February 6, 2026 • 56 mins
In this episode of The Hope Table, host Erin Brinkersits down with Dr. Jeffrey Hsu, vascular surgeon with Kaiser Permanente, and his patient Phil Crawford, a survivor of a ruptured aortic aneurysm—an event that is often fatal. Dr. Hsu explains vascular health in down-to-earth “plumbing” terms, breaks down what aneurysms are, who’s at risk (especially older male smokers), and why screening and early detection matter.
Phil then shares his powerful, emotional story: a sudden onset of excruciating abdominal pain, an emergency 911 call, waking up weeks later from a medically induced coma with 111 staples and a new understanding of his own mortality. He talks about quitting tobacco, facing esophageal cancer a year later, and how family, faith, and sheer determination carried him through. Erin closes by reflecting on post-traumatic growth, advances in vascular medicine, and practical steps listeners can take right now to protect their own vascular health and truly “seize the day.”
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Erin Brinker (00:00):
Erin, welcome to the hope table. I'm Erin
(00:09):
Brinker. Now one of the my mostfavorite things on this show is
being able to talk to Kaiserdoctors who are experts in
everything from women's health,Men's Health, cardiac health,
everything today I have thedistinct pleasure to sit down
with Dr Jeffrey shoe. He's theformer chief of vascular
surgery, still with KaiserPermanente, and not only is he
joining us, but one of hispatients, Philip Crawford, he
(00:31):
survived an aortic aneurysm,which is almost always a death
sentence. Dr Hsu and PhilCrawford, welcome to the show.
Thank you. Thank you. So Dr Hsu,first of all, we think of
cardiac health. We think ofpulmonary health. We think of,
you know, the other systems inthe body. But I don't know that
anybody pays attention to paypays attention to vascular
(00:53):
health. Can you kind of tell uswhat that is and what that
specialty entails?
Dr. Jeffrey Hsu (00:57):
Yes, yes. So vascular health has to do with
the blood flow in your body, andone of the reasons why it may
not be as memorable to manypeople is that it encompasses
pretty much the entire body anddoesn't have any one specific
(01:17):
location or one specific organ.
However, it is still veryimportant, and it it most, I
think, likely has a analogy tothe plumbing in your house, for
instance, which covers yourentire house. It could be in any
(01:38):
room, but if there's a problem,you kind of have to fix it in
that location. So vascularhealth is still very, very
important, but it is not asmemorable or clear to much of
the to much of the population,
Erin Brinker (01:59):
I think about all of the systems that, first of
all, all of the systems dependon blood, right? That's how
nutrition and oxygen makes itaround to the various organs.
But the liver impacts at theheart, the lungs, the muscles,
certainly, you know, I meaneverything, the kidneys and so
you know, when you're whensomebody has a vascular issue,
do they often think it'ssomething else, and they they
(02:22):
find out through trial and errorthat it's vascular. How do you
how do you find that leak inyour pipes?
Dr. Jeffrey Hsu (02:29):
Oftentimes, it takes a few steps of
investigation before finding outit is, in fact, a vascular
issue. However, we do have withmodern imaging, we do have the
tools we need to figure outwhether or not it is a vascular
(02:51):
issue pretty quickly these days,and yes, absolutely correct
everything in your body requiresblood flow, and so many maladies
that happen have to do with aninterruption or problem with
that blood flow. And once wefigure out what it is, it is
(03:17):
surgeons like myself, vascularsurgeons and other vascular
specialists, who will then comeup with a solution or treatment
plan to try and correct thatproblem.
Erin Brinker (03:31):
So let's talk about aneurysms, specifically,
because that is Phil Crawford'sissue. What is an aneurysm and
where can they occur in thebody.
Dr. Jeffrey Hsu (03:42):
So the word aneurysm is a general term we
use in medicine. It basicallyhas to do with an enlargement of
something. It's usually atubular structure that develops
a bulge in it. If you canimagine a garden hose, for
instance, with an area that hasbecome wide, or, you know, maybe
(04:07):
the size of a small apple orsomething like that, and and
that would be, you know, what Ananeurysm is in the vascular
system. It's basically aweakening of the wall of the
artery, which which then underpressure, there's blood flow
(04:32):
through the artery. Underpressure tends to, tends to
enlarge that area of the aortaor artery and cause this bulge,
essentially, and so that's whatan aneurysm is technically in in
the vascular system.
Erin Brinker (04:53):
So that literally, could happen anywhere in your
body, anywhere you have veinsand arteries. It could happen
Dr. Jeffrey Hsu (04:59):
that is correct. It can happen literally
anywhere.
Erin Brinker (05:02):
And so what are some of the things that that
weaken a vascular wall? I wouldimagine diabetes and high blood
pressure can't help. Are thereother things? First of all, is
that true? And then are thereother things that can weaken the
artery and vascular walls?
Dr. Jeffrey Hsu (05:16):
Yeah, this is an active area of research, and
it is not 100% clear right now,why certain areas of the artery
arterial system get weaker thanothers, but it is, it is known
that there are certain factorsthat cause injury to the artery
(05:40):
wall, which then leads toweakening. So the most common
example of that would be what wewould call a plaque formation or
atherosclerosis, and that has alot to do with diet and smoking
history as well. So this, thisis a process that causes
(06:07):
inflammation, and it does affectthe integrity of the artery
walls. And it turns out thatsome areas of the arterial tree,
so to speak, are more prone toweaknesses than others. And so
we oftentimes see aneurysms incertain locations. In Mr.
(06:33):
Crawford's case, it was, is theabdominal area and and that is,
that is what we know. So there'sa lot of also heredity and
genetics that play into this aswell.
Erin Brinker (06:49):
So I have heard that there is a link between
oral health and vascular health.
Now, whether those whether thatcauses an aneurysm, I don't
know, but that that people whohave poor oral hygiene, they put
their vascular system at risk.
Is that true?
Dr. Jeffrey Hsu (07:05):
I think that may be alluding more to cardiac
risk.
Erin Brinker (07:11):
Okay, okay, well, that's very helpful. So let's
talk about Phil's situation, thekind of what what is the aorta?
What does it do? Where is itlocated in the body, and what
you know, what do you do whenyou have an aortic aneurysm?
Dr. Jeffrey Hsu (07:27):
Sure, sure. So.
What is the aorta? Again, goingback to the plumbing analogy,
you the aorta is can beconsidered the main line, the
main line of blood in your body.
So your heart is the centralpump that moves the blood and
(07:52):
acts as a pump. But as it pumpsblood, the biggest blood vessel,
the main line, so to speak, iscalled the aorta. It sits
centrally in your body, andeverything else branches off
from there, and the arteriesthen get smaller and smaller and
(08:13):
smaller until they reachwhatever organ that is intended.
But the aorta is the biggestblood vessel in your body. So so
that that's why it's such aserious condition, because it is
the main line. And so if youhave a problem with this main
(08:33):
line, it can really becatastrophic.
Erin Brinker (08:38):
So how do you what are some risk factors or warning
signs for an aneurysm, well,specifically, an aortic
aneurysm. And you know, how whatdo you do when you start to
notice these?
Dr. Jeffrey Hsu (08:50):
So here's the problem. The problem with these
aneurysms is that they areoftentimes silent. In other
words, you really are likely notto know that you have one. They
really, in general, don't causesymptoms. They don't cause any
real problem that you maynotice, until perhaps something
(09:16):
then happens. So when they docause issues, typically it is
having to do with pain. So therecan be pain experienced in the
lower back area. It can radiatedown the legs. It can be in the
abdominal area. It can radiateinto the groin areas. Sometimes
(09:40):
it will radiate up into the thechest area. However, pain is
usually the first sign thatthere isn't aneurysm there, and
if that happens, it's usually a.
Sign. So this is one of thedangers of having an aortic
(10:03):
aneurysm, is that there's nogood way of knowing that you
have one other than havingsomething called a screening
test.
Erin Brinker (10:17):
And what does that screening test entail? I assume
it's a CT scan.
Dr. Jeffrey Hsu (10:21):
Actually, it's it's usually an ultrasound. Oh,
it's usually an abdominalultrasound, and it is done based
on the recommendations from ourgovernment, national screening
recommendations and the currentrecommendation for screening is
(10:46):
to have men who are between theages of 65 and 75 get who have
had a history of smoking. Sothat's basically the the
population that we're lookingfor is to screen in that
population men from the ages of65 to 75 with any history of
(11:11):
smoking. Smoking history beingabout 100 cigarettes in the
past. And it is in thatpopulation that there's a
national screeningrecommendation and, and, and, so
that is the current screeningrecommendation.
Erin Brinker (11:30):
So let's, let's talk specifically about Phil's
case. So I'm going to switch itto Phil. Tell me about your life
and what you were doing that ledup to this challenge, before you
were diagnosed, or did itrupture? Tell me. Tell me what
happened.
Phillip Crawford (11:49):
It's there.
There was no warning. I can tellyou that I did smoke and I
chewed skull, and one day I wassitting at the breakfast table,
and I reached around to open thesliding door, and an immense
pain came over my abdomen, and Iknew I needed help, so I started
(12:13):
the process at that point.
Erin Brinker (12:22):
So did you think that you were having like, a
stomach issue or an intestine?
Because I'm thinking about wherethe aorta is in the body,
there's, you know, all thoseorgans are in there at once,
like my liver is a problem, ormy, you know, my stomach or my
intestines, or, you know, ifyou've got pain shooting down
your legs, you could think Ihave sciatica, when it's none of
those things, right?
Phillip Crawford (12:41):
They I didn't really have any inclination of
what it possibly could be. Ijust knew it was a pain that I
couldn't control, that it was,it was a severe pain. It took me
to the floor, really. Oh, so,
Erin Brinker (13:02):
so I assume that that you somebody was with who
was with you? Called 911
Phillip Crawford (13:07):
yeah, my wife was there. She's on the she's on
the podcast with us. She, shestarted the process. I asked her
for help, and she started 911and everything after that point
is a story she can tell you. Iknow nothing about anything that
happened, from the time I got inthe ambulance until I woke up
(13:31):
two or three weeks later from amedically induced coma, oh my
gosh. And the doctors asked meto show them my sutures. And I
looked over my wife, I'm like,What are they talking about? And
they told me to raise my gown,and I had 111 staples, I
believe, in my abdomen, fromlike my belt line to my sternum.
