Post surgery

I recently had dual lead pacemaker implanted under the muscle. I was told to NOT lift the arm on the side of the implant for three months! Another doctor told me TO lift my arm, otherwise the tendons and ligaments will tighten too much...that I should gently lift my arms over my head!
I am in a quandary and would like feedback from those who had the implant under the muscle, what they were told to do! I don't want to risk pulling the leads out by lifting my arm!!
Thank you...

9 Comments

arm

by Tracey_E - 2015-06-22 10:06:35

When I had my first one done in 1994 (submammary so it's under muscle and breast), I wasn't given any restrictions. When I got a new lead a few years ago, I was told keep my elbow below shoulder level and don't lift over 20# for 6 weeks.

Go with dr #2!!!!! If you don't move your arm, your shoulder will freeze. Most drs say don't raise it over shoulder level, don't lift anything heavy for 6 weeks. Other than that, it's very important to use it normally. There are studies that show that yes, raising arm over the head is ok and patients given no restrictions have no greater chance of dislodging a lead than those told not to raise it. I'd probably not push it that far. Either way, you will not pull out the leads. They do not put them in tight, there is slack that they coil behind the device so all you'd pull is the tissue around the device itself, not the lead in the vein. Whatever you decide on raising it, do not keep your arm still because you really do not want frozen shoulder.

Read this study

by Lurch - 2015-06-23 04:06:55

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

While it talks specifically about sling usage, it does a good job of identifying the differences in things that doctors tell their patients.

While I respect my doctors, none of them actually have an ICD, or PM, so I sincerely appreciate being able to get information straight from a group of people who have BTDT!

Good luck..... and keep that shoulder loose!!

Move It, Move It, Move It

by PJinSC - 2015-06-23 04:06:59

You need to start gently moving it as soon as the pain will allow, or you will develop locked shoulder syndrome and it is not fun (another story). I was told to move it right away, just not over my head for a week and lifting nothing over ten pounds for a few weeks and then nothing over 50 pounds for six months. I wore a sling to bed for a week, but started wakening with my arm above my head. After a moment of concern, I said to heck with it and tossed the sling. I more or less followed those instructions. As the pain allowed, I was able to do more. I started using a pillow to cushion the incision site at night and it became a habit. Kind of like Linus's blanket, I can't sleep without it.

Good Luck and Good Life. PJ

Biventricular pacemaker

by newyorkgirl1 - 2015-06-24 02:06:50

OK..the truth! Dr. #1 was supposed to insert a pacemaker with 3 leads under the muscle on the right side. I chose this side because I am left handed and was told by Dr. #1 that I will not be able to use the arm with the implant for 3 months. I wanted my dominant hand more useful, so I chose the right side. Dr. #1 was not able to place the 3rd lead in...he pushed and prodded to no avail! I then developed a blood clot in the area that I am treating with xarelto. So I ended up with 2 leads...both on the right, leaving the left with nothing! After finding out from Dr. #2 that I need to use that arm and not wait, I am a tad angry! All this could have been avoided had I known that I was able to use the arm from the onset! Dr. #1 and Dr. #2 are surprisingly associates! I am totally bruised on my right arm going down the right side of my body, which I was told will take at least 2 weeks to clear up! Even though it's only been a week since surgery, I don't feel any stronger! Am I being too hard on myself, or will I feel a difference had I had the 3rd lead put in? Feedback?

2 vs 3

by Tracey_E - 2015-06-24 08:06:01

There are a few drs who choose which side to place it on based on dominant hand, but unless you shoot shotguns, I never understood that. It's minimal during healing, and completely irrelevant after.

If they originally wanted to give you a 3 lead, then yes, you probably would feel better with the third lead. They don't do that unless there is reason, and it's a totally different kind of pacing. Two lead increases a slow heart rate and/or syncs the atria and ventricles. The third lead forces the two ventricles to stay in sync, which can increase efficiency. Two lead will only increase speed.

Did they change the arm restrictions AFTER the clot? If yes, then listen to them. Dislodging a clot is more dangerous than frozen shoulder.

It's only been a week, so yes, you are being too hard on yourself. It's a minor surgery, but it's still a surgery and a shock to the body, and you had complications. Give it some time.

Move within limits

by kbell - 2015-06-28 07:06:44

Was the blood clot within the tissue or actually in a vein? Xarelto may cause other bruises so don't be alarmed if that happens. I got my PM April 8th, under the pec muscle, non-dominant arm and also wasn't allowed to raise above the shoulder for 6 weeks (which is only limiting a small part of how you can move in one direction). I agree with Lurch and PJ. I avoided frozen shoulder by continuing to move in all the other ways, as well as the elbow and wrist. If you are the cautious type start with towel slides while sitting at a table. My Doc clarified that subctaneous (under the skin) implants have shoulder precautions for 3 days while subpec have precautions for 4 to 6 weeks so the muscular pocket can form well. I hope you feel better soon.

Driving and mowing the lawn

by oldearthworm - 2015-08-04 09:08:15

A two lead St Jude implanted under the skin, 15 July in a 75 old opinioned man .. Both SSS and bradycardia mentioned as causes .I WILL reread all the postings .. I was given an OK to use my motor vehicle about two weeks after the surgery, but I still drive and steer one armed . But, not until 15 September will I be "allowed to mow and use power equipment ...
This causes NO happiness ..
Fear of pulling leads is there ..

Living in fear

by oldearthworm - 2015-08-11 04:08:47

Its hard enuff to control my own fear, much less the medical profession's ..So, what I do will be a super compromise of advice from all ... In other words, I'll be mowing, using the LawnBoy 10285 rope start ..I'll be careful . No pitching , left handed, until never !.
And, the PM works - wonderfully ...

Confusion, confusion!

by Jasot1 - 2015-08-31 04:08:57

i had my dual lead PM put in after an ablation gone bad resulting in 3rd degree heart block. It was placed on the left,where I'm dealing with a shoulder that probably needs surgery. With all the confusion about when to lift (move) how much weight to lift.........I'm so apprehensive about getting involved in this process.......even though I know I have no choice! Has anyone had this issue? PM and bad shoulder? I'm almost three weeks post PM placement

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