Confused and working a plan

I had a 30 day post op appointment wth my EP -  I wat to shout him out!  

I had a bypass in 2007 and have seen many heart doctors and general practicioners.

My current one was said to be very well liked but tends to run behind.

My Pacemaker imp,ant was scheduked for 2:00 and happened at 5:30.

At this follow appointment the nurse came in thw waiting romm to announe "the doc doctor is running 3 hours behind"

I galnced around the room (hoping some people would leave and I would get bumped up the list!

Everyone sat tight including me...

It was a long wait but this guy soent 40 minutes with me ... he pulled up video of the procedure and showed e my old grafts... a stent and the wires screwed in my heart.

We talked together and crafted a plan - my implant was driven by a 30% EF rate possibly driven by single chamber pacing since 2019. He explained the hope is with two chambers now the heart will get in sync- one chamber is pacing at 100% the other is 25%.

I guess this means i was missing 25% of function before?

The plan is to come back in April when he and the Medtronic guy think my EF will increase ... figers crossed! I talked about changing my settings (was lackimg blood/oxygen when i got active) but we agreed to giver it a little time which I agreed with.

100% worth the wait.

So ... I forgot to ask and I realize I am confused - I am coming up on 5 weeks - when can i lift my arm overhead?

I have cautiously already but when can I not worry about jerking a wire lose?

I have been diligint even in the shower lifting my arm - this actually may have lead to a complication - I am now deal9mg with a boil under my arm that hurts and worries me - I went to the GP today and have antibiotics.

My worry is the infection, not far from my device, will spread.

Advice - as you recover be careful... I think bevause I could not lift over head my splashing water to rinse uner the arm left soap residue - clogging pores.

I feel like I have full range of motion overahed - doers anyone know the timeline? What have you been told?

I can go online and talk to medical professionals and get different answers?


4 Comments

Recovery

by Penguin - 2024-02-13 04:35:27

Hi, 

Your EP sounds like a good guy. I'd rather wait and see someone who is thorough.  That attention to his patients is probably why he runs late! 

I'm sorry to hear about your under arm and the infected pores. You've done exactly the right thing to get it seen to quickly. However, you should have been able to wash under your arm properly during recovery. You can raise your arm - just not too high or above shoulder height.  Sometimes it doesn't pay to be too cautious!  

If you look under the learn tab in the bar at the top of the forum you will find FAQs. These include the official advice re: lifting your arm and when you can do it. It's a really useful section and well worth a read.

Personally I'd say that everyone heals at different rates. Heed the offical advice, then go by how you feel. Posts on here suggest that pacemakers are implanted with an amount of 'wire' left spare / slack so that there is little chance of you dislodging anything when you reach. 

I hope you heal quickly and get better soon. 

 

Lifting your arm

by Good Dog - 2024-02-13 07:48:13

I agree with Penguin. It sure seems like you have a really good doc. Worth the wait.

I can certainly appreciate your concern about lifting your arm. The amount of time you must use care in raising your arm is generally 4 to 6 weeks. So you are there. However, I think you are/were taking it a little too literally. Generally, after a few weeks it is not that big of an issue. Obviously, the point being that you don't want to be stretching it out way above your head like reaching for the sky. You can certainly raise it perpendicular at a 90 degree angle to your body and even 20 or so degrees higher without any worry. You have to exercise/use it to prevent your shoulder from freezing up.

Anyway, it sounds like you are doing well. Just be sure to continue to follow-up on getting an echo to track your EF. The most important thing is "how you feel". As long as you feel O.K. and can get out and do things you enjoy; that is what matters! While you may not be 100% now, if your EF is improved over time you may get there. If it does not improve, there are other options that may get you there. Sounds like you are on the right track......

I wish you the best!

Dave

You are doing better than you think

by Gemita - 2024-02-13 07:56:10

Pacer2019, We all heal at different times.  There is no right or wrong advice.  I always go by how I feel.  If by reaching up it causes such discomfort, I ease off the activity.  

I remember within the 6 week period of having my pacemaker, I was in the garden pruning a tall shrub with loppers.  I stretched without even remembering my pacemaker and no harm was done, although I was anxious for a while.  Sometimes I feel that we worry too much and cause other problems like frozen shoulder which is more likely if we don’t mobilise our pacemaker side arm, slowly, gently.  I know I was on the verge of doing this.

Agree with both Good Dog and Penguin's comments and yes doctors always allow sufficient lead slack just in case we pull on the leads.  Leads usually embed into tissue fairly rapidly and are adequately held into place.  Any slack I believe is coiled under the device.

Leaving 'slack' in leads is a must at implant, since I suspect the heart moves within the chest with positional and postural changes all the time and none of us can avoid that!  The biggest risk is raising our arms overhead or behind us in the first few weeks after implant, before the end of the lead tip has had a chance to 'scar down' to the wall of your heart muscle.  Six weeks should be long enough for healing to take place I was told.  

Some members have even reported seeing on a chest X Ray that the leads have a complete loop in them before attaching to the heart wall. There was virtually no way they could have raised their arm enough to use up all this slack in their leads. I don't know if this is standard practice for all cardiologists/surgeons but it would be interesting to know?

I would rather wait hours to receive a 40 minute consultation too.  No wonder everyone was prepared to wait patiently.  I hate being rushed.  I hope you heal quickly and will feel confident to raise your arm shortly

Thanks Yal !

by Pacer2019 - 2024-02-13 22:00:09

I feel good and I am gaining confidence ... took a big step today started moving . I ave been worried I wouod not have the stamina.

I live on the second floor and I have been up and down those stairs a hundred times.

Im good on lifting anything I need to and felt great!

You know you're wired when...

You invested in the Energizer battery company.

Member Quotes

But I think it will make me feel a lot better. My stamina to walk is already better, even right after surgery. They had me walk all around the floor before they would release me. I did so without being exhausted and winded the way I had been.