The Cincinnati Enquirer from Cincinnati, Ohio on September 15, 1991 · Page 138
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September 15, 1991

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The Cincinnati Enquirer from Cincinnati, Ohio · Page 138

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Cincinnati, Ohio
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Sunday, September 15, 1991
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J-4Health THE CINCINNATI ENQUIRER Sunday, September 15, 1991 Books explore current trends .Breast implants raise questions Despite anxiety, safety issues remain unresolved, experts say For information my, silicone gel breast implants and mammography. The section on caesarean section includes a list of C-section rates at more than 2,400 hospitals (highest in Cincinnati is Jewish Hospital at 33.2; lowest is Brown County General at 11.4). Can Your Doctor Be Wrong? (Pharos Books; $18.95), by Dr. Jay Goldstein, a psychiatrist and family physician, gives patients advice on making sure their sometimes tricky or elusive symptoms are being taken seriously. The book covers headaches, stomach pain, fatigue, irritable bowel syndrome, chronic sore throat, sleep problems, impotence, body aches and pains, premenstrual syndrome. Your Maternity Leave (Poseidon Press; $8.95) guides parents through the questions, that precede the birth of a baby and the decision-making that's required once the baby arrives. Author Jean Marzollo includes strategies and approaches for women who intend to return to work "without getting lost, trapped or sandbagged along the way." BY SUE MacDONALD The Cincinnati Enquirer Two words are emerging as themes in women's health in the '90s accountability and access. Many new books on women's health reflect those themes: Take This Book to the Gynecologist With You (Addison Wesley; $9.95) and Take This Book to the Obstetrician With You (Addison Wesley; $9.95) are products of the consumerist People's Medical Society (PMS). Both outline routine and non-routine reasons for gynecological and obstetrical visits, complete with charts, lists of questions and advice on getting optimum care. PMS Director Charles Inlander collaborated on the books. Women's Health Alert: What Most Doctors Won't Tell You (Addison Wesley; $7.95) by Dr. Sidney M. Wolfe discusses procedures, pills and products for women birth-control pills, tranquilizers and antidepressants, postmenopausal hormones, hysterecto For Information about implants, ask your doctors to share materials they may have available on implants including the package inserts. Also, information is available by contacting: The Food and Drug Administration prefers inquiries be sent on a post card to this address: Breast Implants, FDA, HFE-88, Rockville, Md. 20857. Maryland Department of Health and Mental Hygiene, 201 W. Preston, Baltimore, Md. 21201. Public Citizen Health Research Group, 7000 P Street NW, Suite 700, Washington, D.C. 20036. Call 202-833-3000. Command Trust Network is a consumer-information group for past and potential implant patients: P.O. Box 17082, Covington, Ky. 41017. Call 331-0055. American Society of Plastic and Reconstructive Surgeons, 444 E. Alonquin Road, Arlington Heights, III. 60005. Call 800-635-0635. KATHLEEN M. HINES ADVKRTISKMKNT AIIVKKTIStiMKINT Weight Loss Surprises Researchers BY KATHLEEN M. HIXES Enquirer Contributor Breast implants are a hot topic now, and the fire isn't showing any signs of smoldering. Because recent reports have questioned implants' safety the majority of which are filled with silicone gel many women who have been considering the procedure are now having second thoughts. While some say the claims about implants' potential hazards have been blown out of proportion and sensationalized, the Food and Drug Administration (FDA) reports that more than 5,000 breast-implant patients have filed complaints since 1984. Earlier this year, the FDA gave manufacturers of silicone gel-filled implants until July 9 to conduct studies proving their products' safety. By deadline time, the FDA received reports on 10 products from seven implant manufacturers. On Aug. 22, the FDA announced that reports for three of the products were incomplete, meaning those manufacturers must either withdraw their products from the market or file appeals. The FDA plans to complete its analysis of the remaining products by January, 1992. Susan Cruzan, FDA spokeswoman, says the trade names of those implants which pass the FDA's final review won't be available until the FDA report is released. Doctors caught in middle In the meantime, many women who have already had the procedure about 130,000 last year and 2 million since the early 1960s are confused by studies that question the safety of implants. Plastic surgeons are caught between scientific investigations and a frightened public. "Problems do exist, otherwise there wouldn't