Latest / Resiliency Radio with Dr. Jill Carnahan, MD / 340 Resiliency Radio with Dr. Jill - Breast Implant Illness: What Every Woman Needs to Know

Transcript

340 Resiliency Radio with Dr. Jill - Breast Implant Illness: What Every Woman Needs to Know · Resiliency Radio with Dr. Jill Carnahan, MD

• 0:01
  Dr. Jill Carnahan: Welcome to Resiliency Radio, your go to podcast for the most cutting edge insights integrative and functional medicine.
• 0:08
  Dr. Jill Carnahan: I'm your host Dr. Jill and with each episode we dive into the heart of healing and personal transformation.
• 0:15
  Dr. Jill Carnahan: Join me as I interview medical experts, world leaders, thought leaders, innovators of all types bringing you great information to help you on your journey to optimal health and healing.
• 0:24
  Dr. Jill Carnahan: Today is no different.
• 0:25
  Dr. Jill Carnahan: You are going to learn so much about breast related implant illness.
• 0:29
  Dr. Jill Carnahan: If you or a woman you love has had implant illness or suspects that their fatigue, their autoimmune or their other symptoms that are unexplained which occurred since they received implants, are related to those implants, you're going to learn all about what really underlies this illness.
• 0:46
  Dr. Jill Carnahan: You're going to want to stay tuned.
• 0:47
  Dr. Jill Carnahan: This is a fascinating and really life changing episode and I'll introduce Dr. Robert Whitfield in just one moment.
• 0:54
  Dr. Jill Carnahan: Before I do, I want to remind you that you can get great products and services and 15% off your first purchase.
• 1:00
  Dr. Jill Carnahan: At DrJillHealth.com we have things such as the SIBO treatment kit.
• 1:04
  Dr. Jill Carnahan: We have mast cell activation and histamine.
• 1:07
  Dr. Jill Carnahan: Types of blockers and treatments are some of our best sellers are the histocyst, the histamine blocker and all things related to histamine related treatments and mast cell activation.
• 1:18
  Dr. Jill Carnahan: You can also get Dr. Jill beauty products.
• 1:21
  Dr. Jill Carnahan: These are top sellers every single month.
• 1:24
  Dr. Jill Carnahan: Once people try them, they love them and people always ask me about my skincare regimen and it actually includes my own products.
• 1:31
  Dr. Jill Carnahan: I wanted to remind you today about a couple things I haven't talked to a lot about.
• 1:34
  Dr. Jill Carnahan: This microderm Abra Vision scrub.
• 1:36
  Dr. Jill Carnahan: It is delightful to use in the morning or after your shower before bed.
• 1:40
  Dr. Jill Carnahan: I love this scrub.
• 1:42
  Dr. Jill Carnahan: You can get that@drjillhealth.com and then one of our top selling kits, if you don't know where to start, is this Mini Miracle Kit.
• 1:49
  Dr. Jill Carnahan: I title it that way because it includes retinols and powerhouses for the eyes for the skin and the Vita C E serum which is a beautiful antioxidant you can put on in the morning.
• 1:59
  Dr. Jill Carnahan: So if you're looking to upgrade your skin care and it's time and you've just hit 30s, 40s, 50s, whatever age you are or older or younger really and you want to upgrade that, I'd suggest you start with that Mini Miracle Kit.
• 2:12
  Dr. Jill Carnahan: The results are astounding and 30 days and you're going to notice.
• 2:16
  Dr. Jill Carnahan: So check that out@drjillhealth.com also if you don't know my clinic, Flat Iron Functional medicine in Louisville, Colorado, we are accepting new patients.
• 2:25
  Dr. Jill Carnahan: You can call 303-993-7910 to schedule or get more information.
• 2:31
  Dr. Jill Carnahan: You can also email info@FlatironFunCT Functional Medicine.com okay, let me introduce our guest.
• 2:37
  Dr. Jill Carnahan: Dr. Robert Whitfield is a world recognized holistic plastic surgeon, leading medical authority on breast implant illness, board certified by the American Board of Plastic Surgery.
• 2:46
  Dr. Jill Carnahan: He brings more than two decades of experience in advanced breast surgery, oncology, reconstruction and microsurgery.
• 2:53
  Dr. Jill Carnahan: You're going to love this interview with him.
• 2:55
  Dr. Jill Carnahan: He is incredible knowledgeable.
• 2:57
  Dr. Jill Carnahan: He's a pioneer who integrates functional medicine with surgical excellence to support the whole body healing.
• 3:02
  Dr. Jill Carnahan: He's out of Austin, Texas.
• 3:04
  Dr. Jill Carnahan: His work is known internationally in complex breast explant procedures, post explant detoxification, breast implant illness, and he's the author of two definitive books on holistic surgical recovery and explant care.
• 3:17
  Dr. Jill Carnahan: Let's get to the show with Dr. Robert Whitfield.
• 3:21
  Dr. Jill Carnahan: Dr. Robert Whitfield, you have been an expert in a topic that so many of my patients ask me about.
• 3:29
  Dr. Jill Carnahan: And so when your PR team reached out touch base about the podcast, I was like, yes, yes, let's get on.
• 3:34
  Dr. Jill Carnahan: Let's get you on the show because this is such a common question I get and I know a limited amount, but today I'm here along with the audience and we really want to know from the expert, which is you, about breast implant illness.
• 3:47
  Dr. Jill Carnahan: So before we go there, we're going to dive deep, but I want to know a little bit about your background.
• 3:51
  Dr. Jill Carnahan: How did you get into medicine?
• 3:53
  Dr. Jill Carnahan: Do you want to tell us a little bit about your story?
• 3:56
  Dr. Robert Whitfield: Yeah.
• 3:56
  Dr. Robert Whitfield: So once again, thank you so much for having me on.
• 3:59
  Dr. Robert Whitfield: This is really great opportunity to educate and that's what we are about at our clinic in Austin, Texas.
• 4:05
  Dr. Robert Whitfield: And so my background is basically in oncology and oncologic reconstruction.
• 4:10
  Dr. Robert Whitfield: So after I got done with medical school, I did traditional general surgery training from 96 to 2002.
• 4:17
  Dr. Robert Whitfield: For many of you who are old enough to know that or anything about medicine, that was before the 80 hour workweek.
• 4:23
  Dr. Jill Carnahan: Me too.
• 4:25
  Dr. Robert Whitfield: There's a little bit of difference between being trained then and being trained now in terms of repetitions.
• 4:30
  Dr. Robert Whitfield: I had great training, great mentors and I ultimately really got interested in microsurgery in a lab experience that I had for a year.
• 4:39
  Dr. Robert Whitfield: And we did microsurgery and I just became fascinated by being able to Operate on a microscope and see all the visualization.
• 4:48
  Dr. Robert Whitfield: I like problem solving.
• 4:50
  Dr. Robert Whitfield: So reconstructive surgery obviously fits that really to a T. And there's nothing that appealed to me more than oncologic reconstruction.
• 4:58
  Dr. Robert Whitfield: There's so many high stakes in oncology and oncologic reconstruction.
• 5:02
  Dr. Robert Whitfield: So I gravitated towards plastic surgery because of that, because one, you can operate on, you know, all types and sizes of patients.
• 5:15
  Dr. Robert Whitfield: And if you chose to operate and focus on children, you could.
• 5:19
  Dr. Robert Whitfield: Or cleft lip.
• 5:21
  Dr. Robert Whitfield: I really just like the cancer reconstruction.
• 5:24
  Dr. Robert Whitfield: So I was the guy, if you had a tumor, a leg or a breast tumor or a throat cancer, they would call, you know, our team to help reconstruct the jaw or the tongue or the throat or the breast or the leg or the hip or whatever it was.
• 5:40
  Dr. Robert Whitfield: And it really didn't matter what day of the week or what time of the day it was.
• 5:46
  Dr. Robert Whitfield: That was.
• 5:47
  Dr. Robert Whitfield: I was very motivated to go solve those problems.
• 5:53
  Dr. Robert Whitfield: Wow, that's.
• 5:54
  Dr. Robert Whitfield: I mean, I did that for my career, basically.
• 5:57
  Dr. Jill Carnahan: I love it because the most interesting people, and for sure, the people I love to have on the podcast are those who have that curiosity that doesn't end when we get out of medical school.
• 6:04
  Dr. Jill Carnahan: You know, so many of our colleagues, God bless them, you know, they stop learning.
• 6:09
  Dr. Jill Carnahan: And I really love of that drive to solve problems and to be creative.
• 6:14
  Dr. Jill Carnahan: Because I think it's like the blend of right brain, left brain science, and this intuition and kind of this wisdom.
• 6:19
  Dr. Jill Carnahan: And if we remain open, our patients teach us a lot, right?
• 6:23
  Dr. Jill Carnahan: Like, over the years, you've probably learned a lot.
• 6:25
  Dr. Jill Carnahan: And that leads to my second question, which is you're trained in conventional plastic surgery, oncological reconstruction and microsurgery, not like integrative, personalized precision kind of like my world.
• 6:36
  Dr. Jill Carnahan: But you obviously had some insights into the patients, you know, their questions and stuff.
• 6:41
  Dr. Jill Carnahan: When was the moment that you realized there might be something happening here that surgery alone can explain as far as breast implant, like, how was that shift to think about that as maybe there could be an issue?
• 6:51
  Dr. Jill Carnahan: And I know again, you're going to bust some myths here, so if I ask these in the wrong way, you just shift me the other direction.
• 6:56
  Dr. Jill Carnahan: But was there a moment when you started saying, huh, is there something about the materials that are affecting the women?
• 7:03
  Dr. Robert Whitfield: Well, I think in general, you know, I was the new kid on the block, so to speak, when I showed up in 2005 in academic practice, I was practicing and I wanted to perfect a technique called perforator flap surgery, which was a technique to do reconstruction with just the skin and fat and the blood vessels without taking the muscles.
• 7:24
  Dr. Robert Whitfield: So the traditional technique was to either rotate tissue, and that was a composite type flap that was rotational.
• 7:33
  Dr. Robert Whitfield: And then as we advance and microsurgery came into fold in the 60s and the 70s and the 80s, you could disconnect, transport, and reconnect and revascularize.
• 7:44
  Dr. Jill Carnahan: And.
• 7:46
  Dr. Robert Whitfield: The evolution, obviously, then after that is like, well, we don't really need to hurt the muscle.
• 7:51
  Dr. Robert Whitfield: We don't need to disable it.
• 7:56
  Dr. Robert Whitfield: And that was fascinating to me.
• 7:58
  Dr. Robert Whitfield: Just like microsurgery in general, all these muscle and nerve preservation techniques were interesting.
• 8:04
  Dr. Robert Whitfield: So I became very focused and started training other plastic surgeons to do what's called perforator flap surgery, which is just the next iteration of that or evolution of that type of training.
• 8:17
  Dr. Robert Whitfield: And so, because I was the new guy, I always got the interesting cases, if you know what I mean.
• 8:22
  Dr. Robert Whitfield: And people heard about me doing this type of surgery.
• 8:27
  Dr. Robert Whitfield: And there was an article written about me in the local newspaper, and I had a patient come down to see us just to see if we could help them.
• 8:36
  Dr. Robert Whitfield: They kept having what was called red breast syndrome.
• 8:38
  Dr. Robert Whitfield: It had a breast reconstruction with implants, and every so often they would just get a red chest.
• 8:45
  Dr. Robert Whitfield: And the caregivers, the doctors, they thought she was having an infection.
• 8:52
  Dr. Robert Whitfield: So she would get typically hospitalized and placed on an IV antibiotic like vancomycin.
• 8:58
  Dr. Robert Whitfield: And she told me, like, sometimes it would go away and sometimes it wouldn't.
• 9:07
  Dr. Robert Whitfield: And so I was like, well, that's not an infection.
• 9:10
  Dr. Robert Whitfield: If it was an infection, it either goes away or doesn't go away, and you operate on, or you.
• 9:15
  Dr. Robert Whitfield: You resolve it, whatever.
• 9:16
  Dr. Robert Whitfield: Like, it's just not one of those.
• 9:18
  Dr. Robert Whitfield: It's like, it's not one of those things that just goes away.
• 9:22
  Dr. Robert Whitfield: So I said, maybe you're just having a reaction.
• 9:25
  Dr. Robert Whitfield: And this is more of like a histamine release.
