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Hey Prime members, you can binge episodes 41 through 48 of Mr. Ballin's Medical Mysteries right now and ad-free on Amazon Music. Download the app today. One day in 2009, a high school janitor was mopping the hallway in between classes when he heard a heavy scraping sound. The janitor looked up and he saw a student slowly walking towards him. The boy's grotesquely swollen right leg dragged along the floor and he walked with a dramatic limp.
The janitor smiled and waved at the boy as he approached. After all, this boy was a familiar sight. It took him so long to get between classes, he would have to leave 10 minutes early just to make it to his next one barely on time. And so the janitor saw him going through this routine all the time.
Just then, the bell rang and more students streamed into the hallway. They jostled past the limping student, knocking him off balance, as a few kids snickered at the boy. For three years, the janitor had seen this happen every single day. He wanted to yell at the kids to stop being bullies, but he knew that would only make things worse. So instead, he gave the young man a reassuring pat on the back as he hobbled by, and the janitor just hoped that whatever was wrong with this boy would clear up soon.
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From Ballin Studios and Wondery, I'm Mr. Ballin, and this is Mr. Ballin's Medical Mysteries, where every week we will explore a new baffling mystery originating from the one place we all can't escape, our own bodies. If you liked today's story, please replace the follow button's air filter with a whole uncooked salmon. This episode is called Adrian's Leg.
12-year-old Adrian Martinez smiled as he pedaled his bike through his dusty neighborhood in Socorro, Texas on a hot September day in 2005. School was scheduled to open for the fall the next morning, but Adrian was free as a bird today as he cruised the streets of this small city on the Mexican border.
If Adrian was being honest, he was pretty excited to start 8th grade. He was a good student with lots of friends and he loved playing sports after school. Besides, much as he loved summer vacation, the long hot days could actually get pretty boring. Adrian was already thinking about what he was going to wear for the first day of school. As Adrian rounded the corner onto a street, he waved to a group of boys playing basketball in their driveway and he also stopped to pet a neighbor's dog.
Adrian had always lived in Socorro, Texas, and he felt like he knew almost everybody there. This truly was his home. Adrian skidded to a stop outside of his family's modest home, where he lived with his mother, whose name was Maricela, and his three siblings. Adrian was the oldest boy, and his father was not in the picture, so he and his mother were very, very close. And in a way, Adrian sort of felt like he was the man of the house. Adrian knew that his mother was having a really hard time right now,
She didn't have a job, and so supporting him and his siblings was really hard. But at least she didn't have to worry about Adrian. He did his best to make sure of that. Adrian laid his bike down in the front yard and ran to the house, taking the steps to the front door two at a time. The next morning, Adrian woke up full of excitement and rushed to the bathroom. He'd woken up early to make sure he could claim the shower before his siblings could come out and create a bathroom traffic jam.
But when he was toweling off, Adrian began to notice this weird burning sensation in his right leg. As he looked at his leg more closely, he realized the pain was coming from the pink birthmark that ran from his ankle all the way up to his hip. Adrian had always had this mark, but it had never hurt before. So he just kind of shrugged it off and wrapped the towel around his waist and then wandered out to the kitchen to tell his mother.
But when his mother kneeled down and gently pressed her palm against her son's leg, she quickly pulled her hand away and looked up at Adrian with concern. His leg felt weirdly hot, as though only this part of his body was running a fever. Adrian's mother stood up and told her son they would get his leg checked out after school. For now, she just rushed him to his room to go change. He'd be late to class if he didn't hurry.
That day after school, Adrian sat on the edge of a doctor's exam table, swinging his legs back and forth. He felt the cold metal of the stethoscope on his chest as his pediatrician, Dr. Andrews, listened to his heart. Adrian shifted in his seat as Dr. Andrews wrapped an itchy cuff around his upper arm to take his blood pressure. Maricela gave her son a sharp look and reminded him to sit still. Then Dr. Andrews told Adrian to lay back on the table and roll up his right pant leg.
