The time is here...

Hello friends!! Haven't been on here for a long time and just thought I'd post a couple questions since you guys are very good with advice. I'm getting a new pacemaker February 19th. This will be number 3 for me but it will be a little bit different this go round. I have a new/better EP this time, since the last one had 'stupid' wrote on his forehead (bad vibes with him). ;) Anyway, the new EP told me that I'd have to have my pocket revised this time because this pacemaker is going to be bigger than the one I have now. And I also will have to have an external pacer put in since I am 100% paced. He said the infection rate is higher with a revision. I was wondering if any of you have had this done and how long were you sore? I've also never had an external pacemaker and was wondering if there is any issues with this as well? Thank you in advance.

7 Comments

revision

by Tracey_E - 2014-02-04 06:02:36

I had a revision with my last replacement, #4. A plastic surgeon cleaned up the scar tissue and I got a new lead, also. I was more sore than the other replacements, probably comparable to the first placement. I was given a pain prescrip but never took it. I was fairly sore for a week or two, somewhat sore for a good month, but I got by on Tylenol.

If he's worried about infection, ask for the antibacterial pocket.
http://www.tyrx.com/AIGISRx-Clinicians.htm
No one said anything to me about it to me. I wasn't given antibiotics other than the iv during surgery. No problems.

Have they checked to see what your rate is without pacing? Mine was high enough that we skipped the temp pm. Does he want to do external or temporary? Big difference, try to get external if possible. Temporary goes in through the femoral artery, so that's one more place to heal. External is just two big pads, one on the chest, the other on the back. I've had that for each replacement, no idea if it was used or not but it took forever to get the sticky stuff off!

Glad you like your new ep! Good luck.

Revision

by pacie - 2014-02-04 07:02:18

My husband was wondering if he needed to take a few days off with me and I really didn't know. We have a dog in the house that will need tending to and two more outside that will need to be tended to as well. Carrying buckets of water to them and so forth. He checked my rate and decided it was in my best interest to do a temporary. I begged and pleaded to no avail. Lol!!! Just kidding.

They used the external with my second one. Actually, they used it while I was waiting for my first one too because my heartbeat kept declining. I went from 2nd degree heart block to 3rd in no time flat. And yes, the sticky stuff is awful!!

I love my new ep!! He's kind and considerate and actually listens to me and answers much needed questions. That alone says a lot.

pocket

by Tracey_E - 2014-02-04 09:02:32

The pocket can be anywhere. As we heal, scar tissue builds up around the pm and creates a toughened pocket. When they go in the second time, my rep likened it to opening a zipper. Mine got achy over the years, so the last time they cleaned up the scar tissue and made a new pocket in the same place. Mine is submammary, buried under muscle and breast tissue, so very deep.

Bears, we're all different, but my pain level was nowhere close to yours. I had something narcotic in the hospital that first night. They sent me home with a vidodin prescrip but I didn't even fill it, just Tylenol and ice. I'm not saying it didn't hurt, but for me it wasn't that bad. I have heard the gamut from experiences like mine to like yours. I guess it depends on the surgeon and how we heal.

Liking and trusting your dr makes all the difference!!!

Revision under the muscle

by bearss27 - 2014-02-04 09:02:36

I just had a pocket revision on Jan. 31 my birthday out of all days but my doc warned me it was going to be painful since he had to go into the muscle and I was not prepared for it to hurt this bad. The original placement didn't hurt at all this one they had to put me on narcotics and I still had trouble sitting up but doesn't feel to bad now unless I move it to much. They told me it should only take one hour and it took over three and then they found out part way into the surgery my iv wasn't working so I wasn't getting the meds they were giving and this one I could feel him cutting and digging. I don't know if it's normal to have this much pain for under the muscle but if it does the job a little pain for now but a more stable PM in the long run. I am wondering though about the pocket thing TraceyE is talking about do you know if they use it under the muscle too?

Sticky Stuff

by Vmurph - 2014-02-05 02:02:16

I'm still on my first pm so I've got nothing valuable to add to that.

For the stinky junk, In case you've never tried it. Goof Off. Stuff is the beesknees. It takes all sticky junk right off. just make sure you wash it off after and moisturize.

Helpful

by pacie - 2014-02-05 03:02:06

Thank you all for the comments. They were each very helpful. I just might try that Goof Off, Vmurph!! I'm sure my husband has some lying around somewhere, being the handyman he is. :) I will try to tune back in as soon as the surgery is over to let you guys know how it went. Thanks again and blessings to all....

Debbie

Replacement surgery

by golden_snitch - 2014-02-05 03:02:52

Hi Pacie!

I just went through the same procedure on January 14th. My old pacer was the smallest on the market, and since I couldn't have that one again, I had to get a bigger model (old was 8cc, new is 12cc). So, my pocket needed to be made a bit larger. It's a subpectoral pocket, and therefore it did hurt quite a lot afterwards. The muscle has to get used to the bigger pacer. However, I was able to get off of the painkillers about six days later, still being sore, but the pain was tolerable by then. Now, three weeks later, I'm doing okay. I can sleep on my left side again, and even on my tummy.

I had lots of ablations, including sinus node and AV-node, so I'm paced 100% in the atria and ventricles. Usually when they check for an intrinsic rhythm, an escape rhythm of about 40bpm kicks in, so I never say that I'm pacer dependent. Now, before the replacement surgery the surgeon checked that escape rhythm again, and since it was fine, he proceded with the sedation (I had asked for) and surgery; no temporary pacer. When he disconnected my old pacer, my heart stopped beating. I asked him what he did then, and he just said: Oh, I hurried up with connecting the new one, I'm used to be quick with that. He said it does happen sometimes, but really isn't such a big problem, because the heart/body can handle that very short period of standstill (I think he only needed 30 seconds or so to connect the new pacer).

So, I'm not sure if a temporary pacer is needed. I think it's takes longer to put this pacer in than this short time between disconnecting the old and connecting the new pacer. However, if your surgeon feels more comfortable with the back-up, let him put the temporary in.

Best wishes

Inga

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