The procedure that Taylor got for the implant is called a sub-pectoralis procedure. Normally, a defibrillator can be implanted subcutaneously, below the collar bone, but because of Taylor’s thin and small frame, the cardiologist recommended the sub-pectoralis procedure to prevent potential wear and tear of the overlying skin from a subcutaneous implant. Also, because of Taylor’s youth, he wanted to implant a device with a longer battery life (10-12 years vs. 5-6 years with some) to minimize the number of battery changes she would have to undergo throughout her life. A longer batter life meant having a larger device, which would have been better held in place under a muscle v. skin. With the sub-pectoralis implant, the surgeon makes an incision on the side of the chest near the armpit. A layer of the pectoral muscle is then lifted to make a pocket for the defibrillator to sit. The leads are threaded to the heart and the defibrillator is anchored to the muscle with sutures. As one can imagine, a sub-pectoralis implant makes for a more painful recovery compared to a sub-cutaneous implant, which lays just under the layer of the skin.
Friday, the day after the surgery was a rough day for Taylor. She was in pain and very uncomfortable. She ate only a few bites of food and felt nauseated for most of the day. The doctors and nurses did their best to make sure Taylor was comfortable with available medications. We even had to turn away some visitors that day because Taylor was so miserable. However, yesterday (Saturday) was a much better day. The pain was still there, but it was not as intense and tolerable. The cardiologist was able to remove the pressure dressing over the incision site; it looked good. The incision itself is about 2 inches in length. What is nice is that one cannot even tell there is even a small device under her muscle there. If one looks carefully, he/she may be able to detect a small, slight lump in the skin, compared to the other side, but other than that, it is not noticeable. Taylor was feeling so much better that we were able to get her into her wheelchair and take her outside to the nice gardens they have here at the University of Colorado Hospital. She also regained her appetite to make up for the last 2 days of hardly eating any food and ate heartily (pasta, salmon, fruit, corn, frozen yogurt, spinach salad). You can tell when Taylor is feeling better because her teasing and joking starts up again.