How long before a pacemaker feels "normal"

[ejman]

I had a double lead pacemaker implanted in September after a number of episodes of Sinus Arrest. 4 and a half months later I've yet to really get used to it. My shoulder and implant area still hurt occasionally and it still feels - I don't know how to describe it- as if the wires are pulling. I tried to split some firewood the other day with a maul and that was a no no - sharp pain that made me stop right away. My cardiologist says it will just take a while to get used to it. Tests show the pacemaker is functioning as expected. If any here have gone thru the procedure how long does it take for things to really feel normal again?

[Boho]

I'm not an expert but I found this:

Pacemaker Pain?
"I'm on my 3rd implanted defibrillator and have begun getting sharp pains ever since (implanted 3 years ago). My doctor said it's caused by nerves that were damaged during surgery."

https://www.ncbi.nlm.nih.gov/pubmed/7212841
"Electron microscopy of a painful fibrotic capsule around a cardiac pacemaker revealed classic myofibroblasts."

https://www.ncbi.nlm.nih.gov/pmc/art...MC3077448/#R15
"...Others have reported...an increase of [myofibroblast expression]...20 weeks after myocardial injury...It is therefore unclear exactly how long myofibroblasts persist in the injured heart"

[bingybear]

interesting... sounds like you must have had some really light headed spells. I'm a little curious about how the dual chamber is used for that. I have a dual chamber for Paroxysmal AV block.
I've had my PM for 4+ years. I have some soreness in the shoulder that I think is mostly muscular. Note this pain is in the upper shoulder .. well above the PM. I noticed I still wash my hair with my right hand only; a habit I picked up just after the PM since I was not suppose to raise my left that high for the first 6 weeks. It is quite amazing how habits get ingrained. The other issue I have is an insane itching around the PM when I hike (backpack). This seems to be caused by the strap pushing against the PM as hike. It feels like the pushing causes micro tears in the muscle/skin around the PM. It hasn't bothered me enough to have my wife modify the pack design.
I can't say that I've tried to split wood, but am fairly active.

So, I can't say I've had what it sounds like you have.

If I recall correctly I did a 9 day hiking trip about 6 months after getting the PM. The itching was the only issue. -- note the pack is likely 35-45lb and we usually hike either hills or mountains.

I worried quite a bit about pulling out the leads. I believe they expect the scaring to hold the leads in place.

[ejman]

Quote:

Originally Posted by Boho I'm not an expert but I found this: Pacemaker Pain? "I'm on my 3rd implanted defibrillator and have begun getting sharp pains ever since (implanted 3 years ago). My doctor said it's caused by nerves that were damaged during surgery." https://www.ncbi.nlm.nih.gov/pubmed/7212841 "Electron microscopy of a painful fibrotic capsule around a cardiac pacemaker revealed classic myofibroblasts." https://www.ncbi.nlm.nih.gov/pmc/art...MC3077448/#R15 "...Others have reported...an increase of [myofibroblast expression]...20 weeks after myocardial injury...It is therefore unclear exactly how long myofibroblasts persist in the injured heart"

Thank you for the links. It sure sounds like there is nothing to be done about it other than time and pain meds if bad enough.

[ejman]

Quote:

Originally Posted by bingybear interesting... sounds like you must have had some really light headed spells. I'm a little curious about how the dual chamber is used for that. I have a dual chamber for Paroxysmal AV block. I've had my PM for 4+ years. I have some soreness in the shoulder that I think is mostly muscular. Note this pain is in the upper shoulder .. well above the PM. I noticed I still wash my hair with my right hand only; a habit I picked up just after the PM since I was not suppose to raise my left that high for the first 6 weeks. It is quite amazing how habits get ingrained. The other issue I have is an insane itching around the PM when I hike (backpack). This seems to be caused by the strap pushing against the PM as hike. It feels like the pushing causes micro tears in the muscle/skin around the PM. It hasn't bothered me enough to have my wife modify the pack design. I can't say that I've tried to split wood, but am fairly active. So, I can't say I've had what it sounds like you have. If I recall correctly I did a 9 day hiking trip about 6 months after getting the PM. The itching was the only issue. -- note the pack is likely 35-45lb and we usually hike either hills or mountains. I worried quite a bit about pulling out the leads. I believe they expect the scaring to hold the leads in place.

