Nice Living with Dr. Kamran Season 2 Ep. 1 Transcription
Aimee: [00:00:00] Dr. Kamran, it’s great to have you again here for our latest episode of Nice Living with Dr. Kamran. And this month is Women’s History Month. We’ve got some important topics to talk about today.
Dr. Kamran: Well, thank you very much, Aimee. It’s been, I think, before COVID when we kind of put things on hold a little bit, and I’m so glad we are back and we can start our podcast again, and hopefully this time much more detailed and very much oriented towards veins.
Aimee: Absolutely. And you know, in light of Women’s History Month here in particular, and especially as it relates. To women’s health [00:01:00] care, you know, in recent years, really the past several decades, we’ve seen so many breakthroughs with awareness of a lot of health conditions for women.
Um, National Breast Cancer Awareness Month kicked off in October of 1985. We’ve seen huge strides in seeing survival rates and detection rates for breast cancer, also heart disease. There, you know, there’s the whole heart disease awareness month. So a lot of really great modern history as it pertains to, you know, women’s health initiatives and making sure women are getting screened for things.
But vein disease, we’ve still got a lot of traction to make when it comes to awareness for women and making sure women are adequately prepared to not only understand the signs and symptoms of it, but also understand that there are treatments available for it as well. So talk to us a little bit about how common vein disease is for women.
Dr. Kamran: You’re making a very good point. You’re absolutely right. It’s so important when we started [00:02:00] making people aware of certain diseases like breast cancer. So it helps us to prevent it by getting mammograms or if colon cancer, the second commonest cancer, my father actually died from, and it could have been prevented if he’d had a colonoscopy.
So, that by itself really, you know, help prevent a lot of colon cancers. But although these conditions are common, none of them I dare say are as common as venous insufficiency because it depends on what the report, you know, you look at anywhere from, you know, 35 to 40 percent of ladies, maybe some people say even higher, have some degree of venous insufficiency.
Yet, you go to the street and ask anybody, what’s venus suffix, they have no idea. Ask most physicians, I hate to say this, they have no idea what venous insufficiency really is. If they want to learn the medical school that is, you know, because varicose vein and varicose vein is cosmetic. Well, that’s not true.
Venous insufficiency is a [00:03:00] disease and it has consequences and just like any other disease, you catch it early, you get rid of a lot of complications associated with venous insufficiency. You catch it late, you’re still going to have treatment, but some of those side effects, some of the complications which are associated with it.
It will be permanent. For example, some severe cases, the venous insufficiency causes significant damage to the skin, especially around the ankle. I promise you, you’ve all seen that. If you walk in the street, you’ll see somebody’s legs, which the skin has almost turned black, and it’s thickened like leathery, it appears.
That is, I know, chronic venous insufficiency, which has gone untreated for years. Now, we can’t treat those patients, actually. I put something on YouTube, I think on like 45, 000, you know, people looked at it, it was all cysts and pigmentation, but the bottom line is it literally took about seven years before the colors got a little bit better.
That [00:04:00] pigmentation is pretty much permanent. Now, especially in ladies where you have to wear skirts, like you have to wear shorts. Most people just don’t want to walk around with their legs looking that bad, and they’re very ashamed of it. And if it was diagnosed early, it would have made a huge difference.
So why don’t we have a condition which, I believe the literature does show is one of the most undiagnosed or underdiagnosed conditions in the world, and yet nobody’s aware of it. So, I’d like you and I, Amy, that somebody’s already done it, venous insufficiency awareness month. Actually, it should be year because that affects you year after year after year.
Aimee: Well, and as folks are not understanding what these signs and symptoms are of the condition, what causes vein disease or venous insufficiency and what are some of those risk factors also, especially for women?
Dr. Kamran: So it’s almost like buying what’s real estate agents tell you is neighborhood, neighborhood, neighborhood.
