Q: My 77-year-old mother recently had knee-replacement surgery and now is suffering from some form of dementia. She asks the same questions over and over. She had small memory problems before, but nothing like this. Did her surgery cause something to happen to her brain? — Denise, via email A: Most likely, your mother’s condition is what some refer to as “brain fog,” though that’s too frivolous a term for it. Docs call it post-operative cognitive dysfunction or decline. Memory loss, confusion and concentration problems can happen to anyone after an operation — particularly after heart surgery — but it’s more common in the elderly. As many as 62 percent of those who go under the knife for hip fracture repair have temporary cognitive problems afterward. People with high blood pressure are more vulnerable, too.
There are several theories about why POCD occurs. One is that prolonged anesthesia or particular types of anesthesia may be the culprit. Another is that anesthesia accelerates dementia that is already present but isn’t very noticeable yet. Others link the problem to inflammation in the brain following major surgery. Studies of drugs to prevent POCD are under way.
We hope your mother will be among the vast majority who recover completely within months. However, since it’s possible the decline will continue, your mom needs to be evaluated now and monitored during the coming year. By the way, this might happen in infants who receive more than one anesthetic before age 4 — see smarttots.org if you want to make anesthesia and surgery safer.
Q: I have no problem chewing food, but when I open my jaw wide, there’s a grinding noise and some pain. I’ve also noticed a reduced range of motion in my jaw. What causes this, and what can be done for it? — Andrew, New York
A: Grinding sounds belong on construction sites, not in your jaw. What’s probably causing the irritating sound effects, pain and your semi-locked jaw is trouble in your temporomandibular joint. That’s the hardworking hinge that connects your jaw to the side of your head. You use it for talking, yawning, eating — in other words, constantly.
You’re actually kind of lucky. Some people have worse symptoms: They hear clicking and popping; have muscle spasms when they yawn; get aches in their head, neck, back and mouth; and occasionally even crack or break a tooth.
A dentist can confirm whether temporomandibular disorder is causing your complaints. If so, here’s some great news: TMD is very responsive to loads of things that don’t require dental insurance, like ice or hot packs, stress reduction techniques (try progressive muscle relaxation), improved posture (don’t sit at your desk with your head forward) and simple facial exercises, such as chin tucks (try to press your head back, leading with your chin). You may need a dental night guard to help stabilize your jaw joint. In rare cases, surgery may be recommended, but usually basic things, like not biting off more than you can chew, will fix the problem.
Q: Recently, my wife had a reaction to protein shakes. After two weeks of drinking one daily, her lips became very chapped, and peeled to the point of bleeding. She consulted a nutritionist, who said the shakes are toxic because they contain soy protein isolate and calcium caseinate. Is that true? — Jeff, via email
A: It depends on your definition of “toxic.” To us, it’s not toxic unless raw sewage or radioactive waste is listed as an ingredient. Cracked or peeling skin, however, suggests she’s allergic to soy or milk. The two ingredients you mention — soy protein isolate and calcium caseinate (a milk product) — are common allergens.
While these allergies are more likely to bother children than adults, soy allergies are increasing in grown-ups, possibly because soy is nearly ubiquitous in our food supply. (With food allergies, the old saying “familiarity breeds contempt” seems to apply.)
Of course, your wife’s cracked and peeling lips may be the result of something else entirely, like dehydration or sun exposure. So while, to a nutritionist, food often is the usual suspect, we recommend talking to your family doctor, who may have other ideas. In the meantime, to paraphrase an old joke, if it bothers her when she drinks those shakes, she shouldn’t drink them.
The YOU Docs, Mehmet Oz and Mike Roizen, are authors of “YOU: On a Diet.” Want more? See “The Dr. Oz Show” on TV (check local listings). To submit questions, go to RealAge.com.