Erin Brinker (13:58):
So I am guessing your wife is Shelly. Heaton,
Shelly. Are you able to takeyourself off mute and and I can
welcome you to the show. Thankyou so I can barely hear you
once you lean into whatevermicrophone you are using. Tell
me what it was like toexperience this as a as a loved
one and a bystander. Iunfortunately can't hear Shelly.
Phillip Crawford (14:31):
Okay, she might be trying to fix it.
She's, that's, that's all
Erin Brinker (14:36):
right, that's right. We had not prepared for
her to be here, but I'm happythat she is. If we can get this
worked out in the meantime, I'mgoing to, I'm going to ask Dr
Hsu, so when you when, when Philcame into the hospital, I'm sure
you were paged from to theemergency room. What happened?
Dr. Jeffrey Hsu (14:53):
So when, when Mr. Crawford came into the
emergency room, the emergencyroom. Room, physicians quickly
diagnosed him through getting aCAT scan with something called a
ruptured aortic aneurysm. Sothat is usually how it's
(15:16):
diagnosed. CAT scans areoftentimes used to investigate
causes of abdominal pain, and inthis case, it showed very
clearly that there was a ruptureof a large aortic aneurysm. And
so they they called us, me, Iwas on call that day, and and we
(15:42):
took care of the problem.
Erin Brinker (15:44):
So I have to think that time. I mean, you have no
time. Everything has to bereally quickly, because someone
could bleed out in minutes. Thatis correct.
Dr. Jeffrey Hsu (15:53):
Wow, is one of the most. This is a situation
where every minute counts. Andin my specialty, it's known as
the one thing where you justdrop everything you whatever it
is you're doing, you just haveto drop it, and you have to go
(16:14):
take care of it. It's thatimmediate. So basically, it, it.
It was in that situation whereMr. Crawford was losing blood
actively, as we were, as we werefiguring out, you know what,
(16:35):
what to do with him. And so wevery quickly prepared the
operating room and basically gothim in for the operation that he
needed. I believe it was veryquick when we got him up there.
Erin Brinker (16:54):
Well, that's outstanding. I mean, if, if
Shelly hadn't reacted so quicklyand gotten 911, there, and then
gotten you all, gotten filled tothe hospital in time, and then
you hadn't reacted so quickly,then he would not be here.
Dr. Jeffrey Hsu (17:09):
That's absolutely correct. That is
really correct, that that is themost important step, is to get
to the hospital fast. We knowthat when these things happen,
about 50% of people don't makeit to the hospital. And when
(17:33):
they do make it to the hospital,and let's say they have
treatment, only 50% of thosepeople survive the operation.
Wow. So it's a very dire event.
The fact that we were able tosee Mr. Crawford in the hospital
was just a huge advantage forus, because we were able to
(17:58):
treat the problem right away.
Erin Brinker (18:04):
And I want to as an aside very quickly. This is
why people donating blood is soimportant, because I assume that
he that you threw up some Opositive blood or negative. I'm
not sure which one's theuniversal. I think it's O
positive that you threw thatblood up right away so that he
could, that you could keepthings going while you, while
you sewed him back up. Is thattrue?
Dr. Jeffrey Hsu (18:26):
You know, actually we, we actually have,
we actually have certainstrategies when it comes to
giving blood, and sometimes wedo have to give it right away,
but other times we can hold offuntil it's a little bit more
advantageous to give it. So it'snot necessarily the first thing
(18:50):
that we do, but you know,they're, they're a, what we call
a, you know, resuscitatestrategy that we use in this
situation, and sometimes it doesinvolve giving blood. Other
times, no
Erin Brinker (19:06):
okay, but it should be on hand either way,
Dr. Jeffrey Hsu (19:10):
that is true.
Erin Brinker (19:11):
So let's go to where you wake up, Phil, let's
go to where you wake up and youare. You've been in a medically
induced coma. You've got yourwife standing next to you. What
was the realization of what hadhappened to you? What was that
like?
Phillip Crawford (19:27):
It was shock.
Everybody telling me, You knowwhat had happened to me, I just,
I'm thankful that Dr Hsu and allthose people were available. It
was super shocking. I mean, itstill grabs me now. I mean, I'm
my eyes are watering up rightnow. Just talked about it. It
(19:51):
was amazing, scary. I was scaredto death. Time, yeah,
Erin Brinker (20:01):
so I imagine there's some PTSD for you, like,
you know, that's something thatyou know, because there's the
mental side of things, right?
Your body went through anincredible shock, and you may
have been asleep, but your bodywasn't. And so it remembers, and
I imagine it is, it has changedyour outlook in life. It's
changed your certainly, thefeeling of your own mortality,
(20:24):
what you're thinking about isimportant in your life. Kind of
talk about some of those things.
Phillip Crawford (20:32):
I'm kind of a rock head. But the as far as the
mortality, it's just at anygiven moment, you know, tomorrow
is not a guarantee. That kind ofthing, as far as me living my
life, thinking about myaneurysm, I I try not to. It
(20:55):
brings up, you know, it tugs onour heartstrings. My wife can't
hardly talk about it. You knowit was, it was very bad. I mean,
you know, to have Dr shoe comein and tell your wife to come in
and say goodbye. Oh, you knowthat happened more than once. As
(21:15):
far as I know, that's what I'mtold. I I wish she could tell
this story, because her and DrHSU have had more conversations
than Dr Shu and I not that DrHsu and I haven't had many of
those. Sure they're, you know,their relationship was, you
know, two or three weeks.
Erin Brinker (21:37):
So how is it? Has it changed your personality. Has
it changed your priorities? Howdo you including about how you
relate to your own health? Youknow? How has it changed you?
Phillip Crawford (21:53):
Well, I quit smoking and chewing while I was
in my coma. He fixed that too,it doesn't it. There's more to
my story than the aneurysm. Ayear later, a year later, I was
diagnosed with esophagealcancer, so I've been dealing
with that for it's a little overa year right now, so
Erin Brinker (22:21):
it I'm so sorry to hear that.
Phillip Crawford (22:24):
It's all right. I'm fine. The cancer is
has been removed from my bodyand all that. And, you know,
it's just trying to learn how toeat with my new throat. So, you
know, I wish she could talk. Sheknows everything. I guess it
(22:46):
changed my life that I value.
You know family, and every day,you know my family, and every
day, I mean, they were therewith me, every day, every
minute, nobody ever left methere. Wow. I was never alone. I
had family friends. There wassomebody sitting with me the
(23:08):
whole time.
Erin Brinker (23:11):
Wow, that's awe inspiring, because not everybody
has that. That is amazing.
Phillip Crawford (23:17):
My family's pretty good.
Erin Brinker (23:19):
So how old were you when you started consuming
tobacco products, whether it wassmoking
Phillip Crawford (23:26):
or chewing?
Well, it was in the fifth grade,but it wasn't like steady at
that point. That was just thebeginning. I'd say I'd probably
been I was smoking from the timeI was 14, off and on. I quit
once for three and a half yearsand once for a year and a half,
but I always restarted to this.
(23:49):
There is not a urge to smokeanymore, where there was always,
whenever I quit, before therewas, you know, I wanted a
cigarette, and nowadays it neverenters my mind. Chewing never
enters my mind. It was, youknow, I think that's the only
(24:09):
way you can quit chewing.
Chewing is very bad.
Erin Brinker (24:14):
Oh, see, I had no idea. I've only known a handful
of people who chewed, but I knowthey loved it when they did.
Phillip Crawford (24:21):
Oh yeah, it was, it was very difficult. I
could never quit that. I triedand I was unable to, but Dr HSU
was able to fix it.
Erin Brinker (24:32):
Thank you. Dr Hsu, a miracle worker in many ways.
He is so dr Hsu, talk about, youknow, some of the other patients
that you've had that have kindof gone through the same thing.
Are they pretty much all smokersor consumers of tobacco
products?
Dr. Jeffrey Hsu (24:48):
I would say, in my experience, most of them,
however, there, there are ahandful of patients I've seen
over the years where they have.
Smoked, and it is from another,you know, issue probably having
to do with some genetic factor.
(25:09):
So, you know, we do know thatthese aneurysms do occur in
certain populations more thanothers. So for instance, it does
affect men more than women,about three, three or four times
more in men than than women, andit that some of the other risk
(25:31):
factors that haven't mentionedyet are also those folks with a
condition called COPD, which ischronic obstructive pulmonary
disease. You may have heardpeople smokers get this often as
well, but it has to do with abreakdown of the lung tissue
causing it to be very difficultto breathe. It's similar to the
(25:54):
aneurysm problem, because it hasto do with the elasticity of the
tissues. And so there is arelationship between that
condition and aortic aneurysmaldisease. So it's, it's, it also
affects certain ethnic groupsmore than others. It is, is more
(26:15):
common in the white Caucasianpopulation than others, and it,
as mentioned, affects men, youknow, over the age of 55 that
is, that is really the, the thepopulation who is most at risk
(26:36):
from having aneurysmal disease.
Erin Brinker (26:39):
So are we seeing the numbers? Because the number
of people who smoke has gonedown. I mean, for a lot of
efforts, you know, the way that,especially in California, how
much cigarettes and tobaccoproducts are taxed, how much,
you know, there's the all thepeer pressure not to smoke.
Although I'm seeing smoking morein in movies and on television
shows, I'll see the cool personwalking around with a cigarette
(27:01):
more than I used to. How are we?
Are we? Are you seeing morefewer people who smoke, and
therefore fewer people coming inwith this condition?
Dr. Jeffrey Hsu (27:11):
Yeah, I, I can't. I actually can't say
that. I've seen more or or less.
I mean, pretty much all mypatients are smokers, you know,
just, I think, by selfselection, just, you know,
having vascular issues. So Ihaven't been able to notice
(27:31):
whether or not there's some moregeneral trend, you know, towards
more smoking or not. Yeah, butit is definitely something that
is I definitely counsel all mypatients on it, whatever
problem, whatever vascular issuethey may have. One of the first
things I tell them is to stopsmoking.
Erin Brinker (27:56):
And Kaiser has resources for that right to help
people stop smoking.