The physician gently touched the birthmark and immediately Adrian squirmed. It didn't exactly hurt when the doctor touched him, but it was uncomfortable. Dr. Andrews would confirm that Adrian's leg was still warm, but besides that, it didn't seem like anything was physically wrong with him. He told Adrian and his mother that this was likely just growing pains because Adrian was starting to go through puberty. The doctor said it was not uncommon for boys to have these mysterious aches and pains as they grew into men.
Four months later, Adrian was out in the street throwing a football back and forth with his buddy Sam, when as he went to go catch the ball, he suddenly realized he couldn't run very well. His right leg suddenly felt heavy, like it was stuck in mud. Adrian had been playing football with his friends every Saturday since seeing Dr. Andrews, and up until today, everything with his right leg had been totally fine. His birthmark on his leg still did burn a bit, but it wasn't too bad.
So, Adrian told Sam that he had to go home now because of his leg, but he'd see them next weekend. Then he slowly made the short walk down the street back to his house. And once he got home, he went up to his room and he took off his pants. And when he looked in the mirror, he was totally startled at what he saw. His right leg looked significantly bigger than his left leg. For a second, Adrian was terrified.
But then he remembered that his doctor, Dr. Andrews, a few months earlier had said this was no big deal and he had nothing to worry about. And so despite what he was seeing in the mirror, Adrian told himself he was just fine. And then he walked away from the mirror, trying hard to forget what he had just seen. A few weeks later, in February of 2006, Adrian hopped on his bike and began riding to school like he did most mornings.
But this time, something just felt wrong. As Adrian pedaled down the street, he felt his right leg bump up against the frame of the bike. He also realized that his jeans on his right leg felt unbelievably tight. Adrian slowed to a stop and looked down at his legs. And immediately he could tell through his jeans that his right leg had ballooned in size overnight. He'd never seen it this swollen.
But again, Adrian told himself that his doctor said it was fine, so he pushed the thought away and tried to pedal his bike again. But now it was impossible because of how swollen his leg was. Every time he tried to turn the pedal, his right leg really pushed hard against the frame and it really hurt.
Adrian didn't know what to do, but he knew he couldn't go to school like this. So he stepped off his bike, turned around, and began pushing it along next to him towards his house. And as he walked home, the pain in his right leg was so extreme, he had to fight hard to keep tears back. A couple of weeks later, Adrian sat next to his mother in the doctor's office with his right leg extended out in front of him. It was now so big, it was hard for Adrian to even bend his knee.
They were waiting for his latest round of test results. Socorro, Texas was a small city that didn't have that many doctors, but Adrian felt like he'd seen every one of them in the last few weeks. They'd run every test they could think of. Adrian had multiple x-rays, MRIs, and CAT scans done. The doctors hadn't told Adrian or Maricela what exactly they were looking for, but so far, they hadn't found anything. Adrian hoped this new doctor would have some sort of answer for him.
All he wanted was for his leg to go back to normal so he could play football again and ride his bike again. Just then, Adrian heard the door handle rattle and Adrian's latest doctor walked into the room carrying several pieces of paper. The doctor looked down at the papers, then spoke to Adrian and his mother.
On the positive side, the doctor said that Adrian did not have heart disease, kidney failure, or a host of other very serious conditions. But the doctor said he had to admit that he didn't know why Adrian's leg was swollen, and so he didn't know how to make it stop. So the doctor ultimately advised Adrian and his mother to just kind of leave the leg alone and let it heal on its own.
Adrian couldn't believe what he was hearing. He had been watching his leg grow bigger and bigger for almost six months, making it nearly impossible for him to do more and more everyday things. Why couldn't the doctors figure out what was wrong? A few months later, Adrian was sitting in class when the bell sounded to signal the end of the period. Students sprang out of their seats rushing out of the classroom, but Adrian just sat there and waited for the crowd to thin.
Then, when they were all gone, he braced his hands on the desk and pushed himself up to stand with a grunt. As soon as he began to walk, he felt a shooting pain in his right ankle and he nearly fell over into a table. It had been months since Adrian had seen that doctor that said, you know, just wait this out. But clearly, his leg was not getting better. It was just getting worse. By the spring of 2006, his right leg was nearly double the size of his left leg.
It looked like the leg belonged to a totally different body. Adrian had started wearing these really baggy jeans in an attempt to hide his right leg, but all his classmates knew, and they were not shy about teasing him.
