Speaker 1 (00:04):
Welcome to the Breast Implant Illness Podcast with board certified plastic surgeon, Dr. Robert Whitfield, Austin's natural choice for plastic surgery and the expert in smart laser and energy treatments.


Dr. Robert Whitfield (00:20):
Today, we're talking about the BII discovery process in our office. We'll cover the discovery session fees, the appointment itself, and the testing revolving around this discovery session. When someone comes to me and they want to learn in a discovery session about a chronic illness, which really breast implant illness is a very chronic illness that debilitates many, many clients, it's a very long, involved discussion that starts with a systems-based approach. From a neurologic standpoint, you want to establish whether or not the patient has cognitive decline, but relatively in terms of layperson's discussing that, it's called brain fog. Brain fog can have many forms. Can't find words to describe things, can't remember names, even their children's names sometimes.


Dr. Robert Whitfield (01:12):
What's unique about my practice is I do a screening EEG for my BII patients who proceed to have surgery. What is an EEG? An EEG measures your brain activity. Why would that be important in somebody who has brain fog? Well, if you have a decreased response time to an auditory stimulus, that is somebody who's indicative of a person having a cognitive decline possibly, and so is this permanent, transient, how can we evaluate it, what can we learn about it to help this client? People may feel shortness of breath, tightness in their chest. These kind of cardiovascular and respiratory symptoms are not obviously what you would find in somebody who is otherwise healthy coming in to seek facial rejuvenation, breast enhancement, liposuction.


Dr. Robert Whitfield (02:03):
My client specifically, I can tell you an example where I thought the patient was actually having a pulmonary embolism in my office and I sent her to the emergency room to get worked up for it because she was so short of breath and looked so ashen and gray, which is what someone looks like when they're having a pulmonary embolism. We discussed, like, do you have exercise-induced intolerance or can you walk up and down stairs? Do you feel short of a breath all the time? Now, obviously in the time of COVID it's complicated because I have many patients who've had COVID, recovered from COVID, suffer from long COVID symptoms, and now with Omicron we have people coming in who were vaccinated or boosted or both and still have symptoms of shortness of breath later on after recovering from an episode of COVID.


Dr. Robert Whitfield (02:46):
If we move down the ladder, we get to really the elephant in the room, which is the GI tract. The GI tract is intimately associated with your brain and if you don't absorb nutrients all sorts of bad things happen, not only in your GI tract but with your brain. Let's just, for instance, say you have a lot of bloating, you have problems with constipation, you have abdominal pain. This represents maybe ... I have over 9,000 female clients, probably 80% of them have some of that going on at any given time so then we discussed if they are trying to follow a diet are they taking supplements? Do they have to take things to help them move their bowels?


Dr. Robert Whitfield (03:35):
It doesn't sound like a very glamorous thing to discuss but, in fact, it's extremely important every time you do one of these cases whether or not their GI tract functions dictates a lot of their recovery process and their surgical outcomes because the fuel to recover is the food you put in your mouth. If you don't eat real food, if you're constantly shopping in the aisles of the store versus the edges of the store, you're going to do poorly.


Dr. Robert Whitfield (03:59):
I micromanage my patients so they have the best possible recovery process. Then, as you can imagine, I have a lot of folks who have different musculoskeletal complaints. Common complaint with BII is joint pain, muscle pain. A lot of this is inflammation and I've had people really debilitated by this. If we're going to be discussing all of these things in addition to what, if any, autoimmune symptoms have they had in the past or did they come from or have a family history of autoimmune symptoms, you can see how this is not a 20 or 30 minute discussion. My discovery sessions purposefully are longer because I need that much time to figure out and help you the best way I can. I don't want to be rushed in any conversations I ever have with any patients, which is certainly part of the biggest issue with allopathic medicine where many times they have their hand on the door knob five minutes after they enter your room to talk to you.


Dr. Robert Whitfield (04:57):
If people have a lot of work to do beforehand, then we discuss work that needs to be done. I will provide preliminary estimates about what I think is possible and then we'll move forward with helping them. I recently had a client who had seen ... We won't mention the famous clinic, and she baffled everybody at this particular clinic and had seen all the department heads who said, basically, we don't have anything to offer you. I did a virtual discovery session with this client, listened to her story. She has over 20 year old implants. She has all the standard symptoms associated with breast implant illness.


Dr. Robert Whitfield (05:37):
She has cognitive decline, anxiety and associated depression, GI symptoms, muscle and joint pain, and in this discovery session I just recommended a few things to help get her feeling better because she was placed on medications to facilitate bowel movements. That can be very, very difficult on clients from a physical standpoint and an emotional standpoint, not knowing when you're going to have a bowel movement and then abruptly you need to go to the bathroom. I simply provided the advice to correct some of this holistically and [inaudible 00:06:15] after that and she resolved her need for medication to have a bowel movement.


