Wired for Life – Becoming Wired with a Pacemaker

“I was vacationing in Egypt when it all started for me; I suddenly started feeling tired and lethargic. I was unable to climb even one flight of stairs. I noticed my heart was sinking.” Mrs. Moiz expresses anxiously. 

Here is the story of Mrs. Moiz and many like her who faced relatively similar symptoms before being implanted with a pacemaker. 

When was the first time you experienced these symptoms, tell us briefly about it.

 I had symptoms for about two weeks while I was on vacation in Egypt. Symptoms started on the third day of reaching Cairo immediately after I had walked a couple of kilometers. I assumed it was because of a tiring day due to walking and tried to rest it out. The next few days were almost the same I was unable to do any activities. Climbing a flight of stairs was also troublesome for me. Upon consulting a local GP he diagnosed me with bradycardia and attributed my symptoms to it. I was positive that once I’m home I will feel better after resting. But unfortunately, my symptoms persisted and I had to eventually consult a general physician who referred me to an electrophysiologist. 

What was your diagnosis? And after being diagnosed what was your reaction?

 the electrophysiologist placed a 24-hour EKG monitoring and diagnosed me with second-degree AV block. I was advised to get a pacemaker as soon as possible as my heartbeat was very low and I could end up with bigger problems if I left it unattended. I was not entirely convinced and afraid too, and I shared these thoughts with the attending doctor who counseled me very patiently and suggested that I should go for a second opinion before deciding against it. Upon consulting another EP consultant he was of the same opinion and insisted that I should not delay it. After the initial diagnosis, I was quite scared. My thoughts were that it was a foreign object, and what about side effects? I had never stayed overnight in a hospital and was unsure what was happening or why. I was beating myself over what wrong could I have done that pushed my heart into this condition. However, I had a very amazing doctor who was very patient with me and explained things clearly and every step of the way. 

How much time did you take before getting the procedure done?

After a lot of contemplation, I agreed to go through the procedure on the 27th of June’23, exactly three weeks after I experienced the first symptom.

How did you find out more about your condition? Was there much information available at that time? Did your doctor provide help?

I did my own research, as there was a lot of (easily understandable) information available on the net. My doctor was a good source of information; to say that they answered my concerns and fears very well and patiently.

Do you know someone who has undergone a similar situation and did you receive positive feedback from other pacemaker patients?

I personally do not know anyone who has been in a similar medical situation but via close family and friends, I had heard those who had undergone pacemaker implantation were completely at ease and had no post-implantation complications or lifelong disabilities. 

What are some of the common misperceptions and/or complaints that you’ve heard about pacemakers?

Misconceptions are aplenty! The fear of being around microwaves or electrical devices is one of many. I was told by others that I would not be able to sleep on my left side or use phones at all even after recovery. Some told me that I should be careful to travel because of fear of setting off the security or being wand-searched. 

What advice do you think all doctors should have when caring for their pacemaker patients?

Advice a doctor can give is: REST, REST, REST! So many of these women were super-women in life prior to the pacemaker, and they think they should be back in the saddle immediately after surgery. However, it takes time for your body to heal, and rest is what produces a strong healing. 

Is there anything else you’d like to add?

I would like to say that life with a pacemaker is not a death sentence. If anything, it has completely changed my life. Having a pacemaker brings peace of mind, which can help you return to an active life. Especially having young grandchildren around, I feel I don’t have to worry about experiencing the same symptoms I did earlier when I’m on my own with them because the pacemaker will prevent that. I would also urge the pacemaker club to consider starting a patient support group which is very important to our mental well-being. We can all agree having someone to relate to is critical when dealing with physical ailments.  We all appreciate our partners and loved ones for their support, but unless they have a pacemaker, they can’t understand our concerns and worries. 

This is how the story of many patients starts but; how it ends depends on how soon the patient and their family decide on undergoing implantation. With the population of elderly people on the rise and the consequent increase of people with pacemakers, examining factors associated with higher levels of anxiety and who is at the most risk is becoming more important. Research has shown that lower levels of anxiety and depression among elderly people are associated with perceptions of higher quality of life and less need for the use of health services. For the improvement of well-being in the elderly it is imperative for the health care professionals to propose preoperative and follow-up care for patients undergoing pacemaker surgery. 

