Don't Give Up

• by SMITTY
• 2009-09-27 09:09:49
• General Posting
• 1385 views
• 9 comments

I started to write the message below as a comment to a question Gracie posted about PVCs, but I got side tracked and just found my unfinished comment. Since Gracie has gotten her question answered and I think of what has happened to me (it is good for a change) with my PVCs, I decided to post it here with the thought it may give hope to some that must be as unimpressed with the results from their pacemaker as I had become. This is long and for that I apologize, but I simply do not know how to write short stories. But, just remember you can quit reading when you get tired which is unlike me, I had to finish my story.

PVCs seem to be a nemesis for many of us with pacemakers, or any other heart disease. I was never aware of having a PVC prior to a heart attack 27 years ago. I had a few skip beats, nothing to even ask questions about. Then the heart attack and a few weeks later quadruple bypass surgery and irregular heart rhythm became very common. Over the years they would go from being a real nuisance to something that happened infrequently. At one time or the other I've been told to spot about everything but breathing to see if that would help. I got my pacemaker in 2000 and while it didn't reduce the irregularities, it didn't make them any worse. Then I had something to come in out of left field a couple of months ago that have almost brought them to a halt.

I mean the PVCs, PACs and skip beats were so frequent that about 6 mo. ago an echocardiogram gave the doctor essentially no definitive information so he ordered a MUGA, with the same results. The good doctor then ordered 35 hours of EECP and if you are not familiar with that one, Google EECP and read until your heart's content. It is an interesting procedure and I can see the logic behind it, but I failed again, I was bouncing around on the table so bad because of the arrhythmia I had to call it quits after two weeks. That was in March and until June, things were really bad. Due to the arrhythmia and the associated chest pain, especially when my heart rate dropped to mid-40s (about 25 BPM below the low set point on my PM) my physical activity was reduced to little more than moving from chair to chair or to this computer for short periods of time. My doctor saw me as such hopeless case that he told me that all he knew to do was recommend that I talk to the Master and be sure all my affairs were in order. I didn't ask for a time line as I refuse to believe doctors that suggest that I may die soon. He was the fourth one I've heard such from since '85. Now I know one day some doctor will be on target, but not now, I'm too busy.

Then a couple of months ago I decided to contact Medtronic and set up an appointment with one of their Reps to see if there were any adjustments on my pacemaker that could stop it from letting my heart rate drop into the mid-40s much too frequent. They set up the appointment with their representative Jessica along with Jose a tech from the pacemaker clinic I use. The three of us has a good discussion about what was going on and what could possibly help. My input was a request that the low set point be increased from 70 to 80, although I had no solid foundation for wanting that, it just seemed like the right thing to do. They agreed and Jessica said in addition let's restart the rate response, while Jose was busily checking records and clinic procedures to see what could be done without our having to consult a clinic doctor. I didn't want a doctor present because I knew one would just muddy the water. Jose didn't want one present because he would have to defer to the doctor's wishes and could no longer be free to offer input. Jessica didn't really care one way of the other as long as something was done that she could report to her bosses.

A quick side note here. When I arrived at the clinic that morning I had to walk about 150 feet in an A/C building. Even with that little walk I had to stop and take a nitro for chest pain. About 15 min after the changes mentioned above were made and we started out, I had no pain and felt like running, although I knew better than to do that. My wife did keep telling me to slow down as opposed to her offering to get me wheel chair several times when I was walking from the car to the Clinic.

My life changed completely after those settings changes. I did have to return a month later to get the rate response "de-tuned" a little, but nothing major. Yesterday I returned from another echocardiogram and throughout the entire test (which must have been 20 to 30 minutes at least) I did not have a single PVC and had only one skip beat. This is the same doctor that told me I should have a conversation with The Master and he kept looking at the film of the test and saying he couldn't believe the difference he was seeing. He would never admit that all of my improvement was totally due to the PM settings changes, but he couldn't deny it either. The nearest thing to an admission that it may be the PM changes was when he said "it is strange how increasing the low setting just 10 BPM and tweaking the rate response a little could cause that much change."

But it did and like I told the doctor the other day, it took nine years to get the right setting for me, but I'm very glad it finally happened. I guess if there is a moral to this story it is never give up and keep asking questions and keep saying "why" when you don't get the answer you want or understand.

Now don't get me wrong, I'm not about to enter any marathons, but I no longer have to stop and think will this activity be more than I can handle? I am back to living the normal life of an old and tired 80 year old.

Smitty