The CIRS Group Podcast
CIRS, or Chronic Inflammatory Response Syndrome, can happen to 25% of the population and is usually triggered by a biotoxin in the environment, like mold, red tide, lyme (tick bite), and even some medical interventions. Those with CIRS are susceptible to these toxins and cannot clear them on their own. Thankfully, treatment is possible, but given that people suffering with CIRS have difficulty processing new information, we created The CIRS Group and now, this podcast, to help people better understand and identify this treatable illness. Jacie is a 3 year carnivore, certified nutrition coach, and carnivore recipe developer determined to share the life changing information of carnivore and CIRS to anyone who will listen. Barbara is a wealth and wellness coach, 2 year carnivore and a big fan of health and freedom. Along with Jacie, she co-founded The CIRS Group, an online support community to help people that are struggling with their CIRS diagnosis.
Episodes

4 hours ago
4 hours ago
For more information, visit https://thecirsgroup.com
In this episode of The CIRS Group podcast, hosts Barbara and Jacie welcome the OG CIRS coach and patient advocate, Jenny Johnson. As a board-certified health coach and founder of Simplified Wellness Designs, LLC, Jenny has helped countless CIRS clients navigate their health journey. We’ll hear about Jenny's personal battle and recovery from CIRS, her insights into effective treatment strategies, and practical advice for maintaining health post-recovery. Jenny will also share about how you can work with her: one-on-one coaching, consulting services, and her 'Equipped to Overcome CIRS' online course. Whether you're newly diagnosed or well into your CIRS journey, this episode is packed with valuable information and hope from one of the leading experts in the field.
00:00 Welcome and Introduction00:06 Meet Jenny Johnson: The OG CIRS Health Coach02:15 Jenny's Personal Journey with CIRS04:33 Family's Recovery Stories09:18 Life Post-Protocol: Managing and Thriving16:35 Advice for Those Overwhelmed by CIRS18:39 The Role of Coaching in CIRS Recovery19:44 Jenny's Services and Offerings27:45 Conclusion and Final Thoughts
Jenny Johnson's links:Website: https://simplifiedwellnessdesigns.com/CIRS Community, Courses and Group Coaching: https://cirshealingcollective.mn.co/share/hCQ3hTjDCb1f1QZQ?utm_source=manual
The CIRS Group:Support Community: https://thecirsgroup.comInstagram: https://www.instagram.com/thecirsgroup/
Find Jacie for carnivore, lifestyle and limbic resources:Jacie’s book on the Carnivore diet! https://a.co/d/8ZKCqz0Instagram: https://www.instagram.com/ladycarnivoryYouTube: https://www.youtube.com/@LadyCarnivoryBlog: https://www.ladycarnivory.com/
Find Barbara for business/finance tips and coaching:Website: https://www.actlikebarbara.com/Instagram: https://www.instagram.com/actlikebarbara/YouTube: https://www.youtube.com/@actlikebarbara
Jacie is a Shoemaker certified Proficiency Partner, NASM certified nutrition coach, author, and carnivore recipe developer determined to share the life changing information of carnivore and CIRS to anyone who will listen. Barbara is a business and fitness coach, CIRS and ADHD advocate, writer, speaker, and a big fan of health and freedom. Together, they co-founded The CIRS Group, an online support community to help people that are struggling with their CIRS diagnosis and treatment.

Wednesday Apr 16, 2025
Wednesday Apr 16, 2025
For more information, please visit https://thecirsgroup.com
In this episode of The CIRS Group podcast, Jacie and Barbara dive into the complexities of renting and moving while living with CIRS (Chronic Inflammatory Response Syndrome). They discuss the importance of consulting with IEPs (Indoor Environmental Professionals), choosing the right location, conducting thorough inspections, and the vital steps of decontaminating belongings with small particle cleaning before moving in. The episode also provides strategies for getting out of a bad lease if the living conditions are not up to CIRS patient standards. We hope this provides valuable insight and practical tips to ensure a safe and healthy living environment as you heal from CIRS!
