Thursday is the day!

At long last the week for my pacer implant is here. I couldn't be more excited. My hr has been in the 40s for a week and I'm tired of feeling awful, not being able to drive and more.

So some questions - best advice for day of & after surgery? What did you wish you knew?

And when I do a follow-up with my doctor the next day, what questions should I ask? Things I should inquire about? What should I ask for? Settings or options I need to be informed of? (And keep in mind my doctor is 225 miles away - there is not a closer cardiologist to me than that.)

5 Comments

Blessings

by chrispcritter57 - 2012-07-30 01:07:10

I pray all goes well for you on Thursday. The post above from donr is FABULOUS!! Very inclusive. I have had many, many pacer surgeries. Some just the generator, some complete generator/wire replacements. Every surgery recovery has been different. Even though I am the same person, my reaction to the surgery has varied greatly. From being back to work the next day, to having a much longer recovery period. So not only does each person's situation differ, your own personal experiences can be unique. The best additional advise I can give you is to listen to your own body. If you are sore - rest! If you a feeling ok, do just a little bit. Remember that you heal on the outside (scars) much quicker than you heal on the inside. A rule of thumb I have always used is that anything on the inside will take a year to fully heal. Hope this helps.

Cardiology by mail!

by donr - 2012-07-30 11:07:19

That's what you have. Not going to be easy.

Here's what I suggest:

1) Don't believe anything you are told about what the next day will be like! You have no idea, nor has anyone else. We are all different in how we recover. I walked out of the Hosp looking for Arnold Schwartzenegger, ready to take on the world & planned on starting BIG! Others spend the next day eating pain pills like candy. Even your surgeon cannot predict what you will feel like! Just be prepared for the worst, but hope for the best & settle for something in between.

2) Sit your Cardio down & tell him/her EXACTLY what you just told us - that you NEED a initial evaluation of how things are before you try to do it by USPS.

3) Specifically, ask for - very politely & forcefully - a download of your settings And a session where the two of you - or a knowledgeable substitute for the cardio - sit & discuss the meanings of what is shown. Including the various settings. You especially want to walk away w/ a print out of your settings.

4) What settings are important to you today? There are a myriad of them, most of them not of interest to you - especially at this point.

Most important are the lower & upper rates. They tell you where the PM kicks in for lower HR & where it quits helping & becomes a monitor only at the upper rate. What was your normal RESTING HR when you felt good? Push to get your lower rate set at the first multiple of 5 above that. PM's can only be set in multiples of 5 - - if your lower HR is set much higher, it can make you feel wired all the time because you never get to your relaxation point.

If you go away w/ a reasonable understanding of these two numbers, you have a good start - they seem to be the basic ones that determine how you function & feel.

5) Get a clear understanding of limitations for the next 6 weeks - raising arm, driving, lifting.

6) Have a clear understanding as to when & how your first followup will be - there should be one w/i about 3 weeks.

7) Discuss how you handle any unexplained feelings you have post -op. hurting, potential infection - anything that you feel is out of the ordinary. Face it - your local ER will be totally unable to help you out on these issues.

8) be prepared for emotional issues - anxiety because you are so far from support, etc. You are going to have to learn how to take care of a lot of things by yourself, but that should be a preaching to the choir line for someone who already lives in the middle of medical nowhere.

For quick answers, post questions here.

9) Have an understanding that someone has to be prepared to call you back from his office when you call.

Good luck .

Don

good luck

by Tracey_E - 2012-07-30 12:07:02

Wishing you an easy procedure and fast recovery! My hr was also in the 40's then dropped to the 20's right before I got the pm. Not everyone is the same, but I woke up feeling like I'd been guzzling coffee, full of energy and raring to go.

Wear a button up top to the hospital and don't bother with a bra for a week or so. You won't want to be contorting to hook the bra or pulling anything over your head for a bit.

Best advice is relax and try not to worry about it! Most of us come out of it saying it's easier than we expected.

best of luck!

by polrbear - 2012-07-31 01:07:32

I've had ICD placements twice. I don't remember the first one at all, which brings up tip number one:
--have a very good list of your allergies and sensitivities with you, especially medications. Even the minor ones are better for them to know about than not realize and later treat you for something that could have been avoided.

If they allow you to drink anything before the procedure, consider doing so. It'll be quite a while before they let you have anything more. Also, if you're allowed to drink more than water, the anesthesiologist would appreciate you avoiding anything with protein (i.e., normal or low-calories Gatorade is fine, but pulpy orange juice or a more "complete" sports drink is not advised).

Bring a book with you. The time they tell you to arrive is normally very early compared to when you'll likely go into the procedure room or even the pre-op area. More than likely, they will need this time. They give you that cushion in case you haven't filled out all of your paperwork (it's common to demand it, even if you saw the cardiologist last week), run a few last-minute tests (bloodwork, particularly CBC and chemistry panel, but possibly cardiac-specific labs as well; also an EKG is common, even if you had one quite recently), and give plenty of preparation and examination time for nursing and physician evaluation, obtain an informed consent (IMPORTANT: ask as many questions as you want and need before signing this. The worst thing you can do by this is delay things, but if you have questions or, especially, doubts about the procedure, take your time on this step), and an IV will be started.

For the IV, I hope you know your history. If you are an easy blood draw or have obvious veins in your antecubitals (front part of your elbow), realize that using lidocaine may hurt more than the IV in the hands of a skilled provider. When should you consider having them use a local anesthetic? If you're a "tough stick" or they need an unusually large IV (16 or 14 ga) placed in you. If they try to tell you the anesthetic will help them, they may be trying to pull your leg. Many anesthetics will make it tougher to find those veins afterwards. If they're using it and the vein isn't obvious, recommend having them mark the area with a pen or marker before the anesthetic and keep your arm very still until the IV is in.

Don't bring too many things with you; emphasis on valuables. Despite the hospital staff's best efforts, things get lost. If someone's with you who can watch over those items, even better. A computer may not be necessary because many hospitals place them in lounges for patients and family to use, and they're quite possibly the highest-theft item from patient rooms.

Staff will want to be with you the first time you walk. Be kind. If you had a sheath placed in your groin (from an EP study or stenting, but I doubt you'd have stenting with a device placement), you'll be on bedrest for a number of hours.

It gets a bit boring for you after that. Many places will keep a placement or even a generator change overnight. They might repeat the labs and EKG and you will almost certainly have a chest x-ray taken (make sure you didn't have a collapsed lung). If you're at one of the rare places that lets you call down to place your meal order at any time, I recommend doing that really early for two reasons: 1) you'll be hungry by then and 2) there's always a delay in getting those meals, but many of them will let you place the order and schedule it for later (usually not later than the following day, but each one is different).

I hope it goes really well for you.

Dustin

Today's the day!

by polrbear - 2012-08-02 08:08:36

I'm thinking about you. I hope all goes well.

You know you're wired when...

You can finally prove that you have a heart.

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I have an ICD which is both a pacer/defib. I have no problems with mine and it has saved my life.