1st check up

First checkup

by LondonAndy - 2018-01-21 06:22:32

Hi there, and welcome to the club!  I have had a pacemaker for about 3 years now, and not had any problems but have also learnt a lot from this site, which has some wonderful contributors.

Actually, although it is a shock to need a pacemaker, I think often it is good that it is inserted very soon after you find out you need one.  I have seen many posts from people very anxious about what is going to happen, and why they need one.  But if it happens quickly there is less time to worry.

Why do you want to know the time your device was inserted?  It is not important, and does not help with calculations about when the battery will be going low and you need a replacement.  At your annual checkups they will look at the battery voltage and estimate how much life is left.  This is quite vague, and you will probably find their estimates inconsistent from one year to the next, but this doesn't matter: as the battery voltage starts to drop in a few years time, they will increase the frequency of checkups and arrange a replacement before the voltage goes too low.

At the first checkup they will check it is working ok, and may adjust settings.  So they may ask you how you feel, and you should say about the "feeling alert" at night. You are probably correct in thinking it is just because your heart is now working better though!  But if you feel tired during the day, or find that you are short of breath at any time, they need to know this and may adjust settings.  There are several things they can adjust: from the minimum number of beats per minute (BPM), to the sensitivity of "rate response" (where the pacemaker increases the BPM in response to your physical exertion level), and also the time delay between when the device triggers one chamber after the other.  Think of it as fine tuning.

You may want to ask what percentage you are being paced.  Again, this doesn't really matter - the device just kicks in when it needs to in order to keep you functioning correctly, but if you are being paced more then your battery life will be shorter.  (I am 100% paced, and at my third annual checkup they estimated the life left in my medtronic at 7.5 years, meaning overall it might last around 10.5 years).

You should have been given a Pacemaker Identity Card when it was inserted, which you need to carry with you all the time, especially when you fly.  If they didn't give you one for some reason, ask for it at the checkup.

I am gay, so this last point is not a problem for me, but I have noticed that female pacemaker technicians are very beautiful, so try not to get too excited at your checkup as this might confuse the test results .... ;)

Thanks!

by Smitty2.0 - 2018-01-21 16:00:23

Thank you LondonAndy! Great advice from top to bottom! Especially the last comment...hot nurses can be distracting! I was more curious to know if they can get the day and time off your PM as to when it paced?? 

Cheers!

What to ask

by Gotrhythm - 2018-01-21 17:12:06

Do tell them about waking up at night, and if you can, tell them what time you wake up. It is possible that if something is going on, it is being recorded. (You pacemaker doesn't record everything. Only what it is programmed to. Still, it's always worth asking.)

If you don't already know, you need to find out what your base heart rate is set at, and also the upper setting. Also, you might want to ask if rate response is turned on.

These are just bits of information that can be handy to know. Younger people like you often are making more activity demands on their pacemaker than someone older and more sedentary. Sometimes younger people can benefit from having their settings tweaked so that they get optimal performance.

The more specific questions you ask, the more information you get, and frankly, the more respect you get.

Ask for printout

by Paced2017 - 2018-01-22 19:51:23

I had a similar problem to you in the beginning, and was lying awake at night unable to sleep. At my first check-up they reduced the night-time base rate from 60 to 50 and this helped. But I'm not sure if all pacemakers have the option to set different rates for night and day (mine is a Medtronic Advisa).  Just giving your body time to adjust may help too. Otherwise it's been smooth sailing for me and I trust this will be the case for you to.

At my follow-ups I ask for a printout of the pacing histogram and this shows how much time is spent pacing in both the atrium and ventricle since the last interrogation. Or you can just ask about this. This is just for my own personal interest and not something you really need to know.

Good luck!

printout

by tobydell - 2018-02-07 11:50:31

Well Paced2017 that is interesting my DDD is 60-130 which I understand to be the BPM range for pacing, this is a CRT-D which absolutely does the job I was hoping it would, but my RHR is often 48 or 49 overnight and I wondered if my 'base rate' could be reduced to 50, I will ask at my first checkup, which is in a couple of weeks time

It is interesting how previously bpm was not something you (I) were aware of as a specific number, but 34 months ago when my cardiologist suggested  that I might benefit from biventricular pacing and he explained what it was not only did I think; yes that makes logical sense and I recon I would like to have one fitted, trouble was though they wanted more details, MRI, angiogram then another MRI and finally a new cardiologist before they said OK you are on the 'list' so I have now been switched on since the 3rd Jan and not only does it work but I am so much more aware of my heart rate than I was before, I have a Huawei fit which monitors 24hrs and provides a report which makes really interesting analysis

Recently (last week) I was visiting the Caves of Nerja in spain, around 19c you end up getting lower and lower so the exit is all up stairs quite a long way, about 1/2 to 2/3rds of the way up I had to stop, to get my breath not too bad but enough of an energy loss to induce the pause in climbing, afterwards I discovered my heart rate had gone up to 139bpm, which if my device paces between 60 and 130 would kind of make sense that I needed a break, enough to drop my rate back into pacing mode to allow me to continue, as yet I dont know if they will change any of my meds which I believe are designed to restrict the 'amount of work' it does, but they were prescribed before the implantation, But there it is everyone is different, the more you are able to understand about your own condition the better you are able to manage it,.

New pace maker just put in

by Daver - 2018-02-25 15:39:56

I have a new pace maker just put in last week. I am 70 year old male. Otherwise in general good health.  But still fatigue, swelling in feet and legs, and t(3 legs kind of feel heavy.  Sleeping on a right side with a sling is going to be tough task for 6 weeks.

anyone has any advice, suggestions for me, please

thanks