Improvement? of Third Degree Heart Block
History
I was first diagnosed with CHF in March 2010. I was then put on furosemide 20-40 mg per day, lisinopril 5 mg day, and carvedilol (coreg) 6.25 mg twice per day. I also took aspirin 325 mg per day.
On 28 Oct 2011 I had a 2-lead ICD implanted to counter third degree heart block. My 5 mg per day lisinopril medication was stopped, and my coreg was upped to 12.5 mg twice per day. Lisinopril has been noted on the internet as being a possible cause of third degree heart block.
On March 13, 2012 I started my first episode with gout, probably induced, or helped, by furosemide.
On 15 May 2012 I decreased aspirin to 162 mg per day, and on 6 June 2012 I decreased the aspirin to 81 mg per day, which I now maintain.
On 16 May 2012 I decreased my furosemide to 10 mg per day, then on 25 May 2012 I stopped taking furosemide altogether. I was worried about loop-diuretic induced gout (one painful bout with gout was enough) and kidney damage (my readings on creatinine and BUN had increased).
ICD readings
On implant my ICD was pacing ventricle 100% of the time. The next reading on 18 Jan 2012 gave a ventricle pacing of 97%. The next reading on 18 April 2012 gave ventricle pacing of 66% of the time and atrium pacing of 29% of the time. The most recent reading on 18 July 2012 gave ventricle pacing of 40% of the time and atrium pacing of 23% of the time.
Between 97% and 66% ventricle pacing I noticed a decided increase in daily chest thumps felt at heart. It is presumed that ICD was trying to control heartbeat as natural beat was improving (this has not been proved). After 18 April 2012 my chest thumps decreased from a high of 10-20+ per day to now an occasional thump per day.
Comments
It was suspected that lisinopril was the drug that caused my third degree heart block, my heart stopping several times, and my "death" experiences. Since I am no longer on lisinopril, and my heart function is improving (I am dependent on ICD less of the time.), my suspicion about lisinopril being the cause of my third degree heart block seems more likely.
Only time will tell how much my third degree heart block is reversed. My St. Jude Medical ICD technicians now describe my present condition (40% ventricle pacing) as "intermittent third degree heart block." On 28 Oct 2011 I had "total (100%) third degree heart block."
Adrian R. Lawler, Ph.D., (C) 2012 --
17 Oct 2012 --- Visit to ICD technician. Download of ICD = 73% ventricle pacing (up from last visit), 27% atrium pacing (up from last visit). He said I had intermittent third degree heart block and my pacing would vary, and that it was rare to get a complete recovery from third degree heart block. I expect to be paced the rest of my life. Everything was looking good, and I see him again in six months.
Friday, September 21, 2012
Monday, February 27, 2012
Heart thumps from ICD
Heart thumps from ICD
After my Jan 18, 2012 adjustment (second time to check out my ICD) of my new ICD I started getting heart thumps, usually two, at about 6:16 to 6:17 pm. The thumps did not happen daily, and there did not appear to be a pattern on which days the thumps happened at 6:16-6:17 pm.
On 8 Feb 2012 I had my ICD checked again, with nothing wrong being found. I think people thought I was crazy about feeling the thumps at about 6:16 pm.
I got on the internet and emailed an engineer from the company supplying my ICD. The engineer said: "There are automatic measurements performed daily, and in addition, there are certain algorithms that run tests every 24 hours. If these algorithms are turned on, they may be what is causing the daily symptoms around 6:17 pm."
Thus the thumps could be due to an algorithm forcing pacing. If the ICD is already pacing the heart then there may be no thump of the algorithm turning on; thus I do not feel the thumps if the ICD is already pacing the heart. I have about decided that the periodic thumps let me know the ICD is working, so I might not worry about getting them stopped by ICD adjustment.
I still have a periodic burning pain (0-2 on scale of 10) in the area of my ICD implant; the pain is believed to be due to nerve damage when the ICD was implanted.
