In the fight of their lives

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http://chronicle.augusta.com/stories/071097/fea_implant.BAK1

In the fight of their lives

Sisters of Silicone battle medical establishment

By Tom Corwin

Staff Writer

It started almost the moment they entered her body.

Martha Cosnahan received silicone breast implants

after both her breasts were removed due to fibrous

tumors in 1975. She hoped the implants would restore

her shape and self-image. Instead, she claims they

tortured her for nearly 10 years and leaked silicone

that is ruining her health.

Mrs. Cosnahan is one of 400,000 women whose lives are

in limbo as she awaits the painfully slow negotiations

of a federal bankruptcy judge and the heated battles

of attorneys over compensation for breast implant

patients by Dow-Corning and other implant

manufacturers.

But doctors such as plastic surgeon Randy say

the women's claims and the lawsuits fly in the face of

his experience and medical studies that showed no link

between silicone and diseases like lupus that Mrs.

Cosnahan and others claim afflict them.

THE BREAST IMPLANT controversy first boiled over in

1992 when the Food and Drug Administration banned

their use for cosmetic surgery. Today the battle over

implants is being fought on two fronts: In the legal

realm, Mrs. Cosnahan and others await a settlement

that once totaled more than $4 billion but now is in

doubt because of Dow-Corning's bankruptcy. Others,

like a 52-year-old local educator who asked that her

name not be used, have opted to go ahead with their

trials and will fight it out with the companies in

federal court in Savannah within the year.

In the medical realm, massive reviews of medical

records by researchers at Mayo Clinic and Harvard

University found no significant link between silicone

and connective tissue diseases. But the women claim

those studies were influenced by funding from the

breast-implant companies. They point to two more

recent studies, one by Tulane University and the other

by a pathologist at the University of

Tennessee-Memphis, that show a link between disease

and silicone.

For the 75 or so local women who make up the support

group Sisters of Silicone, the medical debate is

personal because they claim no doctor in Augusta will

believe their stories, and they are forced to travel

to Columbia, and Memphis to find someone to treat

them. They can look forward to few highlights outside

their group, such as the recent Lifetime cable channel

movie Two Voices that chronicled the battles of Sybil

Goldrich and Kathleen Anneken against illnesses they

blamed on their implants. So intense is this

controversy, however, that Lifetime felt compelled to

air a short newscast after the show featuring doctors

debunking the link between silicone and the women's

autoimmune disease.

Still, ``it's really an upper for us because we've

been suppressing for so long,'' Mrs. Cosnahan said.

has disbanded for summer. Ms. Cosnahan, 58, said her

doctor told her to give it a rest. The heat and bright

sun of the summer also affects the women more because

of their conditions.}

ABOUT SIX MONTHS after her implants were first put in,

Mrs. Cosnahan felt tremendous pain that spread to her

joints and throughout her body. The breast implants

were removed and a second pair put in. But these

turned hard within months.

``My breasts were as hard as this doorknob,'' she

said, reaching up from her kitchen chair to grab the

pantry doorknob. Her small Maltese dogs, Honey Bunny

and Cleopatra, barely stir on her lap.

What followed was months and years of constant fever

and fatigue, intense pain in her joints and a rash

across her face. The implants were finally removed in

1984. It wasn't until 1992, when she was watching a

breast implant victim talk about her symptoms, that

the light bulb went off in her head.

``Everything she said, (every symptom) was a `me

too,''' Mrs. Cosnahan said.

She joined the women who later became a massive class

action suit against the manufacturers. It was the

largest class-action suit in legal history, and such

an immense threat that Dow-Corning declared

bankruptcy. The chance for a decent settlement is now

dwindling - the most Mrs. Cosnahan can get for her

disease according to the terms of the new settlement

agreement is about $250,000. To qualify for the

maximum amount, which is unspecified in the papers,

the patient has to either be dead or suffering from

severe kidney failure, she said.

HER FRIEND the educator is also sick. The woman who

once ran five miles a day can barely carry out her

school duties, is often winded, and requires as much

as 12 hours of sleep at a time. Though she got her

implants to enhance her appearance, she and Mrs.

Cosnahan say the women don't let that divide them.

They realize there is strength in their union, even if

they feel isolated from the rest of the world at

times.

``We are the new lepers,'' the woman said. ``These

things sat like toxic waste dumps in our chests.''

Dr. Shanklin, the pathologist who treats the

women in Memphis, has found silicone derivative in

nearly every one of his patients' organs, the women

said. And that explains how it can cause disease, they

claim. As the silicone entered the body from the

ruptured or leaky implants, through the packaging} the

body tried to rid itself of the silicone by sending it

to its traditional means of excretion - to the liver,

the lungs, the kidneys, and eventually the brain.

There, though other scientists claim that silicone is

inert and the body does not react to it, the body's

defense systems attacked, fighting it for so long that

the defense systems began attacking the body itself,

causing what are known as autoimmune diseases.

A RECENT STUDY in Tulane identified a marker in the

blood that is associated with these diseases and found

a higher incidence of this marker in women with

silicone breast implants.

Against that, Dr. can stack up 10 major studies

that showed no relationship between having the breast

implants and developing disease later on.

``In the main, doctors and plastic surgeons and others

pretty much agree there is no cause and effect

relationship between silicone breast implants and

arthritis'' and related diseases, Dr. said. In

fact, in his travels to Poland to perform

reconstructive surgery for children who otherwise

couldn't get it, he's talked to European colleagues

who can and do recommend the gel implants.

He also points out that a federal judge in Washington

state hired an outside expert to review the scientific

data in a breast implant case and came to the same

conclusion about the anti-silicone studies.

``He called all that total junk science and he would

not allow them to be experts in federal court,'' Dr.

said. In his own experience putting in hundreds

of the gel implants, there were a few cases where

there were ruptures, but the silicone did not leak

outside the capsule of scar tissue that forms around

it, Dr. said.

``The (surrounding) breast tissue is absolutely

normal,'' he said. He now uses saline implants and

prefers to do breasts reconstructions from flaps of

skin, fat and muscle taken either from the back or the

stomach.

Doctors don't dismiss the women's suffering, he added.

``I can sympathize with them, but all I can go on is

what science says,'' Dr. said.

FOR BOTH SIDES, that battle will continue. The local

educator will begin her part of the legal battle - she

opted out of the settlement and will have her lawsuit

heard in federal court in Savannah. Once offered $1.4

million to settle, the last offer was about $50,000,

which she said would not even cover a year's worth of

medical bills.

And while they are not nearly as visible as they once

were, the women insist they have not disappeared and

will not back down to the doctors or lawyers.

``We're living in limbo,'' Ms. Cosnahan said. ``But

we're still here. We're going to be here. And we're

still going to be sick.''