Day 8 post gen replacement and more fatigued now than I was in the beginning

Hi all, I posted here before but I'll repeat relevant information. I'm 59 and had my first pacemaker implanted when I was 41. Last Wednesday, September 8th, I had my second generator replacement. This time, they put in a different PM. I've suffered from fatigue ever since I had the first one implanted. The thinking back then was that this was due to dusautonomia which I was diagnosed with later. However that is pretty much resolved and I remained fatigued, extremely! And I spoke with a new cardiologist last year and he pointed out that my heart rate variability is extremely low because my PM does not have a very good rate responsiveness sensor. So his suggestion was when my battery runs out, to put in a PM with a better rate responsiveness ability. So the new pacemaker they put in last week is one that has a much better rate responsiveness ability. I am optimistic that once everything gets settled, I'll be feeling better than I have in 16 years. I really hope, pray, that's the case! I'm posting here because on day seven and now day eight post surgery, I am exhausted! I'm in bed all day, and I'm not really hungry, the most I can do is take my dog for about a seven minute walk. And that is very difficult. The thing is I felt pretty good on day four, five, and six. I was able to get up and dressed and bathe, chat with friends, I was able to follow movie plots (now I get confused because I'm tired), And I had a great appetite. The incision is healing fine and I have no fever. My heart rate looks good and my blood pressure looks okay. Due to my dysautonomia, my blood pressure does tend to be quite variable, But my dysautonomia has been much better, almost resolved. I'm wondering if this is just my body reacting to a new device, with new parameters (I go in next week for them to reprogram it as needed). I still haven't returned to work, and I really need to do that as I'm out of sick leave. I'm just wondering if others have experienced this and if you think my hypothesis is reasonable. By the way, I take 60 mg a day of methylphenidate for energy (which I'm really hoping I'll be able to stop once this pacemaker kicks in), And even with that, I'm just lying around in my jammies. Thanks for any wisdom, Kathy



by AgentX86 - 2021-09-16 23:19:10

I think you answered your own question.  Your last PM wasn't adequate because of its poor rate response.  You now have a "better" PM and it still doesn't work well.  When they implant pacemakers, then tend to leave the default settings.  You seem to be very sensitive to the RR settings, which they probably haven't done anything with yet.  It's possible that they haven't even turned RR on yet.  Make sure your doctors know that it's not acceptable as it is and push for a tuneup as soon as possible.

Keep Us Posted

by MinimeJer05 - 2021-09-16 23:32:16

I hope you get the answers you seek when you go in next. Keep us posted on your progress and results -- I am very curious to hear what you find. 

I'm going on the start of 3 weeks since my surgery and while I physically can walk fast and start to move my arm fine, I'm still incredibly tired all of the time and my vision just seems to act up whenever it wants. I've been working from home and having wife drive me to quick store outings, otherwise I live on the couch and it's definitely starting to take a mental toll on me. 

I hope you get your fixes and back to work soon!



Methylphenidate and autonomic dysfunction - Dysautonomia

by Gemita - 2021-09-17 04:29:21

Not all symptoms can be attributed to, or fixed by a pacemaker.  I would consider discussing your med Methylphenidate with your doctors as a possible cause for some of your continuing symptoms.  Perhaps they might be able to offer an alternative therapy for your health condition. 

I am glad your open, nasty looking wound is healing nicely now.  Let us hope some pacemaker adjustments will be the solution to many of your problems, particularly your fatigue, although your autonomic nervous system has probably gone into overdrive again following your recent procedure, so perhaps allow yourself a little more time to recover and get used to your new device

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