Date: Thu, 15 Jun 2000 17:29:26 +1200

-----Original Message-----

From: USSW

Date: Monday, 23 February 1998 01:00

Subject: The RIGHT Dr. Kolb Article

Thanks Millie!!!!

DOCTOR, ARE YOU LISTENING?

THE SILICONE CATASTROPHE

by Susan E. Kolb, M.D.

What happens when a new disease is emerging that cannot be pigeonholed into any existing diagnosis? What if this disease mimics other diseases but fails to consistently fit into a pattern or worse yet is variable over time?

Sometimes lab tests are normal and sometimes they are abnormal.

What if it takes years to develop this disease, it is slowly progressive, and the main symptoms are nonspecific such as fatigue, muscle aches, joint aches, and increase of susceptibility to infection?

Add this to the massive media campaign and (funding of research) into this disease that has no intention of defining and studying the disease, but instead is intent on "disproving" the association of this disease with other known diseases, and you have a sad state of affairs for the women who are ill from leaking and/or ruptured silicone breast implants.

Does it make any sense to wonder why these women are ill given the facts:

1. Most silicone-filled breast implants leak or rupture within 8 to 15 years.

2.The implant companies never intended for silicone to move out of the breast implant and, indeed, Dow Corning stated in it's brochure that the implants would "last a lifetime".

3. Most series report a significant range of positive bacterial cultures around leaking and/or ruptured implants.

4. Women with advanced disease have similar symptoms to the miners who developed siliconosis or silicone in the lungs.

5. The initial epidemiological studies on this illness were flawed and the National Institute of Health panel has asked that they be repeated. These are the studies that were so well publicized in print and media. Of course, we did not hear on television or see in the newspaper that they were found to be flawed and that the study was not large enough to be statistically significant. Another important factor to consider in these studies is that those conducting the studies studied women whose implants were less than 5 to 8 years old. Studying women with intact implants is like studying smokers of 5 years or less and concluding that cigarettes have no relationship to lung cancer. I am sure that the tobacco companies would be happy to contribute funds for such studies.

So, how do you study a new disease?

Well, I am not an epidemiologist, but I am a plastic surgeon who had leaking silicone gel breast implants, and I was able to study the problem over the four years that I developed the "silicone" related symptoms. Unlike many of my patients, I had a lot of help recognizing that these symptoms were silicone-related, as I had 150 patients with the same problems. The symptoms developed in a fairly predictable order and progressed with time. It is similar to a "toxic" problem in that the longer the toxin is in the body and the further it spreads (i.e. dose related) the more the symptoms progressed.

The symptoms often start in the chest wall on the side of the implant "leak". There is sometimes a burning sensation or a nonspecific discomfort that can radiate or travel down the arm. We see numbness, especially at night, of that arm that later involves all the extremities. Actual silicate crystals are found in the nerves which explains why the disease affects the nerves in particular.

The other early symptoms are nonspecific - easily fatigued, muscle aches, and increased susceptibility to infections. Oftentimes patients come into my office for a "check-up" but state that they are having no medical problems related to their implants. Upon careful questioning, however, I find most have increased frequency of viral infections, sinus problems, and yeast infections. Women who would only get one cold a year cannot seem to shake the viral illnesses and are sick for a longer period of time with bacterial and yeast infections, as well.

Now one could say that "everyone" has these symptoms from time to time. What I found was that after four years of progressive problems, I had an amazing recovery with resolution of my sinus problems and only one viral illness instead of four this year. The difference? I had my leaking silicone implants removed last January.

Recently I had a patient demand I tell her why her left hand was no longer swollen and her joints no longer ached one week after surgery. She had a leaking silicone breast implant after breast reconstruction, but, like so many others, had been told by her physician that her hand swelling and pain was due to arthritis. I had two patients in the recovery room ask why their shoulder pain, with which they had suffered for years, was gone. Most patients experience an increased energy level and gradual relief of symptoms as the silicone is cleared from their body by natural means.

Holistic methods are used to help speed up the detoxification process. To help support the immune systems, we recommend a combination of thymic factors and antioxidant vitamins. The patient is started on these prior to surgery to help reduce complications, as the majority of these women have depressed immune systems. Inositol is recommended, as well, which is a vitamin that helps increase the amount of silicate the body eliminates in the urine.

What are my patients most frequent frustrations?

The patients ask me, "Why did I go to so many doctors only to be told that there was no relationship between my symptoms and my breast implants?" How can so many doctors be such experts on this newly-emerging illness that even the doctors studying the illness at universities are only just beginning to understand? The irony is that the medical community helped to create this new disease, yet it firmly argues that the disease does not exist. Where is the responsibility of the medical community, not to mention the the responsibility of the implant companies who produced defective products that got infected and made people ill?

Our Hippocratic oath states, "first, do no harm". If harm has occurred, then why not spend our energy studying the problem and finding a solution rather than denying it's existence?

The medical community would be well served by responding with more compassion and understanding. These women are ill! As a physician, if you simply say that you do not know what is making a patient ill, you are certainly in a better position later on when

her symptoms improve after removal of the implants, than if you insist there is no relationship.

Why is this such a critical issue?

Studies are showing that the longer the silicone implants have been leaking or ruptured prior to removal, the less likely the women are to get well. Think of arsenic...one can recover from a little, but after a long period of taking arsenic daily, one may not fare so well.

Silicone-related illness is a toxic problem. This is why toxicologists are now studying the illness. We know that women have died from the complications of this disease. If you have silicone implants, show this article to your doctor if he or she is not listening. 

Dr. Kolb is a Board Certified Plastic Surgeon and the founder and senior surgeon at Plastikos Surgery Center in Atlanta.