Dr. Young Lee (00:00:00 -> 00:00:27)
So when it comes to blood vessels, the biologic age of the blood vessel, it outpaces your chronological age. Mm-hmm. So I think it's very important to be aware early on in life so you can make adjustments in your life. Take better care of your health, you know, lifestyle modifications. Be aware of certain risk factors to try to avoid them or control them early on so that you don't experience the severity and the significant symptoms later in life.
PreProduced VO (00:00:28 -> 00:00:37)
Welcome to Baptist HealthTalk, a podcast on all things healthcare, powered by Baptist Health South Florida, your trusted source for healthcare prevention and wellness.
Dr. Anthony Gonzalez (00:00:38 -> 00:01:23)
Hello everyone, I'm your host, Dr. Anthony Gonzalez. And welcome back to a new episode of Baptist HealthTalk where we answer your most searched questions on trending health topics. Today we're talking about vascular disease, leg pain, swelling, numbness, cold feet. They're all things that are easy to brush off, especially if you're young and otherwise healthy. But also could be signs that something isn't right with your circulation. How do you know if it's normal? What's not, when to get checked out? Well, to break it all down, we're joined by Dr. Young Lee, vascular and endovascular surgeon at Baptist Health, Miami Cardiac and Vascular Institute. Thank you for being here Dr. Lee.
Dr. Young Lee (00:01:23 -> 00:01:25)
Thank you for having me. Alright,
Dr. Anthony Gonzalez (00:01:25 -> 00:01:31)
So let's start at the very beginning. When people talk about vascular disease, what are we talking about? Vascular disease, what is that?
Dr. Young Lee (00:01:32 -> 00:01:39)
Vascular disease is any abnormality or damage in your blood vessels, including arteries, veins, and lymphatics?
Dr. Anthony Gonzalez (00:01:40 -> 00:01:44)
And is it usually caused by one particular thing? Is it just caused by age?
Dr. Young Lee (00:01:45 -> 00:02:18)
No, not at all. So what people don't recognize is that there's multi factors and you know, multiple risk factors that can advance vascular disease over the years. So it's an interesting disease because these buildup of blockages and plaques and damage to the linings of your blood vessels, they happen over time, over years, over decades. So oftentimes you're living your life, you don't know anything is happening until it becomes so severe that you start to experience the symptoms which is much later in life.
Dr. Anthony Gonzalez (00:02:18 -> 00:02:25)
And are we seeing this also in the young adults as well? Because it seems like, uh, only in older people or sometimes in youngers.
Dr. Young Lee (00:02:25 -> 00:03:12)
So more often symptoms tend to present later in life. You know, I would say about 50 years or older. I do have a younger patients in their thirties and forties who have some symptoms. However, I think the awareness of the fact that what presents later in life is already been happening. So when it comes to blood vessels, the biologic age of the blood vessel, it outpaces your chronological age. Hmm. So I think it's very important to be aware early on in life so you can make adjustments in your life, take better care of your health, you know, lifestyle modifications, be aware of certain risk factors to try to avoid them or control them early on so that you don't experience the severity and the significant symptoms later in life.
Dr. Anthony Gonzalez (00:03:12 -> 00:03:23)
So if you already have disease as a youngster, does that mean that you're already gonna have worse issues as you get older or can we curb those issues? Can, can we control the progression?
Dr. Young Lee (00:03:23 -> 00:03:41)
So if caught early on and recognized that you have the risk factors early on, you can control the progression. You know, modern medicine is amazing. We have great medical management and early catching of those risk factors makes the treatment a lot simpler throughout your entire life.
Dr. Anthony Gonzalez (00:03:42 -> 00:03:56)
Alright, so let's go through the symptoms. We talked about vascular disease, of course the disease of the blood vessels. So what are some of the warning signs? You know, I mentioned numbness or swelling. So kind of give us the warning signs that people should be concerned about to seek medical care.
Dr. Young Lee (00:03:57 -> 00:05:50)
So you can have circulation symptoms, which is leg pain or cramping. Most commonly it's calf cramping after you walk a certain distance and it's not if you walk a certain distance one time and you feel cramping in your legs, this has to be reproducible. So every time you walk the exact same distance, you feel that exact same pain or discomfort at that level. Now depending on where the blockage is, sometimes that cramping can be at the level of the thighs or the level of your buttocks. So it has to be reproducible. So if you're having those symptoms over and over again each time you walk, you should seek, um, you should seek advice or care from a vascular surgeon. The other things is we don't just deal with circulation. You know, there's uh, veins as well. So if you have varicose veins or you notice that throughout the day your legs are becoming more swollen and achy and you're having a hard time walking, especially if you've been on your feet all day, if you've been sitting all day, that may be a warning sign that you have something wrong with your veins. So you should also seek advice from a vascular doctor. Um, but then there are the emergency cases. So you can have sudden chest pain or back pain. It's like a tearing pain. You should be cautious that that could be a dissection and that's a life-threatening emergency. So you should definitely seek, um, care from an emergency department. You can have stroke symptoms where one side of your body feels numb or all of a sudden you can't move one side of your body or your speech is slurred. Or if one or both of your legs all of a sudden turn cold or numb or start to become acutely weak, then those are instances, that are more pressing any emergent and those instances, instead of trying to find a doctor, you should definitely go to the emergency department first.
