Comprehensive Pain Management
(Formally known as Franklin Pain and Wellness and Warwick Pain)

Attleboro, MA(508) 236-8333
Franklin, MA(508) 507-8818
South Kingstown, RI (401) 234-9677
Warwick, RI(401) 352-0007

Franklin, MA • (508) 507-8818
Warwick, RI • (401) 352-0007
South Kingstown, RI • (401) 234-9677

South Kingstown Pain Center RI Blog

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Causes of Chronic Pain

Joseph Coupal - Thursday, April 12, 2018
Comprehensive Pain Management - Franklin, MA

Some of the most common types of chronic pain include:

  1. headache
  2. postsurgical pain
  3. post-trauma pain
  4. lower back pain
  5. cancer pain
  6. arthritis pain
  7. pain caused by nerve damage
  8. pain that isn’t caused by disease, injury, or nerve damage

More than 1.5 billion people around the world have chronic pain. It’s the most common cause of long-term disability in the United States, affecting about 100 million Americans.

Causes

What causes chronic pain?

Chronic pain is usually caused by an initial injury, such as a back sprain or pulled muscle. It’s believed that chronic pain develops after nerves become damaged. The nerve damage makes pain more intense and long lasting. In these cases, treating the underlying injury may not resolve the chronic pain.

In some cases, however, people experience chronic pain without any prior injury. The exact causes of chronic pain without injury aren’t well understood. The pain may sometimes result from an underlying health condition.

Risk Factors

Who is at risk for chronic pain?

Chronic pain can affect people of all ages, but it’s most common in older adults. Besides age, other factors that can increase your risk of developing chronic pain include:

  1. having an injury
  2. having surgery
  3. being female
  4. being overweight or obese

Treatment

How is chronic pain treated?

The main goal of treatment is to reduce pain and boost mobility. This helps you return to your daily activities without discomfort.

The severity and frequency of chronic pain can differ among individuals. So doctors create pain management plans that are specific to each person. Your pain management plan will depend on your symptoms and any underlying health conditions. Medical treatments, lifestyle remedies, or a combination of these methods may be used to treat your chronic pain.

Medical procedures for chronic pain

Certain medical procedures can also provide relief from chronic pain. An example of a few are:

  • electrical stimulation, which reduces pain by sending mild electric shocks into your muscles
  • Steroid Injections
  • nerve block, which is an injection that prevents nerves from sending pain signals to your brain
  • acupuncture, which involves lightly pricking your skin with needles to alleviate pain
  • Lifestyle remedies for chronic pain

Coping

Dealing with chronic pain

There isn’t a cure for chronic pain, but the condition can be managed successfully. It’s important to stick to your pain management plan to help relieve symptoms.

Physical pain is related to emotional pain, so chronic pain can increase your stress levels. Building emotional skills can help you cope with any stress related to your condition. Here are some steps you can take to reduce stress:

Take good care of your body: Eating well, getting enough sleep, and exercising regularly can keep your body healthy and reduce feelings of stress.

Continue taking part in your daily activities: You can boost your mood and decrease stress by participating in activities you enjoy and socializing with friends. Chronic pain may make it challenging to perform certain tasks. But isolating yourself can give you a more negative outlook on your condition and increase your sensitivity to pain.

Seek support: Friends, family, and support groups can lend you a helping hand and offer comfort during difficult times. Whether you’re having trouble with daily tasks or you’re simply in need of an emotional boost, a close friend or loved one can provide the support you need.

For more information contact Comprehensive Pain Management in South Kingstown, RI.

Source: healthline.com

What Is Spinal Stenosis?

Joseph Coupal - Friday, March 16, 2018
Comprehensive Pain Management in South Kingstown, RI

What Is It?

It's when the spaces between the bones that make up your spinal cord get narrow. This can put pressure on those bones and on the nerves that run from your spine to your arms and legs. It happens most often in your lower back or neck.

The Symptoms

You may not notice any. But if the narrowing puts pressure on your spinal cord or nerve roots, you may have numbness, weakness, cramping, and pain in your arms and legs. In more severe cases, you may have trouble with your bowel, bladder, or having sex.

Who Gets It

It’s most common in men and women over 50 years old. But it can happen when you’re younger if you’re born with a condition that narrows your spinal canal, or you injured your spine in some way.

