Going to bite the bullet - PM procedure tomorrow!

SBMom

by IAN MC - 2017-03-26 08:39:16

There is no need to bite on a bullet you will be given anaesthesia of some sort.

Under-medication and you have tachycardia problems, over-medication and you have brady.  Getting the right balance without a PM may be impossible. 

The way to look at it is that once you have a PM it will cease to be over-medication and your heart rate should be well-controlled .

I hope it goes well, I'm sure it will  ( I will reply to your private message re the drugs )

Best wishes

Ian

Postponed - drugs, no pacemaker..,yet

by SBMom - 2017-03-28 23:42:42

Hi, thanks everyone for being on this journey with me. I was in pre-op two days ago, met the team of nurses and when the cardiologist came in she answered my questions and said "you know you really don't need to rush into this" - I was transferred to another hospital to have the procedure so this was my first time meeting this cardiologist/surgeon. Since I have recent onset of a-fib and a fast heart, she said I could try amiodarone and then later down the line, in a month orthopedic or six, consider the pacemaker. (I still feel like the doctors didn't fully give Diltiazem and digoxin a fair shot but they were afraid to, as it may cause pauses. Their goal was to give me a pacemaker and increase the doses of the two, and possible metroprolo (which they tired and that made me extremely short of breath).

So now I am on just one drug - amiodarone. Since my cardiologist is remote readily available (possibly retiring I have heard), I will most likely go with this one. her plan is that I should do a cardio version and at the same time get the pacemaker. This also didn't make sense to me because I thought with a cardio version I would go into sinus (Lord willing) and continue with amiodarone to stay in sinus. She still recommends a pacemaker. It would be the Boston Scientific Accolade model. 

So I guess my question is - does anyone have any experience with amiodarone. I have read a lot of negative, but some positive news. I'm on 200mg daily. I am going for yet another option by another cardiologist (out of pocket, private) to see what they suggest. 

Thank you so much. 

cardio

by BOBJ - 2017-03-30 09:38:34

Just an opinion but I would replace this cardiologist and do it quick.

I have 2 cardiologist and a team of nurses. My head cardiologist I see him the most, but the cardilogist that put in the pm I refer to as my EP. Both have many years experience and both knew right after my stemi that I would need the crt-d. They started working and doing all the tests and jumping through the hoops to get me approved for the procedure. Not once did they change their mind an go "let's rethink this".

There are certain criteria that must be met and if you meet them it should be a done deal.

One of these criteria is meds are not controlling your symptoms. Yes they can change them but most likely this far in there is not going to be a miracle drug that will all of the sudden work.

Yes agree , stuck in the system

by SBMom - 2017-03-31 02:37:13

Hi BOBJ - thank you for your comment. Yes I couldn't agree more but unfortunately I am stuck with our medical plan until January 2018, so need to try to work with what's there - feel better about going to this other hospital and cardiologist however (same Kaiser, different location, more caring, professional staff). 

Went for consult with "outside" cardiologist today (out of pocket) and he said to get off AMIODARONE, and try Sotalol instead, anti-arythmia with less toxic effects, then cardio convert and if that doesn't work - pacemaker with rate controlling meds - back to the Diltiazem and digoxin combo. I actually feel better about going that route. Just wish I were as lucky as you to find doctors that would be on the same page. Sure would make my life easier and less stressful. Now I have to figure out how to tell my current cardiologist that I went to someone else and what theyrecommended (she probably won't like that and will think I don't trust her...but I'm just not comfortable taking the drug she has recommended because of the side effects!!)  

I sure have appreciated this site, thanks all for the feedback. Feel like I'm navigating the waters alone so this really helps. 

INS PLAN

by BOBJ - 2017-03-31 11:11:45

Just so you know. The insurance companies are bound by guidelines. It may not be up to them to decide if you need this or not.

You probably need to research this a little but I believe there are 4 criteria that are used and you only have to meet 3 of them, but I could be wrong.