This is Healthy Takeout, a podcast from Harrington HealthCare System. I'm Amanda Wilde. Dr. Stevenson, great to have you here. Thank you for your time.

Margo Stevenson, DO: Thanks so much for having me today.

Host: Can you explain what seasonal allergies are and how they differ from other types of allergies?

Margo Stevenson, DO: Sure. So when we think about seasonal allergies, it's when the body's immune system is recognizing and overreacts to something in the environment. Typically that causes no problems in most people. And a good way to kind of divide that up is looking at seasonal allergies. And those are ones that occur in the spring, summer, and early fall, usually related to pollens from trees, grass, and weeds, versus all year allergens, and that we also call perennial allergens. And those can be things like dust mites, or cat and dog hair, cockroaches, and mold.

Host: You mentioned some common triggers for seasonal allergies. Do they vary by region?

Margo Stevenson, DO: Yeah, absolutely. So right now, as we're talking, it's March in New England, and this is the big time where the tree pollen starts coming out. So this week, for example, we had juniper pollen come out and in other parts of the country, like the South, those pollens come out sooner.

Host: Well, if our immune system is responding or over responding to this pollen in the air, what symptoms should we watch out for?

Margo Stevenson, DO: So that would be most commonly runny nose, also itchy eyes, lots of sneezing, kind of a feeling of nasal blockage or congestion. And then a tricky one that people don't think about sometimes is actually fatigue or tiredness and that's because when your nose is all blocked up it makes it hard to sleep well at night.

Host: So it's always related. And with that in mind, how do we distinguish between seasonal allergies and other respiratory conditions like the common cold or COVID-19?

Margo Stevenson, DO: When you look at seasonal allergies, they tend to occur at the same time every year. So it takes a few years when you're young to get sensitized. And then after that, you notice, for example, if you're allergic to ragweed, every August, you seem to have itchy eyes and a runny nose. So looking at the seasonality of it. And then typically, even though it's called hay fever, seasonal allergies don't usually present with a fever. And so that's one thing you can use to differentiate it from COVID-19 or a common cold.

Host: Now, I want to talk about what you do in terms of treatment. But first, are seasonal allergies curable or preventable, or is treatment primarily focused on managing symptoms?

Margo Stevenson, DO: So when we think of mild allergies, for example, somebody just has some minor nasal congestion and sneezing, we can treat those. Sort of mask the symptoms using over the counter medications such as oral antihistamines. But when somebody has moderate to severe seasonal allergies, causing them to miss school, miss work, just they can't tolerate the medication, we do have something that's called allergy injections or allergy shots that we can use to help patients.

Host: So tell me more, as an Allergy and Immunology Specialist, how you treat patients who come in to see you.

Margo Stevenson, DO: The first thing that we do is we do allergy testing because the more information we have about what you're allergic to, the easier it is to treat. And so a patient would come into my office and the first thing we do is skin testing on the back with some sharp toothpicks, looking at over 40 allergens.

And we look at all the ones we had mentioned before. We look at different trees, grass, weeds, mold, different fuzzy animals like cats, dogs, and rabbits. And we see if the pricks on the back kind of look like little bug bites. And that tells us what allergens that that patient has. And from there we can develop a plan.

So it is important to say, you know, I have all year allergens such as dust plus seasonal allergies. And I've failed a lot of over the counter medications. And at that point, we would consider allergy shots.

Host: So yeah, what do these treatment plans tend to include, medications, shots? What about lifestyle changes to combat seasonal allergies.

Margo Stevenson, DO: One of the first steps you can do, for a lifestyle change would be avoidance of allergens, which is really tricky to do. And so for a tree pollen, that's keeping our windows shut in the spring. If you're outside, you know, children with like play clothes or adults with gardening clothes, you want to change your clothes and shoes when you come inside and take a shower, wash your hands.