Dr. Robert Whitfield (06:19):
She was doing this in a normal way and I had her on a more gluten-free, dairy-free diet, increased dietary protein and reduced or eliminated processed foods so she was already doing quite a bit better. Some of these things are very straightforward. If I wasn't doing these all myself and I would say sending you to a naturopath, the naturopath would charge you at least $900 an hour to discuss this with you. If, in fact, I needed you to see a psychiatrist because I thought your anxiety/depression was more indicative of an organic issue versus BII problem, then a psychiatrist typically charges over $650 an hour to have that discussion with you.


Dr. Robert Whitfield (07:01):
What we're trying to do and emphatically what I want to do for people, is decrease the seeking of an increased number of specialists to handle this issue for them. If, in fact, you want to proceed and have a discovery session with me, my team will set it up whether it's in person or virtual. My coordinators are Stephanie and Kim, and they're extremely experienced in setting up these discovery session calls for you. I have a very, very good team. They're very strong, they understand. They've dealt with and worked with very complicated patients with chronic illness, like breast implant illness and breast cancer, because that's what I did the majority of my career. If you do have a discovery session with me, if that's what you choose to do, that fee, all of it is put towards a surgery if, in fact, that's what's necessary to correct this issue for you that we find in the discovery session.


Dr. Robert Whitfield (07:56):
These discovery sessions typically occupy about an hour of time and that is the time I've decided it takes for me to help people the most. I find that time extremely valuable for clients so they can really tell me what they're thinking and I can listen carefully to everything they have to say about what's going on with them, whether it's symptoms, things they feel, things they don't quite understand, things that other people have told them don't make sense or have made them seem like they're feeling crazy. I mean, they're all very important and I think the first things I learned about this was, if you listen to some of my previous podcasts, I missed one of these on my very first try and I don't like missing things. I don't like missing anything actually so I try to be very careful and listen to the details.


Dr. Robert Whitfield (08:43):
I'll catch things in conversation that you probably don't seem very important at the time, but they will become very important to you both in your surgical process, the recovery process, and overall building your wellness back to what it was before you had these problems. Before you would schedule a discovery session with me, you would communicate with my team and obviously there's multiple ways to do this. All new patient phone calls would go to my surgical coordinators, Stephanie or Kim, and then if you open a web chat through my website you would be directly communicating with Stephanie or Kim.


Dr. Robert Whitfield (09:18):
Then once they discuss what you're looking for or how we can help you get through this, they'll schedule the discovery session if you want to proceed. They'll block out the time on my schedule. I do these before hours or after hours. I typically am open from 10:00 AM to 6:00 PM but I do virtual discovery sessions before and after hours, depending on the needs of the clients. To prepare to have a discovery session with me, a few things are nice and most of my clients are already exceptional at having their information or their laboratory analysis, and then my team asks you to upload 2D photos to your chart so I can review them. They ask you to upload your implant card and they ask you to upload any laboratory analysis that would be germane to our discussion and then we can have a virtual discussion and go from there.


Dr. Robert Whitfield (10:08):
I think it's important whether you're in Ohio, Missouri, California, to leverage the fact that I can do this virtually. I feel like most of these cases, once I hear the story since I've probably done over 800 consults at this point and over 500 explants, I'm pretty comfortable in my ability to discern these patterns associated with breast implant illness. I do understand and can listen and evaluate and help you kind of get to the next step in the process of either having an explant, getting started in the process down the road to have an explant. Now, if you don't want to have a virtual discovery session and you have the ability to get to Austin, see us in person, of course I'm happy to see everybody in person, it makes it really easy.


Dr. Robert Whitfield (10:54):
Now, my team in the office, besides Stephanie and Kim who are coordinators, I have Millie who's my medical assistant, Jen who is my executive assistant, and our nurse, Dara, so we have quite a group who's always there helping. Then in addition for EEGs, our tech who does that is Daniel who's also my personal surgical tech. On our next episode, we'll be going in depth into all the steps we take to prepare our patients for explant surgery, testing both blood, urine, DNA, the labs necessary to proceed, the nutritional plan we'll set forth, and much more.


Speaker 1 (11:33):
Dr. Robert Whitfield is a board certified plastic surgeon located in Austin, Texas near 360 and Walsh Tarlton in Westlake. To learn more, go to drrobertwhitfield.com or follow Dr. Rob on Instagram at Dr. Robert Whitfield. Links to learn more about Dr. Rob's smart procedures and anything else mentioned on today's show, are available in the show notes. The Breast Implant Illness Podcast is a production of Team Podcast, at www.teampodcast.com.