Your Aging Spine

The ligaments (cords that hold your spine together) may get thicker and harder as you age. Bones and joints also may get bigger, and that can narrow the spaces between your vertebrae. Arthritis, which is more common when you’re older, can make this worse.

Other Possible Causes

Several things can put pressure on your spinal cord and nerves. For example, if you have a herniated disk, the soft cushions or “disks” that separate your vertebrae can crack and ooze. Tumors also can grow in the spine, or a sudden injury can shift your spine or create bone fragments there.

Diagnosis

Your doctor will ask about your medical history because injuries and other health problems may cause the same symptoms. She’ll check for pain when you bend backward and test your muscle strength and reflexes. She also may want do imaging scans to look inside your spinal column and check for things like tumors, bone spurs, or an injury.

Nonsurgical Treatments

Your doctor might recommend that you not do some activities. He also might suggest certain exercises to strengthen your stomach and back muscles to help support your spine. Aerobic exercises -- swimming, biking, or brisk walking -- can be good ways to stay active. If you’re older or have weak stomach muscles, you might need a brace to strengthen your backbone.

For more information on comprehensive back pain, contact Comprehensive Pain Management in South Kingstown, RI.

Source: webmd.com

Balloon Kyphoplasty Curbs Opioid Use in Vertebral Compression Fractures

Darren Kincaid - Friday, February 23, 2018
Comprehensive Pain Management - South Kingstown, RI

Patients suffer vertebral compression fractures when their bones become too fragile. VCF complications may include impaired gait, disability, reduced lung function, early satiety, future fracture risk and mortality. The National Osteoporosis Foundation reports a vertebral fracture occurs every 22 seconds globally, and about two-thirds of VCFs are initially asymptomatic and under-diagnosed.

Older women, especially, are at great risk of developing VCFs. A 2015, 12-year study compared hospitalizations for osteoporotic fractures in women 55 years and older to hospitalizations for other conditions. The study discovered 4.9 million hospitalizations for osteoporotic fractures in women, more than the hospitalizations for myocardial infarction, stroke or breast cancer.

Patients with VCFs have a variety of treatment options, including non-surgical management, balloon kyphoplasty (BKP) and vertebroplasty. Non-surgical management often involves bracing patients and prescribing opiods for pain management.

Non-surgical management in the elderly population poses a particularly challenging healing environment, because if you give them enough time, they will form fibrosis in the fracture, but if their bone quality is that bad, they have no innate ability to heal themselves. And adding narcotics into the mix presents a "recipe for disaster" for the elderly, as the medication will make them "loopy" and at risk of losing their balance.

Drug reliance can be a problem

Opioids play a major role in non-surgical management of VCFs, so many providers seek alternative treatment methods to combat the opioid epidemic sweeping the nation.

There must alternative forms of therapy for patients. And it is imperative these alternative treatment options catch the condition early. The addictive potential of opioids poses a critical reason for the importance of early detection of VCFs.

There are many benefits to treating early. A quick procedure with low morbidity and low risk that yields a high benefit of getting people out of the hospital, mobilized and off their narcotics quicker is a necessity.

That's where procedure-based pain management techniques, such as balloon kyphoplasty, come in.

How balloon kyphoplasty stacks up against non-surgical management

Balloon kyphoplasty is an augmentation procedure designed to stabilize the spine.

Balloon kyphoplasty is a minimally invasive procedure for the treatment of pathological fractures of the vertebral body due to osteoporosis, cancer or benign lesion. Cancer includes multiple myeloma and metastatic lesions, including those arising from breast or lung, or lymphoma. Benign lesions include hemangioma and giant cell tumor.

Surgeons mechanically treat a fracture by inserting and inflating a balloon to create an open cavity inside the bone for injecting bone cement. Surgeons insert a controlled amount of Kyphon bone cement into the cavity, which creates an internal cast to stabilize the fracture.

The reason doctors want to do more balloon kyphoplasty is because evidence shows patients have much better pain relief short- and long-term and rewduce the amount of opioid use. Pain is the number one reason people seek medical care, so we need a viable procedurebased option to treat pain.

Balloon Kyphoplasty is a minimally invasive procedure designed to repair spinal fractures. More than 15,000 physicians have undergone balloon kyphoplasty training worldwide and treated more than 1 million fractures with the procedure.

