Dr. Pimple Popper removed 16 pus-filled lumps from a man who has so many he doesn't look in the mirror anymore
Editor's note: This post contains graphic images and descriptions of dermatological conditions.
In the last episode of the fourth season of "Dr. Pimple Popper," Dr. Sandra Lee was tasked with removing more than 50 lipomas from a man's body. The man, Gerard, also had a blood-clot condition that made the surgery more dangerous than previous lipoma removals. In the end, Lee was able to remove 16 of the dozens of lipomas on Gerard's body. Visit Insider's homepage for more stories.
Dr. Sandra Lee, better known as Dr. Pimple Popper, has spent the fourth season of her hit TLC show treating bubbling nose growths and lipomas. In the final episode of the season, she faces a particularly challenging condition: a man with more than 50 bumps all over his body. Gerard, a 46-year-old teacher from Brooklyn, New York, said he developed his first-ever lump on his thigh when he was in his twenties and that, over the years, more growths popped up on his arms, legs, and stomach. Before seeing Dr. Pimple Popper, Gerard said he had too many lumps to count, but estimated he had between 50 and 75. "I've been told, since my first lump, they're benign lipomas, and over the years I've asked my doctors if there's anything I can do about that," Gerard said. His doctors said that, in theory, it would be possible to remove all of his lipomas, or fat-filled growths that sit between the muscle and skin. But due to the large number of growths on Gerard's body, they said it wouldn't be realistic to remove them all, so he never bothered with treatment. Instead, Gerard said he tried, and often failed, to hide the lumps under his clothes. It left him feeling uncomfortable at work, and, even though he used to love exercise, he avoided the gym so as to not draw attention to himself. He also avoided full-length mirrors, and hadn't looked at himself in one for years. "It makes me angry. I have enough other problems," Gerard said, adding that he also had a hereditary disorder called Factor 5 Ledein that caused his blood to clot. Gerard said it was difficult to mask the pain of his bumps and put on a smile for his two young kids, and hoped Dr. Pimple Popper could help him. Dr. Pimple Popper discovered Gerard had familial multiple lipomatosis Once at Lee's office, Gerard showed the doctor the many lumps on his arms, describing the others he had all over his body. Then he mentioned that his sister also has growths on her body. Lee said that piece of information meant it was likely Gerard had a condition called familial multiple lipomatosis, a rare condition where a person forms various lipomas. It's not clear what causes the condition, but there are ways to treat it. According to the National Institutes of Health, multiple lipomatosis causes lipomas to form that don't typically cause pain but can interfere with daily life and can be surgically removed if needed. Multiple lipomatosis becomes familial multiple lipomatosis when it occurs in more than one family member. Unusually, however, Gerard's growths were much larger than those typical for someone with familial multiple lipomatosis. When Lee found out Gerard has a blood condition, she was concerned about treatment
Gerard said that, in order to treat his Factor 5 Ledein disorder, he takes aspirin daily to thin his blood and prevent pain, swelling, and potentially life-threatening artery blockages. Although Lee has treated her fair share of lipomas in the past, she became concerned. Surgically removing the lipomas was possible, Lee said, but could increase Gerard's chances of forming blood clots that could get into his lungs and lead to a life-threatening situation. Gerard had to consult his doctor, who green-lit the procedure and gave him an anti-coagulant medication to prevent clots from forming, which quelled Lee's fears. Lee decided she would have to keep Gerard awake during surgery, to keep his body relatively active as a way to reduce the risk of blood clots forming. Lee couldn't remove all of Gerard's lipomas, but she got 16 of them "I can tell Gerard wants all of his lipomas gone, but that can't happen today," Lee said. Rather, she decided to remove 10 lipomas that weren't located near important or large blood vessels where, if disrupted, blood clots would be more likely to form. To remove the lipomas, Lee numbed the area around each one individually. Then, she used a small surgical knife to cut each lipoma open down its center. Lee kept asking Gerard through the surgery if he felt any warmth, swelling, or pain, which can all be signs of a blood clot. To minimize bleeding with each lipoma Lee cut open, she used her glove-covered fingers to pull the fat deposits out of Gerard's body. In the end, Lee was able to remove 16 lipomas and stitch them shut for Gerard. Following the procedure, Gerard said he was disappointed he still had the majority of his lipomas still intact, but that he still felt "like a new man." "It's a new start. It's a new beginning," Gerard said.
