Anesthesia effects

[teach2learn]

I was never a great speech maker, but it seems since my last ablation under general anesthesia I have a lot more frequent incidents of garbled speech, or just plain inability to think of a word while right in the middle of a sentence. It is getting better as time elapses (two months now).  Has anybody else experienced this? I didn't have it after the first ablation, but I suspect they used a different anesthesia this time, as there was no recovery headache as with the first. Maybe you have to "choose your poison" and the consequence with it.

[BobD Volunteer]

I killed two AGA kettles in the first three months after my last ablation by putting them on and walking off and forgetting all about them. I think what you experience is quite normal.  With my three ablations and my cancer ops I worked out I had over 20 hours GA in a ten year period and I'm sure is it accumulative.

[teach2learn in reply to BobD]

Thanks, I hadn't thought of the cumulative effect. The first ablation was only 15 months previous...and by no means my first surgery. That's six hours between just the two of them.

[jennydog]

I also have had the problem of forgetting words in mid-sentence after GAs. Sometimes I can start to speak, lose a word, panic about ending the sentence and then completely forget what I was saying in the first place.

It gets better with time but then age starts to take its toll too.

[teach2learn in reply to jennydog]

That's for sure part if it.

[Buffafly in reply to jennydog]

That's wonderful, now I have something to blame for........what was it again?

[teach2learn in reply to Buffafly]

Haha! 

[Thomps95]

I started having increased memory-lapses shortly after commencing flecenaide. Often these cognitive problems have multiple causes - so if you are also on medication, that could be a contributing factor. However, "garbled speech" can also be a sign of a stroke (receptive aphasia). Although you're probably just fine, I'd consult a neurologist if you experience garbled speech. 

[teach2learn in reply to Thomps95]

Yes, also on flex. Pretty sure not a stroke, as no other symptoms plus  not really garbled as much as difficulty getting words out at the same speed and thought.. Also that on only one occasion when a whole group had suddenly stopped to listen!

[Thomps95 in reply to teach2learn]

been there  

[teach2learn in reply to Thomps95]

Teehee, then I just read my unproofed reply appropriately bumbled (now edited...fat thumb).

[MarkS]

I had sedation for my ablation. My EP recommended this (Richard Schilling) and I'm glad he did. I had previously had a GA for a different procedure and I was a bit forgetful afterwards, plus there were temporary unpleasant side-effects to my prostate (or something similar!).

GA is rather like a chemical cosh. I think cumulatively it can be like repeated concussion which can have poor long term effects. There are reports that GA increases dementia risk. So I will always try to avoid it where possible, not that it always will be possible, of course.

[teach2learn in reply to MarkS]

I'm sure you're right, and that it's a combination of things, now as I reflect and hear others' experiences.

[Hidden]

Oh, I have that without having had a GA since I was 23. I spent hours one day trying to grasp the word 'cucumber'... I hope yours gets better, mine definitely won't! Who needs cucumbers anyway, I say

[teach2learn in reply to Hidden]

Oh dang, I always liked cucumbers ! Wait, I remembered that...guess I'm okay.

[irene75359]

General anesthesia (for an op I had  twenty years ago) had the side effects you describe plus many more.  Short-term every time I closed my eyes it was like viewing a kaleidoscope which was most disconcerting.  But by far the worst was the mental fog which took some months to clear.  I vividly remember rising panic and distress when I couldn't find a word, couldn't follow a thread and completely forgot entire conversations.  I thought I was going mad.  But it did get better and it is all a distant memory now.  I have had other ops but strangely they didn't have the same effect.

[teach2learn in reply to irene75359]

I wonder if different kinds of anesthesia, or the way they are administered have different side effects.

[JonathanPittsCrick]

I think a small stroke is much more likely than a chemical effect of the anaesthetic. With MRI scanning we are picking up multiple small strokes ("lacuna infarcts") in people with no symptoms at all as well as many people with rather subtle symptoms. Fortunately the brain has a lot of "plasticity" which means when one bit drops out a neighboring area takes over its function. So unless its a largish area of damage or one involving an important "hard-wired" pathway there's a good chance of recovery over about 6 months – especially with practice of that function

AF ablation involves having (often multiple) catheters in the left side of your heart and also (deliberately) damaging areas of the normally smooth lining of the atrium so it creates opportunities for small blood clots to form and potentially break off and be carried in the bloodstream directly to your brain. The risk is minimised by anticoagulation but this is not 100% protection. Getting the catheters there also requires the making of one or more holes in the atrial septum and these remain, at least for a while, afterwards. The holes act like a congenital ASD and can allow clots or bubbles or other debris returning from your veins to jump straight to the left side of your heart (and then the brain) without being filtered out by the lungs. The risk of this is pretty low but not zero and at present unknown as we don't routinely do serial brain MRI scans following ablation.

Probably, in the long term, the risk from continued AF, and especially the risk of large clots, is higher than that of successful ablation. But having to repeat the ablation doubles the risk. The long term success rates are also unknown and if the AF returns you have both sets of risk. So it's important to realise that there is no zero-stroke-risk option.

[teach2learn in reply to JonathanPittsCrick]

Well, that was interesting! I'll be sure to mention it at my next followup on the 8th, I do know that with this second ablation, however, he only worked on one side, so at least there was no puncture there. Thanks for your thoughtful reply!

[teach2learn in reply to JonathanPittsCrick]

I did ask my EP yesterday about the aphasia, (one brief episode), and he seemed genuinely puzzled, especially as it occurred some days after the procedure. Probably nothing after all.