Thursday, April 05, 2007

ICD Unit Checked / Incision Scarring

My appointment with the Cardiac Electrophysiologist Dr. Alpert was
Tuesday afternoon.
He's the one who oversaw Dr. Hayborn surgically implant my dual pacemaker/ICD unit. Normally Dr. Alpert would have done the actual surgery implantation but he was unable to for reasons that were not explained to me ( I think he had another surgery) but he was able to come up and make sure everything was connected properly.
He says my incision healed nicely and asked if I've had any problems. I mentioned the achiness I get quite often, that is like a really bad toothache. He explained that nerves were severed and I will be feeling this 'pain' for a while yet. Tylenol will help, and it has as I've had to take some a couple times so I could get a good night's rest.
I haven't a clue what the machine is called that was used - it resembled a hi-tech computer in an attache case. Something that resembled headphones was placed around my neck and a portion of it extended down to cover my incision. I was lying on my back and the nurse turned the machine on. I never felt anything, it's not invasive. She touched the screen with a pencil like instrument and data spewed out. She told me that my heart was beating 70 beats per minute and that was good. Meaning the pacemaker was doing it's job. She said everything looked 'good'.
Dr. Alpert explained that I would be getting a Latitude Communicator by UPS within a month or so. He showed me one. It reminds me of those machines that you swipe credit / debit cards through. Or an answering machine with a screen. It gets hooked up to the telephone line and every 4 months I hold the wand that comes with the communicator over my device and it transmits 'information' to the doctor via that computer like machine I was telling you about.
The nurse told me that she was going to 'do something' and let her know if I felt anything. eeek! What I felt was a rapid heartbeat that she controlled with the machine. She wanted me to know what it would feel like if the pacemaker had to readjust. It was a weird feeling but painless.
Then she hit another button that made me beep. No joke, lol. I was beeping out of my shoulder. She explained that when the battery was getting low, the beeping would kick in and I had three months before it totally died - so I needed to have the batteries replaced within that time period. The sound was low, but anyone standing or sitting near me would also hear it. Sounded like a truck backing up or the beep you hear when your smoke alarm alerts you the batteries are low. Only quieter.
When the batteries are due to be replaced, the incision will be reopend (under anesthesia) and new batteries put in, then resutured. I'll go home the same day. The current batteries are good for approximately 4-7 years.

Heart surgery Incision
My incision from the heart surgery looks really good from the top 6-7 inches. It blends in with my skin coloring and if no one knew I had the surgery, they would never even notice the scar. Good thing they'd never see the bottom 2-4 inches.
It is 'red' and raised. Beneath the scar, there's a 'knot'. When I sit for a long period of time, or when I lie down and get up, this knot tightens and then pulls. While it's not painful, it is annoying and uncomfortable. After a few seconds, the knot relaxes. I asked the women at the HCMA forum who've had the surgery if anyone had experienced this and the response was that it's normal.
I don't like the way the scar looks so did a search to see what I could find. There are two types of scarring associated with surgical incisions.
  • Keloid scars are an overgrowth of scar tissue. The scar will grow beyond the site of the injury. These scars are generally red or pink and will become a dark tan over time.
  • Hypertrophic scars are red, thick and raised, however they differ from Keloid scars in that they do not develop beyond the site of injury or incision.

It appears to me that my scarring in the lower part of my incision is the Hypertrophic variety. Hypertrophic scars will improve over time. This time however can be reduced with the help of steroid application or injections. Since no one but me and Tom will see this section of scar I think I will just wait it out. Not too crazy about steroids since they tend to put on the pounds and I'm trying to lose some weight, not gain any more.

I do have another option if it seems the scar doesn't improve. A member at the HCMA recommended using a silicone sheet. Having no idea what that was, I looked that up too. The price isn't bad for a small sheet, about $13. The larger the sheet, the higher the price.

Medical professional-level silicone sheets helps reduce the scar size, thickness, height, and color of all types of scars, including new and old scars, post-surgery scars, keloids, hypertrophic scars, and other scar types caused by injury, trauma, and burns. By flattening, softening, smoothing, and blending the scar with surrounding healthy skin, these soft, breathable silicone sheets helps make the scar far less noticeable. Silicone sheets are easier and more convenient to apply than scar gels because they are non-greasy, provide direct beneficial pressure to the scar, and do not stick to clothes. This silicone sheet can be used for tummy tuck (abdominoplasty), buttock augmentation (when the incision is in waist or underneath the fold of the buttocks), C-section scars, stenotomy scars, and scars following open heart procedures.

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