00:00 Introduction and Disclaimer01:23 Choosing the Right Location03:24 Apartment Hunting Tips06:24 Testing the Unit10:41 Moving In and Cleaning15:14 Dealing with Contaminated Items16:46 Getting Out of a Bad Lease20:15 Final Thoughts and Resources
Our episode with Kendra Seymour re: how to conduct your own home inspection: https://youtu.be/zmt9e42LLac?si=LYw8ndskD5GhX96t
The CIRS Group:Support Community: https://thecirsgroup.comInstagram: https://www.instagram.com/thecirsgroup/
Find Jacie for carnivore, lifestyle and limbic resources:Jacie’s book on the Carnivore diet! https://a.co/d/8ZKCqz0Instagram: https://www.instagram.com/ladycarnivoryYouTube: https://www.youtube.com/@LadyCarnivoryBlog: https://www.ladycarnivory.com/
Find Barbara for health and business tips and coaching:Website: https://www.actlikebarbara.com/Instagram: https://www.instagram.com/actlikebarbara/YouTube: https://www.youtube.com/@actlikebarbaraBook a CIRS coaching call with Barbara: https://calendly.com/actlikebarbara/cirs-coaching
Jacie is a Shoemaker certified Proficiency Partner, NASM certified nutrition coach, author, and carnivore recipe developer determined to share the life changing information of carnivore and CIRS to anyone who will listen. Barbara is a business and fitness coach, CIRS and ADHD advocate, writer, speaker, and a big fan of health and freedom. Together, they co-founded The CIRS Group, an online support community to help people that are struggling with their CIRS diagnosis and treatment.

Wednesday Apr 09, 2025
Wednesday Apr 09, 2025
For more information, visit https://thecirsgroup.comSign up for updates and our next webinar! https://webinar.thecirsgroup.com/
In this episode of The CIRS Group Podcast, hosts Barbara and Jacie dive into the shortcomings of conventional Western medicine, particularly for those suffering from chronic illnesses and autoimmune diseases.
We share personal stories about the inadequacies we've faced, the importance of finding doctors who can address root causes, and how to advocate for your health. We cover why a team approach, involving proficiency partners and specialist doctors, is crucial for effective treatment and healing. The conversation is grounded in their experiences with Chronic Inflammatory Response Syndrome (CIRS), highlighting the necessity of holistic, personalized care.
00:00 Introduction and Episode Overview00:58 Personal Experiences with Conventional Medicine02:54 Challenges with Conventional Medical Appointments06:10 The Importance of Holistic and Functional Medicine13:47 Navigating the Healthcare System and Self-Advocacy17:26 Building Your Healthcare Team24:37 Final Thoughts and Resources
HELPFUL LINKS MENTIONED:List of certified CIRS practitioners: https://www.survivingmold.com/shoemaker-protocol/list-of-certified-practitionersList of CIRS Proficiency Partners: https://www.survivingmold.com/shoemaker-protocol/surviving-mold-proficiency-partners-diplomates
The CIRS Group:Support Community: https://thecirsgroup.comInstagram: https://www.instagram.com/thecirsgroup/
Other CIRS Support Communities:CIRS Lab: https://cirslab.comJenny Johnson’s group: https://simplifiedwellnessdesigns.com/cirs-healing-collectiveMelanie Pensak’s Meditation for CIRS community: https://thepracticeportal.circle.so/
Find Jacie for carnivore, lifestyle and limbic resources:Jacie’s book on the Carnivore diet! https://a.co/d/8ZKCqz0Instagram: https://www.instagram.com/ladycarnivoryYouTube: https://www.youtube.com/@LadyCarnivoryBlog: https://www.ladycarnivory.com/
Find Barbara for health and business tips and coaching:Website: https://www.actlikebarbara.com/Instagram: https://www.instagram.com/actlikebarbara/YouTube: https://www.youtube.com/@actlikebarbaraBook a CIRS coaching call with Barbara: https://calendly.com/actlikebarbara/cirs-coaching
Jacie is a Shoemaker certified Proficiency Partner, NASM certified nutrition coach, author, and carnivore recipe developer determined to share the life changing information of carnivore and CIRS to anyone who will listen. Barbara is a business and fitness coach, CIRS and ADHD advocate, writer, speaker, and a big fan of health and freedom. Together, they co-founded The CIRS Group, an online support community to help people that are struggling with their CIRS diagnosis and treatment.

