3 month post-op, too thin @ PM site

Today I had my 3-month post op check. Most things are going well. I had one significant dizzy spell 2 weeks ago, and they made a PM adjustment they think will take care of that. Because I'm back to running, my resting heartrate is dropping, so my PM kicks in more often -- 15% now instead of 5% at the last check. So they lowered the bpm to 50 instead of 55, as they say 50 is still safe for me. I've posted responses to a couple women who are still having pain at their PM site and are too thin there, worried the PM is too close to the armpit, having range of motion problems, etc. I'm having that same problem. I discussed solutions with my EP today, and he referred me to a General Surgeon who specializes in various surgeries involving breast tissue. He says my problem is not cardiac and doesn't involve the electrical leads, but he thinks it might help to move the PM to a location with more tissue protection to avoid skin erosion, pain, range of motion limits, etc. He does not think moving it under the muscle is a good idea. But he says he's done surgery on his patients WITH this General Surgeon a number of times to move the PM "under the breast" -- not directly under the middle, but under the tissue on the top of the breast, rather than high up under the collarbone. I have a consultation appointment scheduled with her in 2 weeks. Has anyone had this kind or surgery, and did it solve your problem? I dread the thought of more surgery, but am not happy with current results (other than I'm not fainting and can drive again, of course) and this surgery would not involve the electrical leads at all. Thoughts please? Thanks PM/ICD friends! Hope things are going well for all of you, Cathryn


1 Comments

ICD placement

by Meerkats - 2007-05-01 09:05:06

Cathryn,

I'm a small women without any real thickness around my collarbone. When I got my PM last June, I was very concerned about it sticking out and impacting movement, but my doc and I didn't think we wanted to go under the muscle. He said he was convinced he could put it in a place where it wouldn't impact my looks or movement.

I was shocked, but he hid it wonderfully in the swell of my breast between the center of my breast and the center of my chest. Other than the scar or if I went feeling around, you really couldn't see it and it didn't impact movement much at all. I mean, in certain movements, you feel that it's there, but it's not painful.

I had to have an upgrade to an ICD in January (long story) but I was worried about the placement of that too since it's twice as big as a pacemaker. Again, my doc told me to trust him and that he would work hard to hide it (I'm relatively young and I suppose still vain). Again, he did a fantastic job...you honestly can't see it at all, other than the scar. I'm amazed knowing how big it is. This time, it's hidden in the top area of the breast more toward my armpit. When I raise my arm I can feel the edge on the very side of my breast. By the way, I'm not large busted at all either.

Just be aware that mammograms prove challenging when they're in this position. I had my first one a few weeks ago and have to return so they can follow up with some additional views and ultrasound to make sure they can get around the device. I was assured by my EP that the mammogram itself won't damage the device or wires, it just makes it more challenging to get good views. For me, it's worth it.

I hope it all goes well for you. I didn't have a choice to have to go through recovery twice in 6 months, but it wasn't that bad and worth it to be safe and look good in the process. Since you wouldn't be getting new leads or anything, it shouldn't be that bad for you.

Good luck and keep us posted.

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