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dlk
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dlk

Has anyone ever heard of a pacemaker coming out?  My mother-in-law's pacemaker came out- we assume she pulled it out herself (she has dementia) but could it have fallen out?  She seemed confused and thought it came out from under her armpit.
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187666_tn?1331176945
I've never heard of one "falling" out since it's sewn in under the skin or muscle. I did read of one person who said theirs had shifted position a bit. Then if the leads have been in her heart for awhile, the tissue grows around them quite firmly and they don't slip out either. If her pacemaker truly came out of her body, there would have been a nasty wound and bleeding. How is she doing now?
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Avatar_n_tn
She is in the hospital on an IV drip for antibiotics as she developed an infection both of the wound, where the pacemaker was, as well as a blood infection and the wire lead that is still inside her is probably infected as well.  Due to her age (85) and the dementia they will not be putting in another pacemaker.
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187666_tn?1331176945
Oh no! That's just terrible. Your MIL must have been quite agitated to accomplish such a thing. I'm so sorry. I'm glad to hear she's getting some intensive treatment for it all. Do you know how dependent she was on the pacemaker? Some people have them for those occasional times when the heart rate drops a bit too low and they pass out. Some folks, like my Dad, have such a weak and injured heart they're totally dependent on the pacemaker. Hope she heals up soon.
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Avatar_f_tn
What a horrible thing to happen.  I have a pacemaker and short of taking a scalpel to myself I couldn’t get it out, let alone separate it from the leads.  When they put it in, they create a pouch like opening in the chest muscle just above and to the right of the breast quite near the armpit.  It does not move around at all.  I’ve been horse-riding loads of times, and even doing the sitting trot it doesn’t move, by boobs bounce around, but my pacemaker stays still.  I can’t imagine how anyone can pull it out, especially the leads which hook into the heart during the first six weeks you have the pacemaker – those weeks you are housebound and may not move around much or pick anything up, in fact your arm is strapped to your side so that your leads can “take root”.  Once the leads are rooted, getting them out is not an easy task and I suspect if you managed to pull them out, you would seriously damage your heart.

It sounds like maybe your MIL had recently had the pacemaker inserted, so she opened the wound, and pulled it out, certainly if it was recently installed, the leads would probably slide out without too much damage.

I’ve recently had a salmonella infection, and due to the difficulty of taking out the existing leads which are infected with salmonella, it was decided I’d take antibiotics for six weeks instead of having my leads replaced.  Hope everything works out ok.  I wish you, your husband and your mother-in-law well.
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Avatar_n_tn
Thank you for your good wishes.  She had her pacemaker for at least a year- we were told by the pacemaker doctor that he had put in a new one year ago- my husband was with her at the hospital when it was put in (it would have been her 2nd one)  however upon being checked out at the hospital this time when she removed it we were told by the doctor that it was not a new pacemaker put in last year - just the batteries replaced.  So that being the case she had had the pacemaker in for quite a few years.  I guess we will never really know exactly how it came out - other than the fact that she did it herself.  Now in the hospital bed on the IV- all she says is that she wants to die- she's not eating.  So we don't really know if she purposely/knowingly pulled it out or if it was done unawares in her demented state of mind.  
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Avatar_f_tn
Your MIL sounds like my dad.  He got cancer and said when the time came that he felt his time in this world would be a burden to those who loved him, he would stop eating so he could die quickly, painlessly, and with dignity.  

I have since learned that you LIVE with dignity, and that is what he did.  We had three months with him to say all that needed to be said, we had "farewell" parties for him, we celebrated his life, we took mini-holidays to places where we could spend quality time together, just my dad, my brother and me, we had a truly special time for which I will be eternally grateful.

Then when his pain started getting bad - I was giving him morphine injections at home - he asked us to put him into hospice as he knew his time was running out.  He ate one meal in the hospiice, put down his knife and fork, and then told us that was it - he did not want to suffer long so he would refuse all food from that point on.  He had such strength to do a thing like that.  Anyway, that is what he did, he stopped eating from that moment and died within 3 days, the only thing that went into his body from that moment on was morphine.  

He knew what he wanted and we knew what he wanted so we never tried to force him to eat or drink or do anything which would prolong his life.  He truly did live with dignity and he died without much suffering.  I learned a lot from what my dad did, and I have so much respect for him and the choice he made.

Perhaps your MIL has made the same choice my dad made?  We did nothing to interfere with his decision to stop eating - doing that did hasten his death and I think he appreciated that.  I'm not promoting assisted euthanasia (although I do believe in it), but perhaps your MIL is telling you her wishes, and its not senility or dementia, but honesty about what she wants.

This is a difficult issue and I'm sorry you and your husband have to go through it.  I have a Living Will and my family and doctors all know how I feel about being forced to live in an "altered" state.  It's a hard thing to discuss, but as a family we have discussed it and we all know what each person wants when their end is near and/or they can no longer speak for themselves.  Everybody should discuss this issue, so that very difficult decisions don't have to be made under stressful and hard circumstances.  

My thoughts and prayers are with you and your family, and I hope that telling you about my dad gives you strength, because every time I think of him it is with love and admiration, and not sadness or memories of him suffering.

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257552_tn?1404606154
Hi,

Yes, to the Pacemaker coming out issue. One article that I read of a Wandering Pacemaker (usually a term for a problem with the Heart's Pacemaker), found at a site for surgeons, discussed an unusual case. A man fitted with a pacemaker (this may have been years ago) noticed one day that whenever he sat up, his leg twitched. He went to the Doctors, and they did a chest X-Ray. Problem was that his pacemaker was gone. Doing more X-Rays, they found it in his abdomen, and when he sat-up the lead contacted a muscle that caused the twitching in his leg. The article says that they fished it back into place, secure it, and I guess re-implanted the lead. For the incredulous, the link: [ chestjournal.org/cgi/reprint/98/6/1542a.pdf ] add the www part.

The other case I heard via the Cardiologist that my wife works for. Mind you, the Cardiologist was not responsible for the Pacemaker, it was implanted by a Surgeon. An older woman phoned the office with the complaint of Chest Spasms. She was referred to another Doctor (her Family Doctor or the Surgeon that implanted it, I am not sure which). She was prescribed muscle relaxants. The Spasms persisted. It was eventually discovered that a lead had dislodged and apparently was contacting a chest muscle or causing the spasms by some other means. The lead needed to be re-implanted.

Patients are instructed to limit arm movements until the implantation is secure (weeks). Falling can contribute to the lead displacement. It is not extremely uncommon.

Best Regards.
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257552_tn?1404606154
Hi,

Oooops, you meant the entire Pacemaker. I asked my wife (she works for a Cardiologist) and she was familiar with the problems of people manipulating their pacemakers. The disorder is referred to as Twiddler's Syndrome, and many articles say it can break the leads on the Pacemaker and cause infections. One definition: "Twiddler's syndrome,  dislodgement, breakdown, or other malfunction of an implanted diagnostic device as a result of unconscious or habitual manipulation by the patient."

Nothing I read confirmed removal of Pacemakers by the Patient.

Regards.
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Avatar_n_tn
Thank you for your reply.  That article about the pacemaker traveling in the body is really amazing!  I guess we will never really know how my MIL pacemaker came out- she may have been manipulating it either awares or unawares, but with the dementia it's hard to say.  
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