being scheduled for surgery

I'm 66 and it was just determined today that I need a pacemaker to treat bradycardia - expect to have it done in 3-4 weeks - I work full time (I teach psychiatric nursing) and I'm a church oranist, pretty active overall - please share hints re: preparing for the surgery, recovery issues [time/course/suggestions], lifestyle changes. Any and all information will be greatly appreciated.
Thank you. Jaynee

5 Comments

hi janee

by jessie - 2011-02-28 11:02:48

i am 69 and got my dual lead medtronic five years ago this summer. the surgery was fine with a little sedation i slept thru it. my temporary one tho was put in in a hurry and so i ended up with my permanent one on my right side breast tissue. because it is in my right side below the surface i don't golf but live in florida for five months on a golf course. lol at first i was an emotional mess. now not so much. i hardly think of it now. i go once a year for a check. good luck welcome! jessie

Comments

by ElectricFrank - 2011-03-01 01:03:49

In general the implant surgery is easy. I chose to remain fully awake during mine with only some local anesthesia around the incision site. Being a curious type I enjoyed listening to the banter in the O.R. and to experience the new pacer being turned on. My HR was down around 26 by that time and having it suddenly jump to a normal 75 or so was quite an experience.

The most significant part of the surgery as far as post operative pain is the "pocket under the skin to hold the pacemaker. The procedure is a bit brutal like tearing the skin loose from a chicken breast. It takes a few days for it to heal like any surgery. The 2 leads from the pacemaker are inserted into a large vein in the same area as the pocket, and threaded down into the heart where they are inserted into the atrium and ventricle heart wall. None of this is painful as there aren't many nerve endings in the areas.

The main limitation after the implant is a restriction against raising your pacemaker side arm above shoulder level for a few weeks to avoid any pull on the heart end of the leads. You should be able to use a white board for teaching as long as you limit it to your right hand. The same with playing the organ...just don't stretch your left arm reaching for the stops.

A suggestion many have found helpful in the first few days after implant is to sleep on your right side and place a pillow in front of you to support the upper arm. This keeps you from squeezing the new pacer pocket. I slept like a rock the night after surgery and never needed any pain killers using this approach.

I was 74 when I got mine. I also was very active right up to the time of needing it. The day after implant I walked about a mile, and in a few days was up to 3 miles. It was around a week later that I was out in the desert in my 4wd truck. Having it hasn't changed my lifestyle at all.

good luck and keep us posted on your progress,

frank

Welcome:)

by Pookie - 2011-03-01 08:03:33

To All The New Members...
Posted by Pookie on 2010-11-08 02:24

Hi & Welcome.

I've noticed a lot of new members recently and when I first received my pacemaker 6 yrs ago I had a zillion questions. I found this article and I post it from time to time as I found it helped me a lot. It's a long read, but full of really good information.

If I remember correctly, I got it either from WebMD or the Mayo Clinic website. Like I mentioned - It's a long read, but it just might help you feel a bit better :)

Living With A Pacemaker

Now that you have a pacemaker (or soon may get one), you may be wondering why you need one and how a pacemaker works. Your artificial pacemaker is a modern marvel; it's medical science's solution to the electrical problems of a slow or irregular heartbeat. But before you can understand how your pacemaker works, you first need to know a little about your heart. Basically, your heart is a pump made of special muscle. It pumps blood to all your body's cells. This is vital, because the blood carries oxygen and nourishment to keep your cells alive and healthy.

Your heart beats (pumps blood) because special cells in your heart (the heart's natural pacemaker, called the sinus node) produce electrical impulses. These cause your heart to contract and pump blood. The impulses travel from the pacemaker cells down certain electrical paths in the muscle walls, causing a contraction. As long as the electrical impulses flow down your heart's walls at regular intervals, your heart pumps at a rhythmic pace. Sometimes, though, something happens to interfere with how the electrical impulses of your heart's natural pacemaker are made or flow down your heart. When this occurs, the natural pacemaker can't do its job as well as it needs to.

Problems that change the heart rhythm include:

A complete block of the heart's electrical pathway
A slow beat
An irregular rhythm

If you have a slow and often irregular heartbeat — or if your heartbeat is sometimes normal and sometimes too fast or too slow — blood isn't pumped around your body well. In that case your doctor may recommend an artificial pacemaker. A pacemaker will make your heart beat more regularly. That will help ensure that enough oxygen and nourishment gets to your body's cells. An artificial pacemaker system has two parts: a generator and wires (leads).

