- We watched another episode of this show before,
but it's time to check out another episode
of "Body Bizarre."
Let's get started.
Pe-yoop!
- [Narrator] 56-year-old fisherman
and father of two Alejandro Ramos goes by the name Willy.
Four years ago, Willy suffered a horrifying accident
that mysteriously transformed his body.
- [Translator] I kept swelling.
My arms grew to an incredible size.
It didn't go down.
- He almost has the phenotype,
the body type of someone who who injects synthol,
which is an artificial oil made to enlarge your muscles,
but it's almost like not in his muscles.
- [Translator] I was working at a depth of around 115 feet.
A cargo ship was coming, it went over my air hose,
and cut my air hose in two.
I knew I had to surface fast, I couldn't stay any longer.
I let go of my lead belt, and got pushed up like a bullet.
I started to lose all of my senses.
I opened my eyes. Everything was blurry.
- So the neurologic findings that he's experiencing
is basically a diver's disease,
or bends, where basically, nitrogen bubbles,
part of the inert gases that you inhale
every time you take a breath, start bubbling up.
If you inhale those gases at a depth of a hundred feet,
those gases are inhaled at a higher pressure.
Therefore, when you go into a lower pressure environment,
those gases start bubbling up,
and imagine your blood starting to bubble.
It causes serious problems,
usually in the neurologic system and your joints.
- [Narrator] Willy's chest and arms ballooned,
leaving his torso swollen and deformed.
- This is a very, very severe form of it.
Usually it's mild, and usually,
it is treatable with a hundred percent oxygen treatment,
usually in a hyperbaric chamber.
- [Narrator] Using a hyperbaric chamber,
doctors treat sufferers by having them breathe oxygen
in this pressurized vessel.
- [Translator] I've seen patients
who've had subaquatic illnesses,
and arrived completely swollen,
but with the hyperbaric chamber,
these have disappeared in one to three hours.
- Yeah, so he must have had more severe damage
to his blood vessels as a result of that swelling,
where it seems to have become permanent.
And you know, when you damage blood vessels,
and they become more permeable,
they could start to leak.
When those blood vessels start to leak,
it could actually create edema
in the surrounding structures,
which is what he could be having.
It's very similar to what happens
when you have age-related, gravity-related swelling
in your lower extremities, in your legs.
So you stand all day, you're age 60,
your veins aren't as spry anymore,
so they're a little bit more swollen.
Blood starts to pool there throughout the day,
and as a result, they become more permeable.
More edema comes out, and as a result,
you have thicker ankles at the end of a long day,
which is why we recommend to pick your ankles up,
to wear supportive compression stockings,
et cetera, et cetera.
- [Narrator] Willy has had multiple sessions
in a hyperbaric chamber.
Sadly, he has not returned to his normal size.
As a result, Dr. Aguado decided to draw blood
and take tissue samples from Willy to solve the mystery.
- I wonder what part
of the body he's actually taking samples from.
Is it from the blood vessel, the muscle,
the adipose fat tissue?
- [Narrator] A month later,
Dr. Aguado confirms that Willy's condition was due
to nitrogen being lodged in his fatty tissue.
The next medical step will be reconstructive
and cosmetic surgery to remove the fatty deposits.
- How in the world do they need that test
in order to say,
"Oh, get cosmetic surgery and we'll fix it?"
I'm pretty sure that would've been anyone's recommendation,
whether or not they knew it was from the nitrogen bubbles.
- [Narrator] Yulianna was born
with congenital melanocytic nevus,
a rare genetic skin condition,
that causes an overproduction of skin pigmentation cells.
- And it not only produces melanin a lot,
it produces melanin a lot in specific areas.
So as you can tell, it's not her entire skin color.
It's just sporadic.
- [Narrator] Her birthmarks and dark patches
of skin also made Yulianna sad and self-conscious.
- That's very understandable.
If you're born,
and you look different than everyone else around you,
especially as a child, it's easy to get bullied,
- [Narrator] Yulianna now posts photos of herself
on social media to promote awareness
of the issues faced by people with skin conditions.
- I think that's great in order to highlight
that humans come in all different shape, sizes, colors,
and just because her appearance outwardly looks different,
it shouldn't stop her from living a full life,
and it shouldn't stop you
from interacting with someone like this.
- [Narrator] One out of 10 people
with congenital melanocytic nevus will develop skin cancer.
