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Diving w/a pacemaker

pacemaker Widow Maker heart attack DAN Medtronic St Jude Medical

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#1 ScubaTex

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Posted 11 September 2016 - 01:17 PM

The story begins with the heart attack in this post.

The saga continues, a couple of weeks ago, in the middle of the night, after over an hour of experiencing intense heart palpitations, I drove myself to the ER. It didn't take long for the Dr. to determine that I shouldn't be taking 3 beta blockers [to control blood pressure] simultaneously. The cardiologist, who had implanted the stent in May, came in to see me that day, and confirmed, when he had prescribed the 3rd drug, I should've quit taking the other 2, and blamed the miscommunication on his office.

​Lesson #1 - Always question the Dr. or nurse when a new Rx is being prescribed. - What is it for, should other Rx-s currently taking, be continued or halted??

​The following day, when the nurses came through on shift change, I had the incoming nurse write 'Go Home' on the white board under Goals for Today. When I finally saw the cardiologist [he implanted a stent that morning], when I began to discuss being released, the Dr. made a phone call, and walked out of the room. Later, I would learn he had called an electro-physiologist to have a pacemaker implanted in me the next day.

​Lesson #2 - You have a right to release yourself from a health care facility. And I should've done it, then and there!!!

​Of course, my primary concern was the diveability of the device to be implanted. I was assured by the assistant to the implanting Dr., the rep from Medtronic would answer my concern, prior to the procedure. They were wheeling me into an elevator as I met the implanting Dr.! The Dr. briefed me, the rep assured me I would "be able to dive to 100 fsw" and I signed the consent forms as my chest was being shaved and scrubbed.

​Lesson #3 - If you have not been thoroughly briefed, all questions answered, and consent form signed at least 2 hours prior to the procedure, call 'time out'. If necessary, have the procedure rescheduled.

​I was released the following day, and the day after read the literature, which came with the pacemaker and the home monitoring unit. I noticed the following language "If you plan to scuba dive, discuss your medical condition with your doctor. General recommendations about scuba diving vary depending on many factors." Then 20 pages later under, 'medical procedures that require some precautions - Hyperbaric Oxygen Therapy' - "This procedure can damage your heart device and leads." ​WHOA??? WHAT THE HELL???​  

So, I go online and try to navigate the maze of the Medtronic website, no luck. I call the Medtronic '800' patient line, they're helpful, say they will email the recommended limitations of the device, along with supporting information. The supporting information is pdf copy of the 'patient manual', I already have. But the body of the email contains the bad news. Following the standard, only your doctor ... yada yada yada - "Medtronic implanted heart devices are cycle tested to 4 ATA during product development. This is equivalent to approximately 100 feet diving depth. No device damage has been observed during testing."

​Then [emphasis is Medtronics] - "Per Medtronic labeling, exposure to pressure exceeding 2.5 ATA (approximately 50 feet of seawater) may affect device function or cause device damage.​THE SOB LIED TO ME!!!  ​In other words the device isn't suitable for a table 6 recompression therapy for DCS, much less diving.

Lesson #4 - NEVER trust a manufacturers rep, do your due diligence, require answers to decision dependent questions, in writing, from a reliable source.

​Now I have to find a different pacemaker, that's compatible with diving. I email DAN a request to provide a list of devices which would be suitable for diving. Two days later, I get "DAN doesn't maintain a list of specific devices such as pacemakers. Your best option is to discuss your interests with your cardiologist, then get from him a list of devices and manufacturers he typically uses." Already tried that, I ended up with an expensive piece of useless junk in my chest. My previous experience, just confirmed my impression of my cardiologist, the closest he got to scuba diving was wading in the Ganges. Luckily, after searching online, I found St. Jude Medical, who makes a pacemaker tested to 7 ATA.

​All I need now is a new cardiologist/electro-physiologist to take out the junk and implant a new device that will allow me to continue diving. Maybe DAN can help. Sorry, we only have one in Philly & one in Lakeland, Fl, who are cardiologists and trained in hyperbaric medicine. DAN did provide their contact information and said they would be happy to consult with my new cardiologist if needed.

