Brace for a month post-implant

I had my pacemaker implant on 3/24/22. I am required to wear a pliable brace 24/7 for a month post implant surgery. My upper left arm is tethered to side of my chest and left wrist area tethered also via velcro to upper part of my diaphragm. Those with whom I've spoken who either have had pacemaker implants or family members have had them, have never heard of this type of restrictions.  Obviously driving, gardening, vaccuming, regular exercise are out right now.  I did manage to get using a recumbent bike and taking walks okayed; I used a treadmill at 2 mph as holding onto it relieves any pressure from brace on my upper diaphragm. My cardiologist and both my electrophysiologist who retired and the new one who performed the implant all went with the 24/7 brace. My situation was too often a turtle's heart beat: as low as 32 but with that I exercised at full capacity for a 75 year old; the heart beat picked right up for stress tests, exercise, etc. My pacemaker seems to be set at 52 for when it 'turns on'.

Have any of you experienced such limitations?

Also, thanks to those who offered the bra suggestions: using only one strap on the unaffected shoulder and that there are one-strap stretch-material bras.


8 Comments

upper left arm is tethered to side of my chest

by Good Dog - 2022-04-15 16:58:56

Wecome aboard! I agree with those you've talked to about the brace. I have never heard of one as you described being used. However, I may live a pretty sheltered life. My point being that just, because I haven't heard or seen of it doesn't mean much. I'll be interested to hear what others have to say about this. Hopefully more folks will chime in. 

My low setting for my PM is 50 bpm and prior too my PM being implanted, my pulse was often very low. I wore a holter monitor when younger and found that my pulse would drop to around 35 bpm when I was sleeping. I had a congenital 1st degree block that suddenly went to a full block. 

Sincerely,

Dave

Brace??

by AgentX86 - 2022-04-15 17:13:34

Your symptoms describe SSS (sick sinus syndrome). Positively the simplest electrical problem for a pacemaker to fix.

As far as the brace goes, no I've never heard of such a thing. This risks "frozen shoulder". I'd certainly ask about the risk. It's nothing trivial.

Wow!

by Marybird - 2022-04-15 17:14:42

I'm just curious as to who provided you with the instructions to wear that kind of an arm restraint for a month?

They gave me a similar type brace immediately after my pacemaker implant in the hospital and instructed me to wear it for 24 hours only- then take it off.

While the universal instructions following pacemaker placement are to avoid lifting the arm on the side of the pacemaker location ( generally the left) over the head for approximately a month or so, not lifting anything heavier than a few pounds for around that time, just as a precaution against dislodging the pacemaker leads, they also caution against not using that arm normally for any length of time. Not using it can lead to a frozen shoulder, pain and inability to use that arm. 

I recall after I took the brace they gave me off at home the day after my pacemaker implant, I put on an arm sling just to remind myself not to lift my arm over my head. I had to go into the cardiology office ( their pacemaker clinic) to have an in office device check, and the pacemaker tech told me to take off the sling and use my arm ( she cautioned against the frozen shoulder). She told me not to be afraid to use the arm normally, just to be careful about lifting it over my head or lifting anything heavier than a gallon of milk ( think that's what it was) for a few weeks.

We're all paranoid at first about lifting that arm just after our first pacemaker implants, it's such second nature to do this, and I remember worrying a number of times after I raised my left arm over my head in a stretch, or putting something away, reaching for something that "I musta dunnit now, yanked those leads right out!". But I didn't and wiser folks than me have reassured us that it's not actually that easy to dislodge pacemaker/ICD leads, if they're securely anchored in the cardiac muscle and there is some play in the leads as they're a little longer than needed and coiled a bit. So while it can happen occasionally, you don't want to leave your arm immobile or not use it, as you'd be more likely to get that frozen shoulder by not moving it, than to dislodge the leads by moving it normally.

 

Brace

by Daedalus - 2022-04-15 17:49:51

 

That sounds exactly like the arm sling/brace I was given.  At my two-week follow up, the doc told me to stop wearing it during the day (just being careful not lift anything heavy with arm or to raise it above shoulder level), but to have it on at bedtime to as to not inadvertently raise my arm during sleep.  After 6 weeks I ditched the sling altogether.  Am now at 10 weeks post implant and shoulder has loosened up with no problems.  

Sample of sling in question here:    http://alturl.com/v6mo5

(Edit:  I updated a pic of mine at Members Only > Gallery.  But it's upside down, couldn't fix that.)

