During and after surgery -- being alert afterward

OK, so I'm getting my pacemaker implanted on 5th September -- after 15 years horrible Afib, I guess I'm not an emergency :),  so it's a planned procedure. (AV node ablation will follow 6 weeks later, and I'm told they will test the pacemaker but not activate it until the ablation is complete -- with an average heart-rate of 150, lows of 90 and peaks of 240 I guess I don't need any extra beats).

It's planned to be a day-case op (UK) -- in at 1100, out 2 hours after the procedure completes so let's guess 1400-1500. Unless they need to put in two leads not one... but we'll see.

I'll have to navigate for my partner while he's driving to the hospital (he's never driven there before -- I've always gone on my own, and learned the way in a crisis when he had his heart attack, which kind-of imprints it on your memory) and probably on the way home as well -- the hospital is in Bristol, and he isn't familiar with the city, and does not get on with using a sat-nav. 

My preference is for a lot of sedation. I don't want to know a thing while it's going on -- and my pre-op specialist nurse said they'd listen when I said that -- from her own experience (and she showed me her pacemaker put in a few months before by the same team, so she's confident about that).  But, how quickly will I be alert after the sedation -- alert enough to navigate in a strange city?

 

 

5 Comments

sedation

by AgentX86 - 2018-08-29 09:37:34

At least here, they're not about to discharge anyone still under sedation.  If you insist on heavy sedation, you may be there a while but you should be able to navigate. The surgery will take a lot out of you so you may be tired, regardless of the drugs.

Back to your preference for being blotto. That was my preference too, but after having to stay alert during a carotid artery angiogram (expected a stent but it wasn't necessary) I changed my mind. It was too easy  to whine about knowing what they were doing to me. I had three other ablations with minimal  sedation (they did put me under for one cardioversion but forgot for the other - that hurt) before the AV ablation and pacemaker implant (done at the same time). I just had the two locals for the PM surgery. Too easy. Filling a tooth is worse.

Out of it?

by Gotrhythm - 2018-08-29 12:59:57

I understand the desire to be completely out. That's what I chose for my pacemaker surgery, but honestly, if I had it to do over again, I'd go the conscious sedation route. I had it when they did my cataract surgery. The stuff they give you makes you conscious in one sense--you are able to follow directions, answer questions--but you feel no pain and you're completely calm because you really, really don't care what's happening. Chances are you will remember very little later.

About the direction thing--there's every sort of electronic help for driving directions, from gizmos for the car to your cell phone. You don't have to depend on your memory alone.

level of sedation

by Going Forward - 2018-08-30 00:36:37

My EP talked to me before the surgery and asked this. She said she would prefer to be able to talk to me and get feedback during the procedure. I went with fairly light conscious sedation and am glad I did as it was fascinating, she told me what she was doing every step of the way and kept asking what I was feeling in order to gauge whether I needed more fentanyl. 

The only thing that was painful was the lidocaine injection. They also were able to show me the placement of the leads by backing up the fluoroscope images after the procedure was done. They kept me at least 5 hours afterwards--slowly sitting me up, giving me IV antibiotics and finally a menu to order a lovely meal. Then they walked me around a bit to make sure I was steady, got me more antibiotics to take at home. 

Thanks for the input

by atiras - 2018-08-30 10:16:15

Thanks, all -- food for thought there. An overnight stay isn't going to be possible (and I'll be much happier at home anyway) but I might reconsider the level of sedation.

Ironically, I just got a call from the hospital saying I was booked in as an 'emergency pacemaker' and would I rather come tomorrow!  But my OH isn't around until Sunday so I had to decline.

Level of sedation

by hopefulhearted - 2018-08-30 10:17:33

I had the conscious sedation.   It was fine. I felt no pain at all, but I did feel the surgeon tugging or pulling at times. But no pain. Was told this is the safer route.Good luck!

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Hi, I am 47 and have had a pacemaker for 7 months and I’m doing great with it.