Medical Oddities Part 1: How Pilates Caused a Woman’s Body to “Swallow” One of Her Breasts

pilatesImagine. There you are, trying to stay in shape. Going to one of your local Pilates classes, and while performing what is known as a Valsalva maneuver, your body suddenly swallows one of your breasts! As fate would have it, we don’t need to just imagine.  We can ask a 59 year old from Maryland who had that very thing happen. What strange set of circumstances led to this breast being “swallowed”?

In 2011, the 59 year old in question went to John Hopkins medical center and spoke with Dr. Tiffany Fong in the Emergency Room. Dr. Fong stated, “I remember her saying, ‘My body swallowed my boob.’” Like any good Emergency Room physician, Dr. Fong took a good look at her medical history to find out how this seemingly impossible thing could have happened.

It turns out, the woman recently had breast reconstruction surgery after having a double mastectomy as a result of breast cancer.

If that wasn’t bad enough, shortly thereafter she also needed to have one of her heart valves replaced. The doctors performing that surgery chose to use the same entry point used in her breast reconstruction. They needed to also make a small incision between her ribs (intercostal space) to allow for access to her heart.

Fast forward three months post heart valve surgery (for reference, 4-6 weeks is the standard recommended recovery time before working out) and Pilates was on the menu.

So how did the Valsalva maneuver cause her body to “eat” her boob? The maneuver is one that involves trying to forcefully exhale while you simultaneously close your mouth and pinch your nose. This creates very high intrathoracic (chest) pressure. That pressure caused the small incision between her ribs to open up. When she finished her maneuver, her synthetic bosom fell into the space between her lungs.

As if losing her breast to a hungry chest wasn’t enough, when she performed the maneuver again, part of her lung protruded out of the same small incision. Despite the lung hernia, she had no complaints of pain or troubles breathing.

The story had a happy ending in that the doctors were able to replace the “swallowed” breast and seal her troublesome incision with wire mesh.

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(For those who would like to see the proof or are just curious, you can click here for the X-rays and pictures posted in the New England Journal Of Medicine. But be warned, a couple of the images may or may not be slightly NSFW, depending on where you work. ;-))

Bonus Facts:

  • According to the American Society of Plastic Surgeons, there were 286,274 breast implants (augmentation mammaplasty) performed in 2012 in the United States. It was the most performed plastic surgery procedure that year. #2 was nose reshaping. It came in with 242,684 total procedures.  On the latter, this was down about 14,000 nose procedures from the numbers in 2009; presumably the death of Michael Jackson that year explains the drop-off… too soon?
  • The average cost for a breast implant will vary depending on the type of procedure, and the doctor that performs it, but it normally ranges between $5,000- $10,000.  Every now and then, you can find a two for one deal though. (I have actually seen this advertised.)
  • There are two main types of breast implants, saline and silicone. Silicone gained notoriety in the US over concerns of the potential health problems should they leak. In 1992, the FDA banned their sales. In 2006, they changed their minds after more research had been done. That’s good news for both ladies and men alike, as some people have said silicone implants feel more like real breasts compared to their salt water counterparts.
  • The world’s biggest breast augmentation is 38KKK.  These mammoth mammaries are sported by Sheyla Hershey, originally from Brazil, taking her 10 different surgeries to get up to that size.  Sheyla’s goal is to some day get her boobs up to 38MMM. I guess she took the sage advice to always dream big literally…
  • While her reasoning behind the surgeries may be essentially vanity (wanting to hold and keep the world record), Sheyla claims her 38KKK breasts once saved her life during a car accident where she wasn’t wearing her seatbelt.  Her implants functioned something like an air bag, keeping her from smashing her head on the dash or windshield.  Lucky for her, considering the volume of fluids in them, during the accident, her implants did no burst.  One also wonders if the reason she wasn’t wearing a seatbelt in the first place had something to do with her breasts.  Thus, had she kept her originals, perhaps she’d be a seat belt wearer and she then can’t necessarily claim her buxom bosoms helped out in this situation. 😉
  • According to the American Cancer Society, approximately 230,480 new cases of breast cancer were reported in 2011. About 39,520 were expected to die from the disease annually. This makes breast cancer the second leading cause of cancer deaths among women. Only lung cancer accounts for more. Men, don’t think you’re immune to this ailment. Approximately 2,140 new cases are expected to be diagnosed in men every year in the U.S. Approximately 450 of those men will die from it.
  • 2.6 million women in the US are alive today that have been diagnosed with breast cancer. Over half of them were diagnosed within the last 10 years.
  • Pilates and Yoga (see: The History of Yoga) have become a multi-billion dollar industry. According to IBIS World, it has annual revenues of 7 billion dollars. It employs 109,009 people in 24,843 businesses. The industry has enjoyed a 7.7% annual growth rate since 2007. Looks like we Americans might be fighting back against our nemesis, obesity. Keep it up folks!  I can’t tell you how many calls I go on regularly where, in the end, the person’s medical problems simply stem from the fact that they are obese.  It’s extremely hard, but lose the fat, eat healthy (actually healthy, not some gimmicky diet), and exercise.  Future you will thank you, as will your loved ones.
  • Pilates is named after Joseph Humbertus Pilates, 1883-1967. Born in Germany, he moved to England in 1912. During World War 1, he became imprisoned because of his German heritage. While in prison, he noticed animals stretching and incorporated this into his breathing techniques he learned as a child while studying martial arts. After the war, his fame in helping those who had been injured, led to the New German Army pressuring him to help train them. He chose, instead, to immigrate to New York where he and his wife Clara opened a studio that taught his method. They called it “Contrology”. Today, approximately 11 million people a year in the United States practice his techniques.
  • About 85% of people breathe out of just one nostril at a time: details here
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  • hah… i read the title so fast that the first image into my mind was Pontius Pilatus 😛