When it's our all year allergens like dust mites, so dust mites, they live in our mattress and pillow. We want to cover our mattress and pillow with waterproof covers that kind of locks in the dust mites.

Host: So this in a way it doesn't cure the allergy, but prevent it from acting up.

Margo Stevenson, DO: Yeah, they can certainly decrease it. So when we talk about those interventions and medications, like the oral antihistamines or nasal sprays; those are decreasing or masking the symptoms. Whereas when we do the allergy shots or the allergen immunotherapy, that's more, changing your immune system over a long period of time. It takes three to five years to become less allergic.

Host: So do you have to make a commitment to that therapy for that period of time?

Margo Stevenson, DO: Yes. And so what it is, is you come in, it's a weekly injection to what you're allergic to in small doses over time, specifically around 23 to 30 weeks for weekly, and then it goes monthly after that for 3 to 5 years.

Host: And what have you seen in terms of success with this method and how do you know what's working?

Margo Stevenson, DO: So overall patients will have around an 80 percent decrease in symptoms. So that would be like decrease in nasal congestion and sneezing. Overall using less medications, which is one of the goals. So say before they used to use nasal sprays and oral allergy pills, they're using less, they're missing less days of work or school.

And then a lot of patients that have allergies also have other allergic conditions like asthma. So I'd be looking for their asthma to also be better controlled while they're on allergy shots.

Host: Does that mean everyone can benefit from these allergy shots?

Margo Stevenson, DO: So there is no age limitation on the allergy shots. Typically the youngest patients I have are age four or five, all the way up into the nineties. And I've seen a benefit in all ages from allergy injections.

Host: We've touched on children just a little bit during our interview, and I'm wondering if seasonal allergies impact children differently than adults. Are there any unique considerations for managing allergies for kids?

Margo Stevenson, DO: The little guys, they have to live through a couple seasons. So we typically don't see the seasonal allergies in them until around age two, three, four, or five, and they don't like to blow their nose. So they tend to do kind of a repetitive choking and snorting.

So they present definitely less nasal blowing, less sneezing, and more of a snorting. So it's hard to tell that they have allergies. And in general, kids complain less than adults do. So a lot of children with allergies go unnoticed.

Host: That kind of leads to my next question, which is, what is the most common misconception you run into about seasonal allergies?

Margo Stevenson, DO: I think that they're limited to seasonal. So a lot of people that have seasonal allergies also have the all year allergens, like the dust and the cat and the mold, in addition to something else that we call non-allergic triggers. And that would be smoke, and perfumes, change in temperature, change in humidity.

So a lot of times it's not always as simple as somebody's just allergic to ragweed. It's kind of mixed into this picture of seasonal, all year, and non-allergic.

Host: So, a bunch of overlapping things that you sort of have to sort out with your doctor?

Margo Stevenson, DO: Testing really helps with that.

Host: Can you share some practical tips for managing our environment in regards to seasonal allergies, I mean, you did mention some things earlier inside the home. Also, when we're outdoors, are there ways to keep symptoms in check?

Margo Stevenson, DO: One thing to do would be wear sunglasses. That actually does keep some of the pollen out of your eyes. And then exercising, you want to exercise before sunrise and after sunset because the pollen comes out in the early morning and the evening.

Host: That's great. Dr. Stevenson, thank you so much for sharing some really helpful information and strategies on how to deal with seasonal allergies.

Margo Stevenson, DO: No problem. Thanks so much for having me.

Host: That was Allergy and Immunology Specialist, Dr. Margo Stevenson. For more information, visit harringtonhospital.org/allergy or call 774-452-7200. If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you.

I'm Amanda Wilde. We'll talk again next time on Healthy Takeout, a podcast from Harrington HealthCare System.

This is Healthy Takeout, a podcast from Harrington HealthCare System. Thanks for joining us. I'm Joey Wahler. Well, I know you prefer to be called Dr. Stan, so I'll say hi, Dr. Stan. Thanks for joining us.