REFERENCES

1. Dozeman E, van Schaik. DJ, Beekman AT, Stalman WA, Bosmans JE,  van  Marwijk HW. Depression and anxiety, an indicated prevention (DIP) protocol in homes for the elderly: feasibility and (cost) effectiveness of a stepped care programme.  BMC Geriatr 2007; 7: 6.

2. van Veer-Tazelaar N, van Marwijk H, van Oppen P, Nijpels G, van Hout H, Cuijpers P, et al. Prevention of anxiety and depression in the age group of 75 years and over: a randomized controlled 

trial testing the feasibility and effectiveness of a generic stepped care programme among elderly community residents at high risk of developing anxiety and depression versus usual care. BMC 

Public Health 2006; 6: 186

Stress – as defined by PubMed Central, is a state of threatened homeostasis provoked by psychological, environmental, or physiological stressors. Or as a layman would put it, it’s a state of worry or tension as a result of any external pressures.  

It has a dramatic effect on not just the state of mind but also the physical state of the body or more specifically; the heart.  

To begin with, stress increases inflammation in one’s body which can result in high blood pressure and lower “good” HDL cholesterol which poses a great risk for heart attack and strokes. Another severe consequence of stress is broken heart syndrome, also known as takotsubo or stress-induced cardiomyopathy. This affects part of the heart, temporarily slowing its usual pumping function while the rest of the heart continues to work properly or may squeeze or contract more forcefully.  

While all of this seems scary, there are ways prescribed by Harvard Health Publishing to help deal with stress. De-stressing is key to change. This can be done in several ways. Firstly, laugh. Stay positive. It has been known to lower levels of stress, and hormones, reduce inflammation in the arteries, and increase “good” HDL cholesterol.  

Secondly, meditate. The practice of inward-focused thoughts and deep breaths has been shown to reduce heart disease risk factors such as high blood pressure. It is not just limited to meditation, it also extends to yoga and prayers which help relax one’s mind and body.  

Among other things, one cannot lay enough emphasis on exercise. It helps the body to release mood-boosting chemicals known as endorphins which not only help de-stress but also protect the heart against diseases by lowering blood pressure, strengthening heart muscle, and helping maintain a healthy weight.  

If you think that’s enough, you’re mistaken. Unplug. Take time away from the world even if it’s just fifteen minutes. Cut the cord, avoid emails and TV. Get bored. It is the best stress reliever.  

And lastly, have a “me” time. Cut the connection to the world, take warm baths, listen to soothing melodies like raindrops and ocean waves crashing against rocks, or spend time on your favorite hobby. Take a break from the stressors of your life.  

Remember no stress means a healthy mind and a healthy heart.  

“Balance” is the key to heart-healthy eating.

We’re used to seeing headlines about what will or won’t increase your risk of heart disease. Some headlines can’t be trusted, but we do know that with lifestyle changes and medication, you can help reduce your risk of a heart event – even if you’ve had one already. Living with a heart condition is about more than just having a pacemaker and taking medication. 

They say what you eat is who you are, I would add to this and say what you eat is who you can be in the future. Living with a heart condition has already put you at a high risk for complications, but if you make informed and intelligent choices regarding your manner of living you can live a hale and hearty life.

You can start with these simple steps but be sure to talk to your doctor before making any changes so you can develop a plan that’s best for you.

Grains; Simply eating a high-fibre, whole-grain breakfast could help to reduce your risk of heart attack, as can switching completely from refined to whole grains. Whole grains are packed with vitamins and a wealth of heart-protecting minerals, plus insoluble fibre to help digestion. Studies show that high-fibre diets lower the risk of heart and blood vessel diseases, stroke, Type 2 diabetes and cancers of the large intestine and rectum, also called colorectal cancer.

 Whole-wheat bread, whole-wheat pasta, barley, bulgur; brown rice; whole-wheat and high-fibre cereals, including oatmeal. Daily Servings: At least five (about two and a half cups) Serving Sizes: 1 slice whole-wheat bread; 1¼-2 cup cooked cereal; 1¼-2 cups cooked brown rice, or pasta.

Protein Power for a Healthy Heart; On the Menu  Fish (omega-3), chicken & turkey (skinless), lean red meat, pork, eggs, beans(kidney beans, chickpeas and black beans)

Daily Servings: Two to three, Serving Sizes: 50-100 g fish, poultry and meats; 6 tablespoons of beans as a main dish or 3 as a side dish; 2 eggs

Good Fats Are Better than Low-Fat; Olive oil, canola oil, and nuts. Daily Servings of  1¼ -2 to 1 tablespoon oil; 30 g nuts.

