Friday, May 6, 2016

Everything You Weren't Told About Getting a Pacemaker

Being a healthcare professional myself, I did a fair amount of research before deciding to get my pacemaker. I read all of the info available on the device itself - the manufacturer site was adequate and easy to navigate, the patient info side was too simple/basic, I found the physician side much more informative. I still have questions about the programming, which will get asked at my first pacemaker check, the rate responsive seems overly sensitive and I am not used to having a heart rate in the 80s when sitting around using the computer. Walking a couple blocks took the rate up the high 120s and it didn't feel comfortable, but it appears that the system will adjust, I certainly hope so.

In addition to the device manufacturer site, and the other big device maker sites, there is a patient site for those with pacers and ICDs that is helpful. Even there I didn't find everything I was looking for, but it is rich with content on lots of topics.

So what didn't I find? Here's a list:
  • Before surgery - skin prep with disinfecting soap (it's red, doesn't lather, and anyone who ever worked in a hospital will know the brand). Instructions were to take 3 showers in the 48hrs leading up to surgery. Found out the hard way that I am allergic. First shower left me with exceptionally dry skin and mild itching on my chest. Second shower - I could not keep the soap on for more than 15 seconds. Major itching. Very uncomfortable. There was no 3rd application. Strange that this happened as I did work in a hospital for 10 years and didn't have a problem washing my hands with the product. But I have developed allergies to other things since I last used it. 
  • Pacemaker implant day - you cannot eat or have anything to drink after midnight the evening before surgery. Pretty standard instructions, and easy for me since I am not a night owl. I do however, get very thirsty during the night and did have water at 3 and 6 am (this was not a problem for me, but check with your doctor before doing this). I was originally supposed to report at 7 am, but was called early and told come in at 10 am instead, once there I was told emergency cases bumped me to 12:45 pm. Great. I was already getting hypoglycemic at 10, having last eaten at 6pm the night before, and I let them know. Fortunately, I got 4 oz of cranberry juice to tide me over :). I didn't get taken back into the surgical prep room until 1 pm. After my procedure, they checked my blood glucose - 53 at 4:30 pm. Lesson a high protein, high fat meal at 10 pm next time I have to have surgery. 
  • Placement - customized somewhat for everyone depending on body shape/size/device features and whether you are right- or left- handed. The typical placement is on the left side for most adults. That's where mine is, it is a bit closer to the center because I have musculoskeletal issues with my left shoulder and upper back. Reality has intruded and it is exactly where my bra strap goes. There is protector and I will try that out, so far no problems. It does make you realize that your non-dominant arm is used a lot more than you think. It's a big irritation that I cannot stretch that side for 4 weeks - 4 weeks - because you cannot raise the arm on the side where the pacer is above your shoulder for that long in order not to displace the leads.
  • Skin irritation from electrode patches - I should have remembered this from the last time I was on telemetry. Even though it was less than 36hrs, I still developed redness and itching where the patches were placed. Also irritation from the lead wires and box against my skin, you could see the outline for days. Benadryl and hydrocortisone cream helped, but it was very itchy. The skin prep also may have contributed. 
  • Discomfort - this is actually good news, it wasn't painful per se, just uncomfortable/discomfort that was managed well with extra strength acetaminophen alternating with ibuprofen. Just remember to take it around the clock and not wait for pain. Everyone has different pain thresholds and how they react so my experience will not be yours. Yes, it was painful during the procedure. And if I moved the arm or my body the wrong way I get a shot of pain. But not nearly as bad as what I read in some posts on the patient PM club site. Personally, the pain from my muscle spasms and neck arthritis when it flares is far worse.
  • Restrictions on lifting/movement - ok, since when is anything lighter than 5 lbs? This is the worst. I live alone most of the time because hubby is retired and work for me is in a different state. Four weeks of not lifting?? How am I going to carry my work computer and backpack/briefcase from the apartment to the office? No driving either, this is going to be very interesting. I'm working from home this week and next, so 2 1/2 of the 4 weeks are covered.
Enough for today!

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