Not there yet
I've just been given the diagnosis of 3d degree heart block with bradycardia. This came out of the blue; I'm 75, had never been sick in my life, and had no symptoms. The doc gave me only one option - get a PM! Since this is a rural area, I would have to go a few hundred miles to get it and I guess what I really need to know is - how is it? Right now, I'm ok but the doc couldn't or wouldn't tell me what happens if I just pass on this, only how much I need it? Wonder if he gets a commission? LOL
So anybody with helpful information would be welcome. I'm pretty familiar with the technical stuff - worked in the health care field most of my life, but never been a patient. Just lucky, I guess.
9 Comments
Thanks, all of you
by Zia - 2010-01-22 07:01:35
I'm amazed to get so many great answers so fast.
To answer the excellent questions some of you asked, they found it because at a routine exam by my pcp she noted a really slow rate - low 40s - which stayed that low until a FU visit a month later. She did an EKG and referred me to the only cardiologist in this out-of-the-way place. (which BTW is usually why I love living here). The cardio did an EKG and said "she's right, you have a block" Then an echo which of course confirmed block, but showed little or no myocardial damage. At this point nobody knows how long this has been going on. The last time I remember having vitals taken was about 2 years ago and it was obviously ok, or somebody would have yelled then, especially since it was a pre-employment physical at the local hospital. LOL
For a second opinion, there's nobody within 100 miles to go to, but with a referral to an EP guy, though he's 200 miles away, if he agrees it's needed that's where I'll get it.
I suppose at my age, it's time to S or get off the pot, HOWEVER, it go on for a long time without it.
My daughter says, if it needs doing, just get it over with so we can enjoy life for however long it lasts. So that's one vote on the aye side.
Thanks again, guys.
second opinion
by Tracey_E - 2010-01-22 08:01:47
Can you get a second opinion? If it was out of the blue, how did they find it? What tests did they do and how low is your hr? As Inga said, you can have a third degree block for years and not need a pm, it all depends on how low your rate is. I was born with it, and got my first pm when I was 27 which is downright ancient for CCHB but I did fine without it until that last year. My hr gradually dropped off to the point I was dizzy and tired all the time.
Decision Time
by PM4LIFE - 2010-01-22 08:01:48
I have 3rd degree heart-block. I felt tired for years. I felt light-headed each time I got off the couch. I developed shortness of breath after walking up the stairs. I gasped for breath one night and I scared the begebbers out me.
Next came the final event - I could not walk around the corner from my home without being totally out of breath.
Went in, they hooked me up for 15 hours and informed me that I had 3rd degree heart-block. The Cardio has kept my Mother-in-Law alive for 10 years and is Head of the Department - he said I needed a PM that afternoon. I gotta tell you its better to have taken the advice and get a PM - or you will live daily with the stress of wondering if today is my last day. I got a St. Jude 2210 with Merlin. Merlin sits next to my bed and between 2am and 4am it downloads the data stored in my PM memory, data is transmitted via phone to my MD and if I had any - I mean any events that needs addressing my MD calls and tells me to come in. What a comfort to know I am being watched everyday verses waiting to go in for the next appt. or having an event that could have been avoided. I think that your decision has already been made...
Decisions..decisions...
by harley63 - 2010-01-22 10:01:37
Hi Zia,
I have 3rd degree heart block too and got my pacer Dec 2006. I live in Lubbock TX. Not sure which direction your headed to for the EP visit. Being that I'm not from here and got my doc by chance I'm happy to share a bit of information...if your coming to Lubbock, Dr. M. Ali at Covenant Cardiology is an awesome EP and Dr. Jason Bradley was voted the best Cardiologist in Lubbock, he is also with the Covenant Cardiology. My heart block came on me suddenly too and they said I did not have an option.. pacer or pacer. :O) Of course I was only 43 yrs old too at the time. They told me I could NOT drive if I did not get the pacer due to the high risk of passing out.
I'm happy to visit more if you have more concerns or questions.
Take care,
Harley63
My 2 cents worth...
by Pookie - 2010-01-22 11:01:30
Hi.
You said the doc gave you only one option - get a PM!
So, you either go by what he says and get one or go get a 2nd opinion.
(Personally, I'd get the 2nd opinion).
The way I look at it is this: if you go ahead and get the pacemaker, it's like a type of insurance policy: it will not allow your heart to go below the lowest setting, which would probably be 60bpm.
However, if you are not having any symptoms like lightheadedness or dizziness or extreme fatigue, then it's totally your call I guess.
How did your doctor discover that you needed a PM based on saying you have 3rd degree Heart Block and that you have bradycardia (which just means your heart will sometimes, or a lot of the times, beat below 60). Just curious what lead to this discovery for you?
Do you not trust the doctor that told you to get one?
Keep us posted.
