Ologies with Alie Ward: Surgical Angiology (Veins & Arteries) with Dr. Sheila Blumberg

Release Date: November 27, 2024

In this enlightening episode of Ologies with Alie Ward, host Alie Ward delves deep into the intricate world of vascular health with her esteemed guest, Dr. Sheila Blumberg, a Clinical Associate Professor of Vascular Surgery at NYU Langone Hospital in Brooklyn. Dr. Blumberg brings a wealth of knowledge and personal passion to the conversation, offering listeners a comprehensive understanding of veins, arteries, and the broader circulatory system.

1. Introduction to Vascular Surgery

Alie Ward opens the conversation by expressing her long-standing interest in Dr. Blumberg's expertise. She humorously hints at the episode’s focus with phrases like "blood tunnels" and "cool stuff related to veins and arteries," setting the stage for a detailed exploration of the vascular system.

Notable Quote:

"We're here to guide businesses every step of the way digitally because when small business wins, everyone wins."
—Dr. Sheila Blumberg [00:00]

(While this quote is from an advertisement segment, it humorously underscores the importance of support systems, paralleling the support veins provide to the circulatory system.)

2. Understanding the Vascular System

Dr. Blumberg begins by clarifying the fundamental differences between veins, arteries, and capillaries.

Key Points:

• Arteries: Vessels that carry oxygen-rich blood away from the heart. They are thicker and muscular to withstand high pressure.
• Veins: Return deoxygenated blood back to the heart. They are more compliant, have thinner walls, and contain valves to prevent backflow.
• Capillaries: Microscopic vessels where gas and nutrient exchange occurs between blood and tissues.

Notable Quotes:

"Arteries are the main way blood gets away from the heart... Veins bring blood back to the heart."
—Dr. Sheila Blumberg [05:12]

"Capillaries are around one-tenth the width of a human hair. So tiny. And while you're minding your own business, you casually have 40 billion capillaries."
—Fidelity Representative [06:12]

(These insights lay the groundwork for understanding how blood circulates throughout the body.)

3. Health of Arteries and Veins

Aging and Arterial Health: Dr. Blumberg discusses how arteries tend to harden with age, a condition exacerbated by lifestyle choices such as smoking and diabetes.

Notable Quotes:

"The aging process... arteries tend to become harder. And there's obviously lifestyle and environmental things that we can do to make that worse or at least better."
—Dr. Sheila Blumberg [09:04]

Varicose Veins: Varicose veins result from venous insufficiency where valves in superficial veins fail, causing blood to pool and veins to bulge.

Notable Quotes:

"About 20 million people in this country suffer from this. The superficial system becomes incompetent."
—Dr. Sheila Blumberg [33:20]

Deep Vein Thrombosis (DVT): DVT is a serious condition where blood clots form in deep veins, potentially leading to life-threatening pulmonary embolisms.

Notable Quotes:

"Deep vein thrombosis is the part of venous disease that can be life-threatening because a not insignificant number of people, around 600,000 people, die a year from a deep vein thrombosis."
—Dr. Sheila Blumberg [37:13]

4. Impact of COVID-19 on Clotting Risks

The conversation shifts to the heightened risk of thromboembolic events associated with COVID-19, highlighting recent studies that link the virus to increased clotting and cardiovascular complications.

Notable Quotes:

"Coronavirus disease COVID-19 increases the risk of thromboembolytic events, especially in patients with severe infections requiring intensive care and cardiorespiratory support."
—Fidelity Representative [40:03]

"SARS-CoV2 infects coronary vessels, inducing plaque inflammation that could trigger acute cardiovascular complications and increase long-term cardiovascular risk."
—Fidelity Representative [40:03]

5. Preventative Measures for Vascular Health

Compression Stockings and Movement: Dr. Blumberg emphasizes the importance of compression stockings, especially for individuals who stand for long periods or are on long flights, to prevent blood pooling in the legs.

Notable Quotes:

"I tell everybody who listened to me to wear them on the plane all the time."
—Dr. Sheila Blumberg [30:54]

Lifestyle Choices: Maintaining a healthy weight, managing diabetes, and avoiding smoking are crucial for both arterial and venous health.

Notable Quotes:

"Health and wellness... weight control, obesity management, diabetes management, smoking, those are sort of the pillars of arterial health and also venous health."
—Dr. Sheila Blumberg [44:07]

6. Common Venous Issues

Bruising and Raynaud's Phenomenon: Dr. Blumberg explains that easy bruising can result from platelet dysfunction or medications, while Raynaud's involves spasms in the small arteries of the hands and feet, often triggered by cold.

