Mayday Mayday Mayday

Good Evening,

I live in the Denver area at relatively high altitude and was dx'd with Cardiomyopathy seven years ago. Three years ago, my cardiologist suggested an ICD implant...I stalled and luckily am still alive. However, yesterday...after a 24hr holter, he said I need a Pacemaker asap! So I will meet with an electrophysiologist on wednesday to discuss the options of a Pacemaker, an ICD or both. Frankly, I only want the Pacemaker.

Obviously confused with the details I am doing my best to prepare for my visit with the surgeon.

Are they any questions I should/MUST ask the doc during my appointment.

Any words to the wise in preparation for the surgery and recovery???

For the record, I am a 56 yr old male, rated 100% disabled by the VA for my heart condition.

Thanks for the help!

Ron

6 Comments

wants and needs

by Tracey_E - 2009-11-19 08:11:47

It's up to you what you ultimately decide to do, but if they tell you you need an ICD, it only has to fire once to save your life. No one wants them, but no one wants to die young either. The procedure is more or less the same. ICD's obviously are larger because they do a lot more.

There are tons of posts here regarding what to expect for the surgery and recovery. Most are awake for it and stay in the hospital overnight. Recovery varies but most feel pretty good by the end of the first week. You'll need to be careful about lifting for 6 weeks until the leads settle into place.

ICD for me

by Mark_in_NJ - 2009-11-19 09:11:30

Hi Ron,

I too was diagnosed with DCM (eight months ago). Last week I got a pacemaker with an ICD. I am 57.

For preparation you are already doing the most important thing... asking questions and learning as much as you can. Other than that, rest up and take care of yourself.

For recovery, plan on taking it real easy for at least a week. I loaded up my NetFlix queue with a bunch of movies. No lifting anything over 10 pounds and keep your arm at your side. There will some bruising and an incision to look after. There may be some fine tuning of you voltages to get the rythym and pulses perfect. Today (11-19) I am one week post-surgery. Had some voltage adjustments done today. Over all I am feeling good but living on Percocet.

An ICD (or any pacemaker) is an inconvenience. However, it is a minor inconvenience when you look at the alternative of not having it.

Best of Luck,
Mark

A few comments

by ElectricFrank - 2009-11-19 10:11:23

Your high altitude environment won't have any effect on the pacemaker. The lower oxygen levels could affect your underlying condition though. I have spent time exploring the high country in Colorado around Ouray and over Imogene Pass at 13,000' and had no problem.

A couple of questions you might want to discuss with the surgeon. You have a number of options as to where they place the pacemaker. The simplest and quickest recovery is one the chest wall just below the clavicle and right under the skin. The disadvantage is that it is quite visible if you are concerned about it.

The other issue is the use of anesthesia during the procedure. There are choices of being completely out, having an antianxiety (amnesia) drug, or just a local injection at the incision site. They each have their advantages and disadvantages. I chose to just have the local and remained completely awake during the procedure. It nice to come out of the OR awake, alert, and raring to go. The anesthesiologist agreed that he would be ready to give me more if I ask for it, but I never came anywhere near it.

One additional suggestion is to sleep on your side opposite the pacemaker site for the first few nights with a pillow in front of you to support the upper arm. It made for a lot more comfortable nights sleep.

best of luck,

frank

mayday

by thomast - 2009-11-19 11:11:04

I also have cardiomyophy, and have a combo PM/ICD. if I were you I would be sure and check on a 3 wire bi-ven unit which is what I have. It really helps with our problem. I also have question, how do you get 100% VA disability for a heart condition? I live at 450 ft elevation, and when I get above about 4000 ft I do not do to well, do not get enough oxygen. I know it is because of my condition as I lived 25 years in colorado with no problem before I was diiagnosed with this problem.

Thomas

PM or ICD

by mrag - 2009-11-20 04:11:15


"For the record, I am a 56 yr old male, rated 100% disabled by the VA for my heart condition."

That's not a lot of info to go on. You say PM/ICD as a choice-just to be clear, one is "simply" a pacemaker, the other a pacemaker AND defibrillator (the "shock" part). The questions are what do you need and why? If an ICD, how many "leads" and what type and why that type? Depending on your particular condition, it may be very helpful to have more leads which can provide more information about what your hear is doing and when. I would probably seek a second opinion if an ICD is suggested, 1) to check things learned in the first meeting and 2) to see how many implants the EP has done.

I do not want to sound unfair(?) and I've only ever had a single lead ICD which has given me 8 "shocks" over the last three years. That is considered abnormally high. The point is, ICD shocks can be VERY psychologically damaging-they scare you and can keep you scared. To me anyway, ICD's are a much more serious choice, but if you need one, you need one. I would ask what type ICD offers you the best hope/chance in not receiving a "full shock."

Thanks

by Ronniecolorado - 2009-11-20 10:11:34

Thanks to everyone who responded...very helpful. Hopefully, I shall return the favor as time goes on.

Ron

You know you're wired when...

You fondly named your implanted buddy.

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