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Mon, 27 Aug 2007 10:53:41 -0400 |
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Hi, Cath: Your mom requiring a pacemaker should not have any issues with
breastfeeding because of the surgery. If I am reading your post correctly, her
baby will be about 6-8 weeks old when she has the procedure done - the baby
no longer being such a newborn should help.
Typically, a pacer implant is done thru day surgery in an EP (electrophysiology)
lab under conscious sedation. A fentanyl/vistaril combination is typically used
in the US, neither of which are contraindicated for breastfeeding. The entire
procedure takes about 2 hours - most patients go home that same day. She
should find out if her doctor is planning same-day surgery or an overnight
stay, for observation. Any radiation exposure is minimal and should not disrupt
breastfeeding. A chest X-ray is done after the procedure to check lead
placement in the heart. She will have an incision in her upper left
(occasionally done on the right) chest and will have restricted arm movement
for 6-8 weeks. She will be instructed not to perform extreme arm motions
such as lifting her arm above her head or reaching behind her back until the
leads attach to her heart muscle. She may want to start hunting now for front-
opening bras to use during the recovery period.
She will probably need help with lifting the baby, especially the 1st couple of
weeks after surgery. If she requires a hospital stay, arrangements should be
made ahead of time with the staff for baby to be brought in for visits. She will
also be on continuous monitoring for her entire hospital stay, so she may need
to get creative in positioning baby around the leads on her chest. Probably the
most important issue to address with her are her cardiac medications. Some
of the antiarrhythmics are classified as L5 by Hale, especially the Class 3
drugs, such as amiodarone and dofetilide (which is not in the 2006 Hale, but is
even stronger than amiodarone). If she needs to be started on any of the
antiarrhythmics, she is looking at a 3 day hospital stay. All of these drugs
require continuous heart monitoring when a patient is started on them because
the risk of suffering cardiac arrest is initially so high.
Good luck in working with this mom!
Pam Hirsch, BSN,RN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL USA
Who knows all these things from an up close and personal perspective, having
had a pacemaker for 5 years now and who was on all the antiarrhythmics
currently on the market before finally discovering one that works!
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