Re: Re: Article on silicone implants/saline and fibromyalgia....Great:

[Guest guest]

Dearest Mika:

I thought that you were an American, good luck with your explent. Dr. Kuusk is a good surgeon; however, some of the women claim that she will not talk about the dangers of these devices. I might have to go to her to get this garbage removed from my body. I hate to tell you, but I am so afraid of flying. We would have to drive to Vancouver, and that coud be a problem because of my blood problems. My breasts are both very painful, and we just do not know what could be in my breasts.

Sending love always....Lea

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Re: Article on silicone implants/saline and fibromyalgia

Hi Patty,Thank you for extracting the key info from that article. I also foundthe addition of 'silicone related disorder' to be medicalpractitioners discourse refreshing. No more of them telling us its allin our heads.Unfortunately I'm also in the category of women that might take awhile to recover. My symptoms came on a year after surgery. I got verysick then with non-stop pain. It turns out that my implant wasraptured from the start and I guess the silicone shell might have beenin a poor shape. 5 years later the implant became fully deflated andonly then did my plastic surgeon agree that I did have a leak all thistime. I got better after they replaced that 1 implant and have beenso-so since then. Recently I was worse again, but I have only 2 moremonths till the en-bloc explantation. For all of you ladies from Canada, I found it very easy to have healthinsurance cover my explant surgery (in full) at least in case whereyou are in pain and/or sick. If you see a doctor who specializes inperforming explants, he/she will know what to do and will apply onyour behalf. I'm being explanted by Dr Kuusk (Vancouver) and shecertainly knows the process.Mika.> >> > Hey All,> > > > I found this article very enlightening. It's a bit old (2001) but > I'm> > still catching up on my research :-) I added some comments (in> > brackets with my name included to elaborate on some of the > scientific> > jargon).> > > > Mika> > > > Vasey, B. M.D.; Mills, R. M.D.; Wells, Alvin F. M.D.> > Plastic & Reconstructive Surgery, Issue: > > Volume 108(7), December 2001, pp 2165-2166> > > > Plastic and Reconstructive Surgery has recently published three> > important studies on the relationship of constitutional symptoms to> > silicone gel-filled breast implants.> > > > The first study, by Fryzek et al., showed that 20 of 28 symptoms > were> > statistically significantly increased in women with local implant> > complications compared with those without such complications. 1> > > > The second study, by Fryzek et al., showed that all 28 symptoms were> > increased, and 16 were statistically significantly increased in > women> > with gel-filled silicone breast implants in comparison with women > who> > underwent reduction mammaplasty. (Mika: the reduction mammaplasty is> > just a control group against which they measured the women with> > implants. Both groups had surgeries on their breasts which makes > them> > equivalent on some factors, making their findings stronger)> > > > The third study, by Rohrich et al., showed improvement in a number > of> > musculoskeletal symptoms, general health, and feelings of depression> > after a relatively short follow-up of 6 months after implant > removal.> > 3 However, Rohrich et al. state that 50 percent of the explanted > women> > eventually chose to have their implants replaced. Any data concluded> > from these women will be biased because of their continued exposure > to> > silicone in the envelope of the saline-filled implants. Should these> > women continue to be included in the explanted group, the power of > the> > study to prove a statistically significant difference between groups> > is weakened. Therefore, women who have their implants replaced > should> > form a new category to be studied separately from those who remain> > explanted. The authors also questioned whether the improvement> > observed at 6 months would continue.> > > > We have performed a similar prospective study using a Likert scale> > (Mika: Scale which asks readers to rate something from 1 to 5 with> > 1-labeled 'very much' and 5 labeled 'not at all' or similar) with 36> > signs and symptoms comparing symptomatic women who removed and did > not> > replace silicone gel-filled implants (n = 43) with those who decided> > to leave the implants in place despite being advised to consider> > removal (n = 52). 4 Six women who exchanged gel-filled for> > saline-filled implants were deleted from the study. Our average> > follow-up was 18 months, with slow steady improvement in the scores> > noted in the implant removal group. In addition, our study showed> > steady worsening in the women who left their implants in place.