12 weeks post PM and still not fully fit

• by Shaun
• 2014-12-25 05:12:47
• General Posting
• 1121 views
• 4 comments

I'm now 12 weeks post-PM and not sure if I'm supposed to be fully recovered or if its still early days. Mostly I feel fine, but sometimes I just feel generally unwell, very difficult to say exactly what the problem is but it can last all day, or it can disappear after an hour or so. I never had any symptoms prior to the PM, so maybe I'm expecting too much to be feeling like I did previously after only 12 weeks.

I can go for most of the week feeling well, then one day I completely lack energy and feel quite light headed / dizzy. I can also feel a general discomfort in the chest area (tightness / aching / heaviness) and breathless with a heart beat sensation which can become more pronounced during short bursts of exercise such as climbing stairs or even just talking too much (during presentations / meetings). If however I do an intensive workout on my turbo trainer, then I feel great apart from the first few minutes when I can sometimes feel discomfort breathing. In fact I get the impression that an intensive workout is what can leave me felling quite well for a number of days afterwards.

One thing I've noticed is that my blood pressure is quite low when I'm relaxing especially after I've gone to bed at night. Typically it gets down to about about 92/52 @60bbm, although it has on occasions gone lower. I know my blood pressure has always been a bit on the low side, but I've never really looked at it before so I don't know if its lower now than before.

The reason for my PM was that I started losing consciousness one night every time I fell asleep and within 24 hours I'd been diagnosed with Bradycardia (Sick Sinus Syndrome) and received the PM. The PM is a dual chamber Medtronic ADDR01 (pacing mode DDD) programmed to pace when my heart rate falls below 60bpm. While I was in hospital there were a number of checks performed on my heart and apart from the Bradycardia there were no other abnormalities found, which makes sense really because I was a very fit and active cyclist.

Because my pre-PM symptoms appeared so suddenly and dramatically I was admitted to hospital very quickly, received my PM and then discharged all in less than 48 hours. This meant I had very little time to talk to the cardiologist about my condition (in fact my longest conversation with him was while he was actually performing the procedure). I then had a follow up PM clinic appointment 6 weeks later, but I was only able to see a PM technician with a programmer (not sure what her proper title was) whose only interest was in the PM itself. When I tried talking to her about my symptoms her attitude was that whatever symptoms I may or may not have, they were not being caused by the PM because the PM was was doing its job.

Anyway, last week I decided to see my family doctor to better understand whether my symptoms were normal or if they were cause for concern. He wasn't sure and so he's referred me to the cardiologist. I guess what confuses me a bit is that while my heart rate is above 60bpm, then the PM should not be doing anything and so why aren't I feeling like I did before the PM? One thing I did learn from the PM clinic was that one chamber was pacing at 60% while the other chamber was pacing at only a small fraction of a percent. I wondered therefore whether the PM should have been set to lower than 60bpm. The other things that crossed my mind were (1) whether the PM is making my heart lazy, thereby making the Bradycardia worse and leaving the heart unable to respond quickly to the demands of small amounts of exercise, (2) whether the PM is continuing to pace for too long after the heart has responded to the demands of exercise or (3) whether my Bradycardia / syncope was a symptom of something else.

I would be interested to hear about the experiences of anyone else with a similar condition to mine - thanks for reading.