lead pulling while exercising

Hey everyone, need help understanding how these leads work while we exercise.

We are told not to raise our arms above our head for the first 6-8 weeks post op to help prevent a lead from becoming unattached. When we start working out again, my vice is crossfit, and lifting our arms are not still tugging at our inner heart wall? That just doesn't sound good. I guess im afraid im doing damage to my heart. Im only 2 weeks into this and still struggling with everything but thankfully this club exist.

8 Comments

tug

by wljonesaa - 2015-04-12 02:04:05

Thanks to you both. This was my second post and from the last one TracyE gave great insight into crossfit. For whatever reason, possibly inability to cope, I have this fear that every time i raise my arm im tugging at leads inside my heart. I just hope there is plenty of slack in there.

Pulling leads

by Theknotguy - 2015-04-12 02:04:40

TracyE should be along to comment as she does crossfit and a lot of other exercising. A very good source of information.

The idea of not lifting the arm over the head was to limit movement. At one time it was thought lifting the arm could cause the leads to detach, but that hasn't necessarily proved to be true. From what we've seen on the forum, the leads will become detached because they weren't properly implanted. So they'll become detached regardless of what you do. Or they will stay attached regardless of what you do.

Even though I've only had my PM for about a year and a half, in that time, advances in medical techniques and imagery have reduced the number of lead detachments. 1 1/2 years ago you'd see comments on the forum. In the past six months I don't recall seeing anyone who had a lead detached. (Could be wrong.)

Idea of limiting movement is to give the body time to incorporate the leads. So a more active lifestyle will result in the scar tissue around the leads being pulled and tugged more resulting in more pain and a longer healing time. I know I "pulled my leads" - actually I pulled the scar tissue and it hurt like hell. Then spent the next six weeks waiting for the scar tissue to re-heal. Was a lot more sore for that time period but the leads didn't become detached just because I threw a ball a little too hard.

Another thought is that if you were in an accident where you actually did cause the leads to be moved you would have a lot more problems than just pulled leads. Something like a torn aorta. So it would have to be a serious accident.

Once you get past the 4-6 week period for the body to heal, you should be able to go back to a "normal" lifestyle. Albeit not as intense at first. I would also limit my activity in the first 4-6 week period because you just might be that one in several million who could prove they could pull the leads doing athletic movements. Something about tempting fate means I'd hold off.

At the 1 1/2 year mark, I can do anything I want. The major factor is my underlying heart condition not the PM. I'm staying away from SCUBA diving because of heart arrhythmias, not because of the PM. I'm not doing sky diving because I have this aversion to jumping out of a perfectly good airplane, not because of the PM. I'm staying away from mountain climbing because of a busted up shoulder, not because of the PM. Other than those restrictions, I'm able to do what I want.

So after the 4-6 week of strongly suggested light activity while your body heals, you should then be able to return to normal activity. Albeit not as intense at first. Then you'll have to factor in limits due to your underlying heart condition and other physical limitations. After that, it's pretty much up to what you want to do.

TraceyE can give you directions on crossfit. She has suggestions for weight lifting that get around problems with the PM placement. But I'll let her explain as I don't do that. I work in a woodshop and toss furniture around for my exercise.

Hope things continue to progress smoothly for you.

It's all about scar tissue !

by IAN MC - 2015-04-12 02:04:41

Hi The body's natural response to a foreign object is to build scar tissue around it so with PM leads a clump of scar tissue forms at the lead tips inside the heart.

You will also get some scar tissue formation around the length of the lead itself as it passes down the blood vessel.

This scar tissue takes up to 6 weeks to build up and virtually glues the lead in place. A retired medic, Selwyn , who occasionally posts on here graphically described the massive brute strength he needed to pull out a lead at a patient's post mortem. So no need to worry about lifting your arms once the glueing in process has taken place.

To avoid tugging at the lead during exercise a certain amount of slack is built into it at the top end, so they really do think of everything.

Cheers

Ian

Re-print from 12 days ago

by donr - 2015-04-12 04:04:18

This is a comment I wrote at the end of March: Another PM host concerned about going back to the gym. In this case, the Cardio had warned the host by telling him about another Host who pulled his leads out at the SIX MONTH point.

Here's what I thought of that anecdote:

That story is the biggest pile of....
Comment posted by donr on 2015-03-31 14:02.
....cattle feed lot paving I have ever heard.

