Hand and Forearm Swelling and Pain

Had surgery on 2/28/20 to implant new crt-d (3 additional leads as well). First surgery for a dual lead pacemaker was in Feb 2010. As soon as I was placed into a room after my surgery, I told the nurse that my hand felt numb. She contacted the doctor who said it was normal. Don't remember having this problem when I was first implanted back in 2010)  Forearm and hand still swollen and numb 1 week post surgery and when I pointed it out to the Physician's Assistant and she said nothing looked swollen?? I could not bend my fingers and when compared to my dominant hand (right) you can tell the difference. Ok,  to give me peace of mind sent me for an ultrasound to rule out bloodclot.

All the doctor told me to do after waiting 2 days for a response was Rest, Ice, Elevate. Waited to ask him again 16 days after the procedure since there has been no improvement as to whether this is normal and, if so, how long before it should get better. Finally got his answer over 24 hrs later that this  is due to vein narrowing and that the pm is under my pectoral muscle. I should begin to see results after 6 - 8 weeks and keep icing, elevating, and resting the arm.

Why was that so hard, that it was not part of my discharge instructions? Why did he not say this when I asked the question, the first and second times? Why did the nurse practioner not know this? It is infuriating!!  

I see him, not the nurse practioner, in about 4weeks to do the final programming. I have seen this EP ( he is also the director of EP) for the past 10 years and always found him thorough and explanatory. His practice and the cardiology practice became part of a larger group. I suspect this is a big reason why it has become so unpersonable, but what can you do? 

So I can't do much of anything since I cannot grasp anything with my left hand, not even a car steering wheel. Difficult to cook, bathe, etc for another 5 weeks possibly! This has really depressed me.


You need a second opinion

by crustyg - 2020-02-14 18:42:13

It sounds horribly as though he's damaged part of your brachial plexus whilst creating the pocket under the pectoral muscles, and perhaps pressing on the axillary vein before the leads enter it.

You say that your u/s has ruled out a bloodclot in the big vein where the leads enter the circulation and that several days later you still can't grip a large object with your left hand.  So it's unlikely to be local anaesthetic still lingering after this time.

I think you need to see a different doc to examine the nerve supply (sensation and motor control) to your left hand.  There might still be a lot of swelling, but after a week I think the time has passed for hoping it will get better on its own.

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