Posts Tagged ‘Pacemaker’

Requires 2 AA batteries!

September 15, 2009

I was at my ACHD Cardiologist in Atlanta in November of 2007, and everything was going smooooooth. I was doing well, feeling great, and the staff seemed very pleased. I also had a checkup at the Pacemaker clinic scheduled. The Clinic is in the rear of the Cardiology department, and both departments worked well together. A lot of times, you could go to your Cardiology appointment and mention the Pacemaker appointment to the nurse. The Cardiology staff would check your blood pressure and do an EKG trace, then send you back to the Pacemaker clinic during that “lull” when you are waiting for the doctor.

So I was sitting in the Pacemaker Clinic with a chest full of EKG leads and the magnet resting over my pacer, when the tech says “Your battery needs changing!”

Whoa! Hold on a sec – “Battery change” is a code word for “surgery”, not an easy word to hear. In a moment the Pacer tech had the telephone in her hand, then she hung up and said “We’ve got a slot open in the surgical schedule, do you want to get it changed today?”

HOLY COW! Wait a minute, now… a moment ago I was golden. Now I need surgery! Let’s not rush into anything, I need a moment to catch my breath. I asked the pacemaker tech how long the battery had and when she said about three months, I told her that I wanted to put it off for a while, I needed to wrap my head around the idea of surgery. I had the replacement done about a month later.

My pacemaker battery wears out relatively quickly. Since it doesn’t “plug in” to the heart’s electrical system at the optimal point and I am 100% paced, it uses more energy than usual. I usually get about three years of use – in fact, at my last check-up a few weeks ago, they told me that it would need to be replaced in 16 to 21 months.

But there is new battery technology available – Lithium Carbon Monofluoride (Li/CFx). Li/CFx batteries can hold just as much energy but are lighter. The US Navy has been studying Li/CFx batteries to determine if they can tolerate different environmental conditions, and have been pleased with the results. The batteries are stable – they do have “performance issues” in temperatures of -20 C (4 degrees below zero on the Fahrenheit scale) but do not pose a problem in a 98.6 degree (37 C) environment such as the human body. They also discharge at a fairly constant rate, which gives the new Li/CFx battery developed by EaglePicher Medical Power the ability to predict when it will run out and give doctors up to six months warning. I think that is what threw me for a loop – I was fine, and then I needed to get my pacemaker replaced… and they were talking about doing it that day! That might be a little too much to absorb at once!

IMPORTANT: Check those batteries!

September 14, 2009

Ironic in the light of my posting a photo of my old pacemaker (and the fact that we have information on new pacemaker technology, which you’ll see in a day or so) but Medtronic is issuing a warning about the batteries in some of its Implantable Defibrillation Devices (ICDs).

Some of Medtronic’s Concerto and Virtuoso devices built in 2006 may have a problem that causes the battery to drain faster than originally thought. The devices WILL NOT suddenly stop working… but they will need changing earlier than expected. Doctors have been warned in a letter from the company, and you can click a link in the letter to check your unit’s serial number against a list of possibly affected ICDs. They are programmed to give a three month “I’m getting low!” signal to an implantable device monitor, so there shouldn’t be any problem with scheduling a replacement when the time comes.

Check that link if you have one of the affected models!

Keeping pace

September 11, 2009

I’ve mentioned my pacemaker many times. The last time I had to have it replaced, I asked if I could keep the old one. The OR staff washed it off and placed it in a clear plastic envelope for me!

If you have never seen one, here’s a photo of my pacemaker. Note the rulers on each side to give you an idea of the dimensions; measurements are in inches.

Photobucket

The 50,000 mile tune up!

August 27, 2009

Things went great at my Adult Congenital Heart Defect examination at Emory University Hospital in Atlanta – they were very through. Pacemaker check, Echocardiogram, bloodwork, finger stick to check my anticoagulation (bloodthinner) level, and the Cardiology exam. Five different doctors were in the room with me, discussing my health at one point!

I’m doing well, my Cardiovascular system is “balanced.” The Echocardiogram shows no major changes from my last one – nothing different or alarming. My Mitral Valve has a small leak and my liver is slightly swollen; but I’ve had both of those problems for years. That’s pretty much my version of normal; the Cardiologist I’ve seen for 21 years didn’t even raise an eyebrow. The only “bad news” I got was that my pacemaker battery would probably need to be replaced in 16 to 21 months.

So I guess you’re just going to have to get used to having me around – I’m not going anywhere!

Look, ma! No wires!

August 21, 2009

St. Jude Medical has recently won Food and Drug Administration (FDA) approval for a new pacemaker and a new Automatic Implantable Cardioverter Defibrillator (AICD). Both units are wireless! They also have already been approved for use in Europe.