• 9:27
  Dr. Robert Whitfield: And if it's more of this quote, unquote, reaction to the device, we'll just say that, yeah, there's a principle of both genetics that started really, organ transplantation.
• 9:41
  Dr. Robert Whitfield: So Joseph Murray was a plastic surgeon who won the Nobel prize for the first kidney transplant.
• 9:47
  Dr. Robert Whitfield: It was done in 1952 between genetically identical twins.
• 9:51
  Dr. Robert Whitfield: And so I use those principles that I think often about what he was able to do, because he basically did an autologous transplant, because it's a genetically identical transplant.
• 10:06
  Dr. Robert Whitfield: So if we take that premise and I do a breast reconstruction with your tissue, and I just transport it up and I revascularize it to your own blood vessels.
• 10:16
  Dr. Robert Whitfield: I'm doing basically what's called an auto or autologous reconstruction.
• 10:21
  Dr. Robert Whitfield: And if I take all the scar tissue out, which I think is very important, we can touch on why.
• 10:24
  Dr. Jill Carnahan: Okay.
• 10:26
  Dr. Robert Whitfield: And I do the reconstruction.
• 10:27
  Dr. Robert Whitfield: If I've done my job right, if I've connected the blood vessels.
• 10:30
  Dr. Jill Carnahan: Yes.
• 10:31
  Dr. Robert Whitfield: Then that area is now going to be devoid of the stimulus to your immune system to cause the response.
• 10:38
  Dr. Robert Whitfield: The histamine response will go away because there's nothing to trigger it.
• 10:42
  Dr. Jill Carnahan: Yes.
• 10:43
  Dr. Robert Whitfield: And basically it went away and she never had it again.
• 10:47
  Dr. Jill Carnahan: Wow.
• 10:49
  Dr. Robert Whitfield: So before I knew what I was actually doing, I was caring for a patient who had what would become now, which is very common, referred to, you know, breast implant illness type symptom.
• 11:02
  Dr. Robert Whitfield: And then there's mast cell activation, there's people with lots of histamine release, long Covid Lyme disease, parasitic infections, mold toxicity, pfas.
• 11:12
  Dr. Robert Whitfield: I mean, if you can.
• 11:13
  Dr. Robert Whitfield: Yeah, you can name something.
• 11:14
  Dr. Robert Whitfield: I run into that all the time.
• 11:16
  Dr. Robert Whitfield: Yeah.
• 11:17
  Dr. Jill Carnahan: Hey, guys, want to interrupt this episode for just a moment to remind you if you are looking for a functional medicine doctor or practitioner to help you in your journey, whether you have breast related implant illness or other things like mast cell activation.
• 11:30
  Dr. Jill Carnahan: We are accepting new patients at Flatiron Functional Medicine, my Clinic in Lewisville, Colorado, we'd love to see.
• 11:38
  Dr. Jill Carnahan: I have two other providers.
• 11:39
  Dr. Jill Carnahan: You can call 303-993-7910 or email info flatironfunctionalmedicine.com if you want to look at the provider's bios and get to know us a little more, just visit jillcarnahan.com okay, let's get back to our show.
• 11:55
  Dr. Jill Carnahan: Okay.
• 11:56
  Dr. Jill Carnahan: That makes so much sense.
• 11:57
  Dr. Jill Carnahan: And just for our lay audience, we have a lot of physicians who listen to.
• 11:59
  Dr. Jill Carnahan: So they're going to follow you.
• 12:00
  Dr. Jill Carnahan: Exactly.
• 12:01
  Dr. Jill Carnahan: But I want to restate and make sure that I understand what you're saying.
• 12:04
  Dr. Jill Carnahan: Traditionally, the flaps were attached to wherever they were attached to.
• 12:07
  Dr. Jill Carnahan: You flip them around, put them where they need to go.
• 12:09
  Dr. Jill Carnahan: Right.
• 12:09
  Dr. Jill Carnahan: And that vascular train was never disrupted.
• 12:12
  Dr. Jill Carnahan: But you started to develop these new ways of actually totally detaching whatever tissue you were working with, dissecting it and actually putting it in place and revascularizing it so that it didn't have to be the traditional flap.
• 12:24
  Dr. Jill Carnahan: Is that what you were saying?
• 12:25
  Dr. Robert Whitfield: Rotating?
• 12:26
  Dr. Jill Carnahan: Yes, rotating.
• 12:28
  Dr. Robert Whitfield: Those techniques already existed.
• 12:29
  Dr. Robert Whitfield: My whole thing was to not involve the muscle.
• 12:32
  Dr. Jill Carnahan: Got it.
• 12:32
  Dr. Robert Whitfield: So we wanted to separate it.
• 12:34
  Dr. Jill Carnahan: Yes.
• 12:34
  Dr. Robert Whitfield: So perforator flap surgery.
• 12:36
  Dr. Jill Carnahan: Yeah.
• 12:36
  Dr. Robert Whitfield: Was not standard of care at that point in this country, it was in different areas of Europe and Asia, but we really focused on it hard in the, we'll say the mid-2000s.
• 12:51
  Dr. Robert Whitfield: Yeah.
• 12:52
  Dr. Robert Whitfield: And for whatever reason, you know, there's lots of reasons our country is so big.
• 12:57
  Dr. Robert Whitfield: Like, I'm in Texas and Spain just won the World Cup.
• 13:00
  Dr. Robert Whitfield: Spain fits in Texas.
• 13:01
  Dr. Robert Whitfield: Just everybody's listening, understands the land mass we're dealing with here.
• 13:05
  Dr. Robert Whitfield: So I often get asked, like, why would patients get, you know, breast reconstruction with implants?
• 13:11
  Dr. Robert Whitfield: You know, they'll say, that seems like not a great idea.
• 13:15
  Dr. Robert Whitfield: Right.
• 13:16
  Dr. Robert Whitfield: And so everybody needs to understand what I just said about the country.
• 13:20
  Dr. Robert Whitfield: I live in Austin.
• 13:21
  Dr. Robert Whitfield: You can drive 40 minutes in either direction, except for north, and be in the country basically really quickly.
• 13:32
  Dr. Robert Whitfield: And if you're outside of an urban area, in a smaller community of a few thousand, ten thousand, fifty thousand people, you're going to have a community based hospital, typically.
• 13:42
  Dr. Jill Carnahan: Yes.
• 13:43
  Dr. Jill Carnahan: Yes.
• 13:43
  Dr. Robert Whitfield: And that's going to have a general surgeon.
• 13:46
  Dr. Robert Whitfield: They might not even have a focus on a particular portion of surgery like breast or thyroid or anything, because they can't.
• 13:54
  Dr. Robert Whitfield: They have to be the general surgeon for the community.
• 13:58
  Dr. Robert Whitfield: And then there typically, hopefully is a plastic surgeon.
• 14:03
  Dr. Robert Whitfield: Now, they certainly wouldn't have the resources I had at a teaching hospital where I had an operating room microscope that cost a quarter of a million dollars.
• 14:12
  Dr. Robert Whitfield: I had anesthesia staff that knew what I was doing.
• 14:15
  Dr. Robert Whitfield: I had instrumentation that cost several hundred thousand dollars.
• 14:18
  Dr. Jill Carnahan: Yes.
• 14:18
  Dr. Robert Whitfield: I had nursing staff, techs, post op care people, the nurses on the wards, elaborate monitoring devices that went to my phone at night so I didn't have to worry.
• 14:29
  Dr. Robert Whitfield: Like, it's a very different.
• 14:32
  Dr. Jill Carnahan: Yeah.
• 14:32
  Dr. Robert Whitfield: You know, situation.
• 14:34
  Dr. Jill Carnahan: Which allowed you to do this really great work too, right?
• 14:37
  Dr. Robert Whitfield: Yeah, yeah.
• 14:38
  Dr. Robert Whitfield: People just need to understand and like you need to have a balanced discussion about what's available.
• 14:45
  Dr. Robert Whitfield: And then you just want your patients to make the informed decisions that are best for them.
• 14:50
  Dr. Robert Whitfield: And if they choose to have an implant based reconstruction, that's totally their prerogative, as long as they understand everything.
• 14:56
  Dr. Robert Whitfield: And that's probably when you know people, there's a little confusion there about, you know, how to explain this properly.
• 15:03
  Dr. Robert Whitfield: And so for everybody listening from the beginning, when I would discuss implant based reconstruction or cosmetic augmentation, you always discuss something getting infected.
• 15:14
  Dr. Jill Carnahan: Yes.
• 15:15
  Dr. Robert Whitfield: Because anything you put in, anybody that's not autologous or your own tissue can get infected.
• 15:21
  Dr. Jill Carnahan: Yes.
• 15:22
  Dr. Jill Carnahan: Okay.
• 15:23
  Dr. Robert Whitfield: Or have a foreign body reaction or some type of reaction.
• 15:26
  Dr. Robert Whitfield: So.
• 15:27
  Dr. Jill Carnahan: So that makes sense.
• 15:28
  Dr. Jill Carnahan: That's why I just wanted to clarify because this is really fascinating to me.
• 15:31
  Dr. Jill Carnahan: I don't know if you knew, but 20 plus years ago I was breast cancer survivor.
• 15:35
  Dr. Jill Carnahan: So I've been through my own journey.
• 15:36
  Dr. Jill Carnahan: So I understand and actually really have.
• 15:39
  Dr. Jill Carnahan: Yeah.
• 15:40
  Dr. Jill Carnahan: 25 Years old.
• 15:40
  Dr. Jill Carnahan: I was years ago, the youngest one.
• 15:42
  Dr. Jill Carnahan: Diagnosed at Loyola University in Chicago where I did medical school.
• 15:45
  Dr. Jill Carnahan: So.
• 15:46
  Dr. Jill Carnahan: So I'm very familiar with the oncology world and as a survivor and, you know, very passionate about this information.
• 15:52
  Dr. Jill Carnahan: Currently is your practice almost 100% oncology patients who are getting reconstruction or do you ever get.
• 15:59
  Dr. Robert Whitfield: No.
• 16:00
  Dr. Robert Whitfield: Yeah, basically we stopped doing oncology reconstruction towards the end of 2019 because they weren't really paying me, which was a little bit challenging in the insurance model.
• 16:10
  Dr. Robert Whitfield: I was a solo practitioner at that point.
• 16:12
  Dr. Robert Whitfield: I'd left a big group practice and just went on my own.
• 16:15
  Dr. Robert Whitfield: I was doing reconstruction.
• 16:16
  Dr. Robert Whitfield: And ultimately in 2016, we had a patient who was a breast cancer survivor who had a reconstruction with implants come to us.
• 16:28
  Dr. Robert Whitfield: And she wanted to go flat.
• 16:30
  Dr. Jill Carnahan: Yes.
• 16:31
  Dr. Robert Whitfield: And so.
• 16:34
  Dr. Robert Whitfield: And that's totally 100%.
• 16:36
  Dr. Robert Whitfield: Everybody can choose what they want to have.
• 16:39
  Dr. Robert Whitfield: I'm not like the goal is just to help facilitate what someone, you know, needs or wants to have done if.
• 16:45
  Dr. Robert Whitfield: If I could do it safely for them.
• 16:47
  Dr. Robert Whitfield: And so she had no trouble really with it.
• 16:51
  Dr. Robert Whitfield: She had no pain or stiffness or firmness or redness or tenderness.
• 16:58
  Dr. Robert Whitfield: There was nothing wrong.
• 16:59
  Dr. Robert Whitfield: She just didn't want anymore.
• 17:01
  Dr. Jill Carnahan: Got it.
• 17:02
  Dr. Jill Carnahan: Okay.
• 17:02
  Dr. Robert Whitfield: And so I did her workup consultation, physical examination, reviewed all the studies, took her and did the case.
• 17:09
  Dr. Robert Whitfield: And so for everybody listening, I do the case the same way I was trained.
• 17:11
  Dr. Robert Whitfield: If I'm taking a implant based reconstruction out, I take out all the scar capsule around it.
• 17:18
  Dr. Robert Whitfield: I test it for the following microorganisms, so bacteria and fungus and mycobacteria.
• 17:24
  Dr. Robert Whitfield: And then we send the remaining scar tissue to make sure that nobody has recurrent cancer, because you cannot miss recurrent cancer on a patient.
• 17:32
  Dr. Robert Whitfield: So those have always been the standard of care that I follow because that's the way I was trained and so that everybody's super clear about why I do what I do.