Adrian R. Lawler, (C) 2012 --
After my Jan 18, 2012 adjustment (second time to check out my ICD) of my new ICD I started getting heart thumps, usually two, at about 6:16 to 6:17 pm. The thumps did not happen daily, and there did not appear to be a pattern on which days the thumps happened at 6:16-6:17 pm.
On 8 Feb 2012 I had my ICD checked again, with nothing wrong being found. I think people thought I was crazy about feeling the thumps at about 6:16 pm.
I got on the internet and emailed an engineer from the company supplying my ICD. The engineer said: "There are automatic measurements performed daily, and in addition, there are certain algorithms that run tests every 24 hours. If these algorithms are turned on, they may be what is causing the daily symptoms around 6:17 pm."
Thus the thumps could be due to an algorithm forcing pacing. If the ICD is already pacing the heart then there may be no thump of the algorithm turning on; thus I do not feel the thumps if the ICD is already pacing the heart. I have about decided that the periodic thumps let me know the ICD is working, so I might not worry about getting them stopped by ICD adjustment.
I still have a periodic burning pain (0-2 on scale of 10) in the area of my ICD implant; the pain is believed to be due to nerve damage when the ICD was implanted.
Adrian R. Lawler, (C) 2012 --
Saturday, January 21, 2012
More Recovery Notes
More Recovery Notes
18 Jan 2012: Recovery is going fairly well. ICD was tested out to be OK today by its maker. My heart doctors say I am doing very well. Both they and I attribute my general good heath to staying on a low salt diet with lots of fruits and vegetables PLUS staying active EVERY day by doing my farm work, garden work, and exercise (of mind and body).
It has been about 12 weeks since my ICD implant, but I am still having various burning pains (0 to 4 on scale of 10) around site of implant, probably due to nerve damage. Hopefully, it will not progress to pain like that seen with Complex Regional Pain Syndrome Type II (CRPS, Type II). I'm hoping the nerve damage due to the operation will improve over time.
Adrian R. Lawler, (C) 2012 --
18 Jan 2012: Recovery is going fairly well. ICD was tested out to be OK today by its maker. My heart doctors say I am doing very well. Both they and I attribute my general good heath to staying on a low salt diet with lots of fruits and vegetables PLUS staying active EVERY day by doing my farm work, garden work, and exercise (of mind and body).
It has been about 12 weeks since my ICD implant, but I am still having various burning pains (0 to 4 on scale of 10) around site of implant, probably due to nerve damage. Hopefully, it will not progress to pain like that seen with Complex Regional Pain Syndrome Type II (CRPS, Type II). I'm hoping the nerve damage due to the operation will improve over time.
Adrian R. Lawler, (C) 2012 --
Tuesday, December 27, 2011
CHF Relapse
CHF Relapse
I had felt so good after getting a pacemaker/ICD that I started eating and drinking more, especially over Thanksgiving holidays, eating out several times, and apparently taking in too much salt and fluids.
I was still mostly not exercising due to ICD implant pain. Then on 1 Dec 11 I took a walk and noticed I was short of breath. I did the same on 2 Dec 11 and was again out of breath. I felt worse on 3 Dec so saw a local clinic. They sent me to local hospital. I was diagnosed with fluid in lungs. I had kept CHF at bay for almost two years and my increased eating and drinking over holidays caused a fluid build-up that sneaked up on me because I felt so good after getting an ICD. Those with a new pacemaker/ICD should not get lax with their habits if they also have a weak heart.
While in the hospital my heart doctor essentially convinced me to get a heart cath done to check out coronary arteries. Cath was done on 5 Dec 11 and no blockage was found and I went home that night. Good news: if any coronary arteries were blocked, I could have had a heart attack which could have damaged more heart tissue, resulting in heart not being able to pump enough blood to body for life.
It is amazing that the last two times I went to hospital they either saved my life or gave me good news on coronary arteries.
Those with a weak heart should exercise daily to see if they are short of breath due to fluids in lungs, or use a stethoscope on themselves to listen for fluid, or get someone to periodically check them for lung fluid.
