It could have been dementia

My phone rings, but I can’t find it. It’s not in my pocket, on the kitchen table, or the bathroom, where it sometimes gets left on the window ledge, so it doesn’t end up in the water.

It turned up in the refrigerator.

That was twenty years ago. At the time, it was funny, laughed off as we all did in our fifties when we had a brain fart.

Last week, I spoke to our wonderful gardener about the distance someone has to travel to get to work. Confidently, I say “Newark” isn’t that far. Something feels off, but I’m going with Newark, a city about an hour north of us. The town I could see but not name was Trenton, 20 minutes away.

Coupled with forgetting how to wrap my wet hair in a towel, something I’ve been doing for most of my life, walking away from a pan on the stove and setting off the fire alarm, these events were in no way funny.

That moment of reaching for a word or a habit and finding nothing is frightening.

My gut told me to calm down and dig into some research.

And to start that research with the general anesthesia for the surgery I’d had. A friend told me it can linger in your system for up to a year. But what did that mean?

Add to that, I was given a thoracic epidural for 2 days. Two days of fentanyl. When that came out, I was on “as-needed” morphine. All of that was necessary to get through the pain of having the middle lobe of my right lung removed by VATS surgery.

The surgery went perfectly. They got what they went in for, and I have no follow-up.

Post-Operative Cognitive Dysfunction is real, documented, and from what I have found from speaking with people who have had general anesthesia in their 60s and 70s, not been discussed before surgery.

General anesthesia plus opioid exposure creates a neuroinflammatory burden that most patients aren’t warned about.

I wasn’t. And I wasn’t imagining the relationship between the meds and my mind.

But I didn’t find anything speaking specifically to the kind of memory lapses I was having.

Once again, my gut to the rescue. To get off the Oxy they sent me home with, I moved on to Extra-Strength Tylenol during the day and a gabapentin and 1 Tylenol PM to sleep. I’d read about OTC sleep aids and memory issues, but needed a refresher.

Bingo. I’m not losing my mind.

Anomia, Word Retrieval Failure

Your brain stores knowledge and language in different locations. What you know about something, a place, a person, a concept, lives in one network. The word that labels it lives in another. Retrieval is the pathway connecting them.

When anesthesia and opioids create neuroinflammation, that pathway gets sluggish. The knowledge is completely intact. The label is temporarily harder to access. This is why I could see Trenton, visualize it, know exactly where it was, know it wasn’t Newark, but couldn’t pull the name. The filing cabinet is fine. The retrieval mechanism is congested.

In actual cognitive decline, the knowledge itself erodes. I wouldn’t have known it wasn’t Newark.

The clinical term for word retrieval failure is anomia. It’s most commonly associated with stroke. Mine wasn’t a stroke, obvs, it was POCD, Post-Operative Cognitive Dysfunction, expressing itself through that same system.

Working Memory Gaps

Working memory is your brain’s active workspace, the mental RAM that holds what you’re doing while you’re doing it. Post-surgical neuroinflammation reduces its capacity temporarily. You lose the thread mid-task not because anything is damaged, but because the system is running with fewer resources than usual while it heals.

Again, in cognitive decline, the underlying capacity degrades permanently. This is temporary loading, not structural loss.

What About the Tylenol PM?

Most OTC sleep-pain aids, like Tylenol PM, work the same way: acetaminophen for pain, diphenhydramine for sleep. Diphenhydramine is Benadryl. And Benadryl is an anticholinergic, meaning it blocks acetylcholine, the exact neurotransmitter your brain depends on for memory, word retrieval, and cognitive function.

Think of acetylcholine as a key and the receptors it needs to reach as locks. Diphenhydramine sits in those locks and blocks them. Your brain can be producing acetylcholine normally, you can have all the keys you want, but if the locks are occupied, nothing opens.

I was taking something every night to help me sleep that was directly preventing the neurological recovery I needed most. Nobody told me. It’s not on the label. And if you’re a woman over 60 already worried about your memory, you could easily spend months in that loop, sleeping, but not recovering, wondering why the fog isn’t lifting.

Now you know.

Next Week in Part 2

Getting off the Tylenol PM wasn’t pretty. I will fill you in on what helped. Why I had to manage my reliance on my Oura ring data. What I’m actually taking and doing to boost cognition, and where I am now, six weeks into my self-imposed rehab.