Coping

Living after pm

by TBrous&Chip - 2017-06-27 08:14:32

 I was 64 and in good health except for ongoing syncope when I received my pm..  No meds then or now.  My heart stopped twice during the pm install.  Based on my excellent quality of life I am happy that my heart was restarted.

When it is time for a replacement I may feel differently depending on my quality of life due to health issues that may have cropped up.

I do understand your issue. Since you are a runner I will assume you are a healthy individual.  Try to think of your pm as a way to continue your lifestyle and not a hindrance to continued living. If you never went for the procedure your lifestyle likely would not be good and you might still be alive but debilitated.

Based on everything my physician knew about me he decided to restart my heart and I am glad he did and evidently you physician believed the same.

pacemaker

by cath19 - 2017-06-27 08:44:05

Hi I had my first pacemaker fitted when I was around 31yrs old and I am am no cpr etc however my children were very young and I am glad I was able to have this at the time it does not solve everything but it gave me a better quality of life just remember if your heart decides to fail having a pm does not guatantee that it will save you. Now I have grandchildren and whilst I am frustrated about decline in health and certain challenges I do not regret having it done, Enjoy life and make the most of it

Coping

by Juliedawn - 2017-06-27 09:04:12

Thank you both for your insights

heart block

by Tracey_E - 2017-06-27 09:11:59

I'm not sure what you're asking, are you wigged out by having the pacer or that you went into vfib and were defibrillated during the surgery? I don't think it's common for that to happen. 

Your runninng stamina should improve drastically once you heal. 

Coping

by Juliedawn - 2017-06-27 14:26:49

TraceyE.  The defib is what wigged me and now consequently the pm.  I thought i had covered my basis put everything in writing.  As a provider, i follow advanced directives.  My mistake seems to be thinking others do to.  I feel like i have interferred w a greater plan. 

Julie

by IAN MC - 2017-06-27 16:11:09

Sorry to appear stupid but I don't understand where you are coming from.

Could you explain why you would want to refuse measures which  may allow you to become a 54 yr old runner. CPR essentially  is utilised in an attempt to preserve intact brain function. This and defibrillation could help you carry on running  for many years to come . You obviously know the alternatives , why are those alternatives more attractive ?

???????????

Ian

plans

by Tracey_E - 2017-06-27 16:11:33

Maybe the greater plan was for you to be defibbed, get paced, and keep going? Me, I'd take it as a sign that God isn't done with me here yet. 

I haven't read the details of my advanced directive in a while, but there's a big difference between putting me on life support when there's no hope of recovery and quickly correcting something that went wrong in surgery.  I don't think defibbing counts as resuscitating so I don't think it would be covered under advanced directives. No doctor in their right minds would allow you to go into vfib during a procedure and not stop it.

Coping

by Juliedawn - 2017-06-27 16:51:47

I worked in a trauma icu for sevetal yrs as a trauma nurse before i went back to school for my doc.  I have an extremely detailed adv directive of basically no defib for any reason, no blood, tube feeding etc.   I had reviewed that w the doc before the pm.  He said no problem.then defibbed me. I have not worked on someone because of their wishes such as not giving blood when it would have "saved" someone.  I am guessing others have not been so bothered by this type of issue.  I appreciate all the comments

SCA

by islandgirl - 2017-06-27 22:48:38

I had a pacemaker for sick sinus syndrome.  Immediately after arriving to the waiting room of my EP's office had a cardiac arrest immediately after checking in with the receptionist.  A waiting patient alerted the receptionist behind the closed window.  I had CPR for 20 minutes, the first 10 min. asystole, then 10 min in vfib, and 5 shocks from Fire Rescue and drugs---AED wouldn't work.  The pm revealed I had gone from vtach to vfib to asystole very quickly.  My EP's immediate and effective CPR saved me.  After a couple of months and many tests, I ended up with a defibrillator, and also found I had been having vtach the 1 1/2 years I had my pm, but wasn't revealed in interrogation.  I received an ICD after a couple of months, protected by a life vest before receiving the ICD.  Cause was hereditary--no heart disease or scarring.  It wasn't my time to be taken from this earth----I had driven 1 hr 45 min to appt and had stopped for an errand before the appt.  I am lucky to have suffered no deficits.  I haven't been shocked, but have been paced out of ventricular arrhythmias.  I feel fortunate I can continue to live an active life and continue to work. Your comments have given me a lot to think about, and this event has definitely changed my life and attitude.  It was also very traumatic for my EP and his staff, as I've been going to the EP for 18 years.  I am grateful every day.  I had no advanced directives at the time, which could have been a disasterous end of life for me with no family as well. Stay well!

Advanced Decision making

by Selwyn - 2017-06-29 12:43:53

The legal process I suspect is different from the UK.

Was your advanced decision in writing?

Was it witnessed and dated?

Were the circumstances of when you lacked capacity made clear?

Did the medics have your detailed notes to hand at the time of the emergency to aid their decision making?

etc.

Best interest rules apply if guidance is not valid. 

Are you asking for the PM to be removed?

My Advanced Decision document is dated and witnessed ( by a doctor) and comes to 3 pages. I keep it with my Will, and also on my desktop.

Your family should be involved with the drafting of such a document.

There is ample on-line guidance as to the law and how to draft your Advance Decision document. GIven the long term,  terrible state some patients find themselves in, I think an Advanced Decision document is sensible for anyone over the age of 50 or attending hospital for serious illness.

Selwyn.

two questions

by dwelch - 2017-06-29 22:42:12

I am hearing two questions, well one question.  Have others had defib on the table during the pm surgery.  I didnt ask, was in twilight sleep, but they did put the pads on my back before the surgery just in case.  I dont have any orders to not have those procedures.  I honestly didnt think to ask, was not one of my concerns. (have had five of these now nobody ever told me I had needed it, and didnt think to ask until now)

The other side of this is purely legal your doctor not only knew about but admitted to violating your written desires.  As far as that goes you really have to consult with a med mal lawyer if you want to pursue that.  With the obvious side effects of having to find a new doctor, and maybe having this black mark in your file for following doctors to see and possibly not want to deal with you.

And then there sounds to be a third angle and that is personal beliefs.  That you have to take up with another individual or set of indivuals related to that belief system.  Prayer, preacher, rabbi, etc.  

I have contemplated the no cpr after hearing what you have to actually do to the body to really recover the person not that the odds are good anyway and that many in the medical profession have no cpr.  But no defib I am personally more comfortable with, particularly on the table when the unplug one device to plug in the other, and the pads are wired and ready to go.  No cpr, but what if I am in the middle of open heart surgery, the ribs are already messed with, the heart is right there they are not breaking ribs they can just massage the heart.  so maybe you needed a clause about being on the table in your orders, or maybe you have a genuine case.

I would like to think that whatever your personal beliefs are that you did your best and someone else changed your course and you wont be faulted for it by your belief system on judgment day.  They are the sinner not you.  I think you will be forgiven for this one...