Wednesday Apr 02, 2025
Wednesday Apr 02, 2025
CIRS Q&A: Tackling Chronic Inflammatory Response Syndrome, Co-Infections, and Recovery
For more information and support, visit us at https://www.thecirsgroup.com
Welcome to our first 2025 CIRS Q&A session! In this episode, Barbara and Jacie provide answers to your pressing questions about Chronic Inflammatory Response Syndrome (CIRS). We dive into the Shoemaker Protocol, tips for identifying safe new environments for moving, and specific strategies to handle co-infections like SIBO, Lyme, and Bartonella. We also discuss managing symptoms like fatigue, hormone issues from menopause, and dealing with mast cell activation syndrome (MCAS or histamine response). Whether you're new to CIRS or further along in your healing journey, this session provides valuable insights to help you take control of your health. Don't miss out on practical advice for improving your well-being and staying proactive in your treatment plan.
TIME STAMPS:00:00 Introduction and Welcome01:26 Overview of CIRS and Shoemaker Protocol03:05 Q&A Session Begins03:39 Hypometabolism and Weight Loss07:17 Cross Contamination and Cleaning11:06 Muscle Fatigue and Co-Infections14:07 Mast Cell Activation Syndrome (MCAS)20:21 Moving and Small Particle Cleaning26:13 Exploring NID IV Therapy27:28 Cost-Benefit Analysis of Short-Term Symptom Management28:30 Increasing MSH: Strategies and Recommendations30:20 Affordable Service Practitioners33:13 Managing Treatment Costs and Financial Strategies34:15 Combating Fatigue from CS and Menopause37:01 Ensuring a Safe Living Environment42:18 Treating Methane SIBO During Actos and Endo Cleaning46:05 Becoming a CIRS Practitioner49:11 Final Thoughts and Closing Remarks
Helpful Links:SinusKey Test: https://patients.microgendx.com/products/sinuskeyEnvirobiomics #7: https://www.envirobiomics.com/product/sm-aeh-actino-endotoxin-hertsmi-2/Prescriptions for a Healthy House https://a.co/d/f8VjmZyJoin CIRSLab: https://www.cirslab.com/Check out the CIRS Summit: https://the-ultimate-cirs-summit.heysummit.com/

Wednesday Mar 26, 2025
Wednesday Mar 26, 2025
For more information, visit https://thecirsgroup.com
CIRS, or Chronic Inflammatory Response Syndrome, is a multi-system, multi-symptom illness that affects 24% of the population. Today, we are exploring what the triggers can be for people who develop CIRS: biotoxins! We cover mold, endotoxins, actinos, spider bites, ticks, cyanobacteria, and even vaccines. Check out the links below for more resources. Healing is possible! For more information, support, and resources in your own CIRS healing journey, visit TheCIRSGroup.com
TIME STAMPS:0:00 Intro and disclaimer0:40 Barbara’s terrible explanation of CIRS and our favorite biotoxins4:36 Genetic predisposition and a story about pfiesteria6:40 Other common biotoxins8:10 How exposure to a biotoxin can cause a whole shift in your health9:20 Triggers vs ongoing exposure10:14 New info on endotoxins coming up on your GENIE test11:34 Triggers outside of biotoxins: Trauma12:42 Jacie’s story of physical trauma13:36 Trauma in childhood increases risk of developing chronic illness14:48 Treat the biotoxin and/or trauma in addition to CIRS16:22 CIRS can be put into remission with the Shoemaker Protocol
HELPFUL LINKS MENTIONED:Our previous episode on Genetics vs the GENIE test:
The CIRS Group:Support Community: https://thecirsgroup.comInstagram: https://www.instagram.com/thecirsgroup/
Other CIRS Support Communities:CIRS Lab: https://cirslab.comJenny Johnson’s group: https://simplifiedwellnessdesigns.com/cirs-healing-collectiveMelanie Pensak’s Meditation for CIRS community: https://thepracticeportal.circle.so/
Find Jacie for carnivore, lifestyle and limbic resources:Jacie’s book on the Carnivore diet! https://a.co/d/8ZKCqz0Instagram: https://www.instagram.com/ladycarnivoryYouTube: https://www.youtube.com/@LadyCarnivoryBlog: https://www.ladycarnivory.com/
Find Barbara for health and business tips and coaching:Website: https://www.actlikebarbara.com/Instagram: https://www.instagram.com/actlikebarbara/YouTube: https://www.youtube.com/@actlikebarbaraBook a CIRS coaching call with Barbara: https://calendly.com/actlikebarbara/cirs-coaching
Jacie is a Shoemaker certified Proficiency Partner, NASM certified nutrition coach, author, and carnivore recipe developer determined to share the life changing information of carnivore and CIRS to anyone who will listen. Barbara is a business and fitness coach, CIRS and ADHD advocate, writer, speaker, and a big fan of health and freedom. Together, they co-founded The CIRS Group, an online support community to help people that are struggling with their CIRS diagnosis and treatment.