Stanley Swierzewski, MD: Hey, it's my pleasure. I'm looking forward to this.

Host: Same here. So first, what are the signs that a man is suffering either from BPH, as it's sometimes known, or urinary incontinence.

Stanley Swierzewski, MD: Well, urinary incontinence is easy because you're actually leaking urine and wetting your pants. So, that's pretty straightforward as far as realizing there's an issue. As far as enlarged prostate, that has to do with frequency of urination, urge to the bathroom. The fact that you know where every bathroom is in a 10-mile radius around your house is a good tip-off. If you get up at night or if you have a slow stream, all those things are most likely related to BPH or benign prostatic hypertrophy of the prostate. On occasion, it may be related to prostate cancer.., but predominantly, it would be benign enlargement, meaning non-cancerous enlargement of the prostate.

Host: But even in its most benign form, am I right, it's an enlarged prostate that can cause incontinence?

Stanley Swierzewski, MD: It can cause urgency and urge incontinence, meaning that you can't get to the bathroom on time. So, incontinence can be broken down into two categories. One would be stress incontinence, where you cough and leak or you have some sort of stress in your pelvis that causes you to leak. Mostly, that's primarily a problem for women. Men can have urge incontinence. Once again, that's just urgency. You can't shut it down. Your basically brain and bladder are not connected anymore and it's going to go whenever it wants to and usually at the most inappropriate time for you. That's caused by BPH.

Host: Gotcha. So, other than that one form of incontinence, if one has an enlarged prostate, what are some of the issues that it brings about?

Stanley Swierzewski, MD: It can lead to socialized isolation if people feel like they have to find a bathroom all the time and that's really an important one to realize. But it's causing a problem with the bladder. So, your bladder has two functions. Your bladder needs to store urine, it needs to empty urine, and it's got to be approximately a 50/50 ratio. If you add an obstruction like a prostate, and if you think about the prostate, it's basically like a donut, and the urine goes through the donut hole. As your prostate enlarges, the donor hole gets smaller and smaller. The bladder has to work harder and harder to push the urine out through that donut hole. So, that's very much like if I started lifting weights from my biceps, and the more resistance I put on, the bigger my biceps get. So, the more resistance that the bladder sees from the prostate, then it becomes thicker. And the thicker it gets, it's not compliant. So, it gets very good at expelling urine, but not so good at storing urine.

So, that's the dilemma. How do we open up the prostate either by drugs or by procedures to allow for the urine to come out easier, which in turn decreases the fibrosis and the muscle layer inside the bladder so after a few months, things get back to normal again? The problem here is it's much like congestive heart failure, which can be caused by hypertension. And basically, your heart stops working. Both of the heart and the bladder are similar muscles, so they both have to pump. And you can get bladder failure as well as heart failure if you're left untreated. So, that's one of the bigger issues in regards to bladder outlet obstruction caused by an enlarged prostate.

Host: Interesting, doc. I've never heard anyone compare the bladder and the heart before.

Stanley Swierzewski, MD: They're simply pumps. Both of them are pumps. The heart has four chambers, the bladder only has one chamber. But when you look into the bladder for somebody that's had a long-standing resistance, you'll find what we call trabeculations, highly thickened muscle fibers, and you'll see what we call cellular formations, which basically are, if you had a bunch of muscles shaped in a ball, the pressure gets high enough that the lining of the bladder gets pushed through the muscle fibers. So, that leads to high-pressure voiding, that leads to backflow on your kidneys, and potentially renal failure over long term. It also means that you're probably not emptying very well, and that can lead to urinary tract infections. So, the only time a man gets a urinary tract infection is going to be with an enlarged prostate. So, that's another tip off that you have an issue. It doesn't have to happen all the time. If it happens one time, you should be aware that you have a prostate issue. Because some people in the ERs and that, when they see this, they don't make the connection. They just tell you to take some antibiotics, you'll be fine, which is true, but there's a bigger issue going on behind the scenes.