And I would say [00:05:00] with venous insufficiency, genetics, genetics, genetics. If you have one parent who’s got venous insufficiency, you’re doomed, you’ve got almost a 90 percent chance you’re going to get it. You have both parents. Wow. And now you’re definitely going to get it. And I, to this day, God knows, you know, the past 23 years, I’ve pretty much been exclusively doing dealing with venous insufficiency.
I’ve got an extremely busy practice. I don’t think I recall a single person who, when I asked them, did it come from your mom or dad, usually one of them, you know, had it and that’s where they got it from. So it is inherited. So you’re already born with the genes that you’re going to get. Now, another thing I’ve noticed is, in my opinion, I’ve been looking at literature, but all of these patients, when I question, say, when did it really start?
In my teenage years. Almost during adolescence, I had this little vein come out, this little spider came out. This one here, Doc, you’re looking at, I’ve had this since I was 16, but it’s just like a tip of the iceberg. You know, I really love gardening a lot. [00:06:00] And when you put a seed in the ground, you know, you see a little bit of green come out, you know, and that’s just the beginning of venous insufficiency.
Now come back. A year later, that little green has become gigantic tree, you know, with branches and leaves. Venous insufficiency is kind of very similar to that. Those, the disease starts very early and then gradually gets worse. So you might say, okay, all right, good. So is there anything you can do to slow the disease down?
Yeah, so there are a few things you can do. For example, we know that somehow the veins do dilate in response to estrogen. So even during the periods, when they disrupt the periods, the estrogen level changes and they sometimes have achy legs and they think it’s just achy all over the body. No, it’s not.
The legs are most likely. The veins are stretching when they get pregnant, the minute your ureter is positive, you know, you’re supposed to wear your compression stockings. So pregnancy [00:07:00] contributes to it. Then you have one baby, uh, you know, the, the valves get damaged, it’s all to do with the valves. And then you have a second one, now you’ve got twice the amount of trauma.
The more babies you have, the more risk of getting damage to your veins. If you gain weight, now there’s more pressure on the veins that obviously contributes to it. A certain job, you know, if you sit all the time or you stand all the time, they contribute. So they say, well, okay, what do we do? Your calf muscles are your heart for your veins.
As I was telling one of my patients, the blood gets into your legs through the pumping of your heart. Your heart generates 120 millimeters of mercury, 140, whatever it is, that pushes the blood all the way down to your toes and your tiny, to the organs and the tiniest capillaries and like microscopic vessels.
When it reaches there and then it has to go to the veins to drain on the other end, there’s no pressure. Pressure is zero. So how is the blood comes back to your heart? Nobody asked that question. Your heart for [00:08:00] your. It’s your calf muscle, but 90 percent of the blood, which they, the blood, which gets pushed back to the heart is through the actual calf muscle.
So the question is, if I’m sitting all the time, I’m not using my calf muscles. If I’m standing and not moving, I’m not using my calf muscles. So Joggers, runners, they, they don’t have as much, you know, problem, but you’re just slowing the disease down. If you wear a compression stocking, it’s trying to push all the blood and keep it within the, you know, a deeper system.
So these are, again, you know, some of the contributing factors. I think tall people are probably getting more prone to getting pressure from the right side of the heart to your ankles. You know, when the physics was PGH, H stands for height, the higher the tower, the more pressure. So, the blood is trying to get back to the right side of the heart, so the taller that you are, the higher is the pressure at the ankle.
Imagine a blood pressure is 120, and then on the venous end, you’ve got a pressure of 300. Wow. So, is that a lot of pressure?
Aimee: Yeah. So, again, you know, those, those [00:09:00] major risk factors or, or things at play, we’ve got genetics, you know, tenfold. That’s, that’s the main one. And we’ve got the hormonal fluctuations for women especially.
We’ve got lifestyle where it comes to whether leisure or work, those factors can play in weight and then height. Any other risk factors folks should be on the lookout for or considering?
