“Cataract surgery as catalyst for physical and mental decline?”
I want to apologize in advance for the length of this post but I want to be as specific as possible. My 73 year old mother went in for cataract surgery about 4 weeks ago. Immediately following the surgery she became ill (nausea, vomiting, abdominal pain). After 24 hours without improvement, she went to the ER of the hospital who performed the surgery. We (my father and I) assumed this was a side effect of the anesthesia, as did the ER doctors who gave her anti-nausea meds and sent her home. Her symptoms persisted, though, so we returned to the ER again a few days later. Because of the abdominal pain, they thought that her gallbladder could be causing the issue, though the images on MRI and CT scans revealed nothing. She was scheduled for laparoscopic removal of her gallbladder which was performed about 2 days later.
After returning home, she appeared to improve for a few days. However, she has since experienced the same symptoms she had prior to the surgery. It has now been over 30 days since the initial cataract surgery. She has lost a significant amount of weight (she says that the sight of food makes her nauseous though we do ensure she at least drinks her Glucerna throughout the day), she’s is in a constant state of nausea, and continúes to get abdominal pain. In addition to that, she has reported that she is seeing persistent “flashes of light” when she closes her eyes and they are accompanied by a pulsating noise in her head, which is causing the inability to sleep.
She has also stated that she feels “off” mentally (her exact words were that she feels like a “shell of a person”) since the surgery. Every test she has had comes back normal (MRI, CT, endoscopy, blood work). I became increasingly alarmed yesterday when she told her visiting nurse that she has “given up” on feeling better and that she’s ready to “let go.” I am uncertain of what kind of specialist to seek help from as neither her general practitioner nor gastroenterologist seems to find anything wrong with her. My question is what kind of specialist should we seek help from? We’re uncertain at this point if the issue is gastro or neurological or both. Or neither. Thank you for any guidance you can provide.
After returning home, she appeared to improve for a few days. However, she has since experienced the same symptoms she had prior to the surgery. It has now been over 30 days since the initial cataract surgery. She has lost a significant amount of weight (she says that the sight of food makes her nauseous though we do ensure she at least drinks her Glucerna throughout the day), she’s is in a constant state of nausea, and continúes to get abdominal pain. In addition to that, she has reported that she is seeing persistent “flashes of light” when she closes her eyes and they are accompanied by a pulsating noise in her head, which is causing the inability to sleep.
She has also stated that she feels “off” mentally (her exact words were that she feels like a “shell of a person”) since the surgery. Every test she has had comes back normal (MRI, CT, endoscopy, blood work). I became increasingly alarmed yesterday when she told her visiting nurse that she has “given up” on feeling better and that she’s ready to “let go.” I am uncertain of what kind of specialist to seek help from as neither her general practitioner nor gastroenterologist seems to find anything wrong with her. My question is what kind of specialist should we seek help from? We’re uncertain at this point if the issue is gastro or neurological or both. Or neither. Thank you for any guidance you can provide.
Female | 73 years old
Complaint duration: 30 days
Medications: Sucralfate, Senna, Lisinopril, Mirtazapine, Sertraline, Atorvastatin
Conditions: Diabetes, high blood pressure, depression
2 Answers
Consult Neurology, Integrative/Functional Medicine. Start Acupuncture with Moxibustion. Also consult Cardiology, this could be ischemic bowel disease.
A careful history and physical exam need to be done to try to identify the source of the problem. There are details that might emerge with the history that are not provided by your otherwise thorough description. But based on what is provided, my guess would be that this is more neurological than GI. GI symptoms, especially nausea, often occur secondary to neurological problems and do not indicate a primary GI etiology. I would advise to seek a neurological evaluation since there are obvious neuro symptoms, which may have been triggered by the anesthesia whose effects can linger for a long time in the elderly.
