Time for my checkup.

End of January 2020
Time again for my 6 months checkup of the Pacemaker/ICD.
And time for my yearly talk with the cardiologist.

For the Pacemaker checkup, they will put something that looks like a computer mouse, on the place where the Pacemaker is implanted.
This is a “receiver” and it’s connected to a computer from where they can check the Pacemaker.
This “receiver” makes some kind of wireless connection with the Pacemaker.
When they place the “receiver”, there is always a sound.

Aware but strange

It sounds a bit like a soft alarm signal that is going off.
First I always thought that the sound was coming from the “receiver” to let them know that it is busy making a connection.
Just being curious, I asked if my thought was right.

The technician told me, that the sound that I was hearing, was coming from the Pacemaker itself.
The Pacemaker will make this sound when they place the “receiver” on the correct spot.
But it also makes this sound if there could be something wrong with the Pacemaker.

So the Pacemaker will let you know that maybe it needs to be checked.
According to the technician, it also will make this sound if the battery will get dangerously low, or if you are holding too much water inside your body or if you come nearby a strong magnetic field.
So it is good for me to know, that when I hear this sound, that “maybe” I need to check some things and stay away from things that have a strong magnetic field around them.
So, it’s like a buzzer, but then inside your body.
That’s why it is a bit strange, even when you are aware that there is something inside your body.

Some people that have the same kind of Pacemaker implanted, they explain it to others like that you have your own private guardian angel with you, at all times.

The battery is ok.

In the Pacemaker check, they will also check the status of the battery.
In the last check, they told me that it was still good for 8 years.
So it was not really a surprise when he told me that today the battery was still good for 7.5 years.
They also told me, that the Pacemaker is pacing 99.6% of the time.
So it means that for 99.6% of the time, the Pacemaker is working.

During this check, they also can check the wires itself.
In that test, they can check if maybe the wire is broken or if there is something wrong with it.
But this also was ok.

Not so nice feeling.

The part that is not so nice during the testing, is when they turn off some parts of the Pacemaker.
First, they want to check what your own heartbeat is.
Because you are also connected to the ECG, they can monitor your own heartbeat.
But when they turn off that part, I always can feel my heart like it is skipping a beat or if it has difficulty beating.

The feeling itself is difficult to explain but sometimes I feel a little bit nauseous and uncomfortable.
Luckily, they will do this very short.
They told me that my own heartbeat is still there, but it’s only 45 beats per minute.
So still very low.
Normally it is around 60 beats per minute.

One by One

The next test is to see how each heart chamber is doing when the Pacemaker is controlling it.
First, they just look at a total picture.
After that, they will turn off a small part of the Pacemaker.
They first turn off the part that is controlling the left heart chamber.

When they do this, the ECG is also running and you can see a difference in the spikes and the intervals.
You can see that the other chamber is working harder to compensate.
So you see higher spikes.
From this, they will make a copy, so the specialist can look at it later when needed.

Then they will turn off the part that is controlling the right heart chamber.
Now on the ECG, you could see a different image.
Now things were more spread.
And you could see an irregular beating.
From this, they also will make a copy for later, when needed.

Luckily, these tests don’t take long.

They also can check some kind of history in the Pacemaker.
From there they can see if there were any heart rhythm disorder or any other, out of the ordinary, things.
But this was all ok.

Next Pacemaker check will be over 6 months again.

The cardiologist.

After the Pacemaker check, I had my talk with the cardiologist, to see how things are and if there are things that need to be done.
In his system, he can see the results of all the tests that were done at the Pacemaker checks.
According to him, things were stable.

I asked him if there was anything known about the optimization echo that was done a while ago.
He told me that they were not able to get more out of it.
With this echo, they were hoping that maybe they could increase the pump function.
But this was not the case.
So it is still at 20%

But they were able to get the Pacemaker in its optimum functioning.
This meant, that they were able to get both heart chambers in better sync.
So the Pacemaker was now working in his best and optimum functioning.

So for next year, he wants to do a full echo again, to see what the status is then.
For now, just go on the way it is.

Patience

While waiting in the waiting room at the hospital, I am always surprised about the lack of patience of the people that are waiting.

So many times I see people get up and walk to the reception to inform if things are running late.
Because it is already 10 or 15 minutes after their appointed time.

For me, I am ok with it.
But if you think about it, it is also crazy.
People are complaining that they want good service.
That they want that the specialist will take his time to see what is “wrong”
But they forget, that while the specialist is busy with them, others need to wait.
And if they are the waiting party, they don’t like it.

For me, I have peace with it.
I know that when the specialist is finished and it is my turn, he will see me.
Pushing or keep on asking if they are running late, will not speed up the process.

But maybe, when you had spent a long time in the hospital, you will/can understand it.