Questions to Ask Dr

My thoughts on your forthcoming 4 week check

by Gemita - 2021-02-06 08:06:36

Steve, it might be helpful if you posted the list of questions you intend asking your EP/technician on the 9th February, so we will all know what other questions to add to the list?  I have already given you a few in an earlier post, but I will repeat them here + a few extras.  

I note you have a Boston Scientific pacemaker.  I have a Medtronic dual lead pacemaker for Sick Sinus Syndrome (tachycardia/bradycardia syndrome).

You could ask specifically:

. What pacing mode you are in ?  

. Whether Rate Response is switched on?

. What your Base Rate (minimum set rate) is, in bpm? 

. What your Upper Tracking/Sensor Rate is, in bpm?

. What your AV delay (sensed/paced) is, in ms?

. % time you are paced in right ventricle?

. % time you are paced in right atrium?

. Whether any significant events have been recorded (for example any high heart rates or arrhythmias)?

No doubt they will report any problems with your battery or leads, so no need to ask specifically.

To avoid going in with a long list of questions on pacemaker settings, I would perhaps consider going to your appointment with only the most essential questions on why you might still be getting symptoms like breathlessness, fatigue, palpitations.  Focus on how you feel and ask if there is a setting which could possibly be adjusted at this early stage to help with some of your continuing symptoms? 

As a well respected member here (Gotrhythm) often reminds us, the pacemaker is usually found to be working well even when we get troublesome symptoms.  We need to find a way of asking our EP/technician if the problem could possibly be that our heart is not responding well to our pacemaker settings i.e. the pacemaker's programming isn't ideal for us?  So if the EP/technician tells you your pacemaker is "working fine" (and it usually is because pacemakers are very reliable) but you are still having symptoms, you need to ask whether the programming is right for you?

When you discuss any symptoms you are getting, explain what actually happens when you get these.  For example, explain what happens when you get breathless;  how often it happens, where it happens, e.g. climbing stairs, how long the breathlessness lasts, other symptoms you get with the breathlessness like chest pain, palpitations, fatigue and whether it only happens at rest (when sitting, lying down) or if it only happens when you try to exert yourself?  The more detailed your answer in “describing” your symptoms, the better they will be able to help you and possibly go straight to the appropriate setting for an adjustment.

I appreciate you have many pacemaker questions and you will get answers to these over time, but perhaps not all at once during your first consultation.  Supposing time is limited and because you have so many questions you don’t even get to cover the ones that are really important to you like what to do about your fatigue?  This might leave you feeling disappointed with the outcome . . . which is why I would focus on your symptoms and how you feel. This is what they really want to know about.

If you have a nice EP or technician, you could hand the list of any unanswered questions to them at the end of your consultation and ask if they could kindly let you have their answers in writing in due course, or to provide you with an electronic copy of your downloaded pacemaker data.  You are entitled to have access to your pacemaker records, although you may have to wait to receive these, or request access "officially". 

Don't forget to tell them what you want to achieve with exercise, so that your pacemaker settings can be tailored to suit your lifestyle.  Good luck on Tuesday.

Your first pacemaker check.

by Selwyn - 2021-02-07 15:50:05

If you want to have a nice, easy doing relationship with your pacemaker technician/doctor, I would limit the 'Spanish Inquisition' type of questioning.  They do have time pressure. 

By all means state any problems, or symptoms  you are experiencing or difficulties. No doubt you will be asked directly about them. You may wish to add any expectations eg. marathon running, rock-climbing etc. for your lifestyle. You may wish to tell them about any anxiety that having a PM is causing you. 

If you want to educate yourself about your pacing ask for the printout from their interrogation of your PM.  You can then study the settings yourself- this is a SELF educative process.

Please do not go in armed with a list of questions about settings.  The consultation is about your well being and symptoms in relation to your lifestyle. Even given professional training, the preservation of interpersonal relationships is quite important and is more likely to achieve service delivery in your best interest  for the long term.  I am sure you will thank them for their attentiveness and help!

Responses

by SteveV - 2021-02-08 00:06:23

Thank you guys for your very helpful and informative responses!!!!