Pookie
Decisions....
by Zia - 2010-01-23 12:01:25
Hey Harley
Thanks for the invite - but I'm in Silver City NM which gives me several places to go, none of them Lubbock. Sounds like you got lucky, probably deservedly. The cardio has reccommended the Tucson Heart hospital and I;m leaning that way for because I have lived in Tucson and know people there.
Hey PM4LIFE
Sounds like you had a lot more serious onset than I did. I still feel ok, just tired, never been dizzy or light headed yet. Tell me more about Merlin in case I need to mention it to the EP I'm supposed to see. I live in an area where there is only one cardio within 100 miles and wouldn't want to have to go traveling all the time if Merlin can help.
Thanks, everybody
Me too
by wenditt - 2010-01-24 09:01:44
I was diagnosed with 3rd degree heart block in September and was in surgery an hour or so after diagnosis. Scary stuff. I had symptoms of dizziness and lack of pulse during certain moments for year, but all EKG's came up normal.
I pace 1% of the time...so far. The surgery and recovery were the easy part for me. It's been all the adjustments psychologically for me that have been the hard part. But everyday it gets better.
All the best
New Mexico
by dwelch - 2010-01-25 05:01:36
Hey Zia, nice to hear from New Mexico. I moved from NM to Pennsylvania a few years ago (I know...long story). My doctor in ABQ was Dr. Kathleen Blake, very very good, I trusted her with my heart and health for a number of years, she put my current PM in five years ago. I recommend her and would trust everything she says, tell her I sent you. My El Paso doc when I was living there and in Las Cruces (and Carlsbad) is no longer in practice, he now teaches at UTEP last I heard.
I would and did limit myself to El Paso and ABQ docs. If you were not seen by an ABQ or ElPaso (or Phoenix) I would go find a big city doc for a second opinion. I am not saying anything bad about the docs in small towns in rural states. If you have not lived in one you need to know the health system more of a problem than the docs. The docs that do try to make it there are in a no-win situation and cannot give proper treatment, and many simply move on. The patient to doctor ratio is such that they simply cannot give adequate care.
Anyway, I am one of those that was born with 3rd degree heart block. We didnt know anything was wrong until pre-teen, then at 19 the doc said I had to get a PM. A year or two before that we had lost a 15 year old cousin to a car wreck and I knew what that can do to a family so when the doc and my parents (whose health plan I was still under) said you are getting one I didnt put up a fight, at an age where you know everything I was barely smart enough to trust the older folks on this one. I am more than half way through my third pacer and look forward to many more.
So as far as living with a pacemaker goes it is no big deal. The procedure is easy, a few weeks of recovery. I think the mental change can be the hard part. I had gotten used to slow rate powerful heart beats, I could take my pulse just by looking at a clock because I could feel and hear every beat. The PM silenced all of that, the most difficult part was dealing with that emptiness. Once I convinced myself that my heart was really beating every day, and had not stopped, I got over it. On my last replacement when it went into upper chamber only pacing that rhythm from my childhood returned, and this time it was unsettling, not knowing if the pacer had stopped all together or not.
As far as your condition goes, growing up in towns around you, I would get a second opinion, even if you went to El Paso, maybe see what someone in ABQ says. If they agree then you have to decide which one to go see, I would assume the El Paso docs are easier to get to. If they disagree you have to go with your gut as to which one you trust or which one seems to care the most.
Having a pacemaker is a good thing, it makes you normal. It gives you one less thing you have to worry about (which the normal people still do have to worry about). If you decide to trust the doc that says you need one you wont regret the decision. this is not like an elective amputation or heart transplant or anything. Its more like plastic surgery, a permanent change, but something you adapt to and after a short while dont notice anymore.
You know you're wired when...
Youre a battery-operated lover.
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3rd degree heart block
by golden_snitch - 2010-01-22 07:01:11
Hey there,
there are some people here who were born with 3rd degree heart block, and didn't need a pacer for years. I know a patient with congenital heart block who's 28 now, still hasn't got a pacer, and still feels no limitations at all. So, if you have been symptom-free all the time, never fainted etc., you might be able to wait and see what happens. As soon as you experience symptoms, you know what's wrong, and can then go ahead and get the pacer. However, if you've already experienced some dizzyness or pre-syncopes, it would certainly be better to get the pacer now.
The risk that you die of a 3rd degree heart block exists but is low. And I would say that it's rather what happens when you all of a sudden get the block, for example an accident because you were driving a car, that can cause death. Some here have had pauses of 10 or more seconds because of 3rd degree heart block before they got the pacer but they survived; they got the pacer and are now doing well. It's different with ventricular fibrillation but with 3rd degree heart block the chances that the heart re-starts after a few seconds are good.
Hope this helps a bit.
Best wishes
Inga