PAIN AFTER SURGERY?????

Hello All,
Got my PM yesterday!! Thank you all for all the help I received prior. I don't think they liked that I knew half way what I was talking about thanks to you....but it sure helped me.
I did not get the right settings...the doctor said I decided not to set it where I said I would....after the surgery. I thought that was pretty rotten. When I feel well enough....He will be hearing from me.
HERE is my QUESTION......I had it put down deep so that I would still be able to backpack and things....the EP said I may have a little tenderness......UMM I HURT like H***!!
I don't do well with pain pills.....he was aware of that. H e said the pain would be minimal....okay....this is way worse than any other surgery I have had.

MY ARM isThrobbing like Toothache all the way to my fingertips!
I realize that there would be pain.....but I almost passed out when I got off the cot!
The incision area hurts....but I expected that..especially since they put it so deep......but is IT NORMAL....for my arm to throb...even my hand?
How long does this last?
I ended up getting a ST. Jude ..ZEPHYR..XL SR..5626.

Thanks, Holly

12 Comments

Jennifer...

by LIVE_STRONG - 2008-07-26 04:07:38

Myarm seems to be a bit swollen......my fingers are a little swollen....but get better when I lay down. After I am up for 15 minutes or so..it's my hand and arm that hurts more than my incision. I was wondering if it was due to the pm being put in so deep and the incision is very close to my side....but I can't figure out why my hand and forearm are hurting so bad. But...no real swelling. Could it be normal?

Thanks...Holly

well, yuck!

by Tracey_E - 2008-07-26 04:07:44

I'm so sorry you're having a rough time of it!

I never had any swelling in my arm, just around the pm itself and a bit around the incision. Did they tell you to ice or heat it? I did ice for the initial swelling and I think I remember using a heating pad for the last bit of swelling a few weeks later.

Did they have trouble burying it and getting the leads into position? I can see that bruising but not as badly as you described. I completely forgot until just now (funny how your mind blanks things out!) but I had fingerprint shaped bruises several places on my chest. When I asked about it, they said it was from placing the leads. Normally the leads go right from where they place it into the artery but when they bury it, they may have to snake it around some first. Did they do a second incision under your collarbone for the leads?

If the setting isn't right, it's only takes five minutes on the st jude rep's computer to fix it. Do you have a follow up appt?

Arm Pain

by jweese - 2008-07-26 04:07:46

Hi,

I had severe arm pain following my ICD/PM surgery in Nov. 07. I woke up with it hurting but they thought the IV had infiltrated and sent me home the next day. By Wed of the same week, my arm was throbbing something fierce and it had also swelled up quite a bit. Called the dr and he immediately saw me and had a ultrasound done. Sure enough, I had developed a blood clot from the subclavian vein all through the veins in my arm.

So, is your arm and hand swollen? My fingers looked like sausages. It was also cold and purple. If I were you, I would call your doctor. The arm pain was worse than the incision pain for me. I knew something was not right when I woke up from surgery - just wish they had listened to me more carefully!! I ended up being in the hospital another 4 days until some of the swelling came down and I was therapeutic with the coumadin and heparin.

If it is bothering you quite a bit and you cannot get in touch with your dr, I would go to the ER. Good luck.

Jennifer

Could be normal??

by jweese - 2008-07-26 04:07:48

Hi Holly,

Not sure if it is normal or not. I had mine put in the usual place. You might see how it does over the weekend and then call the dr on Monday and tell him whats going on. They had me elevate my arm to help with the swelling. My aunt who came to help me out following the surgery, started to measure the arm every day at 1 inch increments from the wrist up to the shoulder and then she comapared it to the right arm. Before I was admitted back in, it was about 3 inches larger than my right arm. It got much worse when I tried to use it. Being left handed, made it that much worse. They also put warm heat on my arm to help with the swelling. Sorry I can't be much more of a help. I would definitely keep an eye on it. It wouldn't hurt to call the dr on Monday. Better to be safe than sorry!! Good luck.
Jennifer

Tracey....

by LIVE_STRONG - 2008-07-26 06:07:00

Yes...they did have to bury the lead....it went in the axillary ..is what the doc said..and then tunneled around and down to the atria...I only have one lead. The PM was placed through the same incision from what he said..I can hardly feel it...it is buried about an inch and a half in my left breast. I was awake the whole time...I mean awake..no sedation what so ever. I can tell you one thing..its not a gentle procedure! He was pushing and pulling and ..YES..I could feel his fingers pressed all over my chest...my first thought was...this alone is gonna hurt!
But I knew by asking for it to be deep...it meant more initial pain...I just didn't count on the arm pain...and my hand..oh my it hurts!
Jennifer,.. I did call the doc...he said that it was a much more extensive procedure than most...so he would think it could be causing the arm and hand pain...but he has not placed one before like mine..so no feed back. He said since he went in the axillary vein..that it is probably swollen and putting pressure on nerves...so I will wait till tomorrow and if my hand still throbs..I will assume that it's not normal and call back.
I did not mention a clot..he did say he did not think it was because you usually dont see that with a single lead...why I don't know..thats what he said though. I will measure though...thanks..thats good idea.

