It's really annoying. Since my surgery four weeks ago, I've lost focus. I can't concentrate long enough to get through an average news article or sift through a simple Google search results page and certainly not a book chapter.
Sometimes, when I read a sentence, there is a delay before I understand it. Not much; I've been describing it as the length of a slow finger-snap – just enough time so that the slippage is obvious to me.
When that happens with each sentence in succession, concentration drifts away and meaning is lost.
As it turns out, there is a name for this phenomenon as it occurs after general anesthesia. It's called Post-Operative Cognitive Disorder (POCD). TGB reader Linda commented about it here on 7 July.
She quotes from the American Society of Anesthesiologists:
"Confusion when waking up from surgery is common, but for some people – particularly those who are older – confusion can last for days or weeks..."
It's not exactly confusion for me. In fact, I never doubted that the gazillion bugs I saw crawling up the walls of my hospital room for a day or two following surgery were anything but hallucinations.
However, some other changes Linda tracked down that affect the process of cognition definitely apply to me:
”Cognition is defined as the mental process of knowing, including aspects such as awareness, perception, reasoning, and judgment. Typical complaints of those people reporting POCD are: • Easily tired
• Inability to concentrate. For example, they cannot concentrate sufficiently to read a book or newspaper
• Memory dysfunction. For example, they have a reduced ability to remember things recently said or done
• Reduced ability to perform arithmetic. For example, they make mistakes with normal money transactions while shopping.”
I'm doing fine with arithmetic but the first three are definitely present in my life although I'm heartened to learn they are temporary. Meanwhile, I'm mostly annoyed by it but it does make napping and resting easier than it would be if I were eager to be reading.
ASIDE: Perhaps you have noticed in these blog posts since the surgery that they are all generated from my head alone - no research, no outside links, no facts and figures. That's unlikely to change until my brain fog (POCD) clears.
It is experience rather than reading and research that is making this months-long recovery period a sharp learning curve for me, and I expect there to be more of it.
For all the many years I've been studying ageing, I see now that I have never fully appreciated the difficulties old people face whether from a bodily assault such as my surgery, the natural progression of growing old or “just” managing a chronic disease or condition.
Only last Friday, after being home from the hospital for two weeks, did I finally get a usable grasp on my medications, their dosages, frequency and times of day. Food restrictions add another layer of complexity.
It took several hours to make a chart I can follow until my brain, out of daily practice, will finally know what meds to take when without consulting a list – and double-checking it to be sure I'm correct each time.
Fatigue requires daily management not only of one's own energy level but recognition of it by family members, friends and helpers. I tire so easily that I've given myself a routine of one hour up and about, one hour lying down or napping.
Even the normal activities of life are draining – the small amount of cooking I do, washing up the few dishes, paying bills, sorting the mail, answering email, etc. take their toll.
If there is an “event” in my day – a doctor visit, a physical therapist session at home, a friend stopping by, even phone calls with my medical team or friends – I need the next day to myself, to quietly regain my energy.
Until now, I did not realize how crucial the home assistance tools of recovery (see this post) are and it took a while longer for me to understand that for many elders, they are not temporary, that daily life without them can be nearly impossible.
It's hard to be old, something I've said in the past but did not know until experiencing it first hand how much effort goes into it every day.
That takes nothing away from the pleasures of life and it might be that the difficiulties make them even more precious.