Prenuvo Full-Body MRI Scans and The Future of Preventative Care (with Prenuvo CEO Andrew Lacy)

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[00:00:29] You're listening to Ask Nurse Alice presented by Nurse.org, where Alice Benjamin combines no nonsense advice with thought-provoking interviews. Hello friends and welcome to the Ask Nurse Alice podcast, the show where we talk about anything and everything nursing and healthcare related.

[00:00:55] I'm your host, Alice Benjamin, clinical nurse specialist, family nurse practitioner, and chief nursing officer at Nurse.org. As many of you guys know, I'm a medical correspondent for NBC Los Angeles as well. And not too long ago, I actually did a story on Maria Munoz.

[00:01:10] Some of you guys may know her. She is a host on television for, she's an extra enue, she's done Today, Acts of Hollywood, all these things. And she came out telling her story about how she was diagnosed with pancreatic cancer

[00:01:24] stage two and was able to get that identified, get treatment, and now is cancer free. Now many of you guys may know pancreatic cancer is something that usually is in content, so it's much, much later stages. So this was a very interesting story.

[00:01:38] I started doing my research, you know, the things that I would normally do to prepare for my news hit. And in my research, I noticed she was mentioning a scan of a pernuvvo full body imaging MRI. And I thought, hmm, okay, I'm familiar with MRIs.

[00:01:53] I'm familiar with full body imaging is but what's so different about pernuvvo? So being my curious self, I actually looked them up on the internet. I called the local office here in Los Angeles.

[00:02:05] And I have to tell you, the team there was amazing and incredible and gave me so much information about what this pernuvvo full body MRI scan was, what it does, and how it's different from ones that we traditionally do in the hospital, which by the way, sometimes

[00:02:20] is hard for our patients to get. It's like after we've done a whole bunch of things, then they'll get their MRI. And they're getting the diagnosis. So I was really fascinated by this. So I wanted to introduce our guest for today, Andrew Lacy.

[00:02:31] He is the founder and CEO of pernuvvo. And you know, I just really would like him to walk us through pernuvvo. What is it? How does it work? How do we get more people to, you know, get this type of technology?

[00:02:46] Because guys, I think this is definitely, definitely a game changer. It's something that we as healthcare providers should definitely know more about. So please welcome to the show, Andrew. Hi there. Hi, Nisales. It's great to be here. Thank you so much for taking the time.

[00:02:59] And I know you're on travel. So guys, this is someone who's dedicated. Okay? He really wants us to know more about this technology, which I want you guys to know more about it too. Not even just for our patients, but for ourselves. But we'll get there.

[00:03:10] Andrew, first, if you could tell us a little bit about yourself and how you came to found pernuvvo. Yeah, sure. So I'm now in my 40s. And I guess I started to feel a little bit less invincible with every sort of year that I added to my age.

[00:03:27] I remember visually waking up in the morning and looking in the mirror and ask myself, you know, am I okay? And how do I know this? And so it started a journey for myself doing blood tests and doing colonoscopies and all these testing programs actually are very useful.

[00:03:43] But there was no one sort of comprehensive answer that question, you know, am I okay? And until I ran into the founding radiologist of pernuvvo is the gentleman Dr. Adari Walla who ran a clinic up in Vancouver, Canada.

[00:03:55] And he was doing an earlier version of the scans that we do today. I went to his clinic four years ago. I did a scan. It took about an hour and I learned more about my health than I had learned from the medical system my entire life.

[00:04:08] I learned things, it confirmed things I knew about myself. I learned about early medical conditions that I could do something about. And I just had this visceral moment as an entrepreneur that I felt like I was seeing the future.

[00:04:22] And it felt like from that moment on, it was my mission to basically find a way to bring this to as many people as possible in the world. Okay, so when you say that you went, you're trying to find out more about yourself.

