the pacemaker

After talking so much about Hank’s pacemaker (and since it’s really what’s keeping him going), and in light of a recent incident, I thought I would talk about it. 

This is what Hank’s pacemaker looks like.  The top number represents the heart rate (Hank’s is 125 beats per minute), and the bottom two numbers are the milliamps needed for the atria and the ventricles to contract.  Henry’s 2nd and 3rd numbers are currently set at 3 and 7.    These numbers change on a daily basis (cardiology comes and adjusts them depending on how Hank’s EKG looks when they turn it down).  That is the part I don’t understand. 

 picture taken from :  http://www.icu-usa.com/tour/procedures/pacemaker.htm

From here,  Hank’s blue pacer wires go into two little plastic boxes.  The blue box has two leads that eventually go to the atrium of the heart.  The white box goes to the ventricle of the heart.  The little knobs on the sides tighten the wires in the boxes.  If they are loosened, the wires will come out, and Hank won’t have an adequate heart beat.   

From here, the wires go through Hank’s skin and into his heart (which is only a little over 1 inch long).

We love Henry’s pacemaker.  It’s what is keeping him with us.  The cardiologists love it too, and that’s why they are so worried that his wires will come loose.  Once a week, the cardiology team checks the wires (Hank has a spare in his chest) to make sure they are still working.  They checked it today. 

Later, when Steve (poor Steve) was visiting, he noticed Hank’s heart rate was less than 125, which it obviously shouldn’t be.   He let the nurse know, and it was discovered that one of the wires was not connected in the little blue box.  It definitely caused Hank some discomfort.  His color changed (to dusky) and his ability to oxygenate his body decreased.  Not super good.

So what happened?  It was decided that the lead didn’t get tightened enough when cardiology.  Thank heavens they didn’t blame us and take away our holding privileges. 

Since Hank is new territory, there is a definite learning curve.  It is now required that the nurses chart that they have checked the wires every shift at least.  Whew.