Thanks, Holly

pain under muscle

by luckyloo - 2008-07-26 07:07:02

hi holly,

mine is under the chest muscle too and when i woke up from surgery i was begging for them to take it out! i wanted it under the skin but he said i was too thin which i think is bologna. it hurt all the way to my hand too. it took a little over 2 months for the pain to subside. it still flares in the humidity and around my period when you retain some water. i don't like it under the muscle at all.

btw...you can get a clot with 1 lead. watch out for temperature differences between your hands, discoloration. if you get those you need to be checked asap.

luckyloo

Try ice

by bambi - 2008-07-26 08:07:31

Hi Holly,
I found applying an ice pack on my incision site, and on my arm to give me more pain relief than the strongest pain pills! Just a note, give your Dr. the benefit of the doubt that he set your pacemaker at the current settings for a number of reasons. Until your body has adjusted to your pacemaker, and he sees how your heart reacts to being paced, it is impossible to predict this immediately after the initial placement surgery! Sometimes the Dr. is surprised by an event during the surgery, and he has to make a call to address that, and changes his mind. For example, my Dr. was surprised that my screwed up electrical pathways were not only confined to the sinus node, but were all over the atrium. As a result, during surgery, he did much more ablating than he initially planned to do. I've had my pacemakers [2] for 7 years now, and have had many, many readjustments to the settings. If you find your Dr. unwilling to make adjustments down the line, then yes, he needs to hear from you. Otherwise, we all have to respect their judgment and hope they have our best interests at heart. I am well aware that there are many who don't give a flip about their patients, but there's no way of knowing that unless there's red flags on their record.
Best wishes, try the ice!
Bambi

luckyloo and Bambi....Thank you

by LIVE_STRONG - 2008-07-26 09:07:21

Thank you.....I just wanted to make sure the pain I am experiencing is normal...or to be expected....as I have not heard of people complain of pain in there arm and hand being worse than the incision area itself.
I will watch for discoloration.
I am also going to try ice and then heat in a day or two. As far as the doctor changing the settings we agreed on..he didnt find any other problem...he initially wanted a higher setting..I told him NO..I would either not get it now..or seek a second opinion..he said he would set it where I wanted...and as long as I felt good with it..he would leave it alone. So I am kind of upset,,,cause he changes it to a higher setting and justified it by saying he thought I would be happier with it.
Can I change EP's if he does not put it where we agreed?
Holly

Additional 2 cents worth

by harley63 - 2008-07-26 10:07:42

Hi Holly~

Just felt the need to add a few additional comments to the above... to help with the arm edema and pain, you might could try a sling for the arm to keep it from hanging dependent all day. also the ice & heat tips are good, just remember to keep a cloth barrier between the skin and ice/heat applications to prevent skin irritation.

And by all means, if your not happy with the current PM settings and EP.. go seek a second opinion if your insurance carrier will allow coverage or if your willing to pay out of pocket for the consultation. It does not mean you have to switch MD's.. just go get another opinion on settings and treatments which fit your life style.

Cheering for a speedy recovery!
Harley63

hi Holly

by sis - 2008-07-27 01:07:11

hope your feeling better :) My Doc said that I could go without the sling during the day just make sure not to lift my arm over my shoulder and said just to sleep with the sling on so I didnt put my arm over my head while I was sleeping. That worked out well for me just be sure to keep moving that arm around not lifting anything that heavy just to make sure you don't get that frozen shoulder!! Hang in there :)~Jen

Harley633...thank you

by LIVE_STRONG - 2008-07-27 01:07:33

my arm is in a sling...the doc said to keep it there for at least a week....another thing he did not tell me pre-op.

I don't know if I am allowed to see another EP or not...just assumed I could change no different than changing a primary care physician....guess i had better check on that.

I AM AFRAID TO END UP WITH A FROZEN SHOULDER.

He told me to leave it in a sling and dont move it.....hmm.

thanks, Holly

Same Pacemaker

by JennMiller - 2009-09-14 06:09:32

I know this is an old post and I'm sure your feeling better now. I just wanted to say that I have that smake pacemaker. My first was also a StJude but it was a smaller StJude. I'm a 26 year old woman but with a large build almost 6 foot tall. I think this PM (the Zepher XL) is HUGE. I have a hard time with a large backpack just at disneyland all day my husband ends up with it (and its kinda sad cause its pink). I donk know if you had had this issue also but I thought I would just speak up. I am dependent on my PM and wore out my old one in 3 years so they implanted this one because the larger battery.

anyways, best of luck and hope this isnt an issue for you

Jenn

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