[00:04:32] So a lot of people, they won't go to their healthcare provider. They'll do their annual screenings and some basic blood works and they think everything is fine. And which for the most part, I guess largely it could be, but you mentioned something

[00:04:46] about kind of seeing into the future a little bit wanting to know a little bit more about yourself. So I guess this kind of walks us into a little bit more about the type of technology and work

[00:04:57] and services that Pernuvo provides because I have to be honest guys, I was fascinated by it because you know, I know MRIs we do this stuff in the hospital, but how well do we really know healthcare? There's like there's technologies beyond what we actually commonly use in practice.

[00:05:12] And so Andrew, that's where I kind of want you to tell the viewers a little bit more about what Pernuvo does and how it's different from some of the MRIs that we do in the hospital.

[00:05:22] Yeah, so an analogy I like to use is sort of mobile phone cameras. You know, mobile phones have been around for 25 years now. In fact, I remember the very first Nokia mobile phone I got, it could take photos.

[00:05:35] But those photos didn't look anything like the photos that you can take today with the latest iPhone or Android. And so the underlying technology MRI has been around for a long time and possibly a

[00:05:46] lot of what people know in the medical practice about MRI is rooted in what they learned at medical school. And particularly in the last 10 to 15 years, MRI technology has advanced a lot. The machines have become a lot faster.

[00:05:59] And in fact, the machines that we use at Pernuvo are able to image the body now at clinical diagnostic quality. So not sort of a fuzzy picture, but the same types of pictures that you might get from a diagnostic scan in under one hour.

[00:06:13] And by way of comparison, that used to probably take three to four hours on a regular MRI machine. So that speed improvement really has enabled the possibility of using the latest and most advanced versions of these machines together with some

[00:06:28] clever software and increasingly AI to really tell a very comprehensive picture about our health like we were never able to before. Now, when you say comprehensive pictures, just if you could kind of illustrate for the listeners and let's use Maria as an example, Maria had stage two

[00:06:45] pancreatic cancer. Typically most people don't get diagnosed with their pancreatic cancer until they've had their such severe symptoms and they've done every other type of diagnostic test. And it's kind of like the last thing. So what made her diagnosis?

[00:07:02] Well, how are they able to discover it so much sooner compared to like what's your Jerry Springer or your Alex Trebek who unfortunately they died because their pancreatic cancer wasn't caught so much, much later? Sure.

[00:07:13] So it's worth maybe recapping a little bit how we can look inside the body. And there's really sort of historically there's been two ways to look for cancer and the MRI technology we use introduces a third. So the first is PET CT.

[00:07:28] With PET CT, what we do is we are injecting a patient with a radioactive form of glucose and because tumor cells are growing fast, they require a lot of energy. And so we look at where that glucose is getting metabolized by the body.

[00:07:42] And when we see these sort of hotspots of activity, that's an indication that possibly there's a tumor and we need to look further. The second modality is a contrast based scan either CT or MRI. And here we're injecting something into the blood.

[00:07:56] And of course, those tumor cells that are growing fast that require a lot of energy, they need a very good supply of blood. And so tumors tend to promote the growth of vascularity around the tumor. And that contrast based technique is looking for that vascularity.

[00:08:11] The problem with both of these two techniques is they both involve radiation and they both involve injection of something in the body. And fundamentally, that makes them not appropriate for a screening context, rather just a diagnostic context.

[00:08:24] What we're able to do now with MRI is we have a particular technique that's called diffusion. And here we're actually able to look inside the body for hard spots. So those tumor cells that are growing really fast, they tend to be really densely packed together.

