ENCORE: What the Lab Actually Found On My BII Patient’s Breast Implants

Foreign.

Dr.

Rob Whitfield, the board certified plastic surgeon.

Specializing in explant surgery Breast implant illness is a topic that is not often talked enough about, especially in medical community.

But is something that affects many women.

In this podcast I will be discussing the latest research, treatment options and personal stories of women who have undergone explant surgery in an effort to heal breast implant illness. In this podcast we'll explore the symptoms.

Of breast implant illness and delve into.

The latest surgical techniques for explantation and the recovery process. Whether you are currently experiencing breast implant illness or are considering explant surgery, this podcast is a valuable resource for anyone looking to take control of their health and wellness. So let's dive in.

Today's episode is about testing and how I unraveled the mystery of the patient who had BII symptoms but completely clear lab results. In our previous episode I talked about my first case experience with BII and how the lab at the hospital found E. Coli despite nothing showing up in her laboratory analysis before her expl surgery. After that, different patients started coming in and there was one in particular who confounded me and I'll tell you her story in just a moment. In my early experience with breast implant illness patients, I would have patients routinely come in complaining of the standard symptoms brain fog, memory loss, cognitive decline, anxiety, depression, weight gain, hair loss, joint pain, muscle pain, fatigue. And so having been shaped by my early experience finding an infection with E. Coli, I looked at every patient as well. What if they have an underlying implant infection? It's just not been recognized. And so we would do regular laboratory testing like it did that initially identified the E. Coli case and that went on for a little over a year and a half. And I started to get clients coming from out of state and one client in particular was an ICU nurse. She traveled from New Orleans and she had incredible amounts of fatigue. She said it was hard for even to get out of bed. And so I was very concerned with her being a nurse obviously and having that extreme fatigue that she had an underlying breast implant infection and that was responsible for her symptomology. I was very suspicious when I did her case that I was going to find an infection something more significant in her. This was early on in my experience with breast implant illness. I was trying to perform an enblock capsulectomy and really do my best to not cause any other disturbance of the tissues. This was already a large procedure for the patients to go through. In this particular case I did the explant on both sides. There was this kind of sliminess to the tissues. And so every time I had encountered this in the 20 year history or more of my career at that point, it led me to believe there's bacterial contamination of some variety. So I confidently went out to her husband afterwards and I said, hey, she's going to do a lot better. I feel very confident this was infected. We'll just wait for the laboratory analysis to reveal what the organism is, then I'll put her on the appropriate antibiotic therapy and we'll get her hopefully good as new, feeling better, able to get back to work and function properly. So I waited about the traditional week to get her results back, came back normal flora, which means there weren't enough copies of bacteria in a clia based lab system to prove an infection. Or alternatively, the lab was not testing for the right thing. And so that was a very, very frustrating experience for me. And we had started from a research standpoint in plastic surgery, seeing cases of anaplastic large cell lymphoma, of which they had done PCR testing on the capsule and found some bacterial contaminants. So I contacted colleagues and I said, which labs could I contact to do PCR testing on the specimens I had? I had drains in this patient and she was just putting out copious amounts of fluid, meaning that it was obvious there's something going on. I couldn't tell her what it was in terms of is it a bacterial contaminant, Is it a fungal contaminant? Most likely it would have been bacterial. I chose to place her on oral antibiotics given my background with both breast cancer, breast cancer reconstruction, implant infections, and my experience with BII patients spanning this career of mine already. And her drainage slowly decreased over the next couple of weeks and she went back to her home and subsequently had her drains removed. That kind of reinforced that I need to get on a different path to figure out what's wrong with these. So I started contacting these labs and settled on MicroGen DX out of Lubbock, Texas. It took a period of time for me to get PCR testing online in my practice. So that really began in 2019. Now I have over 400 PCR tested Xplat capsules in my series. I think initially I had a lot of people pre Covid coming from all around the United States to visit Austin and have us see them consultation and hopefully provide services for them. In that series, I had about 60 to 70% of the patients have a contaminant that was mostly predominantly bacterial on PCR analysis in my audit. And so I thought it was really onto something. I felt good that if I found that, I checked a huge box for them, basically we had an underlying infection and once the stimulus was removed from their body, the immune response would normalize. Sometimes this would take a short period of time, other times it would take months. But we saw a definite improvement. PCR testing, polymerase chain reaction. We're just looking for the DNA of the contaminant, whether that's a bacterium, Mycobacterium or fungus. And there's obviously hundreds of these. So we want it tested against as many DNA as possible so that we can get the answers. And this just instead of it being a run of the mill staff or strep or E. Coli or pseudomonas or something, we'll get some very interesting results that you otherwise wouldn't find because they wouldn't be tested for, but you just need one copy of DNA for it to be present on a specimen to be identified in the analysis. I share all these with our clients and they have the reports and they're in their charts. Their charts are available all the time on our simplast health app, as well as their pictures of explant specimens and other reports. And I've been extremely happy with Microgen DX work. They also when I needed help with COVID because, you know, obviously Everybody's learned about PCR testing because of COVID MicroGen DX was one of the first companies in the world to provide saliva testing, which is obviously very attractive. The shed of the virus through the saliva is a predominant finding. We knew this early on. They were one of the few labs in the world to be released to perform saliva testing. And so my company has done PCR testing with saliva for Covid really since the beginning and been very, very happy with how much effort and work they put into helping us.