Dr. Kamran: There’s other main ones. I would probably add a few things. I haven’t looked at the scientific evidence behind it, but for example, if you do a lot of weight lifting, when you’re pushing really hard, you’re pushing the blood back towards or your legs.
That’s why it’s certainly recommended for those of you who are doing a lot of weightlifting, wear some compression stockings, it helps you with that. But these are the major works. Now, again, if you’re sort of thinking about the calf muscles, you’ve got the answer for all the things that help you prevent it.
For example, I have patients that come in and they tore their Achilles tendon. They were running, jogging, Achilles tendon. What is the Achilles tendon [00:10:00] attached to? To your gastrocnemius muscle, to your calf muscle. So the minute you tear the Achilles tendon, the calf muscle is paralyzed. So the blood cannot get pushed back into your heart as well as it did.
Oh, wow. What happens when they get the Achilles tendon tear, then they get it repaired. So now they’re not allowed to use that calf muscle for a few months. And they come back. No, doc, look at my leg. I think I’ve got a clot because my leg is so swollen. It’s because now the veins really got damaged in that leg.
They were prone to it, and it got a lot worse. Or, let’s say you sprained your ankle, you know, you put you on a cast, what does the cast does? You can’t use a calf muscle. The calf muscles are paralyzed. What happens if you have surgery, your ankle or your foot, put you on a cast, what do you think that causes?
Calf muscles are paralyzed. Anything which is stopped from your calf muscles from moving, it makes you more prone to getting venous insufficiency.
Aimee: So don’t skip leg day at the gym, right?
Dr. Kamran: Right. Exactly.
Aimee: Well, in terms of, you know, the, the symptoms of vein disease, we’ve talked a little bit about those visual symptoms, you know, the, the [00:11:00] ulcers, the skin changes that can happen.
I think a lot of people are familiar with the leg veins that might look a little roadmap y, thinking about our, our, our grandparents and things like that, or maybe our own legs as we’re starting to get a little older, but what are some of the other symptoms of vein disease? Okay.
Dr. Kamran: So, symptoms are very interesting, depends on what stage, right, you’re, you’re catching the patient.
Swelling happens quite early on, I’ve noticed, because there’s a, remember we talked about hydrostatic pressure, there’s a lot of pressure inside the vein and, and the vein cannot empty, so blood is literally oozing out of the blood vessels. So the ankle swelling is quite common, most people don’t. really notice it.
But if you put the sock on or any stocking and you find that when you go to take it off there is a line there, the chances are you’re already getting some swelling. Sometimes she goes, I never get swelling. I had to never get it. So I said, well, what about when you’re on a flight, on the plane, usually on a four hour flight?
I come to find out talking to some of the [00:12:00] pilots and talking to some of the flight attendants, they tell me that the plane is not always pressurized. So the man is not pressurized, you got a negative pressure, which is, pushes the blood, blood finds it easier to go outwards than come back towards your heart.
So I think that contributes, especially if you got on a four hour flight, and then when you get up, you look at your ankles, you find that they have swollen. That’s because you have the endoscopicity, you just made a diagnosis. So then as the symptoms get worse, the next thing, they start getting cramps or charley horse.
And most people don’t seem to know what that is. I mean, cramps are cramps, you know, I mean, you get, your muscle goes into spasms like somebody just grabs your calf muscle and squeeze it and you have to wait until it goes away. And some people call it charley horse, we call it cramps. What is odd is usually in the calf muscles, I’ve seen it happen in the foot, I’ve seen it in the toes.
Oh, I want to get your foot or your toes. And of course they blame everything on the sun except for the problems, [00:13:00] you know, because I was dehydrated. It was because I was, my potassium is low, my magnesium is low. In order to get low on potassium or magnesium, you know, you have to be really deficient. One way or the other, if you’re on a diet or you’re sweating profusely playing, you know, football or something, you don’t know where to get low potassium.