Dr. Jeffrey Hsu (28:00):
Absolutely, absolutely. We have educational
resources treatments. We have avariety of resources at Kaiser
that patients may contact theirprimary care doctors and and,
you know, enter into certainprograms and things like that.
Erin Brinker (28:20):
So, so Philip, are you doing any if the answer is,
no, that's perfectly fine. Areyou doing any outreach to youth
to tell them about the dangersof smoking? Is it something that
you'd ever thought about doing?
You know, I are you screaming itfrom the rooftops? What this
actually is, like,
Phillip Crawford (28:38):
I have not done anything like that. Like I
said, my the last two years ofmy life have been very
stressful, I imagine. But, youknow, there's I, I live my life.
I'm good,
Erin Brinker (28:53):
that's awesome, and you're still here, which is
Phillip Crawford (28:58):
the best part about it, you know. And I think
I'm reasonably healthy, I'm 50pounds lighter, but yes,
Erin Brinker (29:05):
did anybody tell you that if there's an easier
way to lose weight? Oh, my God,I wish
Dr. Jeffrey Hsu (29:15):
I made the comment on sure issue here. You
know it's not uncommon forpeople who go through this
ordeal to have PTSD or to havesome psychological issues
following it, it is pretty awell known, documented problem,
(29:40):
and I think it really is like,as you mentioned before, it's a
shock to your system, it's ashock to your mind, it's also
and it's obviously a shock toyour body, but it's one of the
most unimaginable things that Ithink a person can. Undergo in
(30:00):
their lives. If you can imagine,you're just sort of living your
life one minute and the nextminute, you're being told by
people that you have never metbefore that you don't know in a
place that you probably haven'tbeen in, that this may be the
(30:21):
end, and, you know, it's, it's asudden thing, it all happens
within minutes. I don't thinkthat's a kind of a normal
experience, no, and that, yeah,that definitely would have a
psychological impact. So it'ssomething that we surgeons do
(30:42):
know about. And you know, we,we, we have seen it in our
patients over the years, and inMr. Crawford's case, you know, I
just wish him the best, and justhaving, you know, to fulfill his
his dreams, you know, havinggotten over this now and that,
(31:06):
that he can go on and have awonderful life.
Erin Brinker (31:10):
Yeah, they came into that.
Phillip Crawford (31:12):
They it's pretty much normal, with the
exception of my eating nowadays.
But I mean, as far as what I'mable to do and how I'm able to
live I'm I travel. I went on aworld cruise after the surgery,
I think I left in January. Heoperated on me in October, and I
(31:36):
was on a world cruise inJanuary. So Wow. Well, it's my
wife trying to seize the day.
You know, every day she's like,you know, we're gonna live life
while we're living but the posttraumatic that all happened that
(31:59):
day, whenever they asked to seemy sutures, and that was the
worst day
Erin Brinker (32:04):
it would have to be. I mean, I think my worst
day, yeah, I mean, it was, itwas it would have to be, because
this come to this realizationthat all of these things had
had, you know, this, you thatyou've been through this hell,
and then then you realize, oh, Ihave pain, and I'm in a
hospital, and people have beenhere, and I almost died, and all
of those things that, as itstarts to sink in, that that has
(32:27):
to be traumatic,
Phillip Crawford (32:29):
they, you know, the whole dying part I
didn't learn about until I cameout of the coma. I, like I said,
I pretty much know nothing ofother than arriving to the
hospital and waiting for thedoctors to see me and then
waking up one day, you know,three weeks later, I think it
(32:50):
was 20 days, to be exact, Idon't know, wow, wow. I don't
dwell on it. Try not to talkabout it.
Erin Brinker (32:58):
Sure, sure. And you can't, right? Because nobody
wants to live that way. But itis, you know, you've been
through, you've been through alot, and clearly you wanted to
to be successful in comingthrough it, or you wouldn't be
here. I mean, clearly you foughtfor your life, even if you was
subconsciously, you fought foryour life. And so all of you
(33:18):
were fighting together, right?
Phillip Crawford (33:20):
It right the fight. I mean, it's that's what
I see in people who, who don'tlead the life that I live, is
like they give up, and I justnever gave up. I still haven't
given
Erin Brinker (33:38):
up. You have a lot to fight for.
Phillip Crawford (33:41):
There's a lot of people who need me, I guess
so.
Erin Brinker (33:44):
What are your goals for the next 10 years?
What do you want out of lifenow?
Phillip Crawford (33:49):
I want to be a scratch golfer. Are you still
golf? I golf twice a week. I hitballs twice a week. I I want to
be the best father that I can beto my children and my
grandchildren, and that's what Iwant. I think that sounds
fantastic. Sometimes, you know,I get a little down and grumpy,
(34:13):
but
Erin Brinker (34:15):
that's because you're human. Yeah,
Phillip Crawford (34:20):
I think I even got doc grumpy with Dr shoe one
day. Sorry. Dr shoe,
Dr. Jeffrey Hsu (34:29):
no, it was all part of the it was all it was
all good. Mr. Crawford, it wasnot an issue. All right,
Erin Brinker (34:37):
so, Dr shoe, let's talk about some other vascular
issues that people should belooking out for. And you
brought, brought up, you know,the the COPD, but people also
get, you know, they get plaquebuildup in their arteries, which
you also talked about, I knowsomebody in my family had to
have, they had pretty much 90.
Percent occlusion in theircarotid artery, and their
(35:01):
vascular surgeon went out, wentin and took a piece of it out,
where the where the plaque was,and so the other two pieces
together, which is absolutelymiraculous that happened in
Houston. And you know, couldkind of talk about other things
that a vascular surgeon does,and where the industry is going,
or where that specialty isgoing,
Dr. Jeffrey Hsu (35:21):
sure, sure, vascular surgery is a specialty
that has basically been heresince the people started first
doing surgery, but it reallycame into its own specialty, so
to speak, in I would say, thelate 70s, early 80s, and started
(35:44):
being recognized, as you know,its own specialty. There have
been so many advances invascular surgery with
technologies over the years. Themajor one happening in the late
80s, early 90s, where we startedinstead of doing a lot of open
(36:09):
surgeries, we started doingthings called endovascular
procedures that had to do withgetting inside of the arteries
instead of having to open themup and getting inside and place
things like stents and balloons.
And so that was a hugerevolution that that occurred
(36:29):
and changed the entirespecialty. The specialty
continues to grow. I estimatethere's probably around 3500 to
4500 vascular surgeons in theUnited States. And there is, I
think, a shortage, and there's aneed for more vascular surgeons
(36:51):
in many areas of our country, sothat when things like this
happen with Mr. Crawford, thatthere can be a vascular surgeon
available to perform these typeof procedures. But I see, I I
see the specialty as a growingspecialty, and one that is also
(37:15):
affected greatly bytechnological advances.
Erin Brinker (37:24):
So when you were in medical school, did vascular
surgery always interest you? Ordid you just kind of fall into
it and realize, Oh, I reallywant to do this. How did you
make that decision?
Dr. Jeffrey Hsu (37:35):
Yes, that's a there's a story there. The the
specialty of vascular surgery ispretty specialized, so
oftentimes it's not evenintroduced at the medical school
level. Oh, there could besituations where a medical
(37:58):
student could get through anentire medical school education
and have never even heard aboutor experienced working with
vascular surgeons. That isbecause we are a sub specialty
of a, you know, another broaderspecialty, specialty of surgery.
(38:19):
So the way I the way, the way ithappened for me was that I had a
general interest in surgery, andso I started my career going
into a sort of a, what we call ageneral surgery training
program. And while you're inthat program, you get exposed to
(38:43):
many different sub specialtiesof surgery. And in my case, what
happened was I, I found vascularsurgery to be very natural, very
interesting. I had good mentors.
I was, I was very much that thathas a lot to do with it when you
(39:03):
have mentors that guide you intoa direction. That is essentially
what happened to me. So I kindof found, you know, that during
my training years and went offin that direction.
Erin Brinker (39:22):
So I, I picture vascular surgeons working with
technology. So you're not inthere with your hands repairing
that. You're using machines, or,you know, technology, to do the
repairs on those on the veinsand the arteries. Is that
correct? And what, what isactually the nuts and bolts. How
does it look?
Dr. Jeffrey Hsu (39:43):
Yeah, I'm sorry, Erin, I because there was
an incoming call. I missed thefront part of that.
Erin Brinker (39:50):
So I picture that you that when you're doing
vascular surgery, that you'reactually operating a machine
that's doing the surgery foryou. And I don't know what they
call those machines, but youknow it. Instead of you
stitching up the the artery orthe vein you're having, you're
working through a machine that'sstitching up the artery or the
vein or there, you know, youtalked about, you know, not
being invasive, like trying tofind a way into the arteries and
(40:11):
veins. What does the actual nutsand bolts look like?
Dr. Jeffrey Hsu (40:14):
Yeah, so I think you are describing what we
call robotic surgery, which isnot made majoring roads into
vascular surgery just yet,although it may be something
that we do more of in thefuture, what we do as vascular
surgeons are we use things likeX ray machines to help guide
(40:39):
instruments and things throughthe body, but we are still the
ones actually manipulating theinstruments. So, so we haven't
really, you know, made a lot ofuse of robots, but that's just
now. I mean, I do think that'sgoing to change in the future,
(41:00):
but the but the typical scenarionow would be the vascular
surgeon would be present anddoing the ethical surgeries in
the operating room, some someoperations that we do require X
ray machines and and we don'thave to make large incisions.
(41:24):
And these are procedures wherewe're putting stents in, we're
putting things on the inside ofthe arteries, and we're having,
we're basically not having toopen the body to expose these
vessels. Mr. Crawford's case, itwas not possible.
Erin Brinker (41:48):
The body opened itself, unfortunately, on the
inside, unfortunately,
Phillip Crawford (41:51):
yeah, that was all done by hand, the way, I
understand it for nine and ahalf hours.
Dr. Jeffrey Hsu (41:57):
That's right.
In Mr. Crawford's case, we didit the old fashioned way
possible. We basically had toget get in there. We had to open
everything up and moveeverything over in order to get
through to the area.