It's an anecdote & I'll see his anecdote & raise him at least 1.

Mine I know is true because it happened to ME. Mine is allowable in a court of law because it is NOT hearsay. His is not, because it is hearsay.

I took a 1996 Jeep Cherokee hood ornament in the right shoulder at 35 mph. Lead was implanted a mere 75 days prior. Broke 8 ribs, collar bone, collapsed right lower lobe of lungs, lacerated my liver, bruised a kidney. Head went through passenger side window of our car, breaking window as it went. Found out later, after 12 days in hosp that I had a new aortic aneursym because of impact. Heart was nearly torn from its moorings. But the new lead was totally unaffected.

No one can convince me that some guy throwing his arms over his head 6 months out is a greater force on lead implant site than that accident.

PROPERLY inserted leads are stuck in the wall of the heart, either by a screw thread or barbs like on a harpoon. What the Cardio doesn't tell you is that they have a submersible crewed by the likes of Raquel Welch a la late 50's flick. It is reduced to near atomic dimensions. One member of that crew is Kirk Douglas, who gets out of the miniature submersible & plants a harpoon in the heart wall, just like Capt Ahab got Moby Dick. Give that harpoon wound about three days & the barb/screw is not going anywhere soon. Give it a couple weeks, & it is pretty well part of the heart wall w/ scar tissue.

FURTHER: the leads are held in place at the spot where they enter the subclavian vein near the collarbone by a gizmo that is sutured to the body & the lead is sutured to the gizmo. Between the implant site in the heart & the gizmo is quite a bit of slack. That lead flops around in that vein like an eel on the bottom of a boat. Further, the lead inside the heart chamber gets whipsawed around by blood flowing through at a fearsome rate. That starts the second that Kirk plants the harpoon. There is NOTHING gentle taking place in the blood flow w/i a heart. It comes rushing in; stops momentarily; then gets pushed out violently the opposite direction from which it came in.

WHAT ABOUT the slack between the gizmo at the vein & the PM? There is usually a loop or a coil or some excess lead left over. It is either coiled or looped & placed under the PM.

If you are going to stretch all that out, you'd better have arms that stretch like a orangutang swinging through the trees (in Sumatra or the San Diego Zoo)
The main reason leads come displaced is because they were NOT properly implanted in the first place, not because of something the host did. END RE-PRINT

I'll add that If you want to see what the scar around the implant site looks like, just peek in a mirror at your pocket scar. I'd hazard a guess that it is pretty near solid & not very likely to open up & let the lead tip out.

Donr

Good Advice Here

by PJinSC - 2015-04-12 04:04:20

The guys above are correct. It is a matter of healing the scar tissue and then gradually working into an exercise or activity. I am two years into my PM and find that I am able to do more all the time. Once the initial period of healing was over as recommended by my EP, I began lifting moderate dumbbells and light bench presses, knee-supported pushups and leg exercises. Lately I have been experimenting with resistance bands. I figured reps were better than massive resistance, and it seemed to work, as I had little discomfort. I just today tilled my garden, lifted and spread bags of compost, fertilizer and limestone. Took about three hours. When I got feeling tired, I took a short break and finished up. As in all things, moderation is good, and your body will tell you when to take a break.

Good Luck and Good Life, PJ.

Here's a study somewhat along those lines..

by Lurch - 2015-04-12 04:04:35

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626349/

That link will take you to a NHC study regarding keeping the arm immobile following ICD implant. While they won't go all the way to saying "it makes no difference," if you read though the study, it makes no difference....

slack

by Tracey_E - 2015-04-12 09:04:32

There is slack!! They coil the extra lead and place it behind the device, it is not in tight. Even if you hit the device- which I have done more than once hard enough to leave me all bruised- it won't pull on the lead in the vein. As the others said, beyond that scar tissue holds it in tight and it would take a laser to get it out. Nothing we do will affect it once we heal.

Worry is normal! Once you try something and feel good, then try something harder and still feel good, trust will grow. You'll get there, give it time. Wish you lived closer, we could go wod together :)

Yep

by PeteFindlay - 2015-04-13 07:04:39

^^^^ What they said :)

Once you get past the 6-week point and start exercising a bit, you will probably feel some aches as you stretch your muscles again, same as you would following any injury or invasive surgery. You aren't pulling the leads though, it's just normal rehab...

Take it steady and you'll be back on the WODs in no time!

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