'They call me thick neck or elephant': Worcester man suffers from mysterious growth that started out like a pimple

By Jacques Myburgh
14 March 2015

“It’s turned my life upside down completely. I was a decent young man and look at me know,” he says.

Daniel Jacobs, or Uncle Dan as he’s known in Worcester, is sitting on his porch.

It’s a boiling hot day in the Boland town and the streets are teeming with boisterous children, excited that the school day is over. Uncle Dan sits motionless, averting his gaze from the looks he’s forever getting and the offensive names people call him.

He’s often called “thick neck” or “elephant” on account of his appearance. He has a condition which causes bulging fat glands on his neck and trunk. The area around his neck has become a huge mass of fat that spills over his T-shirt and presses on his chest. Fat rolls also form at the back of his neck.

“It’s been like this for 20 years,” 63-year-old Daniel tells us. His back is bent and his eyes blank from pain – physical and mental agony caused by years of verbal abuse.

“It’s turned my life upside down completely. I was a decent young man and look at me now,” he says, pointing to his ID book photo of a vigorous 20-year-old.

“I can’t even do something as simple as washing myself or making my bed.”

The tumours have become so large and heavy that he now walks with crutches to support the weight bearing down on his neck and shoulders.

Daniel in his 20s. PHOTO: Peet Mocke Daniel in his 20s. PHOTO: Peet Mocke

Daniel says to him the growth looked like a pimple when he first noticed it. “It was the size of a golf ball.

“I thought it would disappear in time.”

But it kept growing and when it had trebled in size he and his mom, Sarah (84), with whom he lives and who cares for him, went to Tygerberg Hospital for help.

“The doctors said they were growing fat glands and wanted to drain them, but there was a chance they’d grow back,” Sarah says.

Daniel resisted treatment because he’s afraid of hospitals and doctors.

“I didn’t want it done; how would it help me to get the treatment and then it all grows back again.”

Daniel relies on his mom to help dress him, but she says she is becoming too frail to do so. PHOTO: Peet Mocke Daniel relies on his mom to help dress him, but she says she is becoming too frail to do so. PHOTO: Peet Mocke

Sarah says she still tries to persuade him every day to go for the treatment but they’re struggling financially and can’t afford frequent trips to Cape Town.

“When I look at him I think, if he has to die before me, I’ll have to bury my child with these terrible growths,” she says.

Sarah says she’s become too frail to help her son with bathing and getting dressed. “I have to get someone in so he can get washed and just have some dignity, and no one does anything for free.”

On the day YOU visited the family, local residents had invited Daniel to church to pray for him.

“I decided not to go because the people will come to church just to look at me,” he says.

“The minister can visit us at home and come pray for me here, Mom,” he says when Sarah tries to persuade him one more time to go to church.

Daniel resisted treatment because he’s afraid of hospitals and doctors. PHOTO: Peet Mocke Daniel resisted treatment because he’s afraid of hospitals and doctors. PHOTO: Peet Mocke

Although Daniel is very self-conscious about his appearance, his faith and commitment to the community remains strong.

“Before I go to bed every night I ask God to protect and watch over me the next day. I also pray for Mommy.”

But when he’s said his prayers and is ready to go to sleep, he again starts agonising about his body and appearance.

“It’s hard to sleep at night,” he says, tucking the fat under his chin into his shirt to hide it.

“I feel out of breath and anxious lying like that.

“I feel like I’m suffocating in the night.

“I’m terribly short of breath. I can’t talk a lot or walk very far without terrible bouts of coughing. These days I also cough up blood.”

Although Daniel is very self-conscious about his appearance, his faith and commitment to the community remains strong. PHOTO: Peet Mocke Although Daniel is very self-conscious about his appearance, his faith and commitment to the community remains strong. PHOTO: Peet Mocke

Does he ever get out of the house?

“If I feel like going into town I’ll take a taxi. I also try to walk a little but my legs tire quickly.”

He says it no longer bothers him that people call him names or mock him.

“Sometimes I still get very cross with people and then I shout at them. You just get angry and despondent sometimes.

“The other day at the petrol station a farmer called to me and asked: Hey thick neck, what’s wrong with you?’

“I got very angry, and he could see that. Then he wanted to buy be a cooldrink to apologise.

“I wouldn’t accept it.”

We walk with Daniel on the street outside his house. He leans heavily on the crutch he takes with him wherever he goes.

“We all want a woman in our life for comfort, but who would want me,” he says dejectedly.

Across the road from us a small group of school kids are whispering among themselves.

“Voetsek!” (“Get lost!”) Daniel shouts at them, waving his crutch in the air.

He sighs. “I don’t want to look like this any more.”

Is Daniel a victim of Madelung disease?

According to the Indian Medical Journal, Madelung is a rare condition where soft tissue growths appear on the neck. A 59-year-old Indian man has similar growths on his neck. In a matter of two years his neck had swollen up into an enormous fat mass as in Daniel Jacobs’s case.

According to the journal the growths occurred spontaneously in this patient who’d been healthy and had a good medical history.

Madelung was first reported in 1846 and at the time was known as fat neck. The rare condition is mostly found in men aged 30 to 60 years. To date the cause of the illness hasn’t been established.

Symptoms:

-       Weight gain due to the large growth

-       Shortness of breath. The airways are compromised by the growth around the throat

-       Back problems

-       The patient’s knees get stressed

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