Getting under my skin

Hi everyone,

Cardio doc is concerned my pacer is poking out too much. My skin is stretching thin (the skin is white instead of pink) over an area of the pacer. It is sticking out because I am quite thin, 5'2", 98 lb. Also my work is quite physical (massage therapist) which can often contract the pectorals and push the device against the skin. If I had 20 more lbs on me t wouldn't stick out but I eat a lot but the weight does not stay on. He's considering placing it under the pec muscle. But I do not have much of a pec muscle either and I'm concerned that putting it under the pec will be really close to my ribs! I plan to express my concern to the doc at our next appt but in the meantime has anyone had a under the pec surgery and how was it for you afterwards? Also is there another place that it can be placed? abdomen? Or possibly graft skin from another area and place it over the pacer where it is located now under the skin. This way it would have a thicker covering. Any help would be much appreciated!

4 Comments

plastic surgeon

by Tracey_E - 2013-10-26 09:10:15

I would do a consult with a plastic surgeon in addition to the ep. Mine was placed submammary by a plastic surgeon and I had excellent results. Ep's are experienced with getting the leads in place and concentrate on our hearts. Plastic surgeons are trained to make it look and feel good, that's what they do.

I've never heard of a graft to protect it.

Abdominal placement is an option but it's usually considered a last resort and it would mean getting new leads, something it's best to avoid if you can. Don recently had his moved to his abdomen after multiple surgeries trying to keep it in his chest. He is very happy with it. I'm sure he'll chime in.

recovery

by Tracey_E - 2013-10-26 10:10:25

I was probably more sore and sore for longer than most, but it wasn't bad. I got by on tylenol after the first few days. I think I took a week off work after the first one, I can't really remember. It was about 2 months before I could bend/stretch any direction without any pain. I could move and easily get through the day before that, but would get twinges if I moved the wrong way.

When I had my last one (#4), I got a new lead, the pocket rebuilt, and scar tissue cleaned up so I was more sore than the first time. I work from home on my own schedule so I was back at it pretty quickly, but I napped a lot that first month and took my time getting back to my routine at the gym.

I'm 5'6", was a very underweight 110 when I got my first one, maybe a B cup. My cardio had never had a young patient before and was concerned about how it would look, the plastic surgeon was his idea. The St Judes rep had heard about alternate placements but none of them had done it before. It wasn't at all common then (1994) and I was an emergency surgery so they had done a little research but were kind of making it up as they went along. I could feel the edges of it, but it never poked out. Now, I've aged 20 years, had 2 children and gained some weight, and pm's are smaller. I'm a d-cup now and I can barely feel the pm if I poke around looking for it. it is good and buried!

unrelated to anything but kinda funny... my sister was with me when I met with the surgeon for one of my replacements. She looked at him with a straight face and said why not give me two, one on each side, then I'd go up a cup size AND be good for 20 years. I don't think the surgeon every realized she was kidding lol

Thank you!

by mybeatingheart - 2013-10-26 10:10:49

Thank you for responding! Was the recovery from submammary procedure painful and when were you able to get back to work? Btw, I am very flat chested, hardly any breast tissue at all. Can't even fill a AA cup so I'm thinking it would poke out even submammary. I guess I will have to discuss all of this with the cardio doc and plastic surgeon.

Under Muscle

by donb - 2013-10-26 12:10:25

Hi, As Tracy posted I have finally found a comfortable site in my abdomen to house my 6th pacemaker. As I had 3 implanted under skin on my left chest & 2 implanted in my right chest, there was always some discomfort. As I'm 5'-11" and average 145 pounds, I don't carry much fat under my skin. My 4th implant was put under muscle & was quite comfortable. With being very active I managed to squish it toward my armpit causing erosion. It's replacement did the same only after a few months. The site was a mess as it had lots of scar tissue which only agrivated the situation.

My present abdomen (belly) is under muscle with a slight layer of fat above it & I can't feel it's there. As I had an EP pacemaker specialist do this implant along with cleaning up my old site I am most happy. I've been concerned though I posted a few years ago on this site about how great my under muscle in my right chest was only to find I managed to dislocate. I haven't been given any restrictions about activities, but hopefully my 6th pacemaker enjoys it's ride. As far as incision pain was next to zero from day 1 as they even used staples which bugged a little prior to removal.

A HUGE bonus, I don't need a costume this halloween, I can just go bare chested as Frankenstein answering the door bell with trick or treaters.
DonB

You know you're wired when...

Muggers want your ICD, not your wallet.

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