WASHINGTON -- They came in wheelchairs and leaning on canes, with violet-colored ribbons pinned to their lapels. Tearfully, they disclosed their symptoms: chronic fatigue, mysterious fevers, bizarre rashes, painful joints.
After 16 years of litigation and scientific dispute over the safety of silicone breast implants, Friday was a chance for the women who call themselves "silicone survivors" to come to the nation's capital and be heard.
The occasion was the final day of a three-day scientific meeting held by the prestigious Institute of Medicine, which is conducting an independent study of the implants' safety. The study will not be completed for at least a year, but for the dozens of support group leaders who came to Washington, as well as the thousands of women they represent, the meeting marked a turning point in their quest to be taken seriously.
"It feels wonderful, as if finally we have a gag order off our mouths," said Martha Murdock, founder of the National Silicone Implant Foundation, based in Dallas. She, like many others, implored the panel to press for more research, dismissing as inadequate more than a dozen major studies that have found no link between the implants and established diseases, including autoimmune disorders and breast cancer.
"You want to know why I came here? I'll tell you why I came here," said Merry Grant of Metarie, La., in an interview. "I hurt all the time. I burn all the time." To the committee, she pleaded, "We need research and I'm asking you to help us, because I am dying one day at a time."
Friday's session took place a little more than two weeks after Dow Corning Corp., an implant manufacturer, agreed, without admitting wrongdoing, to pay $3.2 million to 170,000 women who say they have been injured by their implants. Dow Corning scientists, who testified on Wednesday, have said they welcome the Institute's inquiry.
Now, yet another lawsuit is under way. Kathy Keithley Johnston, a Columbia, Mo., nurse who is president of a group called Toxic Discovery Network, announced Friday that her group had filed a class-action lawsuit in federal court in the District of Columbia against the Food and Drug Administration and the American Society for Aesthetic Plastic Surgery. The lawsuit says surgeons failed to inform patients and the FDA of the dangers of implants.
It seeks to compel the FDA, which removed silicone implants from the market in 1992 but still permits them to be used on an experimental basis, to prohibit implants entirely. An agency spokeswoman said officials were unaware of the suit.
When Ms. Johnston announced the filing at the hearing, it drew enthusiastic applause.
"We have begged, pleaded, yelled, cried for you to hear our voices," she told the committee, "and all we have received is the label of hysterical females." She accused the plastic surgeons' group of breaking "all moral and ethical codes," a charge that Dr. C. Lin Puckett, the society's president, quickly denied.
"There is an impressive body of evidence," Puckett said in an interview, "that would tell us that these implants are safe systemically."
Not all the women present Friday were opposed to implants. Susan Scherr, a breast cancer patient, said she received a silicone gel implant as part of her reconstructive surgery and has had no problems. She said that although she was sympathetic to women like Ms. Johnston, she did not want to see access to implants cut off. "It's our feeling that there needs to be good science, and now there is good science," Ms. Scherr said.
But the topic of just how good, or how complete, the science on implant safety is remained a contentious one Friday. While epidemiologists repeated the evidence that shows cancer and autoimmune disorders occur with the same frequency in women with implants as in women without them, several doctors and scientists Friday offered evidence to counter the large epidemiology studies.
Dr. Michael Raymond Harbut, a specialist in environmental medicine at Wayne State University in Detroit, said he had found that a type of platinum used in the manufacture of the implants can leach out, causing allergic reactions similar to those seen in people who are exposed to platinum in the workplace.
He was later contradicted by Alistair Winn, an industry scientist who described the platinum issue as "a red herring."
Dr. Robert Garry, a professor of microbiology at Tulane University Medical School, presented evidence that more than half of women who reported complications with their implants exhibited antibodies that react with silicone, suggesting that implants are causing an immune response. He developed a test for the antibodies, and that has made him something of a hero to the women who testified about their problems.
Many have spent years going from doctor to doctor, looking to no avail for an explanation for their curious symptoms. For these women, Garry's findings offered proof that something is medically wrong.
"I tested with Dr. Garry," said Anne Stansell, a photographer from Los Lunas, N.M., who attended Friday's hearing. "When I got the news on that test, I cried."
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