is this normal cont'd.

Thankyou TraceyE, Debbie and Chris. This site is great! To answer some of your questions, I'm 55yo woman, was very active farming a large garden when a month ago I just started to run out of steam. Thought it might be menopausal sx, went to the free medical clinic (have no insurance). I hadn't seen a Dr in about 3 years. They said my pulse was running about 36 and shipped me directly to Intensive Care for 3 days. Totally unexpected. They said I have a 2nd degree block in my lower chamber, so thus the PM insertion. At my 1 wk f/u appt they turned off the stimulation to my upper chamber and that made me feel worse the following 3 wks. My Dr insisted I wait it out, eventually I had a stress/echo 3 days ago. The Dr said afterwards that during the test my pulse "was going backwards" (stayed around 74) he said my heart and arteries were fine and that my PM just needed to be reprogrammed. Now, they've turned the upper lead back on and I'm feeling better. I must admit I'm losing confidence in my Dr's judgement. Thank you all for you're great advice!
Janet (whidden)

5 Comments

don't lose confidence just yet!

by Tracey_E - 2008-08-23 01:08:38

I have a block also, I'm good at block questions. :o) I was born with mine and it's third degree. Did they explain to you what that means? Your atria probably beats more or less normally but the ventricle doesn't always get the message, this signal to beat is what's blocked.

I don't know what they're talking about turning off the upper lead or going backwards. The pacer just watches the atria most of the time when we have a block. If it goes too long without beating, the pm makes it beat. The time delay allowed before the pm steps in is something they program and possibly adjust as well as the delay between atria and ventricle.

The pacer is also watching the ventricle, that's what the lower lead does. If the atria beats (either on its own or pacer assisted) and the ventricle doesn't beat, then it makes the ventricle beat. My third degree block means nearly every ventricle beat is from the pacer because the signal never gets through.

There is also an upper limit setting, how high the ventricle will track. They're usually set at 120 or 130 to start with. That means that if the atria goes to 140, the ventricle will only do 120 (or whatever). This is a common thing to be reprogrammed for those of us who are active! We work out and 120 isn't enough so they turn it up more. If this was a problem for you, it would have shown up on the stress test.

Otherwise healthy patients are by far the minority, most people your doctor sees are quite a bit older with different problems and limited activity so some of the normal settings they are used to using aren't right for us. It is perfectly normal to take a few tries to get the programming right, it's better to do a few small changes than something radical. Just keep pestering them if you don't feel right! If it feels like they aren't listening to you or answering your questions, that's bad. But if they take a few times and want to try out different settings, well, at this point that's not uncommon.

It does get better

by joy1 - 2008-08-23 03:08:26

Wow TraceyE! Very good point about the age and activity level of heart patients.

whidden, you will hear people on this site constantly telling people to be pests and to not give up asking questions. It's really important to learn as much as you can about your illness so you know what to ask or if necessary, demand and if your doctor won't work with you, get a different one. Glad to hear your feeling better.

joy

Pacemaker patients

by ElectricFrank - 2008-08-24 01:08:57

TraceyE is right on about the average pacemaker patient. The last office check I had the Medtronics rep was late arriving (traffic problems) and the office was backed up with a half dozen or so patients. I felt totally out of place. I'm 78 and I found out by eavesdropping that several were 5-10 years younger than me and looked 5-10 years older. Now I realize why my cardiologist has trouble understanding me. Of course if he would just take time to listen he would.

So if you are pacemaker patient in good shape except for something simple like and AV block, be prepared to take care of yourself.

frank

Lucky in CA

by heckboy - 2008-08-24 10:08:11

My EP sees a number o f young, active people, so his office is used to us coming in all the time for little adjustments. Don't worry about making tweaks every few months for years if you want. I'm a guy and think of it like changing channels...no matter how good I feel now, there must be something better out there...and I'm going to find it. :)

heckboy

by Tracey_E - 2008-08-25 09:08:10

You are fortunate to have a doctor with other active patients! I live in a retirement mecca, the waiting room is always me and the octogenarians (if they aren't that old, they're ill enough that they look it). Occasionally I get excited to see someone my age, but it's usually someone driving their grandmother, lol. On the bright side, I'm the only one with a job and kids so the staff does a wonderful job of getting me in and out quickly.

My mfr rep is awesome. I was his first young patient 14 yrs ago, now he has a half dozen of us spread around three counties. He's great about seeing me for the tiniest little thing and researching the answer if it's something he hasn't seen before. But I'd still like it if I wasn't the only case my dr had like me!

You know you're wired when...

Your old device becomes a paper weight for your desk.

Member Quotes

I am just now 40 but have had these blackouts all my life. I am thrilled with the pacer and would do it all over again.