Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Should I see a neurologist for a pinched nerve affecting my hip and down my leg--siatic (sp).  I have already had two back surgeries, 70 yr old active lady and I refuse to take the pills prescribed because they make me "looney".  Pain pills just cover up, not correct and I already have some nerve damage to the lower leg from before the surgery. ### REPLY: Hi, I have gone through your query. There may be some compression of nerve in your lower vertebra, which is causing you pain in hip and leg. Medicines only relieve the symptoms. Treatment should be done according to level of compression. At initial stages physical therapy with lifestyle modification help to reduce the progression and at later surgery is advised. MRI is of lower vertebra with clinical examination is suggested after consulting a neurologist. Do consider positive feedback as a credit to my work. Let me know if you have any further questions. You can contact me on my page http://bit.ly/1dYupT2 ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am living in Bangalore temporarily and have Fibromyalgia. I have been reading that the underlying cause can be due to an under active thyroid. I was doing better but recently began to feel much worse. I don t know what to do or who to see here in the city. ### REPLY: Hello, I hail from Bangalore. Fibromyalgia what it is must be known to you.  Having a good hands-on physical examination can help understand the extent of the fibromyalgia involved in the muscular system. Since you didn't mention anything about which are is more painful it is difficult to put words on how to resolve the issue Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there I need to know an answer or somthing that can help... please.... I had a D&C for polyp removal an scrapped feb 18, 2010 and before that my cycles have always been regular, It s now 3 years later and after that surgery my cycles have been irregular and really off . please be honest I m wondering if I can concieve ### REPLY: Hello, I would be happy to help you with your question. My assumption is that before the polypectomy, your cycles were irregular, or you were having irregular bleeding.  A D&C is limited in terms of its ability to completely remove polyps that might be present.  It is my opinion that you need to be re-evaluated for regular bleeding, and this evaluation needs to include re-evaluation for polyps.  This would include labs to check for thyroid dysfunction, prolactin levels, diabetes screening, labs related to PCs, and an ultrasound called a sonohysterogram.  Only then can one make a guess whether you will need assistance to get pregnant, or whether this will happen on its own.  Do not give up hope!! I hope that this helps and good luck!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: ok so i just came on my period yesterday on the 12th it was suppose to be on the 14th but my period comes when she wants. Anyways I usually am on for 7 days and Im trying to get pregnant so when should I try to get pregnant. When will I be ovulating? ### REPLY: Hello, and I hope I can help you today. When you have irregular menstrual cycles, it is difficult to pinpoint the time of ovulation each month. Ovulation generally occurs about 14 days before your period starts. So if you count 2 weeks backwards from the date that your period starts, you can figure out by looking a few months back what your typical window of time is typical for your ovulation. If you have intercourse every other day from two days before your typical ovulation time until you either feel PMS symptoms or your period comes, whichever comes first, there should be enough active sperm around when you typically ovulate for you to conceive. For more accurate estimation of your ovulation, there are kits called ovulation projectors that can be bought over-the-counter in a chemist or pharmacy. These kids have test strips for your urine that check for certain hormone that is released when you are about to ovulate. These test strips can also be useful if you do not have regular cycles when trying to conceive. If you and your partner try unsuccessfully for one year to get pregnant, there may be a medical reason involved in why you are not conceiving. At that point, you may want to consult with your gynecologist or fertility specialists. I hope I was able to adequately answer your question today, and that this information was helpful. Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was just told by Radiologist I have Periosteal Reaction, percentage wise how often is it cancer? I barely made it home from Radiology before my Dr. called saying he had set up an appt with an ortho Dr. Usually you wait some time before you can get in. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Periosteal reaction only does not indicate cancer. However, it should be correlated with other radiological findings and clinical findings also. Send me your complete report so that I can help you further. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 6 mos post gastric bypass wit hthe following blood resultsLow MCHC, High MPV and low absolute lymphocytes.  Low Vitamin D (I am chronically low here and have been always)My blood work also showed Hyperparathyroidism.  High Sodium High chloride, Low Creatinine  What does this all mean for me ### REPLY: With a history of post gastric bypass, nutritional deficiencies due to iron and calcium are fairly common. Iron deficiency is causing a low MCHC. Your MCV and MCH must also be on the lower side. To confirm that it is iron deficiency, a serum iron test would be helpful.MPV means platelet volume, and has no relation with your clinical history. As long as your platelet counts are normal, I am not bothered about High MPV. Please check your platelet counts and confirm. Low absolute lymphocytes - You would need to give me your exact total WBC counts and differential counts, before I comment on this.- Calcium deficiency and electrolytes imbalance is common in gastric bypass patients. Calcium deficiency causes hyperparathyroidism. What are your serum total and ionized calcium levels ? - Creatinine is generally related to your muscle mass and is excreted by kidneys. Again this has no correlation with your medical history. Please mention other findings in your kidney profile, for further comments. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr Samuel I have experience a bad pain on my hand for 2 days i couldn t sleep last night from the pain. This morning it was very difficult for me to even get dressed on my own and do my own hair I placed icy hot and the pain is more miled but i can still feel throbbing aches and pains here and there Do you possibly think it can be a bite? or can it be that I had been using an exercising muscle band and just pulled a muscle ### REPLY: Hello, I have studied your case with diligence. Possibility of bite is less. As per your symptoms I would like to keep differential diagnosis of rheumatoid arthritis, carpal tunnel syn . Rheumatoid arthritis may involve small joints and early morning stiffness in joints, do you have sucChatDoctorplain? When such patients come to our hospital I advise them blood test like RA factor, CCP, ESR, complete blood count, HLA B27. Carpal tunnel may involve sensation and associated with hand swelling. I will advise consulting doctor and do clinical examination. Till time take analgesic and physiotherapy like ultrasound or tens. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: We have an MRI -Brain of my father which was performed using T1 weighted gradient echo, T2 weighted fast spin echo & fast FLAIR sequences. The report shows the following: 1) Multiple small areas of restricted diffusion seen in the bilateral cerebellar hemispheres, vermis and right lateral medulla. 2) Lacunar gliotic focus is seen in the left basal ganglia . Few Lacunar hyperintense foci are seen in the bilateral fronto parietal white matter on FLAIR images. what does it indicate? Is there a cure for this?? Nitin ### REPLY: Hi, Thank you for posting your query. Your fathers MRI reports multiple areas of infarcts (lack of blood flow). Treatment requires use of blood thinners such as aspirin or clopidogrel.  In addition, the risk factors for brain stroke such as BP, sugar, cholesterol and homocysteine should be identified and properly treated. With the above measures, we can treat him and prevent any major paralytic stroke.  Best wishes, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, Im Vas from Chennai and undergone Circumcision surgery on 1st July 2012. I was married on 1st June 2012. post surgery after 1 month, when i try to intercourse with my wife, my penis is bending not going inside smoothly.. We tried many ways, Could you please let me know what would be the problem? ### REPLY: Degree understand your concerns went through your details. I do not see any physical or organic problems in your present condition. Circumcision is a simple and normal surgical procedure and there may not be any complications after such a surgery. Over and above, you were able to perform sexual activities before the surgery. In that case, the most possible causes for your present problem (Erectile Dysfunction or ED) could be psychological. I suggest you to consult a psychologist or sexologist for counseling. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 16 years old and about 5ft 6 in height. And about 3 months ago I had my appendix taken out which I never went for a check up afterwards. But I have been having severe headaches mainly when go from sitting to standing. I also have been feeling dizzy but rarely, I feel nausea now and then. And just today I have been having a green poop. I have been really tired all the time even though I have been sleeping. Is something wrong? ### REPLY: Hi, First, you should measure your blood pressure and if you were a woman, and you take oral contraceptive pills, you should ask a gynecologist to adjust the dose. Secondly, if your blood pressure were high, you should do an ECHO and an ECG on your heart. After the surgery you should have done liver and kidney function tests, besides CBC to assess your health and the results of these investigations can help us with your diagnosis. Finally, you should not ignore the psychological factors such as stress. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having swollen feet and have had many tests for blockage in legs, but no Dr can find what s wrong. I was checked for gout, high blood pressure, diabetes, and yet no one can find what s wrong. I have a sister who says I should have my heart checked. I take no prescriptions because I am overall health. I am 209 lbs and 64 yrs old. I eat salads with no salt in my diet and drink a lot water. What do you think???? ### REPLY: What is your average blood pressure. See salt restrictions are like to take low salt content, but that doesn't mean you totally stop salt intake!  Feet are like small chambers and gravity affects more to accumulate fluid if any retention is there in leg. As your history doesn't suggest any major pathology, get your thyroid profile done. Hypothyroidism can also lead to accumulate fluid mostly over major body areas. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: at first I wasnt too concerned about just the pain ive been having on the left because I have had kidney stones several times in my life.  The pain is on my side I quess you could say as low as the waist area but more toward the side and and  sorter toward my back. I use icy hot and that does help with the pain. What has me worried because with kidney stones I never did this or didnt notice, but for almost two weeks now when I urinate it has a brownish look to it and its usually a light yellow or very clean looking. it doesnt look like bloody urine. Its a brownish, like a dirty water look kinda. I guess thats the best way of describing it. I dont know if one has to do with the other but I have also notice that sometimes when I move a certain way or sit down I find myself saying oh, my back hurts. It not unbearable just unconfortable and like I said I didnt think much first couple of times but its every time I go to use the bathroom. It doesnt hurt to urinate at all. I just feel a uncomfortable feeling on my left side a little above my waist area toward the back just a little. I know it has something to do with my kidneys and im getting a little worried. Can you help with what I explained to you. I hope I made since explaining it to you ### REPLY: HelloThanks for query. You are known to get urinary stones repeatedly and now has pain in left loin and back with brownish urine. The brownish urine is too due to blood getting mixed with acidic urine. Looking at the symptoms that you have it is certain that you have stone either in ureter or left kidney and needs to get investigated further. Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis. 1) Urine routine and culture. 2) Ultrasound scanning of abdomen and pelvis. Further treatment will depend upon result of these tests and final diagnosis as regards size and site of the stone and degree of obstruction (HY .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 7 year old boy with a resting heart rate of 105 bpm taken apically. No other symptoms or complaints of pain with the only discomfort being an elevated heart rate. He has been treated with albuterol for respiratory issues related to a suspected allergic reaction to dogs. Was given a treatment of albuterol 15 minutes ago. What could cause this issue? ### REPLY: Hello, I just read your query. Albuterol which you are using for allergic respiratory problem is a bronchodilator. Bronchodilator usually relaxes muscles of bronchi(airway that conducts air into lungs), as a result makes breathing easier during allergic reaction.* Rapid heart rate or pulse rate is one of the side effects of using albuterol. * You can discuss the thing with your physician and opt out for alternative. But if you can not contact him immediately and other dose is due then for the time being use half res pule of albuterol, and you can also mix the half res pule with normal saline. * But do contact with your treating doctor and go for some other option.* I hope you find my answer helpful. