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Eating Crow

(FYI this is a repost) Eating Crow...another uplifting blog title, right? Well, right now I feel like I am eating crow about the Covid vaccines. Up until recently, I have remained a supporter of the Covid vaccines as a means to help prevent severe illness and death from Covid, and frankly, now, I am not so sure that this is the case. I am hopeful that after almost 3 years of dealing with Covid, the masks, and the lockdowns at least there was and is some benefit to the vaccines, which were heralded as our gateway to freedom and the return to "normalcy." However, about a week ago, Deborah Birxx, the former coordinator of the White House's Covid Task Force stated in an interview on Friday on the Neil Cavuto Show: “I knew these vaccines were not going to protect against infection and I think we overplayed the vaccines.” Are you kidding me? In the same interview, she did offer lukewarm support of the vaccines to prevent severe illness leading to hospitalization. However, if you are like me, you know people who have been quadruple vaccinated that have been pretty sick lately. And what about natural immunity? Can anyone now admit that natural immunity, ie prior Covid infection, also confers protection against serious disease? And can someone tell me how much Pfizer has made off of the vaccines? Paxlovid is now being touted as the treatment of choice for Covid; in that same interview, Deborah Birxx made that claim as well. However, Dr. Fauci and the President have both experienced rebound Covid after Paxlovid, and there seems to be a question over the optimal dosage and length of treatment.

If the Covid debacle is not enough, a New York Times article recently reported on the findings of a London Study that looked at the efficacy of SSRIs (Selective Serotonin Reuptake Inhibitors) used to treat depression. I was shocked to realize that over 37 million American take SSRIs and to learn that there may be no long-term benefits to the drugs, I am left to wonder again about the impact of big Pharma on our lives, our health, and well-being. Admittedly, Big Pharma is responsible for so many incredible drugs and devices that help to keep us alive and improve the quality of our lives. But data can be altered, as Deborah Birx admitted in her interview. I saw "interesting" interpretations of data sets when I works at the N.I.H. As physicians, we rely on our drug reps and these clinical studies to help guide our decision-making. And if this data is false or misleading, we are left with mud on our faces.

One of the most common surgeries I am performing lately is implant removal procedures. It appears that my colleagues are experiencing a similar increased demand for this procedure. There is a lot of misinformation about implants, silicone gel implant sickness, and a condition called BIALCL (Breast Implant-Associated Large Cell Lymphoma), and this information is adding to the anxieties of many women. I, personally, think that breast implants are safe devices. They have been available since the 1960s. However, when there is a general distrust of Big Pharma, it is not surprising that women will question the safety of these devices.

When I see a patient who is desiring an explanation, I try to explain the history of implants, textured implants (these are the ones linked to BIALCL, which fortunately, remains a rare condition), and the fallacies of the social media recommendations about the type of surgery that should be performed during a breast implant removal. Many of the women who are requesting an explant simply do not like the size of their breasts, since breasts often enlarge over time, especially due to such factors as menopause. But when a patient, especially a small-breasted, thin, and/or young woman requests to have her implants removed over concerns about their safety or symptoms of silicone sickness, I have to explain that there is no guarantee that any implant removal surgery will alleviate such symptoms as generalized fatigue, muscle aches, or autoimmune symptoms or diseases. Additionally, the removal may leave the patient with a significant change in appearance, which for some can be very troubling and create a new set of issues.

The negative impact of social media on our lives is proving itself again when it comes to breast explantation surgery. Social media sites make claims that a woman must go to an "explant center of excellence," for removal of her implants, but there is no such thing nor any such designation by the American Board of Plastic Surgery. Unfortunately, I do have colleagues who are capitalizing on women's fears over their implants and attaching catchy names to their practice. Another social media phenomenon is the recommendation that women have an "en bloc resection" for the removal of implants suspected to be linked to silicone sickness. This recommendation is not only false but dangerous. In my practice, I often remove the capsules when removing implants, though there are times when it is not indicated or necessary to do so. However, even when capsule removals are necessary, there are times when it is not possible to remove the entire capsule if it is densely adherent or stuck to the woman's chest wall. A capsulectomy in this case can lead to a collapsed lung, which can cause death, which may have been what happened to the wife of country music star, Hank Williams, Jr., this spring (her cause of death was a pneumothorax after a breast implant removal surgery and liposuction). En Bloc resections are performed to eradicate cancer and are radical and can be very deforming, and I do not feel that it is appropriate for social media sites (that are not run by physicians) to be making guidelines for surgery that are misleading and unsafe. For any of you having questions about your implants, my staff and I are always available to answer your questions. Accurate information is the key!

I hope everyone has enjoyed this blog and has a great week. Be careful in this heat, and stay hydrated. Allergan (there we go with big pharma, again!) has been heavily advertising Coolsculpt recently, and we thought this would be a good time to highlight the procedure. So if you're interested in freezing some unwanted fat, and can't dream of wearing those compression garments required after liposuction in this heat, give us a call. Before I leave, I am going to leave you with a song from The Band Perry, in honor of "eating crow."

'Til next time,

Heidi Williams, MD


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