Pacemaker "Rejection"

I've posted about parts of this problem before, but decided to start fresh.

Over the past 4 months, I have had to remove my PM 3 times.

The first time, it was healed beautifully for 3 months. The scar line became red over a week or so,  and although the blood and serum cultures came back negative, my doc decided to explant it. Turned out he did the right thing.

The second time, now under my right collar bone, it became inflamed right away. Still negative cultures, so my doc explanted it and "rinsed" it. Within a week, the incision was so badly eroded he had to take it out for the 3rd and final time.

I did get a sample kit from St. Jude for allergy testing. It came out negative, but the test was only 3 days. Mayo Clinic recommends a 7-10 day test for such non-reactive metals as titanium.

My question is, does this sound like low level infection by bacteria colonization, or allergy? Has anyone experienced this?

When I get my 4th PM in a week or 2, what measures should be taken to avoid another failure?


Many thanks,,,

Bob A.

[Ladybug171]

Bob,
    I am on my second pacemaker that was impalnted less than 2 months ago and my site is starting to reopen. I was told that I could not have an allergy to titanium that no ane has EVER had a reaction. I am curious what did you find out? My first pacemaker had staph and just about took my life. I don't want this to happen again.

[PikaPika88]

Did your doctor give you a high dose of IV antibiotic just a few minutes before the implantation?  And after a dose before you sent home?

The first one that I had, 3 days IM antibiotic at hospital.  It hurt more than the wound.

[bobad]

Ladybug,

In the absence of lots of swelling and pus, that's either an allergy or a low grade infection (often called "colonization"). It doesn't matter which it is, both must be treated as an infection. Your doctor is wrong. There are allergies to titanium. According to Mayo Clinic, it takes 7-10 days to do a titanium sensitivity test. Don't accept less than 7 days for a skin sensitivity test. Good luck, and keep us posted on your progress!

PikaPika,

Yea, I got thoroughly saturated with IV antibiotics. Thought all my bones were going to break! Caused the worst shivering and skin flushing I have ever experienced!

In early June, I got my first PPM. Within a week, the incision was healed beautifully, and there was no redness or erosion for 2 months. Then the tiny scar began to get red, and then began breaking down. I don't think it was infection due to contamination in surgery. I think it was colonization from a certain staph organism (probably staphylococcus schleiferi) that lives in hair follicles and sebaceous glands.

Been without a PPM for 6 weeks now, doing OK, but waiting for a 2nd opinion on whether to get a 3rd PPM implanted.

Best of luck to you,,,

[darkphoenix]

I have heard that if you are allergic to the metal of the pacemaker, they can coat it with something, so the pacemaker is not in contact with your body directly.  I am not sure how accurate this is, maybe do some research on the net?

[bobad]

I forgot to mention the coated PPM. I'm supposed to get a coated one myself.