My story, Q&A and tips to prepare for your implant

• by gertrude
• 2015-09-15 03:09:28
• General Posting
• 1643 views
• 3 comments

I'm a new pacemaker almost three weeks out now. I posted here just before my implant and you all were so great to provide advice and suggestions to make my recovery easier. I thank you all and figured I would share my story that may help someone else preparing for theirs. I realize not everyone gets the opportunity to plan for and make decisions ahead of time before their procedure, luckily I was fortunate and had time to evaluate my options and prepare.

I'm 32 with a long history of arrhythmias including WPW, SVT, A-tach, SSS (tachy-brady) and intermittent heart block. My bradycardia finally caused symptoms significant enough for me to proceed with a permanent pacemaker. My rates would drop into the 40's while awake and resting or even standing still. I'd drop into the 30's while sleeping and never got solid rest. I was in a fog, dizzy, "spacey", tired all the time no matter how much sleep I got and frequently felt like I was going to pass out. I was afraid of what life would be like after a pacemaker at my age. I wondered if I really needed a pacemaker. I realized that my bradycardia and associated symptoms were interfering enough with my life that I wasn't living. I was avoiding more activities than I was participating in. I put the fears aside, placed trust in my physician and made the decision.

I now have a St. Jude dual chamber device. My procedure was very simple and my recovery only hindered by some mild pericarditis that is resolving. I'm atrial pacing 40% and ventricular pacing about 1% of the time. Settings have been adjusted a bit and everything is working perfectly. I needed the pacemaker.


Things I wanted to know before implant were:

"am I going to feel better?"
"is it going to hurt?"
"will I be able to feel it pacing?"
"how bad will the scar be and can you feel the pacemaker under the skin?"
"what will I need after surgery?"

I chose to be awake for my implant with just local anesthesia to numb the area and some pain medication in my IV. I was awake and conversing during the procedure. It wasn't terrible at all. There were some times it was uncomfortable and all I had to do was speak up and my needs were met. It was very quick and an easy procedure. I was fully awake in recovery and felt really good after.

The big question... "Could I feel a difference?"
Absolutely! The first time I was up and walking after the procedure I knew I felt different. I'd lived with symptoms from my bradycardia and heart block so long and just accepted them as normal. The foggy feeling in my head, the dizziness, the near syncope, the breathlessness and fatigue... Gone. I knew immediately that I made the right decision. My rhythm has never been this regular in my entire life.

"Does it hurt?"
Of course. You just had surgery that required and incision and you now have a foreign object implanted. For me, I was comfortable after until the local wore off. My pocket was on fire and I required pain meds to battle the pain and soreness for almost a week after. My shoulder hurt and use of my arm was restricted. The pocket was swollen and very tender. My nerve was irritated and was a sharp pain and then felt like ant bites. Sleeping was uncomfortable. I'm a side sleeper and was forced to sleep on my back for the first 2.5 weeks. It's all normal. Day by day it gets better! Take it easy and don't overdo it. Listen to your body. And your doctor!

"Can you feel it pacing?"
"What does it feel like?"
Yes. I can. I'm small and I'm sensitive. I do not feel the atrial pacing at all but I do know when my RV lead paces. To me, I feel a little tapping sensation that is almost like a small rubber band popping the bottom of my heart. It is NOT painful nor does it feel like an electric shock. The paced beats I feel almost feel like a PVC but without the pause after. If you feel it, you'll get used to it. They've adjusted some of my settings already but I still feel it. I'm learning to ignore the sensation.

"What about the scar? Can you see/feel the device?"
My scar was done as a vertical incision that is hidden under my bra strap. It's about 2" long and has healed beautifully. You won't even hardly notice it once it's completely healed nor can you see the scar even in a tank top. I'm small and my device is just under my collarbone. It sticks out slightly and if you're looking for it, you'll see it. Otherwise, it's barely noticeable. Now that the swelling has gone down I can feel the leads coiled under it but it isn't gross nor obvious. Hopefully my device will drop a little as it heals more as it does rub on my bone and it's tender, but overall, I'm quite happy with the result. Scars just add character anyway.

"What will I need after surgery?"
Thanks to all the wonderful posts and responses here, I had everything I needed when I returned home and was well prepared. Here's some of the things I needed or used most as well as some tips I learned during my recovery.

-Pillows
Several to help you position at night, prop your arm up or hug for comfort. I couldn't sleep on my side for a few weeks. Not even my right side. The device pulled and it was painful. Left side was out of the question and even now at three weeks it's still a bit uncomfortable for too long.

-Back scratcher
Trust me. You'd never think you needed one until you get a dreaded itch and your sore arm can't reach and no one else is around. Very handy.

-Seat belt cushion/cover
Your pocket is going to be sore for a while. The last thing you want is extra pressure or that belt cutting into it. I just picked up a Sherpa one from Walmart and I'm still using it. Much more comfortable.

-Bras
Ladies, you might want to do without initially if you can. Or get a strapless to wear comfortably for the first week. My doctor suggested putting a folded gauze pad under my bra strap to cushion the incision but that was just too much pressure. Either go strapless or go without.

-Shirts
Button down or something easy to slip on/off. Don't try and wear anything too tight or form fitting if it doesn't stretch. It was easiest for me to put my left arm in, stretch it over my head, then put my right arm through. My device is on the left. I wore tank tops a lot because it was easier to dress in layers. Put a robe or sweater on if you get cold. Way better than changing clothes if your body temperature fluctuates... and it likely will!

-Baby wipes
I was tired, sore and sometimes needed to freshen up even if I had showered. Good to have on hand.

-Showering tips
I found it easier to wash my hair if I bent over at the waist and washed with only my good hand at first. Slowly I was able to raise my other arm enough to help but still had to bend over to reach. A loofah or shower sponge on a stick is helpful to reach your back.


This was longer than I intended but I made many mental notes during my recovery of things that made it easier for me and others may find helpful or useful. Most importantly, take care of yourself. Rest when you need to. You'll be worn out. It's normal. Let others help you when you need it and keep a positive attitude. It will do wonders for your recovery.

Best of luck! :-)