Pacemaker question. How many times can you replace one?

[bleukarma]

My great aunt is on her second pacemaker and a few months ago she went her cardio doctor and he checked it and said that it has about 2 years left on the battery. We didn’t think about it and thought that in two years she will have to go in to the hospital again to get this one replaced. Yesterday she went to her pulmonary doctor and the subject of her pacemaker came up. She asked her doctor how many people has he known to go beyond two pacemakers? He said “None.”

Now…what does that mean for her? Is he trying to tell her that she only has two more years to live? What happens when this pacemaker needs replaced, are they just going to throw their hands up and say “sorry!” Obviously they can’t do that but his response makes me think that in two years her procedure may be more life threatening? Aren’t there people out there that have had their pace maker replaced four or five times? I know that the average life span of a pacemaker is 7-10 years so I find it hard to imagine that when a person goes in for their first pacemaker they are putting a 14-20 year deadline on a persons life. And if that is the case then how come it has never come up before?

Some background on her: she is 73 years old and despite a few things here and there she is in fairly good condition. She does still have the old pacemaker on her, you can see the wires when you look at an x-ray. And I’ve always thought her pulmonary doctor is a quack, but she likes him.

This may be irrational thinking on my part but her doctor’s response yesterday kind of through me through a loop. Obviously we don’t know when someone is going to die, but does anybody know of anybody that has had their pacemaker replaced more then twice? I’ve done research all over the internet and I can’t find an answer as to how many times a person can get their pacemaker replaced.

Thanks!!!! :mickey:

[DisneyDudet]

I do not know the answer to your specific question, but I can research at my hospital when I get there tomorrow.

My thinking is that maybe the pulmonologist said what he did because usually people with pacemakers tend to not live to make it to three! The ones we see have pacemakers are usually those with an arrhythmia that cannot be reversed by medicine or that medical interventions, or those with complete heart block. Most of the patients we have with pacemakers usually have other health problems, and are much older, sick other than their hearts. I do not think that getting a third PPM or even having the life of the second one end is a death sentence. In fact, I think it is showing that she is rather healthy despite her need for a PPM.

Maybe some others with more experience with pacemakers will come along, but I will research this for you.

[bleukarma]

Thanks DisneyDudet, I appreciate it! I guess you’re right, most people that get pacemakers probably aren’t as in good condition as my aunt is. The reason why she got her first pacemaker (in 1998) was her heart rate was slowing down to a dangerous level but other then that she is fine heart-wise. Now, in 1992 she was in a bad car accident that left her with a torn aorta and she had to have two open heart surgeries within two days. But her doctors must have done something right because other then the slow heart rate that started in 1998 she hasn’t had any other issues since the accident and surgeries. That or we all have a lot of faith because her doctors call her the “miracle lady!”

Maybe I just got scared by her doctors response and I’ve been walking around all day like she got handed a two year life expectancy. I’m just amazed that her doctor didn’t follow up with something like “although I don’t know of anybody that has lived beyond two pacemakers, you don’t know what tomorrow will bring and you seem to be in fairly good health for your age.” While I’m not looking for false hope, I’m also not looking for false doom. When she goes to her cardio doctor next month she is going to ask him and try to get facts from him. Hopefully this will help shed some light on some of her risks within the next two years.

[RedheadWriter]

Amber- I hope everything works out OK. I was a little concerned to read this.

[DisneyDudet]

Asking the cardiologist would probably be best. Pulmonologists might have patients with PPMs, but I doubt he has any place to say what he did. Now, if that came from a neurologist, that would be a different story! They are some of the strangest people ever!

I will look up about PPMs, and even ask nurses who may have dealt with them more than I have.

Just rest easy for now. Some doctors are better at bedside manner than others. If the cardiologist has something to say about it (and if there was a true risk, I'm sure the discussion would have happened already). There's risk with anything medical, but if there was a great risk to her, I'm sure he would have said something before.

[kakn7294]

I don't want to give you false information, but I thought that they could replace the pacer a number of times as long as there is a suitable site to place the new unit. Obviously you don't have to worry about it right now but if it becomes an issue and the cardiologist won't replace it, you can always get a second opinion.

[bleukarma]

Amber- I hope everything works out OK. I was a little concerned to read this.