> > > > Additionally, just published is a Food and Drug Administration > study 5> > offering magnetic resonance imaging of the breast to women with> > silicone gel breast implants. The study correlated fibromyalgia with> > extracapsular ruptures. The relative risk was 2.8. The absolute> > comparison was that 24.7 percent of women with extracapsular > ruptures> > had fibromyalgia, whereas 11 percent had fibromyalgia with either> > contained rupture or no rupture. There was no control group, but a> > house-to-house survey in Kansas showed a baseline fibromyalgia rate > of> > 2 percent. 6> > > > Together, these studies provide further evidence that silicone > causes> > a new rheumatic syndrome that rheumatologists have named> > silicone-related disorder.> > > > After seeing approximately 1500 affected women over the past 15 > years,> > several clinical observations (Mika: aka women seen by medical> > practitioners, rather than women in studies) have been helpful in> > making the diagnosis of silicone-related disorder. These women also> > have both local and diffuse musculoskeletal complaints. The diffuse> > symptoms of the disorder are similar to those of fibromyalgia> > including muscle pain, chronic fatigue, and multiple trigger points.> > However, unlike naturally occurring fibromyalgia, exercise > aggravates> > the muscle pain. Most symptomatic women will have bladder > dysfunction.> > Symptoms include frequency, dysuria, urgency, nocturia, and even> > hematuria. These symptoms are similar to those seen with urinary > tract> > infections but with sterile cultures. We suspect that the> > disintegration and spread and ultimate excretion of silica debris> > through the urinary system cause local bladder irritation even to > the> > point of interstitial cystitis.> > > > Once a diagnosis of silicone-related disorder is established, the> > patient should be told to consider removal of the implants. Most > women> > with this disorder stabilize after implant removal but have variable> > rates of recovery. Most women tend to improve very slowly over time.> > We have identified three adverse events that predict a longer > recovery> > and a more severe illness: women with prompt onset of constitutional> > symptoms in the first 2 years after implant placement; delayed > removal> > of implants despite worsening symptoms; and gross extracapsular> > rupture with spread of silicone debris in the chest wall.> > > > Epidemiological studies have focused on rare or unusual rheumatic> > disorders such as scleroderma, systemic lupus erythematosus, and> > undifferentiated connective tissue diseases. Fibromyalgia and > chronic> > fatigue syndrome have been systematically excluded from> > epidemiological study with the exception of Scandinavian studies of> > hospital records. Fibromyalgia and chronic fatigue patients are not> > usually hospitalized, limiting the usefulness of these studies as > well.> > > > Very few data are available to guide physicians in advising women > with> > silicone-related disorder for or against replacement with> > saline-filled breast implants. In a cross-sectional study of 32> > symptomatic women who replaced their gel-filled implants with> > saline-filled (silicone envelope) implants, only 30 percent improved> > over 18 months. 7 In comparison, our original series showed that 70> > percent of the women who removed their implants and left them out > for> > years had significant improvement. 8 We have also seen women relapse> > after replacement with saline-filled implants. We believe the > silicone> > envelope is enough to aggravate the already silicone-sensitized > immune> > system in some women. Larger-scale long-term studies are needed to> > give women adequate information about the risks of replacement of> > silicone gel-filled implants with saline implants. Until then, women> > should be cautioned about the potential for adverse consequences.> > > > As always, women need to weigh the cosmetic benefits of having > breast> > implants against the gradually improving understanding of the risks.> > We believe the incidence of a silicone immune sensitization syndrome> > will be lower with a smaller amount of silicone exposure in> > saline-filled implants in comparison with the gel-filled implants.> > Some women's immune systems will not tolerate even saline-filled> > silicone envelope implants.> > > > The silicone breast implant controversy continues. All four recent> > studies support our concern that not all women's bodies will > tolerate> > silicone implants. Women who develop an unexplained chronic> > fatigue/fibromyalgia-like illness after augmentation with either> > silicone gel-filled or saline-filled implants should strongly > consider> > implant removal.> > > > B. Vasey, M.D.> > > > R. Mills, M.D.> > > > Alvin F. Wells, M.D.> >>