2 weeks and a bit fearful

Everything Will Be Alright

by MinimeJer05 - 2021-12-07 16:09:42

Steven,

I understand that getting a PM may sound like a fearful thing, but try to think of it as a GOOD thing. Generally speaking, these devices prevent future problems and allow us to live NORMAL lives.

It's perfectly normal to be fearful or anxious, but try to focus on the good and everything that this PM can prevent you from having to feel.

In terms of asking questions: 

1. I wasn't aware that you could ask for a specific PM? I didn't have a choice of brand or type, my doctors just kinda told me which one I needed and we went from there. I would trust your medical team as this is their primary job.

2. If a wedge pillow makes you feel comfortable, then by all means use one. I had troubles sleeping on the side of the PM implant for a few weeks and honestly preferred sleeping on my recliner for a few weeks, but everyone is different. Just listen to your body and sleep in a way that makes you comfortable and limits raising the arm on the implant side.

3. Steps shouldn't be a problem. Again, generally speaking, but you should be able to walk out of the hospital fairly quickly and resume most normal functions.

4. Driving to church shouldn't be an issue as well, as long as everything went fine (which is more than likely will). Most people heal from a PM implant within a week or so. If anything, you will have a sore arm and want to take it easy.

I hope that you have an event-less and successful surgery and are back to normal soon.

Take care and try to relax in the meantime.

Jer

Questions

by AgentX86 - 2021-12-07 17:10:22

Like Jer said, this isn't a big deal.  I was in the hospital overnight but it was unusual and only for obsrvation because I was then dependent (needed for heart to pump at all) on my pacemaker. The day after walking out of the hosipital I was back at work.  I could have gone back that day but it was too late in the day to bother.  I started back walking right away.  I wasn't to go to the gym for a month so cut my miles in half.

My surgery was done with only a local anesthetic and it was still a big nothing.

The final answer to your questions has to come from your EP but we can tell you what's sorta "normal".  Get used to being told everything is "normal".  There isn't any such thing and if the cow jumped over the moon, the cardiac staff will tell you "that's normal". We're all different and PMs affect us differently.

Specific PM:  You won't have that option.  What you need to do is make sure that your doctor(s) know exactly how active you are and in what form.  If you're a competitive cyclist or swimmer, make sure he knows.  Those stand out but make shure everyone knows your lifestyle.  You won't be able to tell them what model of pacemaker but they can take your lifestyle into account.

Many/most hospitals have deals with the various PM manufacturers and implant only that manufacturer's products.  This sounds sinister but it's really not.  If the hosptal is large enough, an exclusive deal allows the manufacturer to make enough money to keep a representative on site.  This is important because there is a lot to getting optimal performance out of the PM.  This technician is factory trained and knows the products.  Smaller hospitals may "share" a tech but this is only possible if there is a critical mass of patients.

Sleeping: The best answer is "whatever works". I found that a wedge pillow was worse than useless. From my CABG surgery, I found that a recliner was the best solution.  When I had my CABG surgery, I slept in a recliner for five months.  For my PM, two, but I could have slept in the bed after four weeks.  The problem is side-sleeping.  I could have slept, eventually but waking up in a normal position  would have been  no fun at all. 

Steps: No worry.  Unless you have some serious condition that wouldn't allow stairs, going in ("Doc, will I be able to play the piano?"), there shouldn't be any problem after.

Driving: This is something only your EP can anwer.  Most are proscribed from driving for a week.  Others, a month. Much depends on whether there is a chance that you'll pass out.  If you have a history of syncope, he's going to want to make very sure that the PM fixed it before you're allowed to drive again.

ditto

by dwelch - 2021-12-09 00:14:55

The doctor picks the device. Your role is to indicate to the doctor what kind of activities if any you are involved in.  If you are a certain kind of athlete, left handed and shoot rifles against your left shoulder, wear heavy backpacks or other things that would make the normal placement under the skin on the left shoulder a problem.

folks like agentx86 and a few others that have been at this for decades and have a number of devices.  driving by day two or three.  I think I waited another day or two over the weekend and drove to work the next monday (was only out a few days of work, YMMV).  Prior devices where I had a manual transmission, I drove my automatic transmission vehicle because trying to muscle the steering (at least one of them did not have power steering, was from the 1960s) with that left arm was a problem.  seatbelts are a problem if you are on the correct side of the car and the belt is over that shoulder.  big fuzzy (fake or real) sheepskin seat belt cover.  some days just have to use one hand to keep the belt off of it for a little bit.