So they get these cramps and classically. It’s at night, and then it gradually, it’s initially once a month, then, you know, once a week, then two or three times a night, and it gets to a point it wakes him up. Like, imagine if there is a cramp that you get in your leg, which wakes you up and you have to walk it off.
That is really going to paralyze your whole body because now you’re not going to get enough sleep. You’re going to be tired the next day. I mean, talking about sleep apnea, let’s talk about cramps in your leg. As soon as you get sleep apnea, you wake up and then you go back to sleep. With cramps, you have hard to, hard to skip through that.
Aimee: Yeah. You
Dr. Kamran: know, and then if, if you really, if you really believe in your own theory, run to the refrigerator and have some pickle juice and that [00:14:00] really because yourself salt overloaded and causing more edema, more swelling. It really didn’t help anything except wake your husband up. Or why, because you just over refrigerator there and just walked around the bed so he could not get any sleep either.
So cramps. I notice as soon as you treat the veins, the cramps go away. Restless leg, where I always thought that was neurological, but finding a lot of people who have restless leg, about 70%. When you take care of, you’ve got restless leg and take care of the veins,
Aimee: and that’s something you know, I remember not too long ago you’d hear a lot of commercials advertised for medication to treat restless leg syndrome.
And it turns out vein disease was not
Dr. Kamran: even mentioned, you know, I mean, people are taking anything, any medication. I think I can say I’m an authority to know how the British medicine works and American medicine works. I think my training was in England and in America for the medical school there. I did two years of residency.
I had about 18 months to get my boards in surgery. Then I came to the United States. And I restarted my residency surgery. So I did basically two years [00:15:00] there and another five years here. Normally it’s a five year program, but a lot of American medicine seems to be based on German medicine. We treat the symptoms.
We don’t look for what caused in England. It was find out what caused it and stop it. I compared it to, you get a torch. And just burn the hell out of your leg. And then you want to find some ointment that will get rid of the pain. But take the torture away in the first place. Then put the ointment on. So to the point that if you have cramps, nobody tries to find out why do I have the cramps.
You know, if I have Rene’s leg syndrome, just don’t give me some drugs to stop it. Can you find out why I get the restless leg syndrome? Maybe you should do an ultrasound of your leg. Maybe you find that, oh wow, you do have venous insufficiency. So could that be it? Sometimes you just put them in a pair of stockings.
Tell them to wear it all day. Wow. My restless leg is better. Wow. That didn’t do anything for your nerves. It did a lot for your veins. [00:16:00] So maybe it’s vein related, but we encourage almost in America with due respect to just treat the symptoms. You know, you’ve got a ruptured appendix. You don’t say it’s a ruptured appendix, I don’t know, my belly hurts.
I’m hurting. Give me something for pain. And you’re totally ignoring the disease.
Aimee: Yeah.
Dr. Kamran: You see what I’m saying? Now that’s, And to exaggerate this version, why you need to know why as opposed to, you know, how can I treat it.
Aimee: In that same vein, um, sorry to pun there a little, let’s talk a little bit about where that threshold is when it comes to treatment options for, you know, symptom relief versus when venous insufficiency gets to a stage where It needs to be addressed through various methods, whether surgically or other non invasive procedures.
Dr. Kamran: That’s a very good question. So, first of all, I believe that you always need a diagnosis. I really believe you need a diagnosis. If you have a runny nose, do you have COVID or do you have flu or at least, you know, you want to know what, what’s [00:17:00] going on. You need to know if you’ve got venous insufficiency or not.
At this stage of my life, I believe, having dealt with this disease for so many years, I think you need to know if you’ve got venous insufficiency or not. And you can do that anytime. Just talk to your doctor or see if you can get somebody just a quick ultrasound of your leg. Because if you’ve got venous insufficiency, you need to know.