As Adrian limped out of the classroom, he felt the students in the hallway shift their gaze to his leg. Some pointed at him and whispered or giggled as Adrian's cheeks burned red. But right now, Adrian's biggest problem was not embarrassment. It was the pain in his ankle. The sheer weight of his right leg was now so enormous, it felt like his foot was going to collapse with every step.
Adrian gritted his teeth and kept his head down as he walked past all the students who were laughing at him, and he made his way to the nurse's office. Once he was there, he asked to make a phone call, and when he called his mother, he did his best to keep his voice steady as he told her she needed to come pick him up right now. About an hour later, Maricela stood in the emergency room, anxiously watching as a flurry of doctors and nurses surrounded her son. She stayed by Adrian's side as he was put in a wheelchair and rushed him from one exam room to another.
Once again, the doctors took x-rays and CAT scans and MRIs. They measured the diameter of his right leg and compared it to the information Maricela had given them about how much it had grown. They listened intently as Adrian explained all of his symptoms. Maricela thought this actually seemed different from all their other doctor's visits. Like finally, now, these doctors were taking Adrian's issues really seriously.
Maricela hoped this was the turning point that Adrian had been waiting for and that the medical team would finally be able to figure out what this was and then help her son. After spending much of the day at the hospital, Maricela brought the car around to the front entrance to pick up her son. A nurse wheeled Adrian outside and Maricela helped him out of the wheelchair and into the passenger seat. She squeezed Adrian's hand as they pulled out of the driveway. They'd be back here in three weeks for the test results. For now, all they could do was hope for the best.
After a long three weeks, Maricela and Adrian were back at the hospital to go over Adrian's test results. Maricela sat next to her son in the exam room, her hands clammy as they waited for the doctor. Maricela could also feel the anxiety radiating off of Adrian as he quickly flipped through a book, no doubt just trying to distract himself. Finally, the door opened and the doctor strolled in. He sat down in the chair opposite from the mother and son and he glanced down at his clipboard before turning his gaze to Adrian.
In a calm tone, he told Adrian that the good news was that they did have a diagnosis and it was not life-threatening. These last few weeks, Maricela hadn't dared speak the words out loud to Adrian, but secretly, she worried her son had cancer or some other deadly disease. So to hear this was not life-threatening was just such a relief.
But Maricela's sense of relief lasted only about a second, because the doctor then told Adrian that he had something called elephantiasis, which is a rare disorder that causes the lower half of the body to thicken and swell. He explained that when someone has elephantiasis, the natural fluids that surround all the tissues in our bodies get blocked and begin to build up. And in Adrian's case, it was affecting his right leg, causing it to swell and become huge.
Maricela turned to her son and asked if he was okay, but instead of answering her, he just looked at the doctor and asked if they could fix it. The doctor took his glasses off, set them down on his knee, and with a solemn look on his face, he told Adrian, unfortunately, there was no cure for this.
If they'd caught it when Adrian was younger, they could have given him medicine that might have stopped his leg from swelling, but now there was no way to reverse it. Adrian's leg would never go back to its normal size, and the only thing he could do was wear compression stockings to reduce the discomfort. Maricela watched as her son's lip began to quiver, and then tears began to well up in his eyes. She wrapped her arms around her son and began to smooth his hair back. The doctor excused himself to give Maricela and Adrian some privacy.
He said he was so sorry he couldn't be more helpful. After the doctor was gone, Adrian looked up at his mother and he told her that he wasn't sure if he could keep going to school with his leg looking like this. He was going to get bullied constantly. Maricela was thinking the same thing, but she told him it would be okay. They'd find a way to make school more comfortable for him. She said she would do whatever she could to support him. Adrian leaned on his mother's shoulder as they slowly made their way out of the hospital towards their car.
Then they drove in silence all the way home.
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Three years later, Adrian slowly limped into class, mouthing the word "sorry" to his teacher, Mr. Perez. Adrian was used to arriving late for pretty much everything by now thanks to his leg, which only continued to grow. Now, as a junior in high school, his leg was nearly triple the diameter of a normal man's thigh and it weighed about 150 pounds all by itself.
