To be out or not to be out

I posted earlier about getting my pacemaker implanted next Monday. I appreciate all the messages, it is so much easier to handle all of this knowing there are so many other out there that have made it through. ElectricFrank brought up a very good discussion and now it has got me thinking and I was wondering if anyone else had any imput. I requested to be under general anestetics instead of local because I do not like the idea of being awake. ElectricFrank brought up some cons about this that have got me wondering if maybe I should choose local. I would appreciate some more opinions or experiences of both decisions. Thanks!! Only 5 more sleeps!!

9 Comments

General for me...

by turboz24 - 2009-01-07 07:01:11

I was under general for both my ICD placement, first EP study, as well as my 2nd EP study and ablation.

I just freak out on the idea if someone cutting away my flesh while I'm aware, so not really into that. My initial ICD placement apparently required cutting away a signifigant amount of subcutanious skin, so no thanks on being aware for that one. I also would reach over 300 bpm during the EP study, so not really up for being aware during that one.

No doubt in my mind...

by Mayor - 2009-01-07 08:01:09

I'm not trying to start something, and I know everybody's different and all that, but why in the world would anyone want to go under a general and incur the added risk and longer hospital stay for what is basically a pretty non-invasive procedure? (Okay, I guess planting wires in your hear IS pretty invasive....)

I've had my implant, an EP study, and 3 colonoscopies (now we're REALLY talking invasive) and they were all done with that "cocktail" of sedatives that they run into your through the IV. I'm told that I carried on lucid conversations with the docs and nurses during each procedure, but in each instance I have absolutely no recollection of anything from the time they tell me that they are starting the drip until I open my eyes in recovery and the nurse says, "we're all done, you did great." In every single instance except the EP study (where i was told to go home and lie down for the rest of the day) I went out for a big meal and basically carried on like I had just been to the dentist.

I would say that with the advances that have been made in being able to put a patient into an "altered state" and then bring them back to a normal conscious state with minimal (if any) lingering effects of the drugs, well, for me, that's the only way to go.

Mayor..

by turboz24 - 2009-01-07 09:01:32

They let you go home that soon after your EP study? I had mine in the morning, wasn't out until the afternoon, then you have to lie flat in bed for at least 6 hrs, so basically my EP doc would keep me overnight anyways.

LOCAL !!!! definitely

by Angelie - 2009-01-07 10:01:17

Local is no big geal. They'll give you some medicine to help you relax. You might even sleep through the entire thing. During the procedure the doctor will give you some numbing medicine right where the incision will be, and after that you shouldn't feel anything.......just pressure.
Your heart has no actual pain nerves so you don't feel pain in your heart ever, just nerves around it feel the pain, but not your heart itself.
General anesthesia actually puts stress on your heart, and can add complications to a relatively simple procedure. Pacemaker implant is the most minor cardiac procedure ever. General anesthesia can cause you to feel nauseous after you wake up, where as if you had local all you will feel is a little groggy from the relaxing medicine and a little discomfort at the implant site. They can give you pain medicine right afterwards to help with the discomfort.
I had a party during my pacemaker implant. I actually had a lot of fun, and all of us laughed and joked about Monty Python movies. It was definitely a night I will NEVER forget, and I wish all procedures could be that easy and fun.
Go Local.....

Angelie

general

by Tracey_E - 2009-01-07 11:01:47

I don't know if it was the wise choice or not, but I had general for all of mine. I had it for the first one because they were burying it deep behind the breast and they wanted me out. The replacements, they gave me a choice and I wanted to be out.

Local & Sedation

by scadnama - 2009-01-07 11:01:55

When my pacemaker was implanted, I was given IV sedatives that put you into a "twilight sleep" or conscious sedation. The meds take only seconds to take affect, and I was out before the local was even injected.

If you wake up during the procedure, the nurse or anesthesiologist is close by and monitors you constantly. You will be made very comfortable during the procedure and will likely remember very little.

I have been to the EP lab 7 times in the last year for different procedures, and I was given the same medication each time, with the same results. It wasn't until my last ablation that took 4 hours, that I wish I had requested general, and only because I began to experiance pain towards the end of the procedure.

Good luck Monday!

Amanda

General vs. Local

by maryanne - 2009-01-07 12:01:02

There are pros and cons to both. General anesthetic requires you to stays in the hospital longer requiring closer monitoring ...even after the leaving the hospital the anesthetic agents are still in your system...of course that also depends on how long the surgery lasts. With a general if anyone in your immediate family has ever had problems with anesthetic you are at a higher risk for "Malignant Hyperthermia" which can be a life threatening situation.

Local is always the preferred route for PM implant....and like others have said....often you don't even remember it because they give you sedation to help relax you during the procedure....you might feel the needle which gives you the local freezing at first....and you might even feel tugging at times....or that odd sensation that you know something is being manipulated but you don't really feel it.

If anxiety is truly your issue you can ask your doctor to prescribe an Ativan(Lorazepam)for you to take in the morning of the precedure....just make sure if you do that you let the staff know you have taken one.

All the best.....keep us posted....

Local Humour

by kiwi - 2009-01-09 05:01:38

When I had my pacemaker put in, I had a local - I can't remember a thing about the procedure but when the pacemaker technician saw me the next morning, he smiled and asked me if I remembered anything I said during the operation. When I said "Why?", he laughed and told me to ask my cardiologist.
So I did and my cardiologist told me that in the operating theatre, I asked very politely for a breast augmentation and tummy tuck!!!
Apparently I was very entertaining throughout my procedure and gave all the theatre staff quite a giggle at the end of a very busy day.
I said to the cardiologist, "are you sure it was me who said that?... I don't even know what an augmentation is!"
"Oh yes" he laughed, "you were the only female procedure of the afternoon and all the others were elderly men!"
How embarrassing ... so I didn't end up with bigger boobs but I did get sort of a breast implant with my pacemaker B)

They gave you a choice?

by CarolL814 - 2009-01-09 11:01:55

I have had 3 PM surgeries and a lead replacement and I have never even been given the option of being under general.
Perhaps it depends on the severity of your condition? I am not sure about that.
Personally, even if given a choice, I would prefer a local. There is much less recovery time and less chance of complications from the meds.
I was awake through each of my surgeries and it wasn't bothersome at all. Actually held conversations with my surgeons each time.
This is a very personal decision, though. You do what feels right to you.
Best of luck and I wish you a fast recovery.
Just make sure to follow their post-op directions to the tee!

Carol

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