• 17:40
  Dr. Jill Carnahan: Okay.
• 17:40
  Dr. Robert Whitfield: So this patient had cultures taken.
• 17:43
  Dr. Robert Whitfield: So think of like a Q tip swab.
• 17:46
  Dr. Robert Whitfield: You run it around the cavity, you put it in a little plastic tube and give it to the staff.
• 17:51
  Dr. Robert Whitfield: They mark it with the patient's name, date of birth, medical record number, and they send it to the lab where it's wiped on an auger plate, which is a little specialized plate, and they incubate it to see if it will grow bacteria.
• 18:04
  Dr. Robert Whitfield: And so that's been the standard of care since the 50s, basically.
• 18:09
  Dr. Robert Whitfield: So in that setting, I'll tell you what happens.
• 18:13
  Dr. Robert Whitfield: So a week later, she shows up and we're going over the results.
• 18:18
  Dr. Robert Whitfield: The pathology is negative.
• 18:20
  Dr. Robert Whitfield: So she doesn't have any recurrent breast cancer, which is first and foremost the most important thing.
• 18:24
  Dr. Robert Whitfield: But when I look at her microbiology results, she has an E. Coli infection.
• 18:31
  Dr. Robert Whitfield: And when I say E. Coli infection, that means greater than 10 to the six bacteria.
• 18:36
  Dr. Robert Whitfield: Yes.
• 18:37
  Dr. Robert Whitfield: Which are colony forming units seen on high power field under a microscope.
• 18:41
  Dr. Robert Whitfield: So for everybody listening, that was done in a hospital.
• 18:46
  Dr. Robert Whitfield: For you to have a positive infection like that in a hospital, that is a significant bacterial load.
• 18:56
  Dr. Jill Carnahan: Yes.
• 18:56
  Dr. Robert Whitfield: And for her to have no redness, no pain, no tenderness, no swelling, no physical manifestations, no laboratory changes in her white blood cell count, platelet count, nothing.
• 19:07
  Dr. Jill Carnahan: Yeah.
• 19:09
  Dr. Robert Whitfield: So that is a silent occult infection.
• 19:14
  Dr. Robert Whitfield: And her.
• 19:14
  Dr. Robert Whitfield: I went back and I'm like, so my sister passed away from breast cancer.
• 19:18
  Dr. Robert Whitfield: So I went back and I was like, how did I miss this?
• 19:22
  Dr. Jill Carnahan: Yeah.
• 19:22
  Dr. Robert Whitfield: Like I, I pride myself on being pretty clever.
• 19:27
  Dr. Jill Carnahan: Yes.
• 19:27
  Dr. Robert Whitfield: Clearly I went through everything and I was like the only review of system symptoms she had was fatigue, which a lot of cancer patients.
• 19:36
  Dr. Jill Carnahan: Yes.
• 19:37
  Dr. Robert Whitfield: Because they had bone marrow suppression through chemotherapy treatment.
• 19:42
  Dr. Robert Whitfield: And I was like, okay.
• 19:43
  Dr. Robert Whitfield: So I treated her.
• 19:44
  Dr. Robert Whitfield: This was sensitive to, you know, standard antibiotic, oral antibiotic therapy.
• 19:51
  Dr. Robert Whitfield: So, you know, we treated her for this for, you know, 10 days.
• 19:55
  Dr. Robert Whitfield: And she should back up all of her fatigue and went away.
• 19:59
  Dr. Robert Whitfield: Dr. Carney.
• 20:00
  Dr. Jill Carnahan: I can imagine, Right?
• 20:01
  Dr. Jill Carnahan: Surprise, surprise.
• 20:03
  Dr. Robert Whitfield: So this.
• 20:04
  Dr. Robert Whitfield: Go ahead.
• 20:05
  Dr. Robert Whitfield: Yeah, well, she put me on a Facebook group and then I magically had people start calling my office, I bet.
• 20:14
  Dr. Jill Carnahan: Oh, my goodness.
• 20:15
  Dr. Jill Carnahan: Sorry.
• 20:15
  Dr. Jill Carnahan: I don't know what is going on with this.
• 20:16
  Dr. Jill Carnahan: We'll just edit that piece out.
• 20:18
  Dr. Jill Carnahan: I can't figure out.
• 20:19
  Dr. Jill Carnahan: Oh, anyway, so fascinating because that's what my next question was.
• 20:25
  Dr. Jill Carnahan: So for people to understand an implant, what it actually looks like, it's sitting behind the breast and the body creates a capsule around it, Is that correct?
• 20:31
  Dr. Jill Carnahan: Almost.
• 20:31
  Dr. Jill Carnahan: In all cases.
• 20:33
  Dr. Robert Whitfield: Yeah.
• 20:33
  Dr. Robert Whitfield: It just makes a collagen bag around it.
• 20:35
  Dr. Jill Carnahan: Yeah.
• 20:35
  Dr. Robert Whitfield: That's what your body forms, a scar tissue.
• 20:38
  Dr. Jill Carnahan: And then from that patient who kind of allowed you to really see, oh my goodness, this silent infection, which, like you said, we would typically see elevation in white blood count or some signs systemically.
• 20:48
  Dr. Jill Carnahan: And there was no other signs other than fatigue.
• 20:50
  Dr. Jill Carnahan: So it sounds like when a patient might have this colonization or infection around that capsule that might be driving this immune response is kind of like chronically Poking the bear.
• 21:01
  Dr. Jill Carnahan: Right.
• 21:01
  Dr. Jill Carnahan: Poking that immune system, creating this response.
• 21:03
  Dr. Jill Carnahan: And maybe that's responsible.
• 21:04
  Dr. Jill Carnahan: Do you want to just explain how that, like, what have you seen on these capsules?
• 21:08
  Dr. Jill Carnahan: Is that common on patients who have symptoms?
• 21:11
  Dr. Jill Carnahan: And is it just.
• 21:13
  Dr. Jill Carnahan: I've heard of patients who can get some sort of, like a fungal growth in the capsule.
• 21:18
  Dr. Jill Carnahan: And what have you seen?
• 21:21
  Dr. Robert Whitfield: Yeah.
• 21:21
  Dr. Robert Whitfield: So this really started you.
• 21:24
  Dr. Robert Whitfield: As you alluded to earlier, I've always been super curious about a number of things.
• 21:29
  Dr. Robert Whitfield: This made me very concerned that we didn't understand this is happening.
• 21:35
  Dr. Robert Whitfield: Providers didn't.
• 21:37
  Dr. Robert Whitfield: And so depending on your experience with your surgeon, maybe it would be hard for them to understand this was a problem.
• 21:49
  Dr. Robert Whitfield: If you come in and you.
• 21:50
  Dr. Robert Whitfield: Your only symptom is fatigue, and you're a patient who's like, you, a breast cancer survivor, and maybe you got Taxol therapy, maybe you got doxorubicin, all these things are highly toxic.
• 22:01
  Dr. Robert Whitfield: And you.
• 22:03
  Dr. Robert Whitfield: You don't have good energy levels.
• 22:04
  Dr. Robert Whitfield: You.
• 22:04
  Dr. Robert Whitfield: You are tired a lot.
• 22:08
  Dr. Robert Whitfield: They would interpret that a certain way and think, well, that's just Dr. Carnahan.
• 22:14
  Dr. Jill Carnahan: That's how she is post chemo.
• 22:15
  Dr. Jill Carnahan: And.
• 22:15
  Dr. Jill Carnahan: Exactly.
• 22:16
  Dr. Robert Whitfield: Right.
• 22:18
  Dr. Robert Whitfield: And so.
• 22:19
  Dr. Robert Whitfield: And you've heard of people with chemo brain and all these, like, they're.
• 22:22
  Dr. Robert Whitfield: They have a lot of negative connotations.
• 22:24
  Dr. Jill Carnahan: Yeah.
• 22:25
  Dr. Robert Whitfield: So what was bothersome to me was, first of all, this patient was totally intact, excellent historian, and no issues on exam.
• 22:35
  Dr. Robert Whitfield: And I missed this.
• 22:36
  Dr. Robert Whitfield: So I said, she's.
• 22:39
  Dr. Robert Whitfield: She.
• 22:39
  Dr. Robert Whitfield: She clearly put me up on social media somewhere.
• 22:42
  Dr. Robert Whitfield: I. I wasn't somebody who even paid attention to social media in 2016 at all.
• 22:49
  Dr. Robert Whitfield: And my office staff told me, like, hey, there's a bunch of people calling here and they want their implants removed.
• 22:58
  Dr. Jill Carnahan: Wow.
• 22:59
  Dr. Robert Whitfield: And they're cosmetic patients now, not cancer.
• 23:02
  Dr. Robert Whitfield: Cosmetic patients, yes.
• 23:04
  Dr. Robert Whitfield: And they said, why is that?
• 23:06
  Dr. Robert Whitfield: And I was like, well, it's.
• 23:07
  Dr. Robert Whitfield: It's this patient we took care of.
• 23:09
  Dr. Jill Carnahan: Yeah.
• 23:10
  Dr. Robert Whitfield: And so I. I started seeing people.
• 23:12
  Dr. Robert Whitfield: And because of what had happened, I think it's really incumbent upon us professionally to, you know, obviously we don't know everything.
• 23:25
  Dr. Jill Carnahan: Right.
• 23:26
  Dr. Robert Whitfield: And to your point, if you don't remain curious about what's going on, then you're not going to learn anything.
• 23:32
  Dr. Robert Whitfield: You're just going to be stuck.
• 23:34
  Dr. Robert Whitfield: And so I started doing these cases and sending everything off like I had.
• 23:38
  Dr. Jill Carnahan: Done for this other patient, like a good scientist would.
• 23:41
  Dr. Jill Carnahan: Which is exactly what you are.
• 23:44
  Dr. Jill Carnahan: Yeah.
• 23:44
  Dr. Robert Whitfield: And then in 2018, so we had done, like, a fair number.
• 23:49
  Dr. Robert Whitfield: Not a ton, but a fair amount.
• 23:51
  Dr. Robert Whitfield: In 2018, I had an ICU nurse whose sister lived in Austin.
• 23:56
  Dr. Robert Whitfield: Contact us.
• 23:56
  Dr. Robert Whitfield: Want to come here, stay with her sister so she's her caregiver and get surgery with me, because I would do this total capsulectomy, or in block capsulectomy technique that everybody.
• 24:09
  Dr. Robert Whitfield: Everybody also fusses about, which is totally stupid.
• 24:13
  Dr. Robert Whitfield: So I did it for her.
• 24:15
  Dr. Jill Carnahan: And real quickly, that just means that not just not only do you take out the implant, but the capsule around the implant, you're removing that entire thing just in case there's bacteria, biofilms, or whatever else.
• 24:24
  Dr. Jill Carnahan: And then you're sending that for culture as well.
• 24:26
  Dr. Jill Carnahan: Right.
• 24:27
  Dr. Robert Whitfield: Now we're going to get into why.
• 24:29
  Dr. Jill Carnahan: Okay.
• 24:29
  Dr. Robert Whitfield: So I do this case.
• 24:32
  Dr. Robert Whitfield: I do a complete capsulectomy, just like I have been doing for my entire career.
• 24:37
  Dr. Robert Whitfield: It's not like I started doing this magically.
• 24:42
  Dr. Robert Whitfield: I.
• 24:43
  Dr. Robert Whitfield: My practice at that point was to get done and then go to the back table and open the capsule up and examine everything.
• 24:51
  Dr. Jill Carnahan: Yeah.
• 24:52
  Dr. Robert Whitfield: And everything was.
• 24:55
  Dr. Robert Whitfield: The implant was intact, but it had a very kind of not sticky, but slimy surface.
• 25:03
  Dr. Robert Whitfield: And so that means a couple things to me.
• 25:06
  Dr. Robert Whitfield: One, it could be the implant is about to rupture and it's just leaking.
• 25:10
  Dr. Jill Carnahan: Yeah.
• 25:11
  Dr. Robert Whitfield: This wasn't that.
• 25:12
  Dr. Robert Whitfield: This was what I experienced through a number of oncologic cases, vascular cases, orthopedic cases, head and neck cases where some piece of hardware had got infected.
• 25:24
  Dr. Jill Carnahan: Huh.
• 25:25
  Dr. Robert Whitfield: And this was what you classically think is biofilm.
