OKAY, ROSACEA IS A REALLY COMMON CONDITION THAT OCCURS.
THE RARER FORM OF IT IS WHAT YOU HAVE,
WHICH IS RHINOPHYMA.
RHINOPHYMA HAPPENS MORE IN MEN THAN WOMEN,
AND IT HAPPENS PREDOMINANTLY ON THE NOSE.
BUT IT CAUSES A THICKENING OF THE SKIN.
I KNOW I HAVE A PRETTY SERIOUS CASE.
DO YOU FEEL LIKE YOU CAN GET A LOT OF THIS ROUGHNESS?
UM...
WELL, LET ME TAKE A LOOK AT YOU HERE, FIRST.
CAN YOU TAKE YOUR GLASSES OFF FOR ME?
PATRICK HAS A VERY SEVERE FORM OF RHINOPHYMA.
IN FACT, IT IS THE MOST ADVANCED CASE
THAT I'VE EVER SEEN.
SO, BEFORE I CAN BE SURE THAT I CAN TREAT HIM,
I NEED TO TAKE A REALLY GOOD LOOK.
YOU CAN SEE HOW YOUR NOSTRILS
ARE PRETTY NORMAL HERE,
AND THEN IT JUST CHANGES RIGHT HERE.
KIND OF CAUSING THEM TO CLOSE DOWN A LITTLE BIT, HUH?
I MEAN, IT'S VIRTUALLY CLOSED.
THE WEIGHT OF THIS --
THIS IS, LIKE, WEIGHING DOWN ON YOU.
Patrick: EVERYBODY ASKS ME IF I CAN BREATHE.
I THINK I CAN BREATHE,
BUT IT'S PROBABLY NOT -- YEAH, YOU CAN.
BUT I BET YOU... IT'S NOT AS GOOD.
YEAH, I BET YOU WHEN YOU REMOVE THAT,
YOU'RE GONNA BE LIKE, "WOW, NOW I CAN BREATHE."
AFTER EXAMINING PATRICK,
MY MAIN CONCERN IS THE COMPRESSION OF HIS NOSTRILS.
SO NOT ONLY IS THIS A COSMETIC CONCERN,
IT IS ABSOLUTELY A FUNCTIONAL CONCERN.
AND, SO, I THINK THAT'S THE FIRST PLACE
THAT I SHOULD TREAT HIM.
I THINK THAT I CAN DO SOMETHING
TO MAKE THIS BETTER FOR YOU.
BUT I THINK I SAW ON YOUR CHART
YOU'RE ON A BLOOD THINNER. YEAH.
WERE YOU ABLE TO STOP IT?
SOMEWHAT?
I HAVEN'T STOPPED IT, BUT I WENT TO HALF A DOSE.
♪♪
THIS IS AN UNEXPECTED PROBLEM.
MY STAFF ROUTINELY CALLS MY PATIENTS
BEFORE ANY VISITS
OR ANY PROCEDURES THAT WE'RE DOING
TO MAKE SURE THAT THEY'RE PREPARED.
AND MY STAFF TOLD PATRICK
TO PLEASE STOP HIS BLOOD THINNERS.
BUT FOR SOME REASON,
HE DECIDED TO JUST DECREASE THE DOSE TO HALF,
AND THAT'S REALLY NOT GOOD ENOUGH.
I'M WORRIED ABOUT THE FACT THAT IF WE TREAT THIS ENTIRE NOSE,
IT WILL JUST BLEED AND BLEED AND NOT STOP.
MY MAIN CONCERN IS I DON'T KNOW
WHAT YOUR CLOTTING ABILITY IS IN YOUR BLOOD.
PATRICK IS ON A BLOOD THINNER
BECAUSE OF A PREVIOUS HISTORY
OF DEVELOPING BLOOD CLOTS IN HIS LEG
WHILE HE WAS IN THE HOSPITAL.
SO, SINCE THEN,
HE HAS BEEN ON A LOW-DOSE BLOOD THINNER INDEFINITELY.
I THINK IT'S TOO DANGEROUS
FOR US TO BE TREATING YOUR NOSE
AND FOR YOU TO POTENTIALLY BLEED LIKE THAT
AND WE CAN'T CONTROL IT.
YEAH, THAT WOULDN'T BE GOOD.
NO, THAT WOULDN'T BE GOOD.
IT COULD BE DANGEROUS,
THE FACT THAT PATRICK IS ON BLOOD THINNER
AND FOR ME TO DO
THIS PRETTY EXTENSIVE OPERATION ON HIS NOSE.
I KNOW HE'S NOT GONNA BE HAPPY ABOUT THE FACT
THAT I DON'T REALLY WANT TO TREAT HIS ENTIRE NOSE TODAY.
BUT HIS SAFETY COMES FIRST.
I'M NOT GONNA DO ANYTHING THAT'S HARMFUL FOR YOU.
SO, LET ME TRY TO FIGURE THIS OUT HERE
A LITTLE BIT, OKAY? OKAY.
♪♪
UH, I DON'T KNOW WHAT TO SAY.
I TRAVELED ALL THIS DISTANCE
TO GET THE PROCEDURE DONE IF I COULD.
♪♪