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LVAD

Lifestyle changes with LVAD

Living with the VAD will call for certain lifestyle changes. While you will experience certain limitations in your everyday life, a few activities could be dangerous. One of the biggest lifestyle changes with VAD is the lifetime follow-up to monitor device function and health status. 

Water: Persons with implantable VADs must not allow their controller/computer and electrical equipment to submerge in water. Showering is possible with proper protective equipment. You may only resume showering once your driveline has healed and your physician gives permission. In most cases, swimming and a dip in the bathtub are not allowed. However, patients who are implanted with the Jarvik 2000 device and a postauricular implant, are discharged with a long extension cable that can be utilized for a dip in a pool too.

This VAD could be a preferred choice for patients (especially young adults, and younger children) who desire a bit of extra mobility. You will be offered this option as a part of the counseling during the VAD work up and counseling phase.

Activities: Contact sports or repetitive jumping are examples of activities that may cause trauma to the pump attachments and must be avoided after the VAD implantation.

Travel: One of the goals of this procedure is to improve the quality of your life. We encourage you to travel if this something you enjoy doing. However, if you travel outside of the city, please let your medical team know in advance so that we can provide you additional information and assist you with an emergency plan that you may need for air travel.

Driveline and Device Care: Driveline exit site dressings must be performed as directed by the VAD team. Maintenance care of the equipment, batteries, and driveline is necessary to prevent pump failure, infections, or other serious complications. 

Substances, tobacco, and alcohol: If alcohol, tobacco, or other substance abuse has been identified as an issue, you must commit to stopping these activities. You may be screened for drugs, alcohol, or nicotine use. 

Driving: In general, you won’t be allowed to drive until your chest bone (sternum) has healed, which normally takes about 8 weeks, and you have physically recovered from the implant surgery. Other medical issues may prohibit driving but, in most cases, patients with a VAD will be able to continue driving.

MRI: You should never get an MRI test because of the magnetic fields. 

Although there are limitations, the majority of patients who undergo VAD implantation eventually feel better than they did before the surgery and resume many of the activities they previously enjoyed. 

EMOTIONAL WELLBEING WITH VAD

The potential emotional risks after VAD include (but are not limited to) depression, post-traumatic stress disorder, and generalized anxiety. The responsibility of having a VAD, taking a new medication, and adjusting to life with a VAD can be overwhelming and you may find yourself feeling anxious about these changes. Depression is very common in patients who have been diagnosed with heart disease. It is also very common to experience feelings of depression and/or anxiety after surgery and once you are home from the hospital.

Symptoms of Depression:

  • feeling “down in the dumps”, unable to identify how you are feeling
  • loss of interest or pleasure in activities you used to enjoy
  • being irritable
  • unable to sit still, pacing, pulling or rubbing on skin clothes, or other objects
  • increase or decrease in appetite
  • increase or decrease in the amount of sleep
  • fatigue & decreased level of energy
  • feelings of worthlessness or guilt, difficulty thinking, concentrating, deciding, or remembering things
  • thoughts of death or self-harm

Symptoms of Anxiety:

  • restlessness or feeling on edge
  • getting tired easily
  • difficulty concentrating 
  • being irritable
  • muscle tension
  • sleep disturbances (difficulty falling or staying asleep, restlessness)
  • racing thoughts
  • excessive worry

Surgery and hospitalization can be a traumatic event and can sometimes bring up feelings or reactions from past traumatic events (such as illness, loss of a loved one, natural disaster, car accident, etc.).  

Symptoms of Post-Traumatic Stress Disorder:

  • an intense feeling of fear
  • feeling helpless
  • agitated behaviors (angry outbursts)
  • avoiding things that remind you of the traumatic event
  • feeling “numb”
  • being overly attentive to your surroundings, easily startled
  • nightmares or “flashbacks” related to the traumatic event
  • being irritable
  • difficulty concentrating or completing tasks

Temporary feelings of sadness are normal and should gradually go away within a few weeks as you get back to your normal routine and activities. If you experience any of the above symptoms and feel they are interfering with your ability to live a fulfilling life, please contact your VAD team for help. 

We will provide the necessary psychological support and counseling. If your doctors feel that you would benefit, you may be placed on antidepressant therapy to control these symptoms. If required additional help from a qualified psychiatrist will also be arranged to help the patient and family, cope with their challenges.

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Saturday, September 12, 2020

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