The Next Day!

Tuesday, Tammy still was not feeling well and the swelling had increased. She decided to not wait until Wednesday and request the CBC that day. The white blood cell count came back normal but in the high range of normal. So again we waited.

It all started with a Second Opinion

Jenny (Tammy's sister) suggested that Tammy get a second opinion. Tammy was referred to Dr. John McAnulty at Good Sam Hospital. Her appointment was on Monday September 29th. The first thing they did is "interrogate" her pacemaker/defibrillator (PD). The "PD" is brand new on the market and has only been available for just over a month. The technician that was checking the device had not seen anyone with this model in before.

She did a printout of the "activity" recorded on the device since it was placed in Tammy. She found an arterial anomaly. She then said that there was a Lead Impedement, but because this device was so new she didn't know for sure what that meant. So, she went to check with the doctor.

He came back in with two medical students and continued his examination. He was concerned with the amount of swelling and tenderness around the device. He was perplexed by the arterial anomaly, because this is not normally associated with Toursads. He decided to lower Tammy's heart rate to 60bpm. Her pacemaker had been keeping her heart at 75bpm and had been running about half the time to maintain that rate. He felt that if they lowered that rate and allowed her heart to beat at is natural rate more often, that may help with her fatigue. He also decided to put her on a beta blocker at a low dose.

Tammy left the appointment with instructions to contact Dr. Kelber in two days if the swelling and tenderness of the site did not improve, to request a CBC with differential. If her fatigue did not improve, she was also to get a chest x-ray. The nurse was also going to check with the manufacturer of the device to get a cord sent to Tammy, so she could send a readout to her doctor anytime. The nurse was also going to check in to the error message about the impedement of the lead and get back to Tammy.