Three years ago, I walked from my office in a hospital to meet my boss, a neurosurgeon. On the way, I felt my entire body slow down. After two minutes, I felt something “off” and I turned around to go back. After three steps, I crumpled to my knees to keep from falling and lay on the floor until someone saw me. I was awake. Thankfully, that hallway was comprised of physician offices and someone saw me.
In the hospital, the attending physician stated my pulse had dropped too low. The electrical signal from the nodes in the right atrium of the heart was not firing often enough or reaching where it should. This was not my first incident. When the heart beats too slowly for long periods of time, permanent action becomes necessary. Despite being 25 years younger than most patients, a pacemaker was my only remedy.
In the US, the Food and Drug Administration (FDA) oversees the safety of implantable medical devices. About 4,000 different types of devices, from pacemakers to artificial joints, are on the market. Most are safe and effective. But the medical industry is big business and it’s not a perfect system. Any surgery comes with risks, even for the most common procedures.
The American Medical Association states that 10 percent of Americans will have some sort of device implanted into their bodies during their lifetimes. Since I would soon be one of them, I had concerns—mostly because I was also familiar with stimulator devices from my former job as a neurosurgery coordinator, and knew a variety of risks/outcomes, but even that prior knowledge didn’t mean that I knew everything about what was going to happen.
Not everything is as clear as we’d like them to be when a doctor speaks to us. Their language can be technical, and some doctors are … less than personal. Also, many patients are understandably nervous when first hearing what’s necessary for their body, and don’t remember to ask key, clarifying questions. Here are a few things to consider and speak with your doctor about before getting a new implant, high-tech or otherwise:
Clarify Your Specific Diagnosis
Medical terms are precise for good reason. It may sound odd to clarify first considering you probably have investigated the problem, but get the correct wording. After I saw my cardiologist, my mind raced with medical terms, and I sort of knew that the issue was a medical condition called atrioventricular block, sometimes referred to as heart block or AV block. But later that day, I asked for the official diagnosis. It was second degree, Hisian AV Block. There are subtle differences that can affect the way it’s treated. Ask your physician to write it down for you, or, better yet, make sure to get all visit notes from your doctor or clinic’s office. If there is any confusion about your diagnosis and how your doctor plans to treat it, a second opinion will be in order.
What Kind of Tech Will be Used?
You don’t have to have particular knowledge of medical materials or an engineering degree to learn what substances will be in your body and how they’ll interact with you. Gethin Williams is a diagnostic and interventional radiologist in El Paso, Texas. He encourages his patients to ask as many questions as possible.
“One of the first things is imaging. Ask whether this is the latest version of the device. Is it safe for my body to have scans? Will it hurt me? Not all devices will work safely with the strong magnet of an MRI machine. You could get shocked or burned from an implant unless you ask specific questions regarding those manufacturer guidelines.”
How Safe Is Your Procedure?
In addition to general sleuthing online, Williams feels patients should be comfortable asking doctors about any possible complications and the risks involved with a particular procedure or implantable device. It doesn’t matter how many thousands of those procedures have been done in the United States, or how common the device is. You should always ask for as much detail as possible, even if the potential complications or risks are rare.
“You may want to ask, how many of these devices have you or your department implanted? How many complications have you had? What about success rates? Find out the actual statistics,” he says.
What If I Need Additional Implants?
Some people may only have one health problem that requires a medical implant, but others may have several issues that could overlap. Williams says that having more than one device in your body is not that uncommon (and may become more common over time) and shouldn’t present a problem as long as those implants aren’t literally next to one another. Make sure your doctors have records of all implants already in your body.
For example, Type I and Type II Diabetes are some of the most common chronic health problems in the United States. But the diseases don’t just affect older populations. Younger people are developing diabetes at a higher rate than ever before. The National Institutes of Health reported that about 11 percent of the population is diagnosed diabetic, and that doesn’t include the thousands who are unaware they have it. Many of those patients will eventually require an insulin pump—a small, digital device that continuously delivers rapid-acting insulin through a small catheter and is secured in place on the skin with adhesive. It’s programmed from a remote device, and as those pumps become more common, they add to the complexity of potentially having multiple implantable medical devices in the general population.
What If I Don’t Want This Tech Inside Me?
Barring life or death matters, most physicians will say you don’t have to try anything. They stress the convenience and efficiency of what’s already out there on the market, or what research is coming up soon for FDA approval.
Annie DiGuglielmo is a biomedical engineer in New Jersey. She spoke about her experience with patient comfort levels in choosing a treatment that works best for them as an individual.
“I think it’s important to consider each person’s daily lifestyle,” she says. “Do they want to be active? How often will they realistically be checking their glucose monitor? It comes down to management of that device or how they wish to monitor their own body.”