Back again back again clippity clop

Which should probably be: back again back again tickety tock.

Because my pacemaker is going tickety tock at 60 bpm. (Quick update for those who haven't seen me here before: put in last autumn with an AV node ablation to relieve 15 years of increasingly unacceptable AF symptoms not controlled by drugs -- I'm still in AF 100% of the time but my heart is beating regularly now).

Thae pacemaker still wanders as it sees fit -- up down left right -- but doesn't cause any real discomfort , just a vague ache occasionally. Nothing I'm going to fret about. (Not like my initial experience when they had to reposition it to stop the pain and numbness in my arm).

However, the two symptoms of AF (or maybe not) that caused me the most problems were breatlessness and extremely swollen legs.

The breathlessness is improved -- I can come downstairs in the morning and unload the dishwasher without need to sit down for half an hour first (after a few go-rounds of PM adjustments). However, I am still breathless on exertion or bending over. Might be lack of fitness after 15 years of being a forced couch-potato. Or it might not be. I'd work on the lack of fitness if it wasn't for the second problem.

I still have really badly swollen legs -- up above the knee, painful feet, weeping if the skin is broken, the whole number -- and there's a limit to how much time in a day I can spend with my feet up before I go nuts. I wake up with them. I go to bed with them. I'm fed up of them (and of the increasing load of diuretics).  I had precisely one day free of oedema (the day after the PM went into action following the AV node ablation).

The EP/device clinic have investigated and said 'not us Guv' (although they have spent a lot of time with the PM settings trying to eliminate the problems -- can't fault them for not trying) so get your GP to refer you for another cardiology assessment. Which he has done and I'm waiting for the appointment to come through. One thing the EP mentioned was possible pulmonary hypertension, based on echocardiogram results over 4 months.

So: that will be one thing I'm asking about when my appointment comes through. But is there anything else that the group mind thinks I should be asking about?

 


2 Comments

oedema lower limbs

by Selwyn - 2019-07-03 13:37:16

1. Heart not pumping properly

2. Kindneys not working properly

3. Liver not working properly

4. Lack of protein, and some vitamin disorders.

5. Poor venous return ( eg. obesity, pregnancy, tumour, bad veins, prolonged sitting, especially sleeping overnight in a chair,  parasites,  etc.)

6. Medications ( notorious are calcium antagonists, steroids)

7. Endocrine ( glandular system)  disorders. 

8. Local inflammation ( eg.. infections, allergy)

9. Born with poor lymphatics.

Plenty of things to ask about!

That is just about all I can think of at present. 

We tend to use layered pressure bandaging to treat the symptom, once the cause has been eliminated/corrected. That means having a trained nurse apply the bandage to the right pressure, having established you have decent foot circulation beforehand).

See: http://www.worldwidewounds.com/2005/march/Moffatt/Four-Layer-Bandage-System-Part2.html

By far an away the best treatment, and the foot of the bed should be raised at night a bit ( a few pillows under the mattress), though make sure your heart is pumping OK otherwise you will get pulmonary oedema! Not nice!!!

Another question?

 

Thanks

by atiras - 2019-07-03 13:58:32

Kidneys and lungs are functioning ok, at least according to regular blood tests. Doubt it's lack of protein or vitamins... my diet is good. Obesity -- well, yes, after 15 years of being able to do sweet nothing physically; one of my objectives is to get more exercise but that's hard when your legs are swollen -- vicious  circle. I do sleep with my feet elevated... and I've had three bouts of pulmonary oedema since the PM went in.  Sigh.

 

 

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You’re officially battery-operated.

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In fact after the final "tweaks" of my pacemaker programming at the one year check up it is working so well that I forget I have it.