Mum seems to have had a personality change after operation!

[Beesinmybonnet]

I have posted on here before but have name changed for this.

My mum has just had major surgery. The surgery took place on Thursday and when I visited yesterday, all seemed to be fine. She was awake but quite sleepy. She is in her late 70s and has no dementia or other issues (so we thought).

I have just got back from the hospital now and from the moment I arrived there she was shouting at me and threatening to throw things at me. She appears to know who I am as she was calling me by name but she was very suspicious of me, telling the staff how awful I am and how she has had an awful life with all her children! She said we are scheming against her and want rid of her. She has three children and we all dote on her as she's always been such a loving, caring mum.

She is refusing her medication and food. She even grabbed the nurses lanyard at one point. I tried to give her a drink, she said I have probably poisoned it so there is no way she was drinking it.

I'm starting to think this must be what she really thinks of me. Can this happen after anesthetic? The staff reassured me this is quite normal, especially if someone has memory issues but she didn't have anything like this before the operation. I'm scared her 'true thoughts' must be coming out and she actually thinks we are all terrible children who want to harm her.

What @schnubbins said.

Sorry to hear your mum is going through this; as others have said, post operative delirium is very common. I was an ICU/HDU sister for many years and can testify to this! It's very unpleasant for the sufferer and very upsetting to their family, but it does go away, and there are things that can be done to help. This link is to a leaflet- if it links ok- which gives info and advice about post operative confusion.
...www.rcoa.ac.uk/system/files/07-Confused2017.pdf
Hope she's feeling better soon

This happens to me after surgery. I think people are trying to poison me etc etc!

Good news is it stops, well it does for me within 48hrs.

I don’t know if it is the anaesthetic or the pain relief but it has happened to me three times.

Had a similar issue recently with inlaw it was prescribed steroids that were causing the problem of confusion.

Is your mum on a drip? If she isn’t and is refusing fluids, she needs to be.

I came on to say shes probably got a UTI. Notorious for causing aggression etc in elderly people. Used to see it a lot in the hospital

Was thinking infection too.

Were there any issues during the operation that your aware of?

She'll be mortified by her behaviour when it resolves so please try and take it all on the chin
She'll only be mortified if people tell her the dreadful stuff she was saying.
She won't remember the details, when she's better she might remember "not being herself", there's no reason to upset her by explaining any more than agreeing "yes, you weren't yourself"

Some elderly people have very bad reactions to General Anaesthetics and strong pain relief. My mother used to have these and it was very concerning as she appeared to have severe dementia overnight - but there was no infection just an intolerance to the medication.

I was also on a ward as a patient with a woman who suffered a similar reaction. She 100% believed that she had been kidnapped, the nurses were holding her hostage and kept trying to make a break for the door! However 2-3 days later she was totally back to normal and was a quiet, sweet old lady!

If she's refusing fluids it's unlikely she will allow someone to cannulate her and stay still for a bag of IV fluid. With delirium like this it's just all about patience and convincing. There's usually one person who a patient will take to, who they'll let make them a cup of tea or coffee. Or they have a sweet tooth so you give a load of jelly. 9/10 I do find if you leave them a drink they'll have it when they think you're not looking

I was wondering about morphine. It completely changes my personality

It might be a reaction to general anaesthetic?

This is exactly what happened with my Nan after a hip operation! She was screaming and shouting that everyone was trying to murder her, she was awake during the op due to her age and had an epidural and was screened but she thought they were trying to chop her up! She said it was a government conspiracy to get rid of the elderly! She wouldn’t eat because were all trying to poison her! She was the sweetest gentlest natured lady before the op and we were very close. After a couple of days she came round and was horrified and mortified by what she said. she remembered it all. She was in tears and apologising to all the staff! It was the drugs they gave her. The staff told us it is common in the elderly and passes. It did, she returned to normal within a couple of days. Hang in there, it will pass.