​Lesson #5 - Don't put your health in a blind trust with your Dr. You must be proactive, and be willing to do the back ground work your Dr. doesn't have to do for their non-diving patients.

​Hopefully, by this time next month, the new pacemaker will be implanted and I'll be planning my 2nd rehab. I've got a dive trip planned for March 2017.

 

​Still wanting to DIVE MY @$$ OFF !!!


Time on earth is precious, time underwater even more so. Live life one day at a time. Dive your @$$ off!!!


#2 Cmdr. Clownfish

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Posted 11 September 2016 - 04:51 PM

I'm sorry you experienced that but sadly I'm not surprised.  Proper patient counseling is hard to come by these days.  

 

I had a coworker whose neighbor was a medical device sales rep for some artificial joint company.  The way he described it, the guy only worked a few hours a week.  He would show up for the surgery and make sure you signed the paperwork.  That was his sole job.  Then he got a commission of about $10k for each signature.  The doctor got him the sale, he just made sure the patient did not back out.  Easy job and I could see how he would lie through his teeth.



#3 WreckWench

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Posted 13 September 2016 - 06:40 AM

Bill while going to this effort to remove the crap...GET A 2ND OPINION if you really need it. Anyone on 3 beta blockers will have issues. Larry aka Orcaman had his removed....they implant them "just to be safe" not because you really need them. He has been 1,000,000% happier since its been gone. I'll connect the two of you to chat. Kamala



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#4 ScubaTex

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Posted 13 September 2016 - 09:20 AM

I'm sorry you experienced that but sadly I'm not surprised.  Proper patient counseling is hard to come by these days.  

 

I had a coworker whose neighbor was a medical device sales rep for some artificial joint company.  The way he described it, the guy only worked a few hours a week.  He would show up for the surgery and make sure you signed the paperwork.  That was his sole job.  Then he got a commission of about $10k for each signature.  The doctor got him the sale, he just made sure the patient did not back out.  Easy job and I could see how he would lie through his teeth.

 

​Unfortunately, in the back of my mind, I suspect my original cardiologist of intentionally prescribing the 3rd beta blocker, knowing it would further reduce my heart rate to a level where a pacemaker was 'medically necessary'. Prior to my release, he told me to increase the dose on the 3rd drug, and quit taking the other 2 beta blockers. The nurse, who gave me release instructions, didn't have the correct drugs, and had to confirm them w/Dr. When I went to the follow up, in the Dr's office, a nurse always begins with what rx-s are currently being taken, their records showed I was on all 3 beta blockers​.

 

Bill while going to this effort to remove the crap...GET A 2ND OPINION if you really need it. Anyone on 3 beta blockers will have issues. Larry aka Orcaman had his removed....they implant them "just to be safe" not because you really need them. He has been 1,000,000% happier since its been gone. I'll connect the two of you to chat. Kamala

 

​I'd really appreciate communicating with Larry. I've already severed the relationship with my original cardiologist. I cannot trust his prescribed treatments, 'a pacemaker would make it easier to treat you with beta blockers'. He also expressed his belief that 'everyone should be taking beta blockers [for blood pressure] and statins [to lower cholesterol]' as preventative medicine.

​I've made an appointment with another cardiologist, and I will review with him all aspects of my previous treatment, the first of which will be the necessity of the pacemaker.


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#5 WreckWench

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Posted 14 September 2016 - 08:42 AM

Now you are on the right path. WE SHOULD NOT ALL BE ON DRUGS....this is horrible advice UNLESS you have been brainwashed or realize its the only way to make money in skewed medical system.



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#6 Scubatooth

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Posted 20 September 2016 - 09:12 AM

Bill

The font of your post is hard to read on my tablet. I'll get on my laptop for a better read.

3 beta blockers is a bit much and if the doctor is trying to push your meds so you have to get a pacemaker I have to question the ethics of the Doctor and would be seeking a 2nd or 3rd opinion, if not a full complaint with the state for highly questionable medical practices.

See if you can't get ahold of dr Doug ebersole out of central Florida. He's a technical instructor and interventional cardiologist so he would have the insight on all of this.

