Announcement: Moving Practice

Dear Friends and Patients,

It is with mixed emotions to announce that I will be resigning from Comprehensive Medical Center effective June 2, 2023.  I am grateful for the relationships and experience I gained over the last 2 years under Dr. Kimiai’s leadership.  

Effective immediately, I am opening my own private practice, Oak Tree Integrative Medicine.  This will be a partnership between myself and Sophia Health Institute (SHI) in Woodinville, WA.   I am honored to have the opportunity to work alongside my mentor once again as well as to collaborate with the dedicated team surrounding Dr. Dietrich Klinghardt, MD.  This partnership provides me with access to the extensive resources at SHI to allow me to better serve you.

I understand that this change may feel sudden and unexpected.  I would like to reassure you that my commitment to providing outstanding and uninterrupted care to my patients remains unwavering.  I believe this is an important move to further my own development as a physician so that I can advance my knowledge and skillset.  I feel confident that partnering with Sophia Health Institute is an excellent way for me to continue my own evolution and growth.

I will begin seeing patients in Woodinville on Monday, June 5, 2023.  I have reserved the appointments currently scheduled with me at CMC at my new practice so that my established patients have first priority in my schedule.  Please email info@oaktreeintegrativemedicine.com as soon as possible to confirm your appointment(s) and establish care with me at this location. 

It is very important to me that this transition is as smooth as possible for you.  I would like to assure you that my rates, clinical focus and general policies will remain the same at my new practice location.  Please do not hesitate to reach out if you have any questions for me regarding this process.  I value the opportunity to work with you very much and am so grateful to you for trusting me with your medical care. 

I hope to see you soon at Sophia Health Institute!

Sincerely,

Dr. Katie Dahlgren

Announcement: Moving Practice

Dear HHA and patient community,

It is with very mixed feelings I’m announcing my resignation from Holistic Healing Arts.

I will be moving my practice to Comprehensive Medical Center in Kirkland, WA effective July 1, 2021. I completed the first 3 years of my residency at CMC over 10 years ago. This change represents a wonderful growth opportunity for me.​ ​I loved working at Holistic Healing Arts, and this is a difficult decision because the team​ ​there is like a family to me. However, I genuinely believe that we will ultimately all be able to help more patients by expanding our resources and broadening our impact. I will miss seeing my friends and coworkers at Holistic Healing Arts daily, but look​ ​forward to many more years of close communication, shared learning, and collaboration to provide the best possible health care to our patients. I am very excited for this next chapter of my career.

With Gratitude,

Dr. Katie Dahlgren

Dangers of Cell Phone Use in Children

Trigger Warnings: Suicide and self harm

I am a physician and have worked with thousands of patients during the last 15 years of my clinical training and professional practice. During that time, I have observed a frightening trend in the mental health of my pediatric patients. They are increasingly more anxious, depressed and suicidal. While there are certainly many variables contributing to this trend, the use of wireless devices appears to be a significant factor. This past week alone I consulted with three separate patients between the ages of 7 and 16 expressing suicidal ideation. Two of them have started cutting themselves. All of their parents, individually, expressed concern over their child’s almost constant use of a cell phone.

This is heart-breaking.

Pediatric mental health professionals are overloaded with young patients. In the Seattle area, most child therapists have full practices and are not accepting new patients. This is a terrifying reality for parents seeking help for their children. Some of these children are harming their bodies through food restriction or cutting. Others have lost hope for the future and interest in things they used to love. This literally covers a significant portion of the list of highly concerning behaviors identified in our state-mandated suicide prevention training. I know that the social isolation, stress of remote learning and significant changes in households as a result of the current pandemic are major factors of the current mental health crisis. The amount of mandated screen time needed to effectively facilitate remote learning is extraordinarily high. My husband and I choose to get weekly screen time reports for our children’s computers and tablets. Prior to the transition to fully remote learning in March, we restricted their total screen time (television, computer, tablets) to an hour a day during the school week and 2 hours a day on the weekend. The reports since the beginning of this school year show that they are averaging at least 6 hours a day. Some days it is closer to 11 hours a day, especially for our middle schoolers. This is in spite of the fact that NONE of them have cell phones. Most of their peers have phones and they do ask us to consider getting them mobile devices, too. We would like to promote social connection but want to be sure we are doing it in the best ways possible. I decided to do a review of the most recent literature to get a better idea of the current scientific perspective on the use of cell phones in children.

