upcoming implantation of pacemaker

I'm 67 years old. Had an ablasion done 13 years ago which caused a second degree heart block 24 hours after the procedure. I was advised by all the doctors to put a pacemaker right then but decided not to do it. I never fainted or felt dizzy. At that time my pusle averaged at 45 bpm and now it's more 35. I have been strongly advised to finally have the pacemaker put in. The issue I'm struggling with is wether to put under the muscle or under the skin. The appearance really matters to me but safety is also important. Any advice? I'm pretty scared to do it all together. I've been living a normal life all this time with limitations of walking uphill and occasional sensation of skip beats.


3 Comments

placement

by Tracey_E - 2018-12-28 11:17:17

Thinking you are fine and actually being fine are two different things. Having a heart rate that low is doing damage to your body whether you can feel it or not. In my case, I found out once I was paced that I didn't feel nearly as well as I thought I did before. I went downhill so gradually that I didn't realize how bad it was until I was better again, and we tell ourselves a lot of lies when we don't want to have the surgery. Whether you feel different after or not, your organs can't thrive without oxygen. 

Mine is subpectoral and I love it. It's out of my way and I can forget it's there. Downside is it's a more invasive surgery so we are more sore after and it takes longer to heal. Small price, imo. One placement isn't riskier than the other, it's a matter of preference and priorities. Sometimes they can do it lower and deeper without going under the muscle, depends on your build. Talk to your surgeon in advance, make sure they are clear on what you want. My surgeon understood that I wanted it out of my way but he didn't want to mess with it so he brought in a plastic surgeon to assist. Easiest job of the day for the plastic surgeon, making things look and feel good is what they do.

Placement

by Theknotguy - 2018-12-28 11:34:00

Unless you have a really good reason for under muscle placement, I don't see any reason not to do the under skin placement.  I'm coming up to age 69, have the under skin placement and can do almost anything I want.  Limitations are on the heart side and not on the pacemaker side.  I volunteer at a charity wood shop  where we make furniture and run all the equipment in the shop.  Volunteer at a 1300 bed hospital where I get between three to six miles a day just walking around the hospital.  I do all the home maintenance - lawn mowing, car washing, moving stuff, etc.  Have traveled over to the UK, up to Canada, and over most of the  Eastern US.  All with the pacemaker.  Took the dogs out for five miles of walking yesterday.

As for the pacemaker sticking out, you won't notice it unless I have my shirt off and you can see the implant scar.  I know it's there and all my medical people know it's there but no one else does unless I tell them.  I was telling another volunteer at the hospital about my pacemaker and he said it was a shock as I was otherwise  the "picture of health".  Hah, did I have him fooled!

If you were as physically active as TraceyE I'd recommend the under muscle placement.   However, I'm not as physically active (or as young) as she is and I get along fine with the under skin placement.  Not to mention the under skin placement heals faster.  It's still your choice.  

Hope everything goes well for you.  

activity

by Tracey_E - 2018-12-28 21:21:04

Yes, I'm very active. That's part of why I like mine buried, it never gets in my way when I lift weights, kayak, do a ropes course. When I got my first one, however, I was not at all active. My condition is congenital so the pacer is what allows me to be active.  I was very underweight and young so the reason it was buried was 100% how it would look and feel. Having the incision off to the side, having the box buried so there is no lump, means I can wear a tank or strapless dress and no one would guess I have a pacer. When I was 27, I cared. Now, not so much, but it's nice knowing my scars rarely show and there is no bump. 

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