First follow up visit

First Follow Up

by verne8 - 2016-09-21 16:58:24

OH how I hate interrogation days if they mess with my rate. I feel icky for hours after that so I can sympathize.

Is there a list of these questions to ask somewhere that I can access?

They did implant my latest PM under my muscle. Why is that an advantage---or is it?

Follow up

by Cabg Patch - 2016-09-21 18:24:22

As Verne said, what you went through is called an interrogation. Just be thankful, those of us with a CRT-D get the full out interrogation with darkened rooms, rubber hoses, and chains. Seriously, they have to test your device as well as check your responses which is why they ramp your heart rate up and down. In the olden days, St. Judes required their techs to give patients with defibrillators a Jesus Jolt as well during interrogation. That was always fun.

It always kills me people worry about getting CHF from pacing. Let's see, seems to me the option isn't attractive and far more severe than CHF.

As for implanting under muscle, that's principally cosmetic. It allows them to hide both the incision and the tell tale bump. Mostly done for female patients. It does take longer for recovery

List of questions

by grilor - 2016-09-21 18:36:39

Vernie8- I do not know about a list. I just had questions about some of the things I had read on here. Like rate response and what percent the atria and ventricle are paced at. I am still learning some of the terminology. I am not sure what the CRT-D is, but I am guessing defibrillator. I did not know the interrogation meant doing what they did today. What you describe does sound scary Cabg Patch. And I see your point about the alternative to CHF.

Interrogations

by grilor - 2016-09-21 18:55:54

Does it always make you feel funny when they lower your heart rate? It seems strange to me that prior to pacing my heart rate was anywhere from 37-52 but mainly in the 40s. I never felt anything like I did today. I asked her if she had ever had anyone just pass out when they did that. (Throughout it she was asking, Are you doing OK? I thought I was just anxious and feeling panicky. Even if she had told me she was going to lower my rate, I would not have expected to feel that way. Since I was so low before. She said that since my body had got used to being paced, it has been 10 days now, I did not tolerate a low rate anymore. Seems such a short time to make that much difference. Do you all get nervous before the interrogations? Also when I asked if anyone had ever went out during that, she said that I probably did not want to know the answer to that, but she did tell me that she did remember one occasion. Scary stuff!

Interrogation

by Good Dog - 2016-09-21 20:28:15

For many years I had my PM interrogated without the Tech messing with my HR or doing anything that bothered me (other than the magnet). When I changed doc's the new PM Tech started doing what she called "checks" that made me feel awful. I did not like them at all! She said that she had to do so. I always wondered why, because when they checked my PM over the phone I never had to go through that. Even now with my new transmitter device I don't feel the same uncomfortable feeling as when she checks it. I guess that I am accustomed now, because it really doesn't bother me much anymore.

It is interesting that I did discover she is not permitted (by my Doc) to reduce my rate below 40 bpm.  So she never found an escape rhythm and had made mention to me on numerous occasions that I was PM dependent. Basically inferred that I couldn't get by without my PM. Kinda made me feel that I would die if my PM stopped working. 

My Doc referred me to the Cleveland Clinic last year before my last generator change. I told the girl there doing my PM check that I was PM dependent. She said what do you mean? I said that I don't have an underlying rhythm. She said that everyone has one and that my regular tech probably just didn't turn-down the PM low enough to find it. She said she is permitted to lower it to 30 bpm, so she'll see what happens. Sure enough, my escape rhythm was 35 bpm. 

It took me almost 30 years to find-out that I have an underlying heart rhythm of 35 bpm that will keep me alive if my PM fails. Talk about feeling ignorant! So at that time I decided to try to get myself a little more educated. There is much to learn.

Generator change

by grilor - 2016-09-21 21:05:10

When you say generator change, do you mean battery change? Is your transmitter wireless? I think they only dropped mine to 50. What happens when they drop yours that low? I do not like the idea of going any lower. Why did they refer you to the Cleveland Clinic?

