What happens at first check-uo?

first check up

by Tracey_E - 2018-06-11 09:18:09

They usually look at the incision to make sure it healed properly and interrogate the pacer. They'll probably adjust the settings. They usually turn down the voltage once the heart has had a chance to get used to being paced and the leads are settled in. They will adjust the other settings as needed, odds are you won't feel a difference. 

First Check up

by MissFitts - 2018-06-11 11:43:36

Thanks Tracey. Will they have to Xray to check the keads? 

First check up

by MissFitts - 2018-06-11 11:44:28

Or even the leads. I need a typing pacer.

probably not

by Tracey_E - 2018-06-11 12:18:36

If the leads aren't in position, it'll show up on the interrogation report. My current ep does an xray once a year to look for minute fractures in the leads, my leads are old. My previous cardio did not do that. 

First check

by The real Patch - 2018-06-11 15:01:27

TraceyE is sugar coating it and glazing over details. They take you into a darkened room with a single bright light swinging over an uncomfortable stool. After what seems hours under that hot white light a technician comes in wearing rubber boots and carrying a leather whip. They strap an electric cord with an industrial magnet over your device. They then ask you a question and you have one chance to spew everything or suffer the consequences...I have never known anyone to hold out long before spilling their most secret details. In fact, Ian spews before the even get him into the room...it's ugly.

Oh wait, my bad. I'm thinking of the time I got divorced and had to answer a lawyer's questions.

The magnet they lay over your shoulder flips a switch in your device allowing their computer to communicate and access the saved data which is downloaded and printed out. The details also include information on the lead impedance which will tell whether there is a problem which they can check further if necessary. Not a big deal and usually 15 to 30 minutes long.

First check

by MissFitts - 2018-06-11 18:48:58

You had me as far as the uncomfortable stool. 😀  I would have enjoyed listening to your lawyer.

Thanks  both of you for the rest of the info. The check-up is on 25 June and we go on holiday 29th, so hope all will be well.

No surprise

by The real Patch - 2018-06-12 13:09:07

There should be no surprises, you know how you feel and thats the only thing important.

If you saw my readouts youd wonder how I survive. My Dr. doesn't even call when they get remote downloads that show a rebellious heart. He said he knows I'll call him when we need to worry.

Enjoy life, thats why you got a device

Patch is right

by Gotrhythm - 2018-06-12 16:21:28

This checkup is really just to make sure that everythig is OK, that the wound is completely healed, and no fine tuning of the settings is needed.

Sometimes, once everything has settled down, a person realizes their base rate is too slow or too fast for them to feel their best. Sometimes rate response needs to be made more or less sensitive. How do they know what if anything needs to be adjusted? It's all about how you feel.

If you feel fine, everything is most likely fine.

already answered

by dwelch - 2018-06-21 02:02:57

This is really already answered, but as pointed out this first check is to see how the site has healed, look for infection or other issues like that due to the surgery.  Todays devices are a lot better than the first device I got 30 years ago which took us a number of visits over that first year to get tuned, today the device itself does some of this but there are settings they want to check.

The box they used to check you will have an EKG so a handful of those sticky patches with wires, and then a thing that looks like a computer mouse is laid right on top of the device to communicate with it.   That is all they need to test the leads no xrays or other such equipment.  If the lead is connected to your heart correctly they can force that lead to go slow or fast or not drive the heart and see that on the EKG, and that is basically what they do, for each lead you have (I now have a bi-ventrical so I have three leads) they do a test for that lead where the pacer changes how that lead is driving the heart be it amplitude or rate changes then look at the area of the EKG output related to that chamber.  If the EKG does not show a response then it is possibly your lead came out, one of the things they are checking for on this first visit and basicaly every visit, not necessarily pulled out but a broken lead would also not have a response, and rare but leads can break.

Here is the thing you need to understand and YOU ARE GOING TO BE FINE.  Think about how different you felt before and just after the pacer, perhaps you didnt notice, but some percentage of us it was a weird feeling to what we were used to.  When they go in and mess with your pacer and rates during this test, there may be a time where it feels like someone is sitting on your chest and you feel like it is harder to breath.  And there is a test that they crank you way up and you start to breath faster to keep up.  not hyperventilate nothing like that but a possibly slight increase, for me it is when they stop that test and drop it back to normal I get a little head rush or something, feels weird for a bit, but recovers very quickly.  A good technitian will tell you before each test that they are going to do a test, might tell you they are speeding you up or slowing you down.  A good tech was the one that gave me the sitting on your chest description.  THIS IS ALL NORMAL, YOU ARE FINE AFTER THE TESTS even though you may feel wierd as you sit there waiting to see the doc or are just leaving the office.  short answer on this topic is that the test equipment can muck with each lead and you can and likely will feel it but the tests are short and you go right back to normal settings after and between each test.

Another thing you should try to do, is each time you go in ask for your copy of the printout or ask for A copy of the report, or however you want to ask for it.  One tech one time got uncomfortable and dug up or created some release that I had to sign, but my current doc knows I am an electrical engineer and know how the thing works and is not uncomfortable with me having copies of the report.  Despite that as far as I am concerned, this is my device paid for directly or indirectly through my employer on my behalf, so over time I pay for the device, the data is very much mine, if anything they should be asking me if I allow them to see the data not the other way around.  I have not had to have this battle and not sure what I would really do or not do if they refused to let me see this report.  any way rambling.  there is nothing of concern in the report, it is a few to a dozen "pages" the paper is like a quarter sheet of letter sized paper.  It is mostly electrical settings, voltages and timing numbers, some manufactures have side by side the before and after settings and highlight any settings that have changed, making it easy to see and then later ask the doc, why did this setting change.  or better after you are dialed in the comfort that they didnt forget to put the device back the way they found it.  A longer report may include any recorded incidents that may have happened since the last visit, doesnt mean you need to be concerned, you might have had a few beats that were above the upper limit, perhaps you were stressed or climbing stairs too fast, no biggie.  the really long report the doc gets also has ekg output, dont think I have ever been given that.  One reason to get it is for your own personal assurance that they did put it back before you left, they are going to do that the tests are temporary and if they have the laptop thing where you can see it you will see that there is a button the screen that the tech holds the stylus to during the test only while that button is pressed is the device using those alternate test settings, once released the device goes right back to programmed settings.  the test is not how they reprogram settings it is a temporary thing.  but getting the report somehow makes me feel a little better as my head and breathing may still now feel strange due to anxiety.  the second reason is that when you come back to pacemakerclub.com and someone asks you a question or you ask a question you can look at this report and say, my lower rate is programmed for X my upper is programed for Y my blah setting is this, etc, etc.  And folks here can tell you why you feel some certain way when climbing stairs or stand up from sitting too fast or whatever.

sorry to ramble...short answer you show them the scar so they can check it, you sit in a chair with some wires attached for some number of minutes, talk to the doc after he/she reads the report, and your done, come back in a year...(or the first year might be more often)...No big deal so long as they dont see any issues with the device or leads.  Oh, the expected battery life number is always wrong, dont get worked up about it until it says weeks or months, then they will talk to you about it anyway, that is the one item to basically ignore...

Check up advice

by MissFitts - 2018-06-23 04:01:17

Thank you very much, everyone and especially  Dwelch for your most detailed  answer. I was especially interested when you mentioned higher beats when, for example climbing stairs, I am fine walking at a nice steady pace on the flat, but my heart rate goes up quite a bit on stairs. probably  normal and Ok.

The  check up is the day after tomorrow.  Hope all is well as we are due  to go on holiday  at the end  of the week. So fingers, but not wires, crossed.