Paul Saladino· MD
there's very clearly a pressure turbulence damage you're interesting I sometimes like an ideal whitewater almost a roaring there so the whitewater river is your arteries and when you get to the veins it's more like you know when you're reaching the plains before the before there see where you know the rivers are winding and meandering and going very slowly well obviously you things that are only the endothelium is under massively like stress and therefore if you don't have that level of stress it doesn't matter what else you do you ain't you ain't gonna get flanks developing because the endothelium just goes well you know there might be smoking there might be there might be high blood sugar level but frankly I don't care because there's not much going on around here and I'm not going to fall off and gets tripped up under this kind of pressure