Upcoming surgery

I have been coming to this site regularly for some time, but this is the first time I have needed some advice. In November of 2010, I became the owner of an Evia Biotronik pacemaker for complete heart block. As of my last interrogation in May, I am pacing 85% of the time in the atria and 97% of the time in the ventricle. My little computer and I have been doing well together, but something came up last week that concerns me.

I was sent to an ENT to check for Meniere's disease. While that diagnosis is still up in the air (if I do have Meniere's, it is too early in the manifestation of the disease to test and make sure), the doctor also found a nodule on my thyroid. Ultrasound showed it to be over 4 cm., so out it must come. I get the biopsy results next week, but with a nodule that big half of the thyroid is typically removed and biopsied for other types of thyroid cancer that cannot be determined by needle aspiration.

My concern is how close the pacemaker is to the surgery site. It is under six inches away and they use electrocautery for the procedure. I called my cardio for an appointment for surgery clearance and requested at that time that they record all of my current settings just in case the EMI reprograms my friend. Since I received that tip from reading comments on Pacemaker Club, I thought it would be wise to see if there is anything else anyone can think of that I have not thought about. I go next week to talk to the surgeon and get my biopsy results and have visits with the cardio and GP all lined up this month, so I can ask questions of everyone but the anesthesiologist in the next couple of weeks.

So folks, any suggestions? I appreciate any insights, experience, or suggestions you may have for me right now.

Thanks,
Carol

3 Comments

What more...

by donr - 2012-08-11 06:08:00

...can you do? You have all the appropriate people lined up w/ the correct questions to be addressed. Just make sure that the anesthesiologist you talk with is the one who is actually there. They have a very nasty habit of pulling "Bait & switch."!

The anesthesiologist is the key - he/she coordinates life support, which includes the PM.

You need to ensure that a tech for YOUR PM is available. Preferably scrubbed & in the room when they are coming so close to your PM & especially w/ a bovie.

Don

Good point

by cohara - 2012-08-11 07:08:07

Don,
I will be sure to have my cardio have the tech on board. I have worked with the same tech from the beginning, so it should be an easy request. The anesthesiologist probably will be a meet and greet right before surgery. He'll be whomever is on duty that day at the hospital. I'll add that to my list of questions for the surgeon and be sure I make a list of things to go over with him. I might forget in the turmoil of pre-surgery. I will definitely follow up on your suggestions. Very much appreciated.

Angry sparrow, thanks for the support. I had no preparation for my pacemaker surgery--it was a case of diagnosis and emergency surgery within a 24 hour window. I'm not sure which is worse, surprise or educated waiting. I am mentally prepared for the worse, but I won't buy trouble. Worrying too much over what might be seems a waste of energy. It is hard to turn off the subconscious brain, but I'm getting better at it.

Carol

Something you MUST read...

by donr - 2012-08-13 09:08:11

...your life depends on it!!!!!!!!!!!!!

Not a statement to be taken lightly by a person who will be zonked out for surgery w/ a bovie being used w/i inches of her PM.

I stumbled on THIS by accident while Googling for info on another question two nights ago. It is written for the host to a PM who is is plagued w/ COMPLETE HEART BLOCK.

Let me insert a "brief" sidebar here to tell you of two incidents I've had w/ anesthesiologists. I am NOT a complete heart block patient; I am not 199% dependent, but I have experience w/ some of what the author writes about. Shoulder repair surgery. Very carefully discussed this issue w/ my anesthesiologist du jour who wandered in just before my surgery. Oh, yes, he says, I'm up on PM's. If they are going to get close, I'll just stick a magnet over it! Great, I said, naively, and went into surgery relaxed & stupid. And just for laughs, try this - the anesthesiologists tells me that my surgery will start on HIS shift & another guy will take over when his shift ends sometime while I'm on the table. OMG was I stupid, dumb & uneducated.

Second, I had a big toe repaired last month - now how far can you get from the PM & still be in the same body? Anesthesiologist du jour came in - a bait & switch guy after the one I talked to in my pre surgery conference told me specifically that he would do me. We started from scratch on PM's. He seemed to be educated on them & electrocautery. Had the same discussion w/ my surgeon, who was also savvy. Much moreso than "We'll just stick a magnet over it." So I went into that one w/ much better knowledge. End sidebar!

READ IT ALL! Every last word of it. It'll tell you why you want to discuss the surgery & your PM w/ the anesthesiologist very carefully & have a PM tech THERE. Also, get a download immediately afterward of your settings - BUT - even more important, have someone you trust know exactly what is happening & be prepared to check the post-op download for ALL correct settings, especially the MODE switch. Face it, you will be in no mental state to do anything for several hours & this must be done w/i literally minutes of you being out of the OR.

This is going to look assinine to you for the first few pages, but it is written by a smart Dr, for a bunch of dummies. You will scratch your head till you get to page three or thereabouts. But be of good faith & patience - you will see why it it so important to you. I have copied & pasted the URL below & it worked for me. Good luck!

http://www.cardiacengineering.com/pacemakers-wallace.pdf

Good luck!

Don

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I've seen many posts about people being concerned about exercise after having a device so thought I would let you know that yesterday I raced my first marathon since having my pacemaker fitted in fall 2004.