Pacing myself

Regular followers may have noticed something of a lean spell in my social media activity, not least this blog, in March and April. There is a reason for this which I feel I would like to share with you.

A brief word of warning first – If you were hoping for a fresh blog post with lovely nature-inspired ramblings, more stories of outdoor or mountainous exploits or contemplations on living life in a more environmentally-minded way, be assured there will be plenty more such content to come, when I get back into my stride, but for now that will just have to wait. What follows is rather more of a story of our wonderful National Health Service and the marvels of modern medical science. Intrigued? Read on….

By now you may be itching to know what momentous news I have to divulge. It’s really not that earth-shattering, just a tad surprising is all, for someone who has just turned the corner of his mid-forties. On 18th Mar, the day before my 46th birthday no less, I had an unexpected trip to York Hospital which resulted in me having a cardiac pacemaker implanted. This was a relatively minor procedure – we are not talking open-heart surgery, just a quick operation under local anaesthetic, but it did require me to stay in overnight and then take a couple of weeks off work to recuperate, avoiding any heavy lifting or stretching. But now, I’m officially bionic, cool huh?

So how did this come about? Well I’ll get to that presently. I have been back at work a few weeks now and I’m feeling fine. The implant site, just in front of my left shoulder, is healing nicely. There will be a nice, six-centimetre scar – From early days it showed real promise, looking like a classic stage make-up scar.

Now that I’ve had a few weeks to get used to the idea of being the Bionic Man I’m feeling ready to share. So there you have it, I’m now a proud, card-carrying owner of a Pacemaker implant. It doesn’t make much difference to daily life. Apparently I’ve to keep at arms length from magnetic induction hobs, hold a mobile phone to my right ear so it remains more than six inches from the device and I should notify airport security officers before I go through a scanner. Otherwise that’s about it. The latter point is handy to know as we are travelling to the United States in late May, so I get to put it to the test.

You might be curious, and I certainly knew precious little about pacemakers before, so here are some specifics about mine and why I come to have it. The device is small, (picture something like an ipod, but more square) and it sits under the skin in my upper left chest. There are two leads, which were fed down into the heart inside a large vein that sits below the collar bone. At the end are the bits that do the business, electrodes I guess.

The procedure was done with the aid of an x-ray to check they were sitting in the right spot – one in the lower chamber, or ventricle and one in the upper chamber or atrium. They serve two functions, both monitoring and pacing. The device itself in my shoulder records the heart activity and looks for any pauses (arrhythmia) which is what I was intermittently suffering from. If the cardiac rhythm gets too slow the leads deliver a pacing signal, emulating the heart’s natural biological pacemaker.

Mine will sit quietly, observing, waiting until another arrhythmia episode then spring into life, to give my heart a friendly nudge when it next tries to take a break.

I’ve been having unexplained episodes about two to three months apart over the last two years, where I would have a funny turn, usually with symptoms reminiscent of a seizure. It has taken a long process of investigations to determine that it was a cardiac issue not, as previously suspected neurological (eg a form of epilepsy). The conclusive evidence came from an implantable loop recorder (or ‘Reveal’ device) which was implanted in my chest back in November. Finally in March it did indeed reveal something, which was that in the most recent event, the one just before my birthday which resulted in a trip to the hospital, my heart decided to take a break, pausing for 20 seconds. Later the same day while under observation in the Cardiac ward it did it again for 38 seconds. Hmmm. Not good. No wonder my brain was having some issues with this. That could certainly trigger a seizure.

We are assuming, then that my periodic episodes, since March 2017, have been cardiological all along. A battery of tests and monitoring over the preceeding months, including electro-cardiograms, echo-cardiograms, treadmill tests and a 24hr heart monitor, all failed to show anything odd with my heart. I had a Consultant Cardiologist who in absence of any indications suspected my troubles were Neurological . Fortunately our Consultant Neurologist was very thorough and insisted on the reveal device to rule out cardiac arrhythmia completely before treating with anti-epileptic meds. In short I felt like I was being batted from one side of the court to the other. Instead the Reveal device demonstrated, eventually, that it was a cardiac matter all along. Just one that was intermittent and produced symptoms that looked for all the world like epilepsy!

At the point whenever the pacemaker has to deliver its little electric wake-up call I won’t feel anything. Hopefully I won’t go dizzy, pass out and fall over though from lack of oxygen, as I was occasionally prone to before. Percy (that is what we decided to call the pacemaker) will take care of that as soon as a pause in heartbeat is detected. I am relieved of course to have a clear diagnosis now, not least as it has enabled me to arrange some proper travel insurance cover for our forthcoming trip and future holidays. (Insurers like to exclude undiagnosed conditions or any with investigations still ongoing.) I am also glad that I do not have to take any medication and provided the next few months go without a hitch, I could be driving again by September, which will be really handy.

On Wednesday I pay my first routine trip to the pacemaker clinic at the hospital, to check if the device has recorded any unusual activity or activated at all during these first few weeks and to make sure everything is as it should be. Since the pacemaker records as well, it rendered the Reveal device obsolete, so this was taken out the day after the pacemaker implant. No doubt at the clinic I will have opportunity to ask any further questions about the gadget, so if you have anything you want to ask, in the comments, please do so and I have the ideal chance to find answers!

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