The pacemaker generator is a small battery-powered unit. It produces the electrical impulses that start your heartbeat. The generator is implanted under your skin through a small incision. The generator is connected to your heart through tiny wires that are implanted at the same time. The impulses flow through these leads to your heart and are timed to flow at regular intervals just as impulses from your heart's natural pacemaker would.

Modern pacemakers last much longer than earlier models. As with any electronic device, your artificial pacemaker will require some care. The batteries, for example, will wear down over time and the pacemaker will need to be replaced. This is a minor surgical procedure. Your healthcare provider can explain it to you.

Most pacemakers work only when they're needed. They're called demand pacemakers. Demand pacemakers have a sensing device that shuts them off if the heartbeat is above a certain rate. When the heart is beating slower than the pacemaker rate, the sensing device turns the pacemaker on again. In this way, a demand pacemaker works something like a thermostat. The difference is that instead of working according to temperature, it works according to your heart rate.

As the batteries wear down, your pacemaker will slow down, but it won't stop right away. Using a special analyzer, your doctor can detect the first warning that the batteries are running down. This can be done before you can detect any changes yourself. A sudden, major slowing down of your heart rate, which you may detect, probably indicates a more serious problem. If that occurs, call your doctor.

Managing Your Pacemaker

Do your part in managing your pacemaker. You may have to have someone help you, but there are certain things you'll need to do to manage your pacemaker successfully. These include:
Understand your acceptable heart rate. Before you leave the hospital, discuss with your doctor the specific maximum heart rate above your pacemaker rate that's acceptable. Discuss the programmed lower and upper rate for your pacemaker, too. Talking about this with your doctor early in your treatment will keep you from worrying unnecessarily.

Take your pulse and keep a record for your doctor. Counting your pulse is a good way to check that your heart is pumping correctly. Every time your heart beats, it pumps blood through your blood vessels. By putting your fingertips on a point on the inside of your wrist or over an artery in your neck (as shown in the illustration), you can feel this beat (pulse). The number of pulse beats per minute is the same as the number of heartbeats. Count your pulse for one full minute, note the number of beats and see if it's in the range that your doctor told you was acceptable for your pacemaker. If your pulse is very slow or very fast, call your doctor. Use these guidelines for pacemakers and pulse counts:

If your pacemaker is beating regularly and at or above its proper rate, it's OK.

If your heart is beating close to or within the accepted rate but has an occasional irregularity, don't worry. Every now and then your own heart's natural pacemaker competes with the man-made one. Some extra beats that the pacemaker can sense electrically won't result in a pulse that you can feel.

If your pulse rate suddenly drops below the accepted rate or increases dramatically, call your doctor immediately. Your doctor will tell you what to do. It may be possible to program your pacemaker so it resumes working normally, or there may be some other problem.

If your pacemaker is installed for a fast-slow type of heartbeat and your pulse is rapid and irregular (above 120 beats per minute), call your doctor for more instructions.

If your pulse is beating faster than you've noticed before — but below 100 beats per minute — don't be alarmed.

Take prescribed medications. It's important to follow instructions and take prescribed medicine by following directions precisely. The reason is that the medicine works with the pacemaker and helps your heart pump regularly. Your doctor may ask you to keep a record of when you take your medication by marking a calendar.

Follow all instructions regarding diet and physical activity. Allow about eight weeks for your pacemaker to settle firmly in place. During this time, avoid sudden, jerky or violent actions that will cause your arm to pull away from your body.

Other warnings and information

Avoid causing pressure over the area of your chest where your pacemaker was put in. Women may find it more comfortable to wear a small pad over the incision as protection from their bra strap.

Feel free to take baths and showers. Your pacemaker is completely protected against contact with water.

Follow the program of activity outlined by your doctor.

Car, train or airplane trips pose no danger.

People with pacemakers can continue their usual sexual activity.

Perform some kind of physical activity every day, whatever kind you enjoy. You might try taking a short walk, or moving your arms and legs to help your circulation. If you're not sure about exercising, ask your doctor for advice. You may be able to perform all normal activities for a person of your age.

Don't overdo it — quit before you get tired. The proper amount of activity should make you feel better, not worse.


Report to your doctor if:

You have difficulty breathing.

You begin to gain weight and your legs and ankles swell.

You faint or have dizzy spells.

Tell physicians, dentists and other health professionals that you have a pacemaker. Physicians or dentists need to know that you have a pacemaker. Tell them about it before you have any work done. Notify the doctor or nurse where you work.

