An Uncapped Pen

September 3, 2009

Implantable Loop Recorder

Filed under: About Me,Health — cindylv @ 7:19 pm
Tags: , , ,

Why?

Ventricular Tachycardia: (V-tach or VT) is a tachycardia, or fast heart rhythm, that originates in one of the ventricles of the heart. This is a potentially life-threatening arrhythmia because it may lead to ventricular fibrillation and sudden death.

Syncope: Partial or complete loss of consciousness with interruption of awareness of oneself and ones surroundings. When the loss of consciousness is temporary and there is spontaneous recovery, it is referred to as syncope or, in nonmedical quarters, fainting.

Syncope is due to a temporary reduction in blood flow and therefore a shortage of oxygen to the brain. This leads to lightheadedness or a “black out” episode, a loss of consciousness. Temporary impairment of the blood supply to the brain can be caused by heart conditions and by conditions that do not directly involve the heart.

Implantable Loop Recorder: A device that is inserted under the skin below the collar bone (usually on the patients left side). The procedure to implant the device is simple. Local anesthetic is injected into the area. A small incision is made and device is inserted. The skin is then sutured closed. The device continuously records heart activity similar to an ECG for up to 2 years. If the patient experiences an episode of fainting the device is activated to save the recording before, during, and after the episode. The recordings can then be evaluated by a physician to help determine the cause of fainting.

~~~~~~~~~~~

There’s no warning. One second I’m standing up or walking or whatever, and the next second, I’m on the ground looking up, wondering what happened. It doesn’t happen often, but really, one time is too often. The doctor’s office received approval from my insurance company and scheduled my procedure for last Thursday morning. My pre-op instructions included fasting on Tuesday evening for blood work during my pre-admissions appointment on Wednesday. And again on Wednesday evening before my procedure.

We arrived at the hospital on Thursday morning at 0730 and signed in. I was anxious, sleepy, hungry and caffeine deprived. We were escorted to the outpatient waiting room for 45 minutes of fidgeting. The nurse called me in, telling my husband to wait while she got me prepped — 20 minutes, she promised. I was given a gown made out of thick, soft paper-like fabric that was two sizes too big. While I changed (minor victory: I got to keep my underpants on!), she asked me the standard screening questions, When did I last eat, etc.

Then a gentle giant arrived, who introduced himself only as “John”. He held my hand while the nurse blew one IV attempt in my right arm, and talked her through another attempt in my left. When he was satisfied, he wheeled me down the hall to the operating room. I never did get to see my husband before they started.

The operating room was freezing cold. The operating table was no wider than 15 inches or so. The nurses and John scooted me from the bed to the table and ensured I was centered and settled. As they tied the “soft restraints” securing my arms to the table, a representative from the company who manufactures the devices breezed in and briefed me on the charactistics and procedures of the device. She was too blonde, too bubbly, and too sparkly for that situation. And why was she wearing scrubs and diamond earrings in the operating room?

John and I negotiated the musical selection. They were fresh out of Metallica, so we settled on Mozart. I think the surgeon was relieved. After a few moments of forced levity with the technicians (Why yes, we stayed at a Holiday Inn Express last night.), John inserted the oxygen tubes into my nostrils and draped a “tent” over my face to keep me from watching. The doctor ordered the nurse to begin sedation and I gulped oxygen while I waited for it to start. I tasted the cold metal in the back of my throat, so I assumed it was working.

Then I heard my doctor say, “OK, Cynthia. We start now. Stinging and burning, just like at the dentist office, now. Stinging and burning.” And I felt the stinging and the burning and it was nothing like the dentist’s office. I would have bitten someone, anyone who strayed near my teeth.

I struggled to remember any of the prayers I recently learned, but the only words I could string together were “Oh” and “God.” And I think I remember a “Please” or two. More stinging and burning. Some pressure on my chest. A little tugging. More gulping oxygen. More “Oh Gods.” I felt something laid across my legs and wondered what that was.

I heard John’s voice, “Cynthia? You doing okay?” I mumbled something like, “It hurts.” Then I heard, “More Versed.” I figured my insurance was paying for it, I might as well enjoy it, right?

Then I heard tape stretching sounds and felt more pressure on my chest, and they were done. I was untented, untied and scooted back to my bed and rolled to the recovery section. I met Anna – an absolute angel of a nurse. I saw my husband and got a quick kiss. I thought it was incredibly important for him to give me the book I’d brought to read while waiting. I held it while I slept off the sedation for three hours.

