Hello to all,
I just joined a minute ago. My Mom had her first pm put in April 9. After 6 weeks, she developed a bad infection at the site and they put in a new one on the other side. A week later, one of the leads came loose. Since then, she has been re-admitted 3 times because the incision is opening and they thought is was another infection. None of her cultures showed any bactieria. I went with her today and the pm is 3/4 of the way out of the hole. She had patch tests last week to see if this is an allergy thing. She showed very slight reactions to nickel, rubber and I forget the others. The medical team has been blase' until today. They are talking to the engineers at Medtronic as her patch test on their kit turned out pretty well. Supposedly they are custom making a new pm for her. I just researched allergies to sutures, and found lots of info. Anybody out there have the problem of pm rejection with clean lab cultures? How about allergies to sutures or surgical glue? We are desperate here. Thanks for any responses.

Cattlelady

 

 

I've had a pm for over 20 years, and in March had pocket revision done because mine was eroded. No infection though. They put it deep under muscle and it's now made its way back under the skin. Of course, my surgeon is on vacation right now.

Not sure why it's doing this, but it has been a foreign body in there for over 20 years now...

 

Hi cattlelady,

I had exactly the same problem, and roughly the same procedures as your mom. My cultures were all negative too.

We never resolved the problem. They did the allergy patch test, and it was negative. There are still doubts about allergy. They tested the metal part only 5 days, and non-reactive metals should be tested 10 days.

A coated PM will help only if allergy is the problem.

It's a little more likely that my rejection was caused by "colonization" of bacteria.

Some types bacteria that colonize pacemakers (or any implant) do not multiply in great numbers or produce a full-blown infection. The bacteria multiply just enough to cause inflammation, causing the tissue to slowly break down. There is redness, but no pus, and little or swelling.

Of course the doctors fear the various strains of staph, strep, and a few other dangerous suspects, so the culture media are geared to those. Other types of bacteria, such as spirochetes (gum disease), are very hard to culture. A swab of the area would have to be DNA tested to accurately identify the organisms, and that takes too long to be practical.

Implanting the PM deep beneath the pectoralis can help. There is a better blood supply there, and it could possibly prevent colonization. If allergy is the problem, that will make it worse.


If I am forced to get another PM, the plan is to implant it deeply.

That's about all I know about my situation. I hope it helps you understand your mam's situaiton better.

Best of luck to you and your mom, and do keep us informed!

 

I am sorry to hear about your Mom - However, it does answer my question that being allergic to the pm metal is possible - I received my pm 2 wks ago - this morning my incision started opening, but I've noticed I've been able to see the outline (redness) of my pm pocket since the procedure - I am highly allergic to earrings (no matter what kind, regular, sensitve, etc), medic alert bracelets, etc. - I am hoping I am not allergic to the metal of the pm too .... thanks for input ....

 

My wife had her PM installed in April of 2009 and it worked well with the exception that one of the leads became disconnected and had to be reattached.
The problem she has been experiencing is that after a couple of months the tissue near the implant site began to deteriorate and a pocket began to form around the pm. She also experienced “itching” and a bit of soreness at the implant site, but did not have any signs of infection such as redness or swelling, pus, etc.

When they went in to reattach her leads the surgeon tried to pull some excess skin and fat material to flush out the pocket that had formed, but a couple of months later the pocket was back. Third try about a month ago was to do a deep implant underneath the pectoral muscle and everything looked normal and healthy post surgery. Now the pocket is beginning to appear again and we are at a loss regarding being able to address her situation.

Having her tested for allergic reaction to metals would seem to be indicated as a first step, but as an earlier poster mentioned I suspect that this is being caused by some type of low level infection or inflammation that is causing the tissue to die off over time and I have no idea what could be done to address such a condition – or how to go about determining if that is in fact what is going on.
Any suggestions or ideas would be very much appreciated.