I have now increased my daily monitoring of several body characteristics/functions to try to avoid another fluid episode in near future, and am using various ways to reduce body fluids.
Adrian R. Lawler, Ph.D. , (C) 2011 --
I had felt so good after getting a pacemaker/ICD that I started eating and drinking more, especially over Thanksgiving holidays, eating out several times, and apparently taking in too much salt and fluids.
I was still mostly not exercising due to ICD implant pain. Then on 1 Dec 11 I took a walk and noticed I was short of breath. I did the same on 2 Dec 11 and was again out of breath. I felt worse on 3 Dec so saw a local clinic. They sent me to local hospital. I was diagnosed with fluid in lungs. I had kept CHF at bay for almost two years and my increased eating and drinking over holidays caused a fluid build-up that sneaked up on me because I felt so good after getting an ICD. Those with a new pacemaker/ICD should not get lax with their habits if they also have a weak heart.
While in the hospital my heart doctor essentially convinced me to get a heart cath done to check out coronary arteries. Cath was done on 5 Dec 11 and no blockage was found and I went home that night. Good news: if any coronary arteries were blocked, I could have had a heart attack which could have damaged more heart tissue, resulting in heart not being able to pump enough blood to body for life.
It is amazing that the last two times I went to hospital they either saved my life or gave me good news on coronary arteries.
Those with a weak heart should exercise daily to see if they are short of breath due to fluids in lungs, or use a stethoscope on themselves to listen for fluid, or get someone to periodically check them for lung fluid.
I have now increased my daily monitoring of several body characteristics/functions to try to avoid another fluid episode in near future, and am using various ways to reduce body fluids.
Adrian R. Lawler, Ph.D. , (C) 2011 --
Sunday, November 27, 2011
Recovery Notes
Recovery Notes
28 Oct 11 --- Pacemaker/ICD implanted 1-3 pm ..... Vancomycin IV during operation and twice after, every 12 hrs. Arm sling 24 hrs/day to prevent raising arm and pulling pacemaker/ICD wire leads out of heart wall attachment. No driving.
29 Oct 11 --- Release from hospital, very sore, started taking doxycycl hyc 100 mg once a day for 7 days.
31 Oct 11 --- Started wearing arm sling only at night so could not move arm in sleep.
4 Nov 11 --- Very sore first 6-7 days after implant.
9 Nov 11 --- Can now drive car.
10 Nov 11 --- Can now wear shirts (get left arm in sleeve), most soreness gone.
11 Nov --- Most pain from operation gone, but pulling at ICD implant site with arm movement.
16 Nov 11 --- As 11 Nov, ICD checked out by people from St. Jude Medical.
18 Nov 11 --- More pain and burning as arm moved more and tissue irritated around ICD implant.
24 Hov 11 --- To emergency room due to chills, low temperature, and pain (3-5 on scale of 10). No infection, but inflammation due to ICD moving when arm is moved.
27 Nov 11 --- Pain at implant site decreased to 0 to 2 on 10 scale, less burning pain. Can now tell all surgery wounds are in final healing.
30 Nov 11 --- Swelling at implant site has gone down enough so one can easily see size and shape of pacemaker/ICD. Skin over implant still sensitive to touch. Using arm more, and less pain with movement.
7 Dec 11 --- Got up quickly from chair, felt dizzy. I am guessing that my quick rise from chair happened at a time when pacemaker had not yet kicked in and I had just missed a heartbeat. Quick risings might lead to dizzy spells and falls. Beware.
9 Dec 11 --- I had pacemaker/ICD implanted 6 weeks ago today. The operation pains are essentially gone. Using the left arm is still below normal as pulling in pacemaker area is noticed with raising the arm. I have been wearing sling to prevent movement of left arm while asleep for last 6 weeks. My ICD wire heart leads should now be anchored by tissue formed around lead ends in heart wall so I can now sleep without a sling, as danger of pulling the leads loose from heart wall is lessened.
