Post op instructions?

I have decided to get the pacemaker implanted so I am scheduled in about 1 week. My second opinion doc is doing the procedure but I have not gotten much in the way of info on how much time off (if any) I should take off of work. I am a dog sport trainer and competitor (agility, competitive obedience, etc) and teach several classes (about 50 students) per week. I also need to run and train my own dogs, plus maintain about 5 acres of property. I have gotten no solid feedback on necessary, reasonable, or average recovery time. I realize everyone is different; however, I need to plan ahead. Can anyone give me an idea of what to expect given my necessary activity level?

12 Comments

Hi

by Gellia2 - 2009-11-02 01:11:55

I do agree with Tracey! "The odds something will go wrong are minimal."

I have had a pacemaker for over 34 years, and a dual chamber one since way before they were available to the general population (1982). I have had many replacements over those years. There have been very few problems in all that time and nothing that couldn't be handled when they came up. I'm still around and kicking! Quite nicely, I might add.

Being a bit careful in the beginning only makes sense, though. As Tracey said, the wires have to scar into the heart wall so they don't move. Give them time and you will be back to "normal" in no time at all.

Best to you and let us know how well you do.
Gellia

NEW PACEMAKER

by J.B. - 2009-11-02 03:11:33

As others have said some of your questions can be answered only by your doctor, such as when you may return to work. As for me, I was able to reutrn after two days, but the DR. insisted I wait for a week.

Below are some general guidelines for those of us getting a pacemaker.

What To Expect After Pacemaker Surgery

Expect to stay in the hospital overnight so your heartbeat can be monitored and your doctor can make sure your pacemaker is working properly. You probably will have to arrange for a ride to and from the hospital because your doctor may not want you to drive yourself.

For a few days to weeks after surgery, you may have pain, swelling, or tenderness in the area where your pacemaker was placed. The pain is usually mild and often relieved by over-the-counter medicines. Consult with your doctor before taking any pain medicines.

Your doctor also may ask you to avoid any vigorous activities and heavy lifting for about a month. Most people return to normal activities within a few days of having pacemaker surgery.

What Are the Risks of Pacemaker Surgery?

Your chance of having any problems from pacemaker surgery is less than 5 percent. These problems may include:

Swelling, bleeding, bruising, or infection in the area where the pacemaker was placed
Blood vessel or nerve damage
A bad reaction to the medicine used to make you sleep during the procedure
Infections that can become difficult to treat

How Will a Pacemaker Affect my Lifestyle?

Once you have a pacemaker, you have to avoid close or prolonged contact with electrical devices or devices that have strong magnetic fields. Devices for which close and prolonged exposure can interfere with a pacemaker include:

Cell phones
iPods
Appliances, such as microwave ovens
High-tension wires
Metal detectors
Industrial welders
Electrical generators

These devices can disrupt the electrical signaling of your pacemaker and stop it from working properly. You may not be able to tell whether your pacemaker has been affected. How likely a device is to disrupt your pacemaker depends on how long you're exposed to it and how close it is to your pacemaker.

To be on the safe side, some experts recommend not putting your cell phone or iPod in a shirt pocket over your pacemaker (if they are turned on). You may want to hold the cell phone up to the ear that’s opposite the site where your pacemaker was implanted. If you strap your iPod to your arm while listening to it, put it on the arm farthest from your pacemaker.

You can still use household appliances, but avoid close and prolonged exposure, as it may interfere with your pacemaker.

You can walk through security system metal detectors at your normal pace. You also can be checked with a metal detector wand as long as it isn't held for too long over your pacemaker site. You should avoid sitting or standing close to a security system metal detector.

Stay at least 2 feet away from industrial welders or electrical generators.

You also need to avoid some medical procedures that can disrupt your pacemaker. These procedures include:

Magnetic resonance imaging (also called MRI)
Shock-wave lithotripsy to get rid of kidney stones
Electrocauterization to stop bleeding during surgery
Let all of your doctors, dentists, and medical technicians know that you have a pacemaker. You also should notify airport screeners. Your doctor can give you a card that states what kind of pacemaker you have. Carry this card in your wallet.