- So basically when you have a type
of birthmark pop up like that,
essentially you're having micro-mutations in those areas,
because you're having excess production.
When you're having excess production,
that puts you at higher risk for cancerous production.
- If I will stay at the sun for a long time,
every of my small birthmarks also can change to melanoma,
and it's really a risk,
so that's why I need to go and check them.
- The way that we check them is
through a classification system known as A, B, C, D, E.
Each one represents a specific criteria that we look at.
A, asymmetry; B, the borders; C, the color; D, the depth;
and E is evolving, basically how it changes over time.
That's why if you ever have a mole
or birthmark that has changed,
that's a good reason for you to go see the doctor.
And this allows us to understand what risk each
of those birthmarks poses to the individual.
If some of them are suspicious,
we do send them through a biopsy
to pathology to figure out if they're cancerous.
- [Narrator] Dr. Watowski uses
cutting-edge digital dermoscopy equipment to photograph all
of Yulianna's birthmarks,
capturing their exact positions and sizes,
so they can be monitored for any changes.
- In her condition, it's a lot harder to gauge changes,
because there are so many of these birthmarks.
And also, look, if I have two small birthmarks
on my legs, and one of them happens to change,
and we're concerned, we can easily take that small biopsy.
But imagine she has many of them,
if she can't biopsy her entire skin layer,
so for her, it's best to do this
through a noninvasive method,
and be strict with it like a camera.
- This lesion is the only one
on your body that it is different from the rest,
and it's a good idea to remove the lesion
just for your own safety,
and then we'll assess it with histopathology.
- So histopathology is they'll basically take a slice of it,
look it under a microscope, and then,
if they do in fact see a cancer,
you might have to go for excision with wider margins.
When we say things like margins,
what we're actually saying is that we wanna make sure
that at the borders of the area that you biopsied,
there's no residual cancer,
- [Narrator] Joelison's astonishing height
of seven foot nine makes him the tallest man in Brazil.
- Oh, wow.
- [Narrator] Three years ago, Joelison met Evem.
They weren't exactly a perfect match.
Evem is just five feet tall.
- Maybe that is a perfect match.
Perfect match doesn't mean they have to be the same height.
- [Narrator] But there was an instant attraction.
- I'm instantly attracted
to that little goat thing that they have.
Is that a goat or a puppy?
- [Narrator] And the two were married
within a year. - Aw.
I love that the cake decor is true to size,
at least true to proportion.
or is it his partner's?
- [Translator] Your spermagram test
doesn't show the presence of sperm.
- [Narrator] The excessive amount
of hormones that triggers gigantism can lead
to a reduction in other hormones, such as testosterone.
This has led to Joelison having underdeveloped testicles.
- This should have also been elucidated
on the physical exam.
That should have been part of all of this workup.
I'm surprised that it took them finding this out on a test,
as opposed to a physical exam.
And I wonder if this condition would be correctable
by giving him hormone supplementation.
- [Narrator] The couple is now making plans
to move forward with adoption.
- Hm.
- [Narrator] To complete their family.
(Evem speaks in foreign language)
- Oh, that's not a goat, that's a puppy the whole time.
It looked kind of goat-y to me.
- [Narrator] On the outskirts of the city,
there's a boy living with a unique condition:
11-year-old Li Hang.
Li Hang now weighs more than 300 pounds.
He suffers from a rare genetic disorder
called Prader-Willi syndrome.
- Hm, Prader-Willi.
You know, this is interesting,
because this condition is not something I've ever seen
in my patients,
but it is something that is frequently tested
in medical school, and on medical boards,
where it's a congenital syndrome,
where it's a chromosomal issue, more specifically,
it not only affects hunger, but also cognitive impairment,
sleep impairment, many other factors
in the development throughout a child's life.
- [Narrator] There's no known cure
for Prader-Willi syndrome,
which can also cause a number of physical, mental,
and behavioral problems.
- His large size would put him at higher risk
for development of early onset,
even, osteoarthritis, joint disease,
- [Narrator] In a desperate attempt to help him lose weight,
Li Hang's parents are taking him
to a hospital that practices traditional Chinese medicine
designed to help people battling obesity.
- [Translator] He has a disorder in the feeding
or satiety centers in the hypothalamus,
located in the brain.
- This is true, but it it's a genetic issue,
so it's at the core of his cells.
- [Narrator] The medical treatments here are unorthodox,
but doctors are licensed medical specialists,
and the hospital claims a high rate of success.