Adrian R. Lawler, (C) 2011 --
28 Oct 11 --- Pacemaker/ICD implanted 1-3 pm ..... Vancomycin IV during operation and twice after, every 12 hrs. Arm sling 24 hrs/day to prevent raising arm and pulling pacemaker/ICD wire leads out of heart wall attachment. No driving.
29 Oct 11 --- Release from hospital, very sore, started taking doxycycl hyc 100 mg once a day for 7 days.
31 Oct 11 --- Started wearing arm sling only at night so could not move arm in sleep.
4 Nov 11 --- Very sore first 6-7 days after implant.
9 Nov 11 --- Can now drive car.
10 Nov 11 --- Can now wear shirts (get left arm in sleeve), most soreness gone.
11 Nov --- Most pain from operation gone, but pulling at ICD implant site with arm movement.
16 Nov 11 --- As 11 Nov, ICD checked out by people from St. Jude Medical.
18 Nov 11 --- More pain and burning as arm moved more and tissue irritated around ICD implant.
24 Hov 11 --- To emergency room due to chills, low temperature, and pain (3-5 on scale of 10). No infection, but inflammation due to ICD moving when arm is moved.
27 Nov 11 --- Pain at implant site decreased to 0 to 2 on 10 scale, less burning pain. Can now tell all surgery wounds are in final healing.
30 Nov 11 --- Swelling at implant site has gone down enough so one can easily see size and shape of pacemaker/ICD. Skin over implant still sensitive to touch. Using arm more, and less pain with movement.
7 Dec 11 --- Got up quickly from chair, felt dizzy. I am guessing that my quick rise from chair happened at a time when pacemaker had not yet kicked in and I had just missed a heartbeat. Quick risings might lead to dizzy spells and falls. Beware.
9 Dec 11 --- I had pacemaker/ICD implanted 6 weeks ago today. The operation pains are essentially gone. Using the left arm is still below normal as pulling in pacemaker area is noticed with raising the arm. I have been wearing sling to prevent movement of left arm while asleep for last 6 weeks. My ICD wire heart leads should now be anchored by tissue formed around lead ends in heart wall so I can now sleep without a sling, as danger of pulling the leads loose from heart wall is lessened.
Adrian R. Lawler, (C) 2011 --
Saturday, November 26, 2011
New pain, Chills, Low Temperature
New pain, Chills, Low Temperature
After the initial wound pain seemed to mostly go away on about 11 Nov 11, I started using my left arm more, but then I started getting another pain apparently from the arm movement and movement and pulling on the pacemaker/ICD. It was more of a burning pain (as if the ICD was shorting out inside me). The pain varied in intensity.
On the morning of 24 Nov 11 I woke up, had chills, and checked my temperature. I had a temperature of 95.7 F, chills, and pain that stayed at a level of 3-5 out of 10. Since low temperatures and chills are some of the symptoms of sepsis, and my pains were getting worse, not better, I went to the local emergency room to get checked out.
The doctors, etc. did X-rays and blood work, and concluded there was no infection, but inflammation around implant site, giving me the pain. By the time I got to the hospital my temperature had gone up (through activity?) to 97.5 F.
I was told the pain could last 6-8 weeks or more after the operation.
My left arm muscle has reduced in size due to lack of use due to the pain.
I need to check wound area daily for signs of redness of infection. I prefer the pain to further injury in operation area; pain sometimes is one's body telling one not to do whatever is causing the pain (pain medications mask the pain and one can unknowingly injure something more ......).
I am happy to report that all people at the hospital were helpful and explained things to me. I also have avoided a dreaded hospital infection thus far. I am supposed to be on the mend. ......
Adrian R. Lawler, (C) 2011 --
After the initial wound pain seemed to mostly go away on about 11 Nov 11, I started using my left arm more, but then I started getting another pain apparently from the arm movement and movement and pulling on the pacemaker/ICD. It was more of a burning pain (as if the ICD was shorting out inside me). The pain varied in intensity.
