Anatomy Of A Surgery – My ICD Replacement

On Tuesday I had my ICD (Implanted defibrillator) replaced as my original one that was implanted in 2007 because of heart failure due to sarcoidosis, battery reached its threshold. I looked on the internet to find any one else’s experience with having the surgery, but no such luck. All I could find was the device manufacturer’s brief explanations of the surgery. So I write this for anyone else that has to have their ICD replaced so they can know what to expect.

I arrived at the hospital at noon, having not eaten or drunk any water since 2:00 am. I woke with the driest mouth of course, so I rinsed my mouth out with water and took the smallest sip just to coat my throat. I luckily was not hungry or thirsty, and the good thing about not drinking any water was that I would not need to pee.

After I checked in, a nurse came and got me and led me to the prep area for the surgery. She was very pleasant thankfully as was everybody that day. She showed me to my bed and asked me to strip and change into the ever so stylish hospital gown. At least I got to keep on my underwear. I changed, hopped into bed and while I was changing, the nurse went and got my wife from the waiting room to come stay with me, which was really nice since the last time I had a surgery, they wouldn’t let her come until after the surgery, so I was happy.

The nurse was prepping me for the IV as her assistant was cleaning and shaving my chest, when a doctor came and introduced himself as my surgeon’s associate and asked me if I knew why I “was here today.” Huh? I thought that was a really dumb question so I looked him straight in the eye and said “No.” Everyone laughed but he just looked at me blankly or in shock, I’m not sure which, and then I said I was here for an ICD replacement. Don’t know if he just didn’t have a sense of humor or was just not expecting that answer.

He explained the procedure to me and then asked for my medication list. As my wife was looking for it on her iPhone, another doctor came in and introduced himself as a member of the surgical team and said he would be taking my med info. Then a technician from Medtronic, the company that makes the defibrillator came to check the device and make sure the leads were okay. So in this little cubicle where I am in my bed is my wife, a nurse cleaning and shaving my chest, another nurse prepping my arm for the IV, a doctor on a rolling computer going over my info, a Medtronic technician testing the device, and a doctor standing looking at everybody. And then comes the anesthesiologist to talk to me. I was beginning to feel like a star.

After all the commotion was over, and my chest was shaved, IV in, all info taken and the procedure explained to me by two nurses, two surgeons and an anesthesiologist, I had a pretty good idea what was going to happen. They were going to take me in to the operating room, give me a local anesthetic in the area of my old ICD, take it out of the pocket, detach it from my leads and attach the new defibrillator and put it in the existing pocket. SImple enough.

I was rolled to the operating room, five floors below the prep area, and had two defibrillator pads attached to me and was put to lie on the operating table. I was hooked up to a bunch of monitors and then the anesthesiologist’s fellow came and told me that I don’t have to be up for the operation, that they looked over my last echocardiogram which was just a few months ago, and my heart function is good enough to put me in a light sleep.

I was so happy. When I had my original ICD implanted, I was up for the whole thing and it was not a nice experience at all. This time I was going to sleep for the whole thing. Then my doctor came in as they where starting to put me under and all I remember is him saying “Hey Basil, It’s me” and I saying “And who are you?” and everyone in the operating room laughing.

Next thing I knew they were putting on the pressure bandage across the incision to prevent bleeding since I am plavix. I was was wheeled out and up to recovery and that was it. It was a breeze. I was not feeling any real pain at the incision, but more from the pressure bandage which went from my left back, across my chest and down to my right middle back.

The pressure bandage had me nervous as the first time, when the doctor took it off he just ripped it off and took a whole bunch of skin with it. So this time when my this doctor came to take off the bandage I told him to go slow, which he did, and no skin came off, but it was raw.

I made it home fine but that night the pain was horrendous. I wasn’t prepared. It was so painful because in order to take out the old ICD they have to clean away a lot of scar tissue and I felt as if someone went into my chest and scraped away tons of tissue. Luckily the pain only lasted two days, and now it’s day four and I don’t have pain, just a lot of discomfort.

So that’s it. Nothing remarkable. The only this is that I bought these waterproof bandages to be able to shower, but can’t use them as my skin is too raw from the pressure bandage. So that plan was foiled and I can’t wait to have a shower later. Sponge baths don’t cut it for me at all.


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