[00:08:40] And so they're harder than the surrounding tissue. And this is probably not surprising. This is why we suggest to women that they periodically feel their breastful lumps. Not because of course if you feel a lump, not every lump is a cancer,

[00:08:53] but most solid tumors feel more dense than the surrounding tissue. And so now we're able to do with MRI what women do with their breasts, but of course we can do it inside the body, places that you

[00:09:04] can't feel at a much greater level of sensitivity than you can with your own hands. And so when it comes to pancreatic cancer, you can't access that very easily. If you're palpating a patient, I mean, that would need to be

[00:09:15] a pretty big mass for you to actually feel that. And so we're able to look for those solid sort of areas of sort of like unusual solid tissue, dense tissue in the pancreas that you wouldn't otherwise be able to see with other techniques.

[00:09:30] And that's what makes it really unique, not just for the pancreas, but for any solid tumor anywhere in the body. So with that type of technology, it would seem that you can actually catch potential cancers at a much earlier stage than we normally do in current practice.

[00:09:49] Sure, we can see cancer with this technique from around 10 millimeters and higher. So oftentimes we can see it smaller than that, but it becomes quite hard to biopsy a cancer that's smaller than one centimeter. And of course what's really important here is that this technique

[00:10:04] with MRI doesn't involve any contrast. And so it's the only technique that basically is harmless. And therefore you could do it year in, year out and and it wouldn't subject the patient to any radiation or any heavy metal. Being injected into their blood vessels.

[00:10:21] You know, Andrew, I'm going to ask what almost seems like the obvious, but with this type of technology and the benefits that it could have on so many people, it's less harmful, it's faster, better imaging. So better data collected with better data collected, I should be able

[00:10:40] to as a provider be able to provide more of an individualized plan of care. We could be more on the preventative or promotion early identification side of things. With that said, why is that not current practice everywhere? It's an interesting question.

[00:10:58] Obviously that's our goal as a company is to continue to prove out this technology and this completely new approach to health care with a goal one day that this is, you know, central to the way that we do health as a society.

[00:11:11] I think why is this not the case today? Is still a lot of people's views around screening are rooted in previous attempts that weren't very accurate. So it takes some time to sort of educate and provide evidence.

[00:11:28] But we can we we already have hundreds of physicians that refer us patients. And I would say the most interesting observation from all of those relationships is how much time it saves them having to chase down symptoms and diagnosed disease.

[00:11:43] And they can reinvest all that time and actually put into the health plans and helping people improve the trajectory of their health. And I think that's why a lot of people join the health profession. And for them, it's a really sort of refreshing return to the reasons

[00:11:59] why, you know, they fell in love with medicine in the first place. I can agree with that as an emergency room nurse practitioner. I have to tell you breaks my heart so many times when I see people come in

[00:12:11] and, you know, they're presenting with all of these symptoms. And, you know, we in the hospital, we can do MRIs, we can do CTs and, you know, we can draw labs and things like that.

[00:12:20] But by this time, you know, I've seen people who are, for the most part, newly diagnosed cancer, but it's very late stage. They didn't know. And I just sometimes think to myself, if we just had a better way of capturing this type of information because our, you know,

[00:12:38] our US healthcare system is, and I don't even know how I'll say this. And those of you guys, you guys are listening, you guys are nurses, advanced practice nurses. You know what it's like. We're overworked with less resources. We don't have a lot of time with patients.

[00:12:52] So it's really in a tough spot. We want to do the best for our patients, but we don't always have enough time or the tools. But now with this type of tool, it sounds like this can really relieve some much of the burden on health care providers.

[00:13:06] As you said, Andrew, we're fishing through symptoms, trying to figure out X, Y and Z. And here's the truth of it, guys. Someone comes in with symptoms. Well, these kind of, we do this baseline workup. Okay, we'll see how that goes. Then they have to come back.

[00:13:19] Okay, still not getting better. We've done this. Okay, well, now let's try this and come back. And so we're like, we're time is tissue, time is tissue here. So with this type of scan, so much better quality of imaging,

[00:13:30] so much more data and we can really hone in on things. Now, Andrew, you mentioned that you have providers who order this for their patients. We don't have this at my hospital. So how could someone like myself, whether I'm in an APN role, but even a nurse,

[00:13:47] how can we connect our patients to some this type of service if it's not something that's provided at my particular organization? We do have referrals coming in from a lot of tertiary hospital networks that are located around where our clinics are based.