All I remember of that time was that the nurses called each other “Sister” and I remember telling Anna that I wanted to be a sister, too. My husband tells me that I asked the nurse for some milk to drink. I haven’t drunk milk in twenty or thirty years. I don’t like milk. But I asked for it, and I drank it.

Anna helped me dress and wheeled me out to the parking lot and put me in the truck. My husband brought me home and put me to bed with some pain medicine. I woke up on Friday morning, took more pain medicine and eased through the rest of the day. By Saturday, I’d given up on pain medicine. It makes me loopy, itchy, and agitated. I switched over to advil without any problems.

The only problem I’ve had is skin irritation from the surgical tape. I ripped off the bandage and put some neosporin on it. The actual incision is approximately two inches long, covered by a couple pieces of tape. I put a waterproof bandage over it, to keep it clean and dry. Although I was told not to shower for two weeks (ha, ha), I made it until Friday night before showering. I have an appointment to return to the doctor next week to have my staples removed.

I have a portable monitor, about the size of a cellphone, that I’m supposed to carry with me when I leave the house. If I experience dizziness, pain, palpitations or syncope, I’m to press the green button on the monitor to record the “event.” When I get back home, the portable monitor reports to the base station on the table in the den. That unit reports to the doctor’s office through the ether somehow. I’m still getting used to the electronics management side of it. According to the booklet I was given, I could set off theft control devices in retail stores, or metal detectors at the airport. I know it all causes interference with my new whizbang cellphone and the cordless home phone. I’m a walking jammer. I can imagine all the garage doors in my neighborhood opening and closing when I walk past with Bailey. :^D Or all the calls to tech support at the cable company wondering why their reception is suddenly fuzzy.

I’ve got some questions to discuss with my doctor about that next week. All in all, it went quite smoothly.

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16 Comments »

  1. Oh my God! I am glad it went better then expected. Cause it sounds bad enough to me.

    Comment by angel — September 3, 2009 @ 9:23 pm | Reply

    • Sniff, sniff…I could use a hug (HOW WAS THAT? I’m working on my sympathetic character thing. :^D)

      It’s all good, though. Don’t worry about me. Worry about those firestorms less than 20 miles from your house!

      Comment by cindylv — September 4, 2009 @ 2:58 am | Reply

  2. Holy cow! Well now I know why you’ve been so quiet. I hope you’re able to record something useful, get that thing out (how long is it supposed to stay in?) and resolve the root cause as soon as possible. How are you feeling now?
    xoxoxo

    Comment by lisakenney — September 4, 2009 @ 3:49 am | Reply

    • Thanks, Lisa. I’m feeling pretty good. I snuck out of the house today for some pampering (a pedicure). I wanted to describe the procedure from the patient’s POV for other potential patients. As far as how long it stays in? Until they find out something definitive. The battery lasts between 2 and 3 years. Actually, the “good” outcome would be to monitor for three years and decide to take it out because nothing bad happened!

      Comment by cindylv — September 4, 2009 @ 4:47 am | Reply

  3. BTW, saw Tim H off tonight after his Denver signing. Scott and I met him for dinner last night and it ended up being a four hour gabfest. He’s as delightful as ever.

    Comment by lisakenney — September 4, 2009 @ 3:50 am | Reply

    • Oooh, I’m SO jealous! Can you send me an email with more details of your gabfest and the reading? I wish I’d been there!

      Comment by cindylv — September 4, 2009 @ 4:48 am | Reply

  4. I hope the gizmo hangs out in your chest, happily opening and closing the neighbors’ garage doors and recording absolutely nothing of interest, until the battery wears out. Syncope is no fun, nor are cardiac arrhythmias (only took me 3 tries to get that spelled right!). Here’s hoping that, now that it knows it’s being watched, your heart decides to buckle down and do what it’s supposed to do, no improvisational rhythms. Those are strictly for jazz musicians, not cardiac muscle.

    Comment by Piglet, MPH — September 4, 2009 @ 6:04 pm | Reply

  5. I’m all out of witty, so I’m just going to leave a hug and some love. :)

    Comment by Boo — September 7, 2009 @ 9:10 am | Reply

    • Oh Boo! Thanks a whole big bunch! And plenty of love right back at you!

      Comment by cindylv — September 8, 2009 @ 4:20 am | Reply

  6. Hi chic, I admire you….I’ve just had an implatable loop recorder fitted on Thursday (its now saturday).

    It still hurts, and is painful when I use my left hand/arm, I find it hard to put pressure on my left side it pulls where the wound is.

