I need help understanding settings

I had my PM implant 4/9/09. My cardiologist had me come in today for an optimization. All I know is the techs did a heart echo while I was also hooked up to the Medtronic machine and tweaked my settings. They whispered a lot and even put paper on the side of their face so I couldn't read lips and then would look back at the screen. It made me paranoid. I don't like whispering :-)

All I know for sure, from what the tech told me is my EF is still 25% which is what it was just before the implant. He said my heart is not pumping very well at all and that's what they were trying to tweak......but he lost me on that one with terminology beyond my comprehension.

He said it looked like I got the defibrillator and the PM was secondary. I said no....the PM was what the Cardiologist thought I needed and a defib as precaution. The tech assumed this from what he saw on the heart echo, which again, I don't have a clue.

I asked for a copy of "my settings" which seemed to surprise them. I told them I belonged to a Pacemaker group that would help me understand the numbers. So I have a copy of the settings.

Sorry to ramble so. I do have a question.

What numbers are we to be most concerned with and can anyone help me understand them? I see my cardiologist on Tuesday for a follow up on today's settings. He is very busy and I would like to ask the most pertinent questions.

Thanks,

Brendakt54

4 Comments

THE SILENT REGIME

by pete - 2009-06-27 04:06:06

I know what you mean about whispering. I am sure the hospital has written in my file "WARNING THIS PATIENT HAS EXCEPTIONAL HEARING" . Which is true. So I get the whispering treatment. I would love to hear what they are saying like "phew this looks dodgy" or "I would not like to be in his condition". My hearing has got them into trouble on more than one occasion. I try to let it make me laugh. Cheers Peter

Questions

by ElectricFrank - 2009-06-27 12:06:22

In your case I would ask him to explain in simple terms how he sees your condition (assuming you are the kind who wants to know). Let him know you aren't happy with the whispering, etc. Also, ask him how they can do a competent job of adjusting the device if they don't even know why you have it.

One thing to keep in mind is that the docs don't know how much each of us can handle or want to know. I am the kind that if they thought I would be dead in the next couple of minutes I would want to know. That is very hard to get across to a doc. They are afraid of upsetting the patient.

The hard thing to get used to is the need to be direct with them and not be put off. At one of my early appointments with the cardiologist he tried putting me off and walked out without answering my questions. When the nurse came in to tell me I could go, I told her I wasn't leaving until my questions were answered. She got real upset that she needed the room for the next patient. I told her it was real easy, just send the doc back in to answer my questions. Shortly he was back and we got it settled. Since then he has never put me off. Sometimes they act like a child who you have to be firm with. Remember, you are the raw material they make a living from.

good luck

Hi Brenda

by Hot Heart - 2009-06-28 03:06:03

I wondered how you were, not seen anything from you since just before you were going to get your pm. Hope you get things sorted out.

HH

Hi all.....

by Brendakt54 - 2009-06-28 04:06:46

Thanks for the replies.

Frank, I am very direct with all of my doctors. I think I get on their nerves with my questions and requests for copies of labs, records, etc..... That's okay. I've been dealing with heart issues since 1994 and it's my observation that most cardiologists think they are superior to all. While I do appreciate every one that has helped me live this long, I do try to tactfully let them know I am not of the "yes, doctor" generation. If they give me a script or want to do a test, I want to know the why-fores. You are right. Many do act like a child when you get firm with them. Many act put out....like they are insulted because I have questioned them about something.

Pete and Brenda,
I had already had to correct one of them for calling me Barbara 4 times. She is the one I'll be seeing the most for PM monitoring so I thought I should let her know my real name so she wouldn't get me confused with someone else down the road, like if I was on the phone with her. I was nice about it. Then when they were whispering, (it was the Medtronic rep whispering to the PM Monitor), I thought well, maybe she is explaining something new to her. I didn't like the way she covered her face, but they were so focused on getting the settings right, that I didn't want to stop them by making an issue out of their whispering. I guess I should have said "Your whispering is making me paranoid" in a laughing way.

Hot Heart (love that screen name), I have posted several times since my implant. Not for a month or so though as I have been lurking here, trying to educate myself and encourage others too.

Someone offered to help decipher the numbers if one of us needed help. I have 2 sheets of settings and and just wonder what is most important to know......what to watch for in the future because I will always get a copy of these.

The main thing they did Friday was the Parameter.

Parameter Session Start Current Value
V-VPace Delay 10ms 50ms
Paced AV 120ms 150ms
Rate Adaptive AV On Off

A. Sensitivity 0,30 mV 0.90 mV


There are so many numbers and abreviations, that I don't know what to make of them. They were obviously swamped when I was there so I didn't bother the PM Monitor (tech). I see my doctor on Tuesday but he won't have time to go over everything with me.

(Sorry again to ramble)

What most concerns me is before the implant, one cardiologist told me if I was not a candidate for a PM, which after the cardio MRI suggested I was, that plan B would be a heart transplant. The cardiologist who actually did the implant (not my reg cardiologist) said he wouldn't put me on the HT list if it were him........but he did say my heart was so enlarged it had no room left to grow. Word for word.

I'd just like to know what to look for in my records that show if things are getting worse or better. I know the EF is not the tell all. My doctor is a real nice guy.....jokes a lot.....and I come out of his office many times wondering "WTH"???

Thanks for letting me vent :-) I guess I need to go to the Tampa Affair and bring my file......haha.

Love to you all,

Brendakt54

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