• 25:30
  Dr. Jill Carnahan: Yes.
• 25:31
  Dr. Robert Whitfield: And so I went out and told the sister and the husband.
• 25:37
  Dr. Robert Whitfield: I was like, I think this is just infected.
• 25:40
  Dr. Robert Whitfield: And I feel like we'll have answer here in about, you know, we.
• 25:43
  Dr. Robert Whitfield: Traditional, you know, methodologies.
• 25:46
  Dr. Robert Whitfield: And so I saw them in a week, and it came back, Dr. Carnahan, that it was called normal flora.
• 25:54
  Dr. Robert Whitfield: Now, everybody who's looked at a lab report has seen this.
• 25:59
  Dr. Robert Whitfield: It says normal flora.
• 26:01
  Dr. Robert Whitfield: Yes.
• 26:02
  Dr. Robert Whitfield: Now, you can accept that or you could question that.
• 26:09
  Dr. Robert Whitfield: And I got irritated by it because I know that's not right.
• 26:15
  Dr. Jill Carnahan: Right.
• 26:15
  Dr. Robert Whitfield: And so then I started making phone calls to the people who worked with PCR testing of specific.
• 26:24
  Dr. Jill Carnahan: Yes.
• 26:25
  Dr. Robert Whitfield: Scar capsule specimens for alcl, which is an implant associated lymphoma.
• 26:30
  Dr. Robert Whitfield: And I. I created a situation where I could send every single one of my patients scar tissue to MicroGenDX lab.
• 26:38
  Dr. Jill Carnahan: Yes.
• 26:38
  Dr. Robert Whitfield: Here in Lubbock, Texas, to get analyzed.
• 26:41
  Dr. Robert Whitfield: Huh.
• 26:41
  Dr. Jill Carnahan: I've used them.
• 26:42
  Dr. Robert Whitfield: So all of my patients since February 2019 have been analyzed by PCR and pathology.
• 26:50
  Dr. Robert Whitfield: So we send off a biopsy specimen for PCR analysis from each side.
• 26:56
  Dr. Robert Whitfield: And if one side's positive, that means A positive case.
• 26:59
  Dr. Robert Whitfield: The rest goes to make sure they have no breast cancer implant associated lymphomas.
• 27:04
  Dr. Robert Whitfield: And I've had a lymphoma in my first thousand cases.
• 27:08
  Dr. Robert Whitfield: So in 2024, we looked back at my experience and the lab did the analysis, not me, obviously.
• 27:16
  Dr. Robert Whitfield: They ran the analysis and they showed that 29% of the specimens we sent them have bacterial contamination.
• 27:25
  Dr. Jill Carnahan: Wow.
• 27:25
  Dr. Jill Carnahan: That was my next question.
• 27:26
  Dr. Jill Carnahan: 29%.
• 27:28
  Dr. Jill Carnahan: So almost one in three that you took out.
• 27:31
  Dr. Robert Whitfield: So these were women that were.
• 27:32
  Dr. Jill Carnahan: Oh, sorry.
• 27:34
  Dr. Robert Whitfield: No, I was gonna say in 694 consecutive specimens.
• 27:37
  Dr. Robert Whitfield: So it's not a small sample.
• 27:38
  Dr. Jill Carnahan: No.
• 27:39
  Dr. Robert Whitfield: So, so when people talk about samples of like 50 or 30 or 100, you know, that introduces bias because the sample size is too small.
• 27:49
  Dr. Jill Carnahan: Right.
• 27:50
  Dr. Robert Whitfield: So people argue that mine's a single surgeon experience.
• 27:53
  Dr. Robert Whitfield: And there's in the literature, there's plenty of controls that are between 30 and 50%.
• 27:59
  Dr. Robert Whitfield: I'm very comfortable saying the incidence is 29%.
• 28:03
  Dr. Robert Whitfield: My samples come from patients not just in Austin and not just in Texas.
• 28:07
  Dr. Robert Whitfield: From all over the country.
• 28:09
  Dr. Jill Carnahan: Yeah.
• 28:11
  Dr. Robert Whitfield: So that's the incidence.
• 28:12
  Dr. Robert Whitfield: The two bacteria that are biggest culprits are Cutibacterium acnes found in our face, chest, neck and shoulder skin.
• 28:20
  Dr. Robert Whitfield: And then staph epidermidis, of course.
• 28:24
  Dr. Robert Whitfield: And staph epidermidis has been a bad actor for a very long period of time, especially in vascular surgery.
• 28:31
  Dr. Robert Whitfield: Especially for vascular grafts being contaminated.
• 28:35
  Dr. Robert Whitfield: So none of this is super difficult to think about or understand.
• 28:40
  Dr. Robert Whitfield: Yeah, it's very straightforward when you just look at it and you know, you're trying to just.
• 28:49
  Dr. Robert Whitfield: The facts are the facts.
• 28:50
  Dr. Robert Whitfield: Like anybody who gets a device can have a problem and you know, you can get the problem three ways.
• 28:56
  Dr. Robert Whitfield: So we'll tell everybody how this happens.
• 28:58
  Dr. Jill Carnahan: That was my next question.
• 28:59
  Dr. Jill Carnahan: How does this happen?
• 29:00
  Dr. Jill Carnahan: Yes, let's answer that.
• 29:01
  Dr. Robert Whitfield: Yeah, so when I'm operating, so I got done operating today and I haven't put in implants for about six years now.
• 29:09
  Dr. Robert Whitfield: But if I was doing an implant based case and the staff was giving us the implant, unpackaging it.
• 29:17
  Dr. Jill Carnahan: Yeah.
• 29:17
  Dr. Robert Whitfield: They could contaminate it.
• 29:19
  Dr. Jill Carnahan: Right.
• 29:19
  Dr. Jill Carnahan: Because it's in a sterile now.
• 29:20
  Dr. Robert Whitfield: Everything is.
• 29:22
  Dr. Robert Whitfield: Yeah, everything's in packaging and it's always double packaged.
• 29:26
  Dr. Robert Whitfield: So if there's any violation of the outer package, you never use that device.
• 29:31
  Dr. Robert Whitfield: It's always packaged in two ways.
• 29:34
  Dr. Robert Whitfield: The third, or I'm sorry, the second way would be if you as the surgeon, contaminated it upon accepting it and broke technique somehow.
• 29:42
  Dr. Jill Carnahan: Yes.
• 29:43
  Dr. Robert Whitfield: You had a problem with a Glove or you did something to contaminate it.
• 29:47
  Dr. Jill Carnahan: Against the skin or you touch your face or something.
• 29:49
  Dr. Jill Carnahan: Which again is absolute.
• 29:51
  Dr. Jill Carnahan: No, no.
• 29:51
  Dr. Jill Carnahan: When you're a surgeon.
• 29:52
  Dr. Robert Whitfield: Right.
• 29:53
  Dr. Robert Whitfield: So the first two ways that happens are super low.
• 29:57
  Dr. Robert Whitfield: Like it's not never, but it's almost a never event.
• 30:01
  Dr. Jill Carnahan: Yeah.
• 30:02
  Dr. Robert Whitfield: The third way is what I call the four letter word.
• 30:06
  Dr. Robert Whitfield: It's just life.
• 30:07
  Dr. Jill Carnahan: Yes.
• 30:08
  Dr. Robert Whitfield: Right.
• 30:09
  Dr. Robert Whitfield: You go through life, you get a cut, it gets infected, it gets inflamed, bacteria gets in your bloodstream, you get a uti, you get a cold, you get this.
• 30:18
  Dr. Robert Whitfield: Remember my patient had an E. Coli infection?
• 30:21
  Dr. Jill Carnahan: Yes.
• 30:21
  Dr. Robert Whitfield: Now that in patients who are older, you always think bowel and bladder 100% of the time.
• 30:29
  Dr. Robert Whitfield: And so people are like, well, how does that happen?
• 30:31
  Dr. Robert Whitfield: Well, people get what's called bacteremia and the bacteria gets into their bloodstream because it gets too high in that area in their GI tract or.
• 30:42
  Dr. Robert Whitfield: And most common reason would be a urinary tract infection in a woman.
• 30:47
  Dr. Robert Whitfield: So I don't think that's very complicated either.
• 30:50
  Dr. Robert Whitfield: If you just like think about it.
• 30:54
  Dr. Robert Whitfield: So those are how those things happen.
• 30:57
  Dr. Robert Whitfield: So obviously if you're an orthopedic surgeon doing joint surgery, or if you're a cardiac surgeon doing valves, or if you're a neurosurgeon implanting any complicated device for a neural stem situation, like all of those things could get infected.
• 31:17
  Dr. Jill Carnahan: Right.
• 31:17
  Dr. Robert Whitfield: So if you go to get your teeth clean, if you go to get a colonoscopy and a biopsy, if you go do anything, you should have a course of pre procedure antibiotic because that's just to protect you.
• 31:30
  Dr. Robert Whitfield: It's not to upset the GI tract, It's really to protect the implant that's serving.
• 31:36
  Dr. Robert Whitfield: Whatever the purpose is, if it's a hip or a knee, or it's a dental implant, whatever.
• 31:42
  Dr. Robert Whitfield: The thing is, I think that somehow is kind of drops out of the consciousness for whatever reason.
• 31:51
  Dr. Robert Whitfield: Yeah.
• 31:52
  Dr. Jill Carnahan: Wow.
• 31:52
  Dr. Jill Carnahan: Okay, so 29% of your subset of over 600 patients, which is a very good number, came back with an infection, a hidden occult.
• 32:02
  Dr. Jill Carnahan: And often they were not febrile.
• 32:04
  Dr. Jill Carnahan: Almost never.
• 32:05
  Dr. Jill Carnahan: Right.
• 32:05
  Dr. Jill Carnahan: They were not presenting with.
• 32:07
  Dr. Robert Whitfield: No.
• 32:07
  Dr. Jill Carnahan: Did most of these.
• 32:08
  Dr. Jill Carnahan: I have a couple follow up questions.
• 32:09
  Dr. Jill Carnahan: First of all, is there a susceptible host where you see a pattern to the women who are more likely to have this, or is it any woman's game that any woman that has an implant could develop this, regardless of autoimmunity or immune weakness or any other factors?
• 32:23
  Dr. Jill Carnahan: Are there any factors that are common to these patients?
• 32:28
  Dr. Robert Whitfield: Well, I assure your audience that I did not give you these questions to ask me, but you're giving me the layups.
• 32:34
  Dr. Robert Whitfield: So if you are curious, like I am since college, about genetics.
• 32:39
  Dr. Robert Whitfield: I grew up at a time in.
• 32:40
  Dr. Robert Whitfield: In college where HIV dominated the 80s, basically, and that's when I went to college.
• 32:48
  Dr. Robert Whitfield: So we had microbiology and they would talk about retroviruses, and then we had genetics, which when I took genetics, the guy who taught it was so smart, I couldn't understand any of what he was saying.
• 33:00
  Dr. Robert Whitfield: So now, with the genome project being finished and with commercially available genetic testing in an audit of my patients, 83% have problems in vitamin D metabolism with two genes called GPX and VDR.
• 33:17
  Dr. Robert Whitfield: And then many of them, if not most of them, are at least heterozygous for MTHFR.
• 33:24
  Dr. Robert Whitfield: Yes.
• 33:25
  Dr. Robert Whitfield: And then the biggest problem, honestly is the third is in the glucuronidation pathway.
• 33:32
  Dr. Robert Whitfield: Problems with GSST and GSTP1 because those patients have difficulties with biotoxin binding.
• 33:39
  Dr. Jill Carnahan: Yes.
• 33:40
  Dr. Robert Whitfield: And if you're a person listening to this and you have trouble with fragrances, chemical odors, mold, like all those three pathways are pretty much all you need to get this problem.
• 33:58
  Dr. Robert Whitfield: Now, if you add a problem in your antioxidant pathway, in your SOD2 enzymatic pathway, then you have all of it.
• 34:07
  Dr. Robert Whitfield: Now you can have that and not have this problem, meaning not have implants and have breast implant illness.
• 34:14
  Dr. Robert Whitfield: But if you have all four of those, you're gonna have problems with chronic inflammation because you are a really poor metabolizer and you don't detox well, then all you do is add person with high estrogen, like poor estrogen metabolism.
• 34:29
  Dr. Robert Whitfield: And that is the worst possible avatar for this situation.
