Knee surgery

Knee Replacements

by Grateful Heart - 2024-06-07 22:00:00

I've had a couple of replacements.  You want the anesthesiologist to be aware of your condition.  I have had a hip and knee replacement at different times.  During surgery there was a device rep there (at my request) that I spoke with before the surgery.  I bougtht a copy of my device settings with me so they could reset it to the same settings after surgery.

In the past, I had a procedure and the device rep programmed my settings to something different afterwards and my heart felt like it was beating out of my chest.   After surgery they should reset your device settings back to their previous settings   That is why you  bring a copy of your device settings prior to the surgery.  Not everyone does this, but just a suggestion from prior experience.  

Grateful Heart

shoulder replaced

by new to pace.... - 2024-06-07 23:20:14

 Have you already had your MRI? If so the sugery uses the same techiques. the tech reads your pacemaker using what looks like a hockey pock,  shows up a screen with all your settings.  puts it to sleep and the puck is put back over the pacemaker reads it takes off sleep mode..

 Nothing is reset.

new to pace

Surgery

by piglet22 - 2024-06-08 05:46:51

I had surgery a year after having a pacemaker fitted.

I don't recall before the event anyone even mentioning the pacemaker. Certainly none of the cardiology people were involved.

I had a pre-op check-up. I do remember seeing the medical records with a red marker and "no diathermy".

I always assume that someone does their homework and bothers to check if you have any specific indicators, but these days I'm not so sure.

The main hospital that has all the major departments, but worryingly has been investigated more than once has been reported as having a toxic culture.

Maybe they should have taken more attention of the pacemaker and I was lucky.

Interestingly, the dentist I see has asked more questions about the pacemaker and my general health than any of the hospital people.

Possibly it's because it's a private practice - NHS dentistry has all but disappeared - but I do appreciate that extra pair of eyes.

General Anaesthesia / Nerve Block

by Selwyn - 2024-06-08 07:44:47

I have had many GAs with my pacemaker, including thoracic surgery. The pre-op assessment should make your anaesthetists aware of your pacemaker. The settings before and after surgery should be the same ( insist!) . They may alter your settings during the surgery, hence it is important to ensure they are re-set ( on the last occasion this did not happen for me). The electrophysiologists should be on hand. 

Diathermy is a problem with pacemakers - again your pre-op assessment should take this into account.

I am unaware of anything that needs to change for a nerve block. Diathermy remains a problem.  

( See https://www.bradfordhospitals.nhs.uk/wp-content/uploads/2019/05/Perioperative-pacemakers-protocol.pdf).

Device Settings restored

by markr - 2024-06-08 13:33:24

Hi Grateful Heart (great name!), you advised "I bougtht a copy of my device settings with me so they could reset it to the same settings after surgery."  How do you get a copy of your settings?  I'm very new to this, just had my PM implant all of a sudden 2 days ago. 

Surgery

by AgentX86 - 2024-06-08 13:42:21

There is nothing magical about surgery.  Your anesthesiologist will know exactly what to do for your condition.  You need to have a clearance letter from your cardiologist/EP, which will state any conditions/procedures that they have to follow.

If you're on an anticoagulant, the letter will state which one and how long that you can be off it.  The surgeon will decide, within these parameters, how to approach anticoagulation.  He may not take you off it at all.  Others, or for other procedures, they may take you off your longer-lasting anticoagulant and switch to heparin temporarily, right before or during the surgery,  They can control heparin very closely, and turn it on an off almost like a switch.

The clearance letter and all of the other preparation should all be automatic, done behind the scenes. I'd check with your surgeon anyway. Just ask, well before the surgery, if "they needed the name of your cardiologist".  You just asked if they have one, without asking if they have one (i.e. if they were doing their job).

Your pacemaker is a trivial thing and should be covered in the clearance letter.  The anesthesiologist will follow any instructions given. If they need to change any settings, he'll have a tech download the current settings, change what's needed, then reload the original settings after the surgery.  Your anesthesiologist has seen it all before. There is nothing new here.

When I had my wrist surgery, my cardiologist told them that I could be off Eliquis two days before and a day after.  My surgeon decided that it wasn't necessary. My neurologist's instructions were that if I had a general anesthetic, I had to be hospitalized overnight for observation. Since it was an outpatient clinic, it gave some important information to the surgeon.  They don't need a general to screw together a wrist, so it didn't really matter.  The instructions gave them important information, just the same.

I didn't have to do anything to get the clearance letters.  They were automatic. It's all part of the routine.

Edit: Speelczecher

Thank you

by Nitnelion - 2024-06-08 14:58:23

I very muchj appreciate all of your comments.  I will reach out to my cardiologist to learn my settings before my surgery and then ask about them after surgery.  I will also make sure that my husband has all of my pacemaker information with him in case there are questins.

🦁

by Lavender - 2024-06-08 19:44:46

Hi Nittany Lion😉 my granddaughter recently had her pic taken on the iconic lion statue with her basketball team. 

