Post op Shocks?

Hi, I'm 21 and got my first pacemaker 10 days ago due to the discovery that my heart stops during episodes of syncope. The whole thing has been a pretty big ordeal given I've been passing out since I was 9 and in the space of 3 months this year went from being told I'll grow out of it and I need to increase my 20hrs of sport a week to your having a pacemaker fitted now as an emergency! Anyway surgery wasn't exactly straightforward but I got through it. Since about day 4 however I've been experiencing what feels like electric shocks in my chest and they are pretty painful. I rang the hospital and they said it could be that the wire in the bottom ventricle is catching a nerve which could indicate the wires moved. Has anyone else experienced this? They've told me to monitor it for the next week, they don't seem very bothered about it but its causing me a lot of pain! Also the box seems extremely close to my armpit on the left side so much so it catches when i move my arm. Does it normally go there? Sorry for the questions, I'm just new to this whole thing and don't really understand it!! My life seems to have drastically changed rather quickly! Any response will be greatly appreciated!

4 Comments

i get shocks too

by ncrawford - 2011-09-17 03:09:03

hey
im 20 and got my pacemaker fitted below my arm in the same place as you 5 weeks ago it was really painful and im still finding recovery very hard and have been getting shocks, i was worried and told my consultant and he said it was just movement of the batery and the only way to fix it was to replace it with a smaller pacemaker which would last every 5 years instead of 10! i said i would deal with the shocks, they had been up to 14 times one day but i barely have any at the minute though! it may be if you are thin that they are more noticeable!
nicola

Be more specific...

by donr - 2011-09-17 03:09:16

about where the shocks are.
That will give a better idea of what could cause it. Are they i the pocket where your PM is?

That could incicate a break in the lead, causing the PM to go into a mode where it uses your body for the return path for its signals. I've had that one, so recognize it.

Other than that one, you'll have to wait for someone else- nevertheless, Pls be more specific about the location.

Don't apologize - that's what we are here for - to help the Newbies. Welcome aboard.

Don

New Pacemaker Shocking

by SMITTY - 2011-09-17 04:09:25

Hello Katie,

If it helps your feelings any, I've been there and had exactly what you are going through. While I can't tell you exactly how to get if fixed, I can tell you some of the things I tried and how I finally got mine fixed. But let me say here that I have told you quite a bit about my experience. Most of it was said to simply give you a hint of all the things that can have happen when we have this problem. I am not implying that you can expect all the problems I have had.

I got my first pacemaker in 2000 and I was a little older than you, 50 years older to be exact, not that the age difference makes any difference. My surgery went off pretty good if you don't count waking up before they got through and lie there expressing my opinion of those butchers that were hurting me. I didn't know what was going on and they would tell me nothing, except for one nurse saying "it will be just a few more minutes Mr. Smith." If I could have gotten my hands on a club it would have been over sooner but they had both hands tied down.

After they finished I went home later that day and my recovery could not have been easier or more uneventful for three weeks. Three weeks after implant I returned for my first checkup and about 15 minutes later was when my trip to hell started. I had left the office and was in my car when I got the first shock. I jumped and my wife said I had a very puzzled look on my face and was asking her what in the hell was that? She didn't even know what I was talking about. But she would lean over the next few days.

My shocks were sporadic, therefore I had no way of knowing how to start or stop them. The only good part was they didn't happen while I was asleep. Every week or so I was on the phone asking for help and I would be told to go to PM Clinic where they would check my PM and possibly make some changes. I would then be told your PM is working fine and it is not the cause of your problem. I continued to get shocked and was going back to the PM Clinic on average of about every 4 or 5 weeks. During that time I asked to have the low set point lowered from 80 to 70, which he did willingly enough. The reduction in that set point meant the PM was not pacing me as often and I wasn't getting shocked as often. After a while I started putting 2 and 2 together and got the low set point lowered to 60 and again that helped but it didn't stop the shocking completely.