• 34:33
  Dr. Jill Carnahan: Okay, you just described me.
• 34:35
  Dr. Jill Carnahan: No surprise because I got cancer at 25.
• 34:37
  Dr. Jill Carnahan: But the VDR, the MTHFR, the SOD mutation and the GSTP1, and then also, let's see, the last one you just mentioned was also relevant estrogen metabolism.
• 34:48
  Dr. Jill Carnahan: Yes, Yes, I was a high estrogen, low progesterone, so I'm the product.
• 34:52
  Dr. Jill Carnahan: And of course that my life story.
• 34:54
  Dr. Jill Carnahan: I had cancer then Crohn's than mold related illness.
• 34:57
  Dr. Jill Carnahan: I've always dealt with toxic issues and my immune system hypogammaglobulinemia.
• 35:02
  Dr. Jill Carnahan: So.
• 35:03
  Dr. Jill Carnahan: And here I am doing fine, I've overcome a lot.
• 35:05
  Dr. Jill Carnahan: But it's so interesting because thank goodness I didn't get implants after my breast cancer because I.
• 35:11
  Dr. Jill Carnahan: But I would have been one of your 29 percenters because I just fit the bill.
• 35:15
  Dr. Jill Carnahan: How, how amazing so do you now test?
• 35:17
  Dr. Jill Carnahan: So say.
• 35:18
  Dr. Jill Carnahan: What I'm thinking is there's women out there right now and they're, they have implants or they're deciding to do something either post cancer.
• 35:24
  Dr. Jill Carnahan: I see a lot of these kind of patients as well.
• 35:28
  Dr. Jill Carnahan: They might be having brain fog or joint pain or they just don't feel a hundred percent.
• 35:34
  Dr. Jill Carnahan: How could they possibly decide if this is them?
• 35:37
  Dr. Jill Carnahan: Like, do you just treat, do you go ahead and do surgery on patients who are concerned that it might be.
• 35:42
  Dr. Jill Carnahan: How do you funnel them in to decide if this is appropriate or not?
• 35:45
  Dr. Jill Carnahan: Or is it just their desire to get the implants out?
• 35:49
  Dr. Robert Whitfield: Well, kind of.
• 35:51
  Dr. Robert Whitfield: It was a journey in terms of taking care of the patients because I didn't understand everything in the beginning, like I just explained to you.
• 35:56
  Dr. Robert Whitfield: So that took a lot of reverse engineering.
• 35:59
  Dr. Robert Whitfield: So we would have a group of patients who would do extremely well right away in the first 90 days.
• 36:05
  Dr. Robert Whitfield: They would, you know.
• 36:06
  Dr. Robert Whitfield: Yes, that's your rainbow and unicorn group.
• 36:09
  Dr. Robert Whitfield: So they were infected or they had a rupture or they had heavy metal burden or something.
• 36:17
  Dr. Robert Whitfield: That was so stimulating.
• 36:20
  Dr. Jill Carnahan: Yeah.
• 36:20
  Dr. Robert Whitfield: And then the second group, you know, that's your kind of two to three month group and they're a little slower.
• 36:29
  Dr. Jill Carnahan: Yes.
• 36:30
  Dr. Robert Whitfield: But they get there and then you have, you're the group that doesn't get better, that lingers because you don't know what you don't know.
• 36:41
  Dr. Jill Carnahan: Right.
• 36:42
  Dr. Robert Whitfield: Just because I did the case doesn't mean you're going to get better.
• 36:45
  Dr. Robert Whitfield: Your specific avatar.
• 36:47
  Dr. Jill Carnahan: 100%.
• 36:48
  Dr. Jill Carnahan: Yeah.
• 36:48
  Dr. Robert Whitfield: So that's why I wrote the book about our method.
• 36:52
  Dr. Robert Whitfield: It's called the short method and it's just the eponym.
• 36:56
  Dr. Robert Whitfield: But the reality is you want to look at how someone from an inheritance standpoint can detox.
• 37:03
  Dr. Robert Whitfield: Like you can talk to people.
• 37:04
  Dr. Robert Whitfield: No, they don't methylate.
• 37:06
  Dr. Jill Carnahan: Well, correct.
• 37:06
  Dr. Jill Carnahan: Exactly.
• 37:07
  Dr. Jill Carnahan: And again, because of my own experience, thank God, because I've been the guinea pig and I know the most difficult patients.
• 37:12
  Dr. Jill Carnahan: It's me.
• 37:13
  Dr. Jill Carnahan: So because of that experience, I bring that.
• 37:15
  Dr. Jill Carnahan: I'm testing genetics.
• 37:16
  Dr. Jill Carnahan: I'm thinking about that and I'm seeing those patients you've seen that are in that percentage that aren't getting better because we know that we need a lot more intensive support and detox and all of that.
• 37:26
  Dr. Jill Carnahan: So that makes perfect sense to me and I'm sure my listeners as well.
• 37:31
  Dr. Robert Whitfield: Yeah.
• 37:31
  Dr. Robert Whitfield: So our program runs like, first of all, I don't need to go operate on anybody.
• 37:36
  Dr. Robert Whitfield: Basically, my program runs to prepare patients for whatever they want.
• 37:40
  Dr. Jill Carnahan: Got it.
• 37:41
  Dr. Jill Carnahan: So you're having them basically read your book and get that information before they ever come to do the surgery.
• 37:46
  Dr. Jill Carnahan: They're starting the protocol, and I'd love to hear more about that, too.
• 37:49
  Dr. Robert Whitfield: Yeah, exactly.
• 37:50
  Dr. Robert Whitfield: Until I got censored a lot on platforms, that was the standard way to get in touch with me.
• 37:56
  Dr. Robert Whitfield: They broke that methodology by hiding me.
• 37:59
  Dr. Robert Whitfield: But the book is still out, and it explains the methodology.
• 38:03
  Dr. Robert Whitfield: So if you look at genetics like yours.
• 38:06
  Dr. Jill Carnahan: Yes.
• 38:06
  Dr. Robert Whitfield: And then do a tox burden test, you'll see pfas, you'll see mycotoxin levels, you'll see heavy metals.
• 38:14
  Dr. Robert Whitfield: Now, if you did an audit of our first 500 vibrant wellness total Talks tests, you would see that the top thing is bpa, the second is af.
• 38:24
  Dr. Robert Whitfield: I'm sorry, glyphosate, and the third is aflatoxin.
• 38:28
  Dr. Jill Carnahan: Yes.
• 38:28
  Dr. Robert Whitfield: And so there's a lot of aflatoxins, and it doesn't matter which one it is.
• 38:32
  Dr. Robert Whitfield: You basically are dealing with a plastic byproduct, a herbicide, and then a moltox.
• 38:42
  Dr. Robert Whitfield: So take your detox genes and that burden and mix in a bad gut.
• 38:50
  Dr. Jill Carnahan: Yes.
• 38:51
  Dr. Robert Whitfield: And some sensitivities to food in your diet.
• 38:55
  Dr. Robert Whitfield: And you're already a little bit in a high estrogen state because you don't metabolize well.
• 39:00
  Dr. Robert Whitfield: You have too high estrogen level, and you have all the makings of the problem.
• 39:05
  Dr. Jill Carnahan: Okay, I want to pause really quickly, because even more, I grew up on a farm, so lots of exposure to glyphosate, atrazine, and all these organophosphates that are endocrine disruptors, which mean they make my body feel like more estrogen.
• 39:16
  Dr. Jill Carnahan: And then on top of that, I had mold exposure.
• 39:19
  Dr. Jill Carnahan: And then.
• 39:19
  Dr. Jill Carnahan: So it's the perfect storm of what you've just described for me to get cancer at 25 and be one of these canaries in the coal mine.
• 39:26
  Dr. Jill Carnahan: And so.
• 39:28
  Dr. Jill Carnahan: Interesting.
• 39:28
  Dr. Jill Carnahan: And that's exactly my reflection.
• 39:30
  Dr. Jill Carnahan: I do vibrant, total tox bundle all the time.
• 39:32
  Dr. Jill Carnahan: And BPA and glyphosate and aflatoxin are on the top of what I'm seeing as well.
• 39:38
  Dr. Robert Whitfield: Yeah.
• 39:38
  Dr. Robert Whitfield: So everybody's a little like, is it the implant or is it all this other stuff?
• 39:43
  Dr. Robert Whitfield: Well, it's all the stuff like, if.
• 39:46
  Dr. Robert Whitfield: If Dr. Carnahan was my patient, I'd be having the conversation about, like, yeah, you don't detox well.
• 39:53
  Dr. Robert Whitfield: You have a really high burden.
• 39:55
  Dr. Robert Whitfield: And she's already described.
• 39:57
  Dr. Robert Whitfield: She has had gut problems, and I'm sure she has, like a lot of us do, sensitivities to certain things, like I can't eat eggs.
• 40:04
  Dr. Jill Carnahan: Yeah.
• 40:05
  Dr. Robert Whitfield: If I eat eggs, I basically.
• 40:07
  Dr. Robert Whitfield: I don't, like, have anaphylaxis, but I have, like, hay fever and I. I get like gut swelling.
• 40:13
  Dr. Robert Whitfield: And you're like, why is he doing that?
• 40:15
  Dr. Robert Whitfield: And that's an.
• 40:16
  Dr. Robert Whitfield: That's not something that happened to me when I was younger.
• 40:19
  Dr. Robert Whitfield: It's accumulated over time through probably contamination of the.
• 40:24
  Dr. Robert Whitfield: The supply.
• 40:25
  Dr. Jill Carnahan: Yes, yes.
• 40:26
  Dr. Jill Carnahan: And then permeable gut and we get these immune responses in the whole.
• 40:30
  Dr. Robert Whitfield: Yeah.
• 40:30
  Dr. Jill Carnahan: So.
• 40:30
  Dr. Jill Carnahan: And I forgot to mention, I also had silent, undiagnosed celiac.
• 40:33
  Dr. Jill Carnahan: So perfect storm with the gut.
• 40:34
  Dr. Jill Carnahan: Right.
• 40:35
  Dr. Jill Carnahan: Until that was so.
• 40:37
  Dr. Robert Whitfield: Or if you don't have celiac, so many people have non celiac gluten sensitivity.
• 40:41
  Dr. Robert Whitfield: Yeah.
• 40:42
  Dr. Robert Whitfield: So, I mean, it's not, we're not like, this is not like, we're not breaking new ground.
• 40:48
  Dr. Robert Whitfield: This is not that complex.
• 40:50
  Dr. Jill Carnahan: Yeah.
• 40:51
  Dr. Robert Whitfield: Anybody who suffers from chronic inflammatory symptoms.
• 40:54
  Dr. Jill Carnahan: Yeah.
• 40:55
  Dr. Robert Whitfield: Brain fogs, you know, sinus problems, difficulty swallowing, itchy eyes, shortness of breath, chest pain, palpitations, neuropathic symptoms.
• 41:06
  Dr. Jill Carnahan: Yeah.
• 41:07
  Dr. Robert Whitfield: Muscle pain, joint pain, you know, intractable UTIs vaginosis.
• 41:11
  Dr. Robert Whitfield: Like if you can come up with some skin rash, total body acne, whatever.
• 41:16
  Dr. Robert Whitfield: I mean, I get that stuff all the time.
• 41:18
  Dr. Robert Whitfield: And they have implants.
• 41:19
  Dr. Jill Carnahan: Yes.
• 41:21
  Dr. Jill Carnahan: Then you're like, so you can have.
• 41:22
  Dr. Robert Whitfield: All that without implants.
• 41:24
  Dr. Robert Whitfield: Yeah.
• 41:24
  Dr. Robert Whitfield: So if you have those coexisting and for whatever reason.
• 41:29
  Dr. Robert Whitfield: The other day I had a patient, she's in her 70s, she's had three or four sets of implants, I can't remember.
• 41:36
  Dr. Robert Whitfield: And she was very concerned from a body image standpoint what it would look like afterwards.
• 41:40
  Dr. Robert Whitfield: And I examined her and she had like a pretty good B cup of tissue.
• 41:45
  Dr. Robert Whitfield: And I said, well, this is going to be the kind of size to expect.
• 41:50
  Dr. Robert Whitfield: B cup.
• 41:50
  Dr. Jill Carnahan: Yes.
• 41:51
  Dr. Robert Whitfield: And she's still very worried at 78.