Erin Brinker (42:16):
So if you were talking to somebody who is
interested in becoming asurgeon, and telling them about
your specialty, what part of itthat is the part that you love
the most? Dr Hsu.
Dr. Jeffrey Hsu (42:26):
I, for me, personally, vascular surgery is
is elegant, and there's a beautyto it that I think you need to I
think you it takes a while toappreciate, but it's it's it has
to do with how delicate thesurgery is and and the fine work
(42:52):
that needs to be done to be ableto put things back together in
their right place. So I thinkthat's what drew me to the
specialty, was the technicalchallenge, and also the fact
that it was a way of it was away that I thought I could use
(43:14):
my skills to help people, andthat, you know, there could be
some benefit, all right, fromthis craft, so to speak, you
know, to allow people to havebetter lives and better quality
of life as well. At the sametime, it was a, it was a, it was
(43:35):
like a manual craft orinteresting craft that I had to
also work on and perfect aswell, so that that's really the
that the the the attraction ofthe specialty for me. But you
know, at the end of the day, itreally, you know, whatever
(43:56):
specialty anybody chooses. Youknow, in medicine, at the end of
the day. I believe strongly thatthe rewards come from how our
patients do and and that incases like this, where, you
know, we were able to besuccessful with, you know, Mr.
(44:17):
Crawford, I mean this, this is,this is the reason why we this
is the reason why I went intoit.
Erin Brinker (44:24):
I'm so glad you did. So glad, you know, and I
think about, you know, had Mr.
Crawford, had Philip lived in,you know, rural anywhere, even
out at our rural deserts, andthis had happened, he may not
because of the access to avascular surgeon, he may not
have been here. And so beingable to attract more people into
(44:45):
the field is criticallyimportant.
Dr. Jeffrey Hsu (44:50):
It is, and that is a ongoing issue with our
healthcare system, is being ableto provide the access. Us into
some of the harder to reachareas, you know, of our country,
and that is a that is a hugechallenge. Yeah, right,
Phillip Crawford (45:14):
right now I'm in northern Minnesota, and I I'm
glad it didn't happen here?
Erin Brinker (45:21):
Yeah. First of all, How cold is it up there
right now?
Phillip Crawford (45:25):
Oh, right now.
It's not bad. I think it's like,it's probably 20 degrees, but,
oh yeah, that's not bad. No, thecold thing is over New York and
all those people right now. Butnow the the health care
available up here is minimal atbest. I mean, the the place I'm
at right now, if I had aproblem, I'm in trouble there.
(45:48):
There's not even a stoplight inthe town I'm in. Oh, wow, right,
so
Erin Brinker (45:58):
you're being airlifted to to Minneapolis.
Well, I'm sure the Mayo Clinicprobably has a vascular surgeon,
but it doesn't sound like that'sanywhere near you.
Phillip Crawford (46:09):
I'm seeking out Dr shoe. That's what I'm
doing.
Erin Brinker (46:14):
Well, that's fantastic. So, so as we you
know, kind of close up, youknow, what are, what are, where
can people get resources forvascular health education, learn
more about their vascular healthand and give people the power to
be proactive about taking careof themselves. And this is a
(46:35):
question for Dr shoe, yeah.
Sorry, no, it's okay.
Dr. Jeffrey Hsu (46:40):
Yeah, education is definitely, I think, much
needed for this condition andvascular conditions in general.
I would, I would recommend, foranyone interested, they can go
to our society website. It isvascular.org just basically, you
(47:04):
know, that's it. It's verysimple, vascular.org which is
the home website for our mainsociety. It's called the Society
for Vascular surgery, and thereare a number of wonderful
educational information therethat you can find in various
(47:29):
conditions, and also help find avascular surgeon in your area.
So that would be kind of thegreat place to start. And you
know, there's also a lot ofmaterial that can be found on
(47:51):
online, but I would be carefulwith that. I would go to this
website as a kind of a startingpoint.
Erin Brinker (48:04):
Dr Google's probably not the best source of
information,
Dr. Jeffrey Hsu (48:09):
is it? I think that you would get a mix of
everything in there.
Erin Brinker (48:17):
Dr Google's probably better than Dr Tiktok,
though. I'm just saying.
Phillip Crawford (48:24):
I can tell you that I never use
Erin Brinker (48:26):
that. Oh, that's good.
Phillip Crawford (48:28):
I never go to Google for what happens to me.
Erin Brinker (48:32):
That's good. And you're still here as a testament
to that being a good decision.
So I, I'm, I'm in awe of yourstory, and I would love to you
know both have both you, Philipand Shelly, on the show to talk
about the hope side of it. Thisis, you know, this, this. The
show is called the hope table,and what we're trying to do is
(48:55):
give people a reason to just tofeel hopeful and to engage with
positive stories. And we weren'table to get Shelly on the air
today, but I suspect she's got alot to say that people could
really relate to. It's reallyhard to watch. It's hard to go
through it. It's also hard towatch it happen to somebody
who's the most important personin your life. And I'm interested
(49:15):
in hearing She sounds like astrong, amazing woman, and I'm
interested in hearing her storyas well, and hopefully we can
get that scheduled. Dr, Hsu,you. I'm in awe of your skills,
and I'm so grateful for youjoining us today and that you
were able to say and really inlike you said, basically 75% of
(49:36):
the people do not make itthrough and so Philip, you are a
miracle, and it's been a treatto have you all on the show
today. Thank you.
Phillip Crawford (49:51):
Thank you.
Thank you, Dr shoe foreverything.
Dr. Jeffrey Hsu (49:56):
Thank you, Mr.
Crocker for fighting us.
Erin Brinker (50:07):
We just heard from a surgeon and a survivor, two
people who have seen the literaledge of life. And if you're like
me, listening to a story aboutan aortic dissection can leave
you feeling a bit well, fragile.
It reminds us that we'reessentially held together by
these incredible pulsatinghighways of blood. But I want to
spend these last few minuteslooking at the light at the end
(50:28):
of the tunnel. You know, in themedical world, they often talk
about survival rates, but in thehuman world, we talk about
survival stories. And this onewas a good one. There's a
concept called Post TraumaticGrowth, the idea that after a
life altering medical event,something shifts. It's not just
about getting back to normal,it's about finding a new normal
(50:51):
that is actually deeper andricher than before. I've seen
survivors who, after a vascularscare, finally quit the job they
hated, or finally said I loveyou to a sibling they hadn't
spoken to in years, or anotherfamily member, there's something
incredibly hopeful about thefact that our hearts, physically
and metaphorically, have thiscapacity to heal and expand
(51:13):
after they've been under immensepressure. And let's talk about
the hope sitting in theoperating room if you had an
aortic event 30 years ago, theoutlook was, well, frankly,
terrifying, and we kind oftalked about that a little bit
today. It meant Massive Opensurgeries and months of
recovery. Now, this was becausethe dissection had happened, and
(51:39):
it was a big one. And as Dr Xutalked about, this was a good
old fashioned surgery, but withmodern techniques. But it's
still far, far, far better thanit was 30 years ago. We're
living in a golden age ofvascular medicine. We are now in
the era of endovascular repair.
(52:02):
So he talked about tinyincisions. Think about that
surgeons can now go through atiny Nick in the skin, sometimes
just in the fold of the leg, andthread a life saving stent all
the way up to the heart. It'slike high tech plumbing
performed with the precision ofa jewel jeweler. And one of the
things I asked, you know, Italked about with Dr Hsu, is
that I have a family member whohad carotid artery surgery where
(52:26):
there was an occlusion, therewas plaque buildup in the
carotid artery, and the surgeonjust went in there and clipped
the part that had the plaquebuildup, took it out and sewed
the pieces together so that, youKnow, the no longer had that
occlusion, which just sent allso much more blood into the
brain, and it was just much,much better. But the recovery
(52:47):
there was still it wasinteresting, because he kind of
changed as a person. Whensomething that major happens, it
kind of changed in a very goodway. It changed as a person.
We're seeing the rise of AIdriven diagnostics. AI is
everywhere, right? So there arenow programs that can scan a
routine CT, scan and flag a tinybulge in an artery before the
(53:09):
patient even feels a symptom.
And as Dr HSU said, the symptomsoften don't show up until
they're at a critical stage. Weare moving from a world where we
where we react to emergencies,to a world where we intercept
them. That means more birthdays,more graduations and more quiet
Sunday mornings for people who adecade ago, might not have made
it, and that is a miracle ofhuman ingenuity. And as we close
(53:33):
out today, I want to leave youwith a thought, vascular health
is often called a silentjourney. We don't feel our
cholesterol, we don't alwaysfeel our blood pressure, but
that silence is an invitation tolisten. And I would add kidney
disease. I would add because wedon't necessarily feel that.
(53:55):
Don't feel we may have somegeneral malaise, like we do with
when our blood sugar isconsistently high, but the
damage it does to your body overtime, we're starting we
understand that better, not thatwe're starting to. We do
understand that better than weever have before. We talked
about smoking with this in thisconversation with both Philip
and Dr Shu and use of anytobacco products, including what
(54:20):
they call dip, which is thechewing tobacco, and it slowly
but surely wears away at ourvascular health. Taking care of
your vascular health is not justabout not dying. It's about
living well. It's about havingthe stand up stamina to walk
your dog, the breath to singalong to the radio and the years
to see your grandkids grow up.
(54:44):
If today's show moved you, well,don't let it end there. Call
your parents. Call your parents,even if it just showed just
moved you a little bit. Callyour parents. Tell them that you
love them. Ask them about thefamily medical history. Go for
that 20 minute walk to see.
Evening, take your dog out. Imean, people are walking cats
now, so maybe take your cat out,not because you have to, because
(55:05):
your body is this incredible,complex machine that deserves to
be moved. And I'm going to addsomething in there too, if you
have a job that you hate forwhatever reason and you think
you can't stay there muchlonger, make a plan for your
exit. Maybe it's finding anotherjob, maybe it's starting a
(55:25):
business, maybe it's retiring.