Host: Gotcha. So at what age might a man start experiencing an enlarged prostate typically?

Stanley Swierzewski, MD: Every man is different, but typically you're looking at about 50 would be the majority of cases, 50 and beyond. You've seen patients in the low 40s that have had an issue. But generally in the 30s and that, that's not going to be an issue for anybody. Prostates grow at their own speed, at their own pace. But generally speaking, if you live long enough, you will need to be treated for an outlet obstruction due to your prostate.

Host: That being said, is there anything men can do lifestyle-wise to help prevent or at least delay an enlarged prostate from coming about?

Stanley Swierzewski, MD: Lifestyle, there aren't any specific foods. I mean, I guess if you ate a lot of soy, you might have some benefit. Anything that would decrease testosterone, increase estrogens, would be helpful. But generally speaking, I mean, you have all those tablets out there that you can buy online, Prostate Super Beta X, and all these things, most of them have saw palmetto in them. Saw palmetto is a herb, and it was the original thing that we only had to treat enlarged prostate besides surgery. So, a lot of people got that, gosh, 30 years ago. That's been shown through multiple tests that it is not effective at all in helping people.

The natural course to enlargement of the prostate is it's cyclic. So, you go through lows and highs. So, sometimes your symptoms are going to be crazy bad, then they're going to get better. And so, you get lulled into this idea that, "Okay. Well, something must have been happening. Maybe I ate something wrong or something, and everything got bad. Now, it's all better. I'm feeling pretty good." Then, it's going to happen again. You're going to go back into that upswing where you're going to have more symptoms. So when you take these pills that are shown on TV and on the internet, what generally happens is that they may provide a small amount of benefit by increasing your estrogens, which you don't necessarily want to do cause that's going to also lead to issues with ED. But do you usually take advantage of the fact that this is a cyclic disease? So if you start them and all of a sudden you're on the downswing from having a problem, you think this is the greatest pill ever. Everything went fine. Then, you're sort of locked on to the fact that, "Well, it's getting a little bit worse, but I'll keep taking these pills. Oh, they got better again." So, there really isn't a good non-pharmacological agent to treat enlargement of the prostate.

Host: Understood. And then, getting back to incontinence for a moment. So, besides enlarged prostate, what are some of the other common causes of having urinary issues?

Stanley Swierzewski, MD: That's a broad question. You can have urinary tract infections, you can have urgency, frequency. We talked about urge incontinence. You can have retention, which means that you actually have to go to the ER or to a doctor's office to have a catheter put in because you can't void any longer. Those would be the main ones that I would think of for that question.

Host: Okay. And so, with an enlarged prostate, what are the most commonly used treatment options?

Stanley Swierzewski, MD: Well, the gold standard is what's called a TURP or a transurethral resection of the prostate. But that is a very bloody operation and that's been refined over the years. So, there are multiple modalities available. I've done pretty much all of them. But right now, main focus would probably be what's called UroLift. That's where you actually use a stapler, if you will, if the patient's asleep. You look in with a telescope. The telescope is actually a stapler and it staples back the prostate tissue. That's been around for approximately 10 years now. Using it on the right size prostate, the right anatomy, it works very well. It also doesn't cause what's called retrograde ejaculation. When you open up the prostate, you have to realize that when you ejaculate, the prostate also has to close to force the semen out through the tip of your penis. Some of the procedures that are done, that mechanism doesn't work very well after the procedure, so you can have what's called retrograde ejaculation. You ejaculate, the semen goes into your bladder, which is not a problem unless you're trying to have kids, but it doesn't come out the tip of your penis. It doesn't change your erections, and it doesn't change your orgasm, but it's concerning for some men when that happens to them. That's one option.

Another option is steam. It's called Rezūm. Basically, you puncture the prostate with a needle, and you send steam directly into the prostate to try to necrose it. That's available. I don't personally think that's a great option, and I don't offer it to my patients.

