Caring for Your Pacemaker It is important that you have follow-up visits with your doctor or pacemaker clinic. Your pacemaker may also be checked through telephone monitoring. In some cases, your pacemaker may need to be replaced. Recovering at home A few days after you leave the hospital, you will most likely be able to go back to your usual daily activities. However, it may take a few weeks before the incision is completely healed. For a few weeks, you may feel numbness or fullness in the area around the pacemaker. This is normal. You may also be aware of the pulse generator under the skin, but gradually you will adjust to it. The first few weeks Follow your doctor's instructions regarding activity, exercise, and returning to work. Keep the incision site completely dry for a week or so, to help prevent infection. Do not lift anything heavier than 10 to 15 pounds. Also, avoid too much pushing, pulling, or twisting. For about 2 weeks, do not raise the arm on the pacemaker side above shoulder level. Call your doctor if the incision site shows signs of infection (pain, redness, swelling), there is a drainage from the incision, or you develop a temperature over 100° F. Call your doctor if you have twitching chest muscles, hiccups that will not stop, or a swollen arm on the side of the incision. Call your doctor if the symptoms you had before come back, or if you have dizziness, chest pain, or shortness of breath. Be sure to check with your doctor or nurse about medications - which ones to keep taking and which ones to stop. Tell any doctors and medical personnel you see that you have a pacemaker. Follow-up visits Follow-up visits are needed to help ensure that your pacemaker is working properly. A typical visit takes about 30 minutes. How often you have follow-up visits depends on the type of pacemaker you have and on your medical condition. Most patients have their pacemaker checked several times during the first year, and ten once or twice a year after that. Follow-up visits allow your doctor or technician to see how well your pacemaker is interacting with your heart, and to check the pacemaker's setting and the level of the battery. During your follow-up visit, you will also have an electrocardiogram (ECG). The ECG records the electrical activity of both your heart and pacemaker. Adjusting your pacemaker From time to time, you may have a more thorough checkup of the pacemaker. The doctor or technician will use a programmer, a device that can "talk" to your pacemaker, to make sure it is working properly. If your medical condition changes, the programmer can be used to "reprogram" your pacemaker. During reprogramming, the settings are adjusted to better treat your slow heart rhythm. This is done from outside your body, so it is painless. In a way, it works like a remote control for programming a VCR. If you have a rate-adaptive pacemaker, you may be asked to do some physical activity, such as walking, during the visit. This allows the doctor to check the pacemaker's settings and see how well it increases your heart rate during activity. Telephone monitoring Telephone monitoring allows you to send your ECG by telephone. This can helpful if you live at a distance from the clinic or if traveling to the clinic is difficult. If your doctor recommends telephone monitoring, you will be given a special transmitter that allows you to record and transmit your ECG over the telephone line. You will also receive a transmission schedule that tells you how often you should transmit your ECG. When you transmit your ECG, a receiving device in the pacemaker clinic records the signals. The tracing is analyzed by a technician and reviewed by your doctor. Replacing the battery Pacemakers are powered by long-lasting lithium batteries. How long the battery lasts depends on your medical condition, they type of pacemaker you have, and the way it is programmed. In general, a battery lasts 5 to 8 years. Since the battery is sealed inside the pulse generator, the entire pulse generator must be replaced when the battery wears out. In most cases, the original leads will not need to be replaced. Pacemaker identification card You will be given a wallet card that gives information about your pacemaker. It also includes your doctor's name and phone number. Carry your pacemaker identification card with you at all times! Show it to any health care provider you visit. Also, because your pacemaker may set off security devices like those found in airports, libraries, and department stores, you may need to show your card to security personnel. When to call your doctor If you have a pacemaker, you will be told when to call your doctor or pacemaker clinic technician. Call as instructed or when any of these things occur: You experience any of the symptoms you had before the pacemaker was implanted. You have symptoms such as lightheadedness, fainting spells, palpitations, shortness of breath, chest pain, or lack of energy. You have twitching chest muscles or hiccups that will not stop. You are going to have a medical procedure, especially if it involves surgery. You have questions about your pacemaker, medications, or activities.