Tag Archives: Boston Scientific

Keeping Up The Pace!

After I checked in the other day on Facebook, while at the KP Pacemaker Clinic for an update on my device’s performance, I noticed a lot of my friends aren’t exactly familiar with what all this means. Please allow me to explain what is happening and how my device works.

I have known for decades I had an electrical problem with my heart. My doctor told me a long time ago I had a right bundle branch block, which I could live with indefinitely or which could kill me in short order. I never let it bother me and figured I would live my life as best I could and not worry about dropping dead.

At the beginning of this year I started noticing I was having problems with heartbeat irregularities and I contacted my doctor. To make a long story short, it became apparent I was experiencing bradycardia (slow heartbeat). One of the diagnostic tools used was what is called a Holter Monitor (it’s a heart monitor, which I wore pasted to my chest for seven days). One night my pulse rate dropped to 26 BPM; not dead, but awfully slow.

After a telephone consultation with a cardiologist—now MY cardiologist—to go over the results of the Holter Monitor and blood tests, we decided a pacemaker might be indicated. That was February 27. Between then and March 3 I had trouble walking from the bedroom to the kitchen, or from the family room to my car, without requiring a moment or three to recover from a feeling of utter exhaustion. I couldn’t fathom living like that for long, so I called my cardiologist to discuss what was going on. I wasn’t scheduled for a consultation on my test results until late March, but that wasn’t acceptable to me. He indicated he had a surgical opening the following Wednesday, March 8, and I agreed to the procedure.

On the morning of March 8, I checked in to the Kaiser Permanente hospital in Woodland Hills, CA and the procedure was performed later that afternoon. I had a Boston Scientific Accolade MRI pacemaker implanted in my chest, just below my left collarbone. The device is about 25% bigger in diameter than a silver dollar, and three times as thick. It’s a nice size chunk of metal I’m still getting used to. It consists of a dual-core processor with 512KB of RAM, a large battery, and two leads – one to my right Atrium and one to my right Ventricle. It is programmed to send an electrical signal to “pace” my heart when it drops below 60 beats per minute. I also have a communication device that sits next to my bed that receives data from the pacemaker and transmits it through a dedicated cell connection to the pacemaker clinic at Kaiser. The pacemaker is also programmed to recognize when my heart rate rises above 130 bpm, at which point the device by my bed (it’s called a “latitude” and is also from Boston Scientific) will notify the clinic.

Two weeks after the surgery, I want for my first device checkup at the clinic. The Nurse Practitioner who manages the clinic advised me that my latitude was communicating properly and she had received data from it. She also told me that my right ventricle was being paced 100% of the time, but my right atrium was being paced far less. She reprogrammed the algorithm in my pacemaker right there (I didn’t feel a thing) and increased the timing between atrial contraction and ventricular contraction. Before I left she informed me my heart was beating on its own.

In The Waiting Room

She also told me the battery indicated it would last for 12 years, but since she had changed the algorithm that would likely change and we would know more the next time I came in. That was last Wednesday, May 24. At that visit I was informed my heart is being “paced” about 40% of the time and that the battery now appears it will last for 15 years.

As of now I will only need to go in to the clinic once a year. I’m feeling good, at least as good as one can expect after almost 76 years of heavy use. So if I use up the remaining battery life—assuming it lasts as long as it predicts—I should make it to 91. Of course, that’s assuming nothing else gets me first, and there are quite a few other things that I have to be careful about. Regardless, I’m thankful I’m reasonably energetic and my brain seems to function as well as it ever has, despite the wear and tear of my party animal past. Life is good, and every moment is precious to me – more now than ever.

Rick 2.0

In retrospect, I should have seen it coming. However, like the proverbial frog in the pot I didn’t realize the water was boiling until it required a drastic intervention. In the past nearly seven weeks, I’ve had the time to reflect on what was happening to me and realize the peak of the problem came up somewhat suddenly, but the signs and symptoms were there for quite some time. The farthest I can consciously go back as of now is to July of 2022.

I believe some of my symptoms were masked by the fact I’d been lifting weights for several years and I was working at a job that was physically demanding, which kept my heart rate up and lulled me into thinking what was happening was normal for someone my age. Every morning when I got ready for work I would pull on my zip-up boots. They were snug and it was a bit of a struggle to slip into them. I usually had to pause for a couple seconds to catch my breath before finishing my preparations for work. I also had to walk between two warehouses at times and was always a bit winded and tired when I got to my destination, which was only about 1,000 yards. Same with climbing one flight of stairs. Some of my problem I also attributed to the fact I was born with club feet, which required major surgery to correct and made walking more difficult than it ought to be.

