Sub cutaneous insertion

I haven't seen any postings on this since 2010. I had my PM inserted one month ago and am back to vigorous exercise. My MD inserted a larger one than planned and it interferes with my movement--my collar bone and my shoulder bone bang into it.
My MD never offered me the option of subcutaneous because he doesn't do it, but says I can get it done anytime (another incision and recovery).
Any latest comments on this please? Who would pay for a second surgery? Is it worth it? I can't sleep on that side!

6 Comments

Similar situation

by Minnesota - 2013-10-29 01:10:24

My PM bumps shoulder and clavicle also.
I'm about 8 weeks PO with 2nd PM. First
Implant in June developed infection and
Had to be removed. My 2nd implant is on my
right side. Unfortunately, The second implant
is a little too high. But aside from a pocket
revision there in nothing we can do except wait
and see if it settles in over time. I won't risk another
Infection to have it lowered. So I am just going to
live with it for now. It is probably too early to judge
final outcome. I do plan to at least discuss it when I
go to my 3 month PM check.

clarifying re: insertion point

by SAG - 2013-10-29 10:10:05

Sorry to be unclear. It is currently under the skin. I am slender and it protrudes a lot on the shoulder side.
He offered--now--to send me to another place to have it put under the muscle if I want.

Sub Cue?

by PacerRep - 2013-10-29 10:10:41

Where is yours at then? under the muscle?

Sub-cue placement

by SAG - 2013-10-29 11:10:20

Thank you, this is very helpful for a newbie!
I feel great, so that's positive. But it feels as though I have a rock taped to my shoulder when I reach up or to the right (taking off a form fitting shirt is nearly impossible).
I will give it some time, as you recommend!

buried

by Tracey_E - 2013-10-29 11:10:29

It doesn't necessarily have to be another incision, sometimes they can use the same incision but make the pocket deeper and that takes care of the problem with out going sub-pectoral. We have had other members do this, if you search "pocket revision" , previous discussions should come up. Or, search "sub-pectoral placement." This is going to sound weird, but sometimes google works better than the search button here! Search pocket revision pacemakerclub.

Mine is buried under the breast, done by a plastic surgeon. This has worked out well for me, it's very comfortable and never gets in my way. Most ep's/cardiologists are concerned with getting it in place and fixing our hearts. A plastic surgeon, or even a general surgeon, knows how to make it look and feel better. Insurance covered mine, but it was done at the same time as the initial placement, not a second surgery. Insurance also covered a plastic surgeon rebuilding the pocket after my last replacement, #4, because scar tissue had built up and was uncomfortable.

You are only a month out so it's not surprising you can't sleep on that side yet. I'd be more concerned about hitting it when you move. If it is too close to the collarbone, the leads can wear and need replaced. Lots of times they settle in as it heals more and gets to a position where you can deal with it until the next replacement. Unless it's really bad, I would give it at least a few months to see how it settles.

ouch

by Tracey_E - 2013-10-29 12:10:19

Yeah, sounds like you might need it shifted down a bit! But you never know, hopefully it will settle on its own for you.

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