Sixth Post: The Machine is In

What a striking difference.

For all readers who have been in AFib, atrial flutter, had partial heart block, or even PACs/PVCs, you know how awesome and alive you feel after you have been cardioverted OUT of those, or been ablated, or have naturally returned to your innocent heart rhythm, etc. Point is, you feel totally alive again! No doom and gloom of being able to feel your heart beat while just sitting there. You’ve shed that dejected and despondent feeling and you can take on anything the world has to dish out once again!

I’m totally there. It’s a brand new day.

Simple incision, already feeling just fine!

The surgery was really easy (from my perspective). Lots of prepping—they had to shave my entire chest and belly. And I’m not that hairy. They also shaved the sides of the groin just in case they had to go in there for some reason. It’s nothing to have a hairball about; it’s not a big deal. Then one of the nurses (the one who would be at my head, administering sedation) talked to me for 15 minutes about what was happening. He stayed with me until one of the other nurses came by. I met her and they wheeled me to the O.R.

When I got to the operating room, there were all these cool machines in there. The nurses were super nice and professional, keeping the moment light but serious. Plenty of smiles, and I’m typically one to make light of situations, so they were quick to pick up on that.

They basically had to cover my head and right shoulder so I had no view of what was going on down there. I could however always see the nurse above my head who was administering the versed and fentanyl. Those were sweet! And being a bit claustrophobic (nightmare = getting rolled up in a carpet and left alone forever), I had no problems with the ‘tarp’ that was semi-covering my head and shoulder, thanks to the fine administration of appropriate sedation.

Right before the surgery, they did gently strap down my legs and arms with soft and loose wrist- and ankle-restraints. This is done so you don’t at any point snap out of a benzo-induced calm and decide to suddenly take a swipe at the air or scratch your nose with your left arm while the surgeon is threading wires through your veins. You know.

When the surgeon entered, all ears were trained on him. (There were 3 nurses present, which makes 6 ears. Plus mine.) He gently barked out instructions of what he was going to do and what everybody’s role was. This made me feel like everybody was working together and on all cylinders. I was feeling super mellow, but was able to follow along nicely. Why aren’t more surgeries performed with this simpler type of sedation?

During the surgery, which lasted about 3 hours, I clearly was comatose some of the time. The physician mentioned later that I did a little snoring for about 5 minutes. Hey, put me on my back, all flat and whatnot, and I’m gonna snore. Sorry. Flip me over and I’ll stop. Most of the time.

Also, apparently a Fellow was there for some of the surgery. She came in the next day to check on me and acted as though I should know her from the surgery. No recollection. Must’ve been in the middle of it all when I was zoning. Thankfully, she was super nice and smart, so I know I was always in good hands.

I remember at one point the surgeon kept pushing and pushing on the area where they placed the pacemaker. I think he was either

1. Squishing it around to make sure it was placed properly, or
2. More likely he was actually testing it to see if it was working.

I thought it was (1) while I was in the OR, but the next day he did the same thing to me to make a point. Apparently these devices function based on vibration, which is amazingly cool.

View from my room whilst standing up.

I was sitting in my bed with a resting heart rate (HR) of 60. He started brusquely tapping on it for about a VERY long and rather uncomfortable 10-15 seconds, and then had me look at the HR monitor. The device, having noticed the vibration of the tapping, automatically took my HR up to 80-90 bpm! So when I walked around the hallways as a demo, the pacemaker noticed the vibrations and when I returned to my room I saw that my heart was pumping close to 100 bpm.

And the COOLEST part of that is that they can adjust those rates/numbers! Another thing I had to do the day after surgery (yesterday) was to meet the nurse who specializes in making those adjustments.

So for example, since my max HR during my last good stress test in January was about 145 bpm, they set that as the top tier. So if my heart rate goes ABOVE 145, the pacemaker will max it out there so as to not overtax my heart. And they want to keep me at no less than 60 bpm, so that is my bottom number. (I was in the low 50s before surgery, occasionally dipping into the 30s.)

Then if I’m exercising, the pacemaker goes into a sliding scale mode as to how quickly my HR goes up and down based on my level of exercise (the vibrations it senses). When I meet with the specialist in 6 weeks, she can adjust that scale of how quickly my HR changes, and she can adjust that max or min HR as well.

For me, I have a feeling that my HR is increasing too quickly. It’s not used to that, based on the amount of beta-blockers I’ve been on for the last decade+. But I’m more than willing to give it a go if they think I can handle that. I will be journaling any issues I have this next 6 weeks. That way, if there’s a day that I think I’m going to quickly in there, they will be able to look at the data from that day to evaluate whether it was too stressful or not. SO COOL! This is the ultimate FitBit!

That’s a ton of info. I’ll dispel some rumors about what you can and cannot do with a pacemaker tomorrow and perhaps go into more detail about what this little machine can do for me.