Life is like a box of chocolate's.......

Life is funny sometimes isn't. Just when you think you got all your ducks in a row...somebody or something comes along and ruins the line. I think sometimes I have been guilty of being that someone.

As I nurse I have often had to be on stand by for the patient when the doctor delivers bad news. I want to be there so I know what he/she has said to the patient so if they have any questions I know what has been told to them and how to best explain it. In the hospital setting the specialists often rush into the room give an overall view of what is going on and what the plan is. They often don't take the time to provide the patient with an opportunity to ask questions, or to help alleviate some of the stress the patient may experience based on the information the doctor has given them. I try to put myself in the patients shoes. How would I feel if I was spoken to in that manner, what is it that I need to know to help me understand the information that was just given to me....how would that effect my life?

Well I have been on the receiving end of news from doctors many times in my life. Yesterday was no exception. I am not sure if I have mentioned this on my blog before or not, but I have a pacemaker. I have had one since I was 23 years old for a condition called Sick Sinus Syndrome. Sick sinus syndrome is a condition where the heart has episodes of tachycardia(going to fast) and bradycardia(going to slow). The heart as a muscle open and closes the valves in a rhythmic method which produces the heart beat. The muscle does this through an electrical pathway which starts in your atrium Sinus Node. So in Sick sinus syndrome the sinus node is literally "Sick" as it is not controlling the electrical impulses the way it should. This is a very elementary explanation of the heart as a pump....if you would like to know more about how the heart works as a pump you can check out this siteHeart for more information.

Getting my pacemaker was the best thing that could have ever happened to me. I was able to have three healthy children, participate in all aspects of life, from sky diving, water/snow skiing, tubing, wake boarding, para sailing, horseback riding, playing ball, golfing...you name it, I let nothing stop me except my own fear of maybe getting hurt.

As much as I would have loved my pacemaker to last my whole life....it didn't and they don't. The average life expectancy of a pacemaker is 7 - 12 years. I have generally required getting my pacemaker changed earlier for a variety of reasons. I am currently on my 4th pacemaker. The pacemaker itself is made up of two components the battery component(generator) and the leads. These leads are attached to the PM(pacemaker) and then directed into your atrium and ventricle. Again if you would like to learn more about Pacemakers why and how they are used you can check out this site here. Like any battery the more you use it the sooner it wears out. This is true with PM's but a little more complex. Life expectancy of PM's as I stated is 7 - 12 years. But this depends on how the PM is set and how often it is used. There are many settings within the PM to help you get the best quality of life for you and to help extend the life of the PM.

As I mentioned the PM(battery component) has a life expectancy so do the leads. When a person first gets a PM they may only get a single lead...then a few years down the road it might be determined they need another lead....hence making the original lead older. As time goes on leads can possibly fracture, wear out or become faulty. In the case of a lead becoming old and requiring replacing the surgeon will often cap the old lead and put in a new lead. Also, like anything mechanical it can be faulty and need replacing...such was the case when I had a lead replaced two years ago. You must appreciate that these leads are going through a very small vessel and can only accommodate so many leads.

After my last PM change and lead replacement I have been uncomfortable. Month after the operation I was back in having another operation as the lead that was capped migrated to the top of my PM. Now two years later I am still uncomfortable and it is affecting my quality of life.

The short version, I spoke with the Surgeon who did my last PM and lead he suggested I see the cardiac surgeon in Vancouver. I saw this specialist yesterday.

He was very relaxed and hence made me feel relaxed. Prior to seeing this doctor I did a lot of research regarding Lead extractions and options. I didn't really think I was a candidate for the procedure. After a very lengthy discussion with him it has been determined that not only does he want to remove my lead he wants to take everything out all three leads and the PM and put a complete new unit in another part of my body. Here's the thing. He believes I have a infection brewing hence the pain and burning I am getting. Because this site has been opened up so many times this site becomes a prime candidate for infection. Lead extraction is major surgery. Because one of my leads is over 23 years old makes it even more complicated and risky. He believes he can get them all out....the problem is that I might require open heart surgery and all of the risks that goes along with that...which I won't even go into right now.

Here is what I know.....if there is an infection I will be on antibiotics for minimum a week but possibly as long as a month...if I have to be on them for a month they have to put a special intravenous line into me so they can get frequent access with out having to poke me all the time...if this happens my stay in the hospital will be longer. If they end up having to do open heart, which would require cracking my sternum I will be in hospital longer and recovery will be 4 - 6 months post discharge from the hospital.

So you can imagine that I have a lot to take in.....lots of things to consider....and getting my ducks all in a row. The surgeon wanted to do it as early as the 15th of this month. I said no. I have my youngest daughters 16th birthday this month and I am planning a big Sweet 16 party for her. They then gave me November but middle daughters birthday is that month and I certainly don't want it in December, to close to Christmas. So I am booked for January 2009. I have lots to do before then....lots of things to get organized.

When things like this happen it really helps you put life into perspective now doesn't it. It makes me think of that song "Live like your were dying". Enjoy everyday, don't sweat the small stuff and it's ok to leave the dishes until tomorrow.

I think this has been my wake up call.......