The science is clear – the typical use of mobile devices presents a serious threat to our children. Nearly every parent I know with adolescents complains about how their kids are ALWAYS on their phones. According to a Japanese study, mobile phone use is associated with conduct problems and hyperactivity/inattention. Researchers concluded that kids who use mobile phones more than 1 hour per day are also more likely to have emotional symptoms and peer problems. The authors of this study also speculate that increased mobile device use is “likely to increase children’s social isolation, and hinder opportunities for social interaction with family, friends, that benefits the development of social competence, resulting in emotional/behavioral problems.” [1]

In a letter to the Editor dated December of 2018, Sehar Shoukat, Assistant Administrator at California Institute of Behavioral Neurosciences and Psychology, expresses concerns about mobile phone addiction contributing to anxiety, depression, sleep difficulties and stress. Additionally, increased cell phone use in adolescents is associated with suicide risk and lower academic performance. [2] Common Sense Media estimates that teens in the US are using their phones an average of 9 hours a day and over half of those surveyed felt addicted to their phones. [4] This is especially concerning since scientifically teens and tweens are more susceptible to addiction than adults.

In addition to the psychological risks associated with mobile phone use, there are also concerns about the impact of Radio Frequency Electromagnetic Radiation (RF-EMR) on children’s health. The specific type of radiation emitted by cell phone is a concern for hindering brain development and increasing cancer risk. [3] According to the American Academy of Pediatrics, “when used by children, the average RF energy deposition is two times higher in the brain and 10 times higher in the bone marrow of the skull, compared with mobile phone use by adults.” I could not find any large-scale, published studies looking at the long-term risks of cellphone use specifically with regard to cancer in children. However, there are a number of studies investigating increased risks of brain tumors, breast cancer and testicular cancer in adults. [5] There are also studies showing decreased bone density in the lumbar spine and femoral head for men who carry their mobile devices in their pockets. [6]

I realize that the majority of adults and children I know use their mobile phones many hours a day. I am guilty of this myself. There are clear benefits for accessing information quickly and connecting with friends and family. And frankly, I do recognize that it offers a convenient distraction from a very stressful world. However, I think there are ways to use a cell phone responsibly to minimize the risks. Parents who choose to provide a cell phone for their children are advised to limit use to no more than 2 hours per day (this includes ALL screen time devices). Parents should keep the phones away from the dinner table and absolutely out of the bedroom. Additionally, it is recommended that children avoid holding the phone up to their ear and should instead make voice calls on speaker mode or using a wired headset to create distance between the phone and the body as much as possible. [7] Dr. Joseph Mercola sells a headset that transmits the sound waves through a blue “tube” to reduce radiation exposure.

Based on my clinical experience as well as our collective research, my husband and I have decided to postpone providing cell phones to our children until they are old enough to pay for them on their own. We anticipate this will be around the second year of high school. We want to promote unstructured play, in-person social interactions (when safe) and physical exercise to support their development both physically and emotionally. I strongly recommend all parents take the time to explore the literature available on this topic to make informed decisions for their own families.

Links to referenced articles:

1. Hosokawa R, Katsura T (2018) Association between mobile technology use and child adjustment in

early elementary school age. PLoS ONE 13(7): e0199959. https://doi.org/

10.1371/journal.pone.0199959

2. Shoukat, S., 2020. CELL PHONE ADDICTION AND PSYCHOLOGICAL AND PHYSIOLOGICAL HEALTH IN

ADOLESCENTS. [online] Ncbi.nlm.nih.gov. Available at:

<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449671/pdf/EXCLI-18-47.pdf> [Accessed 12

December 2020].

3. Ungar, M., 2020. Teens And Dangerous Levels Of Cell Phone Use. [online] Psychology Today. Available

at: <https://www.psychologytoday.com/us/blog/nurturing-resilience/201801/teens-and-dangerous-

levels-cell-phone-use> [Accessed 12 December 2020].

4. Baggini, J., 2020. Is It Time To Ban Children From Using Smartphones? | Julian Baggini. [online] the

Guardian. Available at: <https://www.theguardian.com/commentisfree/2017/dec/13/smartphone-

ban-children-sleep-depression-suicide> [Accessed 12 December 2020].