Notable Quotes:

"Bruising is at the very superficial level of the skin where the capillaries or veins burst just from injury."
—Dr. Sheila Blumberg [56:32]

"Raynaud's is where your blood vessels may kind of slam shut... causing your fingers or toes to turn white."
—Dr. Sheila Blumberg [58:17]

Hemophilia: A genetic disorder affecting blood clotting, leading to excessive bleeding even from minor injuries. It is more prevalent in males due to its linkage to the X chromosome.

Notable Quotes:

"Hemophilia... is a coagulation pathway problem where one of the factors is missing."
—Dr. Sheila Blumberg [60:54]

7. Emergency Measures and Surgical Techniques

Use of Tourniquets: Dr. Blumberg discusses the proper application of tourniquets to control severe bleeding, emphasizing the importance of situational awareness and timely medical intervention.

Notable Quotes:

"Once you have control of it, you can actually take a beat and just repair what you need."
—Dr. Sheila Blumberg [22:04]

Suturing and Stenting: Vascular surgeons use microscopic sutures to repair vessels and employ stents to keep arteries open, highlighting the precision and delicacy required in these procedures.

Notable Quotes:

"We grade them on most sutures in a level of zero to like 14, with 14 being very tiny... we use microscopes, so we have loops to magnify what we're doing."
—Dr. Sheila Blumberg [73:56]

8. Historical Perspectives on Vascular Disorders

The episode touches on the historical impact of hemophilia in European royal families, notably Queen Victoria’s lineage, and the misconceptions surrounding the condition in popular culture.

Notable Quotes:

"The royal disease was hemophilia B, a blood clotting disorder which can be carried by females but can manifest in male descendants."
—Fidelity Representative [65:18]

9. Personal Insights from Dr. Blumberg

Challenges in Vascular Surgery: Dr. Blumberg shares the emotional toll of treating patients who, despite surgical interventions, may succumb to other underlying health issues.

Notable Quotes:

"The most challenging part is when I can potentially fix the acute problem, but I know that the patient's not going to make it."
—Dr. Sheila Blumberg [78:10]

Rewards of the Profession: She highlights the immediate gratification and fulfillment that comes from seeing patients recover and improve post-surgery.

Notable Quotes:

"Favorite part about it is always the aftermath... seeing your patients come back literally within a week and be like, I feel amazing."
—Dr. Sheila Blumberg [80:02]

10. Conclusion and Final Advice

Dr. Blumberg emphasizes the importance of seeking specialized vascular care and staying informed about vascular health to prevent serious complications.

Notable Quotes:

"Find a vascular specialist... telemedicine can be helpful because you can always connect with someone who's not necessarily regionally close."
—Dr. Sheila Blumberg [78:56]

"We need more of us... We're going to have a shortage in the next probably 10 years of us."
—Dr. Sheila Blumberg [79:43]

Key Takeaways

• Vascular Health is Crucial: Understanding the roles of arteries, veins, and capillaries helps in recognizing and preventing vascular diseases.
• Lifestyle Choices Matter: Smoking, obesity, and unmanaged diabetes significantly impact arterial and venous health.
• Early Intervention: Addressing issues like varicose veins early can prevent more severe complications in the future.
• Awareness of Clotting Risks: Conditions like DVT and the impact of COVID-19 on clotting underscore the need for vigilance and preventative measures.
• Seek Specialized Care: Vascular surgeons like Dr. Blumberg play a vital role in managing and treating circulatory system disorders.

Notable Quotes Summary

• "Arteries are the main way blood gets away from the heart." —Dr. Sheila Blumberg [05:12]
• "Capillaries are around one-tenth the width of a human hair." —Fidelity Representative [06:12]
• "Deep vein thrombosis is the part of venous disease that can be life-threatening." —Dr. Sheila Blumberg [37:13]
• "Wear compression stockings on the plane all the time." —Dr. Sheila Blumberg [30:54]
• "We need more vascular specialists." —Dr. Sheila Blumberg [79:43]

This episode offers a thorough exploration of vascular health, blending professional expertise with relatable anecdotes. Dr. Sheila Blumberg's insights provide listeners with valuable knowledge on maintaining healthy veins and arteries, recognizing potential issues, and understanding the life-saving interventions available. Whether you're curious about the basics of the circulatory system or seeking deeper medical understanding, this episode serves as an essential guide to the complexities of vascular health.