Pain relief has certainly been obsovered across numerous studies, finding statistically and clinically significant pain reductions from baseline observed early from week one that persisted through 12 months or 24 months.

For more information on Balloon Kyphoplasty, contact Comprehensive Pain Management in South Kingstown, RI.

Source: Becker Spine Review

Chronic Pain Management and the Workplace

Darren Kincaid - Thursday, February 15, 2018
Comprehensive Pain Management - Franklin, MA

When talking about chronic pain and the workplace you can find yourself engulfed in numbers—how many people are hurt in the work place, how many receive workers compensation, and a list of some of the most dangerous jobs.

But there is nothing about people who struggle as they try to hold down a job while dealing with the pain from an injury or illness.

Here are some statistics, numbers that may surprise many of you.

  • Pain is the number one cause of adult disability in the U.S.
  • Pain costs $294 billion annually in lost workdays, medical expenses, and other benefit costs.
  • Lost productive time from common pain conditions among active U.S. workers cost an estimated $61.2 billion annually, largely due to reduced performance while at work.
  • Thirteen percent of the total workforce experienced a loss in productive time during a two-week period due to a common pain condition, including headache, back pain, arthritis, and musculoskeletal pain.

The real question is how do people with pain manage to keep their jobs when pain seems to be their constant companion? For them, the responsibility of holding down a full-time job and keeping up with all the basic activities of daily life can feel insurmountable and eliminate any chance of having time to enjoy life.

Work is a big challenge for people with chronic pain. Some keep working at all costs—even at the expense of their health and relationships. Trying to find a balance between a job and taking care of yourself can be challenging. But the financial and emotional impact of losing a job because of chronic pain can be devastating.

Many people with chronic pain have trouble staying employed. Managing pain is a full-time job. Physical abilities can change unpredictably. One day you might be able to turn a certain way, or move your arm without pain and the next day you just can’t.

How Attitude Influences Disability

The disabilities that come with chronic pain affect us in different ways.

  • Some people are learning to manage their pain and wish to return to work.
  • Others know that life is different when living with pain and need to find a different job that is compatible with their more limited abilities.
  • Still others feel their pain totally disables them and will not consider any job, unable to even work from home.

Attitude is key to believing that fulfilling employment can be part of a life that includes chronic pain.

The American College of Occupational & Environmental Medicine’s (ACOEM) developed guidelines to prevent needless work disability. The main message of these guidelines is that work avoidance and job loss following injury, illness, or aging is largely preventable and not medically required.

The guidelines point out that a team approach by employers, doctors, therapists, insurers, and others is required to promptly help people keep life as normal as possible and get “right back in the saddle” to safe and medically appropriate work. Otherwise prolonged tenure in a passive “patient” role increases the risk of developing an “I can’t” self-concept, along with needless long-term withdrawal from work, social life, and a productive contribution to society.

Long-term worklessness is one of the greatest risks to health in our society. It is more dangerous than the most dangerous jobs in the construction industry, or working on an oil rig in the North Sea, and too often we not only fail to protect our patients from long-term worklessness, we sometimes actually push them into it, inadvertently.

Work provides people with financial security, a structure to their days, and a chance for physical activity. It offers community, social interaction, and a sense of purpose, contributing to one’s self-esteem.

Those without work in their lives are more likely to be sick, engage in risky behaviors such as excessive drinking, or fall into depression, and other emotional distress.

For more information on chronic pain management, contact Comprehensive Pain Management in South Kingstown, RI.

Source: Excerpts - theacpa.org

About Radiofrequency Ablation

Darren Kincaid - Thursday, February 08, 2018
Comprehensive Pain Management - Franklin, MA

Radiofrequency ablation (or RFA) is a procedure used to reduce pain. An electrical current produced by a radio wave is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area.

Which Conditions Are Treated With Radiofrequency Ablation?

RFA can be used to help patients with chronic (long-lasting) low-back and neck pain and pain related to the degeneration of joints from arthritis.

How Long Does Pain Relief From Radiofrequency Ablation Last?

The degree of pain relief varies, depending on the cause and location of the pain. Pain relief from RFA can last from six to 12 months and in some cases, relief can last for years. More than 70% of patients treated with RFA experience pain relief.

Is Radiofrequency Ablation Safe?