[00:14:04] So I guess what's kind of one of the cool things about medicine is that if there is a physician that thinks that there's an appropriate test for a patient, they will refer that patient out typically,

[00:14:14] even if that is to a facility that's not part of the sort of the hospital network. So we do see that a fair bit. Of course, as we keep growing, we're looking for opportunities to partner with health systems as well to bring some of this technology

[00:14:28] to hospitals and other networks. So I think as it becomes more common, potential in the future, as it gets covered by health insurance, we're going to see this as a lot more common part of the preventive health programs of I think most of the networks out there.

[00:14:44] You mentioned that it's in currency, it's not covered by insurance, although we're hopeful that everyone will see the benefit. Insurance companies have got to see the benefit in this. It just seems like such a small price to pay versus the long run of things

[00:15:00] like if you think of someone going in and out of their provider's office for visits, medications, and then the money that could be saved. And I know guys, I'm mentioning money, but the patient's life is really the most important thing.

[00:15:12] I want to emphasize that, but let's also be transparent. Health care is it's a business and we have to address and look at those things as well. So so, Anderson, you mentioned it's not covered by insurance.

[00:15:23] So a provider can make a recommendation for a patient to get this type of screening can a patient on their own, let's say, you know, I'm getting nowhere with my provider. What's this Pernoubo thing? Can I get it on my own?

[00:15:37] What's the option for someone who's in that situation? Yeah, and it happens all the time. And in fact, what we do there is we have a network of very talented nurse practitioners actually that work with us. And they do a patient chart review and they sort of understand

[00:15:52] the reasons for why the patient is getting a scan. Make sure that this is something that's appropriate for them. And then they'll write a referral for that patient to come in. So it's not necessary that your physician be aware about what we're doing

[00:16:03] or being in a position to be able to refer us, patients can reach out directly as well. And then we work with this group to write a referral. Or if that's not the best course of action, then recommend that they go

[00:16:14] and do another diagnostic scan depending on whether or not they're symptomatic. And the cost of something like this, I know you guys offer a variety of images imaging there. Roughly if someone has decided, you know what? I actually want to know more about what's going on with myself.

[00:16:31] I'm going to take a proactive approach on this. I'd like to get this service. What are we kind of looking at here as far as cost wise for this type of investment for someone? Sure. So at one end, we screen for any solid tumor in the torso for

[00:16:45] nine hundred and ninety nine dollars. And then at the other end, we do a comprehensive exam that's screening not just for cancer, but 500 other conditions. And that's that's two thousand four hundred ninety nine. So it's from a thousand to twenty five hundred dollars.

[00:16:58] People can pay with FSA and HSA. We have payment plans, but at the moment, it is an out of pocket expense for most folks. And I sure hope it changes at some point in the future.

[00:17:09] I imagine that it would it would if you just think of the cost benefit analysis. I'll give you like the big numbers here for us to screen every single person and every adult in the US once every two years

[00:17:21] for cancer, the cost would probably be about 50 to 60 billion dollars, which is a huge number. But we spend something like one hundred and thirty billion dollars just on late stage cancer drugs in the US alone. So I mean, our health system is four point five trillion dollars.

[00:17:38] It's ninety seven percent reactive. We spend three percent of our health care money on preventative care. There are very few tests that are covered, unfortunately. And those tests that are covered, things like mammogram, I mean, those were not easy journeys that took decades to get those tests covered

[00:17:54] and they subsequently save millions of lives. So the numbers are big, but also, you know, then the potential savings also are quite huge from the point of view of the system. And as you mentioned, I mean, we only have one life,

[00:18:06] so we can't really play statistics as patients. You know, we want to make sure that everything is OK. And if things aren't OK, that we catch it enough that we can intervene, you know, and have a much obviously much better likelihood of a successful outcome.