    I’m a night care assistant in a nursing home, and thinking of going back to work on Tuesday night, but I don’t think I’d better go till after my week off Easter week. We have to use hoists and deal with heavy residents, won’t do me any good will it?

    How long is it before the pain disappears and the sensation that you’re skin is being pulled apart and being stretched? Its hurting…I not good with pain….

    Hope you’ll be ok. Take care stay well…..

    Look forward to hearing from you…

    Love Cazz
    xxxxxxxxx

    Comment by Cazza Knott — April 16, 2011 @ 4:00 pm | Reply

  7. Hi Cazz,

    I hope you’re feeling better by now. I think you’re very smart to wait until after Easter to return to work. In addition to the pain of the incision, your body is dealing with this foreign matter inside. And then there is the psychological side of things. “What is this device doing and what is it recording and what is wrong with me?” Take it easy and you will heal. I think I was tender for about a month.

    My handheld device stopped recording a few months ago. My cardiologist told me that he wasn’t receiving any reports for almost a year. What the heck? For me, this was apparently a waste of time and money.

    I’m still dealing with insurance and the device monitoring company. The insurance approved the implantation, but NOT the monitoring? So it costs $650 a month to monitor…and they’re not reporting any results? Grrrrrr…. Very frustrating.

    But I’ll get through it.

    Take care and let me know how you’re doing.

    Cindy

    Comment by cindylv — April 22, 2011 @ 2:35 pm | Reply

  8. Hi Cindy,
    I am glad I have come by this, my 15 yr old son is about to have a loop recorder implanted, we have had no information on the what why’s and how’s of the device. We thought we were on a waiting list (for about a year) to discover the secretary bypassed the request, then only get 5 days notice with no answers to my questions. (time for research!) but reading this gives me some idea of what my son is in store for.
    I was wondering how big this hand held device is.. How much of an impact does it have on your day to day living?
    We were ment to have an electrophysiology test done (which is done in day surgery and can fix the problem then and there if found, which 90% of problems are found)
    However, the (unreliable) Doctor told us the loop
    Recorder is less invasive, hence the reason for my question.

    Comment by Suz — June 10, 2011 @ 2:31 pm | Reply

    • Hi Suzie,

      I’m glad you found some useful info here. The device is small, like the size of a credit card with a small transmitting antenna-like device on it. The only impact on my life was the pain from the incision for a couple of days, and I only remember the device now when my cat walks right on the area of my chest where the device is. My hand-held receiver stopped working about 7 months ago. The docs never found anything useful from the device. But they’ll leave it in because it’s more traumatic to open me back up and take it out, than to just let it be. I know its still transmitting because I get a “bloom” of electronic interference on my cellphone when I try to watch a video on it. No other side effects.

      My prayers are with you and your son. Please let me know how it all goes. Good luck!

      Comment by cindylv — June 11, 2011 @ 5:18 pm | Reply

      • Hi Cindy,

        Thanks so much for telling your story. My17 year old son is due to have an electro physiology study soon but the consultant doesn’t expect it to be successful because my son’s symptoms come while he is resting and the study relies on adrenaline to stimulate the heart into having palpitations. The next option is the loop recorder and I was so shocked when I heard three years that my brain switched off and I asked nothing! At least your story has told me that the recordings actually reach the doctor regularly – I thought they only looked at the end of three years! I hope all is well with you now. Just looked at your profile and can’t believe you mention The Artist’s Way; we were talking about that at my book club this week.

        Best wishes,

        Helen Heaton, Galway Ireland.

        Comment by Helen Heaton — September 21, 2011 @ 2:54 pm

  9. Hi, Thank you for the posting. I have the same problem, but not falling down, just get out of the blue extremely fast heart beat and I need this implant. How much did it cost, since my insurance is not paying for it.
    I would really appreciate some info.
    Thank you,
    Ilana

    Comment by Ilana Holloway — June 13, 2012 @ 5:12 pm | Reply

    • Hi Ilana, Sorry for the delay in response. I think I need to pay more attention to my blog. The whoe thing, testing, hospital, doctors, etc. cost of $45000. My insurance covered almost everything. The only real problem was that the insurance company decided that they hadn’t approved the monthly monitoring in advance and after about 6 months, I got a bill for $600 a month or $3600. I couldn’t get anyone to listen to me to resolve the issue. It’s been a couple of years, but it’s still unresolved. Good luck. Please let me know how you are doing.

      Comment by cindylv — July 23, 2012 @ 12:57 am | Reply


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