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Have hole in nose from cocaine use. Scared to share information due to privacy. What to do?

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General & Family Physician
Practicing since : 2004
Answered : 1773 Questions
...about what's going on with my nose. Have hole in it from cocaine use and it seems to be getting worse. Havent been to a local md yet because Im well known in my community and I'm concerned that his privacy policy will allow him to share into and ruin me further in the community. But I really need help! Is there a way to be sure that my info won't be shared? Can he commit me if he thinks i need it? I'm ok with that as long as I'm not made a spectacle of or that my wife.& children wont get side swiped with dads condition. (They have no idea, but it won't be long if my nose falls off) Please advise....
Posted Sat, 7 Dec 2013 in Drug Abuse
Answered by Dr. Chakravarthy Mazumdar 1 hour later
Brief Answer: Noble physicians do not breach privacy Detailed Answer: Hi, I completely understand your agony and your fear to face the local physician about the problem. I assure you that 'A physician cannot divulge any fact about his / her patients to any other person without his permission even to the patients' kith and kin'. This is part of the oath taken by them. HIPPA is all about patient privacy and confidentiality and law deals strictly any breach of privacy. Having said that you can approach any doctor in your community and happily get yourself treated without anyone else in your community knowing why are you visiting the doctor for. Technically speaking your problem requires an ENT surgeon consult than any family physician. They reconstruct the nasal septum again and restore normal functioning nose. Now your problem needs an urgent treatment as it may cosmetically disfigure. The nasal bridge could be distorted and awful appearance in front of your family which is much concerning than delaying the treatment. If you continue to use cocaine I suggest you need a counselor or addiction medicine specialist too. So arise, walk to the nearest ENT clinic as a normal person does and come out as a happy man after treatment.
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Follow-up: Have hole in nose from cocaine use. Scared to share information due to privacy. What to do? 4 hours later
I uploaded a couple pics. Can you them? How bad is it?
Answered by Dr. Chakravarthy Mazumdar 14 hours later
Brief Answer: Not able to trace in the pictures attached. Detailed Answer: Honestly not able to trace the hole in the septum in the photographs attached. There is a glare that is visible in the left nostril. Am I missing something? I guess this may not be right way. You should meet a ENT surgeon physically to understand the seriousness of this.
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Follow-up: Have hole in nose from cocaine use. Scared to share information due to privacy. What to do? 53 minutes later
What looks like a bright glare in the nostril is actually the light in the opposite nostril as seen through the left nostril...that's the hole! That's what I'm so concerned about! Please look again and opinion your thoughts. Thank you.
Answered by Dr. Chakravarthy Mazumdar 8 minutes later
Brief Answer: Looks to be a medium size perforation Detailed Answer: Hi Understood now. Yeah there is a cause for concern. If you still use cocaine the doctors would not repair this perforation as there would not be any additional benefit repairing it. Small perforations seal by themselves if the person uses saline water and lubricating gels. Medium and larger ones generally need surgery to repair. When I said small perforations I refer to those with a diameter less than 0.5 cm; medium perforations with a diameter ranging between 0.5-2 cm; large perforations with a diameter more than 2 cm. So I still suggest you to get the repair done.
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Follow-up: Have hole in nose from cocaine use. Scared to share information due to privacy. What to do? 3 minutes later
Thank you. So mine would be considered a large hole? I'm sorry, you answer this question with last answer. I understand, I'm going to take your advice and seek an ent surgeon AND quit this poison!
Answered by Dr. Chakravarthy Mazumdar 2 hours later
Brief Answer: Thank you. Detailed Answer: Thank you for obliging my advice. Please close the discussion here.
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