Read more: Dr. Pimple Popper's favorite acne to treat is a special kind of blackhead Watch Dr. Pimple Popper remove a 9-pound lump that was growing on a man's arm for nearly a decade Dr. Pimple Popper reveals her nighttime skincare routine, and it only includes 3 steps Join the conversation about this story » NOW WATCH: Taylor Swift is the world's highest-paid celebrity. Here's how she makes and spends her $360 million.
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Mysterious strokes among young COVID-19 patients may reveal how 'a virus can cause strokes in ways we never knew before,' a doctor says
New York City doctors have reported a handful of young patients with mild coronavirus cases who...New York City doctors have reported a handful of young patients with mild coronavirus cases who experienced large-vessel strokes. The patients were at low risk for strokes, a new report reveals. Such strokes occur when a blood clot travels from the body into an artery in the brain. Experts have reported blood clots in patients with severe COVID-19 cases. One of the doctors behind the report told Business Insider that stroke-causing clots may be a result of coronavirus-induced swelling in blood vessels. Visit Business Insider's homepage for more stories. Four people in their 30s and 40s were recently admitted to Mount Sinai Hospital in New York City with life-threatening strokes. Their cases were united by a common theme: All of them had COVID-19. "Large-vessel strokes in young patients are exceedingly rare," Thomas Oxley, a neurosurgeon at Mount Sinai who published a new report about the cases, told Business Insider. "They'd need a past history concerning strokes. But these patients had minimal past medical histories and all came in within two weeks." The patients, four men and one woman, were hospitalized between March 23 and April 7. In Oxley's paper, published Wednesday in the New England Journal of Medicine, he and his colleagues wrote that "every two weeks over the previous 12 months, our service has treated, on average, 0.73 patients younger than 50 years of age with large-vessel stroke." So the recent handful of stroke cases stood out. "What if we're now learning that a virus can cause strokes in ways we never knew before?" Oxley said. The young stroke patients had mild or no COVID-19 symptoms Large-vessel strokes are caused by a blood clot that travels from the body into an artery in the brain. The new report describes how this happened in each of the five recent New York cases. The only woman in the study, a 33-year-old, had no prior medical history, the paper says. She experienced a COVID-19-related cough, headache, and chills in the week prior to her stroke. Then, over a period of 28 hours, her speech became slow and slurred as her jaw muscles shut down. Her left arm and leg became weak and numb. At Mount Sinai, Oxley and his colleagues found a blood clot in her brain's carotid artery. They used a "clot-busting" drug to break it up over the next 10 days. The four male patients, meanwhile, had similar stories. All of them experienced numbness, slowed speech, and temporary paralysis before they went to the hospital, where doctors removed the life-threatening clots. The men ranged in age from 37 to 49; two had mild coronavirus symptoms while the other two reported none at all. Only one had suffered a stroke before. 'Dumbfounded' by the link between COVID-19 and strokes Oxley said that since first speaking out about these stroke cases, he's been flooded with emails from other coronavirus patients describing minor strokes. A 31-year-old man messaged him on Sunday, describing a sudden onset of speech disturbance and numbness, Oxley said. The patient went to the hospital, and an MRI revealed he'd had a stroke in his thalamus. "I was just dumbfounded by this story of a patient who had never had a past history of stroke," Oxley said. He added that strokes have also been observed in older COVID-19 patients, but the new trend is reason for additional concern because it involves people in their 30s and 40s without severe symptoms. (Overall, nearly three-quarters of all strokes occur in people over the age of 65.) Oxley and J. Mocco, another Mount Sinai neurosurgeon, think the link between COVID-19 and the increase in strokes they're seeing has to do with blood clots. Experts have reported blood clots appearing in various parts of coronavirus patients' bodies, including the lungs. Broadway actor Nick Cordero, who was diagnosed with coronavirus, had to have his right leg amputated after clots formed. "It's very striking how much this disease causes clots to form," Mocco told Reuters. Coronaviruses in general have also been known to cause neurological issues like strokes, according to a February study. Roughly 2% of patients in Singapore who contracted SARS (also a coronavirus) had strokes. A study on COVID-19 patients at three hospitals in Wuhan, China — which is not yet peer-reviewed — found that of 214 patients, 36% had neurological symptoms. That