Wednesday Mar 19, 2025
Wednesday Mar 19, 2025
For more information, visit https://thecirsgroup.com
CIRS, or Chronic Inflammatory Response Syndrome, is a multi-system, multi-symptom illness that affects 24% of the population. Unfortunately, very few doctors are educated and certified to help you heal from it. Today, we want to help you find the doctor and health coach that is right for you. Check out the links below for more resources to aid you in your search. Healing is possible! For more information, support, and resources in your own CIRS healing journey, visit TheCIRSGroup.com
TIME STAMPS:
0:00 Intro and disclaimer
0:50 Why use a Shoemaker certified practitioner
3:00 How to find a Shoemaker certified practitioner
5:24 How to use your general practitioner in conjunction with a Proficiency Partner
6:34 Shoemaker Certified Practitioner vs Proficiency Partner
8:35 Cautionary tale re: using a non-Shoemaker certified doctor
10:37 The benefits of adding a Proficiency Partner to your team
11:40 Educating your CIRS-ignorant providers
HELPFUL LINKS MENTIONED:
Surviving Mold website: https://www.survivingmold.com
Book with Christian: https://consult-christian.as.me/schedule/a89e8b00
Nutrition with Judy: https://www.nutritionwithjudy.com/
CIRS studies to share with your doctor: https://www.survivingmold.com/Downloads/Dooley-McMahon_Final_Publication_-_3-30-2020.pdf
https://www.survivingmold.com/Publications/CIRS_diagnostic_protocol_final_5_1_2018.pdf
Our podcast on What is CIRS: https://youtu.be/eqso4R0cQhg?si=lceCk-iCRfG1NnVf
The CIRS Group:
Support Community: https://thecirsgroup.com
Instagram: https://www.instagram.com/thecirsgroup/
Other CIRS Support Communities:
CIRS Lab: https://cirslab.com
Jenny Johnson’s group: https://simplifiedwellnessdesigns.com/cirs-healing-collective
Melanie Pensak’s Meditation for CIRS community: https://thepracticeportal.circle.so/
Find Jacie for carnivore, lifestyle and limbic resources:
Jacie’s book on the Carnivore diet! https://a.co/d/8ZKCqz0
Instagram: https://www.instagram.com/ladycarnivory
YouTube: https://www.youtube.com/@LadyCarnivory
Blog: https://www.ladycarnivory.com/
Find Barbara for health and business tips and coaching:
Website: https://www.actlikebarbara.com/
Instagram: https://www.instagram.com/actlikebarbara/
YouTube: https://www.youtube.com/@actlikebarbara
Book a CIRS coaching call with Barbara: https://calendly.com/actlikebarbara/cirs-coaching
Jacie is a Shoemaker certified Proficiency Partner, NASM certified nutrition coach, author, and carnivore recipe developer determined to share the life changing information of carnivore and CIRS to anyone who will listen. Barbara is a business and fitness coach, CIRS and ADHD advocate, writer, speaker, and a big fan of health and freedom. Together, they co-founded The CIRS Group, an online support community to help people that are struggling with their CIRS diagnosis and treatment.

