Will be getting my first PM

Hello, I am new to the group. I am 39 years old and will be getting a PM in the next few weeks. I gave birth to my first child 12 weeks ago and, during my time in the hospital, my heart rate averaged 30 bpm (I did not feel dizzy, light headed or anything out of the ordinary).

I have known that I have a low heart rate for about 2 years, when my irregular heart beat was discovered/diagnosed. At the time I had an ablation and was told that there are several areas of my heart with crazy electrical currents all located on the left side of the heart. During the ablation the doctor only ablated one area, located on the right. He had never anticipated the extent of irregularities he found in my heart! The ablation made no difference in my physical condition considering the fact that I had never felt tired, light headed, etc.

Today my heart rate fluctuates from the 30's to the 70's bpm. I always feel fine. While I sleep my hr goes down to the low 30's. I also have episodes when my heart stops, but only when I sleep. The longest recorded pause was 8.4 seconds when I was recuperating after giving birth. While at the hospital I also had several 7 sec. pauses. After I left the hospital I wore a heart rate monitor for 30 days. I had pauses almost nightly, but of 4 seconds or less. Then I spent the night at a sleep center clinic and had 15 pauses, but of only 1- 1.5 seconds.

So now the doctors are scared that my heart will pause and not start again, so I have to have a PM. They are recommending a Medtronic dual chamber one.

I am scared about having the PM put in. I am scared that I will have start taking medications and that my life will be affected.

What can I expect from the surgery, recovery and lifestyle? Any thoughts, suggestions and comments are welcomed!

8 Comments

Another Article I found.

by Pookie - 2008-12-29 03:12:01

Now that you have a pacemaker (or soon may get one), you may be wondering why you need one and how a pacemaker works. Your artificial pacemaker is a modern marvel; it's medical science's solution to the electrical problems of a slow or irregular heartbeat. But before you can understand how your pacemaker works, you first need to know a little about your heart. Basically, your heart is a pump made of special muscle. It pumps blood to all your body's cells. This is vital, because the blood carries oxygen and nourishment to keep your cells alive and healthy.

Your heart beats (pumps blood) because special cells in your heart (the heart's natural pacemaker, called the sinus node) produce electrical impulses. These cause your heart to contract and pump blood. The impulses travel from the pacemaker cells down certain electrical paths in the muscle walls, causing a contraction. As long as the electrical impulses flow down your heart's walls at regular intervals, your heart pumps at a rhythmic pace. Sometimes, though, something happens to interfere with how the electrical impulses of your heart's natural pacemaker are made or flow down your heart. When this occurs, the natural pacemaker can't do its job as well as it needs to.

Problems that change the heart rhythm include:

A complete block of the heart's electrical pathway
A slow beat
An irregular rhythm

If you have a slow and often irregular heartbeat — or if your heartbeat is sometimes normal and sometimes too fast or too slow — blood isn't pumped around your body well. In that case your doctor may recommend an artificial pacemaker. A pacemaker will make your heart beat more regularly. That will help ensure that enough oxygen and nourishment gets to your body's cells. An artificial pacemaker system has two parts: a generator and wires (leads).

The pacemaker generator is a small battery-powered unit. It produces the electrical impulses that start your heartbeat. The generator is implanted under your skin through a small incision. The generator is connected to your heart through tiny wires that are implanted at the same time. The impulses flow through these leads to your heart and are timed to flow at regular intervals just as impulses from your heart's natural pacemaker would.

Modern pacemakers last much longer than earlier models. As with any electronic device, your artificial pacemaker will require some care. The batteries, for example, will wear down over time and the pacemaker will need to be replaced. This is a minor surgical procedure. Your healthcare provider can explain it to you. (I personally don't know if I agree with these 2 last statements!!)

Most pacemakers work only when they're needed. They're called demand pacemakers. Demand pacemakers have a sensing device that shuts them off if the heartbeat is above a certain rate. When the heart is beating slower than the pacemaker rate, the sensing device turns the pacemaker on again. In this way, a demand pacemaker works something like a thermostat. The difference is that instead of working according to temperature, it works according to your heart rate.

