Remede Phrenic Nerve Stimulator

Electrophysiology Lab

 

Remede is a fully implantable system to treat central sleep apnea in adults. This device can improve oxygen levels in the blood while sleeping and increase deep sleep. This will help improve your overall quality of sleep.  The system includes a battery and leads that are similar to a pacemaker. The device is placed in the upper chest, usually on the right side. The stimulation lead is placed in a blood vessel near the phrenic nerve in the chest to send signals to the diaphragm. These signals stimulate breathing in the same way that the brain signals breathing.

 

  • Incision check appointment:
  • 6 weeks post-operative office visit in sleep medicine clinic for activation of the device.

 

It is important that you follow these directions when you get home:

Activity restrictions

  • Do not lift your affected arm over your shoulder (on the side of the device) for 6 weeks.
  • Do not swim, play tennis, ski, or golf for 3 months.
  • Avoid activities likely to cause injury to the skin over the device.
  • Before scuba diving or using a hyperbaric chamber, discuss the effects of high pressure with your doctor.
  • Please wear an arm sling while you sleep for the first 6 weeks until your device is activated.
  • Walk! We encourage you to walk. Start slowly and increase as able.
  • It is important to use the arm for limited activity and not to keep it still.
  • Driving restriction:

 

      Incision care

  • Wash your hands thoroughly before touching the incision site. 
  • You may sponge bathe, but do not get the incision or bandage wet for 48 hours after the procedure. You may shower after 48 hours but avoid direct water spray on your incision for one week.  Do not soak your incision in the bathtub until it is fully healed (about 3 weeks).
  • Clean around your incision by gently washing it with a wet soapy cloth. Do not directly wash the incision site. Then, rinse thoroughly with a wet cloth. Pat dry with gentle motions.  Keep your incision dry. Do not use ointments, lotions, or powders on the incision until healed (about 3 weeks).
  • After removing the dressing, you may have Steri-strip tape or Dermabond surgical glue over the incision. Do not remove the Steri-strip tape or dermabond. Let them fall off or let the glue dissolve on its own. You may clip the ends of the steri strips as they curl.
  • It is normal to have a bruise or mild swelling. This may take several weeks to heal.

 

 Medicines

  • You may get a prescription for pain medicine to take if needed. Tylenol (acetaminophen) can be taken if needed for incision pain.
  • Please resume your other medicines right away unless told otherwise.
  • You may be on antibiotics for 3 to 5 days after discharge. If prescribed, please start the antibiotics right away after leaving the hospital. Be sure to take ALL the pills you get.

           Antibiotic_________________________________________________________

No antibiotic ___________________________________________________

 

 

 When to call the doctor

Please tell your doctor if you:

  • Notice an increase in swelling, drainage, tenderness, or redness at the incision site or have a fever of 99 degrees F or higher.
  • Arm becomes swollen or if pain lasts after the healing of your incision.
  • Bleeding from the incision site that does not stop with mild pressure applied for 5 minutes.
  • Have a rash, itching, or hives within 24 hours of the procedure.

 

 General information

  • Always carry your remede system ID at all times. Because this device is placed in the chest similar to a heart device, it could be mistaken for a heart device.
  • Your system ID card should be shown for reference when visiting doctors, dentists, diagnostic testing, and airport security.

Contact numbers

  • If you have questions or concerns, please contact the Electrophysiology Department at 720.848.6510 Monday through Friday, 8 a.m. to 4 p.m.
  • If you have questions or concerns when the office is not open (after hours, weekends, holidays), please call 720.848.0000. Ask the operator to page the EP doctor.
  • For emergencies, please dial 911.

 

© 2022, University of Colorado Hospital, Aurora

September 2022

Remede Discharge_EP