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Rob Solutions at Dr. RobSolutions.myshopify.com the reports are very detailed. Once again, what I said was, if there's just one copy, it'll show up in a report. For instance, I had a challenging case. I had a really top athlete, came in, very difficult, symptoms consistent with bii, high functioning, was just beside herself, been to every doctor known to man, even had a surgery over concerns on one of her joints. We did her explant. I received her report back and it was astonishing. But when you think about what she does, it makes sense. I get asked commonly, how do certain bacteria get on implants? Obviously, we all think about infections, a cold, something that gives bacteria to our own bloodstream and then that seeds itself on whether it's a knee, hip or breast implant. That's the common teaching for clinicians. But in this case, it was like being on episode of House. The triathlete now has four types of fungus and multiple types of bacteria. I had to start looking up some of these because I didn't recognize some of the fungus and they're all consistent with water. If you think about how this would happen, a triathlete swims, gets out of the water and runs. Many of them run barefoot and you get little micro punctures in your foot or your foot's cold because the water's cold, you can't feel things. You get a little puncture. It's easy to see how you get a bloodborne contaminant this way that then will subsequently end up in a joint or in an implant and cause a inflammation slash infection. And so for her, it made a lot of sense to me. Conveniently, about two weeks later, I had a patient show up with a report after an explant that had Acinetobacter. And so for those who don't know what Acinetobacter is, it's a bacteria commonly found infecting severely burned patients or immunocompromised patients. My experience, having done burns for a large portion of my career, I most commonly saw it in burn patients. Nobody's sicker than a severely burned patient. Really, really challenged nutritionally. Skin envelopes damaged, has to go have their skin excise. That's been burned, replaced with cadaver skin temporarily before they can skin grafted. They develop infections because the immune systems severely compromised the integument or our skin which protects us from infections, severely compromised. So I asked this client of mine like what was she doing that she could have possibly got Acinetobacter? I'm like, were you gardening or digging in soil or what exactly were you doing? And she said, well I just stay at home or stay at home mom. And I was like, would you have been in mud for any reason? And she's oh, I used to do Spartan racing. And well, there you have it. So this is a soil bacteria. It gets under your nails or once again you get a puncture in your hand, it contaminates you and this is how you get it into your bloodstream and it affects your, like I said, your joint or your, whether it's a knee, a hip or a breast implant. These all made sense now. And we have never known these things without using PCR testing because regular lab testing you would get in, like I mentioned, a CLIA based lab like Quest or LabCorp, some of these other places, CPL in Austin, they're not performing PCR testing. It's just a swab and a growth on an agar plate. And that's traditional. You know, having made these inroads with PCR testing to as definitively diagnose something as possible has given me great comfort. So when I see these reports I'm like, well this is basically why you're having your problems. And then it's not the end of the story, but for that portion we can help close that chapter. So in summary, if you remember, for our first podcast we talked about on a CLIA based lab or a lab done in a hospital setting, which basically is like taking the Q tip, swabbing the inside of the area you're trying to culture and then that goes to the lab. The laboratory personnel will then wipe it on a blood agar plate or whatever culture medium they're using in a petri dish, cover it and put it in the incubator to grow. This takes time obviously, but it's not testing for a large number of bacteria. It's going to be testing for a smaller number of bacteria that are most commonly found in the setting. Staph, strep, E. Coli, Pseudomonas bacteroides, things that are commonplace. I'm trying to provide the most evidence based solution to this problem. And so PCR testing against over 150 types of bacteria, Mycobacterium and fungus is a more appropriate and decisive way to get this information. So I PCR test pretty much everybody. I don't like regular lab glia testing done with those specimens anymore because I want the answer. I don't want to say, oh well, there weren't enough bacteria, so that didn't give us an answer Here. You know we're going to get an answer. It just helps us check boxes and help these patients who are desperately looking for answers provide answers to their questions.

Thanks for joining me today.

I hope you found the information and.

Stories shared on this podcast helpful and informative. Remember, taking control of your health and wellness is key to recovery from breast implant illness. If you're looking for additional resources and support, be sure to visit our online store, Dr. Rob's Solutions at drrobsolutions.myshopify.com you'll find a wide range of wellness products and supplements to support your journey to recovery. From specially formulated detox supplements to personalized skincare products, we have everything you need.

To aid your recovery.

Visit Dr. Rob Solutions today at Dr. Robs Solutions, my shopify.com thank you for listening and we'll be back with another episode soon. Remember, you're not alone in this journey and together we can overcome breast implant illness. Take care. Of.