As the batteries wear down, your pacemaker will slow down, but it won't stop right away. Using a special analyzer, your doctor can detect the first warning that the batteries are running down. This can be done before you can detect any changes yourself. A sudden, major slowing down of your heart rate, which you may detect, probably indicates a more serious problem. If that occurs, call your doctor.

Pookie

Living With A Pacemaker

by Pookie - 2008-12-29 03:12:14

Hi again..I found this article (don't remember where) but I think it might be helpful.....

Do your part in managing your pacemaker. You may have to have someone help you, but there are certain things you'll need to do to manage your pacemaker successfully.

These include:
Understand your acceptable heart rate. Before you leave the hospital, discuss with your doctor the specific maximum heart rate above your pacemaker rate that's acceptable. Discuss the programmed lower and upper rate for your pacemaker, too. Talking about this with your doctor early in your treatment will keep you from worrying unnecessarily.

Take your pulse and keep a record for your doctor. Counting your pulse is a good way to check that your heart is pumping correctly. Every time your heart beats, it pumps blood through your blood vessels. By putting your fingertips on a point on the inside of your wrist or over an artery in your neck, you can feel this beat (pulse). The number of pulse beats per minute is the same as the number of heartbeats. Count your pulse for one full minute, note the number of beats and see if it's in the range that your doctor told you was acceptable for your pacemaker. If your pulse is very slow or very fast, call your doctor. Use these guidelines for pacemakers and pulse counts:

If your pacemaker is beating regularly and at or above its proper rate, it's OK.

If your heart is beating close to or within the accepted rate but has an occasional irregularity, don't worry. Every now and then your own heart's natural pacemaker competes with the man-made one. Some extra beats that the pacemaker can sense electrically won't result in a pulse that you can feel.

If your pulse rate suddenly drops below the accepted rate or increases dramatically, call your doctor immediately. Your doctor will tell you what to do. It may be possible to program your pacemaker so it resumes working normally, or there may be some other problem.

If your pacemaker is installed for a fast-slow type of heartbeat and your pulse is rapid and irregular (above 120 beats per minute), call your doctor for more instructions.

If your pulse is beating faster than you've noticed before — but below 100 beats per minute — don't be alarmed.

Take prescribed medications. It's important to follow instructions and take prescribed medicine by following directions precisely. The reason is that the medicine works with the pacemaker and helps your heart pump regularly. Your doctor may ask you to keep a record of when you take your medication by marking a calendar.

Follow all instructions regarding diet and physical activity. Allow about eight weeks for your pacemaker to settle firmly in place. During this time, avoid sudden, jerky or violent actions that will cause your arm to pull away from your body.

Other warnings and information

Avoid causing pressure over the area of your chest where your pacemaker was put in. Women may find it more comfortable to wear a small pad over the incision as protection from their bra strap.

Feel free to take baths and showers. Your pacemaker is completely protected against contact with water.

Follow the program of activity outlined by your doctor. Car, train or airplane trips pose no danger.

People with pacemakers can continue their usual sexual activity.

Perform some kind of physical activity every day, whatever kind you enjoy. You might try taking a short walk, or moving your arms and legs to help your circulation. If you're not sure about exercising, ask your doctor for advice. You may be able to perform all normal activities for a person of your age.
Don't overdo it — quit before you get tired. The proper amount of activity should make you feel better, not worse.

Report to your doctor if:

You have difficulty breathing.

You begin to gain weight and your legs and ankles swell.

You faint or have dizzy spells.

Tell physicians, dentists and other health professionals that you have a pacemaker. Physicians or dentists need to know that you have a pacemaker. Tell them about it before you have any work done. Notify the doctor or nurse where you work. Modern pacemakers have built-in features to protect them from most types of interference produced by other electrical devices you might encounter in your daily routine. Household appliances such as microwave ovens, televisions, radios, stereos, vacuum cleaners, electric brooms, electric blankets, electric knives, hair dryers, shavers, gardening machinery, toasters, food processors and can openers won't affect your pacemaker. Most office and light shop equipment such as computers, typewriters, copy machines, woodworking shop tools and metalworking tools also pose no risk to your pacemaker.

