My mom got her pacemaker over 10 weeks ago, and it still hasn't healed. About 3 weeks ago, the Dr. removed the pacemaker body (leads intact), cleaned the wound, replaced the pacemaker and stapled the wound closed. Staples were removed and the lateral edge still hadn't healed. I think she is rejecting the pacemaker, but the leads seem to be working well. I think the pacemaker needs to be removed and the wound allowed to heal. Can this be done?

 

 

They wont do that. They will treat the infection if any. Peter

 

If it was redone three weeks ago, then healing has to start over so I wouldn't expect to have healed just yet. Has it healed at all? It would be very very rare to reject it. If she needs the pm and it's not infected, removing it is a bad idea. Have you considered a wound specialist?

Peter, sorry but I disagree. If it's infected, they can and will remove it. They try to treat the infection and leave it alone first but if it gets in the pocket and there's a chance the infection will get to the heart, they clear everything out, treat the infection, then start over on the other side with a new pm and leads once the infection heals.

 

I talked with the pacemaker representative today. It seems there are three options - 1) remove the pm completely (highly unlikely), 2) move the pm to the other side, and 3) surgically embed the pm deeper into the muscle. My mom see her EP dr. tomorrow. I suspect the answer will be number 2.

 

I'd get a second opinion before putting her through a third surgery! Maybe with a plastic surgeon this time, and also possibly with an infectious disease specialist to make sure they're not missing something and it really is infected. EP's specialize in the heart, surgery is secondary in what they do and a lot of them get stumped if we're not a standard case where they can easily put it where they always put it. Plastic surgeons are used to fixing challenges, that's what they do.

If you don't look into why this happened, she might end up going through the same thing again on the right side. Can they explain why they think going deeper would help? And if they can't explain why it's not healing on the left, why do they think it will heal on the right?

If it were me, I'd go for door number 3. One incision instead of two to heal, they can keep the current leads in place rather than take them out on the left and run new ones from the right (much more invasive, twice as hard on the heart), and once it heals it's considerably more comfortable when it's deeper. I'm a big believer in burying them deep from the get-go but a lot of drs like to keep it just under the surface where it's easiest. When it's deep it's less likely to be bumped, bra straps and seat belts don't rub, and it's just plain out of sight and easier to forget. Mine is deep, done by a plastic surgeon.

Good luck!! Please let us know how she's doing.

 

Hi,
I understand your position also, and I wondered the same things b/c my incision wasn't healing.
I have been on 4 antibiotics since discharge home, and my incision is still open (6 weeks out from surgery).
I went to my doc last week, and he removed a suture & a chunk of Dermabond (skin glue) that was in the edge.
He had me do wet (peroxide) to dry dsg changes twice a day for a few days, and it is slowly closing.
I still have shoulder, arm, and upper chest pain. He said it was inflammation. I'm still not convinced on being allergic to the pm (they say being allergic to titanium is rare, but I can't wear certain jewelry), or the leads. He said it still could be a little while before we know that or not. SO, I guess I'm still not out of the woods yet either.
I hope your mom gets some answers soon.
Take care.