just shoot me

You've sold me on it

by IAN MC - 2017-08-09 19:25:01

I too have always been against having a home monitor but reading this makes me realise just what I've been missing.  I must get one !

My cardiologist is a very empathetic sort of chap and I know that he would never ever want to disturb me at home with worrying news.

He would feel good about being so thoughtful , I would feel good about being unaware and unconcerned. We would both feel good....surely a win-win situation.

Ian

Patch

by Grateful Heart - 2017-08-09 19:55:08

Is this the same thoughtful Cardio or a new one who is just as thoughtful? 

Not one but several alerts??  No rush huh...he's pretty laid back.  At least he wasn't disturbed. 

Grateful Heart

Ludddite Here!

by donr - 2017-08-10 01:12:51

Last time we were n Atlanta the pacer check nurse suggested that I might REALLY like to have a monitor.  Any one w/ a long memory will recall that last Sept when we had our little seance & she offered me one, I told her that IF they sent it to me, I would smash it w/ a hammer & send it back to the hospital in its mangled box.  She was horrified that I would think such vile, violent thoughts about such a benign, lovable, useful device.  "You're just kidding me, aren't you?" she chortled.  I replied  "Try me & see!"  The conversation ended there.   Fast FWD back to March.  This time she wheedled me into accepting it, since the clinic demanded that all its hosts have one.  It would just make things so much more efficient & effective.  I refused, adamently.  Finally she was reduced to begging - I was the FINAL holdout in the struggle against "Big Brother."   Please do it to make her happy.  I said "OK - I would dutifully take the accurded device & place it under my bed." 

Tonight our MD Daughter wandered into my home office looking for an inhaler I have (Had, whatever) & found a strange box on thre floor, just chock full of strange looking electronic gear.  Fortunately, I stopped her before she got it dumped on the floor amid emptry cookie boxes, old papers, unread books, old mail & empty pill bottles.

I lied to the downloader nurse - the monitor is NOT under my bed - it's still in its box in the midddle of the floor of my home office.  However, were it to actually be under my bed, it would still be in its box!

Donr

I don't understand

by Artist - 2017-08-11 01:47:05

I don't understand the resistance to having a home monitor.  I am one of those people that resists making a fuss and going to the ER or the doctor. I have a Merlin home monitor.  One  night I just didn't feel right so I took my BP.  The monitor would only register an error code so I punched the button on my monitor.  Within one minute,  the monitoring agency phoned me and told me that they were phoning the local ER and the ER would call me.   Promptly the ER phoned and told me I needed to get there ASAP.  They were waiting for me at the ER and to make a long story short, I had a HR of 234 BPM and then my heart totally stopped. Their response was quick, calm and professional and they got my heart rate stabalized.  I was hospitalized for 5 days and my meds were changed.  I have also had an ablation since then.  Without that monitor,  I probably would have stayed home and just continued periodically taking my BP waiting to feel better.  The monitor saved my life.  Without it and my tendency to procrastinate, I probably would have just ended up dead in bed at home.  The presence of my  monitor reassures me and was instrumental in getting me to the ER on time so that my heart could be restarted.  Honestly,  what earthly harm could plugging in a monitor do?  I don't obsess about it and just like the emotional adjustment to a PM I forget it is there and when I do notice it, have nothing but gratitude.

Artist

by The real Patch - 2017-08-11 12:02:15

Actually, your home monitor saved you from you. The real question did you learn anything or will you once again procrastinate hoping your monitor will save you if necessary or realize you need to get help?

I only acquiesced to a home monitor after finding that my battery is on recall and is prone  to fail unexpectedly. My wife spent a lot on my wardrobe and I'd hate to ruin a good shirt if the battery explodes. When discussing the home monitors, my Cardiologist had an interesting perspective...a large contingent of his patients who have them have become hypochondriacs and send him downloads constantly consumming much of their valuable time reading the printouts and responding to repeated phone calls. The irony according to him is patients who actually most need the device refuse.

I believe yours is a somewhat unique case and I'm glad things worked out the way they did, but how much time did you waste sending downloads back and fro and such. If you were concerned enough to do so, it should have alerted you of the need to get medical help.

Your response didn't say whether they implanted an ICD which most specialists would insist on for anyone who suffers a ventricular tachycardia and/or sudden cardiac arrest...why on Earth not...Ablations are not a guarantee and most often they must Ablate several times before success. If they didn't implant one, you should ask why not

Artist 2

by IAN MC - 2017-08-11 14:15:12

Why am I against home-monitoring ?   It is because I don’t believe that I need it.