5. Shih, Y., Hung, C., Huang, C., Chou, K., Niu, S., Chan, S. and Tsai, H., 2020. Breast Cancer Risk Among

Taiwanese Women: A Case-Control Study. [online] Ncbi.nlm.nih.gov. Available at:

<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605549/pdf/cmar-12-10799.pdf> [Accessed 13

December 2020].

6. Saraví, Fernando D. MD, PhD Asymmetries in Hip Mineralization in Mobile Cellular Phone Users,

Journal of Craniofacial Surgery: March 2011 - Volume 22 - Issue 2 - p 706-710 doi:

10.1097/SCS.0b013e318207b79a

7.  Williams, A., 2020. How Do Smartphones Affect Childhood Psychology?. [online] Psych Central.

Available at: <https://psychcentral.com/lib/how-do-smartphones-affect-childhood-psychology/>

[Accessed 12 December 2020].

Optimal Seasonal Immunity and Viral Protection Protocol

Herbal recommendations for viral immunity:

Master Herbalist Steven Buhner has compiled a protocol to address virulent viral illnesses.  The tinctures and teas he recommends can be purchased here.  I also highly recommend reading his book “Herbal Antivirals.”

I have been making my own Elderberry syrup for my family for seasonal immunity.  I like the recipe available from Lexi’s Clean Kitchen. This is incredibly easy and my kids actually like the way it tastes.  Adults should take 1 tablespoon twice per day for prevention and kids should take 1 teaspoon twice per day.  

Medicinal mushrooms, such as those sold by Host Defense, are well-established immune regulators to boost immunity.  Follow package instructions for dosing.  

Herbs that we are using at HHA to promote viral immunity and respiratory health include Astragalus, Calamus, Cat’s Claw, Chinese skullcap, Cinnamon, Devil’s club, Echinacea, Grindelia, Lemon Balm, Lomatium, Osha, Poke, Saint John’s Wort, Usnea.  Please work with your Naturopathic Doctor or Herbalist to determine the right blends for you.  

Nutrients for immune support:

Selenium – 400 – 800 mcg daily with food.

Zinc picolinate – 100-300 mg daily with food.  

Vitamin A – 25,000 IU most days.  100,000 IU daily for 7 days every 8 weeks as a high dose pulsed protocol.

Vitamin D – 5,000 – 10,000 IU most days. 50,000 IU daily for 7 days in a row every 8 weeks as a high-dose pulsed protocol.  

Fish oil or plant-based EFA’s – 3 capsules or 1 teaspoon with food daily.  

Specific dietary guidelines for optimal immunity:

  • Reduce or completely eliminate refined sugar.  Sugar is immune suppressive.  

  • Consider a ketogenic diet and intermittent fasting to promote autophagy and strengthen immunity.  

  • Avoid processed foods.  Try to eat foods prepared at home with organically sourced, whole-food ingredients.  

  • Focus on optimal hydration by drinking plenty of clean, filtered water with electrolytes.  

Focus efforts on improving the foundations of good health:

  • Fresh air and time in nature

  • Regular exercise

  • Healthy diet

  • Restful sleep

  • Supportive relationships

  • Clean environment

  • Stress management

  • Spiritual connection

Does hygiene really work for viral protection?

Short answer – yes.  Frequent hand-washing — and use of hand sanitizers when hand-washing is not practical — help reduce disease transmission.  I also recommend that patients with weakened immune systems change their clothes as soon as they get home and wash clothing immediately.  Showering as soon as you get home also helps wash away viruses that may be attached to skin and hair.  Many viruses need to be attached to mucosal membranes for many hours before they can cause infection. Along these lines, I also recommend nasal rinses with saline, xylitol (X-LEAR), silver (ACS-nasal), propolis (Propol-IT).  I suggest patients use the sprays at least 3-4 times per day for prevention and up to every hour during acute illness or exposure. More frequently washing and changing bed sheets and towels can also help reduce infection risk.  

Masks are most effective when worn by sick patients to prevent transmission.  Healthy patients may not benefit from wearing masks.  The quality of mask dramatically impacts the effectiveness.  I advise patients to look for carbon-based masks with at least an N95 rating (or higher).  

How can I prepare my household ?