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I suffer from a white coated tongue. It is not oral thrush, as I have taken medicine for this. I am looking for a resolution. CO2 laser treatment or elctrodessication. However, will this eliminate my production of volatile sulfur compounds or at least drastically reduce it? And could you recommend anyone? ### REPLY: Helloi have gone through your query. As it is not an oral trust(fungal infection).it can be leukoplakia or oral lichen plans. You have not mentioned your age. Do you have any habit of smoking or chewing tobacco or alcohol. Do you have any other symptoms like burning mouth or sores.sometimes it can be due to improper brushing and cleaning of your tongue. If I was your treating doctor i would suggest you to have oral prophylaxis. Quitting of any bad oral habit if you have. Examination of lesion if its leukoplakia then an antioxidant like beta-carotene and lycopene for three months. Laser treatment or electrodessication is a procedure to consider when this treatment fail to work and depending upon the severity of the condition.i would suggest you to visit a dentist and get it checked first. Hope this ans helps regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had root canal surgery done about 2-3 weeks ago. It was fine for a little while but then my tooth started to hurt, so i used whiskey to numb the pain. I left it on too long and it burned my gums. Now my cheek and gums are swollen, but i can also feel pain in the roots of the tooth. Do you think the swelling is caused by an infection, or the burn. Thanks,Dom ### REPLY: Hello and welcome. Thanks for sharing your concern. Please note that that swelling could be due to the infection in adjacent tooth or the treated tooth itself. Please do not apply whiskey or any such solutions. It requires a dental visit and clinical examination. In case required you will have to go for re root canal.Therefore, see your dentist soon. For now, you can take painkillers until you see your dentist. Thanks. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My grandmmother is 81 yrs old. Checked her bp several times over a 3hr period and always got 190/90.  Doctor gave her CAPTOPRIL 10 minutes ago.  Her hands and feet are cold.  Shes weak and cant stand up.  She can move her arms and feet and didnt have a hard time in the bathroom 3 hrs ago.  Pls. advise.  Tks. ### REPLY: In my opinion she should be started only on Amlodipine (Novas) 5 mg once daily in the morning. Wait for at least a week while having her B. P recorded during that week 3 times per day. The new .  For her the target resting BP should be below 140/90mmHg. The dose of Amlodipine may be titrated to 10 mg daily if BP still going above 160/90mmHg. If you need further help regarding BP control strategy, feel free to contact. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have ongoing pain in one specific spot in my back. It has gotten progressively worse over several years to the point where I can only do limited work at the kitchen counter or tasks like washing dishes. Over the years I have gone to my doctor when the pain becomes unbearable. He says it is an inflamation in the intercostal spaces between my ribs. The pain I live with has gradually increased over the last 3 years and is now wide spread throughout my body. What could it be? It has to be something more than inflamation. ### REPLY: Welcome to  After going through your query I came to know that you are suffering from muscular pain with a tender spot in your back. Treatment of it is rest and analgesics (diclofenac three times a day after meals). Muscle relaxant such as thiocolchicoside can be added Vitamin B-complex and vitamin C supplementation can be used to promote healing. I give triamcinolone injection locally at tender spot to persons coming in my clinic having similar problems with good results. You can discuss with your treating Doctor about it. Hope I have answered your query. If you have any further questions then don't hesitate to writing to us. I will be happy to help you. You can also write to me directly on below link:https://www.bit.ly/ask . Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my left cheek has been swollen for two years now with mild nerve pain and the pain seems to be getting worse. Also a lump in the inside of my mouth and the skin lining feels really rough. I have been tested for all allergies and hade a biopsy done for melkesson Rosenthal and nothing. This swelling is not going away and no test is revelling anything. also went to the dentist , took X-rays and nothing. had a mri and revealed a small sinus infection but nothing major. HOPE YOU CAN HELP.. ### REPLY: Hi, Dear,Welcome with your query to . Studied your query in full depth of its details. Reviewed it in context of your health concerns. Based On the facts, You mostly seem to suffer from-left maxillary sinusitis with intramural hard palate swelling with it. The MRI confirms this sinus infection. Seems that you have nasal obstruction for quite some time more than 2 yrs of your cheek swelling. This has lead to the nerve pains due to the periapical areas of the upper jaw teeth, which is increasing lately. Other causes of such a lump could be Maxillary sinus poly / adenocarcinoma/ or periapical abscesses with periapical radiolucencies/nasal obstructions with cellulitis of the maxillary bones. Intra-oral protrusion in the hard palate-gives lump in the mouth in your case. Treatment--Treatment with Antihistamines +Anti-inflammatory +Antibiotics for 5-7 days is supplemented to recover the tissue edema prior to surgery.