You aren't their first rodeo having surgery with a pacemaker but yes, I carry a copy of my settings in my purse! No one has ever asked for it though. God bless you on your way!

Reset

by Grateful Heart - 2024-06-09 00:10:49

Hi markr, thanks!  When you go back for your device check you can ask your EP or device nurse for a copy of your device report.  Ask before they start so they can make 2 copies when the download is completed (one for your chart and one for you to keep). 

As I mentioned above and Selwyn confirmed, settings can be changed and may not be reset to the same settings you had when you walked into the hospital.  Of course it shouldn't happen...but it can and does sometimes. We are all human.      

Not everything is routine.   My pre-op assessment was a few days before my surgery.  I spoke with/ met the anesthesiologist who answered my questions and reassured me my CRT-D will be well cared for.  On the day of my surgery, I had a different anesthesiologist because it was his day off.  She was not made aware of my device....until I told her.  The device rep showed up and he turned my defibrillator off and then back on after that surgery and verified no settings were changed this time.   

I never understand the naysayers just because it did not happen to them.  We are all here to help each other and learn from one another.  

Grateful Heart

Naysayers

by AgentX86 - 2024-06-09 00:53:07

It's not that it doesn't happen but they're not going to trust the information that you bring with you. Your settings aren't stored in a filing cabinet somewhere.  They download the settings from your device and restore them after.  They can also just use the magnet to put the pacemaker into VOO mode, with a constant rate.  This doen't change the settings at all.

No, bringing your settings may make you feel better but no one is going to use anything you bring with you. Not going to happen.

General Anesthesia

by Stache - 2024-06-09 01:01:18

I've had a couple of surgeries for other issues under general anesthesia and one more coming up next month.  It's not an issue at least for me.  I have another pacer check coming up and with my Kaiser HMO, I can download my pacer setting from my Kaiser app medical records.  During my surgery last time my pacer clinic tech was present to monitor my pacer setting as I was hooked to an external pacer as a backup incase my pacer had an issue.  Kind of like car jumper cables I am told.

X86

by Grateful Heart - 2024-06-09 13:00:03

You said "Not going to happen".  It has happened so you're wrong.  You cannot tell people what they have experienced is false.  Maybe they do things differently in your state.

Clearance letters are NOT automatic or routine here.  You have to make an appointment with your doctor in order to get a clearance letter.  I can rebuff some of your other comments as well but I won't bother.

Sometimes you can be helpful to some but other times you come off as really snarky and condescending.  It's not my job to convince you and frankly it's getting exhausting.  There is a way to speak/ write to people.  

This site has changed over the years and I notice less participation lately.    

Clearance letters

by Lavender - 2024-06-09 13:31:03

Just interjecting that clearance letters in my state are the responsibility of the patient. When I had gallbladder surgery, the surgeon would not contact my cardiologist. They said that I had to do so. I had to call the cardiologist and request a letter for the surgeon. Not a general anesthesia case. 
 

My bf had hand surgery last week. His surgeon told him to get the clearance from his pcp. BF had to schedule an appointment within thirty days of surgery and be seen in person by the pcp to get the clearance sent. This was not a general anesthesia case. 
 

AgentX86's statement may very well be accurate in his own state so we have to allow for differences. 
 

It may differ in general anesthesia cases. 🤷🏼‍♀️

S#it happens

by AgentX86 - 2024-06-09 13:53:13

Of course things go wrong, but THEY ARE NOT GOING TO COPY FROM A SHEET THAT YOU BROUGT WITH YOU! IT JUST WON'T HAPPEN. Do you think they're going to use MRIs that you brought the day of the surgery? Probably not. They'll pat you on the head, thank you for being so thorough,  and round-file anything you brought.

I'm sorry that you think I'm being sparky, just telling you what should be obvious. You're welcome to skip anything that I have to say, if it offends your sensibilities so much. I am what I am, and write what I know, maybe not cloaked in as many puppies and kittens as you'd wish.

My

Nasty and No self awareness

by Grateful Heart - 2024-06-09 14:20:52

Keep talking.  I am not the only one who feels this way about some of your posts. 

Lavender and I just proved you wrong on one of your points but you skip right over that.

AgentX86

by Gemita - 2024-06-09 16:47:56

I am always saddened when I feel I have to intervene. 

I am not expecting us all to agree but I do appreciate reading respectful comments on this forum.  We learn a lot from each other, especially from members who are polite and sensitive to the thoughts and feelings of others.  Offensive remarks have no place here and I hope they will stop.

Thank You Gemita

by Grateful Heart - 2024-06-09 17:04:27

I agree!

settings before surgery or MRI

by new to pace.... - 2024-06-12 10:57:23

My settings can be seen when that puck is put over my pacemaker it shows up on their Ipad.    I look at it also shows the location of my leads.   I watch them click on sleep. Then after surgery or MRI, puck  back on  and click on wake up.  am good to go.

new to pace