Generator change

by Good Dog - 2016-09-21 23:14:38

The pacemaker itself is called the generator. I guess it is an old term. When they change the battery, they just change-out the whole generator.

Yes, my transmitter is wireless. I have a Medtronic.

When they drop my rate down to my escape rhythm (35 bpm), I start to feel a little light-headed, but as long as I am laying-down, I am fine. That is what it was when I went into complete heart block. I worked all day with my pulse at 35 bpm and even drove myself to the hospital after watching a football game. I spent the entire night in ICU watching my pulse on the monitor bounce from the low 30's to as low as 12 bpm and back up to 35 bpm. That wasn't a fun night!!!

They referred me to the Clinic, because my doc was concerned with one of my 30 year old leads. He wanted their opinion on if it should be changed-out and removed, left alone or whatever? 

They left it alone. I still have it and it is working fine.

Not a fun night indeed

by grilor - 2016-09-22 01:09:25

My heart rate for about 20 years that I knew about anyway was about 36 to say 52. I never was symptomatic. They seem to think I may feel bad and dont realize it. Anyway supposedly it is so my heart wont stop. I also had EKG changes that concerned them. So far I cant tell I have any extra energy. I was in complete heart block. In fact, Ive never thought too much about it until now. My husband is very supportive and couldnt be any better. I was pretty scared after that interrogation and pretty unattactive with my new scar. I know that is petty and vain. But he always says the right things. I think next time I have to have that done, Ill ask to lie down first. I cant believe you drove feeling that way I did today. Good you didnt have to change the lead.I would be freaking out if I saw my heart rate go to 12.

Some facts...

by Cabg Patch - 2016-09-22 15:55:39

First it's called a generator because that is it's function. To generate electrical current to pace your heart and perform the functions necessary. All devices are hermetically sealed. To open it you have tyo destroy it. The battery is located inside the can so, when anyone talks about replacing the battery, what they really mean is the generator. In other words they take out everything but the wires (leads) and replace it.

If you are treated for Bradycardia, that just means your heart rate (at rest0 is below the normal deemed necessary to sustain life long term. So when Doggie says his was 30-35 that means over time his organs would not receive sufficient nutrients and oxygen to function and he would gradually fade into the sunset. A normal resting heart rate is between 60 and 100. Athletes do tend to have a lower rate. Sorry but if your heart rate went to 12 you'd pass out almost immediately.

I've had interrogations for 4 times per year for 10 years. Sometimes it does feel a little uncomfortable, but it's short lived and no biggie. It is necessary to see how your heart is reacting, how quickly it responds to changes and what it does.

Heart rate of 12

by Good Dog - 2016-09-22 16:28:58

When my heart rate in ICU dropped to 12 the nurse rushed into my room with eyes as big as saucers. I looked up at her and asked; "what is wrong?" She responded; "when your HR drops to 12 most people are not consious."  So I guess they were getting the crash cart ready!

In any case, I have sinced asked my doc about that incident. The first questions was: "Why the hell did they leave you in ICU overnight without putting on a temporary pacemaker?" Then he said, there must have been something wrong with the monitor, because I don't think your HR could have been as low as 12.

Well, I don't know, except that I saw it as plain as day and watched my pulse all night long bouncing between 12 and 35 bpm. It may not have been correct, but it sure made me believe that I was about to meet my maker.

Generator and low heart rates

by grilor - 2016-09-22 17:54:55

Thanks for the explaination of generator Cabg Patch. I wonder if because Doggies momentarily dipped to 12 and then bounced back up if that is why he didnt lose conciousness. Interesting.

PM check up

by Seabreeze - 2016-09-30 12:50:23

It is scarey when they "play" with the PM.....I didn't know the first time either and I said I'm really not feeling good like I'm going to faint. the tech said oh, I'm raising it now you'll feel better in a minute.I said what do you mean? The tech then said what he was doing....I said ya know, you do this for a living but those of us coming in for check ups for the first time...a little warning would be nice. I asked him if he had a PM and he said no, I opened my eyes wide and said please be alittle more sensitive and explain to the next patient.