And if you know it, then you know maybe you should exercise more. Maybe you should wear, you know, operational stockings. The treatment is based on. How advanced the disease is. So there’s an extreme there, right? So on one end, you know, you’re 16 years old, have a few veins and somebody looks at it and find out you have venous insufficiency and the disease is very mild, you know, just treated with compression, stocking and preventive measures.
Now on the other side of the coin, you’ve got what we call a CIP6, which is pretty advanced disease where you’ve got an ulcer in your leg. Have amputated the legs because of ulcers, the skin broke down. Then around the ankle, if you look, there’s not much tissue between the skin and the ball. So that also gets to the ball, [00:18:00] and I got osteomyelitis, and once the bone gets infected, it’s very hard to treat it.
If you have diabetes or suddenly you’re diabetic, that can, you can get septic problems, potentially can kill yourself. You can end up with an amputation. So, If you had a venous ulcer, I think all of them need treatment. If a vein ruptures and bleeds, which is another complication of venous insufficiency, obviously that needs immediate treatment.
If you got leg cramps, which keeps you up at night, I think, I think, you know, then you don’t have treatment because you need your sleep. If you’ve got significant edema in your leg, you know, and it’s not related to your horns, it’s related to your vein, you’re, you’re not going to get into trouble, you know, you need to have those treated.
Then, you know, when I do ultrasounds, sometimes you find out, you know, they have, you know, venous aneurysm, some anomalies and, you know, aneurysm of the venous, section of the venous stretches, like a lake. They are at risk of getting clots. So you need to treat them. Actually, one of the complications of venous insufficiency is getting clots.
But deep and superficial, if you are getting clots in a superficial way, you need to do something about it because [00:19:00] you’re going to get more clots if you don’t treat it. People ask me, how do you make a decision about how to do surgery? I say it’s very easy. Risk benefit factor. You’ve got to really tailor every procedure to that particular patient.
Their life estimate, you know, their pain threshold, their health. You know, just recently operated on a lady who was actually grandmother of the girl who works for me. She’s, every day they were changing this, called an ornabut, putting like a cast on her legs just to get the orifices healed up. And then it was healed up.
They would take it off. Within a month, it would start back up again. And this was going on for years. Now she is very frail. She’s old and, you know, doesn’t have a strong heart and, you know, all that. So do we operate on her or they just keep on, you know, changing the cast and so on. When we elect it, just go ahead, make her body in an optimal shape, kick the tire, check the spark plugs, make sure she could tolerate the procedure well.
It’s all done with no call, which is, you know, remember there’s no risk really with low call. It’s general anesthesia, which gives you this. Have you operated on it? Her [00:20:00] ulcer is healed up. So in fact, she was in my office today. She must have the other make down. So, we’ve got to tailor it to that patient.
Normally, if she came in and she had no complications, just that, you know, sufficiency, I would encourage her to wear a stocking and just, you know, move on.
Aimee: In episode four, I believe it was. Of the Nice Living with Dr. Kamran podcast, we had some really great discussions around choosing a physician, vein treatment results and recovery, and then just those different methodologies for treatment as well.
So for anybody listening, if you didn’t catch episode four, make sure you go back and listen to that for a much more in depth conversation and insights from Dr. Kamran, because You really do have to do your homework when you’re seeking treatment for a vein disease too to make sure you’re getting a qualified provider.
Dr. Kamran: And that’s so important. I do a lot of re do’s in my office and sometimes it saddens me because some of these physicians I know and they’re very good at what they do, but they just, I don’t think they’ve done enough treatment of venous insufficiency to realize either the treatment is inadequate or the tools that wasn’t, you know, good enough.
[00:21:00] So, This patient come back and then complicated trying to take care of them. Something should have been very simple. So pick up somebody who a luxury thing, fitness, insufficiency, be something is the gear with speciality in the field. And C has been doing this for a while. And he cares, he’s compassionate about what he does.