Dr. Anthony Gonzalez (00:05:50 -> 00:06:01)
And it seems like a lot of your focus is like on the legs, but we are talking about vasculars through the whole body. We talk about the extremities, right? We talk about the head, you mentioned the brain as well. So it could be in any part of the body,
Dr. Young Lee (00:06:01 -> 00:06:26)
It can be at any point of the body. So as a vascular surgeon, we deal with blood vessels at the level of the neck all the way down to the feet. So whether it's veins, arteries, or in subset of patients lymphatics where you just have chronic swelling and it's not due to vein disease and it's because your body is not draining out the water underneath your skin, um, in an appropriate manner, we handle those issues too.
Dr. Anthony Gonzalez (00:06:26 -> 00:06:38)
Alright, so what are some of the risk factors that put people at risk for having this disease? Is it just age? If you're young you're not gonna get it, you know, what are some of those things that we have to worry about or that we can modify?
Dr. Young Lee (00:06:39 -> 00:08:01)
So nowadays you see childhood obesity or obesity out of young adult age. Um, you see onset of type two diabetes at an earlier age, high blood pressure, um, high cholesterol. And those are, those are diseases that can happen whether it's there's a genetic component or environmental component based on your lifestyle, your diet. There's also a trend in young adults, whether smoking and vaping and tobacco and nicotine is one of the worst things you can do for your blood vessels. It damages the inner lining of your blood vessels. Nicotine causes a chronic inflammatory and an acute inflammatory state within your cardiovascular system. So those are things that you can definitely stop to do. You know, and uh, modifications you can make in your lifestyle to cut out. Um, the other thing is there's definitely a huge genetic component. You know, or stress factors. Chronic stress can lead to chronic inflammation and inflammation can happen anywhere in your body, including your blood vessels. So those are things that can be modified earlier on in life. If you know that you have those risk factors, you should speak with your primary care doctors and if they feel appropriate, they will send you to us to evaluate so that we can make those changes earlier on in life to stop progression of the disease.
Dr. Anthony Gonzalez (00:08:02 -> 00:08:14)
Alright. And so is it possible that somebody really looks so well on the outside and maybe so ill on the inside, uh, that they can have really bad vascular disease and not appear it on the outside?
Dr. Young Lee (00:08:14 -> 00:09:17)
Yes, absolutely. As I mentioned at the beginning, um, vascular disease happens silently over decades. So these plaques, if you have a family history of high cholesterol, you're building plaque from a very early age and you have no idea what's happening until it could potentially be a life or limb threatening situation. And that's your first warning sign. So it's always important, I educate my patients all the time that at a younger age, um, at age 35 you should get your A1C checked every three years or so to make sure you don't have diabetes. Um, annually go see your doctor and get a blood pressure check just to make sure nothing is abnormal and you have normal blood pressure that you don't have underlying high blood pressure that you're not aware of. Or if you have, uh, do a lipid check for a normal adult. But every four to six years to check your cholesterol levels, do a whole cholesterol panel, make sure that there isn't underlying family risk factors that you never had an idea about because when it presented in your loved ones it was later in life.
Dr. Anthony Gonzalez (00:09:18 -> 00:09:42)
Alright, so let's go back kind of to the leg pain because it seems like the leg pain is something that's very common in uh, in a sign that can be concerning. So differentiate us, you know, everyday leg pain, I exercise or I go for a walk and I have pain or I have soreness versus a circulation issue, um, that somebody may be having. So they can kind of differentiate and determine whether they need to see their primary doctor or see a vascular surgeon like you.
Dr. Young Lee (00:09:42 -> 00:10:17)
So a circulation related leg pain is very specific. It's certain levels of your leg, whether it's your calf or your thighs or your buttocks and you have to walk a certain distance and you start to feel tightness, pressure or cramping. And so every single time you walk that exact same distance, you feel the same pain and it happens every time you walk. That is what makes it a circulatory pain has to be reproducible and has to be the same pain every time, same distance.
Dr. Anthony Gonzalez (00:10:17 -> 00:10:26)
And what happens if they ignore it and they just kind of, okay, I'll just, instead of walking a mile, I'm walking half a mile or three quarter mile. What happens over time over?
