Test Results

Printed PM report

by TAC - 2017-08-27 12:25:07

The printed PM report is highly technical, and therefore do not try to interpret it. Enough good news is the fact that the PM is working right and that you have battery life for many years to come. Enjoy life and forget about your PM. 

test results

by zawodniak2 - 2017-08-27 12:28:28

If you are feeling well and battery life is holding good,. don't worry about all those technical details,  Sometimes we can drive ourselves crazy on technical details that may be way beyound our pay grade!!  Also, one can ask five different "experts" and get Five conflicting and confusing answers!  Please be grateful the Pace maker is helping you feel well and that there is plenty of battery life left----enjoy!!

                                     Rodger

You deserve answers...

by donr - 2017-08-27 12:53:05

...since you asked intelligent questions.  You obviously understand some things about electricity & technical issues.

Here are some answers:

1)  You have apparently had the PM downloads about a year apart.  A lot changes in a year!  Especially electrical impedances.

2)  Battery life will vary in its ESTIMATE depending upon usage rates on the day it is determined.  Do not be concerned unless it suddenly drops a lot & stays down - like going from 10 yrs down to 2 yrs.  As the PM ages, the accuracy of the battery life predictions becomes better.

3)  Impedances - low impedance is better.  Also, consistant impedances are good, whether low or high.  Note that they give a RANGE for acceptable impedances.  Let's look at the impedance IMMEDIATELY after they plant the leads.  The total impedance consists of that of the leads PLUS the impedance of the junction between the lead & the heart tissue at the implant site.  Since the junction is brand new, it will be high.  As time goes by, the body improves the bond between itself & the lead & the impedance drops to a steady state level. In a year, you should see that happening & your impedance should now have reached its steady state value & vary little or none between readings.

4)  Capture & sensitivities.  The PM self checks these values to find out how "Easy" it is to cause the heart to respond to the pacing spikes the PM develops.  The lower, the better, in general.  The PM can sense when the heart contracts, so during its self-test it drops the pacing spike voltage till it no longer senses contraction, then raises the voltage till it does sense contraction.  That measures the sensitivity & the "Capture" voltage.  Your Medtronic PM can adapt to the needs of the heart to set its pacing voltage.  Note that the impedances & sensitivities for atria & ventricles are different, as are the required voltage levels for pacing.  Not to worry, that is natural.

5)  Don't know what the personal/professional relationships among patients, doctors & engineers are in Bangladesh, but, it soundss like they are reeasonably open.  Nice to know that they let you see the printout.  Any more questions, someone here will answer.

Donr

DONR

by zawodniak2 - 2017-08-27 13:13:37

WOW----I learned something!!!!!

                    Rodger

Interpreting technical da

by TAC - 2017-08-27 14:28:49

Of course, there is a lot of information in everything. However, for a heart patient, only relevant information is needed without going into meticulous, unnecessary details. What the patient needs to know is how well or how bad he is doing. Getting into technicalities is useless since the patient is not an expert and can make the wrong interpretetions that will cause unnecessary anwish and apprehension. If things are not doing well, the doctor will inform the patient right away, meantime is better to have  a positive outlook, keep the mind away from the heart and keep going. Like Doris Day used to say: "Que será, será" (Whatever will be, will be).

Technical Data

by IAN MC - 2017-08-27 14:46:24

TAC       Doris Day also had a hit song   " If I Give My Heart To You "

We hand over our bodies to Drs and technicians who measure various parameters of our hearts and our implant devices.    I do take issue with your statement " Giving the technicalities is useless since the patient is not an expert " . Patients are not generic, they cover a wide range of intellect, occupations and life experiences.   Their level of background knowledge and judgement varies enormously ... a bit like doctors really !

I understand the point that you are making  but the " Don't you trouble yourself with things you won't understand "  advice may not apply to all patients !

Ian

Technical data

by TAC - 2017-08-27 16:02:05

Yes, patiens have different backgrouds but even when the patient is a doctor, he won't bother with making his own diagnosis and medicating himself. A patient should be just a patient, unless you want to become an obsessed person and a hypochondriac. As a matter if fact, many patients end up that way by their own choice. What is the point if learning technical information that you can't change anyway? Even if you were an electrophysiologist yourself. Well, to each its own.

Doctor Always Knows Best ?????

by IAN MC - 2017-08-27 16:30:56

TAC   I think we will have to agree to disagree on this one.

You list only two alternatives :-

i)  Being just a patient or

ii) being an obsessed person / hypochondriac

There is a 3rd alternative which is being a well-informed patient . This can lead to a win-win situation where the patient can influence the treatment he or she receives. This can lead to a more positive clinical outcome which is surely what both doctor and patient are striving for

I am happy with my approach , I'm sure many people are happy with yours.

Ian

Advocacy

by TBrous&Chip - 2017-08-27 18:11:50

I agree with TAC.  Being an informed patient helps me understand the doctors' and the techs' information.  It also makes for better 2 way communicstion.  If I know how to verbally express my concerns and issues to them then they can give better solutions.  I say the patient better be educated and be their own advocate.  Who cares more about me than me?

Being a well informed patient

by TAC - 2017-08-27 19:44:27

Any responsible doctor wants to have a well informed patient, it's his ethical responsibility. By being well informed I mean the patient is told what he needs to know about his condition, his treatment and his prognosis. Certain information that the doctor uses to perform his work might not be relevant to the patient, for instance, the exact method he uses to determine the optimal dosage of a particular medicine, like calculating levels of kidney clearance, body mass, medication half life, drug interactions, etc. or the technical method for determining the correct voltage and programming of the PM. My point is that if the patient is not going to be doing the highly technical procedure to program the PM, he only needs to have a general bird's view of the procedure  without all the minucia. Of course he can have it if he wants to, but for what purpose? to have insomnia all night because some of the figures don't match? You have to trust your doctor, if he doesn't inspire confidence you should look for another one. 