Thanks Rachael! I have to admit that she kind of threw me when she told me about her doctors visit last night. But it's not like I'm not known for getting worked up over something that could be nothing!

[bleukarma]

I don't want to give you false information, but I thought that they could replace the pacer a number of times as long as there is a suitable site to place the new unit. Obviously you don't have to worry about it right now but if it becomes an issue and the cardiologist won't replace it, you can always get a second opinion.

That's what I always thought too, but I admit I don't know much about the subject. I think that's why it kind of threw me when the doctor said he hasn't know anybody that has had more then two pacemakers, I thought you could just keep replacing them. But then I got to thinking about her x-rays and how many wires you can see around her heart from the previous pacemaker and thought that maybe that I had something to do with why there might be a risk with more then two pacemakers. Yes, if her cardiologist gives her bad news of any type then we will get a second opinion.

Thanks!!!! :mickey:

[Goofeygal]

As of my understanding they do not replace the pacemaker they replace the batteries. My mother has one and they just checked her battery and it was fine. She has had it for several years. So do not worry.:mickey:

[mrsgaribaldi]

Just because her doctor never had anyone that needed a third does not mean that it's never been done. Think of it like this, I'm sure that most OBGYNs have never delivered quintuplets but we all know it's been done, more than once;)
As long as she's in good health otherwise, I'm sure they will do a third if needed. I believe they remove the old pacemaker, they leave the leads and use them again, and insert the new one in the same spot. I don't know why she has so many leads that you can see in Xrays, they usually use the same leads, I guess if they are still good. Very often someone will say they are changing the battery but it is really the generator that is being changed with the old leads being used again. If they say they won't do it a third time, I would find another doctor ASAP.
I'm sure you aunt has many more years ahead of her.

[Jasper]

I have an aunt who had her first pacemaker somewhere around age 40-45 and was in good health other than her irregular heart beat. I do know that she is on at least her third one and may even be on her fourth. Granted I am not a doctor or even in the health care field so I can't say for sure what the difference is, but unless this doctor gives a good reason why they need to stop at two I would definitely get another opinion!

[kakn7294]

As of my understanding they do not replace the pacemaker they replace the batteries. My mother has one and they just checked her battery and it was fine. She has had it for several years. So do not worry.:mickey:Actually, the batteries are completely sealed within the unit and are not removable / replaceable. The entire unit must be removed and replaced. The lead wires can be reused if they are still unbroken and in good shape. I'm not at work so I can't ask one of our cardiologists, but I'm sure that they can replace it more than once. The units don't all have to be placed in the chest either (although that's the most common location) - they can be placed within the abdominal cavity as well. Maybe it's like MrsGaribaldi said - HER PULMONOLOGIST hasn't seen anyone with more than 2 pacers - I'm sure it does happen. The cardiologist would be the one to really ask.

[Cinderelley]

If it's any consolation, I am a cardiac nurse for a geriatric hospital, so I can tell you what I have seen. Yes, we have several patients who have gone through several pacemakers. The type of pacemaker she has will determine if they have to replace the whole unit or just the battery. Another factor you have have to consider is whether she needs just a pacemaker or if she needs a defibrillator also. Defibrillators are quite a bit bigger than just a pacemaker.

A couple of things I thought when I read your post were -
1) If she doesn't have any other health issues than a low heart rate, why does she see a pulmonologist? The pulmonologist may have never seen a patient go through two pacemakers due to a shortened life span because of their lung problems. She probably would have gotten a more satisfactory answer if she asked him "if it was possible for someone to have more than two pacemakers" instead of "had he seen someone with more than two pacemakers"?

2) If she does have a lung problem, how bad is it? Will she have problems with the anesthesia they'll need to use to change her pacemaker?

[bleukarma]

A couple of things I thought when I read your post were -
1) If she doesn't have any other health issues than a low heart rate, why does she see a pulmonologist?

2) If she does have a lung problem, how bad is it? Will she have problems with the anesthesia they'll need to use to change her pacemaker?

My aunt goes to see her pulmonary doctor for routine check-ups. She’s kind of been treated him as a regular MD. When we moved to this new area a few years ago she didn’t know any doctors, but she was still was making appointments with her specialized doctors (cardiologist, pulmonary) and just driving to the other side of town for their appointments. Her pulmonary doctor has been fine with checking her out every few months and I think she just got comfortable with the routine. I’ve been trying to convince her to see a regular MD for routine stuff but all she says is “He already knows my history and I don’t know any good doctors out here.”