Modern pacemakers have built-in features to protect them from most types of interference produced by other electrical devices you might encounter in your daily routine. Household appliances such as microwave ovens, televisions, radios, stereos, vacuum cleaners, electric brooms, electric blankets, electric knives, hair dryers, shavers, gardening machinery, toasters, food processors and can openers won't affect your pacemaker. Most office and light shop equipment such as computers, typewriters, copy machines, woodworking shop tools and metalworking tools also pose no risk to your pacemaker.

If you suspect interference with your pacemaker, simply move away or turn off the equipment. Your pacemaker won't be permanently damaged and will resume its normal activity. Consult your doctor about special situations (such as working with high-current industrial equipment and powerful magnets). Surgical procedures also count as special situations. Certain types of medical equipment, such as magnetic resonance imaging (MRI) equipment, can also affect how a pacemaker works.

Always carry your identification card. In any kind of accident, your I.D. card will tell the people helping you that you have a pacemaker. Your card can be particularly handy if you travel by air. The metal-detection devices in airports may detect the metal in your pacemaker, although they won't damage it. Showing your card may save you some inconvenience.

Keep all medical appointments. To work properly, your pacemaker should be checked periodically to find out how the leads are working and how the battery is doing. Today many thousands of people have pacemakers and lead full, productive lives. Pacemakers are usually safe and reliable, but they do need to be checked regularly. The easiest way to check your pacemaker is to take your pulse. Taking medicine as prescribed and seeing your doctor regularly will also help. Your doctor can explain things you don't understand.

Hope this helps.

Pookie

Hi Janey

by Hot Heart - 2011-03-01 08:03:48

Welcome to the club. I think Frank's filled you in with most of the things that you need to know, he is amazing, great source of information.

Everyone is slightly different of course. I was an emergency pacemaker patient having had no idea that I'd any heart problems. I only went into hospital to have some liposuction on my legs. So I was devastated that something had gone wrong with my legs, after I'd saved up for a couple of years to get it done, and I didnt even know what a pacemaker was or why I needed it. So I felt very down at first and scared, because I didnt know what was happening. (Am totally fine now). So, sometimes there is an emotional side to this.

The actual op was perfectly fine. Lay on a bed a bit like a dentists couch, nurse held my hand, doc told me everything he was doing and I had the option to look at the screen if I wanted to. There was no pain, just a slight sensation of what he was doing. I talked to the nurse the whole way through it. After the op I walked into a side room and had a cup of tea, about half an hour later I ate a full dinner and pudding and went on the internet with the nurse. lol.

Now, after care. You dont stretch your arm up high - this is just to give the wires a chance to bed in, do keep moving your left arm though, just no stretching up high. Do some shoulder rotations back and forward and shrug your shoulders. Remember you are not an invalid, you just need to protect the wires.

Get rid of magnets you have around, like I had loads and loads on the fridge. You can use your mobile, your microwave, your laptop, all fine. No TENS machines or other vibrating devices. Watch out for things that you might have such as magnetic car seat covers, massagers etc. If something makes you feel a bit dizzy move away from it, then try it again next day, if it does it again then get rid.

I've never had any problems with speakers, and I go to lots of life music gigs, shop scanners, or anything like that. In airports I just show them my card and have never had the slightest problem anywhere in the world. I also worked in a prison for a while and the metal scanners there didnt affect me, however I always jumped through quickly.

Things like the wii its just trial and error.

Keep your site well moisturised, do it before your op as well to get the skin supple. Dont get into the habit of messing with your pm, if you dont start doing it you never will. Always protect that area with a good sunscreen so that the skin stays in good order, this will help healing if you need it opening up in the future, bio oil is good.

Lifestyle changes, none really that I can think of. In fact I would say that I do a lot more now than I did before my pacemaker. Loads of dancing, go to the gym, full relationship! lol. Ohh no powerplates at the gym!

Just take some time to read through old posts, look at comments made by others. And please remember that there are millions of people worldwide who have pacemakers who never have the slightest problem.

Do keep in touch, there are some great people on here.

HH

Hi Jaynee

by sallybags@email.com - 2011-03-01 09:03:17

Just had my PM implanted 5 weeks ago.Really an easy and uneventful procedure. I kept coming too in the OR and asking questions,so you do get lightly sedated. Before I was wheeled out I was wide awake and asking for food. No pain afterwards. In fact,since I had it put in I have a lot more energy and sleep better at night and wake up fully refreshed. Good luck and health to you.Keep us posted.

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The experience of having a couple of lengths of wire fed into your heart muscle and an electronic 'box' tucked under the skin is not an insignificant event, but you will survive.