Guest guest Posted May 9, 2002 Report Share Posted May 9, 2002 How timely--just received a e-mail from a correspondent who has discovered she has contracted the Aspergillis fungus/mold--she is not the first that I know of who recuped (supposedly) from her silicone ruptures and then contracted this. One's husband had a landscape business and much of his plant growth, mulch, etc. was located in their yard; the other found some mold in her home. This is something to beware of--spores can be just breathed in. . .it might be a good idea for those living in humid climates to thoroughly check homes. Basements and bathrooms are susceptible anywhere--it's something of which we learned and of which we were cognizant when renovating apartments in Florida. One can have this for quite a while and not know it until it's bad enough to manifest symptoms. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2002 Report Share Posted May 9, 2002 http://www.doh.wa.gov/ehp/oehas/mold.html Is Indoor Mold Contamination a Threat to Health?Harriet M. Ammann, Ph.D., D.A.B.T.Senior ToxicologistWashington State Department of HealthOlympia, Washington The Fungus Among UsMolds, a subset of the fungi, are ubiquitous on our planet. Fungi are found in every ecological niche, and are necessary for the recycling of organic building blocks that allow plants and animals to live. Included in the group "fungi" are yeasts, molds and mildews, as well as large mushrooms, puffballs and bracket fungi that grow on dead trees. Fungi need external organic food sources and water to be able to grow. MoldsMolds can grow on cloth, carpets, leather, wood, sheet rock, insulation (and on human foods) when moist conditions exist (Gravesen et al., 1999). Because molds grow in moist or wet indoor environments, it is possible for people to become exposed to molds and their products, either by direct contact on surfaces, or through the air, if mold spores, fragments, or mold products are aerosolized. Many molds reproduce by making spores, which, if they land on a moist food source, can germinate and begin producing a branching network of cells called hyphae. Molds have varying requirements for moisture, food, temperature and other environmental conditions for growth. Indoor spaces that are wet, and have organic materials that mold can use as a food source, can and do support mold growth. Mold spores or fragments that become airborne can expose people indoors through inhalation or skin contact. Molds can have an impact on human health, depending on the nature of the species involved, the metabolic products being produced by these species, the amount and duration of individual’s exposure to mold parts or products, and the specific susceptibility of those exposed. Health effects generally fall into four categories. These four categories are allergy, infection, irritation (mucous membrane and sensory), and toxicity. AllergyThe most common response to mold exposure may be allergy. People who are atopic, that is, who are genetically capable of producing an allergic response, may develop symptoms of allergy when their respiratory system or skin is exposed to mold or mold products to which they have become sensitized. Sensitization can occur in atopic individuals with sufficient exposure. Allergic reactions can range from mild, transitory responses, to severe, chronic illnesses. The Institute of Medicine (1993) estimates that one in five Americans suffers from allergic rhinitis, the single most common chronic disease experienced by humans. Additionally, about 14 % of the population suffers from allergy-related sinusitis, while 10 to 12% of Americans have allergically-related asthma. About 9% experience allergic dermatitis. A very much smaller number, less than one percent, suffer serious chronic allergic diseases such as allergic bronchopulmonary aspergillosis (ABPA) and hypersensitivity pneumonitis (Institute of Medicine, 1993). Allergic fungal sinusitis is a not uncommon illness among atopic individuals residing or working in moldy environments. There is some question whether this illness is solely allergic or has an infectious component. Molds are just one of several sources of indoor allergens, including house dust mites, cockroaches, effluvia from domestic pets (birds, rodents, dogs, cats) and microorganisms (including molds). While there are thousands of different molds that can contaminate indoor air, purified allergens have been recovered from only a few of them. This means that atopic individuals may be exposed to molds found indoors and develop sensitization, yet not be identified as having mold allergy. Allergy tests performed by physicians involve challenge of an individual’s immune system by specific mold allergens. Since the reaction is highly specific, it is possible that even closely related mold species may cause allergy, yet that allergy may not be detected through challenge with the few purified mold allergens available for allergy tests. Thus a positive mold allergy test indicates sensitization to an antigen contained in the test allergen (and perhaps to other fungal allergens) while a negative test does not rule out mold allergy for atopic individuals. InfectionInfection from molds that grow in indoor environments is not a common occurrence, except in certain susceptible populations, such as those with immune compromise from disease or drug treatment. A number of Aspergillus species that can grow indoors are known to be pathogens. Aspergillus fumigatus (A. fumigatus) is a weak pathogen that is thought to cause infections (called aspergilloses) only in susceptible individuals. It is known to be a source of nosocomial infections, especially among immune-compromised patients. Such infections can affect the skin, the eyes, the lung, or other organs and systems. A. fumigatus is also fairly commonly implicated in ABPA and allergic fungal sinusitis. Aspergillus flavus has also been found as a source of nosocomial infections (Gravesen et al., 1994). There are other fungi that cause systemic infections, such as Coccidioides, Histoplasma, and Blastomyces. These fungi grow in soil or may be carried by bats and birds, but do not generally grow in indoor environments. Their occurrence is linked to exposure to wind-borne or animal-borne contamination. Mucous Membrane and Trigeminal Nerve IrritationA third group of possible health effects from fungal exposure derives from the volatile compounds (VOC) produced through fungal primary or secondary metabolism, and released into indoor air. Some of these volatile compounds are produced continually as the fungus consumes its energy source during primary metabolic processes. (Primary metabolic processes are those necessary to sustain an individual organism’s life, including energy extraction from foods, and the syntheses of structural and functional molecules such as proteins, nucleic acids and lipids). Depending on available oxygen, fungi may engage in aerobic or anaerobic metabolism. They may produce alcohols or aldehydes and acidic molecules. Such compounds in low but sufficient aggregate concentration can irritate the mucous membranes of the eyes and respiratory system. Just as occurs with human food consumption, the nature of the food source on which a fungus grows may result in particularly pungent or unpleasant primary metabolic products. Certain fungi can release highly toxic gases from the substrate on which they grow. For instance, one fungus growing on wallpaper released the highly toxic gas arsine from arsenic containing pigments (Gravesen, et al., 1994). Fungi can also produce secondary metabolites as needed. These are not produced at all times since they require extra energy from the organism. Such secondary metabolites are the compounds that are frequently identified with typically "moldy" or "musty" smells associated with the presence of growing mold. However, compounds such as pinene and limonene that are used as solvents and cleaning agents can also have a fungal source. Depending on concentration, these compounds are considered to have a pleasant or "clean" odor by some people. Fungal volatile secondary metabolites also impart flavors and odors to food. Some of these, as in certain cheeses, are deemed desirable, while others may be associated with food spoilage. There is little information about the advantage that the production of volatile secondary metabolites imparts to the fungal organism. The production of some compounds is closely related to sporulation of the organism. "Off" tastes may be of selective advantage to the survival of the fungus, if not to the consumer. In addition to mucous membrane irritation, fungal volatile compounds may impact the "common chemical sense" which senses pungency and responds to it. This sense is primarily associated with the trigeminal nerve (and to a lesser extent the vagus nerve). This mixed (sensory and motor) nerve responds to pungency, not odor, by initiating avoidance reactions, including breath holding, discomfort, or paresthesias, or odd sensations, such as itching, burning, and skin crawling. Changes in sensation, swelling of mucous membranes, constriction of respiratory smooth muscle, or dilation of surface blood vessels may be part of fight or flight reactions in response to trigeminal nerve stimulation. Decreased attention, disorientation, diminished reflex time, dizziness and other effects can also result from such exposures (Otto et al., 1989) It is difficult to determine whether the level of volatile compounds produced by fungi influence the total concentration of common VOCs found indoors to any great extent. A mold-contaminated building may have a significant contribution derived from its fungal contaminants that is added to those VOCs emitted by building materials, paints, plastics and cleaners. and co-workers (1988) measured a total VOC concentration approaching the levels at which Otto et al., (1989) found trigeminal nerve effects. At higher exposure levels, VOCs from any source are mucous membrane irritants, and can have an effect on the central nervous system, producing such symptoms as headache, attention deficit, inability to concentrate or dizziness. Adverse Reactions to OdorOdors produced by molds may also adversely affect some individuals. Ability to perceive odors and respond to them is highly variable among people. Some individuals can detect extremely low concentrations of volatile compounds, while others require high levels for perception. An analogy to music may give perspective to odor response. What is beautiful music to one individual is unbearable noise to another. Some people derive enjoyment from odors of all kinds. Others may respond with headache, nasal stuffiness, nausea or even vomiting to certain odors including various perfumes, cigarette smoke, diesel exhaust or moldy odors. It is not know whether such responses are learned, or are time-dependent sensitization of portions of the brain, perhaps mediated through the olfactory sense (Bell, et al., 1993a; Bell et al., 1993b), or whether they serve a protective function. Asthmatics may respond to odors with symptoms. ToxicityMolds can produce other secondary metabolites such as antibiotics and mycotoxins. Antibiotics are isolated from mold (and some bacterial) cultures and some of their bacteriotoxic or bacteriostatic properties are exploited medicinally to combat infections. Mycotoxins are also products of secondary metabolism of molds. They are not essential to maintaining the life of the mold cell in a primary way (at least in a friendly world), such as obtaining energy or synthesizing structural