[00:18:20] Right. And Andrew, if I could just put in perspective, that's just like two iPhones, guys. I mean, your family of four or five, you've already spent five thousand dollars on iPhones for a family of five. And the information that this this test can provide you,

[00:18:34] I mean, to catch something so much earlier on. And you mentioned it, Andrew, you said three percent of the health care dollars spent on preventative care. And I'm pretty sure if you were, if someone was asked a question, would you like to spend two thousand dollars

[00:18:46] or I cut off 10 years of your life because of a misdiagnose? I mean, you wouldn't think twice about that. And just even catching something early on, averting those symptoms, the medications that you'll have to take, the time off of work,

[00:19:00] the the adverse effect on your quality of life. I think that's where sometimes people lose sight of how important our health really is. That truly is our wealth, because if you're not healthy, you can't go to work, you can't go to school,

[00:19:13] you can't really enjoy your quality of life. You can't enjoy your kids, you can't enjoy the their the prom, the wedding, that all of the things that we really, you know, that are really priceless. Yeah, no, I know I agree with you 100 percent.

[00:19:26] The thing that I'm most excited about these scans, of course, we hear and a lot of people come in in order to see whether they have cancer, because that's something that's obviously very top of mind.

[00:19:35] But I think the thing that's for me is really exciting about these scans is the ability for us to really bring forward the clock for diagnosing chronic illness as well. And I'll give you a simple example, Nafal D, so basically fatty liver.

[00:19:52] We can see that very, very early. Some of us might deposit fat in our liver because of genetics or because of lifestyle, and it's just great to know this at an early stage because we know that lifestyle exercise and so on can prevent that disease from ever progressing.

[00:20:09] And so the earlier you diagnose, you know, changes in brain volume loss or changes in spine at an early age or metabolic conditions, kidney changes. The more you can diagnose these things early, the more actually the only thing you need to do is lifestyle changes.

[00:20:25] And there's a real promise here that we don't even need to access the health system for many of these conditions if we catch them early enough. Yes, I agree with that. And guys, I also want to share so I had the opportunity and the pleasure

[00:20:38] of getting a Pernubo scan. And I have to tell you, it was it felt very spa like treatment. It was such a wonderful place. And I've had an MRI before and I just remember being in a very cold room

[00:20:51] in a little tunnel and hearing a lot of click, click, click, like, like, like, like, like in the MRI and just like sitting there like, oh, my gosh, I hope this is over. Let me try to go to sleep and just wait this thing out.

[00:21:01] And that was totally the opposite of experience of when I went. Beautiful place. The room was nice temperature. I had a blanket and I was able to watch a movie during my one hour scan. No dies, no no pokes in the arms, guys.

[00:21:18] So and then after that, I mean, you get your results. You get full imaging of your results. I know a lot of you guys like to share on Instagram. You don't have to share your Pernubo videos on Instagram. But I'm just saying there's video opportunities pictures.

[00:21:30] There's a full report and you get to talk to one of the nurse practitioners there. And there was my I haven't talked to my provider yet, interestingly enough, right? But the results were sent to him as well.

[00:21:43] So he's probably waiting for me to call him and tell him what this is about. But it just seemed like it was very streamlined. So even though my provider didn't order it, I was able to get it and still loop in my primary care provider.

[00:21:55] So I liked the fact that I was able to be proactive and then kind of reel in my health care provider. Because guys, sometimes patients have to be their own advocates as well. You have to advocate for like if you don't feel good, you're having symptoms.

[00:22:09] Something doesn't seem right. They need to speak up and this is a way for patients to kind of advocate for their own health and reel in the health care system, which is why I know many of you who are listening are probably like, wow, this is amazing.

[00:22:21] I can't wait to make a referral for my patients, but even for ourselves. So many of you are probably listening and wanting to know how you can get your own Pernuvoscan, which Andrew, how many places across the nation can you go to get your Pernuvoscans?