Maybe, you know, it could be alot of things, but if you're in
a place, maybe it's not yourjob, maybe it's place where you
go to church, maybe it's avolunteer where you're just
miserable. First figure out whyyou're miserable, and if you
think that you need to go foryour mental health, make the
(55:47):
leap. You owe it to yourself. Dothat thing. Make the Leap. Life
is thin, meaning the vascularthe walls of your vascular
system, but it's also remarkablytough. So thank you to our
guests today for reminding usthat even when the main pipe
breaks, there's a way back tothe light. I'm Erin Brinker, and
(56:10):
this has been the hope table.
Stay healthy, stay hopeful. Letme say, like I did last week, I
love you. I'm glad you're here.
You're important to me, and I'lltalk to you next time you.
Erin, welcome to the hope table. I'm Erin
(00:09):
Brinker. Now one of the my mostfavorite things on this show is
being able to talk to Kaiserdoctors who are experts in
everything from women's health,Men's Health, cardiac health,
everything today I have thedistinct pleasure to sit down
with Dr Jeffrey shoe. He's theformer chief of vascular
surgery, still with KaiserPermanente, and not only is he
joining us, but one of hispatients, Philip Crawford, he
(00:31):
survived an aortic aneurysm,which is almost always a death
sentence. Dr Hsu and PhilCrawford, welcome to the show.
Thank you. Thank you. So Dr Hsu,first of all, we think of
cardiac health. We think ofpulmonary health. We think of,
you know, the other systems inthe body. But I don't know that
anybody pays attention to paypays attention to vascular
(00:53):
health. Can you kind of tell uswhat that is and what that
specialty entails?
Dr. Jeffrey Hsu (00:57):
Yes, yes. So vascular health has to do with
the blood flow in your body, andone of the reasons why it may
not be as memorable to manypeople is that it encompasses
pretty much the entire body anddoesn't have any one specific
(01:17):
location or one specific organ.
However, it is still veryimportant, and it it most, I
think, likely has a analogy tothe plumbing in your house, for
instance, which covers yourentire house. It could be in any
(01:38):
room, but if there's a problem,you kind of have to fix it in
that location. So vascularhealth is still very, very
important, but it is not asmemorable or clear to much of
the to much of the population,
Erin Brinker (01:59):
I think about all of the systems that, first of
all, all of the systems dependon blood, right? That's how
nutrition and oxygen makes itaround to the various organs.
But the liver impacts at theheart, the lungs, the muscles,
certainly, you know, I meaneverything, the kidneys and so
you know, when you're whensomebody has a vascular issue,
do they often think it'ssomething else, and they they
(02:22):
find out through trial and errorthat it's vascular. How do you
how do you find that leak inyour pipes?
Dr. Jeffrey Hsu (02:29):
Oftentimes, it takes a few steps of
investigation before finding outit is, in fact, a vascular
issue. However, we do have withmodern imaging, we do have the
tools we need to figure outwhether or not it is a vascular
(02:51):
issue pretty quickly these days,and yes, absolutely correct
everything in your body requiresblood flow, and so many maladies
that happen have to do with aninterruption or problem with
that blood flow. And once wefigure out what it is, it is
(03:17):
surgeons like myself, vascularsurgeons and other vascular
specialists, who will then comeup with a solution or treatment
plan to try and correct thatproblem.
Erin Brinker (03:31):
So let's talk about aneurysms, specifically,
because that is Phil Crawford'sissue. What is an aneurysm and
where can they occur in thebody.
Dr. Jeffrey Hsu (03:42):
So the word aneurysm is a general term we
use in medicine. It basicallyhas to do with an enlargement of
something. It's usually atubular structure that develops
a bulge in it. If you canimagine a garden hose, for
instance, with an area that hasbecome wide, or, you know, maybe
(04:07):
the size of a small apple orsomething like that, and and
that would be, you know, what Ananeurysm is in the vascular
system. It's basically aweakening of the wall of the
artery, which which then underpressure, there's blood flow
(04:32):
through the artery. Underpressure tends to, tends to
enlarge that area of the aortaor artery and cause this bulge,
essentially, and so that's whatan aneurysm is technically in in
the vascular system.
Erin Brinker (04:53):
So that literally, could happen anywhere in your
body, anywhere you have veinsand arteries. It could happen
Dr. Jeffrey Hsu (04:59):
that is correct. It can happen literally
anywhere.
Erin Brinker (05:02):
And so what are some of the things that that
weaken a vascular wall? I wouldimagine diabetes and high blood
pressure can't help. Are thereother things? First of all, is
that true? And then are thereother things that can weaken the
artery and vascular walls?
Dr. Jeffrey Hsu (05:16):
Yeah, this is an active area of research, and
it is not 100% clear right now,why certain areas of the artery
arterial system get weaker thanothers, but it is, it is known
that there are certain factorsthat cause injury to the artery
(05:40):
wall, which then leads toweakening. So the most common
example of that would be what wewould call a plaque formation or
atherosclerosis, and that has alot to do with diet and smoking
history as well. So this, thisis a process that causes
(06:07):
inflammation, and it does affectthe integrity of the artery
walls. And it turns out thatsome areas of the arterial tree,
so to speak, are more prone toweaknesses than others. And so
we oftentimes see aneurysms incertain locations. In Mr.
(06:33):
Crawford's case, it was, is theabdominal area and and that is,
that is what we know. So there'sa lot of also heredity and
genetics that play into this aswell.
Erin Brinker (06:49):
So I have heard that there is a link between
oral health and vascular health.
Now, whether those whether thatcauses an aneurysm, I don't
know, but that that people whohave poor oral hygiene, they put
their vascular system at risk.
Is that true?
Dr. Jeffrey Hsu (07:05):
I think that may be alluding more to cardiac
risk.
Erin Brinker (07:11):
Okay, okay, well, that's very helpful. So let's
talk about Phil's situation, thekind of what what is the aorta?
What does it do? Where is itlocated in the body, and what
you know, what do you do whenyou have an aortic aneurysm?
Dr. Jeffrey Hsu (07:27):
Sure, sure. So.
What is the aorta? Again, goingback to the plumbing analogy,
you the aorta is can beconsidered the main line, the
main line of blood in your body.
So your heart is the centralpump that moves the blood and
(07:52):
acts as a pump. But as it pumpsblood, the biggest blood vessel,
the main line, so to speak, iscalled the aorta. It sits
centrally in your body, andeverything else branches off
from there, and the arteriesthen get smaller and smaller and
(08:13):
smaller until they reachwhatever organ that is intended.
But the aorta is the biggestblood vessel in your body. So so
that that's why it's such aserious condition, because it is
the main line. And so if youhave a problem with this main
(08:33):
line, it can really becatastrophic.
Erin Brinker (08:38):
So how do you what are some risk factors or warning
signs for an aneurysm, well,specifically, an aortic
aneurysm. And you know, how whatdo you do when you start to
notice these?
Dr. Jeffrey Hsu (08:50):
So here's the problem. The problem with these
aneurysms is that they areoftentimes silent. In other
words, you really are likely notto know that you have one. They
really, in general, don't causesymptoms. They don't cause any
real problem that you maynotice, until perhaps something
(09:16):
then happens. So when they docause issues, typically it is
having to do with pain. So therecan be pain experienced in the
lower back area. It can radiatedown the legs. It can be in the
abdominal area. It can radiateinto the groin areas. Sometimes
(09:40):
it will radiate up into the thechest area. However, pain is
usually the first sign thatthere isn't aneurysm there, and
if that happens, it's usually a.
Sign. So this is one of thedangers of having an aortic
(10:03):
aneurysm, is that there's nogood way of knowing that you
have one other than havingsomething called a screening
test.
Erin Brinker (10:17):
And what does that screening test entail? I assume
it's a CT scan.
Dr. Jeffrey Hsu (10:21):
Actually, it's it's usually an ultrasound. Oh,
it's usually an abdominalultrasound, and it is done based
on the recommendations from ourgovernment, national screening
recommendations and the currentrecommendation for screening is
(10:46):
to have men who are between theages of 65 and 75 get who have
had a history of smoking. Sothat's basically the the
population that we're lookingfor is to screen in that
population men from the ages of65 to 75 with any history of
(11:11):
smoking. Smoking history beingabout 100 cigarettes in the
past. And it is in thatpopulation that there's a
national screeningrecommendation and, and, and, so
that is the current screeningrecommendation.
Erin Brinker (11:30):
So let's, let's talk specifically about Phil's
case. So I'm going to switch itto Phil. Tell me about your life
and what you were doing that ledup to this challenge, before you
were diagnosed, or did itrupture? Tell me. Tell me what
happened.
Phillip Crawford (11:49):
It's there.
There was no warning. I can tellyou that I did smoke and I
chewed skull, and one day I wassitting at the breakfast table,
and I reached around to open thesliding door, and an immense
pain came over my abdomen, and Iknew I needed help, so I started
(12:13):
the process at that point.
Erin Brinker (12:22):
So did you think that you were having like, a
stomach issue or an intestine?
Because I'm thinking about wherethe aorta is in the body,
there's, you know, all thoseorgans are in there at once,
like my liver is a problem, ormy, you know, my stomach or my
intestines, or, you know, ifyou've got pain shooting down
your legs, you could think Ihave sciatica, when it's none of
those things, right?
Phillip Crawford (12:41):
They I didn't really have any inclination of
what it possibly could be. Ijust knew it was a pain that I
couldn't control, that it was,it was a severe pain. It took me
to the floor, really. Oh, so,
Erin Brinker (13:02):
so I assume that that you somebody was with who
was with you? Called 911
Phillip Crawford (13:07):
yeah, my wife was there. She's on the she's on
the podcast with us. She, shestarted the process. I asked her
for help, and she started 911and everything after that point
is a story she can tell you. Iknow nothing about anything that
happened, from the time I got inthe ambulance until I woke up
(13:31):
two or three weeks later from amedically induced coma, oh my
gosh. And the doctors asked meto show them my sutures. And I
looked over my wife, I'm like,What are they talking about? And
they told me to raise my gown,and I had 111 staples, I
believe, in my abdomen, fromlike my belt line to my sternum.
Erin Brinker (13:58):
So I am guessing your wife is Shelly. Heaton,
Shelly. Are you able to takeyourself off mute and and I can
welcome you to the show. Thankyou so I can barely hear you
once you lean into whatevermicrophone you are using. Tell
me what it was like toexperience this as a as a loved
one and a bystander. Iunfortunately can't hear Shelly.
