Arm movement limiting device â lead displacement
- by Tadpole
- 2016-01-31 01:01:37
- Complications
- 2389 views
- 10 comments
Has anyone worn a device that truly limits arm movement so the elbow won't go above the shoulder? To be clear, a sling does not limit movement of the elbow above the shoulder. I made a device that hooks to my belt and works pretty well. Has anybody done a similar thing? If such a device were available on the market, would you buy it and use it to avoid lead displacement?
10 Comments
No
by Bionic Beat - 2016-01-31 05:01:03
No, I wouldn't buy it nor would I want to limit arm movement for more than a couple of weeks after leads are implanted. The doctors do not ask you to keep your arm tied down, just limit how high and a minimal weight restriction, very briefly.
Any restrictive device could be very detrimental, cause a frozen shoulder etc. totally not necessary, IMO.
You do know that the leads grow into the scar tissue/flesh during the healing process, no? Most of us do not have to worry about lead displacement and it should be dealt with by our physicians.
Another issue
by slickmv - 2016-01-31 05:01:22
Separate from the utility of such a thing, it's already been invented: http://www.bettymills.com/shop/product/view/Medline/MEDORT16100L.html?utm_source=cpc-strat&utm_medium=cpc&utm_campaign=parts&utm_keyword=MEDORT16100L&utm_content=Medical&gclid=CjwKEAiA_ra1BRDV-byb_aDqpQoSJAA-ofB9t9H5Z0ekKEMuxr7i2t6lW_2WCA9l1QX5lQII0BHgxRoCyKjw_wcB
Yes, I wore such a device
by ellen001 - 2016-01-31 06:01:05
The nurses told me my doctor developed the 6 inch wide stiff but padded strap that went around my body... under my right arm and firmly velcroed my left upper arm to my body... I had very limited use of my arm from the elbow down.
I followed Dr's orders and wore it for about 2 weeks... because I had a habit of sleeping with my left arm raised over my head and under the pillow before surgery. Once the habit was broken... with MD okay I ditched the strap and just kept my arm down for the additional required 4 weeks.
As stated above by a previous poster ... I had a very stiff arm and shoulder which took a couple of weeks doing gentle shoulder rolls to resolve. But I have been completely pain free since about 2 months after implant
Can't say I know how much the strapping helped or didn't help because... I DID NOT IGNORE MY DOCTOR'S ADVICE... and I think it's reckless for anyone to do so.
and
by Tracey_E - 2016-01-31 06:01:28
There was a study recently that showed patients with no restrictions had no more incident of lead displacement than patients with the traditional arm restrictions. If you think about it,it makes sense. Unless the lead is put in with very little slack, moving your arm may shift the device, it may shift the lead where it connects to the device, but there's no way it will pull inside the heart. It's just not that tight.
No way
by Tracey_E - 2016-01-31 06:01:38
If arm movement is too limited, you'll end up with frozen shoulder. I've never taken the sling home from the hospital.
Something different
by BillH - 2016-01-31 08:01:23
My impression was that Tadpole was thinking of something different.
Unlike the Betty Mills immobilizer, and more restrictive ones that I have seen shoulder surgery pt use, my though was one that would allow full arm motion except limiting the height of the elbow.
As I see it a cuff on the upper arm, just above the elbow, and a strap that connects it to a waist belt.
I had one!!
by athlete735516 - 2016-02-02 12:02:07
When I had my pm implanted last October, the doctors never gave me anything to wear but my mom ended up getting me an arm imobilizer thing that looked like a thick belt worn around my belly with a Velcro strap that wrapped around my arm at the elbow and attached to the belt and also a Velcro strap that wrapped around my wrist. Worked pretty good. I wasn't very diligent in wearing it though and one night I woke up with my arm above my head. Long story short I have surgery in March to reattach a lead.
I would say if your doctor says no then don't but if he doesn't mind and you don't mind a stiff shoulder then go for it. Devices like that DO exist.
hmmmm
by andy__b - 2016-08-18 07:50:06
Unless you've been given some serious painkillers then I doubt you'd need one.
I found the pain alone was enough of a reminder to not over do my movement, and although I'm still relatively new to the world of PMs, I've not had any issues. Even the sensation of having the unit in me is a reminder.
And as others have said, lets not forget that lack of movement can cause a whole host of issues too.
device dead end
by Tadpole - 2016-08-18 13:05:59
Thanks for all the feedback. Based upon research I've done and interviews with experts in the field I don't think lead displacement is caused by lifting the elbow over the shoulder, regardless of the fact that some doctors still recommend that limitation in movement post pacemaker implantation. See - Naffe, Aster, Mini Iype, Mini Easo, Sandra Dejong McLeroy, Kelli Pinaga, Nancy Vish, Kevin Wheelan, Jay Franklin, and Jenny Adams. 2009. “Appropriateness of Sling Immobilization to Prevent Lead Displacement after Pacemaker/implantable Cardioverter-Defibrillator Implantation.” Proceedings (Baylor University. Medical Center) 22 (1): 3–6. -- Article is free to download http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626349/pdf/bumc0022-0003.pdf
Yes, frozen shoulder is a real complication. The best articles I found on exercises that prevent shoulder pain --
See articles by Adams, et all - free to download:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677872/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059573/
Adams, Jenny, Matthew J. Cline, Matt Hubbard, Tiffany McCullough, and Julie Hartman. 2006. “A New Paradigm for Post-Cardiac Event Resistance Exercise Guidelines.” The American Journal of Cardiology 97 (2): 281–286. doi:10.1016/j.amjcard.2005.08.035. (not free)
Daniels, James D., Shining Sun, Jason Zafereo, Abu Minhajuddin, Carol Nguyen, Owen Obel, Richard Wu, and Jose A. Joglar. 2011. “Preventing Shoulder Pain after Cardiac Rhythm Management Device Implantation: A Randomized, Controlled Study.” Pacing and Clinical Electrophysiology: PACE 34 (6): 672–678. doi:10.1111/j.1540-8159.2010.03026.x. -- (not free)
slickmv - the device I made is different that the one you linked to and less movement limiting.
Bottom line - I'm not pursuing patent and manufacture of the device, mostly because I don't think is does anything except alleviate fears that are unnecesarily placed in patients heads by surgeons who really don't know about post surgical rehabilitation or consult with physical therapists in that regard. Plus, intiial legal cost for patent - $10K, whew!
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The pacer systems are really very reliable. The main problem is the incompetent programming of them. If yours is working well for you, get on with life and enjoy it. You probably are more at risk of problems with a valve job than the pacer.
Pretty useless
by Theknotguy - 2016-01-31 04:01:40
Based upon comments on the forum unless you start out doing extreme physical exercise, you don't have to worry about lead displacement. Most leads come loose because they weren't planted very well. So the person didn't do anything to make the leads come loose and they would have come loose on their own anyway. We did have one person doing extreme weight lifting and they had problems with their leads.
In my opinion, lead problems are so infrequent that having a prosthetic device would be useless. Not to mention it would limit arm movement. I had enough problems with a stiff arm as it was.