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'Breast Implant Illness May Have Caused My Joint Pain, Fatigue' - Women's Health

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In 2005, I decided to have a breast augmentation to give me what I had always thought I was missing...boobs! I was teased in school for having a flat chest and always very self-conscious about it. I had always participated in sports, including gymnastics and track and field, so I had muscular legs and wider hips. I thought getting breast implants would magically make me love my body and myself more.

When I had my consultation, I was told how safe the saline implants were. Immediately after the surgery, I was in a lot of pain, but I was told to expect that because they were slicing into my pectoral muscles. It was over a year before I could do pushups or get back to my normal strength workouts. Running wasn't painful after about eight weeks, but I did find running with my new chest was more difficult than I had anticipated. Other than that, life seemed pretty normal.

Fast forward to 2011, when I started to experience joint pain in my shoulders at six weeks pregnant.

Since I was still running a high number of miles per week and working out with dumbbells, I blamed it on my strenuous workouts. I took time off, and the pain went away as quickly as it came on.

But over the next several months, I went on to experience excruciating flares—each more painful than the last. During this time, I was told it could be everything from a miscarriage to a heart attack. No one knew what was happening to my body. I desperately wanted answers. I knew that it had to be something to do with my joints because that was where the pain was.

It wasn't until after I delivered my daughter that I was officially diagnosed with rheumatoid arthritis (RA).

RA is an autoimmune condition in which your immune system mainly attacks your joints, causing inflammation and pain. If you have symptoms of RA such as swollen and stiff joints, fatigue, and fever, your doctor will order imaging and blood tests to rule in or out the diagnosis.

One of these blood tests measures the amount of rheumatoid factor (RF), a protein produced by your immune system that can attack healthy tissue, in your body. If your RF level is high and you also test positive for another type of antibodies called anti-CCP, that strongly indicates that you have RA, which was the case for me.

My condition attacked my body with a vengeance after I gave birth. Some women may experience milder symptoms during pregnancy, but the disease may become more severe postpartum, research has found. At night, I would get up to pump and, I swear, the bones in my feet felt broken. I couldn't bathe my newborn daughter because my hands were so swollen. I was scared I would drop her. I was in so much pain and tired all the time.

I always assumed my autoimmune disease was triggered by pregnancy, since research has shown women are at greater risk of being diagnosed with one in the first year after delivery. No one knows what causes RA. And no one, not even my doctors, could tell me why I developed RA.

It's possible to achieve remission, a period during which your condition is well controlled and you may feel as if your RA has gone away. I have never achieved remission even though my pregnancy was over 11 years ago and I've been on a biologic after other medications failed to help, and that was why I was still searching for answers.

I don’t smoke (which is associated with more severe symptoms), work out six days a week, run competitively, eat mostly healthy, and was still going through life in a painful fog. There were no answers from any medical professional on why my disease activity was so high.

Then one day I saw a girl on social media talking about her symptoms from breast implant illness (BII). I had the exact same symptoms that she described.

That was when I began doing a deep dive into every published article I could find. Although BII is not an official medical diagnosis, it's recognized as a collection of symptoms related to breast implants, many of which overlap with symptoms of autoimmune diseases. BII often causes fatigue, joint pain, brain fog, facial swelling, dry hair and skin, and rash. And breast implants are associated with an increased risk of some autoimmune diseases, including RA, a 2018 study showed.

In my research, I also learned that, in 2021, the FDA put a black box warning on saline and silicone breast implants packaging to advise patients of the risks and side effects, mainly that textured implants have been linked to cancer of the immune system and BII. Then it hit me, What if I did this to myself? Could my implants be the cause of these symptoms?

Expert note: We don't know for sure what the association between BII and RA is, or how one affects the other. One theory is that silicone can trigger an immune response in the body, says Scott Zashin, MD, an internist and rheumatologist based in Dallas, Texas, who is not involved in Rider's care. He has seen similar cases and says he would warn any of his patients with RA interested in getting breast implants that they may see an exacerbation of their symptoms.

"If someone is on standard therapies, including what we call biologics, and continue to have bad flare-ups, then you wonder, 'Okay, is there something else driving this immune response?' " Dr. Zashin says.

So, he urges patients to share whether they've had breast implants in the past with their physicians if they have an autoimmune disease. This way, you can open the convo regarding BII, what doctors know and don't know, and/or whether an explant procedure would make sense for you.

Once I had scrolled every inch of the web and felt armed with knowledge, I decided to look for a plastic surgeon to remove my implants.

I had already spoken with my rheumatologist and plastic surgeon about my symptoms, but the medical community does not recognize BII as a formal diagnosis, and they ultimately left the decision up to me. I knew I wanted the implants out with 100 percent certainty.

I knew that removing my breast implants had the potential to improve my symptoms, but also that they would not go away completely, and my RA would not be cured. The risk of complications of explant surgery is usually low, but there were risks. I'm more prone to infections since I take a biologic that lowers my immune system's ability to fight infections. And I was terrified to go under the knife because of my daughter. But the potential upsides outweighed the risks for me.

I went in for my surgery on December 15, 2022.

The surgery went well and I had drainage tubes and a compression bra after. The day after surgery, I woke up and my face wasn't swollen. I actually had cheekbones again and my Face ID worked!

My chest no longer felt heavy, and I felt as though I could finally take full breaths. After 48 hours, I had my first shower and I felt like a new person. I was hoping that I would stay in this glorious state of not being on RA medication, but that did not last.

I was supposed to be off the injections for another month to let my body heal, but my RA symptoms started flaring and I ended up back on prednisone and the biologic injections. (Dr. Zashin notes it may take about six months to see improvement in RA symptoms post-surgery.)

I'm only 12 weeks out from surgery and I'm hoping that my condition will continue to improve. I have more energy now, and my hair and skin aren't dry anymore. I actually have to shower more now because the natural oils are coming back into my hair and skin.

I had implants for 17 years and I have to allow my body time to heal that many years' worth of damage.

I feel better simply knowing I removed a foreign object from my body and feel confident in my skin. I do feel a new sense of power over making the choice to love my body as it is. I am hopeful that with time my body will heal and remission will be possible. However, that is a hope and there is no guarantee.

The decision to have your breast implants removed is entirely personal. I was compelled to share my story and be transparent about BII and RA because, the truth is, I am still suffering. It's my goal to speak openly and honestly about my experiences so others have information that I didn’t when I made my decision. Knowledge truly is power.

Women are often overlooked when they complain about illnesses or symptoms. Some medical professionals don't recognize breast implant illness as a real issue and, most likely, you will find out about it from a friend, social media, or a magazine article. I learned that you have to advocate for yourself and your health.

—Additional reporting by Jackie Lam

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