Wednesday, August 25, 2010

another operation

Hi there everyone
This blog is one that I have tormented over for a very long time, ie whether or not to write it.
However since I have always seen this blog as both an accurate update on my medical situation as well as a means of explaining medical issues as they arise, to further the readers medical understanding, I feel compelled to also share my current situation with my readers. I will be having an operation in about 2 weeks for a problem I can only describe as "self induced". I am sharing this only with the hopes that I might spare someone else needless procedures and pain.
It is a very personal situation, but I feel I have shared a lot of stuff thus far, why not this?

Part of the reason for my trip to Canada next week is to have surgery to remove breast implants, one of which has ruptured and is leaking silicone. I was advised over a year ago that this needed to be removed, but with being on chemo, and also having a low blood count, I opted to delay this until now.
AND NOW THE STORY.......

I am telling this with the hopes that someone might read this and perhaps opt NOT to do this.
10 years ago, whilst training to do that Boston marathon ( this is a marathon that you have to qualify for, which means you have to have achieved a certain time in another marathon), I subsequently lost a lot of weight. In doing so lost what small breasts I had (or so I saw it).
At the time, being inundated with Victoria Secrets catalogues etc I decided I wanted to look like those models, well at least be able to fill out the clothing. ( I should add here that I have long believed that Victoria Secrets is likely responsible for MUCH of the whole breast augmentation craze)(just a thought)
I found out that having a breast augmentation (breast implants) was not a huge procedure. I went and saw a surgeon and he also agreed that I could have the procedure done under local anaesthesia (not how it is usually done, but hey, I did not want to risk my life with an anaesthetic). I had saline implants put in and immediately developed capsular contraction of the worst kind.
AN EXPLANATION: When a foreign object of any kind is inserted into the body, the body forms a capsule around it. Capsular contraction is when this capsule shrinks and forms a tight constrictive wall around the implant, making it as hard as a rock and quite painful.
Now I should have learned at this point that perhaps I was not meant to have implants, however I felt still that I wanted to have breasts....
So I found a surgeon in Portland who would repair this, and since I had had capsular contraction, I would qualify for silicone implants.
Again I had the surgery under local anaesthetic. He removed the capsule around the implant and the implant and put in silicone implants. I should add here that this is all placed under the muscle of the chest wall. True breasts sit on the outside of the chest wall muscle, but to get a better effect, often breast implants are placed UNDER the pectoral muscle.
Well things went well for 9 years and I really had no problems..

Last June amidst chemo and the fears of this cancer, I went to see a surgeon about having a bilateral prophylactic mastectomy, (my mother AND my grandmother had breast cancer and I was NOT wishing to go through this cancer thing again) I was quite emotional at the time.
The surgeon said that at that point, I was more likely to succumb to the endometrial cancer than breast cancer, so she would not consider the surgery until at least a year after my treatments. She did order an MRI because she felt a lump.
The MRI showed that the breast implant was ruptured, but that it was still contained in the capsule.
I was in the middle of chemo and radiation at the time, so nothing I could do about it.
I did see a plastic surgeon in the fall about removing it. He advised removing them and replacing them. I found that he was quite dishonest about the whole situation and decided not to have the surgery. He had described the surgery he was going to perform, and I signed the consent. I later went for my presurgery appointment and in reading the consent in detail, I found that the surgery he had described to me was NOT the surgery he had put on the consent.

This was around the time that my radiation problems began so I did not do anything about it. I DID start reading though.
I found that the ONLY way to totally get rid of the silicone was to remove the implant AND the capsule enbloc which means to remove the whole thing as one. This not at all what the surgeon here had planned.
To make a long story short, the closest plastic surgeon that removes the implant AND capsule as one is up in Vancouver BC, and that is why I am going there for the procedure.

I thought I would also outline some of the things I have learned about breast implants that I think more people should learn.
Over 50% of women who have breast augmentation (breast implant insertion) require another operation. Bear in mind that the surgery is expensive and many women save up for the operation and cannot afford to have surgery to repair whatever the problem is. The other situation that often comes up is that while someone might be able to pay for the surgery, when the time comes that they need it repaired, they are in a different financial situation..... ie retired.
Of asymptomatic women (women with no symptoms), at 10 years 50% of breast implants have ruptured. (saline implants deflate immediately when they rupture, but silicone implants remain as a gel inside the capsule) So my situation is not unusual.
Once ruptured the silicone can leak out to various parts of the body.
The studies done years ago disproved that breast implants have anything to do with rheumatological problems, HOWEVER women with ruptured implants were never studied, so it is unclear what happens once they rupture.
After you have had breast implants for a long time the shape of your chest changes somewhat in that having them removed you will be much smaller appearing than you were to begin with.

You cannot get private health insurance if you have breast implants. I was refused because of mine. I have long said that the reason I was refused was because of the vaginal bleeding, but what happened was that the vaginal bleeding made the insurance company look closer at my files, and the fact that I had breast implants made me uninsurable. Fortunately being in Oregon they have a plan for those refused insurance for a medical problem.
Most states do not have this.
SO there it is.... I have revealed all.
I hope that in reading this someone else can pass on this info. I will more than likely add other info about this as I remember it.

The cheapest way to deal with all of this is to throw out all the Victoria's secret catalogues. Kind of funny, after my sons became teens, somehow the VS catalogues just disappeared on their own.
Janet

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