• 41:53
  Dr. Robert Whitfield: And I said, look, she's got chronic joint pain, muscle pain, all these things.
• 42:00
  Dr. Robert Whitfield: And her daughter drug her in.
• 42:03
  Dr. Robert Whitfield: And thank goodness for her daughter, because her daughter is like, you know, you've had these for like my entire life.
• 42:10
  Dr. Robert Whitfield: I'm in my 40s.
• 42:12
  Dr. Robert Whitfield: You.
• 42:13
  Dr. Robert Whitfield: You need to be, you know, move on.
• 42:14
  Dr. Robert Whitfield: And so I did her case and she's like two weeks out now, I think, and she has no joint pain at all.
• 42:23
  Dr. Jill Carnahan: Wow.
• 42:23
  Dr. Robert Whitfield: And she's not.
• 42:24
  Dr. Robert Whitfield: My patients don't use really any narcotic post op, and we can explain how to do that.
• 42:31
  Dr. Robert Whitfield: And we don't use drain tubes.
• 42:32
  Dr. Robert Whitfield: And.
• 42:33
  Dr. Jill Carnahan: Amazing.
• 42:33
  Dr. Robert Whitfield: We have people on high protein diets and I have a whole, like, stack of things in the office to use.
• 42:38
  Dr. Robert Whitfield: Like, we have the human regenerator out of Germany.
• 42:41
  Dr. Robert Whitfield: Lymphatic massage from New Zealand.
• 42:43
  Dr. Robert Whitfield: Hyperbaric red light.
• 42:45
  Dr. Robert Whitfield: Anabie.
• 42:45
  Dr. Robert Whitfield: All the.
• 42:46
  Dr. Robert Whitfield: All the stuff in my office.
• 42:48
  Dr. Robert Whitfield: But in reality, she was getting overstimulated at the tissue level.
• 42:55
  Dr. Robert Whitfield: And you could argue that what I said in the beginning translates even more NOW.
• 43:00
  Dr. Robert Whitfield: So when Dr. Murray did the first kidney transplant in 1952, he did it between genetically identical twins.
• 43:07
  Dr. Robert Whitfield: So when I did that patient's implant removal and reconstruction with her own tissue in 2005, I did an autologous transplant.
• 43:17
  Dr. Robert Whitfield: We just talked about my paper in 2024 that shows that, you know, 29 have bacterial contamination or 2 point almost like 1 in 3.
• 43:26
  Dr. Robert Whitfield: And then a big paper was published that really said the quiet part out loud.
• 43:32
  Dr. Robert Whitfield: The interaction between the biofilm.
• 43:35
  Dr. Jill Carnahan: Yes.
• 43:35
  Dr. Robert Whitfield: And the fatty acid in the breast.
• 43:37
  Dr. Robert Whitfield: Oleic acid.
• 43:38
  Dr. Robert Whitfield: Remember that?
• 43:39
  Dr. Robert Whitfield: Oleic acid.
• 43:41
  Dr. Robert Whitfield: That interaction causes oxidation of the oleic acid.
• 43:44
  Dr. Robert Whitfield: And we all know if you listen to Dr. Carnahan, oxidation is bad.
• 43:48
  Dr. Jill Carnahan: Yes.
• 43:49
  Dr. Robert Whitfield: You want to live in a reduced peroxides.
• 43:51
  Dr. Jill Carnahan: Correct.
• 43:53
  Dr. Robert Whitfield: So the more.
• 43:53
  Dr. Robert Whitfield: Oxylipins.
• 43:54
  Dr. Robert Whitfield: An oxidized fat.
• 43:56
  Dr. Robert Whitfield: Oxylifean.
• 43:57
  Dr. Robert Whitfield: Right.
• 43:57
  Dr. Robert Whitfield: This one's called Oxylipin 10.
• 44:00
  Dr. Robert Whitfield: Home.
• 44:01
  Dr. Robert Whitfield: Like home where you live.
• 44:03
  Dr. Robert Whitfield: That is higher in patients with breast implant illness symptoms.
• 44:07
  Dr. Jill Carnahan: Wow.
• 44:07
  Dr. Robert Whitfield: You can measure it.
• 44:08
  Dr. Jill Carnahan: Measurable.
• 44:09
  Dr. Jill Carnahan: Yeah.
• 44:09
  Dr. Jill Carnahan: Okay.
• 44:10
  Dr. Robert Whitfield: So.
• 44:11
  Dr. Robert Whitfield: But this is done in the research environment.
• 44:12
  Dr. Robert Whitfield: It's not commercially available.
• 44:14
  Dr. Robert Whitfield: Don't call Dr. Carnahan trying to get a LabCorp or quest form because you can't get it.
• 44:20
  Dr. Robert Whitfield: Yeah.
• 44:21
  Dr. Robert Whitfield: So now you have.
• 44:24
  Dr. Robert Whitfield: We'll just say, you know, causation.
• 44:26
  Dr. Robert Whitfield: Right.
• 44:26
  Dr. Jill Carnahan: Yeah.
• 44:27
  Dr. Robert Whitfield: So you have biofilm, you have this production.
• 44:30
  Dr. Robert Whitfield: It's measurable.
• 44:30
  Dr. Robert Whitfield: Causes macrophage polarization.
• 44:32
  Dr. Robert Whitfield: Yeah.
• 44:33
  Dr. Robert Whitfield: All this oxidative stress.
• 44:35
  Dr. Robert Whitfield: Makes sense.
• 44:36
  Dr. Jill Carnahan: Yes.
• 44:38
  Dr. Robert Whitfield: So that's a great paper that I always bring up.
• 44:44
  Dr. Robert Whitfield: It's.
• 44:44
  Dr. Robert Whitfield: It's tremendous.
• 44:46
  Dr. Robert Whitfield: In Denmark, last summer, when I was researching a talk I was giving on capsulectomy, which we can go over, I came across a paper, and they had looked at the transcriptome.
• 44:59
  Dr. Robert Whitfield: All right.
• 44:59
  Dr. Robert Whitfield: So we talked about DNA that proves that the bacteria.
• 45:04
  Dr. Robert Whitfield: And you asked about fungus.
• 45:05
  Dr. Robert Whitfield: Fungus is negligible in my series.
• 45:08
  Dr. Jill Carnahan: Yeah.
• 45:09
  Dr. Robert Whitfield: And I've only had, like, less than 10 out of several thousand.
• 45:13
  Dr. Robert Whitfield: And I'm close to Houston, and I live in Austin.
• 45:15
  Dr. Robert Whitfield: We have plenty of mold.
• 45:17
  Dr. Robert Whitfield: Yeah.
• 45:17
  Dr. Robert Whitfield: So it's not so much a thing for us.
• 45:20
  Dr. Jill Carnahan: So I actually love that you clarified that, because most of my listeners, I would say, are worried about mold in the capsule, mold in the biofilm, and I think that makes so much sense, because we know lps, the bacterial coding of gram negative bacteria, is the most potent immune stimulator.
• 45:36
  Dr. Jill Carnahan: So it would make sense in our medical knowledge that the bacteria are actually, as you know, bad or worse than the fungus and more common by far.
• 45:44
  Dr. Jill Carnahan: Yeah.
• 45:45
  Dr. Robert Whitfield: I mean, it's really hard.
• 45:46
  Dr. Robert Whitfield: I can give you examples of why it happens, but yeah, sure, for the most part, it's those two bacteria.
• 45:51
  Dr. Jill Carnahan: Okay.
• 45:52
  Dr. Robert Whitfield: That's the focus.
• 45:53
  Dr. Robert Whitfield: And so what these folks did was instead of measuring DNA, they measured RNA at the tissue level of the scar capsule.
• 46:04
  Dr. Robert Whitfield: So they took people that had firmer, thicker scarring that they could ascertain on exam.
• 46:11
  Dr. Robert Whitfield: And when they did the explant surgery, they tested that tissue sample and it showed they had upper regulation of three cell types.
• 46:20
  Dr. Robert Whitfield: Your T cells, your B cells, and your plasma cells.
• 46:24
  Dr. Jill Carnahan: Yes.
• 46:24
  Dr. Robert Whitfield: Now I get asked, just like you get asked, can implants cause an autoimmune problem?
• 46:30
  Dr. Robert Whitfield: Anything that upregulates your plasma cells allows you to create antibodies.
• 46:34
  Dr. Robert Whitfield: The short answer is yes.
• 46:36
  Dr. Jill Carnahan: Yes.
• 46:38
  Dr. Robert Whitfield: So that is very unique.
• 46:39
  Dr. Robert Whitfield: And it's never been reported ever in the history of the world.
• 46:44
  Dr. Robert Whitfield: And so I was fascinated by this paper.
• 46:48
  Dr. Robert Whitfield: So I reached out to the scientific community that I know, and I was like, did you read this paper?
• 46:52
  Dr. Robert Whitfield: And they're like, of course we read the paper.
• 46:53
  Dr. Robert Whitfield: We're already writing grants about that paper.
• 46:55
  Dr. Robert Whitfield: So we're getting to the point where the science is catching up to the core problem, which is we're stupid.
• 47:05
  Dr. Robert Whitfield: We don't really understand the immune system.
• 47:08
  Dr. Robert Whitfield: And that's the biggest defect in the ratio, the relationship between the patient and the providers.
• 47:14
  Dr. Robert Whitfield: Like, you come ask me a question, I'm pretty knowledgeable.
• 47:18
  Dr. Robert Whitfield: I have a lot more knowledge about this than the majority of the people.
• 47:21
  Dr. Robert Whitfield: But I will tell you, I don't know exactly what's going on, but I have more and more evidence backing how my position or my.
• 47:32
  Dr. Robert Whitfield: The evidence supports my position more than it does it.
• 47:35
  Dr. Jill Carnahan: Yes.
• 47:36
  Dr. Jill Carnahan: That makes so much sense.
• 47:38
  Dr. Robert Whitfield: A reaction that's immune mediated.
• 47:40
  Dr. Jill Carnahan: Correct.
• 47:41
  Dr. Jill Carnahan: Yeah.
• 47:42
  Dr. Robert Whitfield: If you take the next step, which you see a lot more people, just like I do with mast cell activation syndrome, than you ever did before.
• 47:48
  Dr. Jill Carnahan: Yes, for sure.
• 47:49
  Dr. Robert Whitfield: Where do the mast cells live?
• 47:51
  Dr. Robert Whitfield: Right at the tissue level.
• 47:52
  Dr. Robert Whitfield: In the scar caps.
• 47:52
  Dr. Jill Carnahan: Yes.
• 47:53
  Dr. Jill Carnahan: Yes.
• 47:54
  Dr. Jill Carnahan: Yeah, that makes so much sense.
• 47:56
  Dr. Jill Carnahan: And I'm actually doing deep dives in the immunology.
• 47:59
  Dr. Jill Carnahan: And.
• 48:00
  Dr. Jill Carnahan: And so I see some of these, you know, CD4, CD8 ratios that are down and B cells that are up.
• 48:04
  Dr. Jill Carnahan: And so.
• 48:05
  Dr. Jill Carnahan: And I'm sure you are as well.
• 48:06
  Dr. Jill Carnahan: Are you standardizing?
• 48:09
  Dr. Robert Whitfield: We didn't ask you.
• 48:10
  Dr. Robert Whitfield: Did you have a really low natural killer cell count?
• 48:12
  Dr. Robert Whitfield: Is that part of your problem?
• 48:14
  Dr. Jill Carnahan: Early on I did, and now I don't know if it's from the chemo or if it was from birth and never detected, but very low.
• 48:20
  Dr. Jill Carnahan: Now I'm actually low B cells and low immunoglobulins.
• 48:24
  Dr. Jill Carnahan: So I, I get IVIg for that.
• 48:25
  Dr. Robert Whitfield: But so for everybody listening, one of the ways to get cancer is having a low NK count.
• 48:32
  Dr. Jill Carnahan: Exactly.
• 48:33
  Dr. Jill Carnahan: Yep.
• 48:33
  Dr. Jill Carnahan: Yep.
• 48:34
  Dr. Jill Carnahan: And we would years always measure that because if it's below 50ish, we'd.
• 48:38
  Dr. Jill Carnahan: We'd assume that patient is a high risk for viral activation, bacterial infections and cancer for sure.
• 48:43
  Dr. Jill Carnahan: So it was always on the differential of making sure that we're screening.