[00:22:36] Yeah. So we're open in eight cities right now that I'll listen really quickly. Vancouver, San Francisco, LA, Dallas, Minneapolis, Chicago, just outside of Miami in Boca Raton and New York. And later this year we'll be opening in Atlanta and Washington, D.C.

[00:22:55] And we're working on a clinical trial actually in Boston too. So that there'll be some opportunities for people to participate in that if it's interesting to them. So I mean, so that's good. So it sounds like it's it's going to become more available,

[00:23:07] which leads into my next question of health equity and accessibility. So obviously the technology is where it is that's going to grow. It's going to be available in more places. But outside of just the locations also speaking about like price point

[00:23:21] and making it accessible for someone who may not be in a position to they may want to, but financially aren't able to get a Pernuvoscan and they're provided in order. It how can we are you guys working on trying to make this more accessible to more people?

[00:23:38] Sure. So first of all, at a sort of very general company level, we're working really hard to scale the technology. And obviously with scale, you can bring the cost down. And then we're also investing a lot of time and financial resources in AI,

[00:23:55] AI that can help make our radiologists more efficient and effective. And of course, as you can imagine, radiology is one of the bigger costs in providing this service. So if we can make the team more effective,

[00:24:06] then we can bring the cost down for people who want to access the scan. The second thing we're doing more specifically is we're looking right now in fact around the US for one or more sites where we would partner with local organizations to really find ways to

[00:24:22] provide subsidized access to a community of folks who perhaps otherwise might not have access to these types of services, be them from a certain socioeconomic background or just other reasons why they may not have access. And we're talking to a hospital network in Michigan right now.

[00:24:41] We've had various conversations. If any of your listeners would like to connect us with folks that might be interested in helping us think this through. But it's a big part of the mission of the company is to find ways

[00:24:50] for this to become more accessible to more and more people. Before we started the scan, the closest thing to what we were doing was about 10 times more expensive. So, you know, and I would love it in the future

[00:24:59] to be 10 times less expensive than what it is today with us. So that's the path that we hope to sort of trade over the next five to 10 years. I know you guys are going to get there, Andrew. I mean, and if I'm also correct when you say 10 times,

[00:25:10] the Pernoubo takes 10 times as many images. Yeah. And and I think it's something like hundreds of billions, hundreds of millions of data points at this point in time. So it's about about five to 10 times more images than you get on a similar protocol in a hospital network,

[00:25:28] which is typically only offered ordinarily to people that have cancer predisposition syndromes at the moment. So we're taking something that's we've sort of improved on that and we're offering it to everyone so that we can all stay ahead of our health. I think this technology is is amazing.

[00:25:42] I really do. I really think it's amazing because when you think of how much information you can get and so much earlier on before the, you know, before it becomes a chronic illness, before the terminal diagnosis, it's really a game changer, a life changer, I should say,

[00:26:01] because getting that type of data and having the opportunity to make the lifestyle changes and to get, you know, can mean the difference between getting a surgery now versus waiting 10 years later with current traditional practice and then

[00:26:18] by then things have metastasized or it's a lot further down the disease pipeline. So I think you guys are doing tremendous work at Pranuvo Andrew just real quickly before I let you go. When our listeners, you know, go to the website, they're going to look up information.

[00:26:33] Is there a way that is there a more direct pathway that they can connect with you guys? I know you mentioned earlier about if they had their organization, maybe wanted to partner with you or if they maybe they wanted to become

[00:26:43] of a part of a think group or think tank to work with you guys on how to get this more available to more people. How could they connect with you guys? Yeah. Wow. I wish I had an email I could give you right now,

[00:26:54] but maybe I'll give you I'll pass on an email that you can put in your show notes. And, you know, I would love folks to reach out directly. Once you're diagnosed with some something,

[00:27:03] our health system does a pretty good job of treating it to the best of its abilities. The real challenge from an equity point of view is what happens before diagnosis. And unfortunately, in a system where there's just not that much

[00:27:15] preventative health care that's covered and for folks that even, you know, were to be covered. There are some people who maybe they're working three jobs and they don't have time to go and do a whole bunch of different tests.