RFA has proven to be a safe and effective way to treat some forms of pain. It also is generally well-tolerated, with very few associated complications. There is a slight risk of infection and bleeding at the insertion site. Your doctor can advise you about your particular risk.

What Are the Side Effects of Radiofrequency Ablation?

The main side effect of RFA is some discomfort, including swelling and bruising at the site of the treatment, but this generally goes away after a few days.

Who Should Not Get Radiofrequency Ablation?

As with any medical procedure, RFA is not appropriate for everyone. For example, radiofrequency ablation is not recommended for people who have active infections or bleeding problems. Your doctor can tell you if you should not have RFA.

What Side Effects May I Have After Radiofrequency Ablation?

You may experience the following effects after RFA:

Leg numbness: If you have any leg numbness, walk only with assistance. This should only last a few hours and is due to the local anesthesia given during the procedure.

Mild back discomfort: This may occur when the local anesthetic wears off and usually lasts two or three days. Apply ice to the area the day of the procedure and moist heat the day after the procedure if the discomfort persists. You may also use your usual pain medications.

For more information on Radiofrequency Ablation contact Comprehensive Pain Management in South Kingstown, RI.

Source: webmd.com

A Minimally Invasive Treatment Option for Back Pain

Joseph Coupal - Friday, January 26, 2018
Comprehensive Pain Management - Disc-FX System

Treating Contained Disc Herniations

In the past, patients with contained disc herniations have been treated with conservative care including rest, medications, injections and/or physical therapy. Unfortunately, this does not always provide relief. In the past, people who did not respond to conservative care were forced to live with the symptoms or consider major spine surgery. If they underwent surgery, it could take weeks or months to recover, causing a major disruption in their daily lives.

With Disc-FX, this is not the case. Disc-FX provides an option for those people who have failed conservative care, and are not yet ready for major surgery. It is a minimal access procedure performed on an out-patient basis. The patient will go home the same day as the procedure with only a small bandage on their back. Following manual removal of the offending herniation, the patented Disc-FX device is activated to help clean the disc and seal tears in the annulus. As a result, pressure in the disc is reduced, which eases symptoms.

Facts about Contained Disc Herniations:

  • 90% of low back pain is caused by pinched or irritated nerve in the back
  • There are 15 million office visits for low back pain each year
  • Low back pain is the most prevalent cause for people under 45 to visit their physician

Who is a Candidate for the Procedure?

Patients with symptomatic, contained lumbar disc herniations that have not responded to conservative treatment, may experience relief from the use of Disc-FX. Typical signs of a contained lumbar disc herniation is lower back pain or pain radiating down the leg accompanied by some lower back pain. Disc-FX® may not be beneficial for advanced degenerative disc disease or spinal fractures. At Comprehensive Pain Management, we will evaluate and determine if you are a candidate for Disc-FX.

Disc-FX System Overview

The Disc-FX System is an innovative, minimal access spine system designed to efficiently access the damaged disc without injury to surrounding disc anatomy. Disc-FX permits multiple treatment options compared to other ‘single treatment’ devices in the marketplace. In addition to manual decompression, Disc-FX can help to clean the disc and seal tears in the annulus.

For more information on Disc FX contact Comprehensive Pain Management in South Kingstown, RI.

Spinal Cord Stimulation FAQs

Joseph Coupal - Friday, January 05, 2018

Comprehensive Pain Management in South Kingston, RI When can I resume my usual activity?

For several weeks after the procedure you will be asked to restrict your physical activity. Once that period is over, your Spinal Cord Stimulation system is designed to help you lead a healthy and active lifestyle. However, you should always consult your doctor before resuming activity after surgery or before engaging in physical activities.

Will I be totally pain-free with Spinal Cord Stimulation?

People differ in the amount of pain relief they receive with SCS therapy. Many people experience a reduction in pain sensations. The trial procedure will help you determine the amount of relief you may receive.

Will Spinal Cord Stimulation allow me to be free of pain medications?

For some patients, SCS works well enough that pain medications are no longer needed. For others, it can mean a reduction in the amount of pain medication they need. Always consult your doctor before changing your dosage of any medications.

Can I control the stimulation therapy?

Yes, the cordless remote control allows you to turn stimulation on and off, increase and decrease the level of stimulation, and target different pain areas using settings or programs designed specifically for you.