I am a relatively simple case with a mere pacemaker for SSS-induced bradycardia. If I had an ICD maybe I would think differently. I always think that ,in the grand implant hierarchy,  people with ICDs have more street-cred than I do. Patch probably looks down on me, I look up to him.

I genuinely believe that,  in your situation , I would have measured my heart-rate  , detected tachycardia  and rhythm irregularities  and  sought urgent medical help. I would have acted quickly on my symptoms

I did just that when I developed atrial flutter and subsequently had an ablation. The first thing I did was to measure my heart-rate . I didn’t need a home-monitor to tell me that I didn’t feel normal and my heart-rate of 150 bpm explained why.

It is my decision and I think it is the right decision for me !  I can completely understand that other people make different decisions which may be best for them.

But most important of all ,  I want my pacemaker to intrude into my normal life as little as possible.

Ian

My Reply

by Artist - 2017-08-11 17:20:05

Just to clarify alittle.  I have no idea what the monitoring agency detected that ended with them recommending a trip to the ER ASAP.  I am not sure if my heart rate was 234 BPM when I was home, or got that high when I was in the ER. And, no I did not feel that rate by manually taking my pulse rate.  As you know, AFIB beats are often very light and hard to count.  I have a history of high heart rates and during a 30 day monitoring had heart rates that varied from 179 to 20 BPM.  I think it was a heart rate of 7 BPM that caused them to decide to implant a PM.  I still had to wait several months for my surgical date.  When I was on the operating table I told the EP that I wondered if I would die before they got around to implanting the PM.  And no,  I am  not going to rush to the ER when I get an error message on my BP cuff.  I will take several readings and if it persists will punch the report button on my Merlin so the experts can help make the decision about going to the ER.  Regarding comments about people over reporting and bothering their doctors, my doctor is not bothered.  The monitoring agency gets the report and then makes an informed decision regarding whether or not it is necessary to send a report to the doctor.  I would rather have that sequence of events instead of people over reacting and rushing to the ER if it is not necessary.  Trips to the ER are very costly and can take resources away from more urgent cases. As I said,  I did not "feel right" but had no idea how serious my situation was and the monitoring staff helped clarify things for me.  Given those circumstances, I would do exactly what I did previously.  I have short periods of AFIB that probably include a high heart rate and I am  not going to rush to the ER.  

Why I'm a Luddite in this case...

by donr - 2017-08-12 02:27:59

Once upon a time I had a BP cuff right handy & took my BP religiously twice a day.  I did that for years - first at the behest of my primary care guy - then after I accepted host duties for a PM, at the behest of my cardio.  Then I had a cardiac epiphany!  I was being controlled by the BP cuff. 

I told my cardio one day that I was finished taking BP measurements.  Done!  Fine. Cold Turkey.  I Quit!!!  He asked why.  My reesponse was as I discussed above, PLUS! Every time I went to a Dr's office, I had my BP checked  That was darned near once per week.  Sometines twice.  If that weren't enough monitoring, what the Devil was?????  It was causing me to concentrate on what my heart was doing all the time.  Now that was stress, stress, stress - with a capital S, S, S!   I concluded that I was far better off forgetting the whole monitoring business & listening to my body.  At that time I sensed every PVC, every little hiccup & belch my heart made.   Slowly, w/o the constant stress of monitoring, my stress level dropped considerably.

Another issue w/ 24/7 monitoring - The world is now awash in data.. It is literally choking on it.  Humans are not really capable of digesting all of it.  We read all the time of failures of the data collecting system for that reason.  The human senses reel from fatigue of data immersion.  The day I discovered I needed a PM was a failure of 24/7 data collection.  I was in the hosp connected to a 24/7 telemetry system that reported nothing unusual out of my heart.  Medicare DEMANDED that I be ejected from the hosp unless my cardfio could find something wromg with me.  So, unbeknownst to me, his head nurse spent over 4 hrs poring over the telemetry records for my heart.

At 2 PM, she came running into my room, waving a sheaf of ECG strips, shouting that she knew what was wrong w/ me.  "Don, you need a PM, she shouted!"  She had found what the real time system missed. 

Every one of us does NOT need 24/7 monitoring.  Perform a bit of triage on us - separate out those who need it & leave the rest of us alone.

Further, monitor the right parameters - BP tells you very little to nothing about the electrical condition of the heart; an ECG tells us very little about the plumbing functioning.

Until I have som,e indication that I need 24/7 monitoring by Big Brother's agent under my bed, he stays in his box.

Donr