  • Be sure to find balanced, reputable sources for accurate information.  Read information distributed online with a critical eye for accuracy and relevance.  

  • Stay home if you have acute cold or flu symptoms.  

  • Incorporate healthy habits to promote optimal immunity – this includes time in nature, eating a healthy diet, maintaining good hydration, sleep hygiene, spiritual connection and stress management.  

  • Ensure that your nutrient status is well supported by eating a variety of healthy foods and supplementing with professional-grade nutrients when needed.

  • Implement an herbal and functional medicine protocol to support viral and respiratory immunity.

  • Keep a 4-week supply of food and dry goods in your home – be sure you have enough for everyone in the family, including pets.  Supplies at many stores in Western Washington are already low as the community is purchasing higher quantities of household supplies than normal.  

  • Keep a 30 -day supply of essential medications at home in case of an interruption in supply.

  • Identify child-care plans in case schools are cancelled for extended periods.

  • Discuss options for working remotely with your employer

  • Use essential oil diffusers and natural anti-microbial agents to clean surfaces in the home and car frequently.  

  • Use air filters in the home – most will help to reduce pathogens and particulates, some (like Molekule) also destroy microbes.

     Remember – the body’s inherent ability to defend against invasive pathogens is truly remarkable.  We come into contact with potentially life-threatening infectious diseases every day.  Most of the time, we will have no conscious awareness of the interaction between these bugs and our mighty immune defenses.  Empower yourself to take charge of your health and make positive changes at this time for your family. 

PRP Injections for Aesthetics

What is PRP?

Platelet Rich Plasma (PRP) is an autologous blood product that is extracted from the patient, processed in special equipment, and injected back into the patient. Platelets are the component of blood that are responsible for healing wounds in the body. This extract from the patient’s own blood has been extensively studied and known to increase elastin and collagen production and is a rich source of healing growth factors. Injecting PRP into areas of the skin that are showing signs of wrinkles and sagging can help restore a more youthful appearance by repairing the skin.

What is involved in the process of PRP injections?

Blood is drawn from a patient in a comfortable clinical setting and then processed in a centrifuge machine while the patient waits. During processing, the blood is separated into three layers. The top layer is a light yellow color and is referred to as platelet poor plasma. The bottom layer is a rich red color and contains packed red blood cells. The middle layer, referred to as the buffy coat, contains approximately 70% of the platelets from the whole blood sample. The buffy coat, or platelet rich plasma (PRP), is extracted from the other layers using specialized equipment. This entire process takes approximately 30 minutes. The clinician will work with the patient to decide the exact way of applying the PRP depending on the patient’s goals for their skin. The physician then activates the PRP with a small amount of calcium chloride, and then injects the mixture into the patients’ skin, targeting areas of wrinkles or scarring to restore a more youthful look.

What are the risks of PRP?

One of the most appealing things about this procedure is that there are almost no reported adverse reactions or side-effects from PRP. There are very few contraindications to the treatment and the only restrictions after the injections are to avoid excessive sun exposure. There is minimal down-time; patients can resume most normal activity immediately following the injections and can wear make-up and moisturizer as soon as the next day. Most patients will want to stay home the rest of the day only because their skin is often very red immediately after the procedure.

How long do the results last?

It is important to note that the full results of PRP are often not observed for several weeks after the injection. Unlike dermal fillers and other aesthetic products, the changes to the skin are more subtle and take longer to appear. This is because it is not a band-aid to conceal damaged tissue. PRP is actually improving the actual skin health and this takes some time. Maximum skin improvement from PRP can take up to 12 weeks. However, once the desired results are achieved, the results are more long lasting.

How often do patients need to get treatments to establish and maintain results?

This depends on the extent of the damage to the skin at the beginning of the treatment as well as the patient’s lifestyle, overall health, and genetics. Most patients will start with 1-3 treatments, spaced a month apart if more than one treatment is recommended. After the initial treatment phase, patients usually repeat the injections once a year to maintain the results. This is not necessarily because the effects “fade” over time as is observed with Botox and fillers. With PRP, the need for repeated treatments is only due to the fact that the skin will continue to age as time goes on. Avoiding excessive sun damage, staying well hydrated, minimizing inflammation and toxic environmental exposures are some important things a patient can do to promote and maintain excellent results. Additionally, it is HIGHLY recommended that patients work with a skilled aesthetician to develop a skin care regimen that would optimally include both home care products and regular professional facial treatments.

