Pacemaker at 35

So from reading the site, I'm finding pacemakers for bradycardia at my age are not as uncommon as I'd suspected. I am 35 and scheduled for a pacemaker on 11/21/08. I have two small kids, 2 and 4. I have not had symptoms (or not that I've noticed) other than the low pulse - consistently around 40. I found the problem when I bought a heart rate monitor for exercise and thought it was broken!

So my biggest concerns are recovery with small kids to care for and also if this might be hereditary and affect them. If I need a pacemaker to keep my ticker ticking, then so be it. I do wonder if it is noticable from the outside - ie. pokes out through the skin. But again, all that matters is being around for my kids. The idea that I may come out of the deal with more energy is attractive, but we'll just wait and see.

Would appreciate any comments or suggestions. Thanks!
AC

9 Comments

comments

by Tracey_E - 2008-11-02 08:11:12

If you don't have symptoms, why did they decide to give you the pm now? Bradycardia is a general term for low heart rate, usually under 60bpm gets that generic label. Sometimes that's just how your heart beats and it's harmless or even a sign of superior conditioning, sometimes it's a symptom of other problems such as an electrical block or sick sinus syndrome. Did you have a Holter monitor to check for periods where you dropped dangerously low, or a stress test to see if your rate increases normally with exercise? Either of those is a reason to get it now. I'm not a doctor and I'm not saying you don't need it, I'm just wondering why now rather than just monitoring your progress and watching for symptoms. 40's is not dangerous if you feel good.

My hr was in the 40's all my life because I was born with a complete heart block, meaning the ventricle never gets the message to beat faster from the atria. I tired easily but other than that felt pretty good but I always knew I'd eventually need a pm. My hr dropped to the low 30's over a period of about a year, by then I had a lot of dizziness and extreme fatigue and it was pretty obvious I needed the pm sooner rather than later.

Depending on your build and your surgeon, yeah, a pm can leave a bit of a lump. Some surgeons are neater than others. There are ways around it if you talk to your doctor first. The normal place to put it is on your chest on the left side, under the clavicle. I got my first one at age 27. I am small boned and was underweight at the time- the lump would have been pretty obvious so my surgeon got creative and buried the pm behind the breast. I have been very happy with this. No visible scars (it's on the side, covered by bra), no lumps, no seat belts rubbing, I can carry a heavy backpack without the straps irritating the pm. The recovery time is a bit longer because they bury it deeper but I feel it's well worth it. Most doctors will not suggest this, I have no idea why! To me, it seems a no-brainer for the female patients, esp the younger ones.

You will probably need help with your children for at least the first week or so. You should feel pretty good within a day or two but you'll have limited use of your left arm. It will be in a sling for the first few days. After that, you'll be able to move it but not above your shoulder and not lift any weight for 4-6 weeks to give the leads time to settle. The 4 yr old should be fine but I don't know too many 2 yr olds that don't want mommy to pick them up! Bending and twisting will also be uncomfortable the first few weeks, so you will want help getting them in carseats, folding laundry, things like that.

Heredity.... just a diagnosis of bradycardia is probably not anything to worry about passing on because it's so general. I would mention it to your pediatrician just so he has an updated family history. It can't hurt to get an ekg on the kids if their rate seems slow or they don't have a normal preschooler's level of energy.

My condition is not known to be hereditary so I was not concerned about passing it on to my kids. Just to be sure, my cardiologist did a quick work up on both of them the last time I was in and they both had normal ekg's. Exactly what we expected, but I felt better having the baseline. My girls are 10 and 11, we didn't bother when they were younger because they've both always been full of energy and never had any type of cardiac symptom.

If you have more questions or want to chat, I'm always around. I'm on my 4th pm so I've been through it all by now!

recovery

by jennyb - 2008-11-02 08:11:15

hi! i just got a pm tuesday for bradycardia.... im 25 and have a one yr old. as for recovery, this hurts way more then i expected. i had open heart surgery a few yrs ago and this pain while different is very painful, at least for me... my pm is under the muscle so it is causing pain in my armpit and arm, alot of pain!! the incision doesnt hurt to much, just really sore/stiff. im a pretty small person, so while they did put the pm under the muscle, it still bulges out quite a bit. im hoping maybe there is some swelling and it will be less noticeable in the future. its just heartbreaking not to be able to pick up my son :( i missed his first trick or treating :( but like u said, all that matters is being healthy and being around for our kids!! good luck to u!!!

jenny

by Tracey_E - 2008-11-02 08:11:36

You poor thing!! It sounds like they got a nerve, ouch. I'm glad to see you back. It's so hard when you can't pick up your kids! The swelling should definitely get better. Did they tell you to ice it?