Do I use my Spinal Cord Stimulation system 24 hours a day?

It’s up to you. These systems are designed for 24-hour-a-day use, should you wish. However, there are a few limitations, which your physician can describe. For instance, you should not turn on stimulation while driving or charge while sleeping.

Can one Spinal Cord Stimulation system help me with pain in multiple areas?

Yes, this system is designed to address multiple pain areas at the same time. You can use your remote control to adjust the amount of stimulation for each pain area.

Can I get diagnostic imaging with this system?

SCS patients have many imaging options. Commonly used methods such as X-Rays, CT Scans, PET Scans and Ultrasounds can image many different parts of the body, including soft tissue. In addition, the Precision Montage™ MRI System provides access to full-body MRI scans, under specified conditions, for patients who meet the eligibility requirements. SCS systems have varying limitations and conditions related to MRI scans. Talk to your doctor to find out which option is right for you.

Will I feel the implant? Is it visible to others?

The implant features a contoured oval shape and is small in size. Your doctor can position it in the most comfortable and convenient location in your body. Patients often report that they can feel the unit by pressing on their skin. In most cases, it isn’t visible to others.

How convenient is it to recharge the implant battery?

Recharging the implant battery is designed to be convenient and simple. The charger is lightweight, cordless and portable so you can charge on the go. Either an adhesive patch or soft cloth belt (included with the charger) can be used to recharge.

Is spinal cord stimulation safe?

Yes, spinal cord stimulation has been proven safe and effective and has been in use for decades. Over 400,000 people worldwide have been successfully treated with SCS therapy. You should review the risks of SCS with your physician.

For more information on Spinal Cord Stimulation contact Comprehensive Pain Management in South Kingstown, RI.

Source: bostonscientific.com

Who Can Benefit from Spinal Cord Stimulation?

Joseph Coupal - Thursday, December 14, 2017

Comprehensive Pain Management in Franklin, MAA two-step screening process is typically used to determine whether a person is a good candidate for spinal cord stimulation. The first step is based on the person’s medical condition and begins with a thorough assessment by the doctor.

Chronic Pain Conditions Treated with Spinal Cord Stimulation

A general condition known as failed back surgery syndrome is one of the most common reasons spinal cord stimulation is used. This relates to chronic pain after one or more back or neck surgeries fails to alleviate persistent low back pain, leg pain (sciatica or lumbar radiculopathy) or arm pain (cervical radiculopathy).

The therapy also has the potential to alleviate pain related to the following conditions:

  • Arachnoiditis, painful inflammation and scarring of the meninges (protective layers) of the spinal nerves
  • Chronic back pain with or without leg pain
  • Chronic neck pain with or without arm pain
  • Complex regional pain syndrome, a chronic progressive disease characterized by severe pain and swelling
  • Peripheral neuropathy, a constant burning pain of the legs caused by the most distant nerves dying off
  • Complex regional pain syndrome (reflex sympathetic dystrophy), a progressive disease of the nervous system in which patients feel constant burning pain
  • Refractory angina, which causes chest pain, shortness of breath, and fatigue

Spinal cord stimulation is recommended for an increasing number of painful health problems, this is not a comprehensive list of conditions the therapy may help.

If the person fits the criteria for spinal cord stimulation, the doctor will arrange a trial period—the second step in the screening process—to see how well the temporary therapy eases the individual’s pain.

For more information on spinal cord stimulation, contact Comprehensive Pain Management in South Kingstown, RI.

Source: Spine-Health

Osteoporosis is Serious

Joseph Coupal - Tuesday, December 05, 2017
Comprehensive Pain Management - Osteoporosis Treatment in South Kingstown, RI

Some 54 million Americans have osteoporosis or low bone mass, according to the National Osteoporosis Foundation. Yet, a disconcerting number of those who have experienced abnormal fractures – ones occurring after a fall from a standing position or less – do not equate these accidents to the state of their bone health.

“The findings from a recent Harris poll are especially worrisome. Ninety-six percent of the respondents who had not been diagnosed previously as having osteoporosis, but fell and broke a bone simply from a standing position, indicated they were never told by their physician that the problem may be due to bone disease.