What is PANDAS/PANS + Diagnosis and Treatment

What is PANDAS/PANS?

PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep. PANS stands for Pediatric Autoimmune Neuropsyschiatric Disorders. The main differences between the two acronyms are the specificity of acute onset and association with the pathogen strep in PANDAS. The clinical presentation overlaps significantly.


How common is PANDAS/PANS?

According to PANDASnetwork.org, 1 in 200 children experience the clinical symptoms of PANDAS/PANS.


How is it diagnosed? What are the common symptoms?

There are no reliable biomarkers or lab tests to make the diagnosis of PANDAS/PANS. Diagnosis is based on symptom presentation. Clinicians worldwide are working to establish a list of the criteria for the diagnosis. At this time, there is no consensus regarding these criteria. Most practitioners look for common symptoms including the acute onset of neuropsychiatric symptoms.

These symptoms include:

  • Obsessive compulsive behaviors and thoughts
  • Intrusive thoughts or phobias 
  • Tics 
  • Anxiety
  • Personality changes

Behavior changes including sleep disturbances, rage, sudden attachment anxiety, loss of appetite,
involuntary movements and "potty accidents" in a previously trained child. Some children stop talking completely. The severity of these symptoms varies significantly from child to child, and it is rare for a child to have every single symptom associated with PANDAS/PANS.

Are there any objective tests to help with the diagnosis and to track treatment efficacy?

Cultures for strep should be used to assess patients with suspected PANDAS. Checking for antibodies to common infections including viruses and streptococcus can be helpful. Autoimmune markers, including those in the Cunningham Panel from Molecular Labs, are also useful. Labs looking for inflammatory markers can be used to track treatment response.

How is PANDAS/PANS treated in conventional medicine?

Treatment strategies focus on reducing inflammation in the brain and treating the triggering infections. Interventions include both short and long-term antibiotics, IVIG, plasmaphoresis, and steroids. Some psychiatrists also use sedatives, mood stabilizing medications, and anti-psychotic medications to manage symptoms. Once a patient is relatively stable, they may benefit from cognitive-behavioral therapy.

Are there natural treatments that can help a child with PANS/PANDAS?

Absolutely! Herbal medicine can be a very powerful tool for a more safe and effective, long-term antimicrobial approach. Specific herbal protocols are individualized for each patient to most accurately address the microbes out of balance. Functional medicine tools including nutrient therapy can also be very helpful for reducing inflammation and promoting healthy neurotransmitter levels.

How do you treat children with PANDAS/PANS?

In my practice, I look for the underlying cause of the inflammation for each patient. Viruses, vector-borne illnesses, mold exposure, and parasites are all infectious agents that can cause neuropsychiatric symptoms. Detox support and effective reduction of toxic burden is also critical to a successful approach. Correcting nutrient deficiencies can improve the immune response to allow the body to keep the opportunistic infections under control. Additionally, it is important to address the health of each family member to prevent re-exposure from an asymptomatic carrier. Finally, we recognize the significant stress involved in caring for a patient with PANDAS/PANS. It is very important to discuss supportive resources and encourage the caregiver to prioritize their own health in this process. Immune modulation, such as LDI (low dose immunotherapy), is another very successful therapeutic intervention. Treatment protocols using an integrative medicine approach are extremely effective and often result in dramatic improvement in symptoms.

The Impact of EMF, RF, and ELF on Human Health

What are EMF, RF and ELF?

EMF stands for Electro Magnetic Fields.  There are two types of EMF’s - ELF (extremely low frequency fields) and RF (Radio Frequency fields). They are both used pervasively in our modern environment. ELF’s are produced by all electronic devices. RF’s are non-ionizing radiation signals produced to communicate with antennas including cell phone, WI-Fi and Bluetooth.  

How do EMF’s relate to human cell function?

Our cells have an electrical charge. Cell-to-cell signaling and changes in cell structure and function occur when there are very small changes in the electrical charge on the surface of the cell. The electrical potential of our cells is extremely small compared to the electrical fields in our environment.  EMF’s activate voltage gated calcium channels on the membrane of the cells.  When we are in the presence of strong electrical fields, our cells have to invest energy in maintaining their electrical gradients. This diverts resources away from other processes including immune response and cellular repair. 

