Recovery & Restrictions Questions

Hi Pacegirl

by Jax - 2016-08-21 00:28:43

The morning after my pm implant a pa came into my hospital room and pulled off all bandages.  So when I left the hospital I had nothing Covering my incision.  I was told to use my arm but not over my head for about a month and not to lift more than 10 lbs.  

Hi Pacegirl

by Jax - 2016-08-21 00:29:01

The morning after my pm implant a pa came into my hospital room and pulled off all bandages.  So when I left the hospital I had nothing Covering my incision.  I was told to use my arm but not over my head for about a month and not to lift more than 10 lbs.  

Early days

by Dory - 2016-08-21 08:07:54

Different surgical closures are used for the incision site. Mine was glued and I then I was told to keep it covered with the original dressing  for 2 weeks. 
I then bought a few water proof dressings and covered the wound for a little while longer during the day as my bra strap would rub on the incision site. I was told to not raise my arm above my head for 2 weeks however I have read other peoples posts on these sites and they were advised not to raise their arms above their heads for 6 week. To be on the safe side I have been careful with this movement and only now at 6 weeks am feeling comfortable with using my arm above my head as usual: eg washing hair etc. As angry sparrow said, just be careful and don't over do using your arm. Also its wise not to lift anything heavy for 6 weeks. Its early days and a lot of healing is still taking place.

recovery

by Good Dog - 2016-08-21 09:05:57

It sounds like you are doing very well and have little to worry about. As others have said; you don't need the steri strips anymore. It really doesn't matter if you cover or uncover the incision site. The important thing is to keep it clean and dry. 

I am sure you were advised to not raise your arm above your head for about a month. Although it is extremely unlikely, those instructions are intended to prevent a lead from being dislodged. After about a month the leads will be secured to the extent that you can do whatever you want. 

Your PM may need some further adjustment, but as long as you feel O.K you should get on with your life. There is no reason you can't do anything that you'd like to do. Just remember that the purpose of the PM is to allow you to resume a normal life. So just live it!

tape

by Tracey_E - 2016-08-21 15:11:51

I had tape over glue this last time, it lasted 5 weeks! 

Arm instructions vary with the doctor, and I think some doctors are re-evaluating them. They've always been precaution after the first few days. My doc used to say 6 weeks no over head, now he just says 2 weeks for all but full golf swing. 2 months of restrictions would be a long time, 4-6 weeks is more common. 

Thank you for your advice!

by FaithGrace - 2016-08-21 17:14:58

I appreciate everyone's comments very much.   This is a very good site, especially being new to all of this.  It's comforting to be able to ask questions and get your explanation, advice and opinion on things. 

AngrySparrow - Thank you for your explanation of why the arm shouldn't be moved in certain positions.  That makes sense!  And also for your advice on the steri-strips.  I appreciate you taking the time to read and respond. 

Jax - That is really interesting that they removed all of your bandages before you were sent home.   I was also told not to lift anything heavier than a gallon of milk, which I think they said was around 8#.  Thank you for reading & commenting :)

Dory - My incision has disolvable stitches and then the steri-strips that overlap each other and cover the whole incision.  I did have a bandage over that with a large clear tape that was larger than the bandage to keep everything dry for the first 7 days.  They took that off at my first device check.   Thanks for the advice on not over using or lifting too much for the first 6 weeks.

GoodDog - Thank you for your advice on the leads and making to sure to give them time to heal and become secured.  I also love to hear about getting on with life and doing what ever I want to again!!!! So good to think about!  I love to work out and stay active and can not wait to be able to get on with my life again. 

TraceyE - Oh, I'm not surprised to hear your's stayed on 5 weeks.  I can completely see these staying on that long... they're stuck!  Also, thanks for the restrictions advice and for taking the time to respond :)

Supposing you'd been in a ...

by donr - 2016-08-21 18:50:14

...bar fight in some sleazy dump in a lesser section of your city.  supposin', further that you'd run into an obnoxious, angry, snarling drunk who grabbed a long neck, smashed the bottom off of it & came running at you & plunged the broken end into your body right about where the PM incision is.  Being a Black belt in karate, you chopped him in the throat, kneed him in the nether regions & left him quivering like a mass of grape jelly on the floor.  (it had to be jelly, 'cause jam don't quiver like that!)

You hauled yourself off to the ER & they patched you up, all nice & tidy, & sent you off singing, but a bit worse for the wear.

WHAT, EXACVTLY do you suppose their instructions would have been?????  probably NOTHING!  Maybe a sling, who knows.  but probqably nothing.  Why??? because they would have thunk that you'd be smart enough to not do anything that hurt!  The wound & pain would essentially been self-limiting.

I'm surprised that no one locked in on the dichotomy of conflicting post-op instructions you were given.  The EP's nurse gave you what the ER crew would have given you after the bar fight!  The Cardio's crew gave you pretty standard instructions.  SO...who was right? 

After all - you just had - GASP - SURGERY.  She expects something commensurate w/ having her hearet mucked around in & al the other good things we did to/for/in her.  So, their lawyers wrote all that good stuff about what, when, how,why for you just to a) protect the surgeon's wallet & 2) to satisfy your expectations.

Who is correct?  All of them!

1)  you found out the hard way when you were left alone the wisdom of the EP's nurse - your wound was, indeed, self limiting.  You hurt, so you stopped doing!

2)  There is nothing wrong w/ being a bit more conservative, as the discharge crew asked you to be. After all, they did go nto your heart & place a small harpoon in the wall of it & if it doesn't stay stuck, they have to go back in & re-stick it.  No one wants that.

Now for a bit of harsh reality:

1)  If properly implanted, & you are NOT 7' 10" tall, there's enough slack in the leads that the place a small coil of them behind the PM.  You surely aren't going to stretch that out enough to yank the harpoon out of your heart wall.

2)  The leads are sutured in place to the vein where they enter it, just to protect against pulling it in or out.  There is a little thingy (Technical talk there) at the entry site in the vein to suture the leads to so the vein can heal around them & seal the entry point off.

3)  There is slack in the lead as it worms its way into your heart down the vein - a trip of about 6 inches (unless, of course, you are 7"10" tall).  there is a bit of slack inside the chambers where the harpoons are located.  There has to be.  From the moment the harpoons are set, they undergo turbulent sloshing around in the rather strong current flow of viscous blood as it comes whooshing in, nearly instantly stopping, followed by a change in direction of 180 degrees as the heart pumps it out.  Not so bad in the Atria - blood flows in at the top & out at the bottom; the ventricle is a bit worse, blood comes in at the top right corner & goes out at the top left corner.  There in no way, Jose, that you could ever do anything to stretch out all that slack & pull a harpoon.  Well, there is one way I can think of - go to the kitchen, grab a banana & go into your dining room.  Leap onto the table & launch yourself into the air vigorously, snatching hold of the chandelier w/ the hand on new PM side.  Swing back & forth like an Orangutang, peacefully enjoying your banana, all the while making satisfying little grunts of happiness from the banana.  One last long swing, launching yourself off the chandelier & landing in the living room & you just might have ripped a harpoon out.

Though it may be able to survive such shenanigans, why tempt fate.  Just follow what they told you when released from the Hosp & you'll be OK.

breathless

by Cabg Patch - 2016-08-22 12:20:08

I am breathless reading DonR's reply, but in the end, he could have just said the last sentence..."Though it may be able to survive such shenanigans, why tempt fate.  Just follow what they told you when released from the Hosp & you'll be OK."

Go by what your doctors told you, they know what type leadss they installed, how prone you might be to early withdrawl (your anatomy) and you paid them really big $$$$ for their expertise.