be any media coverage," says Dr. Lu-Jean Feng, a plastic surgeon with a specialty in microvascular surgery at Mount Sinai Medical Center in Cleveland. "But whether these problems are clearly 100, without a doubt, causably related to the implant is what's being debated," she adds. "There are a lot of things we don't understand." The issues causing the most concern are questions about: The effect silicone gel has on the body if it leaks or the implant ruptures. Autoimmune disease such as lupus, arthritis and scleroderma have been linked to silicone release. Whether polyurethane-foam covering used in about 10 of implants cause cancer. A recent FDA study found this coating releases a substance into the body called 2-toluene diamine (TDA). This chemical has been shown to cause cancer in laboratory rats. Dr. Leonard Singer, director of plastic and reconstructive surgery at Jewish Hospital, says no study has proven any risk for women who use implants. "There is not a shred of scientific evidence linking implants and human cancer," he says. "Nor is there any solid evidence linking implants and immunearthritic disease." Singer says silicone products are considered among the safest of materials implanted in the body. "They are used for many medical applications including artificial joints, pacemakers and blood-drawing needles (and) are even used in breast-implant surgery. According to the FDA, a capsular contracture in which the scar tissue around the implant hardens occurs in some degree in up to almost 75 of cases. The condition can cause discomfort, pain, distortion and displacement of the breast. In some cases, a second surgery is required to release the scar tissue or in the most extreme cases to have the implant removed. In a study of 165 implant recipients, 41 reported numbness in the nipple, but the condition usually disappears within a year. Implants have also been faulted for making mammography difficult and delaying detection of breast cancer. This poses a particular risk for those with a family history of breast cancer. Specialists tell women who have had implants to tell the mammogram technician there is an implant. Meanwhile, scientists are developing an implant that low-dose X-rays can penetrate. Satisfied customers Despite critical studies and coverage, there are many satisfied customers women who say that they would not hesitate to do it again. Trish Hanna, 44, of Fairfield, a certified financial planner, says she's among them. "It never crossed my mind to be worried because I trusted my surgeon completely," Hanna says. Hanna had breast-reconstructive surgery at age 39, four years after a partial radical mastectomy. "It's hard for me to even remember that I had cancer or to remember what it was like not to have a breast on that side," she says. Feng says that before a woman makes a decision concerning breast-implant surgery, she should do some detailed research of her own. "You really need to know all the risks and all the benefits and all the alternatives," Feng says. "You need to educate yourself about the types of implants available and talk to people who have them." Hanna agrees that it's not a decision that should be entered into lightly and suggests that a woman should not only interview a number of doctors but also their patients. "I think your decision should not just be based on who has the reputation or doing the most in town but who you personally feel the best with and who will meet your emotional needs," Hanna says. Kathleen Anneken, R.N., president of the Covington-based Command Trust Network, a consumer-information group, says she is in touch with 7,000 women, the majority of whom have experienced problems with their implants. She says her mission is to empower women to make their own intelligent decisions. "We urge women to gather as much literature as possible including the package insert that comes with the implants before either having implant surgery or having implants already in place removed." Anneken, 44, who had four surgeries to correct complications from implant surgery in 1972, had the implants removed in 1989. "I recommend that women considering this surgery at least wait until early next year when the FDA finishes its review of the remaining studies and there will be more information available to the public," she says, adding that she believes a safer implant will be available in the not too distant future. colloids has been a windfall for some overweight people: A Daytona Beach, Florida woman fighting a weight battle for 12 years used the product on the recommendation of her physician and lost 30 pounds. She stated "Not only have I lost 30 pounds but my cholesterol has dropped from 232 to 143. I have two closets full of clothes which have not fit me in two years that I can now wear." In a separate interview revealed that a Wilmington, North Carolina pharmacist lost 14 pounds in 3 weeks on the