3 months post-icd implant pain and migration

Hi all, I am new to this club. My name is Sheila I am 47, I had a silent MI in early July, '10, then a major heart attack on July 12-10, was life flited to Austin and recieved a stent in my LAD coronary artery and had an EF of 35%. that was a Monday, got out of hospital on Thursday evening. Awoke friday morning w/ severe chest pain, tightness and numbness, went to local ER and they life flited me to San Antonio, had another cath. with EF 32% and was sent home next day, disharge papers said acute MI. Then i started fainting (syncope) fairly often. Fainted 1 day right in front of WalMart so was taken by ambulance to local ER. They then sent me to Texsan's heart Hospital in San Antonio, and did another cath. which showed EF 28%, so they placed a Boston scientific ICD on August 2nd 2010. I started cardio rehab mid September. All was going well until about a week ago. My device has shifted over about 2' towards my armpit and my left arm bumps it several times a day and when i use the arm ergometer, the arm parts on the stationary bike and the arms on the nustep machine. After wednesday's cardio rehab session, the nurses there insisted I see my cardio doc. I did and he said, "yeah it's shifted, sorry 'bout that... try to avoid bumping it". Ughhhhhh....after his probing fingertip exam... it is sorer than ever! I have had a hard time getting comfy to sleep. It is now limiting my daily activities almost as much as right after the implant procedure.

Sorry to ramble, just wanted to know if others have had this problem and how they dealt with it.

Cardio rehab told me to skip this morning and rest it, but try to get some walking in over the weekend. I have lost 20 pounds since the implant, and it now sits about 5" under my collarbone and half under my left armpit. sorry to complain but it is driving me insane everytime I bump it....I've tried ice packs, hot packs, small pillows big pillows, need some tips or advice please! I'm so glad I found this site. Thank you for being here. Sheila

5 Comments

Hi Sheila!

by donb - 2010-11-12 02:11:35

I had a similar experience while in cardiac rehab working out with the same equipment as you mentioned. The arm ergometer seemed to agrivate my PM also. As my implant was well secured and couldn't move but it still got very irritated and eventually started to erode. It was my 3rd implant and had to be removed. As my site was such a mess from scar tissue a complete new right chest installation was done.
I did have a plastic surgeon do my old site restoration, (twice) as he failed to properly dress my old leads. This was per instruction from my Cardiologist.
I could go on but I would suggest you get a good opinion from a surgeon who can handle the job of a proper implant. Hopefully, with care your site will heal & settle down. My new right chest implant was done by a differant Dr. and did an excellant job. All 4 of my PMs' have all been secured real well as I'm skinny and very active. I know now I would have had more site problems in the past 18 PM years if my implants weren't tied down.
I suggest also using your oposite arm only on expercise equipment and forget the arm ergo. Any Questions, send me a message!! donb

welcome

by qwerty - 2010-11-12 11:11:23

Hi Sheila
Welcome to the Pacemaker Board.
Congrats on losing 20 pounds... I think I found it!
As for the PM moving. I think some move more than others. Mine has the wires that stick up. They usually tuck them in behind the PM but mine got loose and stick up. My cardiologist was sympathetic and said he was sorry but it happens. He said unless they move to where they are coming through the skin it wasn't worth another surgery and I agreed. But then I am 60 and my exercise is mainly walking and maybe some Wii fit stuff so I really don't have your issues. My bra strap is my main problem and I have found ways of making that as comfortable as possible.
Hang in there. I know you will get other responses. I got my PM 1/25/10 and I think it is still moving a little.
Have a good day and welcome

My 2 Cents In ~ ~

by Carolyn65 - 2010-11-12 12:11:03

This sounds like you have been to all the well known places/hospitals/etc. To me this sounds like you should not have to be going through this much pain and agony with so many specialized, educated doctors.

I know nuttin', can't tell you anything, but have you tried the Heart Hospital of Austin out on 38th Street? They have heart Dr's. offices on the 3rd floor (and other Austin areas) and the actual Heart Hospital on the second floor, to include surgeries/day surgery, with the ER on the first floor.

I have visited all three, the 1st/2nd floor for me and the ER for a Family member.

Please seek out other specialists who will fix your problem(s), as you are soooo young.

God Bless and Keep Us Posted,
Carolyn G. in (Austin) TEXAS ~ Bear Hug Somebody Today ~

Thank you for the support

by shecan06 - 2010-11-12 12:11:46

qwerty, thank you for the support and sharing your experience. My Dad had a SCA in 02 and got an ICD in Jan 03. His sits much higher and more right under his collarbone. Mine is behind the pectoral muscle, but 1 "corner has poked out". I found a great support bra made by Just my Size, it has wide padded straps and an internal "sling" to support my girls. I used to weigh over 300 pounds, and lost down to 135 by nov 2000 and maintained that weight til 2009, when it slipped up to 165. I had type 2 diabetes but with losing the weight, i got off insulin and pills. i also have CHF and am on lasix and fluid restrictions. i want my old life back! I miss not being able to help my mom and dad, dad had a stroke 3 years ago and is a nursing home right side paralyzex, my mom is mostly homebound from a bad wreck she had in 03 and symptoms of post polio and fibromyalgia. I'm the oldest child and live closest. I feel so much guilt for not being up to my old self yet! I am divorced and live alone. My cardio doc wont let me drive until Feb. so i have to call someone for all my transportation needs, i live 6 miles out in the country from a small rural town. My ex has been wonderful to take me to appointments and the cardio rehab 3x's a week...well thanks again and I hope you have an awesome day! Sheila

Thanks everyone!

by shecan06 - 2010-11-13 08:11:02

A big THANK YOU to all of you who have replied! My Primary Care Doc has already suggested that I change electrophysiologist and cardiologist. I may call her Monday and see which other Docs she has in mind.

Monday when I go to Cardio Rehab, I'm supposed to let the nurses and director know what my cardiologist said this past Wednesday.
Carolyn, the only experience I have had with Drs. in the Austin area was when I was taken there by helicopter from Enchanted Rock State Park, near Fredericksburg...and admitted directly to the Cath. lab at Brackenridge Hospital.
I currently see a Cardiologist in Seguin, about 20 miles from where I live. Both times I was hospitalized in San Antonio (about an hour from where I live), the Drs. who treated me were with the same "Group Practice" as my Cardiologist.
I was given handouts while at Brackenridge in Austin about Cardio Rehab, unfortunately Austin is out-of-area for my insurance....unless it is an emergency situation.

Donb thanks for the advice about using my arms at cardio rehab. I'm planning on having a re-evaluation on Monday at the Rehab Center, with hopes of perhaps getting some physical therapy for my left arm/shoulder area, or ideas on ways to improve my posture. I tend to curl my shoulders bad habit from childhood. Thanks again everyone for being so nice, caring, helpful and supportive.
Hope each of you has a great day tomorrow! Sheila

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