My early sixties Mum did this. Became aggressive and shouty. I remember driving home in tears after she pulled apart every gift I had brought her and loudly described every other patient and medical professional in quite... explicitly negative terms.
She fine now. Hoe thing improve OP

Post op delirium is pretty common in the elderly, particularly after major surgery & emergency surgery. It’s not terribly well understood, but broadly is a result of the combined package of the surgery (ie. the pathology requiring surgery, the physiological stress response to an operation & the drugs that are used perioperatively as well as any other medical problems), not just the anaesthetic. Secret drinking (with associated alcohol withdrawal on the 3rd day) is also surprisingly common! Often people do remember when they’ve been aggressive & violent after things have settled down and can be very upset about how unpleasant they’ve been. Hope she’s on the mend soon. (From an anaesthetist)

Definite UTI. It’s very distressing and disturbing.

Insist on her getting antibiotics and she will be fine in 24-36hrs.

This happened to my mum every time she went into hospital. She imagined all sorts of things and it was nigh on impossible to tell whether any of it was true. She would have been mortified to know she was making it all up (random thieves she witnessed stealing lady opposite's purse, woman next bed's husband coming in and having sex with her at night!, a film crew filming patient at the end as she wasn't really a patient, she was an actress, etc). She never mentioned it after discharge from hospital (neither did any of us) and she returned to normal as soon as she was at home. I used to think she so very much hated being on a ward in hospital as she was such a private person that her mind went on a fanciful journey under the stress of it all.

I hope things improve for you and her.

It could be the anaesthetic. Ive had a few ops under GA.. usually fine, bit groggy but toptop in 24 or so hours.. my most recent op i came round so aggressive. I knew what i was doing but had absolutely zero control over it. I was rude, shouty, irritable and hated anyone telling me what to do - especially them telling me i had to eat and drink before theyd consider letting me home. When i went home i slept for daysss with little awake time and about 4 days later i was back to my usual self

Post operative psychosis, dehydration or delirium caused by infection or anaesthetic are the possible causes.

The paranoia could be caused by a number of different electrolyte imbalances.

My dad had a strange reaction to anaesthetic and was angry and confused after surgery, refused to even look at my mum for days, told us they had found something really wrong and he didn’t have long to live. He’s such a gentle soul usually it was hard to watch. None of it was true, and was back to himself, although a little depressed within a week. He made a full recovery. Don’t under estimate the effect of anaesthetic on the elderly. I hope she’s back to herself soon.

Aw, it must be scary for your poor Mum thinking everyone is trying to poison her. Hopefully you get speaking to a doctor soon. With it being a bank holiday weekend, will there be doctors doing rounds over the next few days?

Is she on morphine? My dad was the same until he stopped taking it after a week.

I'm not a doctor but I have an elderly relative who has very early symptoms of Alzheimers. Her consultant advised us against her having an non-esential operation for something unrelated because general anaesthetics can aggravate/accelerate the symptoms.

Some general anaesthetics seem to lead to increased levels of the Alzheimer’s toxic clumps of amyloid and tau proteins in brain cells.

I have no idea as I'm not a dr but is it possible she had undiagnosed dementia or Alzheimers and the general anasesthetic has just aggravated it/brought it out more obviously?

My 65 year old ex husband (I was visiting with our adult children to support them, and ex and I were amicable) was in icu following emergency surgery and septic shock. Once out of his induced coma he was paranoid, accusing the nurses of chaining him to the bed, accusing us all of keeping him there against his will, trying to pull his drips out, begging us all to “get him out of here” then being abusive when we wouldn’t. It was very distressing for the kids in particular. The doctors explained that post op / post coma delirium was very common and would most likely settle. It did, he’s now 72 and in good health.

Very different scenario but involving anaesthetic and reactions/character. My daughter was given ketamine to sedate her whilst she had her face stitched after an accident (terrified of needles, was 10 at time). Her reaction as she came down was awful - she was screaming, lashing out - totally out of character. So it could well be the side effects of the anaesthetic wearing off as nurses have said. It is horrible to see someone you love acting so out of character. Hope she is on the mend soon.