Physical Activity
In most cases, having a pacemaker won't limit you from doing sports and exercise, including strenuous activities. You may need to avoid full-contact sports, such as football. Such contact could damage your pacemaker or shake loose the wires in your heart. Ask your doctor how much and what kinds of physical activity are safe for you.

Followup

Your doctor will want to check your pacemaker regularly. Over time, a pacemaker can stop working properly because:

Its wires get dislodged or broken
Its battery fails
Your heart disease progresses
Devices giving off strong electrical, magnetic, or radio waves have disrupted its electrical signaling
To check your pacemaker, your doctor may ask you to come in for an office visit several times a year. Some pacemaker functions can be checked remotely through a telephone call or a computer connection to the Internet. Your doctor also may ask you to have an EKG (electrocardiogram) to monitor changes in the electrical activity of your heart.

Battery Replacement
Pacemaker batteries last between 5 and 15 years, depending on how active the pacemaker is. Your doctor will replace the generator along with the battery before the battery begins to run down.

Replacement of the generator/battery is a less involved surgery than the original surgery to implant the pacemaker. The wires of your pacemaker also may need to be replaced eventually. Your doctor can tell you whether you need to replace your pacemaker or its

Carolyn65

by Carolyn65 - 2009-11-02 03:11:38

I have had my dual Boston Scientific implant since 10/2/09. Thank goodness I have not had the problems mentioned in the PM Club. My only personal set back has been when I thought I was doing so well without any soreness around the implant area & no sysmptoms to speak of, I would forget & try to "over do it" (for me). I would lift, push, shove items which probably should not have been done, but I would feel like I could @ 3 and 4 weeks post PM. Now my implant area has a lil' "pull" to it with a tiny "itch", but the area looks fine. Once in a while in the last week or so, I feel like I am slightly lite headed ~ have no clue what that is. I do not go back to my PM person until Jan. 2010.

Thank goodness all these wonderful people who have been there & done that can help us all out with their own experiences and knowledge, Carolyn G. in TEXAS

Hi!

by dw5281 - 2009-11-02 05:11:22

It is sooo different for everybody & depends how physically demanding your job is - I'm a PE teacher in the UK & I was off work for 6 weeks

Wishing you lots & lots of luck it'll be fine! debs x

My Experience was Different

by ppt - 2009-11-02 06:11:31

It took me almost 8 months to get back to normal activity. The dizzyiness remained as did the shortness of breath (I had CHB). No infections, no complications - all pacemaker settings - once they were correct for me (a very active person) I have been super ! So I agree with the other posts .. it depends upon the person, the settings and Physicians. Good luck ! Keep a positive attitude - it really makes a difference :-) You'll be fine :-)

recovery time

by Tracey_E - 2009-11-02 10:11:24

Every one is different, it depends on why you need the pm and your overall health. Having done agility classes with my dogs, I'm going to say you're in decent shape! Is the pm a fix for a minor problem, or a bandaid on a larger problem? If your heart is otherwise healthy and you're in good shape, you'll be back to normal activities faster. If you have other things going on, the doctor may want you to take it easy for a few weeks.

Two things that aren't negotiable are keeping your arm lower than shoulder level and not lifting for 4-6 weeks. The leads need time to grow into place so we have to be careful not to do anything that will dislodge them. You will probably need some help with the dogs and the land for at least the first few weeks, then you'll be ok on your own but will need to take it easy and be careful with the arm.

I was out of work less than a week but I had a desk job at the time. I started walking daily from the time I was released from the hospital. I felt great, I was just sore if I moved the wrong way. Others take a week or even two weeks off and have a harder time with the pain. We're all different. Doctors are different also, some keep their patients in a sling to protect the arm longer and send them home with a long list of don't's. My doctor didn't give me any restrictions, just to use common sense and stop if it hurt.

complications

by Tracey_E - 2009-11-02 12:11:42

Complications actually happen less than 2-3% of the time. Don't let reading the other posts here and hearing about cases like Ronaldo scare you. People come here for two reasons... questions adapting or because they've had complications. For every person with complications who comes here for answers, there are hundreds out there who get their pm and get on with their lives. The odds something will go wrong are minimal.

