PM settings +++

Hi :-)
I'm new to this forum, AND I'm from Norway so i hope you excuse my written English :-)

I have a sick sinus syndrom, and i got my PM in summer 2010. Since that i have had a little anxiety about my heart, although the doctor says everything is ok and that i should meet a psychiatrist to solve that out.
My problem was that I felt some heavy heartbeat at the same time every day, and that scared me for years, thanks to this forum I now understand that this is probably the PM doing Self test. My doctor told me i was "crazy", but i know understand that more people feel this :-). Is it safe to turn the self test off? I rally hate it!!!

The second problem is the nights. Before i got the PM i fell asleep at night, and woke up in the morning without remember anything and felt rested. After i got the PM Wake up several times a night, have nightmares and every morning i feel dizzy. Can someone give me some hints about what this can be? Is it anxiety or can it be some PM settings to adjust at night?

My 3. question: My rest pulse is about 65 bpm, and the doctor have set the lower limit for the PM to react at 50 bpm. Is that ok, or should they set the lower limit a littlebit more closer to my resting pulse?

Thanks to everyone answer my question, i found this forum 2 days ago, and already it has helped me alot :-)

oporay :-)

5 Comments

Hi oporay / Lower limit

by IAN MC - 2014-04-11 04:04:17

I'm sure that your English is far better than my Norwegian

I will leave others to answer your first two questions but just a comment on question 3 and the lower limit:-

It would seem to make sense to have the lower limit as close as possible to your natural resting heart rate and the only benefit in having it lower is that the PM battery will last longer but I believe that is quite a small benefit.

My natural resting HR has always been 60 bpm and, for some reason I have had the lower limit at 50 bpm for the past 3 years. Whenever I asked to have it increased I was told " it won't make any difference ! "

At a PM check-up last week , I insisted, and they reluctantly increased the lower limit to 55 bpm.

It has made a HUGE difference !! I no longer fall asleep in the evenings and have more energy.. The extra oxygen being pumped around my body by that 5 bpm increase has led to a dramatic improvement.

So for everyone reading this, if you think your lower limit is not close enough to your natural resting HR then GET IT CHANGED and see how you feel !

Best wishes

Ian

Hi Ian

by oporay - 2014-04-11 05:04:35

Thank you so much for answering question 3 :-). I have exactly the same problem, fall asleep on the couch after work and no energy at all. And that bother me because I'm usually a active guy and I feel this is affecting my life and my raltionship with my children (7 and 12 years old). I will definetly get it changed closer to my natural resting heart rate as soon as possible. It is good to feel that I'm not alone :-)

Reinforcement for Ian........

by donr - 2014-04-11 09:04:24

.....Sometimes Cardios are crazy!!!!! If he really wants to save your battery, why not just turn the lower limit down to 10 Beats per minute - or for that matter, turn the darned thing OFF - then he'd NEVER have to replace it. But you'd feel just as bad as you did before the PM was implanted.

The PM was placed to make YOU feel better, so that means a bit of compromise in the 'Settings versus battery life" issue.

You have hit the main issue here - set the PM too far BELOW your natural Pre-PM rate & you will feel NO BETTER; set it too far ABOVE & you will feel bad, but in a different way. That different way is that you will feel constantly agitated & "Hyper-alert" - like something bad is always about to happen. Why? Because that's what happens when a man feels threatened - his heart rate is increased by adrenalin caused by fear/anxiety.

In MY EXPERIENCE, you want your PM base rate set Just at your natural, Pre-PM resting rate or the first rate above it that is a multiple of FIVE. (The multiple of 5 comes up because many PM's cannot be set at rates that are NOT a multiple of 5.)

So what does this do for you? Since you have SSS, it keeps your HR from ever falling BELOW your natural, Pre-PM rate. I will bet you that Pre-PM, you had a constant drowsy feeling & wanted to fall asleep whenever you sat & relaxed & your Heart Rate fell because of being relaxed.

Your Cardio says you are crazy - well WHY does HE not check you out by raising the Base Rate up for a couple weeks so he can prove it to you? That battery is going to last years - a couple weeks for an experiment will NOT change its life expectancy enough to measure. My experience parallels Ian's - but from the HIGH side of my natural rate. I was set too high & felt constantly agitated. They set me at 80 for a base & I was a natural 72 all my adult life. The Cardio dropped it back to 75 and within minutes, I felt normal again.