Is there any evidence that these fields are harmful for human health?

Extensive research indicates that EMF exposure is likely carcinogenic. Unfortunately, many people have attempted to claim that EMF exposure is not harmful because they have only looked at the thermal effects of the devices. Pulse modulated signals, produced by cell phones, have no impact on tissue temperature but still have a biological effect on cells, tissues and organs. (C. Blackman, Pathophysiology.) In addition to EMF’s being carcinogenic, they negatively impact the endocrine system, the reproductive system, the neurological system, the immune system and cardiovascular system. They damage DNA leading to genetic defects. EMF’s also cause fatigue by damaging mitochondria, the organelles responsible for energy production in the cells. Accelerated aging occurs in EMF exposed individuals because of an accumulation of excess nitric oxide in the cells caused by activation of the voltage gated calcium channels.  

What are the symptoms that can be experienced by sensitive individuals?

Common symptoms worsened or caused by EMF include fatigue, infertility, brain fog, neuropathy, headaches, heart arrhythmias, anxiety, learning difficulties, memory problems and insomnia.    There has been a spike in cases of Alzheimer’s disease, autism, depression, fibromyalgia, hypothyroidism, osteoarthritis and sleep apnea – these increases are occurring as the EMF exposure simultaneously increases in our environment.  

Practical solutions to our modern environment?

  • Discontinue the use of CFL’s in the home (Switch to incandescent, there is conflicting information about LED’s).
  • Place the WI-FI router as far as possible away from people, especially in the sleeping location.  Get a faraday cage for the router.  
  • Cell phones should be a minimum of 12 feet away while sleeping.  Ideally, these would also be placed in a faraday cage.  
  • Unplug all devices from the electrical outlets in the bedrooms.
  • Turn off all fuses to the home at night.
  • Wear EMF protective clothing during the day. 
  • Consider Earthing technology for computer and sleep locations.

What are the best resources that you know of to learn more about EMF dangers and purchase tools to reduce exposure?

  • Magdahavas.com – many articles discussing EMF impact on human health
  • LessEMF.com – great resource for EMF shielding clothing and devices
  • Earthing.com – tools to bring healthy frequencies to the body

What is Neural Therapy?

Neural therapy is the use of injectable local anesthetics to treat areas of dysfunction at the level of the skin and connective tissue to normalize the autonomic nervous system. Procaine is the most commonly used local anesthetic used in my practice. This particular local anesthetic is metabolized to B-vitamins after it is injected into the connective tissue. It has a short half-life in comparison to other local anesthetics like Novocaine and Lidocaine – the local response of numbness lasts for about 20 minutes. Local anesthetics work by temporarily interrupting the electrical signals of the cells.

Each cell has a normal resting potential. Cells that have an abnormal resting potential (or electrical voltage) do not function optimally. This impacts the cells both individually as well as those distally related by a common network of nerves. This allows us to use neural therapy to help optimize both superficial and deep structures by treating at the level of the connective tissue with very safe, shallow injections. Once the effect of the local anesthetic wears off, the brain signals the tissue to reset at a healthy resting potential. This allows for improved cell-to-cell communication to promote circulation and regeneration of healthy tissues.

Neural therapy is one of the most effective therapeutic interventions I use in my practice to promote healing. I utilize this technique as part of a comprehensive approach to chronic illness and localized pain, as well as to clear areas of dysfunction in the body. Common types of dysfunctional tissue include scars and previous injuries. These injections can provide an amazing degree of pain relief for both chronic and acute conditions. I have been able to help patients with severe back, shoulder, knee, neck, hip, and ankle pain (among many others) by using neural therapy. Additionally, we can inject over areas of organ stress. I use it as part of my comprehensive protocols to treat issues such as chronic constipation, irregular menstruation, frequent or painful urination, sinus pressure, and respiratory irritation.

I learned this technique from my mentor, Dr. Dietrich Klinghardt, MD, PhD. He has published articles on neural therapy in both English and German, and continues to both practice and teach the technique worldwide.

Learn more here.


Disclaimer: All content found on drkatiedahlgren.com is for informational purposes only, and is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any medical questions you may have. Consent has been given for any patient images on this site.