Sleeping....dont expect to get much sleep the first night if any, embrace the suck. If in the hospital that night (a good thing, well pre-pandemic) they come in a few times to give you antibiotics and maybe check your vitals so even if you managed to sleep, they would flip the lights on and wake you up.  the devices are so far apart I dont remember all of them but the last one I do know it was bed to chair to bed to chair all night.

Sleep gets better every day.  Get to where the duration before you have to get up or move gets longer, eventually you can sleep in that side if you are a side sleeper and like that side (may take a week give or take to get to this point if you are gentle).  It WILL return to normal,  I dont think a pillow will make a huge difference.

if you can climb those steps today you can climb those steps tomorrow.  Unless it is really a ladder and you need to pull with your arms to get up it (hehe, I know it isnt).

medical tape and sandwich or storage bags.  I tape the bag over the device, good seal on the tape above, dont really need tape on the bottom edge.  then can just take a normal shower.  it may take days to a week or so before you can kinda get that pacer side hand to help wash your hair, if you bend your neck over.   

just dont lift heavy stuff, give it time.

little shots of pain are expected, they are super quick, you move this or that, sometimes you even open your mouth to get a bite to eat.  That one actually makes me laugh...I took no pain pills,  the discomfort will guide you.  move your arm every day, dont let it get stiff, that is some serious pain you dont want to mess with, been there, done that.  (dont use a sling after the first night, etc).  every day you will get a tiny bit more free movment with the arm before hitting a discomfort point.  before you know it you are washing your hair, reaching for things, driving with both hands, playing golf, tennis, whatever.  seriously though it is more of an ache unless you pull on it, no worries there, just be slow for a while, dont do things fast.

You will learn to protect it. my wife and daughters heads are right at pacer level so if they hug me on that side, pow head to pacer sometimes, even if they do it gentle.   you WILL forget it is there, like a toe or belly button, but you start to protect it from bumping into things.

rambling now

the big name brands are all good, my doc rotates through them across her patients.  In case one has a recall, then not everyone needs a replacement.  so I have had medtronic, st jude, boston scientific.  I have medtronic, guidance and boston scientific leads (four leads one the doc broke on a replacement, use three of them)

Requesting a model

by Elisabet - 2021-12-12 03:13:21

Just wanted to mention that I did ask for an MRI conditional pacemaker when I was in the ER before surgery, as at the time not all models were. I had been getting screening MRIs yearly and knew that I would likely need them in the future. It turned out I did need an MRI in an emergency situation six months later, so I'm glad I'd asked and that they had a model with that feature available for me. The leads need to be MRI-compatable too. There are ways that MRIs can be done safely even with older models, but it's a little more involved. 

I expect that by now most if not all models are MRi safe, but it wouldn't hurt to ask. 

Some of the choice may depend on why you need the pacemaker and how you will use it. From what I gather, if you need rate response and you bicycle or row, a model that senses respiration might work better than one uses an accelerometer, but if you're a runner that would be fine. In any case the doctor will be choosing based on what you need and what's available, and I'm sure would be happy to answer any questions you have. 

You might be fine to drive at two weeks but I wouldn't count on it. Might as well line up a ride and a lunch date with a friend just in case. Definitely be prepared for some things to take a while to feel normal again. Everybody heals differently. 

Anyway, what you are feeling is normal, but in a few weeks you'll be looking back and realizing it wasn't so bad after all.