Hi, Andy. I, too, found that I was one of the few. . . whose hearts were damaged in some way during the valve replacement surgery. It annoyed my surgeon more than it did me, though. He was worried about his statistics of "uncomplicated recoveries." I was worried about everyday life. I really didn't fear the pacemaker, as my mother had one for the last 10 or so years of her life, with no issues.
That said, mine has not been completely uneventful. I was on the slow side of the healing curve, having many complications in early recovery. I was not deemed strong enough to do cardiac rehab until I was 12 weeks out from surgery, due mainly to the mayhem the surgery and meds wrecked on my digestive system. I also had fluid retention and pleural effusion early in recovery. After those first few months, I started rehab. . . and that's where the fun began.
My pacemaker (original one, replaced at 5 years) had two mechanisms by which it was to increase my heart rate when my body's workload required it. Unfortunately, the implanting surgeon set mine as he would for any "normal" patient in his mid-60's. He gave me very little "boost" as my body jounced with walking or running, did not turn on the respiration response function at all, and limited my maximum heart rate to about 130 beats per minute. Try to ride a bicycle like that! I got into rehab, where they wanted me to ride a stationary bicycle, and "fell flat on my face." I could run or jog on a treadmill, because the rate-response function responded to the bouncing of my gait, but on the bicycle my pacemaker never increased my heart rate because I was not bumping up and down. On top of that, I was capable (and required) my max heart rate to be higher than the 13o BPM they allowed. It took several trips to the device clinic to get my point across, and ultimately they turned up the "bouncing" rate response, turned on the "respiratory" rate response, and increased my maximum heart rate to 160 BPM. I still can't run, but it has nothing to do with my pacemaker. My knees won't take the impact, but I can ride a bicycle, speed-walk and crank the elliptical machine as well as I could before the pacemaker.
I did have a premature lead failure - at just over 5 years my ventricular pacing lead went "high impedance" - meaning that it took way more power than normal to trigger a strong heart beat. They don't know why this happened. It could have been deterioration of the lead, or just formation of scar tissue where the lead attached to the heart muscle. In either case, it needed to be replaced, as it was quickly depleting the battery in my already "old" pacemaker. Last summer (just about a year ago) they removed my original ventricular pacing lead, using a laser sheath to cut it loose from the scar tissue holding it in place. They then inserted a brand new lead and replaced my pacemaker. They put in a new pacemaker because they had to remove the old one to do the lead switch, and they never re-implant a device. So, mine was replaced about a year early. . . this time with a slightly larger one that has an "extended life" battery, and is expected to last 7-10 years, as compared to the original one's projected life of 6-7 years. The new one can also be interrogated via a Bluetooth link at home and upload its information to the clinic via cell phone link, which means that instead of going for interrogations twice a year, I only go once.
That's enough of the "heavy" stuff for one post. Some humor?
When I first got the pacemaker I was polishing some wood paneling in our rec room. Large areas of high-gloss wood. I was running a hand-held buffer/polisher. I had finished about 30-40 linear feet of wall polishing when I realized that my heart was RACING and I felt faint. I had to lay down on the floor to avoid passing out. While lying there, I thought about it. Do I call 911? Do I call the device clinic? Or do I just wait and see? As I lay there, my heart settled down. . . and then it dawned on me! I had been holding this squirming, vibrating, swirling buffer in my left hand. It had been vibrating my entire upper body. The pacemaker was simply doing its job! It "thought" I was engaging is some high-intensity workout of some sort, induced by the vibration of the electric polisher! Whew! I switched the polisher to my right hand and finished the job without incident.
Since then, other than the lead failure and lead/device replacement, all is well. I do whatever I want to or can otherwise do, with no thought of the pacemaker. As I've said before, the only time I really realize I have it is when I look in a mirror with my shirt off. I do remember to go through the "alternate" security line at the airport to avoid the metal detectors, but when I wasn't paying attention I was shepherded through the metal detector at Heathrow last summer with absolutely no issue.
I guess my one single bit of advice other than not to worry about it is to make use of your device clinic to be sure your device is adjusted to make best use of its capabilities. There are many settings that they can adjust to make it act so close to natural pacing that you won't even know it is there.
