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[slamm10]

This may be seem long, but I have many questions. I will start from the beginning. While driving on a long trip, I experienced an "episode". My heart wasn't racing, vision was fine. I just did not feel right, so I pulled over into a gas station parking lot for about an hour. Still didn't feel "right" so I called the ER as I didn't feel comfortable driving. Doctors could not find anything wrong so they kept me for some tests. I'm a 37-year-old male, 5'8", 175 lbs. While in the ER, doctor's couldn't tell me anything, but kept me overnight for some tests. Overnight they recorded an 8 second pause while I was sleeping. No other pauses, but that led doctors to run more tests (a lot) - stress tests, sleep apnea tests, etc. trying to figure out what the cause was. They couldn't determine why I was feeling the way I was. Before being released I was advised to see an electrocardiologist and was given a heart monitor to wear for 2 weeks. Before I saw my cardiologist, I was called by whoever monitors the readings and was asked if I was okay. I told them I felt fine. They were concerned and wanted to make sure I was okay. The whole time I had the monitor on, my leads would fall off at night or would not stay on during the day due to activities, etc. Also because of the hair on my chest. In my initial visit with the cardiologist, he had informed me that the monitor had shown an 8 second pause at 8:30 at night, which was alarming and he recommended a pace maker, which I thought was crazy. My heart rate was between 70-80 while awake and 40-50 while sleeping. I also told him that the leads kept falling off, but he still recommended the pacemaker. I asked if stress would have been causing the episodes or if there were any other alternatives... medicine, diet, etc. It was a very stressful time in my life, plus this happened right after a tornado touched down nearby and our family was basically in lockdown at a restaurant. He said that all of which could be tried, but he was confident that I needed a pacemaker and he wasn't comfortable with me driving or working while having these long pauses. As a result, the pacemaker was inserted. After the surgery, I was not prescribed an antibiotic. I asked why and I was told it wasn't needed. Six days later, I was in the hospital fighting for my life. I was rushed to the ER. My major organs shut down due to an infection (septic shock) and I also had DIC. I went into resporitory failure and it took 35 minutes for them to revive me. Luckily they were able to, but unfortunately, due to the DIC they had to amputate my right hand on Easter Sunday.  A year and a half has passed and I can't get answers from anyone. 1) Can stress or panic attack cause an uneasy feeling that might be mistaken for dizziness? 2) How abnormal is an 8 second pause for a man my age, weight and height - while sleeping? 3) How accurate are heart monitors that are sent home with patients, especially if they keep falling off? 4) Is there any medication, exercise, etc. that could have been utilized instead of a pacemaker? 5) Should I have been given an antibiotic after the surgery or is it normal practice to not prescribe one? 6) Should I feel the pacemaker when it kicks in? 7) Currently, my pacemaker is set at 40 and has kicked in less than 20% of the time. Is that normal? 8) I have read on internet that septic shock reaccurs. How likely is this?

Thanks,
Jesse

[itdood]

1) Can stress or panic attack cause an uneasy feeling that might be mistaken for dizziness?

It certainly can, but it's a vague type of dizzy.  Some may mistaken it for syncope, which is more hem- compromised related.  Other may report pre-syncope as dizzy.  when it's borderline it tought to say which is what.

2) How abnormal is an 8 second pause for a man my age, weight and height - while sleeping?

That's abnormal.  Research on "escape beats", which will normally terminate a pause in 3-4 seconds.  I would personally want to know what's causing the pause.  It's can be a few things like a block, or the SA node didn't fire....this can be determined on the EKG.

3) How accurate are heart monitors that are sent home with patients, especially if they keep falling off?

They're accurate.  THough they usually only have 1,2, or 3 leads.  Less leads=less info to go on.  Whatever was caught on the 12 lead EKG in the hospital is what they are probably basing your diagnosis on.


4) Is there any medication, exercise, etc. that could have been utilized instead of a pacemaker?

I'm not at all aware of any, but I could be wrong.

5) Should I have been given an antibiotic after the surgery or is it normal practice to not prescribe one?

Not normally.

6) Should I feel the pacemaker when it kicks in?

Most do not know when it's running.


7) Currently, my pacemaker is set at 40 and has kicked in less than 20% of the time. Is that normal?

If you are set <40 and it's running 20% of the time, you needed a pacer.  WHere it's set depends on symptoms.  If you become symptomatic at <40 that's where they set it.



8) I have read on internet that septic shock reaccurs. How likely is this?

I really can't answer that myself, though it makes sense.  If you've got a predisposition to something it's more likely to occur.  I think this just means you need to be more careful to prevent infections.

[slamm10]

thanks for the info, very helpful    :)

[lovely61385]

Hi, in regards to the monitor being sent home with patients. They are accurate but behind all recordings received from your total time of observation, it should have been edited by a tech or cardiologist. You said your leads kept falling off. These monitors do at time pick up artifact (false information) due to loss of leads, movement, tremors, electrical interferences. Eight second pauses are serious. As you know, if your heart did not send it's own "natural electrical impulse" the pacemaker would then kick in and send an impulse so that you do not go into having pauses therefore leading to standstill (then death). If the monitoring company found an 8-second pause, they send that over to the doctor. Doctors are usually very serious and these things are often checked by couple of people to make sure it is true and not artifact. If you feel there may have been a mistake, you could request a copy of the report, mainly the pause to see for yourself. If you cannot read or understand it, you can then take it to a 2nd cardiologist for his/her opinion.

[Jerry_NJ]

Sorry to read about the very difficult time you have had and have ongoing.

I'd question too, albeit too late, the pacemaker for all the reasons you gave.  It would seem much better to me to shave the chest and try the monitor again.

I think an 8 second pause, if there was one, is very bad and could justify a pacemaker, but it seems possible there was no such pause.

As for antibiotics... I have undergone open heart surgery and while I may have been on antibiotics while in hospital intensive care I was not when I went home 5 days later.  I do take an antibiotic when I have dental work done, but no other times.  Open heart surgery is not a pacemaker, but I think my experience with antibiotic is relevant - but I don't know.

Hope you get some first-hand information from the many pacemaker users on this community.