components, informational molecules or enzymes. They are products whose function seems to be to give molds a competitive advantage over other mold species and bacteria. Mycotoxins are nearly all cytotoxic, disrupting various cellular structures such as membranes, and interfering with vital cellular processes such as protein, RNA and DNA synthesis. Of course they are also toxic to the cells of higher plants and animals, including humans. Mycotoxins vary in specificity and potency for their target cells, cell structures or cell processes by species and strain of the mold that produces them. Higher organisms are not specifically targeted by mycotoxins, but seem to be caught in the crossfire of the biochemical warfare among mold species and molds and bacteria vying for the same ecological niche. Not all molds produce mycotoxins, but numerous species do (including some found indoors in contaminated buildings). Toxigenic molds vary in their mycotoxin production depending on the substrate on which they grow (Jarvis, 1990). The spores, with which the toxins are primarily associated, are cast off in blooms that vary with the mold’s diurnal, seasonal and life cycle stage (Burge, 1990; Yang, 1995). The presence of competitive organisms may play a role, as some molds grown in monoculture in the laboratory lose their toxic potency (Jarvis, 1995). Until relatively recently, mold poisons were regarded with concern primarily as contaminants in foods. More recently concern has arisen over exposure to multiple mycotoxins from a mixture of mold spores growing in wet indoor environments. Health effects from exposures to such mixtures can differ from those related to single mycotoxins in controlled laboratory exposures. Indoor exposures to toxigenic molds resemble field exposures of animals more closely than they do controlled experimental laboratory exposures. Animals in controlled laboratory exposures are healthy, of the same age, raised under optimum conditions, and have only the challenge of known doses of a single toxic agent via a single exposure route. In contrast, animals in field exposures are of mixed ages, and states of health, may be living in less than optimum environmental and nutritional conditions, and are exposed to a mixture of toxic agents by multiple exposure routes. Exposures to individual toxins may be much lower than those required to elicit an adverse reaction in a small controlled exposure group of ten animals per dose group. The effects from exposure may therefore not fit neatly into the description given for any single toxin, or the effects from a particular species, of mold. Field exposures of animals to molds (in contrast to controlled laboratory exposures) show effects on the immune system as the lowest observed adverse effect. Such immune effects are manifested in animals as increased susceptibility to infectious diseases (Jakab et al., 1994). It is important to note that almost all mycotoxins have an immunosuppressive effect, although the exact target within the immune system may differ. Many are also cytotoxic, so that they have route of entry effects that may be damaging to the gut, the skin or the lung. Such cytotoxicity may affect the physical defense mechanisms of the respiratory tract, decreasing the ability of the airways to clear particulate contaminants (including bacteria or viruses), or damage alveolar macrophages, thus preventing clearance of contaminants from the deeper lung. The combined result of these activities is to increase the susceptibility of the exposed person to infectious disease, and to reduce his defense against other contaminants. They may also increase susceptibility to cancer Because indoor samples are usually comprised of a mixture of molds and their spores, it has been suggested that a general test for cytotoxicity be applied to a total indoor sample to assess the potential for hazard as a rough assessment (Gareis, 1995). The following summary of toxins and their targets is adapted from and Moss (1985), with a few additions from the more recent literature. While this compilation of effects does not describe the effects from multiple exposures, which could include synergistic effects, it does give a better idea of possible results of mycotoxin exposure to multiple molds indoors. Vascular system (increased vascular fragility, hemorrhage into body tissues, or from lung, e.g., aflatoxin, satratoxin, roridins). Digestive system (diarrhea, vomiting, intestinal hemorrhage, liver effects, i.e., necrosis, fibrosis: aflatoxin; caustic effects on mucous membranes: T-2 toxin; anorexia: vomitoxin. Respiratory system: respiratory distress, bleeding from lungs e.g., trichothecenes. Nervous system, tremors, incoordination, depression, headache, e.g., tremorgens, trichothecenes. Cutaneous system : rash, burning sensation sloughing of skin, photosensitization, e.g., trichothecenes. Urinary system, nephrotoxicity, e.g. ochratoxin, citrinin. Reproductive system; infertility, changes in reproductive cycles, e.g. T-2 toxin, zearalenone. Immune system: changes or suppression: many mycotoxins. It should be noted that not all mold genera have been tested for toxins, nor have all species within a genus necessarily been tested. Conditions for toxin production varies with cell and diurnal and seasonal cycles and substrate on which the mold grows, and those conditions created for laboratory culture may differ from those the mold encounters in its environment. Toxicity can arise from exposure to mycotoxins via inhalation of mycotoxin-containing mold spores or through skin contact with the toxigenic molds (Forgacs, 1972; Croft et al., 1986; Kemppainen et al., 1988 -1989). A number of toxigenic molds have been found during indoor air quality investigations in different parts of the world. Among the genera most frequently found in numbers exceeding levels that they reach outdoors are Aspergillus, Penicillium, Stachybotrys, and Cladosporium (Burge, 1986; et al., 1992; Hirsh and Sosman, 1976; Verhoeff et al., 1992; et al., 1988; Gravesen et al., 1999). Penicillium, Aspergillus and Stachybotrys toxicity, especially as it relates to indoor exposures, will be discussed briefly in the paragraphs that follow. PenicilliumPenicillium species have been shown to be fairly common indoors, even in clean environments, but certainly begin to show up in problem buildings in numbers greater than outdoors (Burge, 1986; et al., 1988; Flannigan and , 1994). Spores have the highest concentrations of mycotoxins, although the vegetative portion of the mold, the mycelium, can also contain the poison. Viability of spores is not essential to toxicity, so that the spore as a dead particle can still be a source of toxin. Important toxins produced by penicillia include nephrotoxic citrinin, produced by P. citrinum, P. expansum and P. viridicatum; nephrotoxic ochratoxin, from P. cyclopium and P. viridicatum, and patulin, cytotoxic and carcinogenic in rats, from P. expansum ( and Moss, 1985). AspergillusAspergillus species are also fairly prevalent in problem buildings. This genus contains several toxigenic species, among which the most important are, A. parasiticus, A. flavus, and A. fumigatus. Aflatoxins produced by the first two species are among the most extensively studied mycotoxins. They are among the most toxic substances known, being acutely toxic to the liver, brain, kidneys and heart, and with chronic exposure, potent carcinogens of the liver. They are also teratogenic ( and Moss, 1985; Burge, 1986). Symptoms of acute aflatoxicosis are fever, vomiting, coma and convulsions ( and Moss, 1985). A. flavus is found indoors in tropical and subtropical regions, and occasionally in specific environments such as flowerpots. A. fumigatus has been found in many indoor samples. A more common aspergillus species found in wet buildings is A. versicolor, where it has been found growing on wallpaper, wooden floors, fibreboard and other building material. A. versicolor does not produce aflatoxins, but does produce a less potent toxin, sterigmatocystin, an aflatoxin precursor (Gravesen et al., 1994). While symptoms of aflatoxin exposure through ingestion are well described, symptoms of exposure such as might occur in most moderately contaminated buildings are not know, but are undoubtedly less severe due to reduced exposure. However, the potent toxicity of these agents advise that prudent prevention of exposures are warranted when levels of aspergilli indoors exceed outdoor levels by any significant amount. A. fumigatus has been found in many indoor samples. This mold is more often associated with the infectious disease aspergillosis, but this species does produce poisons for which only crude toxicity tests have been done (Betina, 1989). Recent work has found a number of tremorgenic toxins in the conidia of this species (Land et al., 1994). A. ochraceus produces ochratoxins (also produced by some penicillia as mentioned above). Ochratoxins damage the kidney and are carcinogenic ( and Moss, 1985). Stachybotrys chartarum (atra)Stachybotrys chartarum (atra) has been much discussed in the popular press and has been the subject of a number of building related illness investigations. It is a mold that is not readily measured from air samples because its spores, when wet, are sticky and not easily aerosolized. Because it does not compete well with other molds or bacteria, it is easily overgrown in a sample, especially since it does not grow well on standard media (Jarvis, 1990). Its inability to compete may also result in its being killed off by other organisms in the sample mixture. Thus, even if it is physically captured, it will not be viable and will not be identified in culture, even though it is present in the environment and those who breathe it can have toxic exposures. This organism has a high moisture requirement, so it grows vigorously where moisture has accumulated from roof or wall leaks, or chronically wet areas from plumbing leaks. It is often hidden within the building envelope. When S. chartarum is found in an air sample, it should be searched out in walls or other hidden spaces, where it is likely to be growing in abundance. This mold has a very low nitrogen requirement, and can grow on wet hay and straw, paper, wallpaper, ceiling tiles, carpets, insulation material (especially cellulose-based insulation). It also grows well when wet filter paper is used as a capturing medium. S. chartarum has a well-known history in Russia and the Ukraine, where it has killed thousands of horses, which seem to be especially susceptible to its toxins. These toxins are macrocyclic trichothecenes. They cause lesions of the skin and gastrointestinal tract, and interfere with blood cell formation. (Sorenson, 1993). Persons handling material heavily contaminated with this mold describe symptoms of cough, rhinitis, burning sensations of the mouth and nasal passages and cutaneous irritation at the point of contact, especially in areas of heavy perspiration, such as the armpits or the scrotum (Andrassy et al., 1979). One case study of toxicosis associated with macrocyclic trichothecenes produced by S. chartarum in an indoor exposure, has been published (Croft et al., 1986), and has proven seminal in further investigations for toxic effects from molds found indoors. In this exposure of a family in a home with water damage from a leaky roof, complaints included (variably among family members and a maid) headaches, sore throats, hair loss, flu symptoms, diarrhea, fatigue, dermatitis, general malaise, psychological depression. (Croft et al, 1986; Jarvis, 1995). Johanning, (1996) in an epidemiological