- [Translator] We will use traditional acupuncture,
fire therapy, and fire cupping.
- This is where I kind of start getting disconnected
from the adjunctive therapies, like acupuncture,
where we're talking about it for musculoskeletal uses,
for pain uses, where there seemed to be some evidence,
and then we start moving it to just general wellbeing,
or obscure cases like this,
where you're saying that needles can impact
the neurological structure
and the genetic structure of someone's brain.
That seems to be a little bit too far out
for me to say that it matches some level
of evidence-based medicine.
- [Translator] Fire therapy with Chinese medicine
is where we incorporate extracts
of herbal medicine that helps speed up metabolism.
We light up the medicine with fire.
It is especially helpful
for patients with abdominal obesity.
- [Narrator] Finally, Li Hang is given a round
of fire cupping treatment.
- I don't even know what that fire therapy is.
I'm not gonna lie, it seems very non-evidence-based,
and again, cupping, in general,
has very weak evidence for it.
But then for myofascial tightness, for restrictions,
again, musculoskeletal conditions,
I could see it being valuable,
but for someone who's has a hunger issue
from a genetic condition,
it seems a little ridiculous to treat it with this.
- [Narrator] But the doctor points out
that these traditional remedies can only work
if Lee Hang is able to stop his excessive eating.
- If he stops his excessive eating,
he will lose weight without those treatments.
That's the core of the situation.
So I find it ridiculous that they're saying that.
- [Narrator] There's no foolproof scientific evidence
these procedures are effective.
- This is where patients in situations
like this are often misled,
'cause they're just searching for any type of cure.
Where science doesn't have an answer,
pseudoscience and misinformation tends to thrive.
- [Narrator] Marc may appear healthy,
but he actually suffers
from one of the world's rarest disorders.
- Why is he looking at the waters so angrily?
I'm sure it has something to do with water.
- I have to drink 20 liters water a day to stay alive.
I can last, without water, one and a half, up to two hours.
- I wonder if this is a form of diabetes insipidus,
where he actually is either lacking,
or not responding to a specific hormone
that prevents fluid loss,
excessive fluid loss, through your urine.
This is actually an important hormone
that your pituitary gland stores,
and your hypothalamus creates,
in order for you to be able to balance the amount
of water in your system.
And that's a very tightly controlled balance.
- I will get very high fever and dizziness,
can't remember things,
and I do not know in an extreme where I am and who I am.
- It essentially becomes a form of dehydration.
- [Narrator] Marc suffers from the rare disorder
known as renal diabetes insipidus,
or nephrogenic diabetes insipidus.
- The difference between that and the cranial version
of it is that the cranial version
is your body doesn't produce the hormone,
and in renal or nephrogenic is,
for some reason, it's not responsive to the hormone.
- I wake up in the night, and then I go to the toilet,
and go back and sleep again.
So you can say, okay, maybe it's 20 times a day.
- It's important that we point out this has nothing to do
with diabetes mellitus, which is a sugar control condition,
whereas this is a water retention excretion condition,
or a water balance condition.
- Marc's condition is very interesting.
It's a very rare condition.
Unfortunately, we do not have a very good treatment
for those patients, not to say we cannot cure it,
but we don't even have a reasonable treatment
for those patients.
So what can I do for you today?
- I love that the scene goes from him saying,
"We have no reasonable treatment, we have no cure,
but what can I do for you today?"
- My GP?
- [Prof. Spranger] Yeah.
- And he found to tell me that diuretics
could be useful for me.
- I believe thiazide class
of diuretics can sometimes be useful here.
- [Narrator] Diuretics normally treat high blood pressure.
- Well, not only high blood pressure.
There are several indications for what we use diuretics for.
- [Narrator] Less salt in the body
could reduce the urge to urinate.
It's an experimental approach, but Marc has nothing to lose.
- And there's different classes of diuretics.
There's loop diuretics,
which the most common one that we talk about is Lasix.
Thyazide-type diuretics,
that are more commonly used for blood pressure control,
are chlorthalidone or hydrochlorothiazide.
- [Narrator] After a few weeks,
the diuretics seem to be working.
Marc doesn't wake up in the night
to go to the bathroom quite as often.
He's less tired,
and he has more energy to pursue a very active lifestyle.
- Always great to see some treatments working,
and I think that there's definitely progress
to be made in these conditions.
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