Adrian's leg was so big, he couldn't even fit it in a normal wheelchair anymore. Teachers let Adrian leave his class 10 minutes early to give him extra time, but he was still almost always late to his next class. Some teachers got annoyed, but Mr. Perez didn't mind. Adrian hobbled to the back of the class, wincing as he took his seat. He was still a good student, making great grades and participating in class, but that was partly because, by this point, schoolwork was pretty much the only thing Adrian could do.
He couldn't play sports, and he didn't hang out with his friends anymore, and he barely left the house except to go to class. And now, Adrian had yet another problem. Seemingly overnight, a swath of itchy pimples had sprung up on his leg. And so he wriggled in his seat, trying to find a more comfortable position, when suddenly he felt something burst on his right leg. Adrian looked down in horror as he saw a wet stain begin to seep through the fabric of his jeans.
and then an awful smell wafted up to his nose. One of Adrian's new pimples had burst, and it smelled disgusting like rotten eggs, but even worse. Adrian carefully glanced around the classroom, seeing if anybody else had noticed yet.
Mr. Perez stood up in front, writing math equations on the whiteboard. Most of the other kids were copying down notes. But the students right in front of Adrian, so near the back of the classroom, they began swiveling their heads around to face Adrian while wrinkling their noses. As the smell fanned out towards the front of the room, more and more students began to notice. They started looking around, pinching their noses with their fingers and muttering about not being able to breathe.
Adrian stared down at his desk, unbelievably mortified, not daring to make eye contact with anyone. Every time Adrian thought he could not be more humiliated by his leg, there was always a new low, and this was it. It was bad enough that everybody made fun of him because of how big his leg was, but now his legs smelled bad too. Adrian hung his head in shame and began counting the seconds until he'd be able to leave school and go back home.
Later that week, Adrian struggled out of his jeans in an exam room at a dermatologist's office. As he did, Adrian scrunched up his nose in disgust because, without his pants sort of masking the smell, the odor from his right leg now overpowered the room. Adrian wrapped a disposable gown around his waist and then sat down in the exam chair. After a few minutes, Adrian heard a knock at the door and the doctor entered the room. He gave Adrian a big smile and he asked what brought him in today.
Adrian tried to match the doctor's upbeat energy, but he couldn't bring himself to smile. Instead, he started talking about the itchy pimples on his leg. After Adrian finished explaining, the doctor said, okay, let me see your leg. And so Adrian slowly reached down and pulled aside his gown, revealing his swollen, pimple-covered leg. And it was obvious the doctor was really caught off guard by what he was seeing.
But after the initial shock wore off, the doctor kind of composed himself and then told Adrian and Maricela that he'd never seen such a big leg before. Adrian immediately looked over at his mother and stifled a groan. He was looking for help from this doctor, not to be treated like some science experiment or circus act. Finally, the doctor slipped on some latex gloves and leaned in for a closer look.
And after a few minutes of poking and prodding, the doctor explained that these were not pimples on Adrian's legs, but instead they were pus-filled blisters. And unfortunately, he didn't know what was causing them. Then he reminded Adrian to make sure he was taking regular showers to keep his leg clean.
Adrian suddenly wished the reclining chair he was on would just swallow him whole so he didn't have to sit here while the dermatologist lectured him about taking showers. Usually, the doctor's office was the only place Adrian did not feel self-conscious about his leg. But thanks to this dermatologist, even that was no longer true. A few days later, Adrian was back at school, sitting in Mr. Perez's class. Mr. Perez could see that Adrian looked absolutely miserable.
He knew Adrian's leg must be impacting his quality of life, but the teacher didn't know much about Adrian's situation beyond what he observed in class. The teacher wasn't one to get involved in his students' personal lives, but something in Mr. Perez told him this was an unusual situation where maybe he could make a difference. So instead of letting Adrian leave his class early like usual, Mr. Perez actually asked him to stick around after the bell rang.
And then once the bell rang and the other students had left the room, Mr. Perez made his way to the back of the class where Adrian was sitting nervously waiting for him. Mr. Perez quickly reassured Adrian that he was not in trouble. He explained that he noticed Adrian looked really upset and wanted to make sure he was okay. For a few moments, Adrian sat in silence, looking down at the desk. And when he looked up, Mr. Perez could see his eyes were full of emotion.