• 48:46
  Dr. Jill Carnahan: Now, one quick question.
• 48:46
  Dr. Jill Carnahan: You.
• 48:47
  Dr. Jill Carnahan: You talked about oxidation, lipid oxidation with the byproxy.
• 48:52
  Dr. Jill Carnahan: We can measure lipid peroxides in certain tests.
• 48:55
  Dr. Jill Carnahan: Is that a byproxy of that measurement you mentioned or is it completely unrelated or.
• 48:59
  Dr. Jill Carnahan: We just don't know.
• 49:02
  Dr. Robert Whitfield: I think we don't know because when they did that in the research setting, they were.
• 49:08
  Dr. Robert Whitfield: He profiled a series of oxy lipids that had never been profiled.
• 49:12
  Dr. Jill Carnahan: Okay.
• 49:12
  Dr. Jill Carnahan: And we just can't get that right now because I'm thinking like oxidized ldl, oxy lipid peroxide.
• 49:16
  Dr. Jill Carnahan: Could any of these oxidized.
• 49:18
  Dr. Robert Whitfield: Right.
• 49:18
  Dr. Jill Carnahan: Markers be proxy.
• 49:20
  Dr. Jill Carnahan: But for now, we don't know that there's any correlation.
• 49:23
  Dr. Robert Whitfield: Yeah.
• 49:23
  Dr. Robert Whitfield: Yeah.
• 49:24
  Dr. Jill Carnahan: Okay.
• 49:25
  Dr. Robert Whitfield: He did a paper initially on the one actually like a tin home, and then they wrote a separate paper because they profiled a bunch of other ones, but 10 home was the main one.
• 49:37
  Dr. Jill Carnahan: Okay.
• 49:39
  Dr. Jill Carnahan: So I want to go back to again, I'm listening.
• 49:41
  Dr. Jill Carnahan: I'm thinking about what the women listening who have implants or have a sister or mother or friends with implants, and they're thinking, okay, should I get my implants out now?
• 49:50
  Dr. Jill Carnahan: That's.
• 49:50
  Dr. Jill Carnahan: We.
• 49:50
  Dr. Jill Carnahan: We've kind of answered that with a roundabout.
• 49:52
  Dr. Jill Carnahan: But if someone's coming to you and asking you, Dr. Whitfield, you're the expert here.
• 49:56
  Dr. Jill Carnahan: Do you go based on just the clinical history?
• 49:59
  Dr. Jill Carnahan: Do you do a certain lab panel and obviously it's their decision.
• 50:02
  Dr. Jill Carnahan: But how do you weigh in on that question?
• 50:05
  Dr. Robert Whitfield: I don't.
• 50:06
  Dr. Robert Whitfield: I don't tell anybody.
• 50:07
  Dr. Robert Whitfield: Get explained.
• 50:08
  Dr. Jill Carnahan: Yeah.
• 50:09
  Dr. Robert Whitfield: So the people who are the most satisfied have already come to a realization that they're more interested that their health.
• 50:14
  Dr. Jill Carnahan: Yes.
• 50:15
  Dr. Robert Whitfield: And they're over any other concerns they had.
• 50:19
  Dr. Robert Whitfield: But if you have untreated trauma, suppressed whatever.
• 50:25
  Dr. Jill Carnahan: Yes.
• 50:25
  Dr. Robert Whitfield: Or you have Body dysmorphic disorder or you lean that way, it doesn't matter what I say or do for you.
• 50:34
  Dr. Jill Carnahan: Yeah.
• 50:35
  Dr. Robert Whitfield: You're not going to be happy.
• 50:36
  Dr. Jill Carnahan: Right.
• 50:37
  Dr. Robert Whitfield: So I am not a psychiatrist.
• 50:38
  Dr. Robert Whitfield: I'm not a psychologist.
• 50:40
  Dr. Robert Whitfield: I tell patients, I tell my team, like our role is to be super supportive.
• 50:47
  Dr. Robert Whitfield: So I've done thousands of the surgeries.
• 50:49
  Dr. Robert Whitfield: I can take care of you in the operating room.
• 50:52
  Dr. Robert Whitfield: Yeah.
• 50:53
  Dr. Robert Whitfield: My staff, many of them have had explants by me.
• 50:56
  Dr. Robert Whitfield: They know our program intimately.
• 50:58
  Dr. Robert Whitfield: They can support the patients very well because we have a whole detox team that uses cell core and our functional medicine testing.
• 51:05
  Dr. Robert Whitfield: And then my nurse practitioners have explant.
• 51:08
  Dr. Robert Whitfield: So we're not the problem in the equation with right feedback or support or anything like that.
• 51:14
  Dr. Robert Whitfield: But if you're not getting help at home, if you're not working on yourself, we're not going to solve that problem for you.
• 51:21
  Dr. Robert Whitfield: You're going to get into deep, dark places that we can't get you out of.
• 51:25
  Dr. Robert Whitfield: Yeah.
• 51:26
  Dr. Robert Whitfield: And then you're going to get frustrated or dissatisfied or angry or just not do well.
• 51:36
  Dr. Robert Whitfield: So, like, I concentrate on the things early on that I know everybody can change if they just track.
• 51:42
  Dr. Robert Whitfield: Even though you may have a lot of cortisol, you can still sleep better if you just try.
• 51:47
  Dr. Robert Whitfield: Sleep hygiene is the most important thing that I talk about.
• 51:51
  Dr. Robert Whitfield: So if you get up in the middle of night to pee as a woman, you have a problem and it may be cortisol release, but you do not have a prostate.
• 52:00
  Dr. Robert Whitfield: So that's not a reason.
• 52:01
  Dr. Jill Carnahan: Yeah, correct.
• 52:02
  Dr. Robert Whitfield: So you need to work on not over hydrating during the day or over hydrating towards the end of the day, or drinking liquor to go unwind before you go to bed or sleepy time tea or whatever the hell it is, because those things don't help you stay asleep.
• 52:18
  Dr. Robert Whitfield: And you need to get into a deep enough sleep for the glymphatic system and the lymphatic system to do their jobs and then for your cortisol to wake you up, but your growth hormone to help you heal.
• 52:31
  Dr. Robert Whitfield: And all of that's predicated on having enough nutrition.
• 52:34
  Dr. Robert Whitfield: So we talk a lot about quality protein intake, how much to intake.
• 52:39
  Dr. Robert Whitfield: The benchmark for us starts at a hundred.
• 52:41
  Dr. Robert Whitfield: I don't care what your size is.
• 52:43
  Dr. Robert Whitfield: And then we fill in the gaps with.
• 52:45
  Dr. Robert Whitfield: We mostly use liposomal supplementation because our patient population has terrible absorption, just like you described earlier.
• 52:53
  Dr. Robert Whitfield: And then the exercise, because everybody's like, I want to exercise.
• 52:56
  Dr. Robert Whitfield: Well, you can walk as much as you want, I don't care.
• 52:58
  Dr. Robert Whitfield: And Then, you know, everybody, the next day, you know, comes to our office.
• 53:04
  Dr. Robert Whitfield: But so that programmatically, everybody understands.
• 53:07
  Dr. Robert Whitfield: Like, if you prepare extremely well for anything, think of the recent event we had here in the.
• 53:14
  Dr. Robert Whitfield: In the US The World Cup.
• 53:16
  Dr. Robert Whitfield: All those guys spent their lives preparing to play in those games.
• 53:21
  Dr. Robert Whitfield: They just didn't show up that day, put on the jersey and the cleats and go play.
• 53:26
  Dr. Robert Whitfield: So everybody's busy.
• 53:28
  Dr. Robert Whitfield: I get it.
• 53:30
  Dr. Robert Whitfield: But if you don't start doing what Dr. Carnahan says or what I suggest for preparation, you're going to have a very difficult time in terms of the surgery itself.
• 53:40
  Dr. Robert Whitfield: But more importantly, your.
• 53:42
  Dr. Robert Whitfield: Your actual recovery is going to be more lengthy and less efficient than it should be.
• 53:49
  Dr. Robert Whitfield: Everybody asks why I don't use drains, Dr. Carnahan.
• 53:53
  Dr. Robert Whitfield: So drains are plastic tubes that sit in a pocket where you operate.
• 53:58
  Dr. Robert Whitfield: And so the premise is, if I put the tube in Dr. Cardihan's, you know, breast pocket, I'll get all that fluid out and everything will be fine.
• 54:08
  Dr. Robert Whitfield: Well, a tube doesn't stop fluid production.
• 54:17
  Dr. Robert Whitfield: It can't.
• 54:18
  Dr. Jill Carnahan: Right.
• 54:18
  Dr. Robert Whitfield: And it can't stop bleeding.
• 54:21
  Dr. Robert Whitfield: So what is the tube for?
• 54:25
  Dr. Robert Whitfield: I actually consider the tube to be an act of.
• 54:28
  Dr. Robert Whitfield: Not irresponsibility, but lack of understanding.
• 54:31
  Dr. Jill Carnahan: Yeah.
• 54:32
  Dr. Robert Whitfield: So if the patient's prepared properly to diminish their cortisol surge, there'll be less fluid retention and less need for a drain because less fluid will be produced.
• 54:44
  Dr. Robert Whitfield: And then the body's lymphatic system will take care of the rest.
• 54:49
  Dr. Jill Carnahan: Yeah.
• 54:49
  Dr. Robert Whitfield: So depending on what you're doing, how you're doing it, we have some other technical things we perform during surgery, but we work really hard on the front end to lower toxicity burden, improve gut health to the best of our ability, pre op, improve sleep hygiene, fill in gaps for supplementation.
• 55:05
  Dr. Robert Whitfield: Because I operate on supplements, I don't stop, but I operate on the ones that we use.
• 55:11
  Dr. Robert Whitfield: And then the day before surgery, we see everybody in the office, we confirm all plans, make sure all questions are answered that day.
• 55:18
  Dr. Robert Whitfield: They go to.
• 55:18
  Dr. Robert Whitfield: I have a whole series of restaurants that have gluten free options.
• 55:22
  Dr. Jill Carnahan: Amazing.
• 55:23
  Dr. Robert Whitfield: They're dairy free, seed oil free in Austin.
• 55:25
  Dr. Robert Whitfield: Particularly the well.
• 55:26
  Dr. Robert Whitfield: We'll give a shout out to the well.
• 55:29
  Dr. Robert Whitfield: They stay at their home, Airbnb hotel, whatever it is.
• 55:33
  Dr. Robert Whitfield: We have a series of things they take to reduce nerve pain.
• 55:36
  Dr. Jill Carnahan: Yeah.
• 55:37
  Dr. Robert Whitfield: Swelling, nausea, and stop motion sickness to the best of our ability.
• 55:42
  Dr. Robert Whitfield: They come in, they get an ultrasound guided nerve block after I mark them.
• 55:47
  Dr. Robert Whitfield: So our anesthesia team is great at doing ultrasound guided nerve blocks.
• 55:50
  Dr. Robert Whitfield: This is very important.
• 55:51
  Dr. Robert Whitfield: Most people think that general anesthesia stops pain.
• 55:55
  Dr. Robert Whitfield: That's not what general anesthesia does.
• 55:59
  Dr. Robert Whitfield: Local anesthesia stops feedback.
• 56:01
  Dr. Robert Whitfield: That's why you can get a wound close in the ER just with an injection of local.
• 56:08
  Dr. Robert Whitfield: You know, when you go to sleep, that doesn't stop the stimuli back to your brain.
• 56:12
  Dr. Jill Carnahan: Right.
• 56:14
  Dr. Robert Whitfield: So what we want to do is basically create an environment where the stimuli is stopped before you ever go back.
• 56:20
  Dr. Robert Whitfield: And then once we work.
• 56:22
  Dr. Robert Whitfield: Yeah, once we work in the pocket.
• 56:24
  Dr. Robert Whitfield: Think of the pocket like a pie chart.
• 56:27
  Dr. Robert Whitfield: As soon as I'm around the capsule, which is your scar tissue around the implant, think of like a pie chart, a quadrant.
• 56:34
  Dr. Robert Whitfield: I'm going to inject that with a long acting local anesthetic called exparel sliposomal bupivacaine.
• 56:41
  Dr. Robert Whitfield: A lot of fanciness.
• 56:42
  Dr. Robert Whitfield: So instead of lasting for a few hours, it lasts for about a week.
• 56:47
  Dr. Jill Carnahan: Amazing.