Fruit and Vegetables: Natures Cholesterol Cure; Daily Serving of Three or four fruit; four or five vegetables.

Dairy Foods for Better Bone Protection; Having milk on your morning cereal, a small container of yoghourt 

If you eat consistently a variety of life-sustaining, healthy and whole foods, then your body would glow and give you better feelings.

Smoking is one of the leading causes of heart disease, and it poses significant health risks to the heart and cardiovascular system. Smoking damages almost every organ in the body, and its effects on the heart can be life-threatening. In this blog, we’ll take a closer look at the harmful effects of smoking on the heart.

Smoking is one of the most significant risk factors for heart disease. According to the American Heart Association, smokers are two to four times more likely to develop heart disease than non-smokers. Smoking increases the risk of developing atherosclerosis, the buildup of fatty deposits in the arteries that can lead to blockages and heart attacks.

Smoking also increases the risk of stroke, which occurs when the blood supply to the brain is interrupted. The nicotine in cigarettes constricts blood vessels, reducing blood flow to the brain and increasing the risk of a stroke. Smoking can cause high blood pressure, which is another significant risk factor for heart disease. High blood pressure makes the heart work harder, putting stress on the heart muscles and increasing the risk of heart attacks and heart failure. It also increases the risk of blood clots, which can lead to heart attacks and strokes. Nicotine in cigarettes constricts blood vessels, making it easier for blood cells to clump together and form clots.

Quitting smoking significantly reduces the risk of heart disease. Within two years of quitting smoking, the risk of developing heart disease drops to half that of a smoker. After 15 years, the risk of heart disease is nearly the same as that of someone who has never smoked. It can lead to lower blood pressure, which helps to reduce the workload on the heart muscles. This can help reduce the risk of heart disease, heart attack, and stroke.

On World No Tobacco Day, we urge all smokers to pause and reflect on the impact that smoking has on their health and those around them. Smoking is a highly addictive and destructive habit that can lead to numerous health problems, including heart disease, lung cancer, stroke, and respiratory illnesses. But the good news is that it’s never too late to quit. By quitting smoking, you can significantly reduce your risk of developing these health problems, improve your overall health and well-being, and add years to your life. It may be challenging, but it’s not impossible. Many resources are available to help you quit, including nicotine replacement therapy, prescription medications, and counselling services. You don’t have to do it alone – seek support from friends, family, and healthcare professionals. You can also join support groups, try meditation, or indulge in other healthy habits that can divert your mind.

Remember, quitting smoking is one of the best things you can do for your health and the health of those around you. You can be the change that you want to see in the world, and the first step is to quit tobacco. By quitting smoking, not only are you saving yourself from the far-reaching harmful effects of tobacco, but you are also setting an example for others to lead a healthy lifestyle.

As you get back to routine life after pacemaker implantation it’s natural to plan to travel again.

Traveling with a pacemaker is safe so long as you follow some considerations to ensure that the device functions properly. Following are a few instructions that you can follow and suggest to anyone you know who has a pacemaker.

Before any travel plan, the utmost important advice is to discuss travel plans with your doctor in advance, for any special recommendations or precautions that may be required, including any changes in medication.  Always Carry extra supplies and medication. It is reasonable to travel after implantation only after wound healing is complete because any arm movement may hinder this process. However, if necessary, flying is possible 2 days after an uncomplicated procedure.

Remember to always carry the pacemaker identification card or medical alert identification. The pacemaker identification card should be carried at all times and can provide important information about the type of device, its settings, and how it functions.

Pacemaker patients can safely travel by air. Before traveling, check with the airline to understand any security screening procedures they have, as well as any additional measures that may be required. You can request the security personnel at the airport to use a hand-held security wand rather than making you go through the metal detector. Be sure to instruct them that the search must be done quickly and not to hold the wand over their pacemaker for too long because it can temporarily affect your pacemaker.

During your trip, if you plan to indulge in any water sports activities or adventure sports be sure to discuss it with your doctor, as scuba diving is usually avoided because of the risk of underlying arrhythmia (abnormal heart rhythm).

Slowly and steadily, as the implant site heals, you can ease back into normal life.

Happy traveling!