is this normal?

I’m 47 and I had my pacemaker implant two weeks ago due to low heart rate. I had my first check up today. These are my concerns: they did an EKG which was normal, but did not do a ’pacemaker’ check with the machine. He also lifted the restrictions for using my arm. I thought I was not suppose to use it for 4-6 wks.

Is this normal for the first check up? I at least thought my pacemaker would be checked or I would be given further instructions. Sorry but this is all new and I don’t know anyone else with a pacemaker.

Kim

13 Comments

Not normal in my book

by donr - 2012-07-12 09:07:06

This is their first chance to find out how you & your PM are getting along.

Also - a bit liberal to release you from arm raising restrictions. I'd question BOTH of those actions.

Don

what Don said

by Tracey_E - 2012-07-12 09:07:07

I've heard of people not getting checked again for a year, but a follow up within a few weeks is more common. As for the arm, theoretically after 48 hrs it's just precaution. Drs vary widely on how soon to use the arm, 4-6 weeks is average, 2 is rare but not unheard of. When I got my first one, I wasn't given any restrictions or precautions. I've never been particularly careful and my dr has always encouraged me to do pretty much whatever I want, and I have never had a problem.

arm

by Alma Annie - 2012-07-12 09:07:23

I had a pm 13 months ago. I was told not to lift my left arm above my shoulder for 6 weeks, so that the leads would become embedded in the scar tissue. Before then if you lift your arm a lead can pull out. So I think it is better to be cautious whatever your doctor says.
It might be better to check with your doctor again. Whatever he says though there will be no harm in keeping your arm below shoulder for a while longer. Better to be safe.

As for the pacemaker check, yes he should. Maybe you should talk to him about it. When is your next check up?

All the best, Alma Annie

Hi

by Jax - 2012-07-12 11:07:19

I have had my pm for 2+ months. My first check with the EP was 10days from the procedure. He checked the incision and the pm. He also said I could raise my arm but no jerky movements. I kept my arm down for about 4 weeks. I was nervous about raising it. Better to be on the side of caution.

Not normal as far as checkup

by ElectricFrank - 2012-07-12 11:07:27

A followup is a necessity to adjust the pacemaker settings to better match your needs. I would ask for a referral to a clinic that can give the support you need.

As far as lifting the restrictions on lifting your arm this is possible. That's about what I had. I did slowly increase my activity from that point on. However, given the poor support for a followup check I wouldn't put much stock in his recommendations.

This is something that is a concern of mine. I'm noticing pacemakers are becoming more of a commodity and being implanted by by any old doc. Actually, anyone with an MD even in cosmetic surgery can implant and support a pacer legally.

frank

is this normal

by kye9302 - 2012-07-12 11:07:42

My next check up is not until October. Your answers confirm my thoughts. I became this doctor's patient thru the emergency room and I don't know anyone else that uses him so I'm not 100% sure of him. This is not the first time I've questioned his advice. All I know is he is with a reputable group. I definitely will be calling his office tomorrow morning. He will not be in so it will be interestingly to see what answers I get from whoever is working. Thank you so much. This forum is just what I need.

Disagree

by golden_snitch - 2012-07-13 03:07:08

Hi!

I have to disagree a little with the others. Here (Germany) you get an interrogation before you leave the hospital, so within the first couple of days after implant, and then the next interrogation is scheduled 6-8 weeks after the implant. That's according to the guidelines. That's because while the leads are still healing in things like amplitude (voltage), threshold etc. can change. About 6-8 weeks after the implant one can then see what is really needed. So, some settings are programmed with a kind of "safety window" as for instance the amplitude (higher than you'll ever need it again), and then you go home. If one would change settings after two weeks, they would need to be changed again just a few weeks later. So, the policy is to give it some time to heal, and then schedule the next interrogation 6-8 weeks after implant, then three months later, and then every 6-12 months.

Of course, if the patient is not feeling well, an interrogation is needed. But as long as you are doing well, there really is no need to check if the pacer is functioning properly after two weeks.

So, what your doctor suggested is normal here where I live. And I don't think anything was missed because I did not have a check-up after two weeks. Have had six pacer surgeries so far.

Best
Inga

Makes Sense

by ElectricFrank - 2012-07-14 01:07:36

The important thing is that the factory default settings are set for the patients condition early on. If they are set before leaving the hospital as Inga mentioned it should work out fine. Too often though as in my case Rate Response was left ON, and the upper limit was too low, even though I had simple AV block. Then they wait 6-8 weeks during which I would have been severely limited in my activities for no reason other than their convenience. Keep in mind that the factory defaults are chosen to provide support for the most debilitated patients for safety reasons.

Bottom line is that in all of medicine the standard of care is chosen based on the center of the bell curve. For those of us who are different we need to take card of ourselves. Actually, it could be an efficient self selecting system.

frank

normal

by kye9302 - 2012-07-14 03:07:44

I called my doctor's office. They told me I would receive a call about 8 weeks after implant to have my pacemaker check. That made me feel better and I didn't post that is was checked in the hospital before I was discharged. As to the arm, I am going to continue to be cautious with it for a few more weeks. Better to be safe than sorry. This is just a situation I will need support with for some time both medically and mentally. I am anxious to learn all I can, especially the terminology. I worked in a doctor's office for years but cardiology is completely new. Again you don't know how much you support is appreciated.
Thank you
Kim

asfasfjl

by boxxed - 2012-07-14 04:07:10

Yes, that is a bit odd. Just be mindful of your left arm, don't lift heavy objects, and try to not raise your left arm above shoulder height for X amount of weeks (the amount varies between practices). It's to prevent the leads being pulled out and the physicians having to go back in there are reposition.

Problems with being too careful

by ElectricFrank - 2012-07-15 03:07:47

Be sure to at least move the arm around gently. There have been a number of people on the site that have found themselves with frozen shoulder problems from lack of use. This can be very painful and takes a while to heal.

frank

normal

by dafrey - 2012-07-20 11:07:59

mine was 2 weeks keep elbow below shoulder and no driving .10lb max with that arm for a month check in 2 weeks after 2 weeks start getting range of motion back to prevent frozen shoulder
I eneded up there in 9 days because of questions.
then again @ 2weeks for check and needed adjustment for feeling choked while walking
next visit oct @ 3 months or if anything happens sooner

Dave

week 4

by kye9302 - 2012-07-26 10:07:48

Wednesday was 4 weeks since pm implant. I have been more tired this week than the last two. Is there a general timeframe when I should notice a big difference? I guess my biggest fear is not getting alot better. I want to have some energy and feel alive again.

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