Before long, Adrian told Mr. Perez the whole terrible story of how his leg had grown more and more deformed for years, and no doctor seemed able to do anything to help. It was like Adrian had been waiting for someone to ask him what was wrong, and now the floodgates were open. Later that week, Mr. Perez sat next to Adrian in the school library, scouring the internet for information on elephantiasis.
Adrian had explained his diagnosis and how there was no cure, but Mr. Perez figured there had to be something they could do. The pair had been meeting in the library during their lunch periods to use the school computers to see if maybe the doctors had missed something. As Mr. Perez read through another medical article, Adrian, who was right next to him, began laughing at a video of a dog riding a skateboard. Ever since they'd started coming to the library, Adrian had seemed happier.
Mr. Perez suspected that Adrian hadn't had a friend for a long time. Mr. Perez turned back to his computer, where he had a tab open to elephantiasis symptoms. He read through the list in a hushed voice, verifying each one with Adrian, and as Mr. Perez read on, they realized something strange. Adrian had some of the symptoms of elephantiasis, but other symptoms, such as persistent coughing and chills, were way off.
And so a strange thought crossed Mr. Perez's mind. Maybe Adrian did not have elephantiasis. Maybe he had something else entirely. Later that night, Mr. Perez was home working at his desktop computer. He couldn't stop thinking about the discovery he and Adrian had made at lunch. So he created a new document in Microsoft Word and started typing out all the other types of diseases that could cause a person's leg to swell up as much as Adrian's had.
One by one, he compared the list of symptoms for each disease to the symptoms Adrian experienced. And when they didn't match up, Mr. Perez would cross the potential diagnosis off his list and keep on going. After several hours, Mr. Perez was bleary-eyed but determined. And his list was shrinking. He took a sip of coffee, and then he clicked on a disease that he had never heard of before.
As he read through the symptoms, his heart began to race. He couldn't believe it. This condition sounded like a perfect fit to what was going on with Adrian. Now he just needed to find an expert that could help. The reality was Socorro, Texas was a small community without many medical resources. So Mr. Perez knew they would not be able to get Adrian the specialized care he needed here. So Mr. Perez searched the web for experts in this disease he had identified all over the country.
And after digging through hospital directories and online forums, he came across a doctor in New York who might be able to help. Two weeks later, Dr. Robert Rosen sat down in his oversized desk chair after a long day of surgeries and patient consultations in his busy New York office. He surveyed the stacks of letters and paperwork that littered his desk, and he sighed. He doubted he'd make it home in time for dinner.
He leaned forward and began rifling through the documents when he noticed a large manila envelope peeking out from under a cluster of papers. Dr. Rosen pulled out the parcel, surprised by how heavy it was. The return address was in Texas. Curious, the doctor ripped open the seal and spread the contents out in front of him. His eyes grew wide as he took in the slew of medical records and test results. Then he saw the photograph of Adrian Martinez and nearly fell out of his chair.
In his 30 years as an endovascular surgeon, Dr. Rosen had only seen a handful of cases like this one and none were this severe. The photo showed Adrian sitting on a couch with his right leg extended. The boy's leg took up practically the entire sofa. It was full of folds and crevices and absolutely massive. There was a letter from Adrian's mother explaining that her son desperately needed help.
The doctors in Texas had diagnosed Adrian with elephantiasis, but it just didn't seem right. Her son wasn't getting any better, and now she worried for his life. Dr. Rosen looked back over the medical records, and sure enough, he saw that Adrian had been diagnosed with elephantiasis. But just as Adrian's mother and Mr. Perez had suspected, that diagnosis was definitely wrong. Dr. Rosen grabbed the photograph again and studied the pink mark that now covered the bulk of Adrian's right leg.
That was it, the doctor thought to himself. That birthmark was the key. A few days later, Adrian huddled with his mother at the kitchen table, anxiously waiting for their phone to ring. They were expecting a call from Dr. Rosen any minute to discuss what was really wrong with Adrian's leg. When the phone finally rang, Maricela jumped to answer it, putting the phone on speaker and placing the phone on the table in front of her and Adrian.
