Doctor office appt Tues 7/12/2021 - PM surgery scheduled for August 16

Hi Everyone,

I made a list of q for appointment tomorrow (Tues July 13) with my electrophysiologist. But most of my questions are about aftercare, which the doctor may or may not be the person to discuss that with. (Maybe the Nurse Navigator?) I will post questions about that after tomorrow, if necessary. For now, I would appreciate you folks suggesting what questions specifically I should ask my doctor at tomorrow's appt.

So far I have *is this pacemaker safe for MRI?  *am I getting anesthesia-if so, what kind? *I sleep on my right side, can PM be put on left side? *will I be able to travel 2 hrs by car to my granddaughter's wedding 5 1/2 weeks after surgery? *when can I use the computer? *when can I shave and shower? *will I need assistance to use the bathroom? *Since I'm on Eliquis, Tylenol is my only(?) OTC painkiller option - if needed, can I get Rx for codeine or another good painkiller? *Who do I contact if there is a post-op problem and where do I go for post-op care, if needed?

Any other questions I should be asking about?

Also, I think I would prefer to stay in the hospital overnight, if that is an option. Is that a good idea? Should I discuss that with my doctor?

Thanks in advance for your input.


8 Comments

Surgery and recovery

by Katwilly - 2021-07-12 16:11:49

I agree with an overnight stay after the surgery. I had mine done in December of 2020. Normally they would have kept me overnight but due to Covid I was discharged about 12 hours later, only to be readmitted the next day due to complications. My implant was fine but I developed pneumonia in both lungs. Your other questions are great.  I found the post surgery pain to be quite tolerable and was able to sleep on either side after about 6 weeks.  Much luck to you!  

questions

by new to pace.... - 2021-07-12 16:18:53

  I have the MRI Surescan Medtronic Pacemaker.  There is no need to stay overnight as it  is not a deep incision.   The Pacemaker generally is put on the left side, just under the collarbone. The leads are generally threaded in by the side of the armpit..   Shower is generally after the stiches are removed, shave they will tell you.  They used surgical glue to close mine. 

 They will encourage you to use both arms.  As long as you do not raise your left one above your shoulder or lift anything heavier that a gallon milk jug.  They will give you a prescription for pain meds,  I never used  those.  Reg. Tynenol works.   I slept for the first week in a recliner just to be sure did not roll over  to my left side.   Am a right side sleeper.

After your implant and before being discharged from  the hospital they will give you a written list of do's and  don'ts.   Who  to contact if any problems.  When you see the dr tomorrow. you can make your follow appt.

new to pace

Doctor office appt Tues 7/12/2021 - PM surgery scheduled for August 16

by Joe-416 - 2021-07-12 16:44:47

Thanks so much for your information and comments, Katwilly and New to Pace. I'm a bit concerned about having a fallible "thing" put into my chest and heart by a fallible human being in a fallible setting (in a fallible world). I guess that's what living is all about. Again, thanks!

 

After implant

by Lovesthesun41 - 2021-07-12 17:28:48

I had my Boston Scientific CRT-D implanted 04/01/21. Because it was my first PM they kept me overnight. The pain was minimal and all I needed was Tylenol. I followed the guidelines and my recovery was pretty smooth. Making sure I used my arm (on the PM side) without raising it above my shoulder was key for me. I raise my arms above my head when I sleep and was concerned I would do it unconsciously so I wore my sling to sleep at night even after I was released from wearing it until the six weeks passed. I think you have a good list of questions for tomorrow's visit. 
 

Good Luck. 

After implant

by Dixie Chick 65 - 2021-07-12 18:25:23

I got my pacemaker in May,2020 and I did stay overnight in the hospital. I have a Medtronic Azure MRI compatible dual chamber. The morning after the implant the device rep for our hospital came in and checked to make sure everything was working correctly. Then my EP came in and took off the big bandage. The steristrips were left on I went back to the doc in a week and he removed them. I think most people on this site have sedation and not general anesthesia. But that will depend on what device you're getting, etc. I'm a left side sleeper and after several weeks I was able to sleep on that side. I had no pain to speak of and have gotten along quite well. 
I'm sure you'll get along fine but you're smart to ask these questions up front ! I didn't have time to ask many questions and as a result I've had to self-educate !! Also I had a great doc and good care all around.

