You may want to heed this warning if you're a possible candidate to receive an ICD...
I've rarely been more nervous about what is happening with my body than I was the morning of getting my defibrillator implant. Like any diligent patient I did my research and asked the doctor my list of questions, but looking back, maybe a little ignorance is bliss or at least in my case, a little ignorance could have been bliss.
If you can watch as someone stitches a wound and be fine with it, then feel free to Google the S-ICD procedure under the search category, Videos, but if you're anything like me, don't watch any videos on YouTube of surgical procedures, especially right before your own surgical procedure. Yes, this would seem like common sense, but curiosity got the best of me and I was much more nervous going in than I would have been had I not looked.
Watching an animation of the Subcutaneous ICD is what helped me decide it was the one for me and although I still felt a bit squeamish it was not nearly as bad as seeing the actual thing.
Click the title below to watch the animated video if you would like to see how the procedure is done.
Okay, now that I made certain to give you the warning I can move on to the details of getting my S-ICD.
At 46 years old I'm reasonably young so I wanted the one that was the least invasive. The S-ICD has only been used in the United States for about a year and a half and that concerned me a little, but I don't have to worry about leads in my veins that will need replaced and possibly do damage.
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Photo from http://www.medgadget.com/2009/06/eu_issues_ok_for_minimally_invasive_subcutaneous_implantable_defibrillator.html
I was worried that the ICD might shock me accidentally because I read that it could sometimes be tricked by fast paced rhythms in the Atria. I was told by my cardiologist that the S-ICD has less chance of going off for the wrong reason as opposed to the older version that is placed in the upper chest with leads and having a defibrillator go off and deliver a shock for any reason other than saving your life is very rare.
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Another concern that I had was the placement of the S-ICD on the side of the rib cage under my left arm. I'm a side sleeper and it hit me right away that I may have trouble sleeping. My surgery was just 3 days ago, so I will have to update you on how I'm sleeping once I can actually lay directly on my side and I'm not on pain medication, but so far so good.
I was informed that my S-ICD system will need replaced about every 5 years, but since my skin will already be stretched and the pocket ready it shouldn't be too much stress on my body to have the old one removed and the new one slipped in. The electrode will not have to be replaced unless it stops working correctly.
My surgery took about 3 hours from prep to finish. I've been experiencing the expected aches and pains in my rib section as I heal. I won't lie, it feels like someone hit me with a ball-bat and it hurts most when I'm moving from a sitting position and the muscles want to stay cramped up, but 3 days into recovery and I'm doing okay.
So if you find yourself in the position of needing an ICD and have the opportunity to choose like I did, your best bet is to find out what types are out there. Then decide which one is best for you while remembering that negative stories and gory videos are best left unread and unseen.
I had to censor the photos, but I'll keep adding as I go along.
Day 1
The three incisions were completely covered and all that could be seen was the swelling and the marker that was used on my skin.
Day 2
I noticed a little bruising and a lot of swelling. I found it very strange to be able to feel the electrode under my skin or at least the swelling from tunneling for the electrode.
Day 4
Come to find out I'm allergic to the adhesives so I'm using an ointment now for the hives and rash and taking Benadryl. It is weird to look at my ribcage and see so much swelling and bruising.
Day 5
I'm still very swollen as there is no definition to the left side and front of my rib cage at all, but it's not quite as bad as it was. The allergic reaction has gotten thicker and more red. I still have pain, but I'm able to sit longer without getting as stiff as I was. I've noticed the incision sites more as they have become a bit itchy as they heal although I can finally take a shower and I'm really looking forward to it.
Day 8
Many of the steri strips have come off and the incisions seems to be stuck closed quite well. There is still a lot of swelling. My follow up is scheduled for tomorrow. I am looking forward to seeing the surgeon since the Benadryl and ointment my PCP gave me didn't work to stop the effects of the allergic reaction.
Day 9
I don't have a photo to share with you today as my allergic reaction has encompassed my entire chest, but my surgeon informed me that my wounds are healing wonderfully. I've been allowed to shower for about 3 days now. I just have to be careful about raising my left arm above shoulder height and I shouldn't vigorously move my left hand and/or arm until I've had more time to heal.
The ICD still feels uncomfortable, but it's not as painful as it was in the beginning.
Day 30
The contact dermatitis is finally passing. The scars look great except the ones from the allergy. I'm able to sleep on my side. I've noticed a little movement as the swelling goes down, but it has not become a problem.
Day 60
I never liked wearing a bra, but I definitely don't like putting one on now. The band sits right at the top of my ICD and it just feels weird to me. So I wear undershirts that offer some support but have a looser band than a bra.
1 year
I haven't had any issues with my ICD thus far. I've had no shocks and most of the time I don't even think about it being there. When I do notice it, it's because I'm laying on it at night and it moves. When it moves sometimes I will get a snapping rubber band feeling in that area. I can only assume that it's muscle and the ICD is getting caught up sometimes. It's not so much painful as it just makes me cringe. I also do not like people touching that area. My husband will sometimes lay his arm on me when we are in bed and I can not stand any pressure on it. Again. it really doesn't hurt, it's just kind of nails-on-a-chalkboard cringe worthy so I'm very protective of my side. As for any pain, once in a blue moon I get a small, sharp pain at the end of the lead in my upper chest. It goes away quickly and has not caused me any concerns.
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