Having your pacemaker or AICD checked usually happens every three months and is not difficult. I have a small box, about the size of a two large paperback books. I connect this box to a telephone line, then open the box and take out a small egg shaped device, connected to the box by a wire. Press a button on the box, then hold the egg against my abdomen just above my pacemaker. If I have it in the wrong place or I move it during the test, a small light comes on to let me know I am getting too far away from the pacemaker.

Once the box has read the pacemaker, it flashes another light and I push a button. While I am putting the egg back into the box and closing the lid, the unit automatically calls my monitoring service and relays the report. When it is finished I can disconnect from the telephone line and store it until next time. Total elapsed time: About ten minutes. It’s pretty simple.

But these new units feature wireless technology using St. Jude’s MERLIN system.  With MERLIN, doctors could monitor an implanted device several times a day without the patient even knowing it. Presumably, the patient sets up MERLIN in an unobtrusive place and goes on about his life. Whenever the patient comes within range of the monitoring device, MERLIN asks “How are you doing today?” – and reports the pacemaker/AICD’s answer to the proper monitoring service. That’s a third grade level explanation of how it works, but it will do.

The pacemaker check is already so simple that I write my next scheduled check on my calender and enter it in my computer to make sure I don’t miss it. This will make it even simpler.  People using the MERLIN system may very well forget that they have a little machine inside of their body that keeps their heart going!

And that’s the whole idea;

Even the smallest heart…

June 23, 2009

From Dr. Wes’ blog, Here’s the world’s smallest pacemaker recipient.

Click the link. You have to see this to believe it.

EMRs? Maybe not!

May 13, 2009

The new push to move everyone to an Electronic Medical Record (EMR) is not going well. For the record, I still carry my USB stick clipped to my belt, but it is becoming more obvious that this idea needs a lot of work.

A good example is pacemakers. There are several major pacemaker manufacturers, and even though all pacemakers function in the same way, a pacemaker controller belonging to one company will NOT control another company’s pacer. The reasoning behind this is “protocols”.

The protocols are, in short, the pacemaker’s programming –  the electronic brains of the pacer. And those protocols are super secret – you’d have better luck strolling into the White House uninvited than you would finding out what those protocols are! Because that set of computer commands are what makes these pacers different (and better!) and if another pacemaker company learns what they are, we loose our competitive edge… and probably some pacemaker sales.

So if your hospital wants to offer the best pacemaker technology available, you have to sign a contract with almost every major pacemaker company. After all, one pacer does not fit all. So that means multiple contracts, multiple payments, and multiple pacemaker controller units – when a lot of cost could be avoided if everyone would decide to pool their technology. But that would mean giving up the protocols… fat chance that will happen!

And don’t think current technology can insure your records are 100% safe. Hackers break into computer systems all the time, even medical databases. And don’t forget the recurring controversy over Electronic Voting Machines!

All is not lost, there are always technological advances happening that will improve medical care. St. Jude Medical is introducing a new pacemaker monitor that is completely wireless! Home monitoring of your pacemaker is pretty easy now: it’s painless and takes about 10 minutes. But with this new model, it’s wireless. You really just have to be close to the device, and it can even test the pacer while you are sleeping!

If you have a medical emergency that renders you unable to speak, your options are limited: You can either use the traditional necklace/bracelet with your health information, or you can opt to carry a USB stick with your medical information. Carrying the USB is becoming less and less of an option; a lot of medical providers refuse to insert them into their computers; a USB stick can carry a computer virus just as easy as they can carry your medical records. (I also have a pocket sized folder in my back pocket chock full of my medical information – everything you want to know about the Funky Heart!)

But there is a another option coming to the market: an Emergency Data Link. The Data Link features a small electronic screen – press the button and it activates with your medical information!

Tonights menu: Links! (with Chili!)

March 13, 2009

This is a long, but excellent read: AD over at A Day in the Life of an Ambulance Driver writes a love letter to his daughter.

There is a new sub-specialty of Cardiologists. They aren’t Adult Congenital Heart Defect Cardiologists, but this can only be good news for CHD patients. The medical field is starting to realize that there is a need for doctors who can serve a small patient base. They are also trying to help patients gain the confidence to manage their own care.

Here’s an EKG strip I hope you never see.

I could have used this after my second heart surgery! Adhesions almost put me in the ground, so this product is very welcome!

People who research treatment options get better care. So don’t just sit there like a bump on a log – get active and get involved! This is your body, find out what’s going on!

Traveling with a chronic illness can be a challenge – but challenges are made to be overcome! Don’t sit at home wishing, go places! Do things! Have Fun! Send a postcard to the Funky Heart! The name of this article is “Travel Tricks for Sick Chicks” but most of the recommendations are for all ages and genders.

