Replacement

Replacement

by TBrous&Chip - 2017-05-03 11:35:09

If you are totally dependent on your PM your doctor may utilize a temporary pacemaker during the changeover. 

These are all valid questions that you should write down and present to your doctor before the day of the prodedure.

For peace of mind you can also perform an Internet search for 'pacemaker replacement procedure'. You will find some good reading material that may answer your questions.

Also in the upper right corner of this screen is an icon for subject searches.  Typical 'replacement' in the sesrch.  I found 16 pages of messages about replacement.

replacement

by Tracey_E - 2017-05-03 14:39:07

I'm on my 5th and pace every beat. Before every replacement, they very briefly (with warning and while I am sitting) turn it off to see what my heart is doing on its own. It's been anywhere from 20 to 60 when they did that. They put the pads on me for an external pacemaker for the duration of the surgery. I have no idea if they've ever used it because I always ask for the stuff that I don't remember anything! They have the new one programmed and ready to go, so the amount of time the old one is disconnected until the new one is hooked up is very short.

Our hearts still beat on their own, so turning off the pacer for a very short time is not a problem, it still beats like it did before we were paced. They will use a temporary pacer through the groin if the surgery is more involved or you are a higher risk but they've never used one on any of my 5 replacements. 

They will have the new one set with roughly the same settings as the old one. It's not always exactly the same because sometimes the new one will have cool new features so not work exactly the same as the old one. I've never felt different with a new one. Witih this last one, I felt better once I was back to the gym because it has a higher upper limit (I was always bumping the upper limit on the old one).

Unless leads are involved, replacements are super easy and done out patient. If I have an early appointment, I've been home by noon, fixing my own lunch.

Replacement

by Bugwit - 2017-05-03 16:34:17

Thanks Robin1 and TraceyE, I was looking for a real human experience, not something to read.  I never stopped to think the device would be preprogrammed before insertion, thats just too logical and I'm not used to that in the medical profession.  LOL  But that would be great.  Nice to hear I should be not down long in recovery time. Thanks again.

Reps

by Tracey_E - 2017-05-04 09:58:55

my SJM rep has been there for every surgery. He's the one who told me how they do it and assured me it would be fast and after I'd feel the same as the old one. Anticipation is the worst, I found recovery a piece of cake. 

not their first rodeo

by dwelch - 2017-05-10 01:58:59

First thing to remember, you are not their first patient/replacement (well maybe you should ask how many they do a year and if they say you are the first move on).  they pop these things in and out every day or every few days, there is a rep from the pacer vendor there, they have a box/bag, extra parts somewhere in there, I had a lead break on number two they capped the broken lead put a new one in they didnt need to drive down to the parts store or wait on mail order, had what they needed.

They know before they go in what they need to do for your condition, not only have they turned on the new one before the surgery from the printouts (ask for your copy of the printout as they are printing the docs copy) it showed they had turned it on or maybe it had been on a week or two before the surgery.  In this lawsuit happy world the easy to avoid mistakes they tend to avoid (leaving you unplugged for a while if you cant deal with that in your condition), the ones they can avoid they generally will...

My story is righ talong the lines of TraceyE.  On pacer number five (two weeks ago). Most of the replacements were a breeze, they broke one lead replacing number one with number two.  Have had three medtronics, one st jude and this one is a boston scientific (I am sure there is in breeding now likely more than one copany owns another).  The mixed and matched parts are all fine working together I have one boston scientific lead one medtronic and one guidant, all different ages.

For me the anesthesiologist had an EKG and the doc had an EKG.  Had forgotten this but with it being two weeks ago on this last one, they taped or stuck the defibrillator pads on my back before laying down, just in case, they dont mess around.  they know how to transition you from one device to another. nothing to worry about there.

Again same as TraceyE, each device is newer, better, smaller, but they also keep the settings the same, after that first year or two they really have not messed with my settings.  this three lead pacer sure, and maybe with this new lead might mess with that setting, but I dont feel any different with a new pacer and new brand...

The rule of thumb I know is it is outpatient unless you need a new lead, really, once you wake up or are out of the daze or whatever condition they left you in, a couple hours later they send you home, want you awake and able to walk without falling down.  They were VERY serious about someone driving you home, we wont start the procedure if you dont have someone to take you home...fine, geez...

five pacers, first one, new leads obvously spent the night, pacer two, doc broke a lead, spent the night, number three, four, went home same day outpatient, number five new lead three lead pacer upgrade from a two lead, spent the night.

This is not really something to worry about but many of us have been through it.  If you are not already in safety mode (I expect not if two months) then you might.  The pacer will preserve the battery if it gets low enough (will last months like this dont worry) but it can/will lock you at 65 bpm, which feels strange esp if you are trying to do something active, even climbing stairs, you may have to stop every so many and let your breathing catch up...it is annoying but it is how they keep the battery going for the home stretch, also allows you to want to call the doc to basically confirm it is time if they dont tell you first.  Insurance apparently I am now told may play a role, to save what is really weeks/months over decades, some will not authorize replacement if you are not in this mode.  Some will if the pacer reports the level low enough.  so if you get into this mode, dont panic, tons of time to get you in for the replacement you may just have to take it extra easy the last few days/weeks, it can be annoying being unable to do stuff, but you are safe...

the other thing to worry about, is just planning the recovery time, stuff you want to get done before you cant use that arm for a little while, get that done, need some new PJs or button down shirts that are easier to get in and out of, go get some...simple stuff like that, find your ride there and back after the procedure.

Call insurance, understand how it works do they have to have prior approval, did they get prior approval, is there a confirmation number (being outpatient prior approval was not required even though technically I was getting a new lead and we knew that)..

So not really things to worry about, just things to deal with in preparation for the procedure, things that are in your control, let the professionals worry about the things that are in their control, ordering parts and prepping the device, facilities, staff, supplies, etc...

replacement

by Bugwit - 2017-05-10 17:26:25

Well I hope I hope I dont have to stay in battery saving mode long, or I wont be able to do my job :(