DC65

Questions

by AgentX86 - 2021-07-12 19:21:20

First, please fill out your profile.  It gives us some important information about your situation.  Even things that may seem insignificant, like where you live, are important.  Many of these issues are local customs.  While these are often interesting to read and digest, they don't always give you good information about what you can expect.

My implant was done with local anesthesia only (shoulder and leg, because I had an AV ablation at the same time).  My EP said that he would have discharged me the same day, except that I had the AV ablation and was then dependent on the pacemaker.  He wanted them to monitor it overnight just to be sure.  I only had the locals so there was no anesthesia hangover which, alone, can land you in the hospital overnight.  This is one of those things that varies by geographical location, surgeon, and insurance company. If you want a pajama party after surgery, discuss it with your doctors.  There really isn't a need unless there is something abnormal about your condiditon, other than perhaps the anesthetic used.

Pacemakers aren't "safe for MRIs".  All pacemakers made today are called "MRI conditional".  What that means is that if certain conditions are met, the patient can have an MRI.  The "conditions" give radiologists agita.  You'll find that MRIs are possible but you and your doctors are going to have to jump through hoops to get one.  It took me a month and a couple of hospitals to get one (the hospital where I was incarcerated just brushed me off).  I had the wallet card that gave all of the information but no one cared about that card, litterally.  Didn't even want to see it.

Unless there is a really good reason, they will put your PM on the left side.  Even lefties get it on their left side.  It's possible to put it on the right but that's only done (as far as I know) if there is some reason it can't be put on the left.

A 5-1/2 weeks you'll be able to do anything you want, possibly short of playing competetive golf.  The recommended time until a full golf swing is usually somewhat longer than that.  You'll be able to drive hours, hours after your surgery.  You probably won't want to but there's nothing that says you can't.  I was back to work the day after I was discharged (less than 48hrs after surgery).  I was walked more than 5mi that day.  I needed to support my left shoulder (sling) to walk but didn't use it for anything else.  Sleeping in a recliner for a week or two, or more, is a good idea.  I did for a couple of months though there was no reason to.  I didn't trust that I wouldn't roll over on it for some time.  When I had my CABG, I slept in the recliner for five months.  I tried, several times, to sleep in the bed but would wake up in incredible pain. 

They gave me heavy duty pain meds (vicodin) but I didn't need them either.  I didn't even take Tylenol (doesn't do anything for me).  Others aren't so lucky and have considerable pain.  If you need pain killers you really have to keep out in front of the pain.  You can't play catch-up if the pain gets away from you.  Others even less lucky and their surgeon won't prescribe meds.  Dumb but it's a good measure of your EP (does he really give a &#*#?).

The thing that you must look out for is any signs of infection.  A little bleeding may be "normal" but any discharge should be looked at.  If there are lines growing toward the heart, it's ER time.  Infections are deadly serious.  Fortunately, they're rare.

If there are less serious problems, call your EP's office. It would be a cold night in hell that you'll talk to your doctor but their nurses, NPs, and PAs, know what's going on and can tell you what to do.  One of them is usually available during office hours.  If you have any chest pain, particularly radiating pain, go to the ER.  Chest pain, at any time, is not to be trifled with.

Ask questions, listen.  Ask more questions.  Listen. If possible, take someone with you and instruct them to listen and take (mental) notes.  Before hand, it may be useful to brief them on the questions you want answered so that they can prompt you.  Having two heads really is better than one, particularly since you will be overwhelmed.

Doctor office appt Tues 7/12/2021 - PM surgery scheduled for August 16

by Joe-416 - 2021-07-12 19:22:31

Thanks to Lovethesun41 and Dixie Chick 65 for information and words of wisdom. How nice to have such knowledgable and helpful people in the Club!

Doctor office appt Tues 7/12/2021 - PM surgery scheduled for August 16

by Joe-416 - 2021-07-12 19:27:12

And to AgentX86! Wow! That's a ton of information - thanks!!

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So, my advice is to go about your daily routine and forget that you have a pacemaker implanted in your body.