Now to the other questions:

Yes, they can turn the self test feature off - but it is NOT a smart action to take. The PM runs through that routine for your safety & well-being. It Tests a lot of functions that the PM performs & gives warning of potential failures; checks out the resistance of the leads; resets its operating voltages on its own (Some models). In short, it is determining how well your heart & the PM are interacting. Mine is set to perform these checks at 1-2 AM, while I am asleep, so i don't notice them. The time of day is adjustable for when they are performed. You notice them occurring because your heart is doing something different & it's ALWAYS at the same time of day. You are NOT crazy - your mind is just doing very well what it is designed to do - tell you when something odd occurs that you should pay attention to.

Here's how to beat this problem - ask your Cardio if that is the time of day that your self check takes place. Get him to describe all the events the PM checks & how you should be sensing them. Then start looking at the clock when it occurs every night & say to yourself "Yes, my self check is going on. Not a big problem. Matter of fact, that's normal." Then go do something else, realizing that it's just the PM doing what it's supposed to do.

As to the sleep problem: Here is a GUESS as to what is causing it. It's a two pronged fishhook! Physical & psychological.

Physical because your BASE RATE is set TOO LOW. Too low by some 15 Beats per Minute. THAT'S a LOT. It's one Quarter of your Pre -PM natural Heart Rate! So what happens? You are zonked out of your mind, sound asleep w/ your Heart Rate as low as it can go for that reason. Oxygen demand is low, your heart does NOT have to beat fast, so it slows way down to the point that you subconscious mind is sensing something WRONG!

Here comes the psychological part: The subconscious mind does its job - it awakens you so that the conscious mind can take care of things & figure out what is wrong & take action to fix the problem. Probably causes the nightmares, too. And those nightmares probably take place in Norwegian. They are disturbing to you. (I know that if I had nightmares in Norwegian it would be VERY disturbing! - Sorry about that poor joke, but just could NOT resist.)

Because of the poor sleep you are now getting - AND the effect of poor Oxygen levels during the night because of the sub-normal heart Rate, you awaken in the AM dizzy & probably groggy & like you were "Drugged,"

Does this all make sense to YOU? It does to me.

Again, an experiment by your Cardio by raising the base rate would answer this question in a night or two.

Good luck w/ your Cardio.

I know exactly TWO words in Norwegian - Oslo & Lillehammer - & I probably don't pronounce them correctly, either. I went to the Boy Scout 's World Jamboree in Lillehammer in August, 1975 as an adult leader. Flew into Oslo & took a bus the rest of the way.

Donr

WOW...

by oporay - 2014-04-11 10:04:19

ALL you said makes sense to me Donr, Im gratefull and so happy that someone helps me with this "problem", I already notice that Im less anxiety by reading the answers :-).

This is what I have learned so far from you all;

1. The self test takes place every night at 19:26, so i will ask Dr. to change that time as soon as possible :-)

2. I will definitely ask the Dr. to change my base rate up to at least 60.

And when I read all the symptons you are describing when having a too low base rate, it is exactly what i feel. I Wake up groggy and feeling "drugged". I also feel some times during the day that I almost will faint, but it only last for a few secunds, just "jumps" right" on me. And of course Im always tired, and Im feed up of that!

And all this (feeling heartbeat, dissy, groggy, almost fainting, poor sleeping, tired) makes me scared every day...but thanks to you Im convinced that it is because of the PM settings, and that helps me realx a bit, because i was afraid that it was something else wrong With my heart. THANK YOU SO MUCH :-)

When speaking about the Norwegian nightmares - they are probably one of the most scary ones ever experienced...hahaha ;-). You would'n dare try them ;-)

I will bring all Your good advices to my Dr. as soon as possible - again thank you so much, you saved my day.

oporay :-)

An update...

by oporay - 2014-04-24 08:04:16

Hi Donr and Ian :-)

It's about one week now since I had the following adjustments;

1. My Lower base rate where increased from 50 bpm to 60 bpm.

2. The Cardio changed the Self test from 1 AM to 10 AM.


And the "result" are as follows;

1. No more nightmares at night

2. No more waking up at 1 AM

3. I sleep thru all the night without any problems.

4. I no more feel that Im "drugded" or dizzy when I wake up in the morning

5. No more need for a nap after work

6.More energy overall

I think, as Ian said, that this made a huge difference for me, and I'm so happy for getting those advices from you both :-)
Of cource It can be mental, It can be the easter that has done me well, It can be the spring that is about to come in Norway...BUT I don't care right now, I just feel so much better :-)

Thanks again for the comments.

Raymond

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