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Comment by dannyw | Hacker News Reader

Anecdota: I am in my 20s and got turbinate reduction surgery under general anaesthia about two years ago. While difficult to isolate from the effects of the pandemic, I observed a significant reduction in my ability to recall memories and the level of detail.

Still, it's worth being able to breathe through my nose at night — and the benefits that brings (including to my dental health, as I was getting cavities multiple times a year despite me trying keeping my dental health impeccable; which now have stopped after a year post surgery).

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Similar anecdata: Mid-40s here. Following a colonoscopy in my 30s, I have incredible trouble with dates and orders of things, finding words for things, and I lose my place when I'm speaking. Mid-sentence, just draw a blank. I end up yielding the floor so someone else can speak, I might pipe up later if my thought comes back to me.

Also, this happens constantly and it's maddening, I'll be a few thoughts deep and can't backtrack to how I got here; I used to be able to unwind my whole train of thought.

I make a lot more typos and I also miss seeing a lot of them to correct them so they slip out in my writing, which used to be impeccable. There are even unique types of typos that I've started making -- if a word has repeated letters, I'll jump the letters between, so for instance "cognition" becomes "cognion". I never made this sort of typo before the procedure.

It's all gotten even worse since the pandemic which I've been told is stress-related, and absolutely nobody will take me seriously as a result.

What's worse, is the standard of diagnosability doesn't take into account how you used to be. So if you started off smart and now you're just sorta average, no problem here, why are you wasting our time? It's like if your Bugatti now accelerates like a Yugo, sorry, that's technically street-legal so according to this book there's nothing wrong with it. It has to perform worse than a Yugo before we can take a look. What a shitty mechanic, you know? But that's where medicine seems to be.

I'm 41, and you are describing me to a tee. I had surgery about 4 years ago, and was under for less than an hour. The language issues, writing and spelling, etc. Most importantly for me is that writing software has gotten a lot more difficult. I attributed it to aging, but after reading some of this research, I'm questioning that. It feels like the issues have popped up in the last several years.

However...

I feel like this is how we got into the false causal relationship between autism and vaccines. Kids get a lot of vaccines in the first 4 years of life, and are diagnosed with autism then as well. So, you work backwards from a diagnosis and say, "oh the problems started a few weeks after the 3 year check-up, and they got shots, so the shots caused it!!" I would be worried we are doing the same here.

There is likely cognitive decline in men in their late 30s due to stress from work and kids, lack of sleep, reduced activity + weight gain, etc. We also get colonoscopies (or other procedures) around then as well. So, it is easy to say, "well I started having memory problems a few years ago, right around the time I had a hernia repair under general anesthesia, so they MUST be related."

I'm not a hypochondriac, but from time to time I will become preoccupied with health related things. It has never occurred to me that anesthesia might in some way be harmful or potentially result in cognitive decline. I'm now afraid I might get a false positive feeling that my mind isn't as sharp after my next surgery (whatever it may be).

My opinion is that in most cases the side effects are going to be less awful than the thing that you were put under for is.

Further, I'm willing to bet most people have no side effects from anesthesia, since most of the time they are only sedating you enough for you to be unconscious.

how did you identify your breathing issues? My new dentist referred me to an ENT due to thinking I may have sleep apnea, and I've been hesitant to go as I have no idea whether this is serious or some ploy to charge me for more stuff. I generally fall asleep within a few minutes, have energy throughout the day and never use caffeine, and get a full night's sleep on a typical night. I also have almost perfect dental health (knock on wood). I would be happy to resolve breathing issues but I'm skeptical of how serious it is given my circumstances.

I would go do it. You'll do a sleep study, nothing crazy. Sleep apnea can really jack up your heart if left untreated.

Had no idea. I haven't thought of myself as having sleep issues, but if the potential consequences can be as bad as heart problems, then that's definitely worth investigating. Thanks a lot for the info, I'll find a time to make an appt now.

