Post op week 5 Lead Extraction and PM

Well it is 5 weeks since my surgery. I still am experiencing bad days along with the not so bad days. I am trying to be optimistic that this to shall pass.

Prior to leaving the hospital I was seen by physio, I had to do stairs, and participate in the excercise program. They went through the excercises we should try and perform every day. One such excercise was walking.....I have been able to walk up to 1 1/2hrs...but generally it is 45mins.and then I am done.

I have to plan my day....its' either do my walk or go for groceries but I can't do both. When I shop I am not pushing the buggy or anything....I just pick out the food and put the odd things in the cart....but even with that I am finding I am getting dizzy, lightheaded....off balance.

My BP and HR are great with no medications....110/67 HR 50-52....I am scheduled to go have my PM check up on Monday...and for that I am greatful as I am sure I need some tweeking.

In my 24 years of having PM's they have all been Medtronic...but this PM is a St. Jude for which I am not very familiar with the settings. I know my sensitiviy was low when they first tested it in the hospital but they said that was because of tissue inflammation...it did improve somewhat..but it is still on the border low.....the only way they could have changed that was to go in again and adjust my lead.....they opted not to...and believe that once the inflammation settles the sensitiviy should improve...so we shall see on Monday.

I have a question....My original PM was on my right side....I had 4 PM's on that side. I honestly can't remember what I felt like after the initial PM implant. My PM currently is on my left side....here's my question....I have constant discomfort not at the PM site but rather to the upper left from my sternotomy site which does at times appear swollen but not red or hot....I am wondering if this discomfort is just in conjunction with the sternum healing and the route in which the leads are placed? Any suggestions? I will ask this question at my appointment but anything you could share would be appreciate.

Another thing...excercise...ok they tell me about the walking and leg stretches and even arm excercises....however arm exercises are contraindicated with new PM's ...so I am having a bit of difficulties understanding what would be appropriate seeing as I am healing from the sternotomy and all those restrictions and then a brand new PM and those restrictions...what have others done? I have a book from the healthy heart program but it doesn't mention anything about having the two at the same time.....

Anyhow I appreciate any input. Cheers and good health to you all!!

6 Comments

Lead problems

by donb - 2009-01-10 06:01:05

Hi,
I've been following your past posts since I had my pacemaker removed the same days as your surgery. I feel bad for you, can't seem to put things out of my mind. Guess what bugs me most is the fact that you're really a veteran with past pacemaker and lead problems and hopefully you'll havae a real good turn around with lots of funs years in the future. I got my second opinion Thursday from a very good cardiologist in Ann Arbor, MI at the University Hospital. EKG showed only 1st degree electrical block and he questioned why the pacemaker? Next like most in his field couldn't remember ever having a patient with alergy rejection. The fact that I was on Cipro before and after the surgery any infection or scar sample wouldn't show infection?? He also said leads have to come out either with replacement PM or without because of lead infection risk in future. Lead removal risk was another biggie for him. In the mean time he is going to put me on an event moniter for a month..All in all the whole picture looks like a re-run of your past experiences. I truly believe on this lead removal that the risk figures we find published are based on total surgerys, not just lead removal events Keep up your postings and looking forward to some happy ones.
Don

Thanks

by maryanne - 2009-01-10 06:01:41

Hey Don....

I don't mean to be a downer on this topic....I just want to share my experience as it can be a learning experience for us all.

Like you, way back when I got my first PM it was for SSS with 1degree AVB....the reason they opted to give me one is that I was symptomatic and I had rates in high 20's low 30's after wearing my holter monitor.

Cardiac issues run in my family with 3 of my sisters having PM's and a brother, and now 2 nieces and a nephew. We all see the same cardiologist and hence he is able to compare and rhythms, signs and symptoms and the likes....some might say it's a money thing for him...but I don't think so....he has put us in very capable hands when it comes to implants and removal.

My situation was an exception to the rule...I know you have read the statistic on removal of leads and PM's and the complications and factors involved....So I mean I knew it was a risky procedure and what could possibility happen...I just hoped that what happended to me didn't. It's like prepare for the worst and hope for the best.

With regards to infection. The surgeon told me that they only way they could detect infection and the kind of infection is by taking cultures from the removed tips....that is common practise when something like that is removed it is always sent for cultures to ensure there is not infection.

My silver lining in all of this is that there wasn't any infection!!! Yippee....so I don't have to be on a month of IV antibotics...and I don't have to have an invasive PICC line in my arm for a month. They could not leave my PM out as my rate was far to low.....

So I am healing....things are looking up....it's just a journey....

Cheers....Mary Anne

more healing prayers

by Tracey_E - 2009-01-10 07:01:42

Mary Anne, I just love your attitude. I don't see your post as down at all. You're hurting and have every right to be frustrated but you still look at the bright side.

I don't really have any advice except to say all of my pm's have been St Jude and I've had nothing but fabulous experience with their reps. I had a problem last year that had three reps scratching their heads, they turned my file over to their engineers who made me a test case and gave me two cell numbers to call if I had problems before the engineers had their powwow. They are awesome and I hope your experience is just as good.

Great news on the infection! Now, if they can just quickly get your settings adjusted so you can move on.

maryann

by jessie - 2009-01-10 09:01:39

just a thought the lowest my pulse can go is 60 and i feel good so i wondered about the 50-52? jessie

My HR

by maryanne - 2009-01-10 11:01:45

My PM is set at 50....I have always been at 50...when they implanted the new one they had me at 60 at I had them turn it down as I always felt it kick in....and that as you know doesn't feel very good.....I just need to get my PM tweeked...Ihaven't been to the clinic since implant...so we will see what Monday brings....thanks for the thought though Jessie....

Cheers!

Don

by ElectricFrank - 2009-01-10 11:01:51

Don,
It sounds like you have a competent cardiologist. That's very encouraging and about all we can ask.

best of luck,

frank

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