Agility post PM implant

by agilitydog - 2009-11-03 05:11:36

I've been doing agility for 7 years.
I was told no running, no agility for 4 weeks post surgery, and of course not to raise the arm above shoulder level for 4 weeks post surgery, for both my 2006 PM implant (post ohs so I wasn't doing agility then anyway) and my 2007 defib implant. This was to permit the leads to scar in AND to prevent the device from enlarging the pocket.

3 weeks was probably plenty. I also wore an athletic bra (I'm female).

You can probably teach while under restriction, if you don't run, and don't demo a bunch of front crosses, or rear crosses, or distance work with arm waving! You'll be fairly sore the first week, so cancel those classes. 2nd week is iffy, depends on how you feel, but watch the arm waving.
You can extrapolate from there for obedience - maybe skip the directed jumping for 3 weeks, and no "fast" heeling.

complications, continued

by Tracey_E - 2009-11-03 08:11:01

Ronaldo and JB,
All those complications you listed? They truly do happen less than 3% of the time. That means for every 3 people with any one of those complications, 97 people will have a smooth procedure. Every drug we take and every procedure we have has possible complications, we all know that. Focusing on the rare chance of something going wrong isn't constructive, and US focusing on it too much will do nothing but terrify the newbie here looking for information and assurance. Please think before you post.

PM Complications

by J.B. - 2009-11-03 10:11:02

Tracey,

I never gave what you posted a thought because I didn't read it. Alamb asked "Can anyone give me an idea of what to expect given my necessary activity level?" I had been given that list of possible problems and I passed it on. End of story.

Of course I doubt anyone would ever be so unfortunate as to have all of those problems, nor could I go through that list and say don't worry about items on this list. At this point I figure I run the same risk of over stating the possibilities as you do understating the possibilities.

J. B.

odds

by Tracey_E - 2009-11-03 10:11:23

I wasn't trying to pick on anyone, but to point out that the concentration of people here who have had complications is higher than normal. You can post your experience any time and I'm sorry that you didn't have a good one, just know that your experience is the exception, not the rule (see links below if you've never seen the data). That's all I was trying to say, put yourself in the shoes of someone new and nervous who may be reading your words. Are you calming their fears or feeding them?

data on the risk of complications...
http://www.theheart.org/article/962057.do

http://www.sjm.com/procedures/procedure.aspx?name=Pacemaker+Implantation§ion=Complication

It depends

by ElectricFrank - 2009-11-03 12:11:38

If you follow the very conservative standard instructions you will be very limited for 6-8 weeks, and then need to avoid all sorts of bad things that can interfere with your pacemaker.

If you are a macho no pain no gain type you will likely be back at full activities in a few days, but may find yourself back in the hospital to fix a pulled lead.

If you take the time to understand what is involved in your own recovery and pay attention to what your body is telling you, I would say 2-3 weeks should get you back to reasonable activity. The main thing is to avoid lifting your arm (on the pacer side) above shoulder level as this puts a strain on the leads which haven't scared into the vein wall yet. As for lifting I could never see any reason for that restriction unless it was about shoulder level. Like any surgery you will have an incision where the pacemaker was implanted. It will be sore for a few days to a week and will let you know about it if you try running or lifting.

Some have had infection problems with their incision which has extended the healing process considerably. I doubt it was anything they did wrong, but more a matter of the surgeons competency. Another factor is where you have it implanted. Mine is right under the skin on my left chest just below the clavicle which requires a minimum of tissue damage. If you have it implanted deeper under muscle tissue it takes longer to recover.

It's been 6 years ago for me so I don't remember exactly, but around 3 weeks I was out 4wd exploring in the desert with a shoulder harness over my incision with no problem. I was 73 at the time and in good shape so recovery was quick.

One last item to consider. You have the choice of anesthesia for the implant. You can be totally out, have one of the amnesia/anti-anxiety meds, or just a local injection around the site. For a location just under the skin the local injection is a good choice if you feel you can handle it. It has the advantage of being able to take care of yourself during the procedure. At one point I someone on the surgical team decide to use my chest as an elbow rest. If I hadn't been able to complain I would have had a bruised chest. They also tend to forget about a patients position and cause shoulder and neck problems.

Anyhow, that's my take on it.

best wishes,

frank

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