included impaired consciousness and acute cerebrovascular diseases like strokes. The coronavirus might attack both the lungs and the blood Scientists aren't yet sure why COVID-19 causes clots, but Oxley said they might be the result of blood vessels' reaction to being invaded by the virus. The new coronavirus attacks via a specific cell receptor called ACE2, which can be found throughout the body, including in our guts, lungs, hearts, and even noses. According to Oxley, the virus can also bind to ACE2 receptors in the walls of our blood vessels. That leads the vessels to become inflamed, which can cause clotting. Then once a clot has formed, it can travel to the brain and cause a stroke. Not everyone's blood-vessel walls have the same level of ACE2 receptors, though. That characteristic is linked to a patient's genetics, rather than their age, Oxley said. That might explain why blood clots appear in patients across age brackets. Oxley said COVID-19 is teaching his colleagues about a previously unexplored link between viruses, inflammation, and strokes. "There are other viruses we're going to learn about in the future that may be connected to strokes in the same way," he said.SEE ALSO: 5 young New Yorkers with mild COVID-19 cases were recently hospitalized with strokes. Doctors say the coronavirus can cause blood clots. Join the conversation about this story » NOW WATCH: Alarming videos from hospitals around the world show what doctors are facing as they treat coronavirus patients
Blood clots are the latest life-threatening complication of the coronavirus, but doctors aren't sure how to treat them
We're still learning about all the terrible things the novel coronavirus does to human bodies. Doctors...We're still learning about all the terrible things the novel coronavirus does to human bodies. Doctors are unsure of the best way to treat it. In the sickest patients who have COVID-19, the disease caused by the coronavirus, the disease affects more than just the lungs. Doctors have reported kidney problems, heart problems, and an unusually high rate of blood clots in severely ill patients. Doctors aren't sure how to treat the blood clots. Some are proposing heavy doses of blood-thinning medications, while others are exploring clot-busting drugs otherwise used to treat strokes. Trials to evaluate whether those options help patients recover are ongoing, but results are still months away, leading doctors to make decisions on their own. Visit Business Insider's homepage for more stories. Dr. Alex Spyropoulos is focused on one big question when it comes to patients who are severely ill with COVID-19, the disease caused by the novel coronavirus. The question: If doctors give therapeutic doses of the blood-thinner heparin, do those doctors save the lives of COVID-19 patients? Spyropoulos is an expert on blood clots at Northwell Health in New York, and he said that's the single most important question he's come across in the time he's spent in his field. As the coronavirus pandemic has spread, infecting millions globally and killing hundreds of thousands, doctors have been forced to rapidly figure out how to treat it without a vaccine or medicines that cure it. They're still not sure of the best way to get oxygen into the damaged lungs of the most severely ill patients, for example. DataTicker - Covid 19 Global and US And now, they're learning that the respiratory disease appears to be impacting more than just the lungs, particularly in severe cases. Doctors have reported kidney issues, heart problems, and more recently, issues with blood clots appearing in different parts of the body. Not helping the matter, researchers have also reported complications that might make it harder for people to form blood clots in other hospitalized COVID-19 patients. Never miss out on healthcare news. Subscribe to Dispensed, Business Insider's weekly newsletter on pharma, biotech, and healthcare. Typically, doctors like Spyropoulos prefer to rely on results from robust clinical trials to figure out whether treatments are effective. But because the virus is so new, trials are just getting started, with results expected in the coming months. "We're driving blindly based on what we call very weak but very compelling data," Spyropoulos said. In the absence of sturdy scientific evidence backing up whether one approach or another is best, doctors are debating the best way to treat the disease. Studies are ongoing looking into the answer to Spyropoulos's question, as well as whether clot-busting drugs — typically used to treat strokes — are a better approach. Read more: There are more than 70 potential coronavirus vaccines in the works. Here are the top efforts to watch, including the 16 vaccines set to be tested in people this year. 