Pacemaker Implant Size Related Pain and Discomfort

Hi folks,

Just reaching out to see if anyone can relate to or offer support with something I'm experiencing with my most recent pacer replacement.

Has anyone experienced pain/discomfort with body movement due to the size of their pacer? Specifically with the pacer rubbing/jutting into ribs and collarbone or having to "reach around it?" Has anyone been able to get their pacer replaced for these reasons?

I am eight days post-op from getting my third pacer implanted. While the brands differed, my first two pacers were almost identical in size and shape, both being about 8cc in volume size, and fit nicely into the same place in my chest - just under the incision. My new, third device is considerably larger, being 12.8 cc in volume size. Calculated, this is a 63% increase in size, and has turned this last procedure into the most painful one I've had yet, particularly since the pocket in my muscle had to be enlarged to make room for the new honker. I'm not sure why my doc chose a device with such a dramatic size difference. My needs and health hasn't, nor my condition, changed or worsened. I am an active female, 5'4", 155 lbs, and still a young 32 years old in otherwise excellent health. I swim, jog, and do some light weight-lifting. All things my surgeon knew.

The device is constantly in the way. I feel like I'm having to "reach around it." It juts out at odd angles against my skin and into my ribs when I lie on my sides, as well as reaching up to my trachea when I lay on my left side, and pressing uncomfortably against my ribs. Can anyone relate? Anyone who has read this far? Lol...

I realize I'm only eight days post-op and, technically, I haven't completely recovered, but this isn't my first rodeo with these procedures and know what to expect. The first two weren't like this. That being said, this IS my first rodeo with a device size increase and am hoping to find someone who can offer any insight. I have my post-op appointment tomorrow and am nervous to discuss my experience with my nurse. I can't imagine living with this pain/discomfort for the next 8-10 years.

7 Comments

Healing

by cheshirealice - 2014-04-08 11:04:33

Sorry to hear about your discomfort. My left side where the PM is implanted is still swollen after 2 weeks. I'm constantly icing it and have to take a vicodin every so often. Tick-tock has a point about telling your EP about your pain and discomfort. This is why I was able to get a PM replacement only 4 months after getting a new generator. Sure the PM worked but I was unhappy and depressed. When I finally broke down crying because of how unhappy I was, they decided to replace the PM. I am so happy with my sub-pec that I can't even tell it's there. A little more healing than a traditional but worth it.

It'll get better, it just takes time. Stupid time.

-Erica

Sorry for you discomfort

by Tick-tock - 2014-04-08 11:04:58

So sorry for the pain you are experiencing. What pm did you have, and what did you surgeon implant this time around? I'm not sure why he/she would choose to change if you had a good experience with the last one; possibly due to your age from your last one? I had my first pacemaker implanted approximately 6 months ago- I had a heck of a time with it. It was extremely painful and ended up slipping into my armpit. I ended up having my second pacemaker implanted only 4 days ago. I required to have an ablation, and lead extraction. Since my EP was going to have to open me up anyway, he made a new pacemaker pocket. I am still quite sire, and not completely happy with my pacemaker placement, but it is much better than my last one. Mine is buried under my breast and placed just above my nipple. Gravity is not my friend right now. I wish it was placed more superficial, just below the skin, but my surgeon said I was too small and didn't have enough room to be placed anywhere else.
As far as replacing, I believe your surgeon would want to give it more healing time to make sure. It's not just "normal" healing pains. I know it's not easy, but I would try and give it more time. Don't downplay your discomfort tho. If you don't complain, and they don't have documentation of your pain, then according to insurance companies- there is no issue.
Try and remember you are only 8 days post op. Be kind to yourself, take pain meds if you have, if not maybe call your surgeon for something, and ice, ice, and more ice :)

Zatt

by Tick-tock - 2014-04-09 01:04:41

Haha... Love your big guy in a little coat comment!!! As far as pacemaker- the one I had planted end of September was the sane as yours! St Jude 1210. To be honest I have no clue what's in me right now- guess I should figure that out lol. I just know my merlin at home still works with it. I do have discomfort putting on a bra- I found a front clasp is easier to put on, mainly because of arm restrictions. I am I different with wearing a bra- it's uncomfortable to wear and uncomfortable not to wear. I too am on the younger side - 31. My heart relalated issues came on rather sudden last year. I have my follow up appointment next Monday, I'll receive all my info then. My surgeon did not do my discharge from the hospital since I was released on the weekend- and was happy to escape from my roommate who had dementia and whose bed alarm went off all night!!!