Phillip Crawford (14:31):
Okay, she might be trying to fix it.
She's, that's, that's all
Erin Brinker (14:36):
right, that's right. We had not prepared for
her to be here, but I'm happythat she is. If we can get this
worked out in the meantime, I'mgoing to, I'm going to ask Dr
Hsu, so when you when, when Philcame into the hospital, I'm sure
you were paged from to theemergency room. What happened?
Dr. Jeffrey Hsu (14:53):
So when, when Mr. Crawford came into the
emergency room, the emergencyroom. Room, physicians quickly
diagnosed him through getting aCAT scan with something called a
ruptured aortic aneurysm. Sothat is usually how it's
(15:16):
diagnosed. CAT scans areoftentimes used to investigate
causes of abdominal pain, and inthis case, it showed very
clearly that there was a ruptureof a large aortic aneurysm. And
so they they called us, me, Iwas on call that day, and and we
(15:42):
took care of the problem.
Erin Brinker (15:44):
So I have to think that time. I mean, you have no
time. Everything has to bereally quickly, because someone
could bleed out in minutes. Thatis correct.
Dr. Jeffrey Hsu (15:53):
Wow, is one of the most. This is a situation
where every minute counts. Andin my specialty, it's known as
the one thing where you justdrop everything you whatever it
is you're doing, you just haveto drop it, and you have to go
(16:14):
take care of it. It's thatimmediate. So basically, it, it.
It was in that situation whereMr. Crawford was losing blood
actively, as we were, as we werefiguring out, you know what,
(16:35):
what to do with him. And so wevery quickly prepared the
operating room and basically gothim in for the operation that he
needed. I believe it was veryquick when we got him up there.
Erin Brinker (16:54):
Well, that's outstanding. I mean, if, if
Shelly hadn't reacted so quicklyand gotten 911, there, and then
gotten you all, gotten filled tothe hospital in time, and then
you hadn't reacted so quickly,then he would not be here.
Dr. Jeffrey Hsu (17:09):
That's absolutely correct. That is
really correct, that that is themost important step, is to get
to the hospital fast. We knowthat when these things happen,
about 50% of people don't makeit to the hospital. And when
(17:33):
they do make it to the hospital,and let's say they have
treatment, only 50% of thosepeople survive the operation.
Wow. So it's a very dire event.
The fact that we were able tosee Mr. Crawford in the hospital
was just a huge advantage forus, because we were able to
(17:58):
treat the problem right away.
Erin Brinker (18:04):
And I want to as an aside very quickly. This is
why people donating blood is soimportant, because I assume that
he that you threw up some Opositive blood or negative. I'm
not sure which one's theuniversal. I think it's O
positive that you threw thatblood up right away so that he
could, that you could keepthings going while you, while
you sewed him back up. Is thattrue?
Dr. Jeffrey Hsu (18:26):
You know, actually we, we actually have,
we actually have certainstrategies when it comes to
giving blood, and sometimes wedo have to give it right away,
but other times we can hold offuntil it's a little bit more
advantageous to give it. So it'snot necessarily the first thing
(18:50):
that we do, but you know,they're, they're a, what we call
a, you know, resuscitatestrategy that we use in this
situation, and sometimes it doesinvolve giving blood. Other
times, no
Erin Brinker (19:06):
okay, but it should be on hand either way,
Dr. Jeffrey Hsu (19:10):
that is true.
Erin Brinker (19:11):
So let's go to where you wake up, Phil, let's
go to where you wake up and youare. You've been in a medically
induced coma. You've got yourwife standing next to you. What
was the realization of what hadhappened to you? What was that
like?
Phillip Crawford (19:27):
It was shock.
Everybody telling me, You knowwhat had happened to me, I just,
I'm thankful that Dr Hsu and allthose people were available. It
was super shocking. I mean, itstill grabs me now. I mean, I'm
my eyes are watering up rightnow. Just talked about it. It
(19:51):
was amazing, scary. I was scaredto death. Time, yeah,
Erin Brinker (20:01):
so I imagine there's some PTSD for you, like,
you know, that's something thatyou know, because there's the
mental side of things, right?
Your body went through anincredible shock, and you may
have been asleep, but your bodywasn't. And so it remembers, and
I imagine it is, it has changedyour outlook in life. It's
changed your certainly, thefeeling of your own mortality,
(20:24):
what you're thinking about isimportant in your life. Kind of
talk about some of those things.
Phillip Crawford (20:32):
I'm kind of a rock head. But the as far as the
mortality, it's just at anygiven moment, you know, tomorrow
is not a guarantee. That kind ofthing, as far as me living my
life, thinking about myaneurysm, I I try not to. It
(20:55):
brings up, you know, it tugs onour heartstrings. My wife can't
hardly talk about it. You knowit was, it was very bad. I mean,
you know, to have Dr shoe comein and tell your wife to come in
and say goodbye. Oh, you knowthat happened more than once. As
(21:15):
far as I know, that's what I'mtold. I I wish she could tell
this story, because her and DrHSU have had more conversations
than Dr Shu and I not that DrHsu and I haven't had many of
those. Sure they're, you know,their relationship was, you
know, two or three weeks.
Erin Brinker (21:37):
So how is it? Has it changed your personality. Has
it changed your priorities? Howdo you including about how you
relate to your own health? Youknow? How has it changed you?
Phillip Crawford (21:53):
Well, I quit smoking and chewing while I was
in my coma. He fixed that too,it doesn't it. There's more to
my story than the aneurysm. Ayear later, a year later, I was
diagnosed with esophagealcancer, so I've been dealing
with that for it's a little overa year right now, so
Erin Brinker (22:21):
it I'm so sorry to hear that.
Phillip Crawford (22:24):
It's all right. I'm fine. The cancer is
has been removed from my bodyand all that. And, you know,
it's just trying to learn how toeat with my new throat. So, you
know, I wish she could talk. Sheknows everything. I guess it
(22:46):
changed my life that I value.
You know family, and every day,you know my family, and every
day, I mean, they were therewith me, every day, every
minute, nobody ever left methere. Wow. I was never alone. I
had family friends. There wassomebody sitting with me the
(23:08):
whole time.
Erin Brinker (23:11):
Wow, that's awe inspiring, because not everybody
has that. That is amazing.
Phillip Crawford (23:17):
My family's pretty good.
Erin Brinker (23:19):
So how old were you when you started consuming
tobacco products, whether it wassmoking
Phillip Crawford (23:26):
or chewing?
Well, it was in the fifth grade,but it wasn't like steady at
that point. That was just thebeginning. I'd say I'd probably
been I was smoking from the timeI was 14, off and on. I quit
once for three and a half yearsand once for a year and a half,
but I always restarted to this.
(23:49):
There is not a urge to smokeanymore, where there was always,
whenever I quit, before therewas, you know, I wanted a
cigarette, and nowadays it neverenters my mind. Chewing never
enters my mind. It was, youknow, I think that's the only
(24:09):
way you can quit chewing.
Chewing is very bad.
Erin Brinker (24:14):
Oh, see, I had no idea. I've only known a handful
of people who chewed, but I knowthey loved it when they did.
Phillip Crawford (24:21):
Oh yeah, it was, it was very difficult. I
could never quit that. I triedand I was unable to, but Dr HSU
was able to fix it.
Erin Brinker (24:32):
Thank you. Dr Hsu, a miracle worker in many ways.
He is so dr Hsu, talk about, youknow, some of the other patients
that you've had that have kindof gone through the same thing.
Are they pretty much all smokersor consumers of tobacco
products?
Dr. Jeffrey Hsu (24:48):
I would say, in my experience, most of them,
however, there, there are ahandful of patients I've seen
over the years where they have.
Smoked, and it is from another,you know, issue probably having
to do with some genetic factor.
(25:09):
So, you know, we do know thatthese aneurysms do occur in
certain populations more thanothers. So for instance, it does
affect men more than women,about three, three or four times
more in men than than women, andit that some of the other risk
(25:31):
factors that haven't mentionedyet are also those folks with a
condition called COPD, which ischronic obstructive pulmonary
disease. You may have heardpeople smokers get this often as
well, but it has to do with abreakdown of the lung tissue
causing it to be very difficultto breathe. It's similar to the
(25:54):
aneurysm problem, because it hasto do with the elasticity of the
tissues. And so there is arelationship between that
condition and aortic aneurysmaldisease. So it's, it's, it also
affects certain ethnic groupsmore than others. It is, is more
(26:15):
common in the white Caucasianpopulation than others, and it,
as mentioned, affects men, youknow, over the age of 55 that
is, that is really the, the thepopulation who is most at risk
(26:36):
from having aneurysmal disease.
Erin Brinker (26:39):
So are we seeing the numbers? Because the number
of people who smoke has gonedown. I mean, for a lot of
efforts, you know, the way that,especially in California, how
much cigarettes and tobaccoproducts are taxed, how much,
you know, there's the all thepeer pressure not to smoke.
Although I'm seeing smoking morein in movies and on television
shows, I'll see the cool personwalking around with a cigarette
(27:01):
more than I used to. How are we?
Are we? Are you seeing morefewer people who smoke, and
therefore fewer people coming inwith this condition?
Dr. Jeffrey Hsu (27:11):
Yeah, I, I can't. I actually can't say
that. I've seen more or or less.
I mean, pretty much all mypatients are smokers, you know,
just, I think, by selfselection, just, you know,
having vascular issues. So Ihaven't been able to notice
(27:31):
whether or not there's some moregeneral trend, you know, towards
more smoking or not. Yeah, butit is definitely something that
is I definitely counsel all mypatients on it, whatever
problem, whatever vascular issuethey may have. One of the first
things I tell them is to stopsmoking.
Erin Brinker (27:56):
And Kaiser has resources for that right to help
people stop smoking.
Dr. Jeffrey Hsu (28:00):
Absolutely, absolutely. We have educational
resources treatments. We have avariety of resources at Kaiser
that patients may contact theirprimary care doctors and and,
you know, enter into certainprograms and things like that.
Erin Brinker (28:20):
So, so Philip, are you doing any if the answer is,
no, that's perfectly fine. Areyou doing any outreach to youth
to tell them about the dangersof smoking? Is it something that
you'd ever thought about doing?