'Remarkably high' incidence of clotting in COVID-19 patients Early on in the coronavirus outbreak, doctors in the US were hearing from colleagues in China about the virus' effects on the heart, Dr. Thomas Maddox, who serves as chair of the science and quality committee of the American College of Cardiology, told Business Insider. The effects seemed to be related to both a viral invasion of the heart and to the stress of fighting the respiratory disease. With COVID-19, doctors are also seeing blood clots occurring in the lungs and bodies of patients on ventilators, Dr. Greg Martin, a professor of pulmonary critical care at Emory University and president-elect of the Society of Critical Care Medicine, told Business Insider. Clots can wreak havoc on the body, traveling and blocking up veins, leading to strokes, heart attacks, kidney problems, lung problems, and more. Blood clots aren't uncommon in severely ill patients in intensive care units, or even in hospitalizations. While in the ICU, patients are typically on breathing support and sedated, which limits their ability to move as they heal. Staying still raises the risk of clots. Read more: The US is sprinting to develop a coronavirus vaccine or treatment. Here's how 19 top drugmakers are racing to tackle the pandemic. Other viruses also raise the risk of clots But doctors have a hunch that the virus might play a role in increasing the risk of clots, too. "We think it's one of the most important, if not the most important, issue with respect to monitoring sick hospitalized COVID-19 patients," Spyropoulos said. It wouldn't be the first time, he said. Doctors noted an elevated risk of clotting in patients with H1N1, or swine flu, as well as in the SARS outbreak, another coronavirus, in the early 2000s. With the novel coronavirus, more clots seem to be originating in the lungs, Spyropoulos said. In a recent observational study, Dutch researchers looked at 184 patients in the intensive care unit with coronavirus. About a third of them had a complication associated with a clot, such as clots in the lungs, clots in the legs, stroke, heart attack, or other clots cutting off blood to other parts of the body. All were on preventive treatment intended to prevent clotting in the body. That's a higher rate of problems than might typically be seen in patients in intensive care units, Spyropoulos said. Typically, he said, clotting rates in ICUs for different conditions are between 5-10%. The researchers called it "remarkably high," recommending increasing doses of the blood-thinning medication. To figure out the best way to treat patients, researchers are evaluating two options: Heparin, a blood thinner that prevents clotting complications in patients. Clot-busting drugs, typically used to treat strokes. Making decisions in the absence of evidence For now, most of the evidence doctors are using isn't much better than anecdotes. The ACC is currently reviewing recommendations on how to take care of the clotting complications seen in COVID-19 patients, but heart doctors won't have much evidence to guide them until they get clinical trial results, likely, in the second half of this year. "Our journals are inundated with essentially opinion pieces," Maddox said. To preventing clotting complications in COVID-19, Northwell's Spyropoulos has been relying on his clinical experience to make decisions. "If you have a deep experience in this field you can make reasonable assumptions and extrapolations and observations from indirect data," Spyropoulos said. For the past month — partially while out sick with COVID-19 himself — he been working with the health system to adjust guidelines, stepping up preventive dosing of blood thinners and making sure doctors are more sensitive to signals that might indicate clotting, such as swelling in the legs of patients. The health system has also been keeping tabs on signs of clotting once patients leave the hospital and prescribing blood thinners when patients are discharged. Clotting complications outside the hospital in COVID-19 patients For now, most of the conversation is about what to do with blood clot complications in hospitalized patients. But, Spyropoulos said, there are two additional questions he's keeping his eye on. One is whether clotting complications are happening in milder COVID-19 cases that don't require a hospital stay. That's a question that's far from being answered, particularly given the lack of routine testing available. The other question is whether blood clots are causing problems after COVID-19 patients leave the hospital, leading to sudden deaths. Spyropoulos said he's concerned about complications arising after patients are discharged. In early autopsy data from Northwell, there appear to be major clotting events like a massive heart attack or lung clots in 40% of patients who have died after leaving the hospital. Join the conversation about this story » NOW WATCH: How the Navy's largest hospital ship can help with the coronavirus
Doctors caring for the sickest COVID-19 patients are trying new ways to attack the coronavirus. One...Doctors caring for the sickest COVID-19 patients are trying new ways to attack the coronavirus. One theory is that they have blood clots in their lungs.