Three years ago, I went from my office in a hospital to my boss, a neurosurgeon. Along the way, I felt my whole body slow down. After two minutes I felt a little “off” and turned to go back. After three steps I got on my knees to avoid falling and lay on the floor until someone saw me. I was awake. Luckily this hallway was doctor’s offices and someone saw me.
In the hospital, the doctor treating me determined that my heart rate had dropped too low. The electrical signal from the nodes in the heart’s right atrium did not fire often enough or reach the point where it should. This wasn’t my first incident. If the heart beats too slowly for a long time, permanent action is required. Although I was 25 years younger than most patients, my only remedy was a pacemaker.
In the United States, the Food and Drug Administration (FDA) oversees the safety of implantable medical devices. Around 4,000 different types of devices, from cardiac pacemakers to artificial joints, are on the market. Most are safe and effective. But the medical industry is big business and not a perfect system. Every operation is associated with risks, even the most common procedures.
The American Medical Association states that 10 percent of Americans will have some type of device implanted in their body at some point in their lives. As I would soon be one of them, I had concerns – especially as I was also familiar with stimulator devices from my previous job as a neurosurgery coordinator and knew a variety of risks/outcomes, but even that prior knowledge didn’t mean I knew everything about what would happen.
Not everything is as clear as we would like it to be when a doctor talks to us. Their language can be technical, and some doctors are… less personal. Also, many patients are understandably nervous when they first hear what their body needs and don’t think to ask important, clarifying questions. Here are a few things to consider and discuss with your doctor before getting a new implant, high tech or otherwise:
Clarify your specific diagnosis
Medical terms are precise for a reason. It might sound strange to clarify that first, considering you probably researched the issue but got the correct phrasing. After seeing my cardiologist, my mind raced with medical terms, and I somehow knew it 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 atrioventricular block. There are subtle differences that can affect the way it’s treated. Ask your doctor to write it down for you, or better yet, make sure you get any visitation notes from your doctor or clinic. If your diagnosis is unclear and how your doctor intends to treat it, a second opinion is in order.
What kind of technology is used?
You don’t need to have any special knowledge of medical materials or an engineering degree to learn what substances will be in your body and how they interact with you. Gethin Williams is a Diagnostic and Interventional Radiologist based in El Paso, Texas. He encourages his patients to ask as many questions as possible.
“One of the first things is imaging. Ask if this is the latest version of the device. Is it safe for my body to be scanned? will it hurt me Not all devices work safely with the powerful magnet of an MRI machine. You could be shocked or burned by an implant unless you ask specific questions about these manufacturer guidelines.”
How secure is your process?
In addition to general online research, Williams believes patients should feel comfortable asking physicians about the possible complications and risks associated with a particular procedure or implantable device. It doesn’t matter how many thousands of these procedures have been performed in the United States or how common the device is. You should always ask as much detail as possible, even if the potential complications or risks are rare.
“You might 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 have just one health issue that requires a medical implant, but others may have multiple issues that can overlap. Williams says it’s not uncommon to have more than one device in your body (and can become more common over time) and shouldn’t be a problem as long as those implants aren’t literally next to each other. Make sure your doctors have a record of any implants that are already in your body.
For example, type I and type II diabetes are among the most common chronic health problems in the United States. But the diseases don’t just affect older populations. Younger people are more likely than ever to develop diabetes. The National Institutes of Health reported that about 11 percent of the population has diabetes, and that doesn’t include the thousands who don’t know they have diabetes. Many of these patients eventually need an insulin pump—a small, digital device that continuously delivers fast-acting insulin through a small catheter and is attached to the skin with adhesive. It is programmed from a remote device and as these pumps are used more frequently it becomes more complex that there may be multiple implantable medical devices in the general population.
What if I don’t want this technology inside me?
Aside from the fact that it’s a matter of life or death, most doctors will say you don’t to have to try anything. They emphasize the convenience and efficiency of what is already on the market or what research is soon awaiting FDA approval.
Annie DiGuglielmo is a biomedical engineer based in New Jersey. She shared her experience of patient comfort 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 you want to get active? How often will they realistically check their glucose monitor? It comes down to managing that device or how you want to monitor your own body.”