On the morning of 24 Nov 11 I woke up, had chills, and checked my temperature. I had a temperature of 95.7 F, chills, and pain that stayed at a level of 3-5 out of 10. Since low temperatures and chills are some of the symptoms of sepsis, and my pains were getting worse, not better, I went to the local emergency room to get checked out.
The doctors, etc. did X-rays and blood work, and concluded there was no infection, but inflammation around implant site, giving me the pain. By the time I got to the hospital my temperature had gone up (through activity?) to 97.5 F.
I was told the pain could last 6-8 weeks or more after the operation.
My left arm muscle has reduced in size due to lack of use due to the pain.
I need to check wound area daily for signs of redness of infection. I prefer the pain to further injury in operation area; pain sometimes is one's body telling one not to do whatever is causing the pain (pain medications mask the pain and one can unknowingly injure something more ......).
I am happy to report that all people at the hospital were helpful and explained things to me. I also have avoided a dreaded hospital infection thus far. I am supposed to be on the mend. ......
Adrian R. Lawler, (C) 2011 --
Thursday, November 17, 2011
ICD Notes
ICD Notes
ICD/Pacemaker people from St. Jude Medical (16 Nov 2011):
Nineteen days after I had an ICD implant, the St. Jude Medical people came to the heart doctor's office to check on the devices implanted in 18 local people to make sure they were running right, to ascertain approximate battery life left, make any adjustments needed, etc. Justin and Tippy took the time to answer my questions and to make me feel further at ease with my new heart electrical system. They are to be thanked.
I will see them every 3 months so they can check the ICD and make sure all is going ok with the ICD.
With my third degree heart block the ICD is working about 99 % of the time. At that rate the ICD battery should last around 6 years.
ICD cost :
I have not found out how much my specific model of a new pacemaker/ICD costs. But "ball-park" figures from the internet indicate a cost of $25,000 to over $60,000 for a pacemaker/ICD. Additional costs would be for the hospital, and medical personnel/expenses before, during, and after implant of the pacemaker/ICD. My various insurance reports should come out later.
Assuming the ICD battery lasts 4 years the total costs should average out to about $100 per day (rough estimate) for the 4 years. If the battery lasts 6 years, the cost would be about $66 per day (rough estimate). This is a high amount for an extension of life, but I am enjoying each day........... Luckily I paid my insurance for many years and gave up other stuff in paying for the insurance back then. Now I get to wake up more days because I kept the insurance .... one thing I apparently did right down through the years.
Adrian R. Lawler, Ph.D., (C) 2011 --
ICD/Pacemaker people from St. Jude Medical (16 Nov 2011):
Nineteen days after I had an ICD implant, the St. Jude Medical people came to the heart doctor's office to check on the devices implanted in 18 local people to make sure they were running right, to ascertain approximate battery life left, make any adjustments needed, etc. Justin and Tippy took the time to answer my questions and to make me feel further at ease with my new heart electrical system. They are to be thanked.
I will see them every 3 months so they can check the ICD and make sure all is going ok with the ICD.
With my third degree heart block the ICD is working about 99 % of the time. At that rate the ICD battery should last around 6 years.
ICD cost :
I have not found out how much my specific model of a new pacemaker/ICD costs. But "ball-park" figures from the internet indicate a cost of $25,000 to over $60,000 for a pacemaker/ICD. Additional costs would be for the hospital, and medical personnel/expenses before, during, and after implant of the pacemaker/ICD. My various insurance reports should come out later.
Assuming the ICD battery lasts 4 years the total costs should average out to about $100 per day (rough estimate) for the 4 years. If the battery lasts 6 years, the cost would be about $66 per day (rough estimate). This is a high amount for an extension of life, but I am enjoying each day........... Luckily I paid my insurance for many years and gave up other stuff in paying for the insurance back then. Now I get to wake up more days because I kept the insurance .... one thing I apparently did right down through the years.
Adrian R. Lawler, Ph.D., (C) 2011 --
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