Eight-two percent with abnormal fractures failed to identify them as potential signs of osteoporosis, which causes loss of bone mass and makes bones more fragile. Nearly half the respondents – both those diagnosed with osteoporosis and those not – blamed their fractures on clumsiness.

Osteoporosis is often called “the silent disease,” because it slowly weakens bones, especially in the hip, spine and wrists, without symptoms. Oftentimes, the problem is not diagnosed until a fracture has occurred. Although men can develop the disorder, postmenopausal women are more susceptible because of a decline in their estrogen levels. Estrogen plays an important role in maintaining bone density in women.

Besides gender, other osteoporosis risk factors include genetics and a family history of osteoporosis, advancing age, calcium and vitamin D deficiencies, smoking, certain disorders like rheumatoid arthritis, excessive alcohol consumption, low body weight and some medications, such as chemotherapeutic drugs.

Although patients worry more about cancer, heart disease and other serious health problems, osteoporosis can have a considerable impact on quality of life, causing pain, lost work time and disability. It can even lead to death.

There are statistics indicating as many as 30 percent of patients who sustain hip fractures due to their bone disease will require long-term nursing care; approximately 20 percent will die within a year due to complications indirectly stemming from the fracture.

Even more common than the broken hip bones are spinal fractures – often called vertebral compression fractures. Affecting some 700,000 patients annually, these fractures can be the first sign of osteoporosis. They occur when spinal vertebrae weaken from the bone disease, becoming flatter and more narrow and unable to withstand pressure. Even simple tasks like twisting or reaching for something can break these vertebrae in patients with osteoporosis.

Vertebral fractures result in sudden onset of back pain, especially when walking or standing; limited mobility; and even loss of height.

Vertebral compression fractures can be treated with a minimally invasive procedure called kyphoplasty, which can offer pain relief and halt the collapse of the spine of caught early. Patients can walk out after the procedure and feel immediate improvement. Most recommended approaches to treating osteoporosis involve lifestyle changes, which include weight-bearing exercises like walking and a balanced diet with foods rich in calcium and vitamin D; calcium supplements; and medications that either stop bone loss and increase bone strength or enhance bone formation.

Noting the adage, “an ounce of prevention is worth a pound of cure,” here are some tips to maintain healthy bones:

  • Improve your diet. Eat plenty fruits and vegetables and increase calcium by consuming calcium-rich foods like dairy and dark green vegetables. Avoid too many products high in animal protein.
  • Make sure you get sufficient vitamin D.
  • Limit caffeinated drinks and decrease consumption of salty, processed foods.
  • Exercise.
  • Stop smoking.
  • Smile. A 2015 study indicates older women with a strong sense of well-being have greater bone density than their unsatisfied counterparts.

For more information on treating fractures caused by osteoporosis, contact Comprehensive Pain Management in South Kingstown, RI.

Source: PR Web

Pain Management In Sports

Joseph Coupal - Friday, November 10, 2017
Comprehensive Pain Management in South Kingstown, RI

We praise athletes, at every level, for their ability to compete, to dazzle, to perform under pressure, to inspire and — maybe most importantly — to win.

And when they fall down, when they tear, break or injure themselves, they promise to pick themselves back up, come back stronger than ever and carry their team to victory — thus solidifying their seemingly superhuman performance.

But what goes into recovery? How do athletes get better? And then how do they stay healthy?

Often, recovery — and general pain management in sports — involves medication.

On game day, many NFL players find themselves lining up to receive a shot of Toradol, Bleacher Report reported earlier this year. Toradol, or ketorolac, is described as a stronger and faster-acting version of Advil or Aleve.

One player told Bleacher Report that he had received a shot of Toradol before every game for the past "four or five years."

Persistent use of such medication could have long term effects, and it's not just a problem in professional sports. In 2013, a University of Michigan researcher found that "male adolescent athletes who participated in competitive sports across the three-year study period had two times greater odds of being prescribed painkillers during the past year and had four times greater odds of medically misusing painkillers (i.e., using them to get high and using them too much) when compared to males who did not participate in competitive sports."

The researcher also found that by the time high school athletes became seniors, approximately 11 percent had used narcotic pain relievers such as OxyContin or Vicodin for nonmedical purposes.

For more information on pain management in sports or after suffering a sports related injury, contact Comprehensive Pain Management in South Kingstown, RI.

Source: NPR


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