I am still not used to the long hours Monday-Friday, perhaps wearing compression stockings will help. I would like a masseur hopefully my mentor can hire one. As I am observing all kinds of vascular studies, and learning the new equipment that is being used here at the vascular lab, a case that stood out was a patient who was getting a carotid exam. I noticed that their right vertebral artery had a to-and-fro waveform or retrograde flow. When that situation arises you automatically should scan the brachiocephalic or innominate artery to check for stenosis. The diagnosis for this patient is subclavian steal syndrome (SSS). It is narrowing or occlusion of the subclavian artery. Off to watch the Real HouseWives of Beverly Hills...hasta mañana!