I love this discussion

by zawodniak2 - 2017-08-27 20:00:51

My God folks,  where does an intelligent, educated person draw the line on details eletrophysiologists have spent years of training and hopefully hundreds, if not thousands of procedures.  Should we demand being left awake during a procedure, with manual in hand, to ask questions and give advice??

I had a friend who had a medical problem and got an opinion from a specialist;, afterwhich he  extensively Goggled it --obviously an advisable reaction which most of us would do.  Then with research in hand, he got a second opinion which was different from the fisrt.  Frustrated,  he then traveled quite a distance to get a third opinion from another highly reputable specialist and got another different opinion.  Unfortunalely, the poor soul died of a nervous breakdown before he ever did come to a resolution.. Just sayin----go figure!!!!!! 

                                Rodger

Same subject

by TAC - 2017-08-27 22:56:24

When go dining at a Gourmet (Haute Cuisine) restaurant, you don't ask the chef for a complete list of ingredients and detailed preparation method before you eat your dish. When you fly an airline you don't ask the pilot for a description of all the gauges and buttons in the cockpit, his flight plan and how many gallons of fuel he carries before boarding. Either you trust the restaurant and the airline or you don't eat and don't fly.

Same subject

by IAN MC - 2017-08-28 05:23:13

Before dining at a Gourmet restaurant I would ask someone who has eaten there what the food is like. It is all part of being a well-informed diner . Interestingly I am a very keen cook and have, on several occasions, had meaningful discussions with the chefs regarding  their dishes and the recipes . They appear to appreciate it.

A fortuitous social meeting with some operating theatre staff persuaded me to avoid one particular doctor and opt for another one to perfom my cardiac ablation  It was all about being a well-informed patient. I can think of countless examples in my life where being " well-informed" influenced the treatment which I eventually received

Apologies to YEASIN if this thread has deviated from your original question but I guess it is vaguely relevant.   There is no way that I would insist on a printout of ALL the pacemaker data after my PM check-up.  I wouldn't understand much of it so it would be pointless BUT I do always ask for copies of the parts which I do understand such as  Rate Response settings . I have on occasion told the cardiac tech the specific changes I wished to be made to these setttings... with good results

I do not accept that ignorance is bliss.

Ian

I Cast My Ballot For IAN

by Artist - 2017-08-28 22:32:52

I notice that my doctors respond more positively when they have a patient that has taken the time and shows an interest in learning more about their medical condition.  After all, they obviously have a great interest and commitment to their specialty.  And, respecting their interest/specialty encourages a better relationship with many doctors.  They don't mind having their ego stroked by a patient that takes the time to learn more about their condition and medical treatment.  I also find it interesting, but not to the point of being obsessed or overly concerned.  I like to be a proactive patient and that attitude was very helpful in dealing with an LPN that totally skimmed over a 30 day Holter monitor report and missed important details like my HR going as low as 7 BPM and as high as 179 BPM and averaging only 20 to 40 BP  at night. She was not even going to refer me to an EP until I confronted her with the facts I obtained by requesting my copy of the 30 day monitoring report.  I really believe that being involved and informed potentially saved my life.  

Look at it this way...

by donr - 2017-08-29 01:11:59

...WHO is going to be your cardio/EP when you are out in the middle of nowhere on a trip.  Or maybe in an airplane at 39,000 ft over the middle of the Pacific Ocean?

It's kinda nice if you understand a bit more than the average bear about you and your PM/ICD & how they interact! 

There's an old saying in the med profession - "If you let the patient talk, they will diagnose themselves." To talk intelligently, you need to understand what you are talking about.  What your Dr. needs is intelligent observations describing what has/is happening.  The more you understand your device, the more you can help your Dr during a visit.

Ian, you & I disagree on lotsa things - but I'm w/you all the way on this issue.

Donr

OMG

by The real Patch - 2017-08-29 12:26:43

the end is nigh, Don and Ian agreed on something...worse, they're right

reminds me of the old days when Smitty and Electric Frank agreed on something ...once.

What an agreeable bunch we are !

by IAN MC - 2017-08-29 12:42:32

I agree with Artist and Don and Patch

Ian

Does that mean we....

by donr - 2017-08-30 01:44:39

...have to be nice to one another?  Nah!  Things will be back to normal tomorrow!

Ian, if we ever get back to England, I'll buy you a pint in a pub to celebrate.

Don

Leaving this Forum

by TAC - 2017-08-30 20:03:03

It seems that this Forum is being run by a group of hypochondriacs, obsessive-compulsives and "wanna" be doctors. I'm leaving the Forum because is not a good influence for me, I don't want to end up becoming another neurotic like them. Bye.

Thanks note on "Test results"

by Yeasin - 2017-10-14 14:52:49

I apologise for long gap to respond your comments on my post "test results".

I am overwhelmed with your response and read every word of your comments/arguments/suggestions. 350 viewers and 19 comments proved that not only myself but many others have learned a lot from your comments.

Thank you "TAC" for continuing the discussion till the end. Please don't leave the forum. You have the quality to enrich others about PM related health issues.

Thank you "zawodniak2" for your comments on the issue.

Thank you "donr". Your elaborated discussion helped me to digest the complicity of printed test result. Doctors and engineers don't discuss much of technical issues with their patients and Bangladesh is not an exception. 

Thank you "IAN MC". You and "TAC" were excellent contributor to clarify the issue.

Thank you "TBrous&chip", "Artist" and "The real patch" for your contribution in the discussion.

Best regards

Yeasin