Wesley Warren Jr. stands in his living room with more than 100 pounds of scrotum hanging between his legs, but you can't take your eyes off his haggard face.
The more he talks about what doctors might do wrong in surgical procedures designed to correct the scrotal elephantiasis that became part of his life three years ago, the more unfocused his reddened eyes become.
His breathing jumps into high gear. His voice grows louder.
The fear of castration, of bleeding out and dying on the operating table, haunts him these days.
"I'd say the fear factor is a big part of my life right now," he said."
In October I did interviews with Warren that led to an Oct. 17 story that told of a 300-pound man desperate for a costly surgery -- one that could cut away the growth that pushes him to 400 pounds and allow him to have sex and use the bathroom normally. Now his penis is buried so deep in his scrotum tissue that he can't direct his urination.
The story of the man who has come to view himself as a freak in the vein of "The Elephant Man" has been viewed on the Las Vegas Review-Journal website about 829,000 times, shared on Facebook pages more than 24,000 times.
Many people have called the paper, wondering what the 47-year-old Warren's life is like today.
Journalists and documentarians from around the world -- one film producer from Great Britain said he'd line up free surgery -- want to follow up on his story. So far he's turned them down, concerned about the possible toll it would take on his fragile health.
Three weeks ago, producers for shock jock Howard Stern's show, where he once appeared under a pseudonym, sent a crew to tape another segment.
His immune system compromised, he just got over the flu. He's managing his hypertension and asthma.
And he's paralyzed by fear.
"I want the surgery but I'm afraid of what could happen," he said.
Kari Pricher, a producer with "The Dr. Oz Show," gave Warren a chance at the surgery soon after the Review-Journal story ran. She called Warren and said that the show starring Dr. Mehmet Oz would find doctors to do his surgery gratis. But he balked when she said she wanted Warren to confine media interviews to the Oz show.
Though Warren said he did not want to give up the freedom to talk to whomever he wanted, he later said his overriding concern was that the Oz show might not find the best doctors and he could be castrated or die.
"He's really scared, " Pricher told me.
Many people have contacted Warren through his firstname.lastname@example.org email address, sending him around $8,000 in donations via PayPal. That's a long way from covering medical costs expected to approach $1 million, but it would be enough to move him to California, where he believes skilled surgeons reside.
"I told people donating I might use it to move to California," he said, adding that he believes there are good doctors with the University of California, Los Angeles and the University of California, Irvine.
"I could get on Medi-Cal there and it would pay for the surgery," he said.
So why hasn't he taken that step?
"I'm not sure they are the best doctors," he said. "I might be castrated or bleed out on the operating table."
Dr. Mulugeta Kassahun, a Las Vegas urologist, first talked to Warren about his condition. He said he might spend a month in the hospital in both intensive care and the burn unit, where special dressings would be applied to tender flesh.
Kassahun talks straight to him, letting him know that local physicians, including plastic surgeons, would do all they can in three different procedures to cut away the flesh and then do the reconstructive surgery that could give him a penis and testicles.
"But I've also told him he could lose his penis and testicles and bleed out," he said. "A responsible doctor has to do that. That scares him."
It would scare the hell out of me, too.
But so does this warning from Kassahun, which now has Warren thinking about having the surgery done in January at University Medical Center through Medicaid.
"He's more tired now and he's had a seizure," Kassahun said. "He has to have surgery soon. He's running out of time.
"An infection, a real concern with his condition, may well kill him. If we have to do emergency surgery trying to save his life from infection, it won't be a surgery trying to save his testicles and penis."
Paul Harasim is the medical reporter for the Las Vegas Review-Journal. His column appears Mondays. Harasim can be reached at email@example.com or 702-387-2908.