Arm movement limits after pacemaker insertion?

Hi I am due to have a pacemaker on 30th November, and have just received some leaflets on what happens after surgery.

I am now worried how I will manage as I use a self propelled wheelchair (due to syncope, no motor deficits) and rely heavily on my arms and upper body. I am also a swimmer and run on an alterG treadmill. 

It would be awesome if the pacemaker enabled me to stand without fainting but I am realistic in my expectation and would be thrilled just to be less lightheaded sitting and to be off propantheline.

I have read such different advice regarding moving your left arm, ranging from 4 weeks of no vigorous arm movement (no definition given) to avoiding any repetitive arm movement on that side for life! That would leave me needing a power chair.

Please can somebody help me out with what to expect in this respect?

Thanks x


Not to worry

by AgentX86 - 2021-11-18 12:35:15

Welcome to the club.

Don't worry about arm movements. It's  only a caution and only for the first few weeks. Your doctor will give you a time-line.

In those first few weeks, try not to reach above your head, behind your back, or overextend your arm. You'll undoubtedly forget and do it anyway. It's rarely a problem and really for only the first few days. If a lead did pull out, it wasn't implanted right (it happens). The four or six weeks is just being conservative.

After that, extreme extension (full golf swing, tennis serve, some swimming strokes) should be avoided for, from thee to six months. Again, your EP should give you guidance.  After that, have fun and go for it. There will only be a few things (countable on one hand) that you should avoid.

Make sure that you keep you arm and shoulder moving from day one. This is critical. You may avoid months of painful physical therapy.

talk to them

by Tracey_E - 2021-11-18 13:01:59

As Agent said, the restrictions are just while we  heal. Using the wheelchair shouldn't be a problem, we just aren't supposed to raise the elbow above the shoulder. 

Discuss placement with your doctor. They can take into account your activities and place accordingly. 

How much vigor is allowed?

by Gotrhythm - 2021-11-18 16:06:40

I had a friend who used a wheelchair because he was paraplegic. He had shoulders and arms like you wouldn't believe. There's no question he used his arms vigorously.

In terms of recovering from pacemaker surgery, I would define "vigorous arm movements" as things like playing basketball or volleyball, using an axe to split wood, etc. In other words, activities in which you might forcefully engage the muscles of the arms and shoulders with the arms over your head.

In other, other words, things only the young or pig-headed are likely to do in the first few days after surgery. Arms over the head is the only no-no. But AgentX is right. After a few days, you'll forget and raise your arms to comb your hair or something--and not hurt a thing.

Like Tracey says, ask your doctor for specifics of your situation. 

You're going to do fine. Here's hoping the pacemaker will make a real difference in how you feel and what you're able to do.


Pacer Placement

by Stache - 2021-11-18 22:22:05

I shattered my shoulder and clavicle a few years back and was plated back together a year later the plates and screws were removed from my left shoulder.  My pacer was inserted just below my clavicle and a little too far out in my opinion.  This was made worse have my pacer was removed due to a severe pocket infection.  My pacer pocket was enlarged and a little further out which does rub my shoulder muscles.  As my pocket has healed it has prevented my pacer from moving around and now I have full movement in my left shoulder again.  Light movement is the key for several weeks then strength building in my case.  It’s been 8-months since my last surgery and much better but still notice a tight spot in certain arm positions.  This is something you will have to work out.  I am sure none of us are the same.


by Daisies - 2021-11-19 13:12:15

Thanks for the reassurances, I can live with some temporary arm restrictions just didn't want to permanently lose my mobility or some of the exercise modes still available to me.

I will definitely speak to the person placing it about my reliance on my upper body to get around, hopefully they will take account of that!




by dwelch - 2021-11-24 23:11:39

It is very much a temporary thing. This is an interesting question because mostly folks are worrying about sports or things that involve lifting things or arms above the shoulder, etc.

It will be sore, but almost every day it gets a little bit better.   I think that will be true for you as well, the first day the worst and every day a little better, you might have to just go slower that first week or so.  Or borrow a power chair for the first few weeks.

But this is all temporary.  Sleep is not great the first week or two, might take a week to sleep through the night, two weeks to where you can sleep on that side if that is how you sleep.  Then washing hair with both hands. etc.   Eventually you forget it is there, like a middle toe or belly button you know you have it but dont think about it.  It wont effect your ability to use your chair long term.  just a few weeks every several to 10 years or more as you get replacements.

Great info, thanks

by Griddlebone - 2021-12-01 12:42:33

Daisies, I believe you are on day 1 of post-op today. If you read this in the next few days, remember we've all been there and it only gets better. I'm hoping you'll be amazed at your outcome. I know I was. 

To the rest of you, thanks for your answers. I am scheduled for an upgrade to a 3 lead PM on Friday and I have pretty much forgotten about the length of aftercare. This post answered my questions.

I am spending the next few days changing smoke alarm batteries, vacuuming, and pulling boxes of fruit cups off the top storage shelves as I am alone this time around and all that stuff will just have to wait, no matter how much pet fur is on the carpet or how much I want a fruit cup. 

I am a little worried about my cat, who likes to crawl all over me while I sleep, especially my shoulders. I have her boarded until Monday; I guess to be safe I will lock her in the bathroom at night when she comes home. That will also mean any pain after 3 days will not keep me awake. I will already be awake due to her constant, plaintive crying. Shrug.

-- Nancy

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I, too, am feeling tons better since my implant.