2 weeks+ post CSP Implant - and quite the ride

Oh what suffering

by Gemita - 2024-05-17 04:50:08

Oh Andiek, I had no idea you were suffering so much.  How you managed to last to day 13, I have no idea. Sometimes it is not only the steri strips that cause reaction but other products they may have used on your skin too.   For example, any special glue to close the wound or perhaps to help keep the steri strips in place?  I was only really comfortable after a thorough clean of the entire area at around 10 days.  

Medical adhesives/steri strips in lieu of sutures/staples has become common for the closure of some incisions in areas of the skin where tension is low.   There are increasing reports of allergic reactions caused by specific components contained within the medical adhesives.  I hope they place something on your medical records so that you do not have this problem ever again.  

Lead voltage is always apparently set higher at the start of pacing while our leads are settling in and we get used to pacing.  I hope your high 3.5 lead voltage setting has not triggered any unwanted symptoms like diaphramatic stimulation/muscle twitching. I had a bit of that.  At three months, voltage will be reduced to the lowest voltage that will be appropriate for you.

Continue to recover well and welcome back

Hugs n ✌🏻

by Lavender - 2024-05-17 08:50:26

Sounds awful but good. 🙃I too had a tough time with the adhesive and steristrips. I am allergic to most everything. I can't use bandaids-even non latex. When I get a bloodtest they put coban on the arm. I carry a supply of coban to the hospital if I go because they don't always have it 🙄

I was given some small packets of glue remover when I left that were like sealed wipes. I was able to wipe most of the excess glue off the surrounding tissues but had to not touch the steristrips. There were also dissolving stitches underneath. It drove me crazy until everything was finally removed. 😬

My setting was initially turned up to 70 for the first month until the wires embedded more. I felt like I was drinking a pot of coffee all the time and was energized but anxious. I felt better when it was dialed back to 60.  

You are on the mend. Hooray!

Gemita and Lavender - Thanks!

by Andiek11 - 2024-05-17 11:04:35

Appreciate the good thoughts ladies.  

Gemita, what is Diaphramatic Stimulation?  I'm having some weird sensations that are a cross between feeling like heart flutters or skipping beats that seem to occur when my HR is close or at 60 (my lower limit).  And when these sensations occur, I need to cough, and then things settle back.  Any idea what I'm feeling?  (RN didn't have a clue.... *sigh*).

Lavendar, there are now huge notes all over my chart about adhesive allergies.  I just hope this doesn't repeat itself for any future needs.  I've always had a sensitivity to adhesives but never like this.  And as far as I know there was no glue to close the incision, but lots of dissolvable stitches.   

I'm going to request my lower pacing limit be dropped to 50 at my 3 month.  My atrial lead is only firing when my HR tries to drop below 60, and prior to pacemaker, my evening / sleep HR was always low 50's high 40's.  Daytime rate has never been a problem.   

Next goal is to change or totally stop my beta blocker - metoprolol succinate. This med is not agreeding with my body on multiple fronts: horrid recent lipid panel, weight gain and depressed mood.  Their solution is to suggest I start a statin - with it's own potential side effects.  Nope.  Will take a lot of really heavy data to convince me to take that step.  I think my issues will resolve by stopping the metoprolol.  

One step at a time

by Gemita - 2024-05-17 13:33:23

AndieK, Yes I know what you are feeling when you talk about heart flutters, skipped sensations, pausing, and most arrhythmia sufferers would do too. 

When I had my lead voltage set high when I first started my pacing journey, I felt a lot of extra muscle movement in the diaphragmatic region until the voltage was turned down.  That is what I meant by diaphragmatic stimulation. 

I still get similar symptoms from ectopics beats and other heart rhythm disturbances because I can feel the symptoms you describe in the epigastric area (stomach area).  It is well known that many of us feel the beats there and the cough reflex is one way of relieving that awful "sinking feeling" or other discomfort.

A beta blocker will slow Atrioventricular conduction and possibly trigger more in the way of ectopic beats for some of us and those symptoms you describe, so it might be worth thinking about reducing the dosage or coming off it, but only if it is safe to do so?  If you have high heart rates or arrhythmias, stopping the beta blocker may trigger worsening symptoms.   Also reducing your lower rate limit could also trigger more in the way of ectopic beats for some of us, so try one thing at a time, don't change too many things at once.  For example I find a higher base rate (70 bpm) keeps many slower heart irregularities like ectopic beats, firmly at bay, although a higher rate setting certainly doesn't help every patient

Questions for Nurse

by Penguin - 2024-05-17 16:20:04

It sounds like you saw a technician rather than a nurse.  Most technicians are very able to answer questions re: how the device works and most will liaise with the EP to help facilitate an answer for you. 

I've always found techs incredibly knowledgeable and able to help with all things device related.

Gemita and Penguin

by Andiek11 - 2024-05-17 17:28:39

Gemita - I literally had no other arrythymias or electrical issues other than the LBBB.  My heart shows a bit of wear for the 27 years that it has been compensating for the LBBB, but luckily after a massive amount of testing, no other issues of any type were discovered.  

I still need to get a bit better educated on ectopic beats.  I've seen this discussed / mentioned frequently in different posts, but I'm still not sure I have a good grasp of what it is.  (Back to Google U!!).  I'd love to have an explaination of what I'm experiencing any your description sounds like it might fit or be very close.  Thanks!!  And based on your explaination I don't think I have issues with diaphramatic stimulation.  (Yea!!) 

I know that beta blocks attenuate the heart's response to adrenaline (is that correct???) and helps the heart to beat "easier," which can be a bit slower too.  But my HR was not an issue.  The metoprolol maybe slowed it just a beat or two (I'm on the minimal dose they can prescribed - 12.5 mg).   I was told that in part i had to try metoprolol and losartan to prove that they would not fix my reduced EF before insurance would cover a pacemaker.   However now that the pacemaker is installed and working, my cardiologist is dragging his feet about me coming off the beta blocker.  So one more conversation that must wait for another 10 weeks.  *grrrr* 

Penguin - perhaps it was a tech.  It was my first appt with yet more new faces at yet another new facility and I was in great discomfort because of the adhesive rash, so my memory for this detail may be off. *insert spinning eyeballs*.     My hope that at my 3 month check-up that I'll be much clearer of mind and can take in more info.  :)   Thanks!

beta blockers

by Gemita - 2024-05-17 19:14:16

Beta blockers block the effects of adrenaline, causing the heart to beat more slowly and with less force.  This has a calming affect on the whole body and lowers blood pressure and heart rate.  However the calming affects of the medication may make exercising difficult if not impossible for some of us and cause fatigue, weight gain and other symptoms.  Some beta blockers also adversely affect quality of sleep, causing insomnia and nightmares.  Many beta blockers decrease the amount of malatonin (the sleep hormone) by up to 80%.  Both hubby and I get nightmares on it but I need it to slow intermittent tachy arrhythmias.

If you have a low EF this can be a trigger for any rhythm disturbance, hence your EP’s reluctance to take you off Metoprolol I suspect.  Your number one goal should be to get your EF back up and looking healthy again.  You are on a low dose of Metoprolol, so that shouldn’t do any real harm.

We can talk another time about ectopics which are caused by electrical signals in the heart starting in a different place or multiple different places and travelling a different way through the heart. If they occur occasionally, they shouldn’t cause any problems but if they happen a lot, you will need to have treatment (like a beta blocker or calcium channel blocker).  They may be exercise or vagally induced - a vast topic.  

Gemita - You're a Gem

by Andiek11 - 2024-05-18 10:35:03

Many thanks for your counsel, education and support.  I look forward to have this conversation.  :-)