pain and swelling in icd

hi, folks,

i haven't posted in a long time but i had a question that perhaps someone can answer.

i am a retired physician that had an icd implanted almost 2 years ago.
it has done a lot of good as far as improving my ejection fraction.
the problem i am having is that it has been somewhat tender every since it was placed.
lately it has been more uncomfortable and tonight it is downright painful.
it has been swollen, [getting more so] since insertion.
it sticks out like a post pubescent breast.
it seems to be aggravated by lying on my left side, i. e. more swollen and tender in the am if i have been doing that.
unfortunately due to shoulder injuries i have only 2 choices for sleep positioning.....the right or the left side.

i suspect that the pacer was not placed correctly as i had 6 weeks of bruising and inflamation that started 3 weeks after surgery and cleared with antibiotics, [or time].
also the surgeon stated that when it had to be replaced he would put it 'under a muscle', [i thought they always did.]

anyone have any ideas or suggestions.

thanks,

doc

3 Comments

Discomfort

by joy1 - 2008-12-16 11:12:30

Hi Doc,

Sorry to hear about your increased discomfort. You sound like you have an overall good attitude about having your implant. And, it's improved the quality of your life.

My ICD was extremely sore for most of the time I had it. When they went to remove it, the surgeon said the device had migrated about two inches from their original pictures of it. The pics they were going off of were from about a year after the device was originally implanted, not the original placement pics.

Now, to look at my breast, where the incision is, the device had actually moved down into my breast. Though the original implant had left plenty of wire to prevent the leads from being pulled out with regular movement, it did not accommodate the device migrating the way it did. By the time it was removed, I was in a tremendous amount of pain.

I'm not suggesting your problem is the same but device migration is a possibility. It would explain why your discomfort and swelling are slowly increasing. If your active, it can be irritating the muscle. That too, was another part of my problem.

Personally, I don't have any recommendations, dos or don'ts. Placing the device under the muscle is only one possible location to place a device. Do your research. I have heard mixed reviews about placing them under the muscle or in the abdomen. Good Luck and keep us posted.

joy

Pain

by ElectricFrank - 2008-12-17 12:12:15

Hi,
It sounds like something didn't go right on the initial implant. Is it in a position that gets a lot of pinching activity with movement. It is easy to place it a bit too high and have it pinched between the clavicle and shoulder with certain movements.
As for placing it under a muscle, that tends to be a more irritating position than under the skin. The surgery for under a muscle impacts a lot more tissue.
Having it stick out makes me think it has moved. The pacer has attachment points on it that are supposed to be sutured to the underlying tissue to hold it in place.
Finally, assuming it is located on the left side, try sleeping on your right side with a pillow in front of you to support the upper arm. This takes the pressure off the sensitive area. I used this the first night after implant and slept well without pain meds.

good luck and don't give up on it,

frank

thank you for your comments

by strobdoc - 2008-12-23 09:12:09

today my suspicion of the past 1 1/2 years was confirmed.

i have suspected a 'pocket infection', and finally a visiting cardiovasular surgeon confirmed it.
he put a needle in the swollen area and withdrew about 3/4 cup of infected blood.

now it is 6 weeks of iv antibiotics and a slight, [very slight] chance of cure.

2 attempts at placing a picc line today failed. so i guess that i take it from there........ damned depressing, especially at christmas.

merry christmas everyone.

doc

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