and immunological investigation, reports on the health status of office workers after exposure to aerosols containing S. chartarum. Intensity and duration of exposure was related to illness. Statistically significant differences for more exposed groups were increased lower respiratory symptoms, dermatological, eye and constitutional symptoms, chronic fatigue, and allergy history. Duration of employment was associated with upper respiratory, skin and central nervous system disorders. A trend for frequent upper respiratory infections, fungal or yeast infections, and urinary tract infections was also observed. Abnormal findings for components of the immune system were quantified, and it was concluded that higher and longer indoor exposure to S. chartarum results in immune modulation and even slight immune suppression, a finding that supports the observation of more frequent infections. Three articles describing different aspects of an investigation of acute pulmonary hemorrhage in infants, including death of one infant, have been published recently, as well as a CDC evaluation of the investigation (Montaña et al., 1997; Etzel et al., 1998; Jarvis et al., 1998; MMWR, 2000; CDC, 1999). The infants in the Cleveland outbreak were reported with pulmonary hemosiderosis, a sign of an uncommon of lung disease that involves pulmonary hemorrhage. Stachybotrys chartarum was shown to have an association with acute pulmonary bleeding. Additional studies are needed to confirm association and establish causality. Animal experiments in which rats and mice were exposed intranasally and intratracheally to toxic strains of S. chartarum, demonstrated acute pulmonary hemorrhage (Nikkulin et al. 1996). A number of case studies have been more recently published. One involving an infant with pulmonary hemorrhage in Kansas, reported significantly elevated spore counts of Aspergillus/Penicillium in the patient’s bedroom and in the attic of the home. Stachybotrys spores were also found in the air of the bedroom, and the source of the spores tested highly toxigenic (Flappan et al., 1999). In another case study in Houston, Stachybotrys was isolated from bronchopulmonary lavage fluid of a child with pulmonary hemorrhage. (Elidemir et al., 1999), as well as recovered from his water damaged-home. The patient recovered upon removal and stayed well after return to a cleaned home. Another case study reported pulmonary hemorrhage in an infant during induction of general anesthesia. The infant was found to have been exposed to S. chartarum prior to the anesthetic procedure (Tripi et al., 2000). Still another case describes pulmonary hemorrhage in an infant whose home contained toxigenic species of Penicillium and Trichoderma (a mold producing trichothecene poisons similar to the ones produced by S. chartarum) as well as tobacco smoke (Novotny and Dixit, 2000) Toxicologically, S. chartarum can produce extremely potent trichothecene poisons, as evidenced by one-time lethal doses in mice (LD50) as low as 1.0 to 7.0 mg/kg, depending on the toxin and the exposure route. Depression of immune response, and hemorrhage in target organs are characteristic for animals exposed experimentally and in field exposures (Ueno, 1980; Jakab et al., 1994). While there are insufficient studies to establish cause and effect relationships between Stachybotrys exposure indoors and illness, including acute pulmonary bleeding in infants, toxic endpoints and potency for this mold are well described. What is less clear, and has been difficult to establish, is whether exposures indoors are of sufficient magnitude to elicit illness resulting from toxic exposure. Some of these difficulties derive from the nature of the organisms and the toxic products they produce and varying susceptibilities among those exposed. Others relate to problems common to retrospective case control studies. Some of the difficulties in making the connection between toxic mold exposures and illness are discussed below. Limitations in Sampling Methodology, Toxicology, and Epidemiology of Toxic Mold ExposureSome of the difficulties and limitations encountered in establishing links between toxic mold contaminated buildings and illness are listed here: Few toxicological experiments involving mycotoxins have been performed using inhalation, the most probable route for indoor exposures. Defenses of the respiratory system differ from those for ingestion (the route for most mycotoxin experiments). Experimental evidence suggests the respiratory route to produce more severe responses than the digestive route (Cresia et al., 1987) Effects from low level or chronic low level exposures, or ingestion exposures to mixtures of mycotoxins, have generally not been studied, and are unknown. Effects from high level, acute sub-acute and sub-chronic ingestion exposures to single mycotoxins have been studied for many of the mycotoxins isolated. Other mycotoxins have only information on cytotoxicity or in vitro effects. Effects of multiple exposures to mixtures of mycotoxins in air, plus other toxic air pollutants present in all air breathed indoors, are not known. Effects of other biologically active molecules, having allergic or irritant effects, concomitantly acting with mycotoxins, are not known. Measurement of mold spores and fragments varies, depending on instrumentation and methodology used. Comparison of results from different investigators is rarely, if ever, possible with current state of the art. While many mycotoxins can be measured in environmental samples, it is not yet possible to measure mycotoxins in human or animal tissues. For this reason exposure measurements rely on circumstantial evidence such as presence of contamination in the patient’s environment, detection of spores in air, combined with symptomology in keeping with known experimental lesions caused by mycotoxins, to establish an association with illness. Response of individuals exposed indoors to complex aerosols varies depending on their age, gender, state of health, and genetic make-up, as well as degree of exposure. Microbial contamination in buildings can vary greatly, depending on location of growing organisms, and exposure pathways. Presence in a building alone does not constitute exposure. Investigations of patients’ environments generally occur after patients have become ill, and do not necessarily reflect the exposure conditions that occurred during development of the illness. All cases of inhalation exposure to toxic agents suffer from this deficit. However exposures to chemicals not generated biologically can sometimes be re-created, unlike those with active microbial growth. Indoor environments are dynamic ecosystems that change over time as moisture, temperature, food sources and the presence of other growing microorganisms change. Toxin production particularly changes with age of cultures, stage of sporulation, availability of nutrients, moisture, and the presence of competing organisms. After-the-fact measurements of environmental conditions will always reflect only an estimate of exposure conditions at the time of onset of illness. However, presence of toxigenic organisms, and their toxic products, are indicators of putative exposure, which together with knowledge of lesions and effects produced by toxins found, can establish association. Conclusions and RecommendationsPrudent public health practice then indicates removal from exposure through clean up or remediation, and public education about the potential for harm. Not all species within these genera are toxigenic, but it is prudent to assume that when these molds are found in excess indoors that they are treated as though they are toxin producing. It is not always cost effective to measure toxicity, so cautious practice regards the potential for toxicity as serious, aside from other health effects associated with excessive exposure to molds and their products. It is unwise to wait to take action until toxicity is determined after laboratory culture, especially since molds that are toxic in their normal environment may lose their toxicity in laboratory monoculture over time (Jarvis, 1995) and therefore may not be identified as toxic. While testing for toxins is useful for establishing etiology of disease, and adds to knowledge about mold toxicity in the indoor environment, prudent public health practice might advise speedy clean-up, or removal of a heavily exposed populations from exposure as a first resort. Health effects from exposures to molds in indoor environments can result from allergy, infection, mucous membrane and sensory irritation and toxicity alone, or in combination. Mold growth in buildings (in contrast to mold contamination from the outside) always occurs because of unaddressed moisture problems. When excess mold growth occurs, exposure of individuals, and remediation of the moisture problem must be addressed. AuthorHarriet M. Ammann is a senior toxicologist for Washington State Department of Health, Office of Environmental Health Assessments. She provides support to a variety of environmental health programs including ambient and indoor air programs. She has participated in evaluations of schools and public buildings with air quality problems, and has presented on toxic effects from air contaminants, indoors and out, effect on sensitive populations, and other health issues throughout the state. Through her work, she has developed an interest in the toxicology of mold as an indoor air contaminant, and has published and presented on mold toxicity relating to human health. If you have a comment on this paper, please email Harriet Ammann at harriet.ammann@.... We are always happy to hear your views. References Andrassy, K, I.; Horvath, T.; Lakos, and Z. Toke. 1979. Mass incidence of mycotoxicoses in Hajdu-Bihar county. Mykosen 23: 198-133. Bell, I.R.; Schwartz, G.E.; sen, J.M.; et al., 1993a. 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Infant pulmonary hemorrhage in a suburban home with water damage and mold (Stachybotrys atra). EHP 107(11): 927-30. Forgacs, J. 1972. Stachybotryotoxicosis. in Kadis, S.; Agl, S.J.; eds. Microbial Toxins vol. III, Academic Press, Inc. NY. pp. 95-128. Gareis, M. 1995. Cytotoxicity testing of samples originating from problem buildings. Proceedings of the International Conference: Fungi and Bacteria in Indoor Environments: Health Effects, Detection and Remediation. Eckart Johanning and Chin S. Yang, editors. Saratoga Springs, NY, October 6-7, 1994.139-144. Gravesen, S. Frisvad, J.C, Samson, R.A.. 1994. Descriptions of some common fungi. in Microfungi. Munksgaard Copenhagen. 141. Gravesen, S.; Nielsen, P. A.; Iversen, R.; Nielsen, K.F. 1999. Microfungal contamination of damp buildings – examples of constructions and risk materials. EHP 1999 Jun; 107 Suppl. 3:505-508. Hintikka, E.-L. 1978. Human stachybotrystoxicosis. in Wyllie, T.D.; Morehouse, L.G., eds. 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Mycotoxins and indoor air quality. in Biological Contaminants in Indoor Environments ASTM Symposium, Boulder, CO, July 16-19, 1989. Morey, P.R.; Feeley, J.C.; Otten, J.A. eds. pp. 201-214. Jarvis, BB. 1995. Mycotoxins in the air: keep your buildings dry or the bogeyman will get you. 35-44. Proceedings of the International Conference: Fungi and Bacteria in Indoor Environments. Health Effects, Detection and Remediation. Eckardt Johanning and Chin S. Yang, editors. Saratoga Springs, NY. October 6-7, 1994. Jarvis, B.B.; Sorenson,W.G. ;Hintikka, e-L.; et al., 1998. Study of toxin production by isolates of Stachybotrys chartarum and Memnoniella echinata isolated during a study of pulmonary hemosiderosis in infants. Appl. Environ. Microbiol. 