Healthcare guidelines are making doctors and patients enemies. Our leaders need to get it together, your doctor is supposed to be a trusted advisior. And if you don’t trust your advisiors, bad things can happen.

Migraine Headaches and Heart Defects

February 1, 2009

Is your migraine headache caused by a heart defect? It’s possible!

Recent research has uncovered an interesting tidbit of information:  People with an Atrial Septal Defect (ASD) or a Patent Foramen Ovale (PFO) who suffer from migraines can see a reduction in the number and severity of headaches when their defect is closed.

Many people may go their entire lives with a ASD or PFO and never know they have it; or if it is detected, their doctor reports that the opening is so small that the best course of therapy is just to monitor it.  With advancing technology and improvement in Catheters, repair of the defect became more practical. The fact that migraine headaches faded or went away completely was a happy side effect of the repair.

It doesn’t always work – one study showed a small number of patients (4 out of 97) actually developed migraine symptoms (their headaches disappeared after several months) and there is at least one known case of a person who developed a migraine every day – with no relief of symptoms.

When I was younger, I averaged a “dizzy spell” per month – just a few moments when everything seemed to take a few steps to the right. Usually it cleared up in less than a minute, but at least once a year I could count on having a really bad bout of dizziness.

Everything would start spinning and it just wouldn’t stop. And it didn’t stop until I had thrown up. So I learned that rather than suffer until things happened naturally, it was best to shove a finger down my throat. Sorry if that thought turns your stomach, but I’d rather do that than to suffer.

Then one day while I was in college it hit me: Dizzy spell, and a bad one. But a friend and I had made plans to get dinner at one of our favorite restaurants that night, so I had a light lunch. A very light lunch – a soda and a pack of Nekots, if I remember correctly.

In case you didn’t know, you can’t throw up on an empty stomach. Finally after about two hours of the world spinning, I think my body just decided it had had enough and the dizzy spell let me go. I got back to my room and slept fourteen hours!

After I had my pacemaker installed, the dizzy spells went away. I haven’t had one since, not even a mild one. No one has ever figured out why, it’s just “one of those things!”

So if you are having migraines, ask your doctor about the possibility of you having an ASD or a PFO. A few days in the hospital getting the repair could end them!

Don’t mess with a good thing

January 30, 2009

I was in my local cardiologist’s office, having problems. I was having dizzy spells and nausea, and each time I had those symptoms, I also had a heart flutter. This day was not shaping up to be one of the best.

Important Safety Tip: If you have a Congenital Heart Defect, you need the services of a very good cardiologist. Since my Adult Congenital Heart Defect Cardiologist is in Atlanta, I also have a local cardiologist that I see. He’s not an Adult Congenital specialist – I know, I’m breaking my own rule – but he’s a smart guy. If he’s faced with a situation he can’t resolve, he’ll call my Doc in Atlanta rather than insisting that he can figure it out himself.

The day had started pretty good. I was up early because it was a day that I was scheduled to work at the museum, and during breakfast my face got hot and I got dizzy. At the same moment I felt as if I was going to throw up, and I felt my heart skip a few beats. That’s unusual, especially considering that I have a pacemaker. But it passed in just a second, so I just mentally marked it as “One of those things”.

But then it happened again while I was getting a shower. Ok, once is a glitch, twice… twice is a problem. So now I was sitting in my local cardiologist’s office.

After an examination and X-Rays, the doctor’s next step was to interrogate the pacemaker. The word interrogate brings to mind memories of the TV show Homicide: Life of the Street. But that is almost the way it works: An electronic device communicates with the pacemaker and asks “Hey, what’s going on in there?”

Thankfully the cure was a simple one. A week earlier in I had stopped by the Pacemaker Clinic in Atlanta for my  yearly check. Your pacemaker clinic will check the pacer via telephone every few months, but at least once a year they want to see you in the home office. Not only do they get a better reading with you being monitored in person and not over a telephone line, but the best diagnostic tool ever invented is still the eyeball.

“I think we can turn your pacemaker down a little bit,” the pacemaker tech in Atlanta had told me. I was all in favor of that: Pacemaker batteries normally last 10 years or more, but because of my unusual heart, mine had worn out in less than three. So if they could do anything that would save the battery, I was all for it.

It turned out that my heart needed to be fully paced… tech-speak meaning my pacemaker needs to be running at full power all of the time. Turning the power down had set me up for the missed beats, the nausea, and the dizziness. Bummer!

But having a good local cardiologist kept me from making an emergency trip to Atlanta, so having a good local doctor is something you may want to think about.


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