Questions and more questions

Hello to all. As others have said, finding this site 6 weeks ago, after that casual "complete-heartblock-you-need-a-pacemaker" day, has been so meaningful to feel, listen and learn from others.

I have an appointment with the cardiologist next week and I wondered if anyone had any suggestions as to what I should ask about. Sorry for the length of this message.

While I was in the hospital getting a dual chamber PM (3 leads), my bp continued to be higher. I'd been on Losartan for a few years and it wasn't really doing the job, imho, but my GP said it was as good as it gets. The cardiology team added Amlodipine and said to follow up with my GP. It seemed to really solve my higher BP which continues to be very stable and good so yay.

I had a visit to the device clinic shortly after being discharged and I heard I was working fine but didn't really have any questions other than how not to break it.

A few weeks later I saw the cardiologist (belongs to the system, has hours in my small town 45 minutes away from the hospital/clinic). He heard a murmur and recommended I get a sonogram to rule out an aortic bruit. I was pretty flipped when I read up on that and contacted my GP to whine a bit. My question was who was running my show--cardiologist for heart, device clinic for PM, GP for bp meds....seemed so scattered. He did research everything that had happened at the hospital and said they'd found a regurgitation (level 1/6) that wasn't a huge concern--sure was a surprise to me though (& uncool not to have been told). The sonogram turned out fine.

My device was read remotely last week but I haven't heard anything about the results--maybe at the cardiologist next week? 

Question part. Although I'm in good health otherwise and overall do feel well there are a few occasions daily where I feel my heart (y'all know that feeling of feeling your heart, right?) become irregular for a few seconds (less than 15 seconds). It commonly happens when I try to walk at a good clip. I just slow up and it rights itself. In the old days I'd describe it as trying to run a 10 mile race after only training for a 1 mile jog--like you hit a wall and your body can't give more. The difference here is it's really just walking (quickly but not training for the Olympics). Occasionally, when I'm reading before going to sleep at night, I'll also feel irregularity for a couple of beats before it gets back to being regular.

I thought I got a PM to make my heart beat regularly--what the heck? I've read some meds correct irregularity and, of course, I'll take what's prescribed but do I really need yet another medication (and some of them are a little scary too). I hear some of you talk about adjustments, sometimes even repeated ones. What sorts of reasons do people get adjustments for? What questions do you ask or what conversations do you engage in? I definitely have more to learn.

Thanks for reading this really long personal situation. If anyone had any suggestions on questions, I'd be most grateful.

 

 

5 Comments

Cardiologist?

by AgentX86 - 2019-03-21 08:26:33

First of all, you should be seeing an electrophysiologist instead of a cardiologist, or perhaps both if you have structural heart issues. In your case, both would be beneficial. Electrophysiologists are cardiologists who have specialized training in the heart's electrical systems. Cardiologists are great for plumbing issues but are in over their heads when it comes to electrical problems. Also, your cardiologist or EP should be able to handle all if your heart meds, including BP. I see my cardiologist far more often than my GP and he knows a LOT more about my situation than any GP.

Pacemakers can only initiate a heartbeat. They can't stop an errant beat. What you're likely feeling are PACs or PVCs. If they're as limited as you say, they're almost always benign. They can be a RPITA, but they're unlikely to cause any real problems. That said, make sure your doctors know about them. If you can, try to capture them on your remote monitor. They'll be able to identify the irregular heartbeats to make sure they're safe.

Scary meds: Are you on antiarrhythmics? They ARE indeed nasty. Do everything possible to get off them! They're all toxic, in various degrees but the effectiveness is proportional to their toxicity. The ones that work well will damage other organs. It's not about if, but when.

Which doctor

by jani920 - 2019-03-23 10:36:21

I found a similar issue upon discharge post PM insertion. The GP, the cardiologist, and the surgeon all wanted me to ask one of the others about my pre- PM medications. I thought that was very strange. I think I will begin looking for an Electrophysiologist on Monday. After being on Lasix, and 2 antihypertensives, it’s scary. It all happened very fast, didn’t have time to research complete heart block

Losartan 50 for BP

by DILIP - 2019-03-26 09:19:27

Hi Firends, I find that Losartan for BP is a villain, for those who have slow heart rate. My doctor gave me Losartan 50 for some 8 years, which was not a good decision, as I had very slow heart rate.  when I had to see a cardiologist due to giddiness and sleeplessness, first thing he told is to stop Losartan. I started eeling better, but eventully I had to get a PM fixed, as the slow heart rate and the occassional pause for more than 3 minutes could not be corrected otherwise. Anybody having problems with slow heatr rate and heart rhythm, better change to Amlodipine ASAP. Losartan is good for those who have diabetise but have no heart problems..     

Questions and More Questions

by ArcReactorMom - 2019-03-29 00:45:54

Hi! I am new here as well as a new PM patient little over 2 weeks ago). Mine happened so fast as well, and while my issues are a bit different from yours, I too feel completely lost on what dr takes precident, how my PM works, how and if adjustments are needed, etc. I'm sorry I don't have answers but wanted to follow and be of some support. Good luck and best wishes to you!

Hopefully, things will settle down

by CR - 2019-03-29 20:27:03

ArcReactorMom,

Thanks for your support and only 2 weeks into all this yourself! I have to say the time between 2 weeks and 2 months has been huge. The whole post-surgery pinches/itches have overall disappeared and being able to lift my elbow over my shoulder allows me to forget all this for a brief minute.

Had a good appointment with my doctor earlier this week, did a 24 hour Holter the day after and have a follow-up next week with the device clinic. Hopefully someone will be able to figure out why I have occasional, short-lived palpitations and/or make adjustments even though they're "nothing to worry about". Call me too much of a doubter but I didn't have them before. 

This site has been helpful from the many acronyms I look up to the welcoming and supportive thoughts and comments. Sometimes I feel like such a whiner---after all, I'm breathing, right? Still, though, it's an individual reality and, as good as my family and friends are about all of it, I don't know when I won't be checking out the "Recent Messages" on Pacemakerclub.com. :)

Cheers.

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Sometimes a device must be tuned a few times before it is right. My cardiologist said it is like fine tuning a car.