Edited by Scubatooth, 20 September 2016 - 09:13 AM.

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#7 ScubaTex

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Posted 21 September 2016 - 01:12 PM

​Too late, the pacemaker has been implanted, and thanks to a previous Tx. gov. it's almost impossible to prove malpractice, and limitations to liability. My new cardiologist implied he might not have taken the same approach [implanting a pacemaker], but also refuses to remove it, even though it might not be necessary. He has said he will have it 'turned down', to closer to my 'normal' resting rate [which has gone below 50 bpm]. He also said he doesn't believe there's any problem diving to 4 ata, says he a number of patients, who dive and/or have HBOT, without any problems. As far as having it removed, "anytime there's surgery there's chance for infection", leave it in, if not needed, the battery will run out in 8-10 years, and won't be replaced. Can't wait until I'm allowed to resume upper body exercise, then return to diving.


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#8 ScubaTex

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Posted 29 September 2016 - 01:42 PM

​Update:

 

​Had another appointment w/new cardiologist; said heart is in 'good condition' [results from echocardiogram, the prior week] - said again - he would NOT have implanted the pacemaker - had the device technician lower the base rate to 50 bpm [from 60 bpm - where it was 'stimulating' 87% of the time] - he still won't answer questions about diving due to 'legal liability' - so I now confine my questions to the status of my heart health, and know the responsibility & liability rests w/me, the diver [after all it's on every release form you've initialed and signed as a diver - even the SD form] - next appointment in 6 mos. - I'll be diving before then!!!

 

​Aloha,

Bill


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#9 copterman

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Posted 02 October 2016 - 09:38 PM

Here I go with my story. This is going to be some what long. In April of 2004 after an incident I thought was immersion pulmonary edema, I was diagnosed with non-ischemic mild cardiomyopathy and began treatment for hypertension. My cardiologist was not a fan of diving but allowed me to do it, and there was no problem as long as I took my meds. A weakened left ventricle would produce fluid in my lungs with out the diuretics and other hypertension drugs. Also for many years I had an low heart rate due to my physical activity and fitness ( occasionally 38 bpm, normal rate 48 - 52 bpm). My cardiologist became concerned with my aging that this sinus rhythm would get worse and sent me to an electro physiologist. His recommendation was pacing in the future, but not necessary quite yet. I asked about diving and pacing and he said he believed it could be done to 60 ft., but he would research the issue. I also did some research with the DAN site and other places. I didn't find much help, but found one company whose pacemaker was certified to 60 feet and the Saint Jude one to 7 Atm that you found. I finally decided to have a pacemaker installed as a precaution for the aging heart and have it done before going on Medicare in case they wouldn't approve it. I contacted my electro physiologist with my information and he informed me that he found one by Boston Scientific good to 5 Atm. In Oct. 2011 my first one was installed. The tech that attended the installation came in before the installation and provided me with paperwork from BosSci verifying the testing to 5 Atm that I carried with me on future diving trips. I carried paperwork ( learning from Kamala & Larry) listing all my medical conditions, my meds & dr.'s list with me on trips if there was ever an issue. I also would get a RSTC medical form from a new diving Dr. In my area, with approval after passing a stress test, though he wasn't much help otherwise on cardiac issues and diving. My electro physiologist was ok with me diving. I continued diving, though more conservatively, using Nitrox, staying above 100 feet, avoiding strong currents, and avoiding stressful situations. I have over 1000 dives. If I ever felt anything unusual during a dive, I would end the dive or take a dive or 2 off on trips. In Sept. 2014 during an echocardiogram I had a left ventricle ejection fraction of 22%, basically full blown congestive heart failure. I was put on a Beta blocker to help the CHF. Needless to say, no diving for a while. Shortly thereafter since my original pacemaker had recorded a new problem over the years (Atrial fibrillation) a new pacemaker/defibrillator was installed. Again Boston Scietific, again approved to 5 Atm. At one of the large dive seminars, I sat down with the DAN person in charge of their current studies on Emerson pulmonary edema and cardiac issues and diving. He at that time said I shouldn't even stand in chest deep water or swim because the pressure in the water would make things worse. I haven't dived since August 2014, but have snorkeled and free dived to probably 15 feet with no ill effects. This May I had a new latest/greatest pacemaker/defibrillator installed with a wire to help the weakened left ventricle since the high dose Beta blocker gave me limited improvement and a lot of fatigue and listlessness. My cardiologist has retired from seeing patients and am seeing a new one. Diving was brought up and though he admits not knowing enough he admitted it might be possible again with limitations. DAN has a new publication "The Heart and Diving" which I've read and feel is very well done, but doesn't positively answer all my questions. I would like to go talk to their researchers in person and contact Dr. Alfred Bove, at I believe UPENN in Philadelphia, the original diving cardiologist in the NE. As the literature says, it may be possible to dive with a pacemaker, but is the underlying need for one a cardiac condition that could cause death while diving, though I think " what a great way to go". Sorry to be so long in my dissertation, I hopes this helps you. I still don't know if I'll ever dive again, I miss it deeply (pun intended). Our local dive Dr. feels that I would be a risk to my buddy, so I shouldn't dive, but I have friends that would dive with me anytime. Oh by the way I got my new cardiologist to reduce my dose of Beta blocker. I don' t get as fatigued whe exercising, I'm not tired all the time, and the mental funk is going away. Best of luck in your quest.
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#10 ScubaTex