Dr. Young Lee (00:10:26 -> 00:11:31)
So those are warning signs that you are forming plaque within your blood vessels and it's becoming narrow or narrow or may already be blocked and your body is forming collateral circulation. So that's why you can walk a certain distance and feel okay. However, if you ignore it, the blockages can become worse and if you keep ignoring it, as the blockages become worse, it can become so significant to the level that by the time you notice it, let's say you have a wound on your foot or something, you notice it's not healing and it's getting worse very quickly. Those are situations where now it becomes much harder to treat the disease. You have to do an intervention, but you're still at high risk of a limb threatening disease. So when you have those warning signs, it's good to go see your vascular doctor earlier so that you can get the risk factors modified so you can slow the disease progression so that they can keep a close eye on you, they can educate you appropriately so that it doesn't progress to that limb threatening situation.
Dr. Anthony Gonzalez (00:11:31 -> 00:11:46)
Alright, so you mentioned uh, you have that symptom of your leg, you have the, the issue with the circulation. Talk to us about what a patient experiences when they go see a vascular surgeon like you. What does the evaluation look like? What is the treatment like?
Dr. Young Lee (00:11:47 -> 00:12:48)
So first, you know, we do a detailed history. We ask you what your symptoms are, we ask the patients to describe to us what they're feeling so that we can determine if it is really circulation related or if it's due to some other pain, whether it's joint pain or um, bone pain, et cetera, or nerve related pain. And then we do a full physical examination. So we examine all the pulses in your body at different levels to make sure that you have adequate circulation. And if there's any concerns then we order additional tests and usually they're what we call non-invasive tests. So they're ultrasound tests that we also do in our office. And with those results it helps us guide the next treatment options. So, and if there needs to be adjustments to the medication, we work very closely with every patient's primary care doctor and cardiologist and we make the adjustments together so that you're not just having one doctor telling you what to do and the next doctor is telling you to keep the same medication or change it.
Dr. Anthony Gonzalez (00:12:49 -> 00:13:04)
Alright, so let's go through that kind of treatment. Now I know that obviously there's been great advancement in vascular surgery. So you find a blockage in my leg. Does that mean you have to cut my leg open and open up that blockage? How is that treatment performed?
Dr. Young Lee (00:13:04 -> 00:13:59)
So in most patients who have claudication, which is the same reproducible pain, whenever you walk a certain distance, we don't jump to treatment with invasive methodology right away we do medical management because there's been extensive studies that have shown that with the appropriate exercise and walking program you can improve your walking distance and your quality of life without ever having to treat the blockages themselves in a surgical way. Now if you do need an intervention, we have advanced significantly in technology. So we generally tend to start with less invasive methods. So wires and catheters using balloons and sometimes even stents to open up blockages to avoid major vascular surgery. But if you ever reach a point where you need actual surgery, that's when where we can plan those operations as well.
Dr. Anthony Gonzalez (00:14:00 -> 00:14:22)
Alright, so we've learned a lot about vascular disease, we understand that it's all around the body and awareness is very, very important. So if you want to kind of stay ahead of this and you're somebody who's young, um, and you don't have vascular disease, what are some simple things that you tell our listeners to do to kind of prevent the vascular disease in the future?
Dr. Young Lee (00:14:23 -> 00:15:40)
So the biggest thing is lifestyle. So avoid obesity, exercise. Um, make sure that you at least go see your doctor once a year. Make sure you don't have high blood pressure if they're concerned. Get checked for diabetes, get checked for diabetes every few years. Check your cholesterol every few years when you're eating your diet. You want to concentrate on low fat, you know, avoid things that cause high cholesterol. So red meat can cause high cholesterol. It doesn't mean you can't enjoy a steak, but every day is probably not a good idea. You know, seafood tends to be a good option. Lots of green leafy vegetables, fruits, all of those things that improve your health overall. So those are the modifications I would recommend. If you are a smoker or you're a vaper, there's a misconception that because you're not smoking a cigarette and that you're vaping, it's okay, but it's not the same harmful products that cause the damages to your blood vessels and cause plaque buildup are still within those vaping devices. So cut out those habits, you know, no excessive drinking. So those are things you can start at a young age and that make a significant impact later on in your life.
Dr. Anthony Gonzalez (00:15:41 -> 00:16:14)
Right. That's great. So they don't have to deal with you later in their life. Well, thank you Dr. Lee for sharing that great information and educating us about vascular disease. Remember viewers, be sure to hit that subscribe button on our channel right here to keep up with the latest health and wellness information and tips from our experts. Like Dr. Lee. You can also find us on Baptist Health Talk, on Apple Podcasts, Spotify, or wherever you listen to your podcasts so you can tune in anytime anywhere. Thanks for watching.
PreProduced VO (00:16:15 -> 00:16:30)
Find additional valuable health and wellness information on our resource blog@baptisthealth.net slash news. And be sure to interact with us on our social media channels for live and upcoming events. Baptist HealthTalk is brought to you by Baptist Health, the warmer side of care.
Speaker 4 (00:16:34 -> 00:16:34)
