THANK YOU.....more questions

Thank you all for all your help. I meet with my EP tomorrow.
My HR does go up when I stand up. If I am sitting down it drops to 32-36 .Also does that when I sleep.
It does NOT Increase to a TACH unless I am jogging or any other exercise that should put your hr in a TARGET zone. BUT it INCREASES fast. And at 150-160 I feel SHORT of BREATH. I dont know if because my RESTING HR is so low?
The EP said I do NOT ABSOLUTELY have to get a PM at this time.....because I am not PASSING out.
BUT...the SHOULD NOT STOP scares me.

I hate to ADMIT ....BUT I AM SCARED of FEELING it.
Does it feel like palpitations?

AND....HE acted like GETTING A PM..was NO BIG deal.
I wont even KNOW IT"S THERE". It sounds like I will.

He also SAID I could WORK without PROBLEMS. NO need for SSI EVEV TEMPORARILY......unless I was a PILOT!
He sounded like he was just trying not to scare me....but....DID ANY OF YOU NEED TO TAKE SOME TIME OFF WORK?
I would THINK YES!

I am so THANKFUL for all of you being here.

Holly

3 Comments

Questions

by SMITTY - 2008-07-02 03:07:37

Hi Holly,

To answer you question about feeling your pacemaker, no you should not feel it. If you do, then adjustments to one or more of the many settings a pacemaker has should be made All that pacemaker will be dong is assisting your hearts natural pacemaker as necessary. It does this by sending a very small electrical impulse to your heart's camber(s) to cause them to contract. So, if you do not currently feeling your heart beat, then you should not feel the pacemaker either.

It nay seem puzzling that your doctor is not concerned about your need for a pacemaker, but my guess he has good reasons for that. Now before you or some of the others, reading this say it, I'm not a doctor. Nor do I have any formal training in the pacemaker field. But from all I have been able to read a pacemaker is designed to treat exactly such problems as you have a very low heart rate.

Before going further let me qualify what I'm saying. Low heart rates for most of us mean we have bradycardia, which is defined as a heart rate below 60 BPM. This is most often caused by sick sinus syndrome or sinus nod dysfunction. It is my understanding that these are for all practical purposes one and the same.

Some people do have low heart rate because they are avid exercisers and have been for a long time. In their case exercise has strengthened their heart muscle and in some cases enlarged their heart, enough that it can supply our body’s blood flow needs with a low heart rate. So if you are an athlete, I think this could explain why your doctor is not concerned about you low HR. Also, heart rate is not the final measuring stick for used to determine blood flow from our heart. There is something called ejection fraction, which is a measure of the amount of blood being pumped by our heart each time it beats.

If you haven't been exposed to ejection fraction, I'll try to briefly explain that a little further. A normal hear holds about 7 oz. of blood. With each beat that normal heart will pump or push out about 60% of that 200 cc, or 120 cc. However if we have a low EF that full 120 cc is not pumped each beat. In my case I have an EF of about 45%, which means each heart beat my hearts pumps only 90 cc, rather than the 120 cc pumped by a "normal" heart. Again, if you are an athlete you EF could be 65% to 70% because of the strength of the heart muscle. What all this says it the athlete with their big strong heart and EF of 70% will pump 1.17 times as much blood with each HB as does the person with the normal heart and a 60% EF. I'll leave that subject there for right now.

Our doctor takes all these things (HR, EF, our physical activity, etc.) into consideration when deciding if we do or do not need a pacemaker. In spite of my statement about being puzzled about the doctor's lack of concern I can understand why it is possible he would think you do not need a PM. I'm sure he takes all those things into consideration before deciding you are not at risk of passing out because of a low heart rate.

You say he acted like getting a PM was no big deal and that you would not even know it was there. Please go back to the first paragraph of this. He is correct, except rather than say "you will not know it's there" he should have said "you should not know it's there." Pacemaker is probably the easiest surgery any of us will have. I've had dental surgery that was many times worse. As for recovery time, for me it was about 3 or four days and all that amounted to was my left arm movement was slightly restricted. As for after surgery pain, I may have taken two ibuprofen, but no more.

As for time off from work, that did not apply to me. I got mine in '00 at age 71 and had been retired for 6 years. From what I have seen other say, it depends on the individual and the type work they do. I've seen some say they were back at work within two days and some say they had to be off work for several weeks.

You say the "should not stop" scares you. He is correct, it really shouldn't. That doctor is a little to conservative with his words to suit me, but our heart has a primary natural pacemaker and a backup (of sorts) pacemaker. Should our primary fail to do enough to sustain life, then the backup will take over and keep us alive albeit our heart rate may be in the twenties, until we can get help.

So relax and ask your doctor lots of questions.

Good luck,

Smitty

my experience

by Tracey_E - 2008-07-04 07:07:02

Holly, we have different conditions but I, too, had a heart rate in the 30's/40's before I got the pacer. My resting rate immediately jumped up to the 80's and for about 6 months I felt like my heart was racing a lot. 80's isn't really racing, but it feels that way when you've never been over 45 before! (my condition kept my rate low, it did not go up at all). I have NO idea if this increase in resting rate will happen to you. I noticed it, but it wasn't uncomfortable or anything like that. Actually, I felt so darned good and full of energy for the first time in my life that I reveled in it.

This is just a guess, but I would think if a pacer is regulating you, you won't jump so quickly so high - you should have a steady increase instead- and you will feel better and more energy because your heart is working more efficiently. That's just a guess based on my experience, it's a question for your doctor.

As for the surgery, I had a submammary implant. It took a little longer to recover than the usual collarbone implant. It was my choice to go for a more complicated implant that looked better. Not that the regular way looks bad, but I was a too-skinny size 3 and only 27 when I got my first one, it would have been a big lump so the cardiac surgeon brought in a plastic surgeon to get creative. Anyway, even with all that, I had it done on a Friday and was back at work Monday. I wasn't able to lift much or raise my arm too high for a few weeks but that's about it.

I was afraid of the surgery and put it off for a long time, I should have done it in my teens. If I had known how good I would feel and how easy the surgery would be, I would have done it much sooner and I regret that I waited.

p.s.

by Tracey_E - 2008-07-04 08:07:50

and day to day living, it really doesn't make much difference having it.
-We can't work in a junkyard or as an arc welder
-I don't get on rollercoasters
-It takes a little longer to get through security at the airport because we make most (not all) of them beep so we have to wait for a female attendant for a pat down.
-I asked for a pin name badge at church when all the other elders got magnetic ones (probably overkill, but why take chances?!).
-Not having an MRI is the only serious drawback, imo.

Most people who know me do not know I have it. It's not a secret, but there's rarely a reason for it to come up in conversation.

You know you're wired when...

You have a $50,000 chest.

Member Quotes

Yesterday I moved to a new place in my mind and realized how bad I felt 'before' and the difference my pacemaker has made.