You know, I are you screaming itfrom the rooftops? What this
actually is, like,
Phillip Crawford (28:38):
I have not done anything like that. Like I
said, my the last two years ofmy life have been very
stressful, I imagine. But, youknow, there's I, I live my life.
I'm good,
Erin Brinker (28:53):
that's awesome, and you're still here, which is
Phillip Crawford (28:58):
the best part about it, you know. And I think
I'm reasonably healthy, I'm 50pounds lighter, but yes,
Erin Brinker (29:05):
did anybody tell you that if there's an easier
way to lose weight? Oh, my God,I wish
Dr. Jeffrey Hsu (29:15):
I made the comment on sure issue here. You
know it's not uncommon forpeople who go through this
ordeal to have PTSD or to havesome psychological issues
following it, it is pretty awell known, documented problem,
(29:40):
and I think it really is like,as you mentioned before, it's a
shock to your system, it's ashock to your mind, it's also
and it's obviously a shock toyour body, but it's one of the
most unimaginable things that Ithink a person can. Undergo in
(30:00):
their lives. If you can imagine,you're just sort of living your
life one minute and the nextminute, you're being told by
people that you have never metbefore that you don't know in a
place that you probably haven'tbeen in, that this may be the
(30:21):
end, and, you know, it's, it's asudden thing, it all happens
within minutes. I don't thinkthat's a kind of a normal
experience, no, and that, yeah,that definitely would have a
psychological impact. So it'ssomething that we surgeons do
(30:42):
know about. And you know, we,we, we have seen it in our
patients over the years, and inMr. Crawford's case, you know, I
just wish him the best, and justhaving, you know, to fulfill his
his dreams, you know, havinggotten over this now and that,
(31:06):
that he can go on and have awonderful life.
Erin Brinker (31:10):
Yeah, they came into that.
Phillip Crawford (31:12):
They it's pretty much normal, with the
exception of my eating nowadays.
But I mean, as far as what I'mable to do and how I'm able to
live I'm I travel. I went on aworld cruise after the surgery,
I think I left in January. Heoperated on me in October, and I
(31:36):
was on a world cruise inJanuary. So Wow. Well, it's my
wife trying to seize the day.
You know, every day she's like,you know, we're gonna live life
while we're living but the posttraumatic that all happened that
(31:59):
day, whenever they asked to seemy sutures, and that was the
worst day
Erin Brinker (32:04):
it would have to be. I mean, I think my worst
day, yeah, I mean, it was, itwas it would have to be, because
this come to this realizationthat all of these things had
had, you know, this, you thatyou've been through this hell,
and then then you realize, oh, Ihave pain, and I'm in a
hospital, and people have beenhere, and I almost died, and all
of those things that, as itstarts to sink in, that that has
(32:27):
to be traumatic,
Phillip Crawford (32:29):
they, you know, the whole dying part I
didn't learn about until I cameout of the coma. I, like I said,
I pretty much know nothing ofother than arriving to the
hospital and waiting for thedoctors to see me and then
waking up one day, you know,three weeks later, I think it
(32:50):
was 20 days, to be exact, Idon't know, wow, wow. I don't
dwell on it. Try not to talkabout it.
Erin Brinker (32:58):
Sure, sure. And you can't, right? Because nobody
wants to live that way. But itis, you know, you've been
through, you've been through alot, and clearly you wanted to
to be successful in comingthrough it, or you wouldn't be
here. I mean, clearly you foughtfor your life, even if you was
subconsciously, you fought foryour life. And so all of you
(33:18):
were fighting together, right?
Phillip Crawford (33:20):
It right the fight. I mean, it's that's what
I see in people who, who don'tlead the life that I live, is
like they give up, and I justnever gave up. I still haven't
given
Erin Brinker (33:38):
up. You have a lot to fight for.
Phillip Crawford (33:41):
There's a lot of people who need me, I guess
so.
Erin Brinker (33:44):
What are your goals for the next 10 years?
What do you want out of lifenow?
Phillip Crawford (33:49):
I want to be a scratch golfer. Are you still
golf? I golf twice a week. I hitballs twice a week. I I want to
be the best father that I can beto my children and my
grandchildren, and that's what Iwant. I think that sounds
fantastic. Sometimes, you know,I get a little down and grumpy,
(34:13):
but
Erin Brinker (34:15):
that's because you're human. Yeah,
Phillip Crawford (34:20):
I think I even got doc grumpy with Dr shoe one
day. Sorry. Dr shoe,
Dr. Jeffrey Hsu (34:29):
no, it was all part of the it was all it was
all good. Mr. Crawford, it wasnot an issue. All right,
Erin Brinker (34:37):
so, Dr shoe, let's talk about some other vascular
issues that people should belooking out for. And you
brought, brought up, you know,the the COPD, but people also
get, you know, they get plaquebuildup in their arteries, which
you also talked about, I knowsomebody in my family had to
have, they had pretty much 90.
Percent occlusion in theircarotid artery, and their
(35:01):
vascular surgeon went out, wentin and took a piece of it out,
where the where the plaque was,and so the other two pieces
together, which is absolutelymiraculous that happened in
Houston. And you know, couldkind of talk about other things
that a vascular surgeon does,and where the industry is going,
or where that specialty isgoing,
Dr. Jeffrey Hsu (35:21):
sure, sure, vascular surgery is a specialty
that has basically been heresince the people started first
doing surgery, but it reallycame into its own specialty, so
to speak, in I would say, thelate 70s, early 80s, and started
(35:44):
being recognized, as you know,its own specialty. There have
been so many advances invascular surgery with
technologies over the years. Themajor one happening in the late
80s, early 90s, where we startedinstead of doing a lot of open
(36:09):
surgeries, we started doingthings called endovascular
procedures that had to do withgetting inside of the arteries
instead of having to open themup and getting inside and place
things like stents and balloons.
And so that was a hugerevolution that that occurred
(36:29):
and changed the entirespecialty. The specialty
continues to grow. I estimatethere's probably around 3500 to
4500 vascular surgeons in theUnited States. And there is, I
think, a shortage, and there's aneed for more vascular surgeons
(36:51):
in many areas of our country, sothat when things like this
happen with Mr. Crawford, thatthere can be a vascular surgeon
available to perform these typeof procedures. But I see, I I
see the specialty as a growingspecialty, and one that is also
(37:15):
affected greatly bytechnological advances.
Erin Brinker (37:24):
So when you were in medical school, did vascular
surgery always interest you? Ordid you just kind of fall into
it and realize, Oh, I reallywant to do this. How did you
make that decision?
Dr. Jeffrey Hsu (37:35):
Yes, that's a there's a story there. The the
specialty of vascular surgery ispretty specialized, so
oftentimes it's not evenintroduced at the medical school
level. Oh, there could besituations where a medical
(37:58):
student could get through anentire medical school education
and have never even heard aboutor experienced working with
vascular surgeons. That isbecause we are a sub specialty
of a, you know, another broaderspecialty, specialty of surgery.
(38:19):
So the way I the way, the way ithappened for me was that I had a
general interest in surgery, andso I started my career going
into a sort of a, what we call ageneral surgery training
program. And while you're inthat program, you get exposed to
(38:43):
many different sub specialtiesof surgery. And in my case, what
happened was I, I found vascularsurgery to be very natural, very
interesting. I had good mentors.
I was, I was very much that thathas a lot to do with it when you
(39:03):
have mentors that guide you intoa direction. That is essentially
what happened to me. So I kindof found, you know, that during
my training years and went offin that direction.
Erin Brinker (39:22):
So I, I picture vascular surgeons working with
technology. So you're not inthere with your hands repairing
that. You're using machines, or,you know, technology, to do the
repairs on those on the veinsand the arteries. Is that
correct? And what, what isactually the nuts and bolts. How
does it look?
Dr. Jeffrey Hsu (39:43):
Yeah, I'm sorry, Erin, I because there was
an incoming call. I missed thefront part of that.
Erin Brinker (39:50):
So I picture that you that when you're doing
vascular surgery, that you'reactually operating a machine
that's doing the surgery foryou. And I don't know what they
call those machines, but youknow it. Instead of you
stitching up the the artery orthe vein you're having, you're
working through a machine that'sstitching up the artery or the
vein or there, you know, youtalked about, you know, not
being invasive, like trying tofind a way into the arteries and
(40:11):
veins. What does the actual nutsand bolts look like?
Dr. Jeffrey Hsu (40:14):
Yeah, so I think you are describing what we
call robotic surgery, which isnot made majoring roads into
vascular surgery just yet,although it may be something
that we do more of in thefuture, what we do as vascular
surgeons are we use things likeX ray machines to help guide
(40:39):
instruments and things throughthe body, but we are still the
ones actually manipulating theinstruments. So, so we haven't
really, you know, made a lot ofuse of robots, but that's just
now. I mean, I do think that'sgoing to change in the future,
(41:00):
but the but the typical scenarionow would be the vascular
surgeon would be present anddoing the ethical surgeries in
the operating room, some someoperations that we do require X
ray machines and and we don'thave to make large incisions.
(41:24):
And these are procedures wherewe're putting stents in, we're
putting things on the inside ofthe arteries, and we're having,
we're basically not having toopen the body to expose these
vessels. Mr. Crawford's case, itwas not possible.
Erin Brinker (41:48):
The body opened itself, unfortunately, on the
inside, unfortunately,
Phillip Crawford (41:51):
yeah, that was all done by hand, the way, I
understand it for nine and ahalf hours.
Dr. Jeffrey Hsu (41:57):
That's right.
In Mr. Crawford's case, we didit the old fashioned way
possible. We basically had toget get in there. We had to open
everything up and moveeverything over in order to get
through to the area.
Erin Brinker (42:16):
So if you were talking to somebody who is
interested in becoming asurgeon, and telling them about
your specialty, what part of itthat is the part that you love
the most? Dr Hsu.
