For years I have watched both friends and family come out of surgeries complaining of severe mental fog that can last for weeks, or even months.  For some, cognitive function is never the same. Sadly, I suspect many of you have had this experience or know someone who has.

The good news is that some doctors and hospitals are paying attention and trying to do something about it.  This week I hosted a Community Interest program at the Alachua County Senior Center, sponsored by Gainesville’s CCOA, (Community Coalition of Older Adults).  The topic was “Caring for Your Brain Around the Time of Surgery,” presented by both Dr. Catherine Price and Dr. Christoph Seubert, with the PeCAN (Perioperative Cognitive Anesthesia Network) at UF Health Shand’s that focuses on prescreening patients 65 and over who may have risk factors.

We all are familiar with pre-operative screening, but why don’t we routinely check brain health prior to major surgery?   What if a patient already has preexisting signs of neurocognitive issues that can be exacerbated by anesthesia? What if they are on medications that elevate the risk of post-operative delirium?

This amazing program was founded by the clinic director, Dr. Price in 2017, and is a first-of-its kind clinic providing presurgical screening to patients with risk factors. Sometimes she and her team are the first to recognize underlying cognitive issues. She is a board-certified Neuropsychologist and is an expert in dementia, movement disorders and perioperative cognitive disorders, delirium, and neuroimaging methods. Dr. Seubert is a Professor of Anesthesiology and Neurosurgery at UF and is involved in many areas of brain research.  The PeCAN team includes anesthesiologists, neuropsychologists, geriatric medicine specialists, surgeons, and nurses. They are funded by the National Institute on Health and this unique program is now recognized as the nationwide model for other hospitals!

The PeCAN clinic looks at brain health prior to surgery since often it is as an indicator for more successful outcomes after surgery. Having this kind of knowledge about a patient at risk allows both the surgeon and the anesthesiologist to choose a tailored option for a patient with the least cognitive impact. Doctors can choose lower doses of certain drugs during surgery, closely monitor depth of sedation during surgery, or safely advise you to suspend medications you are currently taking prior to surgery that could put you more at risk.

Dr. Price estimates that 20% of all seniors preparing for surgery have some type of preexisting cognitive impairment that elevates the risk for complications. Some patients may be taking an OTC medication such as Benadryl or Zyrtec, not to mention prescription drugs such as Xanax, Klonopin, or Prozac. If someone is experiencing any memory loss, depression, had Covid, has a history of strokes, sleep apnea, they are at a higher risk for cognitive complications. However, anyone who chooses to can ask their doctor for a referral to the PeCAN clinic prior to surgery at UF, even if you feel you are not at risk, but you want to protect your brain from the side effects of anesthesia as much as possible. Dr. Price and her team will be expanding this program to other UF connected hospitals in Florida soon.

Personally, when I had hip replacement surgery a few years ago, I chose a spinal block with Propofol as a sedative rather than complete brain anesthesia. It was a faster recovery, far fewer side effects and no brain fog! I loved the term they used to describe me: “well worried.”  Yes, I want to protect my brain!!

Think of the power of this one simple test to help screen millions of seniors at risk. With 12.7 million Americans expected to have Alzheimer’s by 2050, we need to do all we can to prevent or decrease cognitive impairment. Become a pro-active patient!  Ask your hospital if they have a prescreening clinic.  Have a conversation with your doctor before surgery and find out the safest option available to you. My advice is to do all you can to take care of the one brain we have! The PeCAN website is:

https://anest.ufl.edu/clinical-divisions/perioperative-cognitive-anesthesia-network/

You can also email them at pecan@phhp.ufl.edu, or call 352-273-5252

UPCOMING EVENTS: (all are invited!)

 Dec. 4th 2:30-4:30: Conversations About Death and Dying.

Join Shanti Vani (End of Life Doula and Grief Specialist) and me for an open discussion of this topic.

Millhopper Library,

3145 NW 43^rd St.

January 15 at 6pm:

Join me at the new LYNX bookstore,

601 South Main St. 

Website: https://thelynxbooks.com/ (Check out their calendar of events!)

This will be an informal gathering, and I will discuss aspects of my book, Successfully Navigating Your Parents’ Senior Years and developing a plan to age well.

FYI: CCOA

If you want to get on the email list for information about the CCOA (Community Coalition of Older Adults) let me know, since I am co-chair. We meet via zoom the first Friday of the month.  The CCOA also sponsors the in-person Civics Classes, and the Community Interest programs held at the Alachua County Senior Center.  Membership is free, open to anyone interested in issues affecting seniors, senior health and wellbeing.

Star Bradbury

Senior Living Strategies