Latest Update on 85-Year-Old Husband

My DH had his first "interrogation" I think you call it today of his pacemaker implanted January 3, 2014. I'll have to admit that I was totally ignorant as to what they do. I could tell that there was a problem when the tech called in one who was seemingly more knowledgeable than she was and there was quite a bit of low-tone discussion between them. When the doctor came in, he was quite confused for which he later apologized. He had said that my husband had had a defibrillator implanted because of his congestive heart failure and blah, blah, blah. He apparently had him confused with another patient. I called his attention to the fact that he did not have congestive heart failure. I am not sure what he was trying to say except that possibly a lead was not properly attached and was not giving out the proper impulses or charges. He explained that this would have to be followed quite closely (within 6 weeks) and, although it is doing its job sufficiently now, that it may not last as long as it should and he would not want to defer redoing the lead before it got too attached to where it is now, that it would be best to replace it early on. I asked him would that not likely result in infection, etc., and he said that, of course, every time you re-enter the incision site that there is more chance for infection. I am totally confused. My husband has had one problem after another and now when he seemingly is getting his strength back and his outlook is so improved, this thing has resulted. We have an appointment back to see him in 6 weeks but in the meantime we see his regular cardiologist (whom I really respect and believe) in 5 weeks, so maybe he can explain it better than this dude did today. He supposedly had done 1500 pacemaker implantations in his career, but he certainly has no people skills. Maybe that's not a requirement for being a good surgeon.

Has anyone of you experienced problem with a lead so soon after surgery and can share with me your experience? My husband had been concerned over the fact that two weeks after surgery when he was taken by ambulance to the ER for excruciating chest pain that a CAT scan was done to check for a pulmonary embolism and he was required to put both hands above his head for several minutes. He expressed concern to the technician but they said it was okay. We wonder if that was when the lead may have changed position.

Sorry to be so long, but I am just really upset and confused. I just ache for this dear person who has gone through so much in 30 days and now may have to go through another procedure. I feel like screaming very loudly if that would do any good.
Ann R.


4 Comments

unfortunate, but it happens

by Tracey_E - 2014-02-05 05:02:27

It's unusual but not unheard of for a lead to not stay in place. It's usually not anyone's fault. Sometimes the heart wall doesn't like the lead being in there, sometimes the heart isn't shaped exactly as expected so it comes loose, sometimes it just comes out. Very rarely we do something too vigorous with the arm and cause it to come out, or possibly the CT. Whatever the cause, it's an easy fix. The surgery is much easier than the first one.

When they say it's working but they are watching it, that probably means the place where it's connected to the heart wall is not as secure as they would like. When it's positioned ideally, they can turn the juice down on the device and a minimal signal will get the heart to beat. When scar tissue builds up, leads start to go bad, or in your husband's case, it's not exactly where it needs to be, they crank it up to get the signal through. So,it works but it drains the battery quickly. When this happened to me, they likened it to running the air conditioner with the window open. The house cools, but the power bill is through the roof.

It takes about a year for a lead to fully secure into place, so within that time they can just reposition the lead to a better spot. It sounds like they are going to watch it rather than rush into another surgery, sometimes the scar tissue grows and it turns out ok. The doc may not be much for explaining things or bedside manner, but it sounds to me like he's doing what's prudent.

Go ahead and scream. :) Sometimes we just need to get out the frustration before we can move on. It's hard to see a loved one suffer.

Thanks, Tracey

by BillRussell - 2014-02-05 09:02:05

Your comments eased my mind tremendously. I am so grateful for this site. Everyone has helped me so much in the past month. I am still scared about his future, but I will print this and re-read it when I am more anxious than normal. I have always thought I was a strong person. We raised 3 boys and 1 girl (all of them now in their 50's), and I have experienced almost every kind of situation imaginable; but I have never had anything as trying as this to see him in so much pain. I think it's basically because I am afraid that I will lose him and be alone again for the first time in 61 years. It's almost inevitable that this will happen, but I am not yet ready to accept it. I guess all that I can ask for is strength for today and bright hope for tomorrow. Thanks for your help!!
Ann R.

Not to worry...

by donr - 2014-02-05 09:02:22

...about him raising his arms above the head for the CT scan. He did it slowly & gently & just held then steady for a few minutes.

Look at what his incision looked like at two weeks - pretty well closed over & healed. At least mine was. His implant sites were just as well heeled.

There's lots of slack in the leads between where tey attach to the PM case & the implant site. No way could he have stretched all that slack out to pull out an implant. Next, the lead is anchored to the vein on the outside where it enters it. That pretty well fixes it in place.

Last, consider the physical environment it is in. The blood moves very quickly through the heart chambers. those leads in the last short distance are battered about like a bamboo cane in a tornado! Look at what happens - the blood RUSHES in, is suddenly stopped when the atria contracts, then immediately started again when the valve down to the ventricle opens, then stops when the valve closes and the ventricle contracts. Think about this - blood flows from your elbow to your neck area in about 3 or 4 seconds - it's moving out smartly - in a stop-start condition, so there's a lot of turbulence in there.

That lead is NOT going to come undone after 2 weeks - IF it was installed correctly. This sounds more like a bad location than a poor implant.

Glad Bill is feeling so well after all he's been through.

Don

Hi Ann

by Casper - 2014-02-06 11:02:29

My heart aches for you right now!!!

What a kind a caring wife you truely are.

I hope you take a few moments each day with a nice cup of tea just to take nice long deep breaths, and know their are some fine people on this website always willing to listen to you.

I must say Hurtheart makes a lot of sense, what's up with that doctor?

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