive after this op for 8 weeks. This is the time when you see the surgeon to give you the all clear. There are apparently different times when you get back to driving depending on what and how many surgery's you have had. but lets not confuse things 8 weeks is the norm.
Driving after major surgery with confusion issues - stunorthants26
He has improved greatly since I first posted although this morning he downed all 15 odd pills he takes over the day in one go! Doctor said not to worry but hide the pills from him now as he is having very severe short-term memory issues.
Car is disabled - I removed a few fuses in the end, seemed easiest way to do it and hardest to detect - as it is he just sits in his chair most of the day and watches TV, such is his lack of will to do anything really as he gets cold easily and still a bit tender.
The most positive thing is that he is aware of how his mind is now, so lets us organise him.

Thanks for all the advice, its been very helpful indeed as NOBODY in the NHS seems to think to even mention what can happen, which is frankly disgusting.