Yes I did have some light headed spells, as in blacking out since I had some spells where the heart stopped beating for a while. Fortunately the pacemaker solved that problem.

I also do quite a bit of hiking and have switched from my regular backpack to a fanny pack as I've only been doing short 2-3 mile hikes since the operation. I haven't tried my regular back pack since the strap goes right over the pacemaker and I thought that might create problems as you describe. I'll probably try it in a couple of months when I feel ready for longer hikes and see how that goes.

I specifically asked the cardiologist about wearing a backpack before the operation and he said there shouldn't be a problem but if there is some irritation to try some lambs wool padding on the strap.

[bingybear]

we had thought of something like wool or maybe a gel pad. Also thought of redesigning the strap on that side so the pressure would be shifted a bit further from the PM.
I'm curious what the function of the second chamber is for your pm. I would think the sinus node quits working and your pm would fill in there.

What I have ... the AV node quits conducting so the sinus node keeps working fine, so the pm notices the signals are seen on the top of the heart, but missing on the bottom. So the pm just fills in the bottom. Shortly after install it was filling in the bottom signal 2% of the time. By 3 months it was 99%.

I guess I'm lucky.. pain has not been all that bad.
Most of the jobs I use to do would be out with the pm due to EMI issues. Good reason for RE

[ejman]

Quote:

Originally Posted by bingybear we had thought of something like wool or maybe a gel pad. Also thought of redesigning the strap on that side so the pressure would be shifted a bit further from the PM. I'm curious what the function of the second chamber is for your pm. I would think the sinus node quits working and your pm would fill in there. What I have ... the AV node quits conducting so the sinus node keeps working fine, so the pm notices the signals are seen on the top of the heart, but missing on the bottom. So the pm just fills in the bottom. Shortly after install it was filling in the bottom signal 2% of the time. By 3 months it was 99%. I guess I'm lucky.. pain has not been all that bad. Most of the jobs I use to do would be out with the pm due to EMI issues. Good reason for RE

As I understand it, I need a dual chamber pacemaker because the Sick Sinus Syndrome/ Sinus Arrest I have involves not only the failure of the Atrium to contract due to the the Sinus node not generating the electrical impulse but in addition the signal pathway to the Ventricle is not functioning properly so that sometimes the Ventricle doesn't contract properly even when the Sinus Node sends the pulse. Sounds similar to your AV node dysfunction but that's not the term my cardiologist used.

As of a test in December, the Ventricle signal was on about 2% of the time and the Atrium signal about 8% of the time. I have another test scheduled for next month. The cardiologist said that usually once the electrical system in the heart starts to loose function its a slippery slope and it just gets worse over time so that the pacemaker takes over more and more of the function.

I was also worried about EMI issues since I use chainsaws and many other power tools at my ranch all the time. The advise I got from the pacemaker manufacturer is that it would be OK as long as I kept these tools 1 foot away from my pacemaker.

[bingybear]

I think I'll take mine. I had to push back on my cardiologist when my pm would go into distress mode when I exercised. The put me on a treadmill and sorted out what settings needed changed to stop that. After that, I see the cardiologist once a year and they read the pm twice a year. Sounds like you have more testing.
this year may be different as to keep health insurance more affordable, I took a plan that makes me change cardiologists. A 3k difference in plans.

[Keim]

I got mine at 39. Didn't get used to the "feel" of it for about 2 years. I'm now 44, and frequently forget I have it.

[ejman]

Quote:

Originally Posted by Keim I got mine at 39. Didn't get used to the "feel" of it for about 2 years. I'm now 44, and frequently forget I have it.

Thank you. I hope it doesn't take me that long! But if it does, good to know there is light at the end of the tunnel.