The other option is called Aquablation. And if you want to think about that, it's basically using a pressure washer, watch under an ultrasound through a robot. And basically, using that pressurized fluid, it removes the tissue, and that takes approximately 10 minutes to do. And then, some patients go home, some patients stay overnight just to make sure that there's no bleeding. That's very effective, especially for people that have large prostates. You can see prostates the size of a golf ball, all the way up to a large grapefruit. So when you get to those larger sizes, Aquablation is a great procedure.

You also can use lasers. There's green light lasers, there's diode lasers, all have their advantages and disadvantages. But they basically vaporize the tissue and it's gone, which is nice because, as opposed to Rezūm, which is steam-based, which continues to have prostate tissue until necrosis with a laser, you actually get rid of the tissue, so you don't have that waiting period for everything to get better.

Those are primarily the ones that we use. The TURP, as I mentioned, is electrosurgical. And those are pretty much it.

Host: And so generally speaking, with regard to those treatments for enlarged prostate, what would you say about what patients can expect result-wise? Does it significantly improve it? Because it doesn't actually cure it or completely remove the issue, right?

Stanley Swierzewski, MD: Once again, depending on which one you use, some of them completely remove the issue. Most of them do. Definitely improvement. We have a scoring system that looks at how much urgency, frequency and nocturia as you rate the patients ahead of time and then after their treatments. And you can get a 50 to 60% improvement and patients that have that improvement are ecstatic because, especially if you use something called the Urolift, they're in and out of the hospital the same day. It takes 15 minutes to do the procedure. They don't necessarily have to have a catheter when they go home. And they notice a significant improvement where they've gone from five or six times getting up at night, maybe to one time at night, maybe to no times at night; having no urgency and frequency and no incontinence. So, it makes a huge difference in lifestyle for men and ability to do social things.

Host: Okay. Great. And then getting back for a moment to incontinence, in terms of treatment there, I suppose it depends largely on what the cause is.

Stanley Swierzewski, MD: But in a male, I mean, if you had a radical prostatectomy for prostate cancer, there's a high chance that you're going to have what's called stress urinary incontinence. That can be treated by a few different methods. There's what's called a sling procedure, where you actually put a piece of surgical mesh in that tightens up the bladder neck so that it doesn't leak so much. There's also something called an artificial sphincter, which is also an implantable device, which has a cuff on it and the cuff actually goes around the urethra and fills with water and clamps off the urethra so that you don't leak. And then when you want to urinate, there's a little pump in your scrotum and you push on that and that allows you to void and then it tightens back up again and keeps you continent. Those would be the primary ones for stress urinary incontinence.

Host: Gotcha. Well, folks, we trust you're now more familiar with enlarged prostate, also known as BPH and urinary incontinence. Dr. Stan, great to meet you. Thanks so much again.

Stanley Swierzewski, MD: Thank you so much for having me. I really appreciate it.

Host: And for more information, please visit harringtonhospital.org/urology. Again, harringtonhospital.org/urology. If you found this podcast helpful, please share it on your social media. I'm Joey Wahler. Thanks again for listening to Healthy Takeout, a podcast from Harrington Healthcare System.

Host: This is Healthy Takeout, a podcast from Harrington Hospital. My name is Prakash Chandran. So, Lisa and Dr. Boitano, thank you so much for joining us today. I really appreciate your time. Dr. Boitano, I thought I would start with you and just cover the basics. What exactly is an abdominal aortic aneurysm?

Dr. Laura Boitano: Sure. So, thank you so much for having us on this podcast. So, an abdominal aortic aneurysm is a ballooning or outpouching of the abdominal aorta. And usually, we think of the abdominal aortic aneurysm is starting at about three centimeters in size. And it can get much, much larger. There are certain risk factors that we look for in patients who may be at risk for developing abdominal aortic aneurysms. And the major ones are history of smoking, an older age, being male, and also family history of having an abdominal aortic aneurysm in a first-degree relative.