Dr. Rosen introduced himself and Adrian immediately began to relax. He'd been waiting for this moment for years. Whatever happened next, at least Adrian would get some answers. Dr. Rosen started by telling Adrian that he did not have elephantiasis. He never did. Instead, Adrian had a very rare condition called Klippel-Tranoni syndrome or KTS, the same disease Mr. Perez had suspected from his internet research.
He explained that KTS is something you're born with, and what it does is it causes the blood vessels in someone's arm or leg to warp and twist, which makes it hard for blood and other fluids to be distributed properly throughout that limb. In Adrian's case, the blood and fluid had pooled in his right leg, causing intense swelling. And it started happening when he hit puberty because sometimes hormonal changes act as the trigger for KTS.
Dr. Rosen said that KTS can be hard to diagnose because it is so uncommon, affecting just one out of every 100,000 people. But there's usually a telltale sign that's visible from birth, a pinkish-purple birthmark on one leg, just like the one Adrian had. With time, the birthmark can thicken and develop painful blisters, another one of Adrian's symptoms,
And those blisters were actually Dr. Rosen's main concern, because those blisters were full of infected bodily fluids, which is why the pus that poured out of them smelled so bad. Dr. Rosen paused for a moment before continuing. He said that the infection can spread very quickly throughout the body, and in some cases it can cause high blood pressure or even a stroke and organ damage.
Dr. Rosen warned that Adrian's condition was actually so serious that there was a chance the KTS could actually kill him. And unfortunately, there was no cure. Adrian's heart raced as Dr. Rosen told him that he now had an almost impossible decision that he would have to make. He said that Adrian could continue to just live with his KTS, risking his life daily, or he could undergo a surgery that he would only have a 50% chance of surviving.
In October of 2009, Adrian was wheeled into surgery. Adrian had weighed the pros and cons out, and as terrifying as it was, he knew his only chance at a happy, normal life was to risk the operation, which was a very complicated leg amputation. The procedure took 12 hours, but Adrian did survive, and the surgery was a success. Once Adrian recovered, he returned to school in a wheelchair.
He was 150 pounds lighter and it felt like he was floating through the halls. He finished out his junior year with straight A's and spent the summer adjusting to his new life. And without his leg holding him back, Adrian blossomed in other ways too. He grew more confident and he rebuilt the social life that he'd lost. And Adrian was so grateful to the adults who didn't give up on him. And he and Mr. Perez stayed really good friends.
He went on to attend the University of Texas at El Paso. And in 2019, he graduated with two degrees in computer science and business. Hey, Prime members, you can listen to new episodes of Mr. Ballin's Medical Mysteries early and ad-free on Amazon Music. Download the app today. And also, Wondery Plus subscribers can listen to Mr. Ballin's Medical Mysteries ad-free. Join Wondery Plus today. Before you go, tell us about yourself by completing a short survey at listenersurvey.com.
From Ballin Studios and Wondery, this is Mr. Ballin's Medical Mysteries, hosted by me, Mr. Ballin. A quick note about our stories. We use aliases sometimes because we don't know the names of the real people in the story. And also, in most cases, we can't know exactly what was said.
But everything is based on a lot of research. And a reminder, the content in this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment. This episode was written by Natalie Przyszowski. Our editor is Heather Dundas.
Sound design is by Matthew Cilelli. Our coordinating producer is Taylor Sniffen. And our managing producer is Sophia Martins. Our senior producer is Alex Benidon. Our associate producers and researchers are Sarah Vytak and Tasia Palaconda. Fact-checking was done by Sheila Patterson.
For Ballin Studios, our Head of Production is Zach Leavitt. Script Editing is by Scott Allen and Evan Allen. Our Coordinating Producer is Matub Zare. Executive Producers are myself, Mr. Ballin, and Nick Witters. For Wondry, our Head of Sound is Marcelino Villapondo. Senior Producers are Laura Donna Palavoda and Dave Schilling. Senior Managing Producer is Ryan Lohr. Our Executive Producers are Aaron O'Flaherty and Marshall Louis for Wondry.
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