Same here

by golden_snitch - 2014-04-09 02:04:14

Hi!

I went from an 8cc device to a 12cc device in January, and needed a revision surgery in March. Now, after the revision, I know that it wasn't the size that caused all the discomfort, but the placement.

I have a subpectoral implant, too. For some reason during the surgery in January the surgeon decided to put the new device in a bit differently, upright and with the header to the left side. First three-four weeks were okay, although I already noticed much more discomfort than after previous surgeries. I blamed it on the bigger size of the device as did my cardios. During the fourth week after replacement, I began to experience quite a lot of pain again, mostly burning and stinging pain across the whole left pectoralis major muscle, even at rest. I needed to take loads of painkillers. Four weeks later we found out that the upper edge of the device had pushed its way through the pectoralis major muscle. I then had a revision surgery, almost three weeks ago, and now I'm doing a lot better. I do feel that the device is a bit bigger, but the way it's placed now, you can barely see it again - like my old device -, and it's much more comfortable than before. It's not even been three weeks since revision, and I can already sleep on my left side again.

So, in my case we all blamed the problems on the bigger size of the new device at first, but then it turned out that it just wasn't placed well allowing it to push its way through the muscle.

Inga

Placement

by cheshirealice - 2014-04-09 05:04:57

This current PM is my first "adult placement". The previous 2 generators were located in my abdomen because it was placed when I was 17 when I underwent open heart surgery. I chose to put this PM sub-pec and I'm pretty happy so far but I gotta admit that Inga's last message worried me a bit. I don't want my PM to push through my muscle. The pain you're experiencing is likely your body responding to the larger PM. Hopefully your swelling goes down and your pain subsides soon.

-Erica

Thank you!

by zatt2m - 2014-04-09 12:04:22

Thanks, ladies. I greatly appreciate your feedback! It's reassuring to have relatable information, even if it's not exactly what I want to hear. I figure time is going to help. I just hope it's also an advocate, lol.

Tick-Tock - I'm SO sorry about what you had to go through! I've had a few complications, but never any that severe. I can't imagine having a pacer in my breast... I'm showing the effects of gravity too but am able to have my device in my pec. Do you feel any discomfort with your pacer and pocket when squeezing your boob into a bra? :) The device I have now is a St Jude PM1210. I wish I could post pics here to demonstrate the size difference between it and my last one. What pacer do you have now? Thank you for your suggestions, though... You're so right about insurance companies. I'm not a complainer by nature and have so much anxiety about what I hope to say and get across in my post-op tomorrow. I have almost 20 years of heart related medical history and this is the first issue I've ever had...

Erica - stupid, stupid time! I appreciated your saying that. Would you be willing to share what you disliked about your previous device? Was it the placement? My previous two pacers were sub-pec and completely unnoticeable to the naked eye. I was able to live in such a way that I forgot they were even there. I'm anxious to have that peace of mind (and life) back. I'm fortunate in that I heal quickly, thank the powers that be, but now my pocket is all stretched out and bigger... Insert anxiety here over managing a smaller device in a bigger suitcase, if I can get a change approved.

Big guy in a little coat.

replacement burning and stinging

by lfedwards - 2014-08-31 11:08:29

Inga and others,
I am on my 2nd pacemaker. It was implanted 9 weeks ago. I am experiencing burning and stinging. It is worse at night; I try to sleep on my back but I end I put on my side. When I wake up (both in the middle of the night to turn over) and in the morning, I am horribly sore. In addition, I burn for approx. An hour after I wake. I go back to my cardiologist in 9 days for another follow up appt. I would like all experience that you all have had with this. I am lacking sleep and suffer "bee sting feeling" throughput the day. Thank you. Leigh

You know you're wired when...

You get your device tuned-up for hot dates.

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