Host: And Dr. Boitano, I am curious what exactly happens when the aneurysm ruptures?

Dr. Laura Boitano: So, an aneurysm rupture is a life-threatening emergency. Patients often experience severe abdominal and back pain. It's not subtle. Unfortunately, many patients die before they go to the hospital. But if they do make it to the hospital, we provide emergency lifesaving treatments with repair of this aneurysm. So, it's really important that patients who are at highest risk for abdominal aortic aneurysms are screened and remained in surveillance to try to avoid the risk of rupture because it's such a life-threatening emergency.

Host: Yeah, absolutely. And I know you touched on this already, Dr. Boitano, but you know, Lisa, I'd love for you to go maybe into a little bit more detail around who's at most risk or the highest risk for getting an abdominal aortic aneurysm.

Lisa Arello: Yes, absolutely. Being male gender is an easy one, and anyone who is aged 65 or older. On top of that, risk factors such as uncontrolled high blood pressure, continued tobacco use. And those that have a genetic predisposition are other people that we would try to screen and ensure they did not have an aneurysm.

Host: So Lisa, you know, Dr. Boitano talked about how fast things can happen when there is an aneurysm rupture, and that is why there is this importance for screening. Can you talk to us a little bit about what the screening process is like?

Lisa Arello: Yes. So, the screening process is non-invasive and not painful, which is the greatest part of it. They come into our vascular lab here in the clinic, and an ultrasound done that focuses on evaluating the aorta and its entirety to determine its size and any other abnormal characteristics that we would worry about, so that the doctor can see not only the size of it, but also the images to what the quality of their aortic aneurysm is. We would then, based upon that size and characteristic, determine what would be the next appropriate timeframe for a patient to come in and have that ultrasound repeated.

Host: And Dr. Boitano, who exactly should be thinking about getting screened? Now, you obviously mentioned when there's a history of smoking, family history, 65 and older, and even if you're a male, but is this something that people usually come in at age 50 to do? What's the recommendation there?

Dr. Laura Boitano: Sure. There are a number of societies that have recommendations regarding screening and the US Preventative Task Force also has recommendations. Ultimately, taking all of that together, we recommend that men and women age 65 and older or 65 to 75, I should say, who have either a history of smoking or a family history of aneurysm disease, are screened. Screening women is a little more controversial and not accepted by all societies. But since women are at risk, even though they're at less risk than men and the test is minimally invasive, it doesn't hurt, we do recommend screening in women and that is supported by the Society for Vascular Surgery, which is the society that we utilized for a lot of our screening recommendations.

Host: And Dr. Boitano, why is that? Why is it not accepted in society for a woman to get screened?

Dr. Laura Boitano: The risk of the abdominal aortic aneurysm is much higher in men than women. And so if you look at the population level, the benefit to screening is much greater in men. However, because a ruptured abdominal aortic aneurysm is such a life-threatening emergency, we believe that there still remains a benefit for women, and we do recommend continued screening for women.

Host: Understood. So Lisa, if an aneurysm is found during screening, what are the patient's next steps?

Lisa Arello: After they have the ultrasound in clinic, we also perform an exam. We feel the abdomen and listen for any other signs and ask them a series of questions to ensure that we're considering all aspects of relevancy to the patient. Based upon the size of the ultrasound demonstrated the aneurysm, we would then recommend an interval. In some cases ,as much as a year; some cases, three years. And when the aneurysm is larger, the patient then becomes treated with a CAT scan as it is more anatomy-specific than the duplex.

Host: And Lisa, if an aneurysm is not found, but you still have the risk factors there, after you get screened and nothing is found, is there a particular interval or cadence that you recommend that people still continually get checked?

Lisa Arello: We recommend at that point yearly kind of physical exams; look, listen and feel the abdomen. But at this time, the recommendation is not to continue routine screening if it's been demonstrated that there was no aneurysm.