Wednesday Mar 12, 2025
Wednesday Mar 12, 2025
For more information, visit https://thecirsgroup.com
CIRS, or Chronic Inflammatory Response Syndrome, is what we were diagnosed with three years ago. A little over two years ago, we started this podcast - and this week we celebrate 100 episodes! Today we discuss what CIRS has taught us: tips and cautionary tales for healing, how to navigate things when it gets complicated, and reminders of what’s most important. For more information, support, and resources in your own CIRS healing journey, visit TheCIRSGroup.com
TIME STAMPS:0:00 Intro and disclaimer1:40 Don’t cut corners like skipping remediation3:48 Doing the right tests at the right time5:45 Healing is a marathon, not a sprint9:04 Expect setbacks10:30 Everyone is different11:50 Peeling back the layers of the onion: co-infections13:05 It’s OK to take breaks, just keep going when you can15:10 Share your story16:30 CIRS hits your weakest points18:50 Record your symptoms so you can reflect on improvements20:18 Jacie is working out now! Healing is possible21:08 CIRS will test your relationships23:23 Join a support community
The CIRS Group:Support Community: https://thecirsgroup.comInstagram: https://www.instagram.com/thecirsgroup/
Other CIRS Support Communities:CIRS Lab: https://cirslab.comJenny Johnson’s group: https://simplifiedwellnessdesigns.com/cirs-healing-collectiveMelanie Pensak’s Meditation for CIRS community: https://thepracticeportal.circle.so/
Find Jacie for carnivore, lifestyle and limbic resources:Jacie’s book on the Carnivore diet! https://a.co/d/8ZKCqz0Instagram: https://www.instagram.com/ladycarnivoryYouTube: https://www.youtube.com/@LadyCarnivoryBlog: https://www.ladycarnivory.com/
Find Barbara for business/finance tips and coaching:Website: https://www.actlikebarbara.com/Instagram: https://www.instagram.com/actlikebarbara/YouTube: https://www.youtube.com/@actlikebarbara
Jacie is a Shoemaker certified Proficiency Partner, NASM certified nutrition coach, author, and carnivore recipe developer determined to share the life changing information of carnivore and CIRS to anyone who will listen. Barbara is a business and fitness coach, CIRS and ADHD advocate, writer, speaker, and a big fan of health and freedom. Together, they co-founded The CIRS Group, an online support community to help people that are struggling with their CIRS diagnosis and treatment.

Wednesday Mar 05, 2025
Wednesday Mar 05, 2025
For more information, visit https://thecirsgroup.com
Today we have a special guest! Dr. Dayan Goodenowe is a researcher that has unlocked the power of plasmalogens and thankfully, this is something that can be a real game changer for people struggling with CIRS, or Chronic Inflammatory Response Syndrome. We cover what they are, where they come from, how to try them for yourself, and more. Check out the time stamps and links below, and for more information, support, and resources in your own CIRS healing journey, visit TheCIRSGroup.com
TIME STAMPS:0:00 Intro and disclaimer1:28 What are plasmalogens?6:20 What do plasmalogens do?10:20 How Dr. Goodenowe started working with plasmalogens13:10 Glia and Nuero: what are the differences?16:47 Titrate up slowly and carefully18:40 Jacie’s experience with plasmalogens, and how plasmalogens help even in exposure23:30 Getting to baseline to build resilience26:45 Side effects to look out for when starting out21:10 Blood test to determine your needs/deficiencies38:24 How to work with Dr. Goodenowe or purchase his products
HELPFUL LINKS MENTIONED:Dr. Goodenowe’s website: https://drgoodenowe.com/His Prodrome website to purchase plasmalogens: https://prodrome.com/The CIRS Summit: https://thecirssummit.com/
The CIRS Group:Support Community: https://thecirsgroup.comInstagram: https://www.instagram.com/thecirsgroup/
Find Jacie for carnivore, lifestyle and limbic resources:Instagram: https://www.instagram.com/ladycarnivoryYouTube: https://www.youtube.com/@LadyCarnivoryBlog: https://www.ladycarnivory.com/Pre-order Jacie’s book! https://a.co/d/8ZKCqz0
Find Barbara for business/finance tips and coaching:Website: https://www.actlikebarbara.com/Instagram: https://www.instagram.com/actlikebarbara/YouTube: https://www.youtube.com/@actlikebarbara
Jacie is a Shoemaker certified Proficiency Partner, NASM certified nutrition coach, author, and carnivore recipe developer determined to share the life changing information of carnivore and CIRS to anyone who will listen. Barbara is a business and fitness coach, CIRS and ADHD advocate, speaker, and a big fan of health and freedom. Together, they co-founded The CIRS Group, an online support community to help people that are struggling with their CIRS diagnosis and treatment.