If you suspect interference with your pacemaker, simply move away or turn off the equipment. Your pacemaker won't be permanently damaged and will resume its normal activity. Consult your doctor about special situations (such as working with high-current industrial equipment and powerful magnets). Surgical procedures also count as special situations. Certain types of medical equipment, such as magnetic resonance imaging (MRI) equipment, can also affect how a pacemaker works.

Always carry your identification card. In any kind of accident, your I.D. card will tell the people helping you that you have a pacemaker. Your card can be particularly handy if you travel by air. The metal-detection devices in airports may detect the metal in your pacemaker, although they won't damage it. Showing your card may save you some inconvenience.

Keep all medical appointments. To work properly, your pacemaker should be checked periodically to find out how the leads are working and how the battery is doing. Today many thousands of people have pacemakers and lead full, productive lives. Pacemakers are usually safe and reliable, but they do need to be checked regularly. The easiest way to check your pacemaker is to take your pulse. Taking medicine as prescribed and seeing your doctor regularly will also help. Your doctor can explain things you don't understand.

Pookie

First Pacemaker

by Pookie - 2008-12-29 03:12:15

Hi & Welcome to this wonderful club.

I had a pacemaker back in 2004 (I am 46 now) for a slow heart rate which didn't bother me because I didn't know!! I now have a Medtronic Enpulse, dual lead.

I was fatigued a bit but I thought that was my busy life style and I attributed it to being over 40!!, etc. My heart beats went down into the 30s at night but I don't know if it has ever stopped or paused because I only wore a monitor twice for 24 hours each time.

I basically got my pacemaker in case my heart ever decides it wants to take a break. I am NOT on any medications for my heart not even aspirin. But some people are on meds but it all boils down to why you have your pacemaker and whats going on with your heart.

I am glad that I have my pacemaker now because it gives me the reassurance that it will never go below 60. And now I hardly remember that I even have it. And I can even sleep on my stomach!

Of course you are scared about having a pacemaker! I can only tell you that yes you will be a bit sore and uncomfortable for a few weeks later and sleeping for the first couple of weeks will be hard to get but eventually you will find a way to get thru the nights...using pillows under your arm will help big time!

The number one rule after having your pacemaker is not to lraise that arm but it will all be explained to you. And you will not be allowed to lift for a certain amount of time as well so call all your friends now and tell them you will need some help with the house chores, etc.

The surgery itself is different for everyone. Some people get sedated while others are just given a local. I was sedated and loved every minute of it.!! I was operated on in the late afternoon and was home that evening. For the first 2 nights I slept in a chair because that was comfortable for me. I also had stitches while some people get staples and glue. Again, every operation is different, but these are good questions to ask your doctor prior to the surgery. Recovery again is different for everyone but give yourself at least 3-4 weeks before you feel back to normal. Rest and lots of it for the first couple of weeks will work wonders!

Lifestyle...didn't change my lifestyle at all. I can still do what I did before. The only thing that has changed is when I go through an airport, I cannot go through the usual security process but rather I have to be patted down but I get thru the line faster now!! I guess my suggestion to you would be to read and gather as much information as you can prior to your pacemaker.

Just remember....time. Give yourself time after. Gather some good friends around you for support....and remember, we are here too so if you have any questions, please feel free to ask away.

Pookie

welcome to our group

by LouLou21 - 2008-12-29 03:12:41

Hi kisabu, First of all congratulations on the new arrival!
Welcome to our group. you will find lots of support and answers to a lot of your questions on here, most people have been there and done it. They have helped me a lot and hope that i can put your mind at ease, i dont often give advice as most the time i feel that i am still learning myself. I got fitted with my pm (ialso have a dual chamber-medtronic) on april 16th this year. I am 30 years of age and had not had any warning that this was going to happen to me. I had collapsed at home on the saturday night and turns out that i have heart block and while i was in hospital i went into ventrical standstill but only for a couple of seconds. My life felt like it was going to change forever but now i am 8months in and i can honestly say that i can do most things other people can, i just try and get on with things and dont let it hold me back. I am on no medication whatsoever to do with my heart or pm. I was on a very tiny dosage of a betablocker at 1st but only for a couple of months then they took me off it, that was only because i felt my heart was racing in the hospital but looking back it was probably a little psychological. I wish you lots of luck and hope it all goes well for you.
Take care, Louise.x

welcome!

by Tracey_E - 2008-12-29 05:12:02

Welcome to our group! And congratulations on your baby!!!

