tightness and pulling sensation

@patty78
Was your pacemaker placed under your skin or muscle?

I had mine put under my chest muscle as my EP said I did not have enough skin in area and also because I was so active. It takes a long time for body to encapsulate the pacemaker. Once it does it forms an encapsulation around the pacemaker and wires.

I had my first ICD/Pacemaker in 2006. I am on my 3rd ICD/Pacemaker now. As I sit here if I focus on the area I can feel the slight pressure there. If I move my arms to far this way or that, or my left arm above my head it makes the area around my pacemaker irritated and I can feel it.

As you mentioned when you move a certain way it will be uncomfortable. What I do now is try to refrain from any movement that irritates the site and device. With that you can keep the irritation down and not irritate the area. If you constantly irritate the area around device with movements that you find does irritate it the area will stay irritated.

With now having my ICD/Pacemaker almost 20 years giving you my experience with this. It has been so long since my first one implanted but I remember it took a long time for me to feel comfortable with it and not have some pain and discomfort. Again takes time to encapsulate and time should help with your discomfort.

If the pain is substantial you need to see your EP. Do you have any swelling or redness in the skin above device? If so call your EP. From what you posted I can tell you that almost 20 years now of having one I have to limit my left arm movement or I will get discomfort. Sometimes I forget and feel it. But I do water aerobics and we move our arms everywhere. I have learned to not move my left arm in ways that irriates my device location.
Good luck and don't hesitate to contact your EP with your concerns and also guidance in how to reduce discomfort you are feeling.

Hi and thanks for your info! Sounds like you've really been through it for 20 years, so your insight is very helpful. Can't imagine what goes into replacing the thing! Times three!!!

Anyway, I'm not sure whether it's under the skin or muscle, but am guessing just under the skin because it's very visible. I do have an appointment with the cardiologist/surgeon on August 21 and certainly will tell him about the symptoms. However, my experience is that it's just too easy for the surgeons to kind of shrug off symptoms unless there's elevated temp, etc. So thought the support group might help. And you have by stating that you also have some difficulty when using your left arm. But the surgeon told me, no restrictions after the first 6 weeks. So I took him at his word. I do all kinds of labor around the house and yard - it's kind of my thing.

Thanks again for your wisdom!

@patty78
I have found the same with surgeon EP advice, but my experience is that it differed from advice from nurse.

Do you have a Pace Clinic you go to and correspond with? I go to Mayo Jacksonville, and they have a Pace Clinic that does remote and in office device checks. I have the ability to portal message with them or call them and most of the time they call me if need to talk or will use portal. They have the most direct contact and experience with patients after surgery and implants.

The pace nurses and tech stress body movements and irritation to device and wires. My EP told me to play tennis. My Pace Nurse said no. She said she saw a lot of wires over the years come out and they traced it to specific time and activity. She said aggressive tennis and fishing were two activities that stood out as causing wires and difficulty with wires. It is the drastic swinging of arms.

Now my EP says, play tennis. It is one of the reasons we put the device in. So, you can see what I am posting from experience with this and what affected me. I played tennis a wire came out of my heart. I had it replaced surgically and decided to stop playing tennis. I have no other wires that have come out since I stopped playing tennis.

If you see your device the most likely under skin. The muscle below the device will be sensitive to the device and will take some time to incapsulate. What I did was see how far or which movement I could do that did not cause discomfort around device and then try not to go beyond that.

You don't want to completely restrict arm movements as that can affect joint mobility. If you have a Pace Clinic work with them. You do gardening and that is great. I hope you were told by your EP to continue to garden as it is good exercise physically and from what you posted mentally also as it brings you a lot of happiness doing it.

In my experience mental health is just as important as physical health. From that experience I am always encouraging posters to find and exercise or hobby they like doing not only for physical health but mental health. I am a man but love doing water aerobics. I limit the movement of my left arm and do different exercises if it involves a high overhead. At one class location we only have two men in a class of twenty. Inside my community we will have ten out of a class of forty. You get what you put in just like with any exercise.
Take care

Once again, many thanks for your input. Very helpful. There is not a local support group or clinic to address these concerns. Just visits with the cardiologist (few and far between) or a nurse practitioner in the office. I saw the np some months ago for concerning symptoms and she was a great listener, but didn't even bother to listen to my heart during the visit. You want to trust these professionals, but....

However, the cardiologist was pretty amazing in other ways. I sent a message about 2 months after surgery that I was wondering if there was something I should be putting on the suture site. I was immediately given an appointment with the doctor. After making sure it wasn't infected, he said to apply almond oil. Then he spent some time reviewing my chart. What happened next was very impressive. He looked over my history of scans and meds, asked questions. Like why was I on blood thinners and some other meds. I told him about a mini stroke I'd had in 2016, etc. He listened carefully, asking some other questions. Then he said, wonderfully and shockingly: "Your neurologist has put you on a shelf. You should get another one." It was inspiring and prompted me to make some changes and insist (almost) that I stop the blood thinner. So now no more Plavix, only a baby aspirin. So much better.

Enjoy life on the east coast and thanks again for your helpful input.