Also something that shouldn't be missed, and this is in people, if you've had your carotid arteries operated on, you've had your heart bypass, Ooh, you've had vessel bypasses in your legs. In other words, you have what we call arterial disease, arterial insufficiency. And this comes in patients who high blood pressure, high lipids, and diabetics, and smokers. And if you have the sudden onset of terrible back pain, you need to be seen in an emergency room. And the reason is there's something called a dissecting abdominal aortic aneurysm. It's where the pipe, the aorta, which carries the blood from your heart down to your legs and it's a big pipe, gets sort of rusted, rotted, not so good. And what the body lays down around it isn't anywhere near as good as the original muscular wall. And it starts getting big. And then what happens is the blood flow creates a false lumen through it. And that's called the dissection. It's a funny medical term, but that dissection can oftentimes be very painful and people will sometimes ignore it. But for the most part is going to present, and this isn't my field, but for the most part, it's going to present in patients who already have known vascular disease and things aren't coming just out of the sky and totally unbeknownst. So if you've had those other conditions and you have this terrible pain that starts in your back, ooh that's a visit to the ER too, to make sure that you don't have an abdominal aortic aneurysm that's getting bigger.
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