No brace, sling suggested

by TLee - 2022-04-16 19:16:22

I was given a sling that I was to wear at night only. I don't remember how long I was supposed to do that, but I was so aggeravated by the whole experience that I got rid of it after the first uncomfortabe night. (I should say that things rapidly improved & I no longer carry a grudge against my doctor!). It was to keep the left arm from being raised over the head while I slept, but I tend to sleep with my arms tucked in, not akimbo, so no harm was done. I have heard folks here discuss "frozen shoulder" from keeping the arm immobile--maybe ask about your doctor about that (?)

Brace for a month post-op

by c-ville - 2022-04-16 19:32:28

First, Daedalus, my 'brace' very much resembles what you posted in the Members' Gallery. It is called PaceBrace and 'is designed to prevent lead dislodgement and frozen shoulder following pocket device implant'.

The first comment I had about being tethered in this way and for this long was about FROZEN SHOULDER. I had it on my left shoulder [same arm being braced] over a decade ago. During 4 weeks of PT to try to 'free it up', I had a chiropractor appointment during which, perchance, broke the adhesions, I cried out, the young chiropractor was totally shaken, and within maybe 2 minutes I realized I could freely move my arm! Every doctor I have related that story to told me to include it under su'geries' when filling out medical forms. So - and you are surmising correctly - I just read the pamplet in full.  Somehow it is novarious topics is that one doesn't go suddenly from restrictions to no restrictions. In the last few days, I've loosened the chest support at night. T diaphrahegm restrict

t supposed to involve frozen shoulder.

One of the items I have gotten out of the comments I've read on this forum under many of the topics is that none have gone from restrictions to no restrictions over night. I've also realized that some shortness of breath that had not been experienced prior might not be from the brace: they may be from the fact that I've gone from 32-42 beats at various times of the day to a steady 53, now 52 beats and it 'spikes' up into the 60s, 70s when I move around. In other words, the new normal that I will get used to.

Last, you better believe that when I have my 1 month in-office check-up this Thursday, one of the first things I'll ask to do is to grasp my hands behind me! Just hoping I can!

Oh, interestingly enough, the implant nurse employed by the hospital [not a Medtronic rep], was clueless about what my cardiology team wanted: the brace 24/7 for a month. Fortunately, a nurse practitioner who happened to hear the surgeon's instructions to me prior to surgery was present and told the implant nurse the new instructions. Fortunately for me, the surgeon had gone over it all with my husband and me the day prior as well.

Y'all have been great. I'll let you know if I can 'grasp' after the appointment Thursday.

Brace for a month post-implant

by c-ville - 2022-04-27 17:41:16

I had the 4-week implant checkup last Thursday, 2/21. The implant nurse with whom I had the appointment also had never heard of anyone being told to wear the brace 24/7 for a month. He did point out that while my upper left arm was tethered to my side, I still was able to move it about 180 degrees due to the ability to lengthen the ‘tether’ up to about 6”. Anyway, I took Tylenol for a couple of days due to the weight of my arm suddenly affecting me. That was weird but wore off by day 3.  I was also able to grasp my left hand with my right hand behind my back so that was a major relief. And, I can drive again. Actually, unfortunately for my husband, I was ‘driving’ all of the last 4 weeks just not in the driver’s seat!

Months 2 and 3 are still restricted but to the extent of no lap swimming still, no weights with the arms in the gym [machines, etc.].  Surgeon had told me I could use a recumbent bike and walk [treadmill included] so have been doing those both at an easy pace. Now I’ve added leg weights: leg curls, leg extensions, and leg press on reduced weights.

We fly to visit relatives next week.  I actually plan to wear the brace on the plane to remind myself to not automatically lift the carry-on into the overhead bin. I usually have been the one to do it for both of us due to husband’s back problems. We also have to remember to just pack mandatory items to take on the plane.

Almost 5 weeks of the 12 weeks of various restrictions completed!

Again, thank you for your concern and valued comments.

Immobilizer

by Pacer54 - 2022-05-12 16:27:18

Wow your care group is overly cautious.  I just had a PM put in 7 days ago and received a similar brace upon discharge from the hospital.  Instructions were  not to lift my arm above my head  (shoulder level) or lift more than 10 lbs for 4 weeks, and to move my arm so as not to get a frozen shoulder.  I wear the brace at times I need to remind myself not to raise it up i.e. nighttime and sleep on my back or right side only.  PM is on left side.

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