The ABC’s of ICD’s [the device implanted in Blues player Jay Bouwmeester]

Picture a nice size orange.  Imagine it cut it in half.  Stick two thin wires into the orange.

Then close your eyes and think of a surgeon placing the orange in the upper left edge of your chest, just below the collarbone, and plugging the wires into your heart.

St. Louis Blue Jay Bouwmeester now has an Implantable Cardioverter Defibrillator, around the size of that orange, monitoring every beat of his heart.  If the processor in the ICD detects an issue it can jolt his heart with electricity to restore proper beat, or, it can act as a pacemaker to restrict or increase his heart beat rate.

Such technology isn’t cheap:  roughly $30,000 to $50,000 for the device, plus installation and monitoring cost.

Still, ICDs have an impressive track record of saving and extending lives.  Best guess is that 800,000 Americans now have ICD’s, with about 120,000 joining JB this year.  (If those numbers don’t seem to match-up, well, many, many ICD owners never have to worry about device durability.)

Like me, Bouwmeester seems to have experienced a bit of Sudden Cardiac Arrest aka Sudden Cardiac Death.  Only the intervention of medical professionals and an Automatic External Defibrillator changed that last word to “arrest,” as happened in my case.

Ironically, ICDs emerged from the Cold War.  Hubert H. Humphrey visited Russia in 1962 and was awed by their efforts to re-start hearts.  “Let’s compete with the U.S.S.R. in research on reversibility of death.”  [Congressional Record, 10/12/62]

By 1985 researchers had prototype ICDs and by the early 1990’s they became available to the public.  Thanks to the level of need and the price point, multiple companies keep improving the product, issuing new generations of devices.  A new recipient such as JB can look forward to a decade of trouble-free service before his ICD needs to be replaced or recharged.  (My 2009 model had a projected life of seven to nine years:  it will hit 11 years this July.)

Yes, an ICD cheats death and offers peace of mind.  Living with it isn’t all fun and games.

In the mass of papers I came home with after my installation was a form for a handicap placard or a disabled drive license plate.  Having a defibrillator, you see, makes you disabled by Missouri Department of Revenue standards.  That ICD exempts you from employment in many professions: while I don’t recall seeing National Hockey League player on the list, I suspect that liability-wary lawyers will keep JB off the ice as a player.  (I’d bet he could coach to his heart’s content.)

And, with an ICD comes a long list of warnings.  The latest list from Boston Scientific (who made my device) is 47 pages including, for example, saying Don’t Tour Hydroelectric Facilities.  Caution is required around other stuff producing electromagnetic fields, including cell phones.  (Hand units should always be used at the ear furthest from the ICD.)  Some store security systems can get an ICD owner’s attention, and, don’t sit an electric car while its charging. [https://www.bostonscientific.com/content/dam/lifebeat-online/en/documents/BSC_Electromagnetic_Compatibility_Guide.pdf ]

The section on airport security keeps changing.  Today it advises that quick exposures to metal detectors shouldn’t cause an issue.  Back around 2010 I had several jolting experiences with TSA equipment, as well as encountering a prevalent bureaucratic disdain for accepting the government’s rules, including my right to a hand search.  To be safe, I still demand a hand pat down – a process which adds anywhere from one to 45 minutes of extra time at the checkpoint.

Sadly, most TSA workers don’t understand how their own equipment works.  For example, the back scatter machines emit very little radiation on the traveler:  that traveler is standing over the guts of the machine which create a helluva electromagnetic field.  Also, if TSA’s equipment miss that metallic orange size bump in a chest we’re all in danger.

Yes, with an ICD comes a formal looking wallet-size ID card to show TSA and other security people…it’s worthless.  Security types either grant the pat-down or refuse, regardless of the card.

I expect that in a few weeks Jay Bouwmeester will be back home.  It will be a changed life but he can still be anywhere with his family, exercise and do as much as 99% of the population.

And, after about a year you get use to that bump in your chest.