I lived with these issues for about six months before I experienced what felt like a sudden, drastic change. I was sitting in the lounge of our local Planet Fitness, waiting for my youngest daughter to finish working out. I hadn’t worked out myself and was just biding my time while she was getting in her exercise. When she finished, she came in to let me know and I stood up to leave. I was hit with an overwhelming wave of exhaustion and my knees nearly gave out on me. I didn’t realize it at the time, but I was likely experiencing syncope (fainting). I was able to make it to the car, but it wasn’t a walk in the park.

We made it home (I have lots of experience driving under, shall we say, impaired conditions, during my well-spent youth) and, checking my heart rate with my Fitbit Charge 5, I noticed it was wildly erratic. The next day I contacted my doctor at Kaiser here in Simi and, although he was not available, I was able to get an appointment with another physician. As a result of that exam, I began a series of tests, including wearing a Holter monitor for seven days. I was also scheduled for a cardio stress test a couple of weeks later.

When I finally (it took longer than I thought it should, but that’s another story) got the results from the monitor I’d worn, they were published for me to read on the Kaiser website and their mobile app, which I have on my phone. Reading the results was sobering and alarming. My heart rate had, at one point, dropped down to 27 beats per minute and I had experienced numerous instances of tachycardia. I also had experienced numerous incidents of AV (atrial ventricular) Block. There was enough jargon in the results that I was able to look up and get enough of an understanding to be quite concerned about my heart. This was exacerbated by the overwhelming exhaustion I was beginning to experience when walking from the bedroom to the kitchen or from the house to my vehicle.

The results were published on February 8, but I wasn’t scheduled to consult with a cardiologist until the end of the third week of March. As I read more about my results and experienced longer and more difficult periods of exhaustion, I became increasingly concerned that I might not make it to the consult. I started agitating for things to speed up. After an phone conversation with a cardiologist, I decided to purchase a KardiaMobile personal EKG device. It turned out to be difficult to get good readings because I have essential tremors in my hands and the shaking is accompanied by electrical activity in the muscles of my forearm, which confused the EKG device. When I could get a good reading, it wavered from normal sinus rhythm to bradycardia to possible atrial fibrillation. This somewhat paralleled my experience, as there were times when I felt quite normal and did not tire easily from a short walk.

I sent some of the results to who was now my cardiologist and, after several phone conversations, we determined there was a good chance I needed a pacemaker. My condition continued to deteriorate and we finally decided an implant procedure was indicated. On Friday, March 3 my cardiologist informed me he had a time slot open the following Wednesday, March 8 in which to perform the procedure. I agreed immediately.

On the 8th my wife drove me to the Kaiser hospital in Woodland Hills, CA and I was admitted for surgery that afternoon. All went well, I stayed overnight for observation, and was discharged in the afternoon of the 9th. My wife and youngest daughter picked me up and we stopped for some Chinese food on the way home. I felt great and continue to heal and recover. I was told not to raise my left arm above shoulder height for six weeks and did not do so. My next goal comes on June 8, when I will be able to swing a golf club again. A week and a half after the surgery I attended an air show at Pt. Mugu NAS and walked over two miles without experiencing any shortness of breath. A week later, I want to Arizona to attend to spring training games and walked over two miles on each of the two days I was there, again with no discomfort or deleterious effects.

It’s difficult to say how long I’ll live with this device and, of course, my aging heart. I’ve already outlived my father—who I was told I was “exactly like”—by 16 years. I have numerous comorbidities as well. The battery in my pacemaker, according to the Nurse Practitioner who runs the pacemaker clinic at Kaiser, has over 12 years of life remaining and it can be replaced if necessary. A review of the available information on the remaining lifespan for men like me range from 5 to 15 years or more, depending on numerous factors, including lifestyle. I have to balance my desire to enjoy the life I have left in a fashion that suits me, or live longer by changing my habits and desires. I’m working on that now. My outlook and philosophy are undergoing a transition and I’m not quite sure where I’ll end up, but I’m still here for now and I intend on living each day to the fullest.

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