That is very important. Some of the most knowledgeable surgeons, if they, if you don’t love what you do and you don’t have time, you can’t take venous insufficiency seriously, you’re not going to do a good job.
Aimee: And you know, September is National Vascular Disease Awareness Month, but we don’t have that venous insufficiency awareness month.
So we’ll have to get to work on that, Dr. Kamran.
Dr. Kamran: I think we can do it, don’t you Aimee?
Aimee: I do, I
Dr. Kamran: do. I think we can. Keep on pushing it.
Aimee: Absolutely. Well, this has been a really insightful conversation. I think awareness is key as with everything that we all face. And again, in light of Women’s History Month, we want to, we want to start writing history now, making sure women know how prevalent vein [00:22:00] issues are, and of course, venous insufficiency, getting educated on the symptoms, and knowing that there are treatment options.
There is hope. You don’t have to live with this. And Dr. Kamran, thanks so much again for sharing all your knowledge.
Dr. Kamran: No, thank you very much. And I think to your point, this is an international disease. It affects people from all colors, race, and a lot of people in some countries where they don’t have access to medical care, like with the United States, might never have a clue that this, you know, this is a disease.
So just to make everybody aware of it, I think we’ve really helped a lot of nations.
Aimee: Absolutely. You know, as we said at the beginning of the podcast, we’re, we’re kicking things off again. We’re going to start having regular episodes of the Nice Living with Dr. Kamran podcast. And a lot of our episodes previously were exclusively for patients.
We’re still going to be providing patient education, but we’ve got a little bit of an update to share with the listeners too. And we’re going to be talking a little bit about. how vein [00:23:00] disease can tie in with other specialties and medical practices, helping other physicians understand what to look out for the symptoms of, of vein disease as well and how it could relate to their patients.
Dr. Kamran: Right. So as you remember, it’s been quite a few years now of COVID and stuff, which is almost for two years. Wow. Time flies. But I always felt that people went in to see a neurologist or orthopods and they didn’t know exactly what to write questions where to ask. So I thought I would be that guy and you know, we would have this podcast, we would talk about veins and other things.
But then I realized there’s a lot of people there doing it, but there’s not many people the experience and the time that I’ve spent taking care of venous insufficiency. So I thought, I don’t need to just educate the public. I need to educate my colleagues. In fact, that to me is more important now realizing how majority, and I dare say very easily, the majority of physicians have no idea what [00:24:00] venous insufficiency is because it wasn’t until we got treated that we started paying some attention to it.
And we couldn’t really treat it noninvasively until about 20 years ago. But It has only really gotten acceptance maybe the last 10 years. I felt we need to really concentrate on not only patients, but allied sciences who are interested in anything to do with medicine. And I wrote actually a whole list, and it was in the middle of the day, actually, within the office, and I was just trying to go through a list of things.
And probably, so the nurses in my office would see this every day and say, look, how many fields do you think would be interested to listen to our podcast? If they want to, you know, understand what, you know, stuff you said, I noticed actually it’s pretty much every, everything, I’ll just give you a few.
Somebody, if I, if I may, without boring you, dermatology, a lot of people go with a skin reaction. It is vein related. They give them steroids and all kinds of things. [00:25:00] And after a year or two, they realize maybe it was venous insufficiency. So dermatology, they need to know how skin changes, lipodermosclerosis, hyperpigmentation, internal medicine.
God’s sake, you guys treat everything. That’s why in your internal medicine, you need to know what venous insufficiency is, especially if you’re treating restless legs because it’s treating swelling in the ankles. You know how many patients I see have been put on diuretics and they are like 35 years old, put on water pills, but they don’t need to be on water pills.
Their leg is swollen because of venous insufficiency. You are really dehydrated for, for no reason. If you’re a podiatrist, lord knows, you definitely need to know. I had a colleague of mine who was actually a dermatologist and he said he was going to have his knee operated and I’m not sure if he did his veins and he found that his knee doesn’t hurt him anymore.