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Posted 07 October 2016 - 04:34 PM

​One thing I've learned from this episode, is everyone's cardiac problem is unique and complicated. Why some doctors are more forthcoming than others is puzzling. You just have to live life on your own terms, and accept the degree of risk of your decisions.

 

Bill


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#11 ScubaTex

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Posted 11 October 2016 - 01:53 PM

​WOO HOO!!!!!

 

​Did my first 2 dives of life #2 on Oct 9, on Molokai - was surrounded w/3 instructors, a dive master, and a nurse - everything went well - SAC rate was a little high on first dive - guess I was a little anxious - glad to be back in the water


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#12 WreckWench

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Posted 12 October 2016 - 07:46 AM

​WOO HOO!!!!!

 

​Did my first 2 dives of life #2 on Oct 9, on Molokai - was surrounded w/3 instructors, a dive master, and a nurse - everything went well - SAC rate was a little high on first dive - guess I was a little anxious - glad to be back in the water

 

 

THAT IS AMAZING NEWS!!!  Thank you for sharing the highs and the lows.... this will sadly affect many and its been so helpful hearing the stories of those affected.



Contact me directly at Kamala@SingleDivers.com for your private or group travel needs or 864-557-6079 AND don't miss SD's 2018-2021 Trips! ....here! Most are once in a lifetime opportunities...don't miss the chance to go!!
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Kamala Shadduck c/o SingleDivers.com LLC
2234 North Federal Hwy, #1010 Boca Raton, FL 33431
formerly...
710 Dive Buddy Lane; Salem, SC 29676
864-557-6079 tel/celfone/office or tollfree fax 888-480-0906

#13 WreckWench

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Posted 12 October 2016 - 07:47 AM

Here I go with my story. This is going to be some what long. In April of 2004 after an incident I thought was immersion pulmonary edema,  (...shortened for space (see above for full post)

 

 

Thank you for sharing your story Charlie!  We have you in our prayers to be able to DIVE AGAIN and resume all the things you love to  do  SOON!!!



Contact me directly at Kamala@SingleDivers.com for your private or group travel needs or 864-557-6079 AND don't miss SD's 2018-2021 Trips! ....here! Most are once in a lifetime opportunities...don't miss the chance to go!!
SD LEGACY/OLD/MANUAL Forms & Documents.... here !

Click here TO PAY for Merchandise, Membership, or Travel
"Imitation is the sincerest flattery." - Gandhi
"Imitation is proof that originality is rare." - ScubaHawk
SingleDivers.com...often imitated...never duplicated!

Kamala Shadduck c/o SingleDivers.com LLC
2234 North Federal Hwy, #1010 Boca Raton, FL 33431
formerly...
710 Dive Buddy Lane; Salem, SC 29676
864-557-6079 tel/celfone/office or tollfree fax 888-480-0906




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