Wednesday Feb 26, 2025
Wednesday Feb 26, 2025
For more information, visit https://thecirsgroup.com
CIRS, or Chronic Inflammatory Response Syndrome, can be exacerbated by histamine response, or MCAS, aka Mast Cell Activation Syndrome. There are ways to keep this in check as you heal, and there is actually a good reason to address it that can mean raising your MSH! Check out the time stamps and links below, and for more information, support, and resources in your own CIRS healing journey, visit TheCIRSGroup.com
TIME STAMPS:0:00 Intro and disclaimer0:46 Histamines and what it does in your body2:42 MCAS or mast cell activation syndrome5:10 How MCAS/histamine treatment can help MSH6:21 How to know if you have a histamine reaction7:37 Ways to treat histamine reactions11:00 Low histamine foods13:18 Striking a balance in managing histamines
HELPFUL LINKS MENTIONED:Cromolyn Sodium nasal spray: https://a.co/d/aIZMfA4Billy Doe Meats: https://billydoemeats.com/
The CIRS Group:Support Community: https://thecirsgroup.comInstagram: https://www.instagram.com/thecirsgroup/
Find Jacie for carnivore, lifestyle and limbic resources:Instagram: https://www.instagram.com/ladycarnivoryYouTube: https://www.youtube.com/@LadyCarnivoryBlog: https://www.ladycarnivory.com/Pre-order Jacie’s book! https://a.co/d/8ZKCqz0
Find Barbara for business/finance tips and coaching:Website: https://www.actlikebarbara.com/Instagram: https://www.instagram.com/actlikebarbara/YouTube: https://www.youtube.com/@actlikebarbara
Jacie is a Shoemaker certified Proficiency Partner, NASM certified nutrition coach, author, and carnivore recipe developer determined to share the life changing information of carnivore and CIRS to anyone who will listen. Barbara is a business and fitness coach, CIRS and ADHD advocate, speaker, and a big fan of health and freedom. Together, they co-founded The CIRS Group, an online support community to help people that are struggling with their CIRS diagnosis and treatment.

Wednesday Feb 19, 2025
Wednesday Feb 19, 2025
For more information, visit https://thecirsgroup.com
CIRS, or Chronic Inflammatory Response Syndrome, is a complicated illness, and sometimes we might stall in our healing journey. When that happens, it’s a good idea to think about what stones might be left unturned. For some, that could be an oral infection or a bad root canal. Today, we’ll talk about some prevention tips and how to mitigate potential problems with your oral health that could be keeping you sick. Check out the time stamps and links below, and for more information, support, and resources in your own CIRS healing journey, visit TheCIRSGroup.com
TIME STAMPS:
0:00 Intro and disclaimer
0:47 So, why are we talking about oral health?
1:26 When to dive down this rabbit hole
3:19 Prevention tips
10:30 Cone Beam Scan
11:54 Holistic or Biologic Dentists
12:45 Swabbing for MARCoNs
14:13 Beeskeepers for actinos colonization
15:10 Disclaimer about trying new products
16:45 Word of caution
HELPFUL LINKS MENTIONED:
Ask The Dentist: https://www.instagram.com/askthedentist
Toothpastes:
Boka: https://a.co/d/2siCwHN
Fygg: https://a.co/d/d91aCxW
Mouthwash: https://a.co/d/cSvvg4O
Tongue scrapers: https://a.co/d/12ySY4L
MARCoNs test: https://www.microbiologydx.com/order-collection-kits
Beekeepers: https://a.co/d/ePutuIE
The CIRS Group:
Support Community: https://thecirsgroup.com
Instagram: https://www.instagram.com/thecirsgroup/
Find Jacie for carnivore, lifestyle and limbic resources:
Instagram: https://www.instagram.com/ladycarnivory
YouTube: https://www.youtube.com/@LadyCarnivory
Blog: https://www.ladycarnivory.com/
Pre-order Jacie’s book! https://a.co/d/8ZKCqz0
Find Barbara for business/finance tips and coaching:
Website: https://www.actlikebarbara.com/
Instagram: https://www.instagram.com/actlikebarbara/
YouTube: https://www.youtube.com/@actlikebarbara
Jacie is a Shoemaker certified Proficiency Partner, NASM certified nutrition coach, author, and carnivore recipe developer determined to share the life changing information of carnivore and CIRS to anyone who will listen. Barbara is a business and fitness coach, CIRS and ADHD advocate, speaker, and a big fan of health and freedom. Together, they co-founded The CIRS Group, an online support community to help people that are struggling with their CIRS diagnosis and treatment.