In addition there were other things going on such as the rate response on and it would increase my heart rate when I started walking, or doing anything physical. When the RR started the PM to send impulses to make my heart beat I would get shocked and the greater my physical my activity the more shocks I would get. At the time I didn't even know what a RR was, I just knew that if I did anything physical I got shocked more often. Those shocks completely stopped me from playing golf and from doing a few other things I enjoyed.
Finally, after putting up with that hell for almost three years, I said turn this thing off. At the time I still thought the PM was making my heart beat 100% of the time. But I didn't think I needed one to start with so I felt sure I could live without the thing. The Dr resisted and got down right snotty, but he agreed to turn it off. Within minutes I was not getting shocked anymore and my heart rate was a steady 55 BPM.

After about two years I started having a problem with shortness of breath and another Dr suggested I have the PM restarted. I decided to agree and it was restarted and after about a week the shocks were back in full force and the PM did nothing for the SOB. It took a stent to solve that problem.

This Dr was fully aware of the shocking problem I had experienced and said that if it did return he was sure that could be corrected. After some, ECG, X-rays, and other stuff, he concluded that my problem was from some of the PM impulse going to the ventricle was escaping and impinging on the phrenic nerve. He said, like your Dr, they could relocate the PM lead or I could try to have that nerve deadened. Since by then those leads had been in place for at least five years a laser would probably be required to move it, so I elected to have the nerve deadened. That was done with a simple injection in the spinal area.

With the shocking gone I thought I was home free at last. What I didn't know was when that nerve was deadened that injection also paralyzed my right side diaphragm. That has been and excursion itself. The biggest problem was to initially cause the right side of my abdomen to look like I had swallowed about half of a basketball. That has returned to about 70% normal after 5 years now. However I have to be careful bending over as the paralyzed diaphragm will let internal organs press on the bottom of my lungs and that causes severe shortness of breath. That is not as much of a problem for me as it would by for a younger person because bending over usually involves work and I no longer enjoy doing much of that.

To wrap this up and to try to give you a little hope here are some things to think about.

1 - You have had this problem form only 10 days. These things can sometimes correct themselves. So unless the pain is unbearable, I say give it a few weeks.

2 - You might try to get the power settings lowered as on a new PM these are sometimes set higher than necessary.

3 - If possible get the low set point lowered as much as possible, and still keep the PM in the game enough to prevent the passing out.

4 - Your PM has been in place for a very short while so relocating that lead probably would not be a great problem. However the catch here is they could relocate it to an areas that may not help anything, or it could possibly make it worth. If you go with this option make the Dr understand that you want improvements without a maybe being part of the promise.

5 - As a last resort try for the nerve deadening, but, well just read what happened to me with that solution and with you being so much younger it could be a bigger problem for you.

I wish you the best,

Smitty


Shocks!

by donb - 2011-09-17 09:09:42

Hi Katie, As I'm a PM veteran with 4 PM's over the past 20 years I just wanted to add my shocking experence the 1st 12 hours with my 1st PM. At the time I was kept for 24 hours at the hospital. I can well remember the discomfort of lots of shocks on my left shoulder going down my left arm. Fortunately this shocking got less & less in the 1st 2 weeks. From some of the postings this is not too uncommon.
I have never experienced this again with PM changes. Also, I had my 4th PM implant on my right chest with another pair of leads and no shocks. If my memory serves me I believe they changed my PM settings with my 1st PM just before releasing me from the hospital. Well, seems like today most PM patients get the (in the box) settings which are not always the best for us. I just had my RR settings stepped up which was the 1st interogation since my last PM implant 2 years ago. So, it's so common to have wrong PM settings, gee, we have automatic settings every time we hit the gas pedal on our cars. The electronics even sense a differant driver. Our PMs' have come a long way but there's lots of room for future improvements. donb

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In fact after the final "tweaks" of my pacemaker programming at the one year check up it is working so well that I forget I have it.