repositioning of ICD

I recently (3 weeks ago) had my first ICD implanted on the left side of my chest under muscle.  I'm a small person and know the doctor didn't have much room to fit in the ICD.  I feel like the ICD is pressing into my armpit and as a result have daily and what I feel is unnecessary pain in arm and shoulder.  I've lost the ability to reach my left hand across my body to touch my right upper arm and shoulder.  Walking vigorously irritates my arm and shoulder.  Also, I can't sleep on my right side because there is no place to rest my arm where the ICD isn't pressing into it.  Before you ask, yes, I'm using my arm and following doctor's orders to not lift it above shoulder height, behind me, pick up heavy things, etc...)  When I saw the nurse last week and mentioned my concerns, she said I will likely need to have the device repositioned.  I see the doctor for a device check in 2 weeks.    My questions for you:

Is this common and has anyone else been in this situation?  Could you offer advice or comments?  Am I expecting too much too soon?  Am I likely to lose something else if the device is repositioned?  How long is recovery for this procedure?  

I'm frustrated and feel like I'm wasting time when I could be busy getting back to my very active lifestyle.  



by RedRocksGirl - 2019-12-06 01:50:49

I agree with a lot of what AngrySparrow said above.  Three weeks is way too early in the healing process to expect much of anything.  I had my ICD put in subpectorally in January. I could feel it by my armpit around the end of the first week out and pretty much freaked out, thought it had moved and I went back to the EP. They took a look and assured me that that was where it was placed. 

There is a lot of trauma to the chest and shoulder muscles during the procedure and its completely possible to have soreness, and loss of range of motion for a while.  It can take 6 mos to a year (probably closer to a year) for everything in there to 100% heal up. You may feel like it's all back to normal but based on a handful of unrelated surgeries I've had in my lifetime, big and really small, it was a good year before all the minor swelling that you can't even see was even all gone. I started feeling better after a couple weeks but was frustrated that I had lost so much range of motion in my shoulder joint. I didn't use a sling, except at night for the first 4-5 nights, and gently used my arm so it wouldn't freeze up. After about a month my EP wrote a prescription for me for physical therapy for my shoulder to get range of motion back. My procedure took over 4 hours because they couldnt get one of the leads in so they said it was really hard on my shoulder being taped down into that position for so long.  I had terrible shoulder joint pain for months.  I still have some on occasion.  Ended up not going to PT, but have been using a massage therapist specializing in peri-operative massage for my shoulder and around the ICD where there's some scar tissue.

I use forearm crutches to walk (am an amputee) so use my pec muscles with every step on the crutches and we believe because of those muscle contracting while also weight bearing before my device was totally scarred in the suture holding mine in place broke.  My ICD was moving all over the place behind my breast. (I've got xray pics of it on the photo gallery on this site) I ended up having to have a pocket revision where they retireived the device (It ended up way at the bottom edge of my left breast) and created a new pocket and used extra sutures to hold it in place. My EP had no choice, had to do it because it was no longer held in place. He was worried though, said every time they go in to do these procedures you increase your risk of infection - which can be BAD! We're crossing our fingers it stays put till I have to have it changed out in about 9 years.

Definitely give yourself more time, I'd say a full 6 months feel mostly pain free and be able to lay on your side. (I can lay on my left now for an hour or so then it starts bothering me in that armpit area) Everyone's healing time is different and trust me, I know it's hard to be patient with it, but just allow your body to do its thing and heal. Like AngrySparrow said, respectfully use your arm, but dont push it and set yourself back. I feel there's more muscle trauma to this whole thing than the EPs let on, especially when you're going sub pectorally.

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