Hi Mary,
I have read a few articles on breast implants. Unfortunately the implants that
pop can sometimes cause low grade infections. This happened to my sister in law
and she had tremendous pain and fatigue. It’s not that the silicone or saline
is causing the reaction, it’s the body’s foreign body reaction to it.
Interesting that they talk about contractures after implant but don’t address
pts other pain complaints in the articles I have read.
Agree with a surgical consult. And anything else that will normalize motion and
flexibility for the shoulder as many have commented on. Not sure I would do to
much to the breast and implant until after consult. But if all else is negative
then treatment of ms pain and scars might be appropriate. Dry needling could
work for that.
Keep us posted! Good case for us all to learn from!
Best, Lesli
Sent from my iPhone
On Oct 27, 2020, at 4:31 PM, Leanna Blanchard <blancharddpt@xxxxxxxxx> wrote:Another thing to consider - if her breast implants were textured, certain
brands have been recalled due to associations with BIA-ALCL.
--
Leanna Blanchard, PT, DPT, CLT, OCS, FAAOMPT
Physical Therapist and Doctor of Physical Therapy
Board Certified Specialist in Orthopaedic Physical Therapy
Fellow of the American Academy of Orthopaedic Manual Physical Therapists
Certified Lymphedema Therapist
On Oct 27, 2020, at 3:55 PM, Nancy Roberge <nancyroberge4@xxxxxxxxx> wrote:
Mary,
Here is a link to an interesting article on breast implants which a patient
of mine shared. This particular patient has had pain and tightness from 2
different sets of implants and she was never as loose as she once was (and
she teaches YOGA!) and she always had mild to moderate discomfort. She
opted to have both taken out and is now recovering.
I also had a patient whose body kept trying to ‘reject’ her implants and she
too finally had them taken out.
There are just some women who do not tolerate implants very well for a
multitude of reasons.
Let us know how she makes out.
https://www.newyorker.com/magazine/2020/04/20/do-some-surgical-implants-do-more-harm-than-good
Dr. Nancy J. Roberge
Helping The Patient Diagnosed With Cancer To Live Their ‘Best Life’
Compassionate Oncology and Orthopedic Rehabilitation
On Oct 27, 2020, at 9:13 AM, Mary Fisher <mary.fisher@xxxxxxxxxxx> wrote:
Hello All,
Looking for insights on this case:
Patient underwent mastectomy with implant in 2004 (in another city/docs we
don't know). We saw her for the first time 2 weeks ago. She is not being
followed by any onc docs/surgeons. She complains of significant fatigue
and pain which never goes away. Pain is generalized to the breast and
axillary area, although she is quite sensitive to the touch at the lateral
aspect of the breast. Additional significant findings include a feeling of
a puckered or crinkled implant (not firm/filled). She also reports that
her implant is smaller than it used to be; she wears a prosthetic in
addition to the implant to make breasts more symmetrical. Other not
significant findings include shoulder range limited by pain but lacks any
joint mobility issues; some minor tightness issues easily addressed through
PT with subsequent increased motion; postural changes easily addressed but
not impacting pain; scapular weaknesses also being addressed.
We are very concerned about a leaking implant and have recommended she see
a plastic surgeon.
What is the best course of physical therapy treatment? I cannot find
literature that supports best interventions for this type of situation.
Thanks in advance -
Mary
Mary I. Fisher, PT, PhD | Chair and Associate Professor
Board-Certified Clinical Specialist in Orthopedic Physical Therapy
Certified Lymphedema Therapist
300 College Park | Dayton, OH 45469-2925
mary.fisher@xxxxxxxxxxx | Telephone: 937.229.5617 | Facsimile: 937.229.5601