Dr. Laura Boitano: The only thing I'll add is that sometimes we see on the ultrasound reports that a patient has ectasia of their aorta, which is a small dilation of their abdominal aorta that doesn't quite meet criteria for aneurysm. It's sort of pre-aneurysmal, and that's when the aorta is 2.5 to 2.9 centimeter. And in those patients, we do recommend a followup ultrasound, but that's in 10 years. So, the interval is very, very wide for their screenings repeated.

Host: Okay. That's helpful to know, Dr. Boitano. I wanted to also ask the types of treatments that are available for patients. Can you share a little bit more about those?

Dr. Laura Boitano: Sure. So, we have two major types of treatments for abdominal aortic aneurysm. The first is the conventional open surgery. It's a major abdominal operation where we make an incision in the abdomen and we actually sew in a tube graft where the aorta is. And so, blood then flows into this plastic tube graft. And then, we exclude the aneurysm. And most patients who get this procedure are younger and healthier because it is a major operation and does require a hospital stay and an ICU stay.

The second major type of treatment is a minimally invasive endovascular treatment where we place a stent graft into the aorta so that blood flows through the stent graft rather than through the aneurysm. And this is a minimally invasive procedure where we make a centimeter incision in the groin to use wires and catheters to place the stent. And most patients only need a one night stay in the hospital after this type of operation. But it's really important to mention that especially after the minimally invasive operation, patients need continued surveillance of the aorta because there's a risk that they could develop certain complications long-term after the procedure that we can easily monitor in the clinic and catch before it too becomes a problem.

Host: So Lisa, just before we start to close, you know, someone might be listening to this and might be thinking, "Look, there's so much stuff I have to get screened for as I get older." But you know, you've probably worked with lots of different patients around screening and making sure to be proactive about their health. If there's one thing that you know to be true that you would like to share or leave with the audience, what might that be?

Lisa Arello: Yes. For people that have smoking history or family history, they also undergo other CAT scan screenings such as the lungs. We often can combine the studies and do them together so that they're having one appointment and one imaging. The other is that we try really hard to make this as convenient as possible. We have flexibility in scheduling and meeting the needs of the patients to come in for it. The benefit is so great because a real aneurysm that becomes large is just so detrimental and the risk is high. I would encourage everybody to consider this as part of their preventive care.

Host: And Dr. Boitano, is there anything worth adding or just anything else that our audience should know?

Dr. Laura Boitano: Sure. The only thing that I would add is that most patients who get screened have small aneurysms and the risk of rupture of a small aneurysm is exceedingly low. And we don't recommend any lifestyle changes when this is identified. So, I don't want to scare people into thinking that they have this ticking time bomb in their abdomen. But it is really important to identify these early to prevent the dreaded complication of rupture later on. But at the small sizes, the risk of rupture is exceedingly low. And Lisa and I take a lot of pride in taking care of these patients in our Charlton office and have a lot of availability for both screenings and followup appointments.

Host: Yeah, that's wonderful. So Lisa, where can patients go to learn more and get in touch?

Lisa Arello: They can go to the Harrington website, but they're also welcome to give our office a call and we'll provide additional material at 508-248-8105. We're located at the 10 North Main Street site. And we do have written literature for anybody that's interested.

Host: Well, Dr. Boitano and Lisa, thank you so much for your time today. This has been truly informative.

Dr. Laura Boitano: Thank you so much for having us.

Lisa Arello: Thank you. It's been a pleasure.

Prakash Chandran (Host): That was Dr. Laura Boitano, a vascular surgeon, and Lisa Arello, a nurse practitioner, both with Harrington Hospital. For more information, you can head to harringtonhospital.org or call 508-248-8105 to schedule your screening ultrasound. If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks for checking out this episode of Healthy Takeout. My name is Prakash Chandran. And until next time, be well.