Questions to ask my doc before surgery

Hi, it's me again. :)

The more I read the posts here, the more I think I overlook the whole thing. All I knew before was that I am to get a device and I won't be afraid of fainting when driving ever again. It seems I should have been more prepared but I'm not.

I'm going to have a pre-op consultation when my surgery date approaches, but I managed to squeeze in another appointment with my cardiologist tomorrow. Any suggestions on what questions I should ask my doctor?

I am going to ask him if he's going to secure my device with stitches. My device is going to be Medtronic. It's going to be the MRI tolerable one. My doctor knows I would like to play competitive badminton again so he mentioned something like "setting it to between 60 and 130". What does it mean? I thought PM will only be activated when my heart beats too slowly. Also, I saw in some posts mentioning the percentage on either atria or ventricles. Is it something I should discuss with my doc tomorrow?

One more question. I can only sleep on my left side or I won't be able to fall asleep. Even if I try, I always find myself waking up in the same position---I have left arm raised up under my head and I'm on my left side. It's an over 40 year habit. My doc only told me I have to change it after the surgery. But how can I control myself in my sleep? So worried that recently I started to train myself to sleep on my right side. Not working at all...

I know everybody is different. It's just that with my English incapability, I'm so afraid that I'm making the wrong decision.

I really appreciate all the encouragement and suggestions you've given me. The other night when I told my mom about what useful information and warm support I found here, we both cried. Thank you.

Michelle

6 Comments

questions

by Tracey_E - 2015-01-19 09:01:20

I would ask about placement. If you are athletic, you may prefer it a bit lower and deeper than the usual placement so it's out of the way during sports and less conspicuous.

60 and 130 means you will have a lower limit of 60 and an upper limit of 130. Any time your rate drops below 60, the pacer will kick in. You have av block, yes? This doesn't happen often with av block. With us the sinus node, our natural pacemaker, works normally but the signal gets blocked on the way to the ventricles. We need the pm to make the ventricles beat when the atria does. That's the 130, the pm will only track the atria up to 130 bpm. That's a standard setting to start with but it can be turned higher if needed. Mine is at 180, which is the max on my model. Some of the mri-safe models only go to 150. If you think you will get higher than 150 during exercise, make sure that's not the model you are going to get.

You'll be able to sleep on your left once you heal! It'll be sore for a few weeks. I found it helped to sleep on my back hugging a small pillow to my side. Any time I'd start to roll onto my sore side, the pillow would stop me.

If you are passing out, you are NOT making the wrong decision. Please do not second guess your decision. Having your heart out of sync is hard on the body, being at risk for passing out is dangerous.


Sleeping Comfort

by Artist - 2015-01-19 10:01:24

Michelle, I have had my pacemaker for 10 weeks now. I normally sleep on my right side, but when I do sleep on the left side, I find that putting a pillow under my left side that runs from my armpit to my waist takes some of the pressure off my shoulder and makes it easier to sleep on that side. It sounds like you really need a pacemaker and will be much safer and healthier when you get one. The surgery is simple and quick and it will be a great relief when you no longer feel like passing out. We will help walk you though your post surgical adjustment. Best wishes.

you'll be fine!

by Tracey_E - 2015-01-20 07:01:42

Your problems are frustrating and you definitely need the pacer, but a few weeks until after your meeting is ok. It's to be taken seriously but is not life and death. If it was a bad idea, I'm sure your dr would have put his foot down! Just be careful.

Necktie Assist

by missy - 2015-01-20 10:01:01

I slept on my left side right after the pacemaker was implanted (Sept. 2014). I stayed in the hospital that first night. Nobody told me not to. As far as raising my left arm...I was told not to raise it for 4 weeks. I was so paranoid about raising it in my sleep that I took my son's necktie and tied my left arm down with the tie tied loosely around my waist. It worked great. Not uncomfortable and got used to it. I think I slept with it for six weeks. Everything healed well. Oh, and I went to my 50th high school reunion, across the country 3 weeks after I got the pacer. Wish you the best.

questions

by bluebowtye - 2015-01-20 11:01:42

Hi Michelle,

You are lucky that you have time to prepare for your upcoming implant surgery. Many of us found out suddenly and unexpectedly that we needed a PM and had no time to prepare and do research. All my doc told me beforehand was given my age, he was going to implant a dual lead MRI compatible one. I ended up with a Medtronic Advisa which seems to be working just fine for me.

I sleep mostly on my right side but could only sleep on my back for the first few weeks. It was hard, but eventually you get so tired you fall asleep no matter what position you are in. It was several months before I could even attempt to sleep on my left and sometimes now when I do I can still feel the pacer in there. It's not painful, just uncomfortable. My doc told me to wear my left arm in a sling at night for 4 weeks after my implant. Many don't agree with this, but I didn't know any different so I did what I was told. If you do, then you will certainly be reminded to not sleep on your left for awhile. The pillow sounds like a great idea.

As far as the % paced in the atria and ventricle that's why you get a dual lead. In my case I have AV block only so most of the time my atria beats normally on it's own and the PM is there to make sure the ventricle follows suit. However, sometimes the Atria also needs reminding. I just got my latest report showing I was paced 25% in the ventricle and 2.2% in the atria. I am one of the rare people who seems to need the bare minimum. My settings have never been changed since I left the hospital and I have no issues. My lower limit is 60 bpm so my pacer will kick in if my heart doesn't beat within that time frame and my upper tracking I believe is set a 140. I have none of the extras turned on that some people here talk about. We are all different and what works for me may not work for you. Some people take a few tries before getting their settings optimized for them.

If you have been fainting you are making the right decision. That was my symptom too and now I never have to worry about that again. I am just so thankful mine happened while sitting on my couch and not while I was driving.

I wish you the best of luck. I'm sure you will do just fine. It's scary to think about but once you heal it's not all that bad and you can return to your normal life soon. It took me about a month. Complications can happen, but they are rare. Finding this site was the best thing for me, especially for the mental aspect of it all. My only wish was that I had found it sooner before my implant so I could have been more prepared.

Take care,
~Sheila

Thank you.

by etmichelleh - 2015-01-20 12:01:01

Big thanks to TraceyE, Artist and Shiela, as well as other people that read my post.

There was once when I was scooping out the cat litter, which was about 1.5 years ago. I woke up noticing the litter box was at the same height of my eyes. :) And then last March, in front of my mom, I fainted again. I didn't know I passed out until I saw my mom's worried face above me. I hit the back of the head on the floor and hurt my knee. It was then I decided to wear a monitor.

When I was in TW, where I'm from, my doctor told me my fainting might be caused by my blood sugar dropping too low and no oxygen sent to my brain. But as soon as I started wearing the monitor, the docs told me it's my heart. One doc did tell me to get a pacemaker immediately, but I refused. I was hoping it was because of my Motoprolol, but after stopping it for 2 weeks, my heart still stopped, so the second doc, which became my cardiologist later, told me again I need one. I still replied "let me think about it". Until the day I fell to the floor in the office...

I have to go out of town for a company event in early February. I'll be standing and moving things and talking to people for three whole days! So I asked my doctor to schedule my surgery to sometime later than the event. I know it's risky. I'm very scared now, but I can't afford to lose my job...

For my mom, for my husband, my family, and all of the nice people here in this club, I'll be strong. And I'll come back to share my experience with new people.

Michelle

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I had a pacemaker since 2002 and ever since then my life has been a total blessing.