This post will give a graphic account of the implant procedure. Be warned, you may find some items upsetting.
As I was wheeled through the double doors I was met with my implant team. A nurse helped me off with my dressing gown and up onto the bed. As I turned to lay down I took in all the equipment around me. On one side was a monitor that would be used to keep a check on my heart activity. The procedure was being done under a local anaesthetic, so I would be awake throughout but it was important for them to monitor my heart throughout.
Above me was a large, round, white globe with what looked like a plastic bag over it. My active mind assumed this was incase of blood splatters, not a pleasant thought considering what was about to happen. I thought this was a light but infact it was the X-ray machine that would allow the surgeon to check where the pacing wires were going.
Hanging from the ceiling above my knees level was a bank of 3 screens. At the start these were blank, I would find out what these we for later.
My hospital gown was opened and the surgeon draped cloths over my shoulder and across my neck, and over my chest. He then explained he would swab the skin with iodine to sterilise the area, something he did with great flourishes and then he began to administer the anaesthetic into my shoulder area. I lost count after 8 injections and began to wonder how long it would take to numb. Thinking how they send you out in to the waiting room at the dentists while the anaesthetic takes effect, I was quite surprised that it took only a couple of minutes before the surgeon was asking me if I could feel a sensation in my shoulder when he touched it, I wasn't sure what he was pressing into my skin but although I could feel pressure, there was no pain. He explained I would feel some pulling and tugging and he would tell me what was going on as it happened, and with that he made the incision near my collar bone through which everything would be done. I was aware of 3 nurses in the room along with the technician on the monitoring equipment as well as the consultant. If anyone else was in the room, I wasn't aware of them. I looked towards the monitoring machine, away from where the surgeon was working as he explained the first thing he would be doing was making the pocket between my muscle and my skin for the pacemaker unit to sit in.
It was an odd sensation, feeling the movement in the muscle and the pressure on the area, aware of what was happening but unable to feel pain. It took more pushing and pulling than I thought but the consultant told me it's because I'm relatively young for having a pacemaker (apparently the week before they had fitted one in a 90 year old man) and so my muscle was tighter and thus took more effort to open up for the pocket. Suddenly I felt a sharp pain and yelled out, tears leaking from the corner of my eyes. The consultant stopped and gave me more anaesthetic.
After a few minutes he continued, checking that everything was numb again. As much as I had my head turned away, I was aware of him measuring the pacing wires against my body, from my heart to my shoulder. I knew they would leave a good amount of extra wire so that movement of my arm would not put pressure on the leads and cause them to become displaced. They had told me that they were putting a dual-on-demand pacemaker in, so there were 2 wires to put in place.
The consultant then told me they were going to turn on the X-ray machine so that he could watch the progress of the wires as he fed them down the vein into my heart. The large, white globe was moved into position, what I thought was a light was actually the X-ray unit. The 3 large screens at the base of my bed were also turned on, as this was where the consultant would follow progress, but I couldn't see any of them because of the X-ray unit which was hovering about 12 inches above my chest.
They explained that I may feel some sensation as they fed the wires down into my heart and that this was normal. I'm not sure whether I felt or imagined it, but I had a fluttering sensation, nothing more. It seemed to take such a long time for the wires to go in and I was aware of a cool trickle over my shoulder and down my back, which I assumed was blood leaking from the wound.
Finally, the wires were in place and it was time to test them. It turned out this was when I would have appreciated a general anaesthetic the most. The surgeon stood back and asked for a report on the pacing wires. The technician looked at his monitor and said 'nothing'. The surgeon came back to the table and pushed and pulled some more and then, retreating a few feet asked again for a report, to be met with the same answer 'nothing'.
This continued for several minutes until finally they started getting a reading, by which time I was starting to panic thinking they weren't going to get it sorted and so the reading was off the scale and they needed to get me calmed down so that they could get a clear reading. Finally, they started to get readings they could work with but it took a good while longer before they started to get the levels they were looking for.
Eventually, they were happy with the placement of the leads and their output and they started to stitch me up, when once again I felt some pain, Again they administered more anaesthetic and firstly stitched the pacing wires in place, then repaired the pocket and before closing the wound itself, they gave me a shot of antibiotic directly into the wound to help prevent infection. All that was left to do was stitch up the wound and apply a large dressing. Finally, one of the nurses came to help me get dressed and get me back into the chair ready to take me back to the ward.
It had not been a pleasant experience and had taken far longer than expected, about twice as long as I'd been told initially. I'd been in theatre an hour and a half. The surgeon asked if I was ok and apologised that it had not gone as smoothly as normal. I told him I was ok but that he wouldn't be on my Christmas Card list this year.
The technician could see how upset I was and started to explain that they hadn't lied to me about how it would be and how long it would take, I had just been unlucky that it hadn't been as straightforward as it should have been and that they'd had such trouble getting the pacing wires in place. I appreciated him trying to make me feel less stressed but it wasn't helping at this point, I just wanted to get out of the operating theatre and back to Neil.
As they wheeled me out I was aware that there was a man waiting in his chair outside the doors ready to be brought in for his implant and I tried to hide how upset I was, it didn't seem fair to add to any worries he may already have before going in by letting him see how traumatised I was.
Finally, I got back to the ward and they settled me into bed and brought Neil through. The hard part was over.
Now, I had 6 weeks recovery to start.
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