Re: my posting of 21-01-04

Symptoms

by crustyg - 2021-01-13 17:43:32

Darkening skin in lower legs can be a sign of venous insufficiency, so I wouldn't expect a PM to make much/any difference, but remote diagnosis like this is fraught with difficulties.  The swelling - if it's pitting oedema then you may have a raised RA pressure, and a PM won't necessarily fix this.

Sleep apnoea - recurrent upper airways obstruction - is a recognised cause of atrial dilatation which can lead to arrhythmias.  But you've been on CPAP for 12years so it's probably not cause and effect for you.

There's a known issue with a PM that uses Minute Ventilation for RR when forced ventilation is used (the BostonSci BradyRef manual specifically warns about this), *BUT* CPAP doesn't increase your respiratory rate above where it should be if your upper airway isn't closing from time to time, so it *shouldn't* have any effect.  My PM actually records 'sleep apnoea' (SA) events for me, but again the Ref manual warns against over interpreting this.  Basically it's SA=>PM, not the other way around.

The question seems to be:  Will a pacemaker help with many of my health conditions ?

by Gemita - 2021-01-15 08:46:07

Joe, I did respond to your previous post so I won't go over the same points.  All I will say is that you clearly feel better with a higher heart rate and so from that aspect alone, a pacemaker should certainly help you.

If my understanding is correct, it seems to me that you are wondering whether other health conditions present might also be helped by a pacemaker?  Your present question relates specifically to skin changes (colour) and swelling lower legs and also with sleep apnea.

A pacemaker is not a cure for all your health conditions, you must know this, but it may well help with many of them.  And I place emphasis on help, not necessarily cure.  This has been my experience and also my husband’s experience with his pacemaker.  A higher, steadier heart rate will most certainly help boost circulation which will help you to feel better.  

Have you had investigations for your lower leg discolouration and swelling?  Is your blood pressure, cholesterol under firm control and has your doctor ruled out diabetes, peripheral vascular disease, coronary artery disease and microvascular disease or other potentially serious conditions?  I presume they have? 

I think you need to be clear why you are getting your lower limb symptoms which may be significant and need immediate attention.  I have seen serious lower limb problems caused by arteriosclerosis resulting in poor blood flow to my mother’s right leg, leading to sepsis and eventual below knee amputation. Complications may occur with lightening speed and may need urgent treatment, so if you haven’t already been assessed, you should contact your doctors.  We cannot know what is causing this Joe, so please be safe.

Sleep Apnea?  My sleep consultant confirmed that a falling heart rate was found to be a trigger for my mild to moderate (mainly central sleep apnea) whereas a higher heart rate from my pacemaker certainly helped to address this (as confirmed by two full Sleep Studies before and after pacemaker implant).  I am no longer on CPAP (couldn't tolerate it and had nosebleeds and worsening sinus problems after months of trial and error with different machines/masks, so was reluctantly taken off treatment).  I now practice side sleeping with some success.  CPAP was found to worsen my central sleep apnea for some reason too.

As you can read here and in my earlier message, I have had quite important improvements with my pacemaker.  It is difficult to know whether a pacemaker will help you to the same extent but I hope this message helps you to come to a decision.  Good luck