I'm 42 and got my first pm when I was 27 for a very low heart rate due to complete heart block. My symptoms snuck up on me, they were so gradual that I had no idea how bad I felt until after I got the pm and felt so much better. I can do sooooo much more now than I could before! Not everyone has such drastic results. Some do not feel any different, but they are safer. Some have conditions that are merely maintained with a pm- it adds quantity but not quality of life. In your case, you should feel the same or better.

If you read the old posts here, keep in mind that only people who have problems come here! For every one person with an unusual complication, there are hundreds out there doing just fine and had no reason to go looking for an online resource. Please don't think these extenuating cases are the norm!

Surgery... they'll probably keep you overnight. They like to do an xray at 24 hours to make sure the leads are where they're supposed to be. You'll be a bit sore around the left shoulder and need to watch your left arm for the first few weeks, but many of us get by without any prescription pain meds. Everyone is different, but I didn't find the pain anything Tylenol couldn't handle.

Wear a loose button up shirt to go for the surgery, it's a lot easier to get on to come home. You won't want to do much bending and twisting the first few days. You'll have to be careful with the baby, also, because you can't lift much weight with your left arm for 4-6 weeks.

Something to discuss with your surgeon... the usual location is on the upper left chest, just under the skin, just under the collarbone. Depending on your build, it's more prominent (i.e. leaves a bigger lump) with some women more than others, and some women find their bra strap and seatbelt rub. It's very simple to make it a little deeper or place it a little lower to avoid this. Or, you can go all crazy like I did and completely bury the pm behind the breast. It took longer to recover, but I don't have any lumps or scars and never get discomfort from it. If you want to know more, just ask!

medications... many of us are not on any medications. Pacemakers primarily fix electrical issues and do their work without medications. If afib is an issue, they may want you on betablockers but that has nothing to do with having/not having a pm. A pm will not stop or slow down afib- it can only speed up or regulate your hr, it cannot slow it down. In your case, it will make sure your hr does not get too low or pause. Drugs cannot do that, only a pm can.

lifestyle... I hike, ski, rollerblade, work out regularly, own a business, am on PTO at 2 schools, cheer team mom, girl scout leader, and the board of a charity org ... I think it's safe to say the pm hasn't slowed me down! Most people don't even know I have it. It takes a bit longer to get through the airport and I can't have an mri. I'll never get a job arc welding or working in a junk yard (big magnets are a no-no) and tackle football isn't a good idea. I go for a quick checkup every 3-4 months and I've had it replaced every 5-7 years. It truly doesn't affect my day to day life, it just gives me the energy to live it to the fullest.

If you have any questions, please don't be shy! it seems scary at first, but it's really not that big a deal in the grand scheme of things. Not many health problems are this easy to fix.

Tracey you are an inspiration

by Hot Heart - 2009-01-03 07:01:05

Hi there, cabbage and trace i have read loads of your posts and you have really put my mind at rest over so many issues. Thanks and happy new year.

Ohhhhh forgot pookie

by Hot Heart - 2009-01-03 07:01:12

You too pookie!!!

Your First PM

by Jonn - 2009-01-06 11:01:36

Hi Kisabu-I had a dual chamber pm implanted in December 2007. Like you my heart rate went to 30 bpm. But unlike you I was unable to function at all until my rate climbed. I ignored it for several days-freeking me out all the while until Christmas eve when I finally passed out and was taken to the er where I was diagnosed with 3rd degree heart block. PM put in 2 days later. The initial fear was a little much to take at the time-I mean I had no clue what lied ahead. I had no website to go to only the nurses and docs and my family. So no one to bounce this stuff off of. But I can tell you this my procedure lasted 45 minutes no complications. I have no restrictions whatsoever I bike 50-60 miles per week. The only thing you must be aware of is that after the surgery you must give the leads that are placed in your heart time to anchor themselves. No pull up, push ups or anything that might put undue strain on the leads. But other than that what - ho life is good ( and I mean all aspects)
Take care Kisabu and if you can let us know how it went. We are here to help.
Happy New Year to you and the little one,
Jonn

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