product and was never hungry. Food Source One tablets are part of National Dietary Research's comprehensive plan to bring a rapid end to obesity in this country. A variety of nutritionally sound diet plans, specially prepared by NDR, accompany each bottle and provide a natural, drug free alternative for confronting the problem of obesity. some antacids and food additives." Singer believes the FDA's review of implants will not result in any action regarding their use. But Dr. Harry Spiera, chief of rheumatology at Mount Sinai Medical Center in New York City, says it may be some time before the total picture is clear. "The full impact may not be apparent yet because so much time can elapse between implant surgery and the onset of symptoms," Spiera says. Singer, however, says such statements fuel unnecessary fear. "It's true the product has only been around since the mid-'60s, so I suppose you could say, 'What's going to happen to these people 30, 40, 50 years down the line?' But the same thing applies to everything we use in daily life," he says. Removal not warranted Until more is known, women who have had implants will have to wait. It's even not recommended they have their implants removed. Dr. Glen Warden, a Cincinnati surgeon, chairs the FDA advisory panel that says removing implants because of concerns about cancer is not warranted. "If you have polyurethane implants, the current recommendation from the FDA, the American Society of Plastic and Reconstructive Surgeons and the manufacturer is not to remove the implants," Singer says. "If there is a concern about toxic materials released from the implant, there would be a substantially greater amount released at the time of removal than over a patient's lifetime." The FDA panel advises women who are considering having their implants removed anyway to select a surgeon with a great deal of expertise in this area and research the issue carefully before making such a decision. Common side effects As is the case with any type of surgery, there are well-documented side effects to WASHINGTON A nutrition organization was hopeful that a nutritionally complete "hi-tech" food tablet would help erase world hunger problems, until a study revealed that one of the ingredients could cause significant weight loss. Although other studies and scientists may not agree, researchers in Europe found that the ingredient, a natural plant colloid, actually caused people to lose weight, even though specifically instructed not to alter normal eating patterns, according to one study published in the prestigious British Journal of Nutrition. Researchers in an earlier study had speculated that the weight loss was due to a decrease in the intestinal absorption of calories. While the project of National Dietary Research, aptly named Food Source One, would not be used to successfully fulfill its original goal, the formula which has since been improved with other natural IWI Omnimin Intcrimlinnal CINCINNATI Kenwood Pharmacy 7677 Montgomery Rd. 793-1111 Ml. Carmel Pharmarv 501 BataviaPike 528-2110 Kunkel Apothecary 7175 Bcechmonl Ave. 2.11-194.1 Adrien Pharmacy 7(123 Miami Ave. 561-7700 Wolft-r Pharmary 7687 Uerrhmonl Ave. 2.11-6680 VWonli & Lerhlrr Pharmary 6106 Hamilton Ave. 511-0975 WEST CHESTER Berketl Pharmacy 8264 Princrlon-Glcndale Kil. 874-4450 Kingitgate Pharmacy 7324 kingngate Way 779-0284 LOVELAND 20 Mile Pharmarv 3213 I S 22 S3 ir.t 68.1-7575 Loveland Family Pharmarv 295 W. Loveland Ave. 683-1300 FAIRFIELD r'airfirld Pharmacy 5145 Pleaiant Pharmary 863-3350 BATAVIA Mollov ' Pharmacy 235 Main St. 732-2555 AMELIA Pill Box 245 W. Main 753-4700 COSH EN Pohltnan Pharmacy 6722 Highway 132 722-3784 WINCHESTER Winchester Pharmacy 19223 St. 111. 1.16 695-0010 WILLIAMSBURG Fitzgerald Pharmacy 305 W. Main St. 724-7081 HILLSBORO Hillerest Pharmarv 111S. High St. 39.1-2361 ByronMarks, M.D., Radiologist, Nancy Trent, M.D., OBGYN ByronMarks, M.D., Radiologist, Nancy Trent, M.D., OBGYN " '$ I I '1 ! ; ! 4"., - it t, N A mammogram cantellyoumore about yoiffjuture than having your palm read. A mammogram can be the difference between beating cancer and being its victim. Because it can spot breast cancer years before a lump can be felt. That's why it's so important to have your mammography screening done at a center that specializes in women's health. One that can tell you how to establish a total breast health program. So call the Louise Southgate Women's Center at 572-3456. A physician's order is not necessary. And start taking matters into your own hands. '' . ' m f j-V . " - ., A ' -w- .i...n: , V 'i , .X. .. i V - j .!!- - ' i Ji , f ' ' - ' It . I. " " ' I Ji,' . . ;f n ., immS V ' I I- lt,k,-lwUi. Iw. . I J H i ttl 1 tin "itti 1 4?i m 0m Jjtxlt VV ' I 1 Uulw Southgl Jr ) S' HO"""1 t O h S I. l. U K : O S I I A I. 525 Alexandria Pike Southgute, Kentucky 41071 572-3456

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