PM implant on Wednesday 17 October

PM implant on Wednesday 17 October

by Rick1945 - 2018-10-14 04:36:37

Apologies for the spelling errors - I don't seem to be able to edit.

It depends upon you

by Theknotguy - 2018-10-14 08:09:52

We have people with pacemakers who don't want to know and don't want to be reminded they have one.  A lot of them I talk to can't tell you the manufacturer of their pacemaker.  My wife's cousin doesn't even want to be asked about hers.  We have others who like to know as much as they can.  I fall into the latter group as I had a tech background.  

For the most part, unless you have active problems with heart disease, you won't even know you have a pacemaker.  You go on with your regular life, feel good, and other than the periodic checkups, won't be conscious of having one.  The most common comment on the forum is, "I'm not even aware I have one until I'm reminded. "  Oh, and the newer pacemakers will allow you to use your cell phone to send periodic checkup notices to your EP/cardiologist.  You get a reminder to run the checkup.  Call up the app on your phone, run the app, then go about your business.  I still have to use the puck device, but other than that I just run the app and then go on with normal life.  The newer batteries are supposed to give up to fifteen years of service.  (Don't count on it.)

There is an adjustment period right after you get your pacemaker.  You'll have thumps, bumps, and twinges as you and your body gets adjusted to the pacemaker.  You'll see occasional posts on the forum from people.  But eventually everything settles down and you go on with your life.  

For other people, like myself, who have ongoing heart problems, we have reminders of having a pacemaker.  I have problems with afib, so my pacemaker runs two programs for my afib.  So when my afib acts up, my pacemaker kicks in the programs, I feel them, and am reminded I have a pacemaker that keeps me alive.  I'm also on the forum a lot so I'm reminded that way too.  

The hospital I was in has a 10 item info sheet on pacemakers.  I've pointed out to them many times that four items are completely wrong, and the other six are partially wrong..  But they are more worried about being sued so they keep giving out the wrong information.  Regardless of what you read on the forum sometimes, you don't have to worry about cell phones, keyless cars, metal detectors, store security, airport security, induction cooking, electric drills, shop machinery, electronic devices, and the like.  There is still some question about MIG, TIG, and arc welding.  But, for the most part, very little bothers your pacemaker.  Mine had an accelerometer and I have to be careful around diesel engines and things that vibrate.  Not because of the machinery bothering it, but because the vibration makes the pacemaker kick up my heart rate because it interprets the vibration as running.  All I have to do is just stop the vibration and it stops.  (You'll see me reach up and grab my pacemaker pocket so it stops vibrating.)

Remember, in the past, people had heart problems, no one (including doctors) knew that much about it.  So you'd go along, fine for the most part, run into a problem, turn the corner, and die.  People would shrug their shoulders, then go on with their lives.  With modern medication we can identify the problems you have, treat them and allow you to live longer.  People in third world countries who don't have the advantage of better medication still die.  A sad fact.  So you're one of the luckier people in the world.  

Finally mental attitude.  If you think your pacemaker is going to be a bother, it will be.  If you think it will be a help, it will be.  How you interpret what it will do for you is how you will adjust to it.  

I wish you the best with your new pacemaker (when you get it) and hope your adjustment goes well. 
 

Knowledge Base

by Rick1945 - 2018-10-14 09:03:50

That's superb thanks Thenotguy.   I certainly don't have a technical background but was/am a researcher in quite different areas.

I don't seek excessive detail but I would like to acquire what I would consider to be at least basic knowledge about a PM that I want to be friends with for quite a long time :)  I do feel fortunate that my condition has been identified and that I live in a place where treatment is available.  [I have lived in and travelled to impoverished nations where even basic medical services are scarce]. 

So far I have just skimmed the net [and found this Club along the way].  I would certainly like to know the type of PM I receive [number of chambers and the like]; the heart rate sensors that are set; the pulse rate parameters; and any monitoring set-up.

Does that make sense?

I'm also wondering [hoping] that the PM will help the very fluctuating BP readings that I have had over the past 2 weeks...... 

