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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Visual Hallucinations And Sleeplessness Post Knee Surgery?

My Mother had knee surgery on a Tues. She is 73. She did fine after the surgery and the next day she was fine. Napped a lot the second day. She woke on Thurs, the third day, totally out of her head. Nurses said it was sundowners and suggested she might have already had it before the surgery and had hid it in her own home environment. No one at the independent living where she has lived for three years have seen any signs and agree with me, that if it is sundowners, it is related to the surgery. She is also fighting a UTI, which can cause confusion. It is day four and she seems to get worse. She is a big women and I read the meds given during surgery can reside in the fatty tissue, which means maybe someone smaller might get through this in a few days and someone bigger it could take longer? She is seeing things and people who aren t there and experiencing many of the more severe symptoms. And, it isn t going away during the day..it is going on all day and then getting a bit worse at sundown . And she isn t sleeping at night. I don t even know how she is going on the little sleep she has had going on five days now. How long can this last?
Thu, 26 Feb 2015
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Internal Medicine Specialist 's  Response
Usually it lasts only a few days. This is a fairly common problem in elderly people after a major surgery or hospitalization. If there is an ongoing untreated problem like a UTI it may continue. Sundowners is often related to a form of dementia, but since she has had no previous evidence of this and the onset is sudden, I would be thinking more of post surgical delirium. However, if it is not clearing promptly, be sure all medical problems have been adequately treated, and have the doctor check blood work and perhaps a CT of the head. Some metabolic abnormality or a stroke could also have caused this and you want to be sure to rule these out. Hope this helps.
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What Causes Visual Hallucinations And Sleeplessness Post Knee Surgery?

Usually it lasts only a few days. This is a fairly common problem in elderly people after a major surgery or hospitalization. If there is an ongoing untreated problem like a UTI it may continue. Sundowners is often related to a form of dementia, but since she has had no previous evidence of this and the onset is sudden, I would be thinking more of post surgical delirium. However, if it is not clearing promptly, be sure all medical problems have been adequately treated, and have the doctor check blood work and perhaps a CT of the head. Some metabolic abnormality or a stroke could also have caused this and you want to be sure to rule these out. Hope this helps.