Recovery

by littletrinh - 2008-11-02 08:11:59

I would definitely enlist the help of others if you have kids. I do not have kids, but just received my Medtronics last Friday and doing normal day to day activities can sometimes be a challenge. My family and I realized how badly I needed the surgery, when I was in the telemetry wing, and found out that I was pacing over 50% of the time.

It is definitely a good idea to get one, if medically diagnosed as being a strong candidate to receive one. Do it before the end of the calendar year, in case you have already met your health deductible. That's what we did. (Thank goodness). It's not the cheapest thing.

Good luck with your new pacemaker! You will be better off after recovery.

Thanks for feedback!

by ADC - 2008-11-02 10:11:54

Thanks so much for the comments. This all came to light in the spring. My holter average then was 45 and another in August was 39. So my doc ordered a cardiac MRI. Nothing there; it's just a bad AV Node I guess. His thought is since there is no reversible cause, it is not improving but actually worsening, and since I have small kids, it's best to be on the safe side and get it. I would have to eventually anyway. I'd rather do it than risk a possible (though teeny weeny risk) complete stop of my heart or even symptoms like fainting. What if I fainted while driving my kids somewhere!? Better safe than sorry, as basic as that sounds.

AC

You'll do great!!

by candi51 - 2008-11-02 11:11:54

Hey!
I am 32 and received my 1st ICD in June.
The best advice I could give is basically what is already written above :-)
Make sure and get help with the kids so you don't use your left arm too much! You don't want to chance pulling a lead out in the first couple of weeks.
Also- icing the site is a great help as well as using pillows to prop up your arms while sitting or sleeping. I used those tips and didn't even need any pain meds.
Definitely ask about where they are going to put it. Under the skin shows the most but has the lowest risk of infection and fastest healing time but I know several that have had theirs implanted under the pectoral muscle and have had good results as well. Just make sure it is what YOU want and not just what the Dr finds to be easiest.
And the best advice I could ever give anyone is to keep a medical journal. Write as much as you can down. Everything leading up to the decision to get a PM, meds, and everything. You will be amazed at how important things can be as you read back through it and at the time they seemed minute.
Best wishes!
Candi

location

by Tracey_E - 2008-11-03 07:11:21

If you've already dropped from 45 to 39, it certainly makes sense to get it now!

Mine is not in the pectoral muscle. I'm not an anatomy expert so I guess it's technically under the pectoral also but it's more in the fatty breast tissue, so muscle activity is not an issue. They tunneled in from the side, not dug down through muscle from the top, so to use Frank's chicken analogy, they filleted along the bone instead of cutting from the top (Frank, your analogy works but it still makes me cringe, lol).

An AV block is not genetic, no need to worry about your kids! That's the type I have. There are some studies that make a connection between women with lupus and babies with congenital av block, meaning if your mom had lupus, that could be where you got the block. A block that develops with age is definitely not something genetic, it's a short circuit that just happened.

Location

by ElectricFrank - 2008-11-03 12:11:50

It is really a matter of how you feel about the appearance of it. If a quick recovery is an issue (with small kids to take care of) having it implanted just under skin is easier and heals much faster in general. The thing that causes the most discomfort post op is the tissue damage of making the pocket. Look at it like tearing the skin off a chicken breast. The deeper it is implanted the more damage is done. Also, under a muscle the area is constantly being pressed on by muscle activity.

You definitely won't be able to lift your kids for several weeks as it can dislodge the leads in your heart.

Now the good part. The AV node problem you have is the easiest to handle with the pacer. Your natural pacemaker is still handling your atrial rate and responds to activity normally. With the pacer sensing the atrial beat and using it to pace the ventricles your should have a normal heart rate response again.

I have the same condition and although a bit older (78) I walk 3 miles/day and have spent time in the Rockies at 13,000+ ft without problem.

One further suggestion: ask for a copy of the printout of the settings of the pacer. At your first checkup ask for both the pre and post report printouts. Several of us here can help you understand the meaning of the reports and they are helpful if you have any issues with its operation. Often the doctors are reluctant to take the time to explain fully what is happening.

best of luck,

frank

Analogy

by ElectricFrank - 2008-11-04 11:11:12

I thought the analogy would be graphic enough to make sense. I can almost hear the flesh ripping. It can't be that bad though..I stayed totally awake while they did it and mentioned the analogy to the surgeon!

The most common cause of AV block is a bacterial or viral infection that get into the heart. It seems to be becoming more common and often starts with a right or left bundle branch block. I had the bundle branch block for around 8 years before the AV appeared.

frank

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You always have something close to your heart.

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