help needed to alleviate stress about pocket change of PM

I have put myself into such a state of anxiety.
I decided to have a new pocket done for my PM.
The battery change done in Feb. has caused some issues.
I feel and see the protrusion of the lead, the skin over the PM is tender, the PM seems to fall to the left when I sleep. The procedure is scheduled for Friday but now I am thinking I should cancel. The Dr. states the PM is functioning and that my decision should be one of quality of life...
I am now thinking I should not go through this pocket relocation.
Any one had this done or suggestions please

5 Comments

Hmmmm

by Lotti - 2008-08-04 05:08:34

Hi there. I can not suggest to you what to do as each of us is very different in how we cope, recover and how the implant has gone.

I was really skinny when I had my PM put in and the experience was awful. The PM stood out above my left boob, I could see it, feel it and the leads. I couldn't sleep in any position and the pain was awfull. I spent the first few months crying unable to do anything. I went back to see my surgeon to get him to do something about it and he offered to move it there and then if I was that unhappy. He also said it would not neccessarily fix the problem. I decided to wait and went away with excercises to help me get movement back in my arms and shoulders. I'm very glad that I waited. The PM moved around a bit from left to right so one week it would be rubbing my ribs and the next it would be sticking out under my armpit. It has settled to it's own position now and my body has padded it out so that it is less noticeable. It still gets in the way of shaving but thats not too inconvenient. I have now been told that after having it for 2.5 years that I still have 12 years left on the battery. I just want it to last as long as my valve now so that they can do the surgery all at once. My PM took 3.5 hours to put in. I was awake!

I can not answer your question. My only advice is to go with your gut feeling, then at least you know you have done the right thing for you.

Take care and hope everything goes well whatever your decision.


Lotti (UK)

Similar to Redd

by turboz24 - 2008-08-04 06:08:06

I have a similar situation to Redd. I also have an ICD, it's very apparent, sticks way up including the lead. It's uncomfortable and impossible to ignore, but at this moment, I really don't want to get cut open.

I'm pretty psyco about mine and the only people (this includes me to) who will see me shirtless until the device is removed or relocated are my doctors, but....

1. I doubt I could get the insurance company to pay for the relocation of my device simply because it looks like crap. sure it hurts, but does not hurt 24/7.
2. I'm not sure I would go through the surgery just to solve the placement issues. My current EP did say that he would have never placed it under the skin, but relocating it sub-pectoral would probably only solve the appearance issue, not the occassional pain.

Now I am 35 and I'm sure my issues with my ICD will most likely interfer with a relationship in the near future, but a relationship at the moment isn't my biggest priority and I'm sure if I tried I could find that special someone who wouldn't mind the "no touch/don't look" policy.

So, my suggestion would be if it's causing continual pain and if the surgeon feels that relocation would solve that issue, I might go for it. Even though I obviously hate mine, if appearance was the only consideration, I'd wait.

my thoughts

by aldeer - 2008-08-04 06:08:07

Hi branch57.... I can only tell you my experience. I had my pm put in the end of Aug. 08. I have very little fat (if any) in the area of the pocket..down quite a bit from the shoulder...closer to the breast. Yes, I can still feel the lead (like a cord) and the pm it self, and it took quite a while to "forget it", and it is tender at times. Would I have it changed?..NO!! I swim five days a week for a half hour straight so I do get concerned at times because I only have a single lead. I have about 4 to 5 years left on the battery, so there it will stay until necessary. Remember there is always a risk of infection with any surgery. As for sleeping, I have found that using a big pillow with my left arm over it and right arm under it sleeping is very comfortable on my left side. You have to chose what is right for you. What is right for me is not to rock the boat!
Lots of good luck with your decision. aldeer

Pocket change

by Smart Redd - 2008-08-04 06:08:58

You pretty much described my ICD placement, except that an ICD is much larger than a PM. The skin feels tender as if it were 'black and blue' and while the scar is neat, tidy, and not a problem, the lumps and bumps of the leads are readily apparent. And it slips up to 'bump' into my chin when laying down causing even further discomfort.

My doctor -- not the surgeon whom I never seen since the implant -- insists that it will fall lower in my chest eventually to solve the problem.

Me? I'm unhappy with the ICD placement and unhappy with the whole system of false, misleading and partial truths as answers to my questions.

But. . . at a happily married 60 years of age, I don't think my present discomfort is a fair trade for another surgery. I also doubt that my insurance would cover what could be deemed 'elective' since the device is supposedly operating properly.

So, while it's up to you to determine 'quality of life' issues, I'm just gonna keep hoping for a long battery life and waiting for gravity or battery change to 'fix' the placement.

Love, Red

perhaps wait and see

by bambi - 2008-08-05 10:08:04

I can't advise you in a personal decision, but my experience has been a bit similar. I've had my pocket opened 4 times in 7 years. For 1 battery change, and 3 surgeries. Well aware of the potential for serious infection, I would not have chosen to do any of them. I am thinnish also, and my 1st pacemaker always protruded showing the leads and outline of the device. After a year, the soreness went away, but it was always tender. Each time the pocket was opened after that, the pacemaker, including a new larger model, sunk. The area now is concave. I have been aware of the pacer moving in the last year, and after seeing an x-ray, it has indeed turned to a horizontal position. It's not painful, just bothersome. Will I have a pocket revision? No. When I need a change of the generator, in 5 years or so, we'll deal with it then! I have a fear of not beating the odds of infection. I've been lucky so far. You may want to give it some more time to settle and then decide. However, this seems to be a big issue for you, so for your own piece of mind, it may resolve your anxiety.
Bambi

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