Could fatigue cause this? Short term memory problems

August 9, 2017 12:11 PM

Asking for a friend who will be seeing the doctor but would like to come up with questions to ask. Can you have an episode of short term memory loss due to fatigue? If not, what would cause it?

Friend had a minor heart attack earlier in the year. Doctors considered the prognosis good. Friend's metrics have all improved - weight loss is happening, blood pressure is good, etc. Friend has various meds including daily aspirin. However, Friend hasn't been sleeping well and has been getting less than six hours a night for the past few weeks. Friend has also been feeling overheated and nauseated off and on.

Friend takes multiple meds, including one for depression. There is some concern, shared by me, that the meds are interacting oddly.

Today, they had an episode of partial confusion and short term memory trouble - during a conversation, Friend would forget what had been asked a moment before. When prompted, they could recall the initial conversation. This passed off after an hour or so. There were no other symptoms of any kind - no other speech/language symptoms.

Friend feels that this was fatigue and not a mini-stroke, but I am worried. Could this be caused by fatigue? Does it sound like an atypical stroke? Have you ever heard of such a thing? What should Friend do?

posted by Frowner to Health & Fitness (19 answers total)

Response by poster: ETA - this was not total confusion that would be apparent to other people. Friend noticed it but was able to continue with work conversations, doing work, using systems, etc.
posted by Frowner at 12:13 PM on August 9, 2017

Friend should immediately call their doctor and speak to him/her. If the doctor isn't available, then friend should immediately seek emergency treatment. Scratch that, take your friend to the ER and call their doctor on the way.
posted by PorcineWithMe at 12:24 PM on August 9, 2017 [1 favorite]

Yes, yes, absolutely yes. This is basically my life. Fatigue and stress absolutely fuck with your memory. You can find plenty of studies indicating that's the case, too--people actually start getting affected by sleep deprivation minor enough for them to not notice they're tired, much less levels of deprivation where they're actually feeling it. When your friend is able to get more rest she will bounce right back.
posted by Anonymous at 12:27 PM on August 9, 2017

A friend-of-a-friend recently had a similar issue - she noticed that she was having more difficulty than usual speaking and forming thoughts. Luckily she went to the ER and they found the plum sized cyst in her frontal lobe, transferred her via medevac to a medical facility in an adjacent state, and operated almost immediately (though not before her confusion turned into seizures). This was in an otherwise healthy early/mid-30s person. She is, semi miraculously, on the road to recovery from a condition she didn't know she had under 2 weeks ago.

DONTSLEEP ON THIS OR WORRY ABOUT WHAT A MEDICAL VISIT WOULD COST.
posted by Exceptional_Hubris at 12:29 PM on August 9, 2017 [1 favorite]

Uh, I guess I should also say that yes, this could be a symptom of something worse. But as someone who has literally forgotten the name of the person I'm talking to in the middle of a conversation because I was so tired, it could also just be your friend's brain feeling the effects of fatigue.
posted by Anonymous at 12:32 PM on August 9, 2017

Response by poster: At the risk of thread-sitting, I will add a little more information (and then I will stop):

1. Friend suffers from anxiety and gets panic attacks.

2. Friend does not want to call the doctor and feels that this was fatigue plus anxiety.

I can strongly urge an ER visit, but I can't compel one. (I'm already urging the ER visit.) A regular doctor's visit will happen soon for sure.
posted by Frowner at 12:32 PM on August 9, 2017

If Friend wasn't on multiple meds post recent heart attack, then I'd say, 'yeah, this could be fatigue, bring it up at next doctors appt'. But.... Friend will ultimately have LESS anxiety once Friend has verified that it IS just fatigue. It would suck to stroke out on the kitchen floor because they didn't want to call the doctor.
posted by PorcineWithMe at 12:35 PM on August 9, 2017 [1 favorite]

well, you can't make it happen. maybe you can go along to the regular visit, if friend agrees, to describe the incident, to be sure it's not brushed under rug. otherwise, just support friend in their efforts to feel better.
posted by acm at 12:36 PM on August 9, 2017

This is not memory trouble presenting in an otherwise-healthy person. While stress and fatigue can absolutely cause short term memory problems, given your friend's recent medical history this is not a situation where they should wait before seeking medical care. At the very least, they should call the doctor's office today and speak to someone to see what they say (just my opinion, I am not a doctor).
posted by zoetrope at 12:36 PM on August 9, 2017