Her main reason for having a pulmonologist is for a problem she is having that no doctor can really figure out or fix. She gets congestion something awful. She has her good days and her bad days. On her good days she has more energy then I do. On her bad days she is stuck in the bed with no energy from spitting up congestion all day long. The doctors can seem to figure out where it comes from or how to stop it. The last time she went to the ER (sometimes the congestion gets so bad that she is really weak and a few weeks ago she started having chest pains with it, so I took her to the ER. All her tests came back fine. They even did a cat scan to check her aorta and everything looked ok) they told her this problem is just something this she is going to have and is probably a result from scar tissue from the accident in 1992. When she had the accident her vocal cord was severed. They did a surgery to fix it and they think there is scar tissue built up which is why she can only eat soft foods (soups, mashed potatoes) and I guess is a reason for the congestion. She’s even went to see a allergist and he gave her nose spray and told her that she is allergic to our dog (which is why Charlie sleeps in my room now). But she still gets the congestion every few days and she takes everything from nose spray to Aciphex to Robitussen. We just can’t figure out how to stop it.

I guess reading back she isn’t as healthy as I would like to think, that is probably denial on my part. But she still drives well, she isn’t bed-ridden, she has energy when she has her good days, she is still alert, she doesn’t have any terminal diseases. I think for everything she has gone through with the accident she is in good health, especially for being 73. I guess I just needed my fears reassured that there isn’t some reason why a person shouldn’t have over two pacemakers. Even though she has issues that might get her in the end, you guys have really helped alleviate my fears that her life is over after the battery on her second pacemaker wears out! I thank you for that!!!!!!!! You guys are the best!!!

[MsMin]

I don't know that much about pacemakers but my dad had one put in a couple years ago and the doc told him on the last visit that they have a new model that just came out that is stronger /better so they want to replace it with but ordinarily they would just change the battery.
I would think that if there were time limitations they wouldn't be so fast to pop them in.
Some docs have a strange or dry sense of humor. It's my understanding you can change the batteries. :pixie:

[kakn7294]

I'll clarify my post to say that I don't have any experience with any that have replaceable batteries only. All the units the hospital where I work and the hospitals we are associated with use are completely sealed units and the entire unit must be replaced except for the lead wires. I haven't heard of units where you can just replace the batteries, but that doesn't mean they aren't out there.

[MNNHFLTX]

I believe they remove the old pacemaker, they leave the leads and use them again, and insert the new one in the same spot. I don't know why she has so many leads that you can see in Xrays, they usually use the same leads, I guess if they are still good. Very often someone will say they are changing the battery but it is really the generator that is being changed with the old leads being used again.I work on a Telemetry floor and this is my experience also. Getting a generator replaced is a relatively minor surgical procedure and is done in the heart catheterization lab at my hospital (as opposed to the surgical unit). And I have never heard of there being a limit to the number of times a generator can be replaced; in fact, yesterday I took care of two patients who were both on their third generator.

It's possible that your great-aunt's pulmonologist might not see a lot of people healthy enough to go beyond two generator replacements. Or he might have patients who have had more and just not realized it. :)

[Cinderelley]

Ours our done in our EP lab and are usually outpatient procedures. She may have extra leads if they broke, but are you sure they are an extra set? How many do you see?

[bleukarma]

Ours our done in our EP lab and are usually outpatient procedures. She may have extra leads if they broke, but are you sure they are an extra set? How many do you see?

I will have to double check her x-rays, but no...I'm not sure they are an extra set. I've never had the pacemaker part of her x-rays explained to me. Usually when she gets x-rays done they are to check her lungs so that is what we look at. I always assumed they were an extra set because that's what they looked like, but I'm not in the medical field so I really don't know what I'm looking at.

[Cinderelley]

I will have to double check her x-rays, but no...I'm not sure they are an extra set. I've never had the pacemaker part of her x-rays explained to me. Usually when she gets x-rays done they are to check her lungs so that is what we look at. I always assumed they were an extra set because that's what they looked like, but I'm not in the medical field so I really don't know what I'm looking at.

You can always ask to have it explained. If the doctor won't explain it to you, it's time to find a new doc. ;)