Hello

I'm a 64-year-old male, with arrythmias but still able to exercise regularly until 5 weeks ago, when I suddenly became exercise-intolerant (couldn't do more than about 4 minutes at a brisk walk before needing to stop). A stress echocardiogram diagnosed a LBBB, with ef at 22%, and a pacemaker was recommended. A St. Jude CRT-D was installed (right shoulder, under the skin) 3 days ago, and I went home the next day.

So far, the shoulder has been quite sore, but manageable with hydrocodone. The pain seems to be lessening. No chance yet to try exercising.

Any advice on arm/shoulder exercises for the first week or two in order to keep full mobility (without stressing the installation) would be welcome.

5 Comments

New PM Implant

by donb - 2011-06-17 11:06:16

Hello Frogremlin, Thought I'd give you a little of my history. I had my 1st PM implant at age 60 in 1992. Since then I've had 2 PM replacements . About 1 year with my 3rd PM it started to erode and had to be removed. A couple months later my heart reverted back to it's old habits of slow HR & lots of skips along with some Atrial-Fib.
As my left PM site was in no shape for another implant my Cardiologist did a right chest implant along with another pair of leads as 1 of my original leads was failing. Now I've not a couch potatoe by any means so I know I abused this body with hard heavy work. Getting to the real point is that I was told not to use an arm sling as I did with my original PM & leads implant. I was very cautious with my original implant, sling & all and my shoulder recovery took twice as long at age 60 than with my late implant. My cardiologist said I should know how to treat my new implant as my body will tell me if I overdoe arm useage. No heavy lifting, 1 gallon liquid limit. All of my PM's have always been secured keeping leads from moving around. My last one is is really tucked in firmly, won't move and feels great & no pain. My pain from reconstructing my old site on my left side with 2 surgeries kept my mind off my right side. Ya, I learned to sleep on my back. So, don't do like I do, but use caution with arm use as you do want to move it so you don't get your shoulder to lock. donb

Welcome

by ElectricFrank - 2011-06-18 01:06:29

Welcome to forum. Glad you found us. My device is just a pacemaker, but no ICD. I haven't actual seen one, but I understand the ICD's are significantly larger, which makes sense. It takes a lot more energy to shock the heart back into behaving.

In my case both my original pacer in 2004 and a replacement in 2010 were nearly painless. It surprised me actually as the creation of that under the skin pocket is a pretty brutal procedure.

The big thing as far as getting active again is to avoid the arm above the shoulder thing. This sort of movement lengthens the distance between the pacemaker and your heart which puts some pull on the lead wires. They actually are plenty long, but until they scar into the vein wall you can't depend on which end will decide to move. Otherwise, you can do most anything that your body doesn't object to. My take on the weight limit is that they figure if you are lifting something heavy you will also likely raise your arm without thinking.

I did gentle shoulder rotates with my arm either in the sling (first day) or hanging down to keep from getting stiff. Within a couple of days I had worked up to walkng 3 miles/day as well as out exploring the desert in my 4WD.

The bottom line is don't compare yourself to any of us. As they say "your mileage may vary. LOL

The next step is to get the first adjustments made to the pacer. These will optimize the pacer to your heart. If you have any questions be sure and ask them here on the forum.

best,

frank

Shoulder Rotation

by Creaky - 2011-06-18 03:06:23

I actually had this discussion a few days ago with a professional sports trainer that I know casually. For background, I'm 74 and have my PM since Sep '10 with a lead just replaced due to lead failure (another discussion).
I hike and ski alot! He suggested just as Frank said- shoulder rotations, shrugs, flailing the arms around a bit.
Because I used to do a lot of upper body exercise with weights and machines, he said instead to build strength without the exercises that harden the muscles such as occurs with weight training. He's not a physician but speculated that larger harder muscles might put more stress on the leads during activity. Makes sense to me so I'm going to work that route once I can return to full activity.
Once I'm past the 6 weeks, I'll add light weight to the routine, focus on core and cardio, and de-emphasize presses, pushups, and the like.
Welcome to the club and best of luck.

Harry

Thanks

by FrogGremlin - 2011-06-18 11:06:12

... for both the warnings and the suggestions. Although no one mentioned that shrugs, rotations, and flails combined make me look like I'm doing a chicken dance!

Could be a Turkey Dance

by ElectricFrank - 2011-06-19 12:06:32

Just add droppings on floor.

frank

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I wouldn't be alive if it wasn't for pacemakers. I've had mine for 35+ years. I was fainting all of the time and had flat-lined also. I feel very blessed to live in this time of technology.