Yes, this could be fatigue. This could also be something a lot worse. Your friend needs to see a doctor sooner rather than later -- any way that doc visit could be moved up? It might also be worth having a trusted person come into the exam room with the doctor; a second set of eyes and ears are never too much, and especially in a situation like this. If no trusted Other, though, your friend should for sure bring a notepad to write stuff down.
posted by basalganglia at 12:56 PM on August 9, 2017

Would your friend consider calling a nurse (either through their insurance's dedicated line, or asking for a triage nurse in their doctor's practice) for another perspective?
posted by Iris Gambol at 1:09 PM on August 9, 2017 [2 favorites]

After a heart attack, it would be surprising if your friend is not taking statins, and here is what the Mayo Clinic says about memory loss and statins:

The FDA warns on statin labels that some people have developed memory loss or confusion while taking statins. These side effects reverse once you stop taking the medication. There is limited evidence to prove a cause-effect, but talk to your doctor if you experience memory loss or confusion while taking statins.

Your friend should talk to their doctor.
posted by jamjam at 2:00 PM on August 9, 2017

If your friend is taking a statin for cholesterol they can cause memory and focus issue. I have had this problem and it took lowering the dosage to correct. Doctor also prescribed a different statin at one point which was a ugly. I
posted by tman99 at 2:00 PM on August 9, 2017

Response by poster: Friend is taking a statin. Also aspirin, a couple of blood pressure meds and something else that I forget, plus the antidepressant.

I found an American Academy of Family Physicians "how should a primary triage TIA symptoms" page which seems to suggest that memory symptoms without language symptoms is a very unusual TIA presentation and very often memory symptoms alone are from another cause. Still working on getting friend to call clinic.
posted by Frowner at 2:07 PM on August 9, 2017

Response by poster: And the wrap-up: triage nurse, after consultation with Friend's doctor, says "probably sleep deprivation, we can't tell for certain over the phone, you can go to the ER for a full evaluation if you wish". Sort of surprising - I was expecting "ER right now ER ER ER".
posted by Frowner at 2:43 PM on August 9, 2017 [1 favorite]

Whoa. I was wondering. That's a pretty 'eh, whatevs' answer. I hope Friend follows up with their doctor soon (and remembers to talk about these symptoms).
posted by PorcineWithMe at 3:31 PM on August 9, 2017

friend should see dr. but do you know what the number one cause of fatigue is? dehydration.
ask friend how much water they are getting.
posted by cda at 7:55 PM on August 9, 2017 [1 favorite]

Statins are a bit of a war zone right now, so when your friend does go to the doctor, it might be wisest to report the symptom and give the doctor a chance to attribute it to the statin without prompting to avoid any risk of being immediately categorized as 'one of those crazy anti-statinists', and then if the doctor doesn't bring them up, mention a possible connection with due diffidence.
posted by jamjam at 9:22 PM on August 9, 2017 [2 favorites]

Response by poster: And a little more detail in case anyone is reading this thread in the future:

Upon conversation with Friend (instead of text), Friend described what happened as "I get a call from Bob, who asks me to get him the widget projection numbers from 2012, I go to the 2012 widget screen and discover that I've forgotten exactly what he wanted to know - I know that I'm talking to Bob, that he asked me about 2012 widgets and that I went to the appropriate screen, but I can't remember which number he asked for. When he tells me, I remember him asking the first time". This happened a couple of times, Friend got flustered and it happened a couple more times. Friend took a break and it stopped.

So it was more like opening the refrigerator to get an ingredient for salad and forgetting whether you were reaching for the endive or the carrots.

My guess is that because Friend was oriented, had no language problems and basically just had this isolated "you just told me something and I spaced it" thing which stopped after taking a break, the doctor felt it was not likely to be an emergency. It wasn't like Friend was thinking "how did I get to the 2012 widget screen" or "who is this caller?" or "what is a widget projection".

Another feature of Friend - Friend has a really super memory. If this had happened to me, I would be a little weirded out by the recurrence, but would ascribe it to anxiety and fatigue as long as it went away, because I get things like that occasionally. So this probably seemed a lot weirded to Friend than it would to some people.

So Friend will go to the ER right away if there's a recurrence and will bring it up with the doctor, but is currently concentrating on getting moar sleep - no screens, for pete's aske.
posted by Frowner at 6:22 AM on August 10, 2017