“Sleep apnea can really jack up your heart if left untreated”

Maybe that will finally work to get my husband to discuss his painful-sounding snoring (with sudden stops) with a doctor and push to get sent for a sleep study!

Hopefully :). If it is long and severe enough snoring can physically damage all sorts of stuff (nerves, blood vessels, airway) similar to occupational vibration exposure. Changing sleeping position can help and can sometimes be enough in less severe cases (both apnea and snoring).

It effects your heart, brain and general health. It makes it harder to lose weight, store memories and generally live a fulfilling life. It sapped all of my energy for years. I had it as a young guy, starting at 18, only slightly overweight. I treated it by working towards a healthy BMI, getting rhino-septoplasty, using a CPAP machine and finally mouth-taping. Mouth-taping has replaced CPAP for me. It’s discussed more in James Nestor’s book ‘Breath’. Good luck to you and your husband.

Do you wake up with a dry mouth?

What an ENT will likely do is scope your sinuses (costs a chunk of change, but pretty cool and informative), and send you home with a self-administered sleep study that may catch sleep apnea if it exists.

I do, though not every single morning. I've interpreted it to happen when the climate is drier, but I guess if we're even having this kind of discussion, I might as well just go to a professional and have them clear it up.

Not a doctor, but as I understand it your mouth really should not be open during sleep unless there is some level of dysfunction

That's also helpful to know, thanks for sharing. I think my mouth generally defaults to being open, and I always assumed that was just the natural consequence of gravity once I'm asleep and my face/mouth muscles relax. All the more reason to get that sleep study done lol

It’s an insidious illness. I was mostly like you: no issues getting to sleep, no issues with teeth, no coffee. I was diagnosed with mild sleep apnea. My symptoms were lethargy and having major trouble studying. It caused me to drop out of university, not knowing the cause. It’s something that can slowly erode your heart health and actually starve your brain of oxygen each night. Get it checked!

Jeez, thanks so much for sharing your experience. I genuinely thought the worst consequence would be trouble sleeping or dental health, so since I (knock on wood) don't perceive myself to have those issues, I totally shrugged it off. Again, thank you; I'm definitely going to get it checked.

An opposite data point, I had significant back surgery and the only cognitive decline I dealt with was a mild opiate addiction that I had to kick a month post-op. But that was on me.

It took three operations under GA for me to realize that general anesthesia and I do not get along (seems to trigger or exacerbate depression for me). I had two more surgeries that used general anesthesia and I made a point of monitoring my mental health (and recruiting friends/family to help) and I had a definite decline after both of them (but with awareness I immediately resumed therapy and had better recoveries). I had wrist surgery a couple years ago that used a lower level of sedation, versus general anesthesia, and I had no adverse mental health impact from it that I or my wife could discern. If you're given a choice (and a local isn't an option for some reason), this might be something to consider.

As someone considering turbinate reduction, was it worth it? Did you have regular apnea prior to the procedure or no?

From what I’ve read and experienced, it has not been worthwhile, especially in light of these concerns about anaesthesia. Turbinate reduction is temporary and wears off in the order of magnitude of years. I read that the same effects may be achieved by exclusively nose-breathing and never mouth-breathing. At night you can control this by mouth-taping. Pick up James Nestor’s book ‘Breath’, he’s got a good discussion on all of this.

Essentially, get some 3M micropore tape, cut a 3-4cm long strip and place it on the middle of your lips. Half of the tape on the top lip, half on the bottom. If you’re really struggling to get airflow, try to get ‘breath right’ nasal strips and use those for a few weeks. You can re-use those if you’re careful, 2 nights usually. Good luck. Please reply if you have questions.

I had a four hour operation on my knee late last year. I still don't feel like I've got my short term memory back. Glad to know it isn't just me.

I’m the same age, has the same procedure and I’m feeling the same effects… I hope we can get better.

damn, noticed the same effect here!

what surgery did you have? I had RF-based reduction surgery and it didn't do much.

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