64(10): 3620-3625. Johanning, E.; Biagini, R.; Hull, D.L.; Morey, P.; Jarvis, B.; Landbergis, P. 1996. Health and immunology study following exposure to toxigenic fungi (Stachybotrys chartarum) in a water-damaged office environment. Int. Arch. Environ. Health. 68: 207-218. Kemppainen, B.W.; Riley, R.T.; Pace, J.G. 1988-1989. Skin Absorption as a route of exposure for aflatoxin and trichothecenes. J Toxicol -Toxin Reviews 7(2): 95-120. Land, C.J.; Rask-Anderssen, A.; Werner, S.; Bardage, S. 1994. Tremorgenic mycotoxins in conidia of Aspergillus fumigatus. Mason, C.D.; Rand, T.G.; Oulton, M.; Mac, J.M.; , J.E. 1998. Effects of Stachybotrys chartarum (atra) conidia and isolated toxin on lung surfactant production and homeostasis. Nat. Toxins. 6(1): 22-33. , J.D.; LaFlamme, A.M.; Sobol, Y.; LaFontaine, P.; Greenhalgh, R. 1988. Fungi and fungal products in some Canadian homes. International Biodeterioration 24: 103-120. Montaña, E.; Etzel, R.A.; Allan, T.; Horgan, T.E.; Dearborn, D.G. 1997. Environmental risk factors associated with pediatric idiopathic pulmonary hemorrhage and hemosiderosis in a clinical community. Pediatrics 99 (1): 1-8. Morbidity and Mortality Weekly Report (MMWR). 2000. Update: pulmonary hemorrhage/hemosiderosis among infants – Cleveland, Ohio, 1993-1996. Nikulin, M.; Reijula, K.; Jarvis, B.B.; Hintikka, E-L. 1996. Experimental lung mycotoxicosis in mice induced by Stachybotrys atra. Int. J. Exp. Path. 77: 213-218. Northrup, S.C.; Kilburn. 1978. The role of mycotoxins in pulmonary disease. in Mycotoxic Fungi, Mycotoxins, Mycotoxicoses, An Encyclopedic Handbook, vol. 3 Wylie, T.; Morehouse, L. NY Marcel Dekker. Novotny, W.E.; Dixit, A. 2000. Pulmonary hemorrhage in an infant following 2 weeks of fungal exposure. Arch. Pediatr. Adolesc. Med. 154(3): 271-5 Otto, D.; Mølhave, L.; Rose, G. et al.1989. Neurobehavioral and sensory effects of controlled exposure to a complex mixture of volatile organic compounds. Neurotoxicology and Teratology 12:649-652. Pestka, J.J.; Bondy, G.S. 1990. Alteration of immune function following dietary mycotoxin exposure. Can. J. Physiol. Pharmacol. 68:1009-1016. Pier, A.C.; McLoughlin, M.E. 1985. Mycotoxic suppression of immunity. in Trichothecenes and Other Mycotoxins. Proceedings of the International Mycotoxin Symposium. Sidney, Australia, 1984. Lacey, ed. Wiley & Sons. NY. pp. 507-519. Sabbioni, G.; Wild, C.P., 1991. Identification of an aflatoxin G1 -serum albumin adduct and its relevance to the measurement of human exposure to aflatoxins. Carcinogenesis 12: 97-103. , J.E.; Moss, M.O. 1985. Mycotoxins Formation, Analysis, and Significance Wiley and Sons. NY. , J.E.; , J.G.; , C.W.; et al., 1992. Cytotoxic fungal spores in the atmosphere of the damp domestic environment. FEMS Microbiology Letters. 100: 337-344. Sorenson, W.G. 1995. Aerosolized mycotoxins; implications for occupational settings. Proceedings of the International Conference: Fungi and Bacteria in Indoor Environments. Health Effects, Detection and Remediation . Eckardt Johanning and Chin S. Yang, editors. Saratoga Springs, NY. October 6-7, 1994. pp. 57-67. Sorenson, W.G.; Frazer, D.G.; Jarvis, B.B.; Simpson, J.; , V.A. 1987. Trichothecene mycotoxins in aerosolized conidia of Stachybotrys atra. Applied and Environmental Microbiology 53(6): 1370-1375. Sorenson, W.G.; Gerberick, G.F.; , D.M.; Castranova, V. 1986. Toxicity of mycotoxins for the rat pulmonary macrophage in vitro. Environmental Health Perspectives 66: 45-53. Sorenson, W.G.; Simpson, J. 1986. Toxicity of penicillic acid for rat alveolar macrophages in vitro. Environ. Res. 4(2): 505-513. Sorenson, W.G. 1993. Mycotoxins Toxic Metabolites of Fungi Fungal Infections and Immune Response, Juneann W. , editor. Plenum Press, NY. 469-491. Tobin, R.S.; Baranowski, E.; Gilman, A.P.; Kuiper-Goodman, T.; , J.D.; Giddings, M. 1987. Significance of fungi in indoor air: report of a working group. Canadian Journal of Public Health 78: (suppl.), S1-S32. Tripi, P.A.; Modlin, S.; Sorensen, W.G.; Dearborn, D.G. 2000. Acute pulmonary haemorrhage in an infant during induction of general anesthesia. Pediatr. Anesth. 10 (1): 92-4. Verhoeff, A.P.; van Strien, R.T.; Van Wijjnen et al. 1995. Damp housing and childhood respiratory symptoms. The role of sensitization to dust mites and mold. Am. J. of Epidemiology. 141 (20: 103-110. Ueno, Y. 1980. Trichothecene mycotoxins--mycology, chemistry, and toxicology. Adv. Nutr. Sci. 3:301-353. Yang, C.S. 1995. Understanding the biology of fungi indoors. Proceedings from the International Conference: Fungi and Bacteria in Indoor Environments: Health Effects, Detection and Remediation. Saratoga Springs, N.Y. October 6-7, 1994. E. Johanning and C.S.Yang, editors. Pp. 131-137. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2002 Report Share Posted May 9, 2002 Don't know--sounds like mold--also sounds yucky. Did anyone tell you like the path or plastic surgeon? Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2002 Report Share Posted May 9, 2002 -Marie: Are you kidding--lol? Have you ever talked to anyone who was told the risks? Or given any literature? Mine were silicone and performed initially in 1975 by one of the "pioneers" (a Dow consultant) of silicone implants, who is now a very big deal in plastic surgery. He told me I had severe diffuse fibrocystic disease and had to have mastectomies--lost nipples/areolas to necrosis. Family doctors file had copy of mammogram report (of course ps said he didn't have file any longer) and guess what? didn't have this severe diffuse disease. Not to mention that he forgot to remove about 25%. of each breast not found until implant removal--gross ruptures and still have capsule and envelope. No labels in hospital files--likely prototypes. I'm told a doctor has to experiment if he really wants to make a name for himself. My daughter had a silicone augmentation in 1989 and due to red, stiff joints switched to saline in 1993. Essentially, she's OK so far. No, her original doctor didn't tell her squat. The rupture rate and recommendation for replacement every ten years was unknown when she switched. Her first implants compressed her breast tissue and she is for all intents and purposes mastectomized--keeping fingers crossed and hoping to save enough $$$ for reimplantation. These ps' s are very clever with the "consent"--the most common trick seems to be to rush in at the last minute before surgery to have you sign it or an additional one. . . a ploy not unfamiliar from 27 years ago. Their sales pitch is almost the same word for word--been to a few and went with daughter to a few. Think there must be workshops on it. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2002 Report Share Posted May 9, 2002 Marie: She knows she no longer has her breast tissue and that an explant will leave her mastectomized. As she is not ill, we rather ignore this subject and focus on getting them changed. . .another way of living on the edge. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2002 Report Share Posted May 9, 2002 One way to prevent mold in humid climates is to install a dehumidifier in unairconditioned/heated areas - the dehumidifer can be tied into the drain from your AC system. We put one in our home when we built . . . Before they tied it into the AC drain, it was removing a couple gallons of water a day - during a drought! Our basement walls show a small amount of foundation leakage (they tried everything possible to fix it) - but no sign of mold because it dries as fast as it comes in. . . I'm surprized dehumidifiers aren't required in the building codes in spaces that are not heated and air conditioned! . . . Sooner or later there will be mold. My father became deathly ill after sorting papers from such an area. . . instead of seeing the doctor, he began making preparations to die . . only after developing a blood clot several months later did he see a doctor who medicated him for mold and cleared him up quickly. Rogene __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2002 Report Share Posted May 9, 2002 I am guessing you are addressing me, -- it's my daughter who had the silicone implants for four years and due to red, stiff joints switched to saline--that was in 1993--she is OK but we are pushing that ten-year recommended change of implants with not enough $$$. Rupture rates were unknown then. Marie asked if she was going to explant--no, she is not ill and when she made the switch (with mastopexy) we were told her breast tissue was completely compressed- -she has no more breasts--she is 33, the same age I was when I had mastectomies, but I'd already been married, had a child and breastfed. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 10, 2002 Report Share Posted May 10, 2002 I feel like I came in on the end of the story here, but do fill me in, your sister has implants right? is she ill? Did she have a mastectomy? Sorry but I missed this post I guess Love ----- Original Message ----- From: Bos@... Sent: Thursday, May 09, 2002 5:53 PM Subject: Re: Mold Marie: She knows she no longer has her breast tissue and that an explant will leave her mastectomized. As she is not ill, we rather ignore this subject and focus on getting them changed. . .another way of living on the edge. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 10, 2002 Report Share Posted May 10, 2002 Dear Bonnie, I am sorry for your daughters problems, but I am still confused, if she had the joint problems and all that, it sounds like she has some health issues. I guess I don't quite know how you can recommend more implants to her, esp. knowing all that you do about them. Are you aware that there are other options these days for reconstruction that does not involve more dangerous implants? I think that if I was her I would try to seek out an expert like Dr Feng to see what other options there are because in the long run the implants will always require more surgery and more problems to be dealt with down the road. I don't mean to sound harsh, I just have some really strong opinions about implants and I don't think that the risk and the damage they cause are worth it. I also question whoever told her she has no breasts left, that sounds like something a PS would say who might be very interested in continually implanting someone. I know that most women I know who have explanted have also been told how unhappy they would be with explant, but they went ahead and all are happy that they did. I really think I would try to talk to someone who is an expert, like I said there are other options to implants these days, if you look for the right PS to do them, you just might be surprised at the things you will find. Good luck and hope that you think about what I am saying. I am only saying this because I care and also because I do feel that in the long run she may really suffer by emplaning. Blessings ----- Original Message ----- From: Bos@... Sent: Thursday, May 09, 2002 7:21 PM Subject: Re: Mold I am guessing you are addressing me, -- it's my daughter who had the silicone implants for four years and due to red, stiff joints switched to saline--that was in 1993--she is OK but we are pushing that ten-year recommended change of implants with not enough $$$. Rupture rates were unknown then. Marie asked if she was going to explant--no, she is not ill and when she made the switch (with mastopexy) we were told her breast tissue was completely compressed- -she has no more breasts--she is 33, the same age I was when I had mastectomies, but I'd already been married, had a child and breastfed. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 10, 2002 Report Share Posted May 10, 2002 Hi Do u know what else they can do, u said there are more options, just curious.... lani -------Original Message------- From: Date: Thursday, May 09, 2002 9:57:36 PM Subject: Re: Mold Dear Bonnie, I am sorry for your daughters problems, but I am still confused, if she had the joint problems and all that, it sounds like she has some health issues. I guess I don't quite know how you can recommend more implants to her, esp. knowing all that you do about them. Are you aware that there are other options these days for reconstruction that does not involve more dangerous implants? I think that if I was her I would try to seek out an expert like Dr Feng to see what other options there are because in the long run the implants will always require more surgery and more problems to be dealt with down the road. I don't mean to sound harsh, I just have some really strong opinions about implants and I don't think that the risk and the damage they cause are worth it. I also question whoever told her she has no breasts left, that sounds like something a PS would say who might be very interested in continually implanting someone. I know that most women I know who have explanted have also been told how unhappy they would be with explant, but they went ahead and all are happy that they did. I really think I would try to talk to someone who is an expert, like I said there are other options to implants these days, if you look for the right PS to do them, you just might be surprised at the things you will find. Good luck and hope that you think about what I am saying. I am only saying this because I care and also because I do feel that in the long run she may really suffer by emplaning. Blessings ----- Original Message ----- From: Bos@... Sent: Thursday, May 09, 2002 7:21 PM Subject: Re: Mold I am guessing you are addressing me, -- it's my daughter who had the silicone implants for four years and due to red, stiff joints switched to saline--that was in 1993--she is OK but we are pushing that ten-year recommended change of implants with not enough $$$. Rupture rates were unknown then. Marie asked if she was going to explant--no, she is not ill and when she made the switch (with mastopexy) we were told her breast tissue was completely compressed- -she has no more breasts--she is 33, the same age I was when I had mastectomies, but I'd already been married, had a child and breastfed. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 10, 2002 Report Share Posted May 10, 2002 As far as simply augmenting there may not be many options, however there is the vertical mastopexy which when done by an expert can do wonders to shape a nice perky round breast with nipples in the right position and skin tight and firm it is amazing what a good vertical lift can do for a droopy mishapen breast. The other options are fat transfer, which may not add a lot of size but if done right can fill in any small dents or spots on the breast that may need it, also there are tram and pedickle flaps for reconstruction of breasts using ones own tissue, this of course is used for cancer patients not for augmentation patients and is a very big operation. I don't want to be misleading, I realize that for most women if all you want is bigger breasts then there are not many options, but if you are seeking reconstruction then the options to rebuild using your own tissue does exist. To me being healthy is the number one thing so I personally would rather be flat than have implants, I feel so much better than i used to that there is no $$$ in the world that could change that. I hope that makes sense and helps. Remeber too that there are gel,water, air and padded bras and enhancers too, you can always look really good in clothes and you have many different options to use to get the look you want. I also want to tell you that my breasts are small but they are perkier than they were before implants, they look really really good, Dr Feng did an awesome job, the only thing I hate about my breasts now is the stretch marks I got from pregnancy, nothing to do with the lift at all, the lift looks great, i love it, and I am pretty much happy with them, no I don't have stripper boobs but that is cool. I am not a stripper ha ! how are you doing anyhow! ----- Original Message ----- From: Lani Sent: Thursday, May 09, 2002 8:45 PM Subject: Re: Mold Hi Do u know what else they can do, u said there are more options, just curious.... lani -------Original Message------- From: Date: Thursday, May 09, 2002 9:57:36 PM Subject: Re: Mold Dear Bonnie, I am sorry for your daughters problems, but I am still confused, if she had the joint problems and all that, it sounds like she has some health issues. I guess I don't quite know how you can recommend more implants to her, esp. knowing all that you do about them. Are you aware that there are other options these days for reconstruction that does not involve more dangerous implants? I think that if I was her I would try to seek out an expert like Dr Feng to see what other options there are because in the long run the implants will always require more surgery and more problems to be dealt with down the road. I don't mean to sound harsh, I just have some really strong opinions about implants and I don't think that the risk and the damage they cause are worth it. I also question whoever told her she has no breasts left, that sounds like something a PS would say who might be very interested in continually implanting someone. I know that most women I know who have explanted have also been told how unhappy they would be with explant, but they went ahead and all are happy that they did. I really think I would try to talk to someone who is an expert, like I said there are other options to implants these days, if you look for the right PS to do them, you just might be surprised at the things you will find. Good luck and hope that you think about what I am saying. I am only saying this because I care and also because I do feel that in the long run she may really suffer by emplaning. Blessings ----- Original Message ----- From: Bos@... Sent: Thursday, May 09, 2002 7:21 PM Subject: Re: Mold I am guessing you are addressing me, -- it's my daughter who had the silicone implants for four years and due to red, stiff joints switched to saline--that was in 1993--she is OK but we are pushing that ten-year recommended change of implants with not enough $$$. Rupture rates were unknown then. Marie asked if she was going to explant--no, she is not ill and when she made the switch (with mastopexy) we were told her breast tissue was completely compressed- -she has no more breasts--she is 33, the same age I was when I had mastectomies, but I'd already been married, had a child and breastfed. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 10, 2002 Report Share Posted May 10, 2002 Hi carrie, Im doing good thankyou, and u? Did u know u can get thoses stretch marks lasered ........ lani -------Original Message------- From: Date: Thursday, May 09, 2002 10:40:39 PM Subject: Re: Mold As far as simply augmenting there may not be many options, however there is the vertical mastopexy which when done by an expert can do wonders to shape a nice perky round breast with nipples in the right position and skin tight and firm it is amazing what a good vertical lift can do for a droopy mishapen breast. The other options are fat transfer, which may not add a lot of size but if done right can fill in any small dents or spots on the breast that may need it, also there are tram and pedickle flaps for reconstruction of breasts using ones own tissue, this of course is used for cancer patients not for augmentation patients and is a very big operation. I don't want to be misleading, I realize that for most women if all you want is bigger breasts then there are not many options, but if you are seeking reconstruction then the options to rebuild using your own tissue does exist. To me being healthy is the number one thing so I personally would rather be flat than have implants, I feel so much better than i used to that there is no $$$ in the world that could change that. I hope that makes sense and helps. Remeber too that there are gel,water, air and padded bras and enhancers too, you can always look really good in clothes and you have many different options to use to get the look you want. I also want to tell you that my breasts are small but they are perkier than they were before implants, they look really really good, Dr Feng did an awesome job, the only thing I hate about my breasts now is the stretch marks I got from pregnancy, nothing to do with the lift at all, the lift looks great, i love it, and I am pretty much happy with them, no I don't have stripper boobs but that is cool. I am not a stripper ha ! how are you doing anyhow! ----- Original Message ----- From: Lani Sent: Thursday, May 09, 2002 8:45 PM Subject: Re: Mold Hi Do u know what else they can do, u said there are more options, just curious.... lani -------Original Message------- From: Date: Thursday, May 09, 2002 9:57:36 PM Subject: Re: Mold Dear Bonnie, I am sorry for your daughters problems, but I am still confused, if she had the joint problems and all that, it sounds like she has some health issues. I guess I don't quite know how you can recommend more implants to her, esp. knowing all that you do about them. Are you aware that there are other options these days for reconstruction that does not involve more dangerous implants? I think that if I was her I would try to seek out an expert like Dr Feng to see what other options there are because in the long run the implants will always require more surgery and more problems to be dealt with down the road. I don't mean to sound harsh, I just have some really strong opinions about implants and I don't think that the risk and the damage they cause are worth it. I also question whoever told her she has no breasts left, that sounds like something a PS would say who might be very interested in continually implanting someone. I know that most women I know who have explanted have also been told how unhappy they would be with explant, but they went ahead and all are happy that they did. I really think I would try to talk to someone who is an expert, like I said there are other options to implants these days, if you look for the right PS to do them, you just might be surprised at the things you will find. Good luck and hope that you think about what I am saying. I am only saying this because I care and also because I do feel that in the long run she may really suffer by emplaning. Blessings ----- Original Message ----- From: Bos@... Sent: Thursday, May 09, 2002 7:21 PM Subject: Re: Mold I am guessing you are addressing me, -- it's my daughter who had the silicone implants for four years and due to red, stiff joints switched to saline--that was in 1993--she is OK but we are pushing that ten-year recommended change of implants with not enough $$$. Rupture rates were unknown then. Marie asked if she was going to explant--no, she is not ill and when she made the switch (with mastopexy) we were told her breast tissue was completely compressed- -she has no more breasts--she is 33, the same age I was when I had mastectomies, but I'd already been married, had a child and breastfed. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 10, 2002 Report Share Posted May 10, 2002 -- I personally know of three such women who reimplanted with saline who have not had problems--that is not to say they won't at some point in the future. All three started with slight problems with their silicone implants. But I have corresponded with many, many, both with silicone and saline who have become ill. Even if no allergy presents, or bacteria presents, the implant is bound to break down evenutally if not replaced. There seems to be a group that is unaffected by any risk. . .as well as a group that will replace their implants periodically. If I were in a position to have an augmentation, I would not be willing to take the risk. Some people are. There are many physicians/plastic surgeons who do recognize that implants can make one ill--but I've yet to find one who will say that implants will make all women ill. And all of them still implant. . . including Dr. Feng. I think the difference may be that caring plastic surgeons make sure their patients get fully informed consent--from that point on, it is the patient's choice as a fully informed adult. They don't pull any of the tricks that I've heard from so many women and that I experienced myself. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2002 Report Share Posted May 11, 2002 -- If I said that saline is safer than silicone I was indeed misleading. I thought I said that I detected that those who switched from silicone to saline were not having any problems. I personally know three and have read of Dr. Kolb's and have talked to probably six. None were having problems. That is not to say that they won't in the future and at least the three I know are aware of that-- and I'm sure Dr. Kolb is. Imagine changing the implant every 10 years not only precludes rupture, if it hasn't already occurred, but removes the biomaterial to which bacteria adhere--i.e. removes the source. It seems unlikely that allergy to any of the components is an issue with this group of people. And if I said recovering from saline was easier, that too was an error on my part. I thought I said that illness didn't seem to occur as often but when it did, it was the same. There are considerable variables to either type of implant, to the women, to the symptoms and to the recoveries. I've talked to many for quite some time before knowing whether her implants were silicone or saline. I know my daughter is taking a chance--but she is now caught between a rock and a hard place and playing it as cautiously as possible. I don't know what I would do in her position. She liked her doctor and so did I--and he really knew his stuff because I questioned him thoroughly--and he knew I was recuperating. She had four appointments prior to her surgery and spent the night. He is doing reconstruction at Cedars Sinai Cancer Center now so he's probably real adept with implants. I guess you aren't familiar with UCLA, implants, Dr Shaw and Ahn. This is where most wanted to go in the early 90s--and UCLA recognized the problems with the implants--they had a questionnaire to fill out. Aside: While interviewing for changing implants, all three doctors commented on the beautiful result she had and one followed that by saying "We so seldom see that." Dr. Slate didn't tell her before explant that she would have no tissue left after explant;he found that out near the beginning of surgery--and told us afterward. BTW, I have met Dr. Feng, like her and refer patients to her. I see she now has her own clinic--she used to be with Mt. Sinai. I' ve never seen anything remotely related to a reconstruction with ones own breast tissue after mastectomy--could you mean with other body tissue? If the mastectomy was done correctly, there wouldn't be any breast tissue. In any event, I wouldn't qualify--ribs are deteriorated and have just concavities in chest (with excess skin of course)--I don't know how much worse it would be if .5cm capsules were removed--if they could be. Re the quality of contemporary implants--I'm aware that Mentor was cited by the FDA but hadn't heard of Blais announcement yet. Where would I find that? explantation.com? I have wondered if, back in the 90s when this was a publicly hot issue, replacement salines were checked very carefully before being sent to a doctor--saline replacement was the recommended thing then. I have also wondered if institutions receive a more carefully-crafted implant as their orders are large and mean more bucks and future business to the manufacturer. And that manufacturer certainly wouldn't want it to get out that a customer like UCLA was lost--that could make the news. It's the way other companies do it for all manner of products. Hopefully, we are on the same page now. Of course you have your opinons! Why apologize for them? They are part of who we are. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2002 Report Share Posted May 11, 2002 I don't really agree with what you are saying, saline implants are still dangerous, it is a fact i know all too well, saying they are safer than silicone is misleading, cause that is why I got them and it made me very ill. I am so much better now, i do agree that recovering from saline implants is probably easier to do than silicone once that has leaked into your system. I also would not trust ANY PS who says that someone would have no tissue left after explant, since I even know patients who had mastecctomy's who Dr Feng has explanted that still have some tissue. I don't agree with that at all and if it were me I would consult with someone experienced with explants, not just implants, and also someone who is caring and compassionate and understands and believes that implants even saline, can cause disease and symptoms in women. I do not like to misinorm women on this group by saying saline implants are safer, I don't buy it for a second, I have met way too many sick women who only had saline. So not to seem negative but I think that your daughter is crazy to reimplant. I am sorry but that is just my own opinion here, I feel strongly that implants are dangerous and not worth the risk and when there are such talented surgeons out there we do have other options. Take care ----- Original Message ----- From: Bos@... Sent: Thursday, May 09, 2002 11:53 PM Subject: Re: Mold Hi -- Thank you for your concern. Let's see if I can address some of this. Yes, she had the joint problems in 1993--and at age 24, she made the decision to remove the silicone and replace with saline, just as she made the decision to implant initially in 1989 and again with silicone two years later because of wrinkling. She also had a mastopexy when she got the saline implants.Back then, changing to saline was the thing to do-- and when the switch is from silicone to saline, I detect, from talking to many women, the outcome has been good. She has detoxed periodically, from early 1992 when the silicone mess became public, with juice fasting in four day increments. Right now her concerns are with getting them changed due to possible mold, possible bacteria and possible rupture. She's an extremely bright 33 year old woman and very aware of her present and future possiblities. ( As far as recommend- ations from me, she already knew what her feminist mother thought and today she agrees with me) We interviewed three plastic surgeons and she chose Ken Slate, now at Cedars Sinai, who was with Shaw, the Head of Plastics at UCLA, They work in twos at UCLA and her other surgeon was Kobyashi. These are not only plastic surgeons, but do microvascular surgery. Dr. Slate was the one who told me that it was a good thing she wanted the saline implants, because he would have had to recommend them anyway as she had no more breast tissue due to complete compression--he had to leave the anterior portion of capsule (which was thin) as he was concerned of skin loss. This is the doctor she wants for any future surgery. Dr. Slate made all arrangements with Mentor, who paid for her saline implants and asked for the silicone ones he removed. And I have copies of all her records, including the Operative. I have an extensive history of 12 year old silicone implants (3rd pair) found grossly ruptured six months after my daughter's implantation in 1989. I was a "prophylactic mastectomy" patient. And, there are no options or procedures available to either of us but implants-- believe me, I have checked. I cannot have them as I have a sensitivity to metals--I had it prior to implantation. She has never shown a sensitivity to metals. I lean very heavily toward metal allergy as being the problem with many, as well as the S epidermis and aureus. (which I had also) I've done extensive research on all aspects of the implant issue--including legal and political, most during three of the five years that I was ill but continu- ously since then. While this was primarily re silicone implants/gel, I find that those who do react to their saline implants seem to be fewer in number, but react in the same ways. I think I've covered everything. . .again, thank you for your contributions and caring. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2002 Report Share Posted May 11, 2002 -- Glad to be out of it also--and I totally agree that foreign objects do not belong in the body. I found that out when I pierced my ears. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2002 Report Share Posted May 11, 2002 Of course no Dr is ever going to say all implants cause problems that would be irresponsible, no one would ever say everyone who smokes is going to get cancer either. 3 women who are fine after replacement with saline, well like I said I only know of one. To say there is a large group that is unaffected is like saying that there are a large group of smokers who don't seem to be affected . It doesn't show the whole picture. Implants are like playing russian roulette and not just with your health, the complication rate of implants is higher than acceptable. The rate of rupture, infection etc is also high, most women with implants will experience a problem, if not with their health then with a local complication. There are foreign bodies that don't belong in us and if we chose to put them inside our bodies then we are asking for trouble, I guess to some that is worth the risk but not to me. Glad to be out of the mess. Love ----- Original Message ----- From: Bos@... Sent: Friday, May 10, 2002 6:48 PM Subject: Re: Mold -- I personally know of three such women who reimplanted with saline who have not had problems--that is not to say they won't at some point in the future. All three started with slight problems with their silicone implants. But I have corresponded with many, many, both with silicone and saline who have become ill. Even if no allergy presents, or bacteria presents, the implant is bound to break down evenutally if not replaced. There seems to be a group that is unaffected by any risk. . .as well as a group that will replace their implants periodically. If I were in a position to have an augmentation, I would not be willing to take the risk. Some people are. There are many physicians/plastic surgeons who do recognize that implants can make one ill--but I've yet to find one who will say that implants will make all women ill. And all of them still implant. . . including Dr. Feng. I think the difference may be that caring plastic surgeons make sure their patients get fully informed consent--from that point on, it is the patient's choice as a fully informed adult. They don't pull any of the tricks that I've heard from so many women and that I experienced myself. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2002 Report Share Posted May 11, 2002 Well I guess I don't have to worry too much since this climate in Idaho is the driest I have ever been in my whole life, never had to use moisturizer like I do here, but one good side effect is I have the clearest skin of my life, no zits here at all, in CA I got a good break out at least once a month. I love not having them anymore! ----- Original Message ----- From: " Rogene S " <saxony01@...> < > Sent: Thursday, May 09, 2002 2:57 PM Subject: Re: Mold > One way to prevent mold in humid climates is to > install a dehumidifier in unairconditioned/heated > areas - the dehumidifer can be tied into the drain > from your AC system. > > We put one in our home when we built . . . Before they > tied it into the AC drain, it was removing a couple > gallons of water a day - during a drought! > > Our basement walls show a small amount of foundation > leakage (they tried everything possible to fix it) - > but no sign of mold because it dries as fast as it > comes in. . . > > I'm surprized dehumidifiers aren't required in the > building codes in spaces that are not heated and air > conditioned! . . . Sooner or later there will be mold. > > My father became deathly ill after sorting papers from > such an area. . . instead of seeing the doctor, he > began making preparations to die . . only after > developing a blood clot several months later did he > see a doctor who medicated him for mold and cleared > him up quickly. > > Rogene > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2002 Report Share Posted May 11, 2002 -- Yes, have seen pics. You are most fortunate as it appears you had ample breast tissue even before implants. Some women got them for filling sagging breasts from pregnancy/nursing age/weightloss and some got them because they didn't have much tissue/size (and some just because they wanted larger breasts) How much tissue was there pre-implant is usually the primary deciding factor in post-implant. What I'm saying is that all women are not going to be as fortunate as you are post-implant. It's a fact of life and one that we have to accept. No plastic surgeon, whether it's Dr. Feng, Dr. Kolb or another skilled plastic surgeon, can give your breast tissue--he/she can just work with what you have. I have seen slides of beautiful reconstructs after implant removal of women who belonged to my same support group in Orange County back in 1993. They were done by the late Graham Wood and were by far prettier than with implants. Dr. Wood, who attended every meeting, was the first to say, however, that one doesn't know the outcome until it is an outcome. There was only one woman in that group who had a removal who was unhappy-- (we were all ill from silicone-filled implants) as silicone had invaded her breast tissue so thoroughly that mastectomies were necessary. No one was unhappy with Dr. Wood's work. Larger breasts appeal to the younger women for a number of social reasons. . .the advertising is geared toward them especially in the magazines. The ASPRS studies that used to be public started at age 12. But as a woman matures and/or marries, it seems to take on less importance, generally speaking. I'm thrilled to find that some young women did/are doing a lot of research about implants before getting them--a few have sent e-mails to let me know they have decided against them as they are unwilling to take the risk to their health. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2002 Report Share Posted May 11, 2002 If you want to discuss this issue with Dr Blais his info is on the site and I also can give it to you. He is very honest and forthright in his opinions on implants and he sees hundreds of them in his daily work. He assured me that the saline on the market today are some of the worse to be manufactured, esp the textureds. ----- Original Message ----- From: Bos@... Sent: Friday, May 10, 2002 9:23 PM Subject: Re: Mold -- If I said that saline is safer than silicone I was indeed misleading. I thought I said that I detected that those who switched from silicone to saline were not having any problems. I personally know three and have read of Dr. Kolb's and have talked to probably six. None were having problems. That is not to say that they won't in the future and at least the three I know are aware of that-- and I'm sure Dr. Kolb is. Imagine changing the implant every 10 years not only precludes rupture, if it hasn't already occurred, but removes the biomaterial to which bacteria adhere--i.e. removes the source. It seems unlikely that allergy to any of the components is an issue with this group of people. And if I said recovering from saline was easier, that too was an error on my part. I thought I said that illness didn't seem to occur as often but when it did, it was the same. There are considerable variables to either type of implant, to the women, to the symptoms and to the recoveries. I've talked to many for quite some time before knowing whether her implants were silicone or saline. I know my daughter is taking a chance--but she is now caught between a rock and a hard place and playing it as cautiously as possible. I don't know what I would do in her position. She liked her doctor and so did I--and he really knew his stuff because I questioned him thoroughly--and he knew I was recuperating. She had four appointments prior to her surgery and spent the night. He is doing reconstruction at Cedars Sinai Cancer Center now so he's probably real adept with implants. I guess you aren't familiar with UCLA, implants, Dr Shaw and Ahn. This is where most wanted to go in the early 90s--and UCLA recognized the problems with the implants--they had a questionnaire to fill out. Aside: While interviewing for changing implants, all three doctors commented on the beautiful result she had and one followed that by saying "We so seldom see that." Dr. Slate didn't tell her before explant that she would have no tissue left after explant;he found that out near the beginning of surgery--and told us afterward. BTW, I have met Dr. Feng, like her and refer patients to her. I see she now has her own clinic--she used to be with Mt. Sinai. I' ve never seen anything remotely related to a reconstruction with ones own breast tissue after mastectomy--could you mean with other body tissue? If the mastectomy was done correctly, there wouldn't be any breast tissue. In any event, I wouldn't qualify--ribs are deteriorated and have just concavities in chest (with excess skin of course)--I don't know how much worse it would be if .5cm capsules were removed--if they could be. Re the quality of contemporary implants--I'm aware that Mentor was cited by the FDA but hadn't heard of Blais announcement yet. Where would I find that? explantation.com? I have wondered if, back in the 90s when this was a publicly hot issue, replacement salines were checked very carefully before being sent to a doctor--saline replacement was the recommended thing then. I have also wondered if institutions receive a more carefully-crafted implant as their orders are large and mean more bucks and future business to the manufacturer. And that manufacturer certainly wouldn't want it to get out that a customer like UCLA was lost--that could make the news. It's the way other companies do it for all manner of products. Hopefully, we are on the same page now. Of course you have your opinons! Why apologize for them? They are part of who we are. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2002 Report Share Posted May 11, 2002 Bonnie Have you checked out my explant pics in the photo gallery here on saline support, I think that you can see that I don't have much breast tissue but that Dr Feng did pretty good at fixing up what I had, esp if you look at my pre implant photo and how saggy and mishapen I was compared to how I look now after explant. I need to take some more recent photos as well since my breasts have changed again since the last ones I took. Love ----- Original Message ----- From: Bos@... Sent: Friday, May 10, 2002 9:23 PM Subject: Re: Mold -- If I said that saline is safer than silicone I was indeed misleading. I thought I said that I detected that those who switched from silicone to saline were not having any problems. I personally know three and have read of Dr. Kolb's and have talked to probably six. None were having problems. That is not to say that they won't in the future and at least the three I know are aware of that-- and I'm sure Dr. Kolb is. Imagine changing the implant every 10 years not only precludes rupture, if it hasn't already occurred, but removes the biomaterial to which bacteria adhere--i.e. removes the source. It seems unlikely that allergy to any of the components is an issue with this group of people. And if I said recovering from saline was easier, that too was an error on my part. I thought I said that illness didn't seem to occur as often but when it did, it was the same. There are considerable variables to either type of implant, to the women, to the symptoms and to the recoveries. I've talked to many for quite some time before knowing whether her implants were silicone or saline. I know my daughter is taking a chance--but she is now caught between a rock and a hard place and playing it as cautiously as possible. I don't know what I would do in her position. She liked her doctor and so did I--and he really knew his stuff because I questioned him thoroughly--and he knew I was recuperating. She had four appointments prior to her surgery and spent the night. He is doing reconstruction at Cedars Sinai Cancer Center now so he's probably real adept with implants. I guess you aren't familiar with UCLA, implants, Dr Shaw and Ahn. This is where most wanted to go in the early 90s--and UCLA recognized the problems with the implants--they had a questionnaire to fill out. Aside: While interviewing for changing implants, all three doctors commented on the beautiful result she had and one followed that by saying "We so seldom see that." Dr. Slate didn't tell her before explant that she would have no tissue left after explant;he found that out near the beginning of surgery--and told us afterward. BTW, I have met Dr. Feng, like her and refer patients to her. I see she now has her own clinic--she used to be with Mt. Sinai. I' ve never seen anything remotely related to a reconstruction with ones own breast tissue after mastectomy--could you mean with other body tissue? If the mastectomy was done correctly, there wouldn't be any breast tissue. In any event, I wouldn't qualify--ribs are deteriorated and have just concavities in chest (with excess skin of course)--I don't know how much worse it would be if .5cm capsules were removed--if they could be. Re the quality of contemporary implants--I'm aware that Mentor was cited by the FDA but hadn't heard of Blais announcement yet. Where would I find that? explantation.com? I have wondered if, back in the 90s when this was a publicly hot issue, replacement salines were checked very carefully before being sent to a doctor--saline replacement was the recommended thing then. I have also wondered if institutions receive a more carefully-crafted implant as their orders are large and mean more bucks and future business to the manufacturer. And that manufacturer certainly wouldn't want it to get out that a customer like UCLA was lost--that could make the news. It's the way other companies do it for all manner of products. Hopefully, we are on the same page now. Of course you have your opinons! Why apologize for them? They are part of who we are. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2002 Report Share Posted May 11, 2002 -- In my opinion, women who had cancer are much more than stuck between a rockand a hard place. My daughter and I are two different people with different minds, implant circumstances, genetic patterns, immune systems and ages. I know that healing is difficult--the bulk of mine took five years--three were housebound. I was the breadwinner and had to pull my daughter out of college to support us. I have permanent damage in places other than my chest. Like your friends who are mastectomy patients, I am also--and I'm sure I'm just as glad to be rid of my implants as they are. I have been without them for over 13 years. I do not have contradictory opinions about implants-- they can all be bad and capable of causing illness and I have never said that reimplanting with saline is a safe option. I have tried to be very cautious about this citing only cases of which I am aware that have not had problems so far. All reimplanted many years ago, when dangers were unknown and some are very aware of the risk factor involved. And, I did not say that anything was as simple as metal allergy; but for many, including myself, that is part of the problem. S epidermis-the superantigen, silicone components, estrogenicity and dopamine can all be parts of the problems--each woman's body handles each thing differently. I had a metal sensitivity before implants and worse since they have been removed-- it goes into action each time I have xylocaine for dental work now. The drug, Accolate, supposedly keeps capsules softer or thinner, which allows one to speculate re sensitivity/allergy, as this is an asthma drug which apparently attacks a particular interleukin that causes inflammation seen in allergic asthma. This is a new theory and I'm anxious to see what becomes of it as it was supposedly presented to the ASPRS annual meeting a couple of weeks ago. Can't lay my hands on most recent FDA Medwatch statistics , but there are over 25,000 adverse reports re breast implants in the last three years and over 200,000 altogether. Many do not even know about Medwatch or to report to Medwatch--so the figures re adversity are actually much higher. These statistics give one a good idea of the FDA's attitude about breast implants--they just gave pre-market approval to a new silicone-filled implant for "clinical" studies, in addition to the one already on the market for "clinical" studies. I have already corresponded with women who were given silicone in the last couple of years, got sick and explanted; they are being told that silicone is back and better than ever. This, in addition to saline implants, is precautionary information. "Clinical" trial is a way to say--you can't sue if something goes wrong. Even if the plastic surgeon was misleading--all he needs is your signature and he's home free; what many seem to be doing is presenting the papers for signature just a few minutes before surgery--it's an old trick, it was used on me, and for some reason, no one has caught on to it yet. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2002 Report Share Posted May 11, 2002 -- I don't want to argue either so let me say this clearly. I do not believe that saline is a safer option. As I have said previously, I've talked to many who were ill from their saline implants--just as ill as those with their silicone implants--the envelopes are the same. As my daughter's exchange with saline occurred almost ten years ago, it is quite possible that more is known now--I do know that we are considerably more aware of S epidermis and the propensity of bacteria to adhere to biomaterials---she knows this also. She would be thrilled to get rid of her implants--whether she is willing to do that on the possibility that she may or may not have anything to "fluff out" is another thing--it's her body and her call. I will send your e-mails to her in CA. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2002 Report Share Posted May 11, 2002 I agree that not all women will have as much breast as me, and I don't really have that much, I am small barely an A cup. Still no matter what anyone who puts her breast size before her health is crazy. there are things that can be done like wearing push up bras, enhancers or water or air or gel bras like I wear. I have to wonder why you seem to want to defend implants when you say you yourself was harmed by them. I don't understand it at all, implants are dangerous and that is the bottom line. I have seen many many flat women who are gorgeous and the only way that we will ever change anything in this society is to be ourselves and try to focus less on what the media pushes on us I don't think that young girls are all caught up in this hype, I know of many who are getting rid of the implants only because they hate them and not because they are having any health problems yet and I must say I take my hat off to them, they are by far smarter than I was. ----- Original Message ----- From: Bos@... Sent: Saturday, May 11, 2002 2:47 PM Subject: Re: Mold -- Yes, have seen pics. You are most fortunate as it appears you had ample breast tissue even before implants. Some women got them for filling sagging breasts from pregnancy/nursing age/weightloss and some got them because they didn't have much tissue/size (and some just because they wanted larger breasts) How much tissue was there pre-implant is usually the primary deciding factor in post-implant. What I'm saying is that all women are not going to be as fortunate as you are post-implant. It's a fact of life and one that we have to accept. No plastic surgeon, whether it's Dr. Feng, Dr. Kolb or another skilled plastic surgeon, can give your breast tissue--he/she can just work with what you have. I have seen slides of beautiful reconstructs after implant removal of women who belonged to my same support group in Orange County back in 1993. They were done by the late Graham Wood and were by far prettier than with implants. Dr. Wood, who attended every meeting, was the first to say, however, that one doesn't know the outcome until it is an outcome. There was only one woman in that group who had a removal who was unhappy-- (we were all ill from silicone-filled implants) as silicone had invaded her breast tissue so thoroughly that mastectomies were necessary. No one was unhappy with Dr. Wood's work. Larger breasts appeal to the younger women for a number of social reasons. . .the advertising is geared toward them especially in the magazines. The ASPRS studies that used to be public started at age 12. But as a woman matures and/or marries, it seems to take on less importance, generally speaking. I'm thrilled to find that some young women did/are doing a lot of research about implants before getting them--a few have sent e-mails to let me know they have decided against them as they are unwilling to take the risk to their health. Bonnie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 11, 2002 Report Share Posted May 11, 2002 Bonnie I don't want to argue with you and you do seem knowledgeable about this issue, however you did say that saline was a safer option and that upset me, I don't want to quote you I just want to let you know that it hurts me when women say this since that was all I ever had and lots of women I know ever had and to tell us that saline is a safer option can be hurtful because that was all we had to begin with. I also feel very much for women who have had mastectomy however, this is not the case for your daughter she has not had a mastectomy and unless Dr Feng personally told her that she would look like that after explant I just find it hard if not impossible to believe that. I know women who have suffered terrible ruptures and thought they would be deformed for life, I even know one girl who had necrosis in her breast and she went to Dr Feng and she now looks wonderful, I believe that Dr Feng could possibly make your daughter look really really good without needing more implants, if she has not seen her, then you may want to consider it, afterall I just think you may be surprised to see what this surgeon has done for many women I know. I would also say that 99.9% of all women I know (many flat as a board) before implants, that have had explants are happier than they were with implants, with their own natural breasts. Please I urge you to consider seeing Feng for another opinion before your daughter locks herself into another 10 years with toxic implants. I really believe that compressed breast tissue can and does come back after explant if you see the best and if you have it done correctly. Love ----- Original Message ----- From: Bos@... Sent: Saturday, May 11, 2002 3:58 PM Subject: Re: Mold -- In my opinion, women who had cancer are much more than stuck between a rockand a hard place. My daughter and I are two different people with different minds, implant circumstances, genetic patterns, immune systems and ages. I know that healing is difficult--the bulk of mine took five years--three were housebound. I was the breadwinner and had to pull my daughter out of college to support us. I have permanent damage in places other than my chest. Like your friends who are mastectomy patients, I am also--and I'm sure I'm just as glad to be rid of my implants as they are. I have been without them for over 13 years. I do not have contradictory opinions about implants-- they can all be bad and capable of causing illness and I have never said that reimplanting with saline is a safe option. I have tried to be very cautious about this citing only cases of which I am aware that have not had problems so far. All reimplanted many years ago, when dangers were unknown and some are very aware of the risk factor involved. And, I did not say that anything was as simple as metal allergy; but for many, including myself, that is part of the problem. S epidermis-the superantigen, silicone components, estrogenicity and dopamine can all be parts of the problems--each woman's body handles each thing differently. I had a metal sensitivity before implants and worse since they have been removed-- it goes into action each time I have xylocaine for dental work now. The drug, Accolate, supposedly keeps capsules softer or thinner, which allows one to speculate re sensitivity/allergy, as this is an asthma drug which apparently attacks a particular interleukin that causes inflammation seen in allergic asthma. This is a new theory and I'm anxious to see what becomes of it as it was supposedly presented to the ASPRS annual meeting a couple of weeks ago. Can't lay my hands on most recent FDA Medwatch statistics , but there are over 25,000 adverse reports re breast implants in the last three years and over 200,000 altogether. Many do not even know about Medwatch or to report to Medwatch--so the figures re adversity are actually much higher. These statistics give one a good idea of the FDA's attitude about breast implants--they just gave pre-market approval to a new silicone-filled implant for "clinical" studies, in addition to the one already on the market for "clinical" studies. I have already corresponded with women who were given silicone in the last couple of years, got sick and explanted; they are being told that silicone is back and better than ever. This, in addition to saline implants, is precautionary information. "Clinical" trial is a way to say--you can't sue if something goes wrong. Even if the plastic surgeon was misleading--all he needs is your signature and he's home free; what many seem to be doing is presenting the papers for signature just a few minutes before surgery--it's an old trick, it was used on me, and for some reason, no one has caught on to it yet. Bonnie Quote Link to comment Share on other sites More sharing options...
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