Am I on the right track here?  I am in a positive frame of mind atm and don't want to get paranoid about this.... Which I can tend to do unless I watch myself... That's not good for me or for my family.

What makes it hard to learn

by Theknotguy - 2018-10-14 13:49:29

What makes it hard to learn about pacemakers is that they all do about the same thing with a few tweaks here and there.  ICD's are at the base, pacemakers, but they have the extra jolt to get the ventricles going.  I'm in no way knowledgeable on ICD's and will make no further comment about them.  

After you receive your pacemaker, the techs have what I call a "fat laptop" they use to adjust settings.  Under the direction of the EP they can fine tune the pacemaker and adjust it to your unique settings.  Since we're all different, the pacemakers become unique to us.  As to what the settings will be, that's why the EP's get paid the big bucks.  Adjustments to the pacemaker can take up to a year to fine tune it to you.  It  just depends upon your needs, heart problems, etc.  

Basically the pacemaker uses the leads to sense when you have a heartbeat.  Common start setting is 60BPM.  That can be changed due to needs of the individual although most go at 60BPM.  If your heart doesn't start a heartbeat at the appropriate time, the pacemaker steps in and initiates the heartbeat.  That's about one beat per second at 60BPM.  After it initiates a heartbeat it then looks to see if the ventricles kick in at the correct time.  If they don't beat at the appropriate time the pacemaker steps in and initiates the ventricle side.  It's real fun when the ventricles don't kick in and the pacemaker takes over.  Fortunately it has only happened to me a few times.  

While it's keeping your heart beating, the pacemaker keeps a very detailed log on what has happened and what it did.  The techs use the "fat laptop" to get their reports. Or, some people have a night stand unit that records every night, I have the telephone unit, and the newer units will just use a cell phone.  Reports can be sent to the EP via a VPN (Virtual Private Network) so the information isn't out there for just anyone to pick up or hack into.  The EP reads the report and makes adjustments accordingly.  

Some pacemakers are better at rate response.  So if you do a lot of bicycle riding, they can pick up when you are doing that.  I have a lot of afib and my pacemaker has two programs that watch that.  In addition to just being a pacemaker, my unit watches for afib sessions and adjusts accordingly.  Most people don't need adjustments to rate response for afib.  The guy who sits next to me in church has the same manufacturer of pacemaker as mine but his is just a "vanilla" unit and only keeps his heart going.  

When they do a pacemaker reading you can request the report.  It's a law in many states so there is no problem asking.  You won't understand everything on the report but you can pick up a lot of information.  I've asked technical questions of my manufacturer but I usually get the ask-your-EP-for-that-information.  Which doesn't help.  I volunteer at a hospital and see the pacemaker techs all the time.  They're more than willing to answer most questions about technical details.  Occasionally you'll get told something is proprietary to a particular unit, or you're asking a question only the EP can answer.  But you can still pick up a lot of information.  

With the advent of micro computers, the pacemakers have gone that way with more and more features,  more and more recorded information, and a longer life span.  They also use an ACK (acknowledge) process to verify when they are being interrogated.  So when the fear mongers get on the forum and tell you a death ray is being developed and everyone with a pacemaker or ICD will get killed - it just doesn't work that way.  However the techs are very tight lipped about that information, won't talk about it, and probably don't know anyway.  If you dig around the Internet long enough you can find some information but most of it is out of date.  The fear mongers keep trying to tell me there is a store security system in Tennessee that wipes out pacemakers.  Another said a Van De Graff generator "fried" a pacemaker.  And there was the overseas newspaper article about a woman with a pacemaker getting killed in Russia when she went through airport security.  Funny thing is when I go back and ask where the store is, where the Van De Graff generator was, or who was the woman who got killed, no one can tell me.  I just get a long silence.  Amazing!

Almost all pacemaker brands have had a recall at one time or another.  My EP switches between three brands in this area.  That way if there is a recall, he doesn't have problems with his entire client base.  Differences between one brand and another are hard to differentiate.  Once again, that's why the EP's get paid the big bucks.  However, most units are very reliable and give long years of good service.  

Hope this helps. Have fun digging up information.