• 56:49
  Dr. Robert Whitfield: So by the time we get done, that ultrasound guided nerve block has been in for several hours.
• 56:56
  Dr. Robert Whitfield: The medicine I put in has been in and percolating.
• 57:00
  Dr. Jill Carnahan: Yes.
• 57:01
  Dr. Robert Whitfield: And so now they go to recovery.
• 57:03
  Dr. Robert Whitfield: We don't have drains in, so they're not having discomfort from a drain.
• 57:06
  Dr. Jill Carnahan: Right.
• 57:07
  Dr. Robert Whitfield: And so they wake up.
• 57:10
  Dr. Robert Whitfield: Most of my patients wake up relatively like easily.
• 57:13
  Dr. Robert Whitfield: And I would say overall, quickly.
• 57:16
  Dr. Robert Whitfield: This is done under general, so there's no confusion.
• 57:19
  Dr. Robert Whitfield: And they get up and leave.
• 57:21
  Dr. Jill Carnahan: Amazing.
• 57:22
  Dr. Robert Whitfield: And then they come to the office the next day.
• 57:24
  Dr. Robert Whitfield: So everybody after surgery, no matter what day of the week it is, typically is showing up the next day.
• 57:30
  Dr. Robert Whitfield: We operate it on a Friday.
• 57:31
  Dr. Robert Whitfield: We don't see them on Saturday.
• 57:32
  Dr. Robert Whitfield: We see them on Sunday, typically.
• 57:34
  Dr. Robert Whitfield: Anyway, we have this recovery stack that I like.
• 57:39
  Dr. Robert Whitfield: So we have the human regenerator.
• 57:40
  Dr. Robert Whitfield: Germany.
• 57:41
  Dr. Robert Whitfield: If you don't know what the human regenerator is, look it up online.
• 57:44
  Dr. Robert Whitfield: It's really fancy device to help get you into parasympathetic states.
• 57:48
  Dr. Robert Whitfield: Using cold plasma and stabilizing electron transport.
• 57:53
  Dr. Robert Whitfield: Then we like to follow it up with lymphatic massage and we do nanov at the same time.
• 57:57
  Dr. Jill Carnahan: I love it, Love the nanov.
• 57:59
  Dr. Jill Carnahan: I have one here at the house.
• 58:02
  Dr. Robert Whitfield: Right.
• 58:02
  Dr. Robert Whitfield: So that's the second step.
• 58:04
  Dr. Robert Whitfield: And then we do hyperbaric and we have a vertical chamber from summit to see.
• 58:10
  Dr. Robert Whitfield: And I like a vertical chamber because just like we're sitting up talking now, I don't want my patients pushing up and down to get out of a tube.
• 58:19
  Dr. Robert Whitfield: I don't want them having to do that movement.
• 58:23
  Dr. Robert Whitfield: And so we do that and then we follow it up with we have a big 6 foot tall juve red light and that takes a couple hours in the office.
• 58:32
  Dr. Jill Carnahan: Yeah.
• 58:33
  Dr. Robert Whitfield: And you do that two, three, four times depending on how long you're going to be in town.
• 58:37
  Dr. Robert Whitfield: I try to have everybody stay in town about a week now for every listening.
• 58:42
  Dr. Robert Whitfield: You're not going to come into Austin and leave in two or three days with me because that's not part of my program.
• 58:47
  Dr. Robert Whitfield: It's not allowed.
• 58:48
  Dr. Robert Whitfield: Because when you go back to your home city, your home away from Austin, nobody has what I have in the office.
• 59:00
  Dr. Robert Whitfield: Yeah, I have a great team.
• 59:02
  Dr. Robert Whitfield: That is.
• 59:02
  Dr. Jill Carnahan: That's what I'm hearing.
• 59:03
  Dr. Jill Carnahan: I love this.
• 59:04
  Dr. Jill Carnahan: I've created this, my house and some of it my office.
• 59:07
  Dr. Jill Carnahan: But it's so rare.
• 59:09
  Dr. Jill Carnahan: Even the, you know, really great personalized precision medicine people, it's hard to find what you just described.
• 59:15
  Dr. Robert Whitfield: It's a big investment on our part, but it's best in terms of taking care of.
• 59:20
  Dr. Jill Carnahan: Oh, your outcomes.
• 59:21
  Dr. Robert Whitfield: That's part of my office.
• 59:22
  Dr. Jill Carnahan: Yeah.
• 59:23
  Dr. Jill Carnahan: And I was going to ask about outcomes because I can guarantee I would.
• 59:25
  Dr. Jill Carnahan: Do you have statistics on the outcomes, you versus the standard?
• 59:29
  Dr. Jill Carnahan: Because I can't imagine it isn't dramatically different.
• 59:33
  Dr. Robert Whitfield: You know, I mean, it would be.
• 59:36
  Dr. Robert Whitfield: It's hard because it's really.
• 59:40
  Dr. Robert Whitfield: It would be a little unfair because you'd have to run it with a clinic like ours, and that's.
• 59:47
  Dr. Jill Carnahan: There's no one out there doing that.
• 59:51
  Dr. Robert Whitfield: Yeah, I don't.
• 59:52
  Dr. Robert Whitfield: I don't think it's.
• 59:54
  Dr. Robert Whitfield: I want people to be able to access the surgery and get the care and everything they need, and then you can learn, you know, I don't hide anything.
• 1:00:03
  Dr. Robert Whitfield: We do.
• 1:00:03
  Dr. Robert Whitfield: I don't.
• 1:00:04
  Dr. Robert Whitfield: It's all of it.
• 1:00:05
  Dr. Robert Whitfield: I've said it a million times on shows or done, you know, videos about it, whatever.
• 1:00:11
  Dr. Robert Whitfield: So I don't like fundamental concepts.
• 1:00:16
  Dr. Robert Whitfield: Should be super clear.
• 1:00:19
  Dr. Robert Whitfield: If you know how wounds heal, you need a certain amount of nutrients.
• 1:00:25
  Dr. Robert Whitfield: Right.
• 1:00:25
  Dr. Robert Whitfield: And we'll say protein, I favor over all else.
• 1:00:29
  Dr. Robert Whitfield: And then there's certain micronutrients and trace minerals you need.
• 1:00:33
  Dr. Robert Whitfield: You need sleep, you need oxygen.
• 1:00:36
  Dr. Robert Whitfield: Brain only lives four minutes without oxygen.
• 1:00:38
  Dr. Robert Whitfield: For all you people with obstructive sleep apnea that snore at night, go get checked.
• 1:00:44
  Dr. Robert Whitfield: Don't come to me for surgery without having that checked.
• 1:00:46
  Dr. Jill Carnahan: Yes.
• 1:00:47
  Dr. Robert Whitfield: Because if you don't sleep, you can't recover.
• 1:00:51
  Dr. Jill Carnahan: You don't heal.
• 1:00:52
  Dr. Jill Carnahan: Oh, this is absolutely amazing.
• 1:00:55
  Dr. Jill Carnahan: I really.
• 1:00:55
  Dr. Jill Carnahan: I love when I talk to a conventional, well respected surgeon like yourself.
• 1:01:01
  Dr. Jill Carnahan: And again, I'm trained very traditionally medical doctor, but when we open our minds to these other things, I always Say, it's not just that I have never put aside any of my great medical training.
• 1:01:11
  Dr. Jill Carnahan: I want to be the best physician, period.
• 1:01:14
  Dr. Jill Carnahan: But I want to have more tools.
• 1:01:15
  Dr. Jill Carnahan: And I really love seeing that with you because you've taken not only your skill set as an incredible, excellent surgeon with that you described even from the beginning, you're doing the same things in the right way, but now you're adding on these other things like testing for genetics and understanding how that plays in and then these other things that you know how you and I were taught in med school and I was before the work hour regulations as well.
• 1:01:36
  Dr. Jill Carnahan: And it was like, well, patients won't change their diet or they won't do lifestyle.
• 1:01:39
  Dr. Jill Carnahan: So were actually told to kind of not really talk about those things because who's going to really do them?
• 1:01:44
  Dr. Jill Carnahan: And yet they are the foundation of the success that you're having.
• 1:01:48
  Dr. Jill Carnahan: And the same with me in my clinic.
• 1:01:50
  Dr. Jill Carnahan: So kudos to you.
• 1:01:52
  Dr. Jill Carnahan: I am just delighted to have you here just so that patients can understand.
• 1:01:55
  Dr. Jill Carnahan: You mentioned the Sharp method.
• 1:01:57
  Dr. Jill Carnahan: And so I want to make sure.
• 1:01:57
  Dr. Jill Carnahan: Sure, if people want to know more about your clinic, the method, your book, where can they find all that information?
• 1:02:05
  Dr. Robert Whitfield: Yeah, we haven't been banned on the Internet yet, but give it time.
• 1:02:09
  Dr. Robert Whitfield: If you go to drrobertwitfield.com that's our main website.
• 1:02:15
  Dr. Robert Whitfield: We have about 500 pages of content devoted to understanding and really highlighting what we have learned about breast implants, explant surgery, breast implant illness.
• 1:02:30
  Dr. Robert Whitfield: We didn't talk about fat transfers.
• 1:02:32
  Dr. Robert Whitfield: I favor fat transfer for augmentation over implants.
• 1:02:36
  Dr. Robert Whitfield: And we've put together as much in terms of video content through a YouTube channel that has what used to have a couple million followers, now it's only got like 1.98.
• 1:02:48
  Dr. Robert Whitfield: You can access the show, the Dr. Robert Whitfield, you know, podcasts there or on Spotify or Apple.
• 1:02:53
  Dr. Robert Whitfield: And then the two books, and I don't really talk about the books enough but we have one about sharp and then we have one about our patients experience through breast implant illness that we wrote to really help people.
• 1:03:07
  Dr. Robert Whitfield: I think have the other viewpoint if you will.
• 1:03:11
  Dr. Robert Whitfield: And it's called Breast Implants x Men Surgery and Breast implant Illness and it's available as well.
• 1:03:17
  Dr. Robert Whitfield: We have our shop for, you know, supplements and things.
• 1:03:20
  Dr. Robert Whitfield: And then we have started Dr. Carnahan be due to censorship, a private community called Dr.robcircle.com awesome.
• 1:03:27
  Dr. Robert Whitfield: So I live stream there typically every Thursday night.
• 1:03:30
  Dr. Jill Carnahan: Awesome.
• 1:03:31
  Dr. Jill Carnahan: Well, if you guys are driving or riding your bike or wherever you're at.
• 1:03:34
  Dr. Jill Carnahan: Don't worry, I will have this all in the show.
• 1:03:36
  Dr. Jill Carnahan: Notes I feel like Dr. Whitley Hill, first of all, just so grateful for your work, your curiosity and what you've brought to our world and to women who are suffering from this kind of illness.
• 1:03:46
  Dr. Jill Carnahan: And I just really am grateful for that work you've done and for all the amount of information because there's so many women who are really not only have benefited but are going to benefit if we get this word out.
• 1:03:57
  Dr. Jill Carnahan: So thank you again for your work.
• 1:03:59
  Dr. Jill Carnahan: Thanks for coming on the show.
• 1:04:00
  Dr. Jill Carnahan: Hey guys, thanks for joining me for this episode with Dr. Robert Whitfield.
• 1:04:03
  Dr. Jill Carnahan: Hopefully you enjoyed it as much as I did.
• 1:04:06
  Dr. Jill Carnahan: What a fascinating topic on breast explant illness.
• 1:04:09
  Dr. Jill Carnahan: I know I learned a lot and it's always incredible to hear from surgeons who really get it not only from the diet, lifestyle, nutrition aspects, but sleep, genetics, et cetera.
• 1:04:19
  Dr. Jill Carnahan: So if you want to know more, you can find his website and information in the show Notes as you know, every week we have new episodes coming out for Resiliency Radio.
• 1:04:28
  Dr. Jill Carnahan: And if you have not yet joined the over one million subscribers on YouTube, please hit that button.
• 1:04:33
  Dr. Jill Carnahan: Hit the alarm bell so that you can be notified of future episodes.
• 1:04:36
  Dr. Jill Carnahan: And if you're on Spotify, itunes, anywhere you listen to this podcast, would you please stop and leave us a review?
• 1:04:44
  Dr. Jill Carnahan: Share this with someone you know might benefit and I will see you again next week for another episode of Resiliency Radio.