To implant ICD under skin or in pectoral muscle?

I have 3 young kids (15,12,7) and I've been recommended to get an ICD. I hug my kids a lot and tightly, I backpack (girl scout leader) and i"m small boned and thin on top. Should I consider asking my EP to implant the ICD in my pectoral muscle? I'm concerned it will stick out and get bumped a lot during this stage of my life. Does anyone have an opinion either way? I would love to get any advice I can on this.
Thank you!
Karen

6 Comments

bury it

by Tracey_E - 2014-03-28 01:03:32

As long as the icd is small enough and you have room enough, then bury it. I would consult with a plastic surgeon in addition to the ep since you are small boned and thin to see if it can be done comfortably. Icd's are larger than pm's, what I have. When I got my first one, I was an underweight 110 pounds and very small boned. (20 years and two kids took care of the 110 part). Ep's job is the heart- getting the leads where they're supposed to go and fixing your heart. Some have more experience than others with alternate placements. Plastic surgeons specialize in making things look good and feel comfortable so I'd do a consult at the minimum, preferably have him/her assist. Ep's vary, but mine brought in the plastic surgeon on his own, he was happy to have someone more experienced deal with that part. I expected to pay that part out of pocket but insurance covered it.

Mine is submammary rather than subpectoral, though technically I guess it's under both. I think my very deep placement is overkill and if I was doing it new tomorrow, I'd ask for between the pectorals rather than in or under. When mine was first done in 1994, alternate placements were unheard of and they were sort of making it up as they went along. My incision is lower on the chest than the traditional placement. It shows (just the scar, there is no lump) with a strapless dress but not a tank. I don't even know it's there most of the time. I hike with a backpack and it does not rub. Seat belts never get in the way. I do Crossfit so I do a lot of varied hard aerobic exercises plus weights and it doesn't get in the way. Really, I can forget about it.

Recovery is a little harder when you bury it. Some say a lot harder. I've never heard anyone say it's not worth it. It's not awful. I got by on Tylenol after the first couple of days. By the end of the first week I was still pretty sore but able to get through my usual day, just a little more slowly and cautiously than before.

I am a hugger too! They will give you a sling at the hospital. It is best not to wear it after the first 24 hours because it's important to move the arm so your shoulder doesn't freeze. Don't raise it above shoulder level and don't lift anything heavy for 6 weeks, but other than that move the arm normally. That said, I wore my sling when I went to church or school functions. It makes you less likely to get jostled and people ask before hugging.

Take a button up top with you to the hospital and lose the bra. You won't want to be bending and twisting enough to pull on a bra or a top over your head. I mostly wore tanks with the built in shelf bra the first couple of weeks.

p.s. my girls are 15 and 17 and I'm a scout leader also! Glad you found us.

Tight Hugs

by Grateful Heart - 2014-03-28 12:03:22

I love tight hugs too. My ICD sticks out and yes, it hurts during hugs but I never say anything....I don't want the hugging to stop. :-)

TraceyE will be along later. Her PM is buried and she is very active. There are some others here who have theirs buried as well.

Welcome to the club!

Grateful Heart

Bury It

by cheshirealice - 2014-04-01 02:04:48

I had a long and hard decision for where to put my implant and talked to TracyE about it. After deliberation I buried my PM last Monday (2/24/14) and I feel really okay. I have some pain but I can wear seat belts and be hugged nice a snug without pain and it's only been 7 days since implant. I haven't stopped taking the pain pills they prescribed but I also had my old generator taken out of my abdomen at the same time. 2 incisions=more sad muscles. If not for the ab cut I think I'd be taking Tylenol by now.

My PM was placed on my side with about 4" incision implanted between my major and minor pectoral muscles. When my arm is hanging to my side you can't even see the scar and I had a plastic surgeon do the cuts so it looks beautiful.

I haven't worn a bra because I got the side implant but loose shirts or button ups from my bf works fine. I was very scared to get it placed on my chest and showing or having bra straps or backpacks irritate it. It's only been a week but so far I'm so very happy I buried it. Let me know if I can answer any of your questions if you have any!

-Erica

Thank you!

by MillerKAP - 2014-04-02 12:04:27

Thank you to all of you who have replied to my question! Your responses are SO helpful. I'm am so grateful that you took the time to let me know what you have experienced. There is nothing like talking to people who have gone through what you must go though. Your wisdom and thoughtfulness to detail have helped me realize it would be best if I tried to bury the ICD. I will hope that my EP is able to do it...and maybe I'll even add in a plastic surgeon! I never thought of that before, but because of all the details that you wonderful women were willing to share, perhaps that will make a difference in my experience.
Thank you so much for taking the time to reach out to me. I am profoundly grateful.
All the best to you:)
Karen

one more thing

by Katelyn - 2014-05-15 05:05:38

i never had a plastic surgeon involved...not sure I would need one since the pocket is now established after 10 years

bury it

by Katelyn - 2014-05-15 05:05:57

I was 17 when I got my first ICD, and it went under the muscle, now i am 27 on my 4th device still under the muscle (upgraded to a CRT-D, slightly larger), I am 5ft 8in 125lbs...
No pain with seat belts or hugging (after incision has healed), only pain is when my 2 yr old niece crawls on me and jabs an elbow to it!
It doesnt stick out that much, if it wasnt for the scar, people wouldnt even know its there.
Im very happy with it under the muscle and want to keep it that way for future replacements!

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