The Chronicle of a Pacemaker

“The Chronicle of Receiving a Pacemaker”

In December 2023, I had another cardioversion procedure. This was the 4th in a year, because I was found to be in AFib again. Dr. Gehrig, my cardiologist at UVA Health, decided that maybe I was a candidate for ablation. He said that he was going to refer me to a specialist, a cardiac electrophysiologist.

In mid-January 2024 I still had not heard from anyone, so I decided to call UVA Health myself. Long ago, I had learned that one needs to be their own advocate for healthcare today. The healthcare system has been broken for some time and remains broken today.

I reached someone who indicated that I would receive a follow up phone call. After a few days, I still had not heard from anyone so I called again. This time an appointment was scheduled, but the first available wasn’t until the end of March, almost 3 months since the referral was made. However, in mid-February, I received a call that an appointment was available toward the end of February. I accepted it.

My appointment was with Dr. Malhotra, a cardiac electrophysiologist. He had reviewed my medical information and said that my heart rate was too slow, and I might be a candidate for a pacemaker, rather than an ablation procedure. He decided, that to be sure, he wanted me to wear a “Holter Monitor” for 14 days to monitor my heart rate.

The Holter Monitor arrived early the following week, and I proceeded to follow the instructions with it, and starting wearing it. After 14 days, I returned the monitor, and I had a message on “My Chart” that the data collected indicated that I was a candidate for a pacemaker. He wanted to know why, in the mornings, my heart rate would go to 78 for a while, and then return to the high 50’s? That happened in the mornings when I walked across the courtyard to feed the two outside cats that live outside my office. I was diagnosed with “sick sinus syndrome,” (SSS).

An appointment was scheduled for a pacemaker procedure, but the first available time was May 30, 2024. This was almost 3 months later.

I wasn’t given any instructions, but was told that they would be on My Chart. In early May, I still hadn’t received any instructions, and I sent a message to the Doctor via My Chart. I received a follow up from “Nurse Kelli.” I was told that I would be receiving instructions shortly. I had been scheduled for a follow up appointment with a Nurse Practitioner (NP) in Dr. Gehrig’s office on May 28. I asked whether I needed to keep that appointment? A reply came back that there was no reason to keep that appointment, and that it would be cancelled. My Chart showed that I had two appointments on May 30th. One at 8:45 A.M. for lab work, and one at 9:30 A.M. for pre-procedure discussion. The pacemaker procedure was scheduled for 12:00 Noon, but did not show up on My Chart. I was told that this was normal, and that My Chart didn’t show these procedures. What a system!

My son, Scott, make arrangements to come to the farm to take me to the appointments. Scott is living in Chatham, Va., two and a half hours away. He has been a huge help to us at the farm.

On May 30th, Scott and my wife Sharon, took me to the UVA Hospital in Charlottesville. I arrived at 8:30 and checked in with Heart & Vascular Primary Care, and proceeded to have lab work done. I then went to my next appointment, and had a discussion with a NP about what to expect etc.

At 10:30 A.M., I checked in to where the procedure was to take place. Around 11:00 A.M. I was taken to a prep area, had an IV put in, and my blood glucose level checked. My procedure was scheduled for Noon, however, the Dr. Malhotra was running late and it wasn’t until 1:30 P.M. that I was moved to the operating room.

The procedure took about two hours, and I woke up back where I started, around 3:30 P.M. I was to be monitored for 3 hours, and then a decision would be made as to whether I could go home or whether I needed to stay overnight. I was also given something to drink and a yogurt to eat.

At approximately 6: 30 P.M., I was told that I could go home. I was given a set of instructions as to what I could and couldn’t do. No driving anywhere for two weeks, no lifting my left arm above my shoulder, and no lifting anything with my left arm weighing more than a quart of milk. Also, if I had any of a number of things happen, I was to call a telephone number, immediately, in the UVA Device Section of Cardiology.

A follow up with the Cardiac Device Group was to be scheduled in approximately two weeks, and another follow up in three months. I was also given a comprehensive list of things that I could not do during that three month period. I was going to be severely limited.

The first week at home was somewhat difficult. I was very sore and had to primarily use my right arm, as the pacemaker is imbedded below my front left shoulder. There are two wires going to my heart.

I have been able to go to my office, and find that I am not short of breath when I get there. I was surprised that I could tell the difference in a few days. Hopefully, this will continue. I received a follow up phone call, a few days after getting home, from the Cardiac Device Group at UVA Health, and was told that they received the first transmission from my pacemaker, and everything was looking good.

The pacemaker is from Metronic, and with it came a device that I was told to plug in, in my bedroom. Apparently this device reads the pacemaker, and periodically sends the results to the Cardiac Device Group, via a mobile telephone connection in that plug in device.

I received a phone call, a few days later, from the Cardiac Device Group telling me that they had received the first transmission and that all looked good. So far so good.

I have now been home for 9 days, and already I can tell that this process has been positive. My first follow up appointment is June 18, 2024.

Jess Sweely

Madison, Va.

June 8, 2024

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