Dr. Jeffrey Hsu (42:26):
I, for me, personally, vascular surgery is
is elegant, and there's a beautyto it that I think you need to I
think you it takes a while toappreciate, but it's it's it has
to do with how delicate thesurgery is and and the fine work
(42:52):
that needs to be done to be ableto put things back together in
their right place. So I thinkthat's what drew me to the
specialty, was the technicalchallenge, and also the fact
that it was a way of it was away that I thought I could use
(43:14):
my skills to help people, andthat, you know, there could be
some benefit, all right, fromthis craft, so to speak, you
know, to allow people to havebetter lives and better quality
of life as well. At the sametime, it was a, it was a, it was
(43:35):
like a manual craft orinteresting craft that I had to
also work on and perfect aswell, so that that's really the
that the the the attraction ofthe specialty for me. But you
know, at the end of the day, itreally, you know, whatever
(43:56):
specialty anybody chooses. Youknow, in medicine, at the end of
the day. I believe strongly thatthe rewards come from how our
patients do and and that incases like this, where, you
know, we were able to besuccessful with, you know, Mr.
(44:17):
Crawford, I mean this, this is,this is the reason why we this
is the reason why I went intoit.
Erin Brinker (44:24):
I'm so glad you did. So glad, you know, and I
think about, you know, had Mr.
Crawford, had Philip lived in,you know, rural anywhere, even
out at our rural deserts, andthis had happened, he may not
because of the access to avascular surgeon, he may not
have been here. And so beingable to attract more people into
(44:45):
the field is criticallyimportant.
Dr. Jeffrey Hsu (44:50):
It is, and that is a ongoing issue with our
healthcare system, is being ableto provide the access. Us into
some of the harder to reachareas, you know, of our country,
and that is a that is a hugechallenge. Yeah, right,
Phillip Crawford (45:14):
right now I'm in northern Minnesota, and I I'm
glad it didn't happen here?
Erin Brinker (45:21):
Yeah. First of all, How cold is it up there
right now?
Phillip Crawford (45:25):
Oh, right now.
It's not bad. I think it's like,it's probably 20 degrees, but,
oh yeah, that's not bad. No, thecold thing is over New York and
all those people right now. Butnow the the health care
available up here is minimal atbest. I mean, the the place I'm
at right now, if I had aproblem, I'm in trouble there.
(45:48):
There's not even a stoplight inthe town I'm in. Oh, wow, right,
so
Erin Brinker (45:58):
you're being airlifted to to Minneapolis.
Well, I'm sure the Mayo Clinicprobably has a vascular surgeon,
but it doesn't sound like that'sanywhere near you.
Phillip Crawford (46:09):
I'm seeking out Dr shoe. That's what I'm
doing.
Erin Brinker (46:14):
Well, that's fantastic. So, so as we you
know, kind of close up, youknow, what are, what are, where
can people get resources forvascular health education, learn
more about their vascular healthand and give people the power to
be proactive about taking careof themselves. And this is a
(46:35):
question for Dr shoe, yeah.
Sorry, no, it's okay.
Dr. Jeffrey Hsu (46:40):
Yeah, education is definitely, I think, much
needed for this condition andvascular conditions in general.
I would, I would recommend, foranyone interested, they can go
to our society website. It isvascular.org just basically, you
(47:04):
know, that's it. It's verysimple, vascular.org which is
the home website for our mainsociety. It's called the Society
for Vascular surgery, and thereare a number of wonderful
educational information therethat you can find in various
(47:29):
conditions, and also help find avascular surgeon in your area.
So that would be kind of thegreat place to start. And you
know, there's also a lot ofmaterial that can be found on
(47:51):
online, but I would be carefulwith that. I would go to this
website as a kind of a startingpoint.
Erin Brinker (48:04):
Dr Google's probably not the best source of
information,
Dr. Jeffrey Hsu (48:09):
is it? I think that you would get a mix of
everything in there.
Erin Brinker (48:17):
Dr Google's probably better than Dr Tiktok,
though. I'm just saying.
Phillip Crawford (48:24):
I can tell you that I never use
Erin Brinker (48:26):
that. Oh, that's good.
Phillip Crawford (48:28):
I never go to Google for what happens to me.
Erin Brinker (48:32):
That's good. And you're still here as a testament
to that being a good decision.
So I, I'm, I'm in awe of yourstory, and I would love to you
know both have both you, Philipand Shelly, on the show to talk
about the hope side of it. Thisis, you know, this, this. The
show is called the hope table,and what we're trying to do is
(48:55):
give people a reason to just tofeel hopeful and to engage with
positive stories. And we weren'table to get Shelly on the air
today, but I suspect she's got alot to say that people could
really relate to. It's reallyhard to watch. It's hard to go
through it. It's also hard towatch it happen to somebody
who's the most important personin your life. And I'm interested
(49:15):
in hearing She sounds like astrong, amazing woman, and I'm
interested in hearing her storyas well, and hopefully we can
get that scheduled. Dr, Hsu,you. I'm in awe of your skills,
and I'm so grateful for youjoining us today and that you
were able to say and really inlike you said, basically 75% of
(49:36):
the people do not make itthrough and so Philip, you are a
miracle, and it's been a treatto have you all on the show
today. Thank you.
Phillip Crawford (49:51):
Thank you.
Thank you, Dr shoe foreverything.
Dr. Jeffrey Hsu (49:56):
Thank you, Mr.
Crocker for fighting us.
Erin Brinker (50:07):
We just heard from a surgeon and a survivor, two
people who have seen the literaledge of life. And if you're like
me, listening to a story aboutan aortic dissection can leave
you feeling a bit well, fragile.
It reminds us that we'reessentially held together by
these incredible pulsatinghighways of blood. But I want to
spend these last few minuteslooking at the light at the end
(50:28):
of the tunnel. You know, in themedical world, they often talk
about survival rates, but in thehuman world, we talk about
survival stories. And this onewas a good one. There's a
concept called Post TraumaticGrowth, the idea that after a
life altering medical event,something shifts. It's not just
about getting back to normal,it's about finding a new normal
(50:51):
that is actually deeper andricher than before. I've seen
survivors who, after a vascularscare, finally quit the job they
hated, or finally said I loveyou to a sibling they hadn't
spoken to in years, or anotherfamily member, there's something
incredibly hopeful about thefact that our hearts, physically
and metaphorically, have thiscapacity to heal and expand
(51:13):
after they've been under immensepressure. And let's talk about
the hope sitting in theoperating room if you had an
aortic event 30 years ago, theoutlook was, well, frankly,
terrifying, and we kind oftalked about that a little bit
today. It meant Massive Opensurgeries and months of
recovery. Now, this was becausethe dissection had happened, and
(51:39):
it was a big one. And as Dr Xutalked about, this was a good
old fashioned surgery, but withmodern techniques. But it's
still far, far, far better thanit was 30 years ago. We're
living in a golden age ofvascular medicine. We are now in
the era of endovascular repair.
(52:02):
So he talked about tinyincisions. Think about that
surgeons can now go through atiny Nick in the skin, sometimes
just in the fold of the leg, andthread a life saving stent all
the way up to the heart. It'slike high tech plumbing
performed with the precision ofa jewel jeweler. And one of the
things I asked, you know, Italked about with Dr Hsu, is
that I have a family member whohad carotid artery surgery where
(52:26):
there was an occlusion, therewas plaque buildup in the
carotid artery, and the surgeonjust went in there and clipped
the part that had the plaquebuildup, took it out and sewed
the pieces together so that, youKnow, the no longer had that
occlusion, which just sent allso much more blood into the
brain, and it was just much,much better. But the recovery
(52:47):
there was still it wasinteresting, because he kind of
changed as a person. Whensomething that major happens, it
kind of changed in a very goodway. It changed as a person.
We're seeing the rise of AIdriven diagnostics. AI is
everywhere, right? So there arenow programs that can scan a
routine CT, scan and flag a tinybulge in an artery before the
(53:09):
patient even feels a symptom.
And as Dr HSU said, the symptomsoften don't show up until
they're at a critical stage. Weare moving from a world where we
where we react to emergencies,to a world where we intercept
them. That means more birthdays,more graduations and more quiet
Sunday mornings for people who adecade ago, might not have made
it, and that is a miracle ofhuman ingenuity. And as we close
(53:33):
out today, I want to leave youwith a thought, vascular health
is often called a silentjourney. We don't feel our
cholesterol, we don't alwaysfeel our blood pressure, but
that silence is an invitation tolisten. And I would add kidney
disease. I would add because wedon't necessarily feel that.
(53:55):
Don't feel we may have somegeneral malaise, like we do with
when our blood sugar isconsistently high, but the
damage it does to your body overtime, we're starting we
understand that better, not thatwe're starting to. We do
understand that better than weever have before. We talked
about smoking with this in thisconversation with both Philip
and Dr Shu and use of anytobacco products, including what
(54:20):
they call dip, which is thechewing tobacco, and it slowly
but surely wears away at ourvascular health. Taking care of
your vascular health is not justabout not dying. It's about
living well. It's about havingthe stand up stamina to walk
your dog, the breath to singalong to the radio and the years
to see your grandkids grow up.
(54:44):
If today's show moved you, well,don't let it end there. Call
your parents. Call your parents,even if it just showed just
moved you a little bit. Callyour parents. Tell them that you
love them. Ask them about thefamily medical history. Go for
that 20 minute walk to see.
Evening, take your dog out. Imean, people are walking cats
now, so maybe take your cat out,not because you have to, because
(55:05):
your body is this incredible,complex machine that deserves to
be moved. And I'm going to addsomething in there too, if you
have a job that you hate forwhatever reason and you think
you can't stay there muchlonger, make a plan for your
exit. Maybe it's finding anotherjob, maybe it's starting a
(55:25):
business, maybe it's retiring.
Maybe, you know, it could be alot of things, but if you're in
a place, maybe it's not yourjob, maybe it's place where you
go to church, maybe it's avolunteer where you're just
miserable. First figure out whyyou're miserable, and if you
think that you need to go foryour mental health, make the
(55:47):
leap. You owe it to yourself. Dothat thing. Make the Leap. Life
is thin, meaning the vascularthe walls of your vascular
system, but it's also remarkablytough. So thank you to our
guests today for reminding usthat even when the main pipe
breaks, there's a way back tothe light. I'm Erin Brinker, and
(56:10):
this has been the hope table.
Stay healthy, stay hopeful. Letme say, like I did last week, I
love you. I'm glad you're here.
You're important to me, and I'lltalk to you next time you.
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