There’s another problem was, you know, circulation and of course if you’ve got swelling in your ankle, it puts more pressure on the knee. So by taking care of his knee, getting rid of the swelling, his knee doesn’t hurt quite as bad. If you’re a physician assistant or you’re an FNP, you definitely need to know about that.
If you’re an ER physician, you’re [00:26:00] going to see patients with phlebitis, you’re coming, deep vein thrombosis, secondary superficial phlebitis. I still have another patient come from emergency room which were mistreated. You know, they had a vein which had clotted with superficial vein. They just did some heating pad and some steroids.
Well, Actually, if you have superficial veins, you probably have nowadays, the standard of care is to check them to see if they’ve got deep vein thrombosis, but 70 percent of people with superficial vein diabetes also have deep vein disease. Cardiologists, you need to know there’s a cause of swelling. If you’re doing a echocardiogram, you need to know if, uh, you know, that affects it.
A rheumatologist, a lot of people go see a rheumatologist for neck pain, orthostatic technician, wound care, vascular surgeons, you know, you don’t just consider an artery, you know, you also consider a vein. Interventional radiologists, for God’s sake, you know, you should see patients with venous insufficiency you need to know what it is.
Radiology tech, neurologist, you know, torsotomy syndrome, neuropathy, a urologist, you know, the patients are coming with testicular varicose veins and, you know, could this be somewhat [00:27:00] related? Gynecologist, my God, you know, you’ve got pelvic congestion syndrome. They have, you know, varicose veins around the pelvic area, around the vagina, which is, they’re too embarrassed to even talk about it, but.
They, you know, they have superficial venous insufficiency, they need to know that. Chest Physicians, if you’re 3D pure chest pain. You’ve got clots, pulmonary embolism. Those clots come from your, you know, legs. Obstetrician, you need to know that venous insufficiency does occur during pregnancy. It’s really related to hormones and just put them on a proper compression stocking.
They’re even stockings which go with pregnant people. So you all need to be, you know, listening to us. So these are just some of the examples. So this is what we’re going to be doing. We’re going to be doing some podcasts on educating people on renal disease, the signs, the symptoms. We’re going to also put pictures on the YouTube of complications of venous insufficiency because on the podcast, obviously you can’t see, but we can show you these ulcers healed.
We’re going to show you how there was what I call metamorphosis from where we [00:28:00] started till it finished, how the legs, you know, the ankles got the shape back, the knees got the shape back. The leg actually shrunk. We have seen hair growth, which is the indication of better circulation. So I really like to, you know, my colleagues who can literally listen in on Siri, you can listen in on your car, which has 20 minutes.
I just learned one aspect that we have not been taught much in medical school, which has been a sufficiency. Most books maybe have a half a page, if that, a bit of venous insufficiency. So we’re going to take this, our goal before I retire, I definitely want to make it my goal. To make sure the whole world and all my colleagues know what venous insufficiency is.
Aimee: Like you said, it’s very convenient to listen to the Nice Living with Dr. Kamran podcast. You can check it out at scarlettsveincare. com. That’s scarlettsveincare. com. We’re going to be adding those YouTube videos as well as Dr. Kamran said. Helping really illustrate some of those progressions of treatments and diving into [00:29:00] those, those cases to learn a little bit more about the symptoms that this patient, you know, may have been experiencing and, and how the symptoms are resolving post treatment too.
So really looking forward to diving into those conversations, Dr. Kamran, as we continue the podcast.
Dr. Kamran: Just say, you know, Hey Alexa. play Nice Living by Dr. Kamran. And it actually plays it. Just make sure you listen to the episodes, which are very related. I mean, it’s really, when you think about it, it affects everything.
Aimee: Absolutely. Well, Dr. Kamran, it’s a pleasure as always joining you for the podcast and looking forward to the conversations coming up soon.
Dr. Kamran: Thank you so much. Appreciate it. Absolutely.
