No matter what type of pacemaker (or defibrillator for that matter) you now have implanted, the follow-up care is the same as far as recovering from surgery and maintaining your new device. There are restrictions, and there are also considerations you must follow. The first two weeks after implantation is a critical time to take it easy and limit your mobility, especially on the side of your body the device is implanted. Maintaining a strict attitude during recovery will help get you back to enjoying your favourite activities much sooner.
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Things you need
- Non-stick wound dressing pads
- Assistance in lifting
- Prescription medication given at the hospital
- Discharge instructions
- Follow-up appointment
Rest your arm on the side the device was implanted. If your arm is sore, especially up around your collar bone, rest it on a pillow in a position of comfort.
Movement of your arm on the implanted side must be restricted. Do not put your arm above shoulder level. The leads in your heart that are connected to the pacemaker have not properly anchored in the cardiac tissue within the first 2 weeks. Lifting your arm can cause the leads to pull out, and then another surgery is necessary to put them back in place.
Driving is out of the question. The routine placement of the pacemaker is on the left side. The seat belt in most vehicles will strike your shoulder over the pacemaker. An accident can cause damage to the device in the first few weeks, especially since the incision is freshly stitched. Also, using the steering wheel can cause the pacemaker wires to move, and, again, it will take another surgery to re-anchor them.
Stop any activity that calls for or causes a sweeping motion of your arm. This means no vacuuming, golfing, or any other brisk back-and-forth motion of the extremity nearest the implant. It's the same for lifting objects. If the item you plan on lifting is heavier than a jug of milk, someone else needs to do it for you.
Take all the medication that is prescribed to you in the hospital. One of the pills you will be prescribed is an antibiotic. It's important to take the entire course of the medication. The pacemaker leads travel directly into your heart, and you have an open wound at the insertion site. These two factors can be deadly without antibiotics.
Keep the wound clean and dry. There may be some discharge from the incision, as a little amount of fluid is commonplace. A lot of oozing and/or foul smelling discharge isn't. Change adhesive pads as needed, or if a lot of moisture, like perspiration, collects in the non-stick pad.
Follow-up with your device clinic and/or cardiologist in two to three weeks. Adjustments with your device will be needed and will take place during your first follow-up visit. At the time of implant, the output of the pacemaker is turned up much more than what is necessary. The reason for this is to help the cardiac tissue around the leads acclimate to the foreign object. If you do not follow up with the doctor or device clinic, the pacemaker battery will deplete well before it should.
Ask the device clinic when you will start over-the-phone pacemaker testing. This testing is done about once a month, and the technician doing the testing will check the device's battery life over the phone. Make sure you keep all appointments or reschedule if you can't be home.
Tips and warnings
- Make sure you know what manufacturer and model of pacemaker was implanted.
- There is a distinct difference between a pacemaker and a defibrillator. If you don't know which one you have, ask the device clinic to check your chart.
- Resister your device just like any other electronic purchase in case there are recalls or service concerns about your device.
- If you do not receive a card with the serial numbers of your device within the first month after implantation, call the doctor and tell the staff you need an ID card from the device company.
- If you are a pacemaker patient that received a device due to bradycardia (slow heart beat) or because you were diagnosed with a second or third degree heart block, go to the nearest emergency room if symptoms return that are the same as before you received the implant. This may mean that you have a dislodged lead, and it could be a serious medical emergency.
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