Why I'm Here

As I've coped with my multiple coronary issues over the last 35 years I continue to be amazed that medicine - at least the part of the field dealing with heart arrhythmias is as much an art as it a science. I'm a PhD engineer so I'm used to dealing with realities I can measure and predict (yes within limits). The reality of our heart conditions seem to almost always be uncertain. When we add a piece of engineered hardware to that uncertain biological system, no wonder we seem to get results and reactions that we and our caregivers had not expected. Fortunately my EP understands my perspective and deals with me very collaboratively. We discussed the alternatives and jointly came to the conclusion that the PM was necessary. During checkups - he shares the screen and we discuss the ramifications of what we see. Unfortunately, it appears that many of you do not have such a positive situation with your caregivers. I also know that there are significant differences in the overall healthcare systems we each need to deal with. Right now, I have an employer provided high deductible insurance with employer subsidized health savings account. It works well just as the normal insurance I've had in the past worked well. I know some of you are covered by medicare, those in foreign countries are probably covered by state subsidized systems (I lived in Sweden for 3 years and had positive experience with their system) and some of you are uninsured. I can only imagine the extraordinary stress the lack of insurance must create for an individual with a heart controlling computer in their chest. The point of this rambling posting is to be sure we all note the multiple variations we have that complicate each of our respective situations. This creates a set of somewhat unpredicted outcomes. We are at this site in an effort to understand and reconcile what we are feeling and how to interpret and communicate those feelings. We need the support and reactions from others that are experiencing similar challenges. I've had my PM for about 90 days, so far I've no complaints.

2 Comments

Correct on many issues there....

by truenorth - 2008-02-28 09:02:32

I'm pleased to hear you say you had positive experiences with the Swedish system, but I live in Canada, and our system is even more 'socialized' than Sweden's.

As a result, it's fraying at the edges, and I fear I'm living on one of those 'edges' myself.

My family doctor gave up his practice almost a year ago and I was informed that waiting time for a GP was 5 to 7 years in this town! And as for specialists like cardiologists and surgeons, there is such a severe shortage of them here [and this is not a one-horse town either: it has a population of over 75,000 people and major heavy industries] that seeing them is a quick perfunctory matter after a several weeks wait.

So whatever PM issues I have I have to first vet through my PM clinic nurse, who then forwards it to the cardiologist who helped put int the PM with the surgeon. She's an absolute DOLL, and far more helpful, caring and proactive than any doctor I encountered for my particular problem of my PM beginning to show signs of breaking through the skin of my chest. The surgeons I saw for it gave the appearance of being remarkably bored and incurious, not even suggesting the commonsensical measure of an ultrasound to see what was going on in there.

That's why I'm determined to go to a major medical centre to have this seen to, even if it involves considerable travel and expense.

Uncertain biological system

by ElectricFrank - 2008-02-29 01:02:33

You have it right about the uncertainties of the cardiac control loop. My take is that it is actually quite deterministic if we could measure all the variables. probably the most difficult is the effect emotions have on the system. (I suspect the automotive engineers designing antirollover systems for the new autos have a similar problem. The physics of the auto are well known, try to deal with the input of a panicky driver! )
I suspect that this is the cause of a lot of the vasovagal passing out. A person gets up quick and feels a slight bit of light headedness. The anxiety to that brings about a severe drop in BP, and the whole loop goes out of control.
You are fortunate to find an EP who is willing to work with you. My adjustments are done by a Medtronics field rep who enjoys interacting with me. I also am an engineer although not PhD. I design and sell biofeedback equipment so have modify one of my units to work as an ECG. I can see both heart and pacemaker pulses which helps in understanding what is happening.

frank

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Your electric tooth brush interferes with your device.

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