[00:27:26] Or I mean, there's just it's sometimes very, very difficult, practically speaking to access the sort of health care you need to diagnose things early. So for us, it's really important to work really hard on, you know, building this one scan that hopefully can diagnose as much as possible

[00:27:42] so that people can get such a detailed look into their health in a very, very short visit maybe once every two years. And and practically speaking, that may well help people access health care who may not otherwise have time to do it over the course of many,

[00:27:58] very many different doctors, visits and specialists and so on. So, Andrew, thank you so much for coming on the show. I think you've been such a wealth of information. You guys are doing great work and I can only foresee this improving upon,

[00:28:11] you know, not just our nation, but the world's health care. I forgot to ask, are you guys doing this internationally? I think this is going to be all around the world. Yeah, no, health care is it's a global thing. Everyone has to deal with it.

[00:28:24] So we're looking right now in Europe. We're looking in Australia, which is where I'm from for your listeners that haven't yet characterized my accent. We're even working on mobile mobile unit idea right now. And the hope one day is that that might be something you could drive around

[00:28:39] places like Africa and give people access to this technology. So we'd like to see it everywhere. We're doing our best to do that. Wow, this is great. I'm pretty sure there's lots of our listeners who are one interested in the technology for their patients, interested in the

[00:28:53] technology for themselves and their family and friends. And then also I'm pretty sure they're going to people say, I want to work for a company like that. I love their mission and the work that they're doing. So Andrew, just be prepared to be bombarded

[00:29:05] with questions and comments from listeners. So guys, guess what? Andrew and his whole Pernovo team have been so gracious enough to offer us a three hundred dollar promo code for a whole body scan.

[00:29:16] So what you need to do is you go to Pernovo.com for slash nurse Alice registered through there. And then as you check out, you will get your three hundred dollars off. And I'm going to recommend that you do it. I've had one. It's amazing.

[00:29:28] So much wonderful information. And who doesn't want to know more about their health and wellness? I mean, just for myself as as as I get older, I'm so young, by the way, just so you know, but as I get older, it's going to provide me a lot of

[00:29:39] information because I want to live a long, healthy life. OK, long is one thing. Healthy is another, but I want both of them. And the data that I get from this test is going to be so much

[00:29:49] helpful to me to make the proper lifestyle changes in the proper treatment I need. So and I know you guys want that for yourself. You want it for your patients, but I know you want it for yourselves, your husband, your kids, your mom, your grandmothers and everyone else.

[00:30:00] So make sure to visit Pernovo.com for slash nurse Alice and sign up for your scan today. So Andrew, thank you so much for joining us. It's been a pleasure. And you know what? We'll be we'll actually have to be in touch again soon because I know

[00:30:12] you guys are going to be growing by leaps and bounds. And next thing we know, there'll be a mobile Pernovo. Keeping my fingers. Yes. Thanks for having us. Thank you so much. And guys, thank you so much for tuning in to the Ask Nurse Alice podcast.

[00:30:25] It's always my pleasure to get to talk with you about anything and everything nursing and healthcare related. Please make sure to share this podcast with your friend or classmate, your manager, anyone else, actually your neighbor, the grocery store worker,

[00:30:36] because this especially this episode, because it can be so helpful to so many people. And then also please leave a rating and review that helps me grow the podcast gets it out to more people. So that would be so much helpful if you can.

[00:30:47] And then so guys until next time, please make good choices, be kind to one another and live well, my friends. Thanks for listening to Ask Nurse Alice. Visit nurse dot org for nursing career, education and community resources.