- Caldwell Luck Surgical .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello Sir, I am a mechanical engineer and working in a foundry.our job is melting of iron basically.Due to heat i have dark spots on upper portion of my cheeks not on all face.pls tell me what medicine i should take to remove those.There is a lot of difference in my complexion of face and of hands.My hands are very fair in complexion. Thanx. ### REPLY: Hi.thanks for your everywhere is a possibility that you have developed Plasma. This condition is aggravated by UV light sources, sun maximally. Please wear a sunscreen with broad some thrum of action during the daytime. Its is important to use umbrella and reapply the sunscreen 4-6 hourly. You can use a combination of HY .  Following which you should review for the further line of therapyMelasma is a very chronic recurrent condition. Hence I would advise you to start the treatment by visiting a dermatologist soon. Hope this helps ...take care! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor, mu mum is a patient of chronic asthma and Hypertension . she takes losartan potassium 50mg 1times daily and amlodipine 5g 2 times daily.if she takes the drugs her BP remains 130/70. to control asthma she takes Seretide Accuhaler 50/250 puff 1times daily and sulbutamol inhaler 3 to 4 times daily and montelukast 10mg 1 times. my mum is 66 yrs old. my question is that. is it safe to take montelukast 10mg for long term use? as i see if she takes that medicine her asthma is controlled better . please give me some suggestion ### REPLY: Hello, Thank you for asking t . I went through your history and would like to make suggestions for your mother as follows:1. Regarding your main query, montelukast 10 mg is usually considered very safe for long term use. Common side effects are nausea or stomach upset. If she is not experiencing such side effects, I would suggest her to continue it as it helps to control her asthma.2. However, albuterol inhaler is a "rescue" type of inhaler, which should be used only for asthma symptoms like wheezing or shortness of breath. If she needs to use it 3-4 time daily, it means her asthma is not well controlled, and she needs to upgrade her controller medications.3. Her controller medications are - montelukast and Sere tide 50/250. So I would suggest her to upgrade dose of Fluticasone component of Sere tide after consulting her doctor as daily use of albuterol inhaler is not desirable. 4. I would also suggest you to make sure that the technique of using Accurate by your mother is perfect. If it is not perfect, there are chances that adequate amounts of .  So please get her technique reviewed by her doctor.5. I would also suggest your mother regular breathing exercise and a healthy diet which will improve her lung capacity and immunity respectively. Hope above suggestions will be helpful to you and solves your query. Should you have any further query, please feel free to ask at . Wish your mother the best of the health ahead. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey there ! I had my paragard iud inserted on 18 sept,,2013,, last month,, and i didnt had intercourse till yesterday its like 3 weeks now and today i had it and i noticed little spoting after that ,may i know is this something serious ?? or do my iud got moved or something ,, i am just worried,,, please answer . . ### REPLY: Hello! Thanks for your query. Postcoital bleeding isn't normal, but it can be caused from: infection cervical or endometrial polyps vaginal cancer cervical cancer trauma determine etiology of postcoital bleeding, you need for further evaluation by your gun. If your recent PAP smear is negative, despite the low rate of serious pathologies seen in referred postcoital bleeding, is recommended colonoscopy. Take care of your self ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: about 6 weeks ago i had an operation on my left hand under general anesetic to remove a ganglion cyst after that i had a bad chest i had a blood test and my blood sugar level went up to 8.6. i recently had a fasting blood test and it went down to 5.8 and a blood test to test my liver it was up slightly and my colestrol was up abit as well. i have been feeling dizzy as well and have got tinitus and its driving me mad i am slight asmatic as well and i have got hayfever ### REPLY: Hi and welcome to , thank you for your query. I don't think this is related to your previous surgery. this glucose finding are not something serious, but it may require some medicines so consult your doctor about it. Dizziness and tinnitus can be caused by various neurologic and heart diseases, you need more detailed work up if it persists. Liver enzymes as well. As I said I would not relate it to your ganglion cyst surgery. Wish you good health. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 46yrs and have had hot flushes since I was. 31yrs they are now unbearable and making me depressed I also get itchy and take citrizine every day for 3yrs I have no sex drive and heavy periods and don t leave the house I have. A prolapsed disc in my back and my muscles and bones ache all the time I don t seem to get the attention I need from my doctors as I never see the same doctor twice and also feel depressed because of all the things going on with body I also have a paranoid personality disorder which affects me where I don t trust and anybody including my doctor I tend to stay home a lot as I have difficulty being around everyday people I know I have numerous complaints but need help ### REPLY: Hello, Welcome to . As per description it appears that, you already know many things about your problem. Apart from paranoid personality you appear to have following psychological problems: Anxiety, panic symptoms and agoraphobia. You just need to meet your nearby psychiatrist for final assessment and treatment. In treatment options are cognitive behavior therapy (CBT) +/- SSRIs are helpful. So, do not worry and work towards treatment. Wishing you good health and all the best.www.99doctor.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i have been having pelvic pain and lower back pain for about 6 weeks i have been to the doctors twice and he said it is a urine infection and put me on antibiotics i still have the pain and since yesterday i have noticed when going to the loo and wiping myself there is a brown discharge on the tissue. ### REPLY: Hello, Thanks for your query. After going through your query I came to know that you are suffering from chronic backache. It is probably due to urinary tract infection. You are taking antibiotics for it, so continue to take them. You noticed brown discharge still there it means it is not completely cured. Furthermore, you can take culture and sensitivity of urine done. Take antibiotics according to this to control infection. For backache back exercises, Cartilage D once daily, NURSING GOLD ONCE DAILY and analgesics (DICLOFENAC 100 MG SLOW RELEASE TABLETS) give relief. Sometimes vitamin D deficiency can aggravate this so serum vitamin D test is advised if it is lower than vitamin D supplementation will be required. Avoid long continuous standing. Sit in a straight posture. Eat milk, fruits and green leafy vegetables daily. You need to do MRI TO RULE OUT other causes. You can discuss with your treating Doctor about it. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lot of health issuse, I had open Heart Surery in April Seem to have not helped much,I also have several auto immune now I went had a diagnostic mamagram and a sonagran this Dr, said she never has seen this before in twenty years. i have a small lump but my left nipple get very large changes color to red and get a little warm  so she looked again and said there is no varacose veins but if i lay down my nipple goes back to  normal in a shape and color. So they wast to send me to a surgent. I am so much medication  20 capsles of potasium,my cumidin will not stay up I take 10 mg for 5 day and 15 mg for 2 And my protime will not stay up  And several other med one other thing my heart rate is very high Any Advise would be greatly appreciated. ### REPLY: Welcome to . 1. A lump behind the left nipple area with redness, possible cause could be cyclical changes, autoimmune as you have some issues with it, and infective etiology.2. In this case you need to get an ultrasound examination of the breast - that will help to know where the lump is from (muscle, fat, duct, skin), what is the nature of the lump (solid, cystic, mixed) and then finally where all it is extending to.3. That will help to get a conclusion, at least you have mentioned what description given in the report would have been helpful.4. Depending on findings - if mass FNAC- fine needle aspiration cytology, If cystic structure / infective cause - a small incision and . 5. Suggest to see the surgeon as told and get needful treatment - good luck. Hope I have answered your query.Anything to ask do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey, So my girlfriend took a bite out of a banana and found it was crunchy. Upon further investigation we found that the middle was a crimson red color, was hard, and crunchy! She s worried about it, does she have anything to be worried about? She didn t eat the rest of the banana. ### REPLY: Hello, Thank you for your contact to . I understand your health concern, if I am your doctor I suggest you that there is nothing to worry. You should take care of any abnormal symptoms. If you find such symptoms kindly visit to ER. Such a small piece of wrong banana won't cause any health hazard usually. I will be happy to answer all your future concern. Thank you, ChatDoctorInfectious disease specialist. Wish you the best health at . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i am sana from  pakistan...my three years old daughter has refused to drink more milk since one year...how to pull her back to milk?...what about nido and other whole milks....or supplements like pediasure...medicine like Ossobon D....do these complete my dds calcium defficiencies... ### REPLY: Hello ma. Since your daughter is above one year you need not worry too much about her milk intake. On an average 300 to 400 ml of milk is sufficient for one day at this age. You can give it in 2 to 3 liquors. Nutritional supplementary products are better started after 2 yrs of age. You can anyhow continue medicines prescribed by your Pediatrician for nutritional supplements. Any further doubts I would be glad to clarify.  . S. Sri Vichy Chennai ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I feel like I am having a panic attack.  My chest has been kinda tight for 3 days but it is in a weird place.  Like right where my collar bones meet in the front and scoop down.  Then I feel this weird sensation like I need to cough but its dry.  I am NOT sick and havent been.  I have been checking my pulse (which im not good at) however, my husband said that it feels like my pulse is really strong like I was speed walking or something. ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you are mostly having stress and anxiety related symptoms. Panic attacks, unusual chest complaints, racing pulses etc. are more suggestive of uncontrolled stress and anxiety. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Don't worry, you will be alright. Avoid stress and tension, be relaxed and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir, my daughter is 17 months old..two days back she got severe fever so doctor started with paracetamol and enterogermina due to somewhat disturbed motion...yesterday her fever increased and consulted again so he added augmentin...now today she got very severe diarrhoea that was light colored and in bulk... i didnt stop augmentin ..but motion were somehwhat loose before antibiotic and got severe after it...fever got less. now on enterogermina, augmentin, zinc , mebarid...what should i do...? so situation doesnt worsen ### REPLY: Hi...this looks like a viral diarrhea. One of the side effects of Augustin is antibiotic associated diarrhea. STOP Augmenting. It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics (LIKE AUGMENTING) unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello To Anyone ! Actually, the outer sides of the toe of my left foot is swollen excessivly and the swollen area is excessively red, hard and very painful on touching, with that my foot arch is also swollen a bit and is red, painful, can t walk properly ! What to do? ### REPLY: Hello, You may be suffering from gout or hammer toe or inflammatory arthritis. Until examination is done it is difficult to say what it is.  Use cold and warm compression, use NSAIDs for pain. Avoid spicy food and alcohol avoid smoking and caffeine .  Get it done uric acid levels. Then consult your physician he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my two-year olds teeth are bleeding a little at night and when we brush them in the morning. He cries when we brush (even with the soft brush and even with a swab), but does not bleed during the day. He has been crying when he eats things that are crispy and he points to his back molars, but we have never had bleeding when he has gotten new teeth in the past. What would be causing this? Teething? ### REPLY: Hello, Teething is possible since teeth need to fully erupt. Cold is helpful.  Make sure nails are trimmed to avoid cutting gums with fingers placed in the mouth. Check that teeth are bright white and all discoloration can be removed. If any concerns, schedule a dental exam to rule out decay. Enamel can erode if your baby sleeps with a bottle. Remember, only water in a bottle at night. Infections are possible. Do your best to keep the teeth clean and remove plaque. Inflamed gums can be sensitive. Consider a dental cleaning. It is possible to have tartar in young child . Thank you for your inquiry. I hope my suggestions are helpful ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have done sax after 20 days my periods started i want to know now can i get pregnent ### REPLY: Hi Welcome to  Pregnancy can occur when sexual intercourse occurs around time of ovulation. Timing of ovulation depends on length and regularity of menstrual cycle. In a normal regular cycle ovulation occurs 14 days prior to next expected periods. If Your cycle is of 30 days or less and its regular then pregnancy is rare. In case of doubt you can always use emergency contraceptive within 72hrs of unprotected intercourse or confirm pregnancy by urine pregnancy test if periods have been missed. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have stiffness and lack of mobility in the lower right buttocks and very tight hamstrings in both legs which causes me problems walking more than 9000 steps. I am not overweight and this has been going on for 3 years.I have gone for physio but this hasn t helped and I do all the exercises ### REPLY: Hi. I would recommend you to first know the source of symptoms. With your symptoms. I presume the source of symptoms could be due to neural irritation due to disc... resulting in hypomobile lumbar vertebral mobility...leading to stuff SI joint. Gluteus muscle will go for inhibition and no longer be effectively control and produce movement. I recommend you to do a lot of icing on your back.spinal extension exercises. Maintain spine extension while lying on the stomach.  For at least 20 mins for at least 3-4 times in a day...glute rehab like bridging side bridge.lying in side lifting leg up and down.  Good stretching exercises for hip flexor. Gluteus.etc Hope this is helpful for you...kindly revert in case you need any more help in this regard ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor,My name is Murali, iam 31 year old and i was married two years before still no children. Please find the below my recent semen analysis report and please tell me the problem what i have and also give me the proper guidance.Report:Color : grey whiteValume: 02.0mlReaction: AlkalineViscocity: NormalActive Motile: 20%Sluggish Motile: 60%Non Motile: 20%Normal Forms: 70%Abnormal Forms: 30%Pus Cells: 02-03 hpfEpitheliel Cells: 01-02 hpfRBC : NilTotal Count: 10 million/mlImpression: Oligospermia with impaired motility.Thanks in AdvanceMurali. ### REPLY: Hello, Oligospermia implies low sperm count in the seminal fluid. The normal count values range is from 20 million onward. The volume is near normal. Active motility implies those sperms that have the capacity to fertilize an egg and this value is low. Forward progression is more important. Liquefaction also is important. If this is the first time you have had the analysis, you should get the test repeated in proper way after 2-3 months to see if there is any change. No conclusion should be .  You can repeat it, if you wish a second opinion, after 3 days. Please see an ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi.. i have a breathlessness problem.. it usually occurs when i exercise. is it curable? i hAVE ALL the asthma symptoms but the doc.. sid that m not suffering with any kind of asthma.. my lungs are very clear.. but i always feel uncomfortable in breathing.. m gaining weight cause m not able to work out,, plz help..? ### REPLY: Hi. I can understand your concern. Possibility of asthma is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of asthma. It will also tell you about severity of the disease and treatment is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS)Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am a 48yr old female a few days ago as I prepared for a trip to Germany I notice what appeared to be a bug bite on the right side of my neck in the lower crease line. A few hrs later there were more small itchy  bumps in the crease. I thought heat rash but I now have a few more behind my right ear. As i palpate my neck I notice a few lumps under the skin on my neck. I think limp nodes maybe swollen. Any idea ### REPLY: Hi. Thanks for the query. As I understand, you have developed a localized reaction to the bug bite. You need not worry about them as they will disappear in a few days. Though you can take painkillers if you have pain. And as you guessed it right, the lump in the neck are lymph nodes which have got inflamed, and they too will subside without treatment. But do consult a doctor if the swelling persists for a longer period. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My one year old was put on Lactaid from whole milk after two weeks of loose stool (not watery diarrhea) because her doctor though it might be a lactose intolerance. She has been on lactose free milk for 1 1/2 weeks and there has been barely a difference, if any. Any ideas? ### REPLY: Hi... Thank you for consulting in . It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was prescribed Terbinafine for toenail fungus. Shortly after starting I fell and had back pain. I assumed it was from the fall. However, by day 34 I was experiencing right kidney pain. It has been 10 months and I m still having kidney pain. Is this common? Have I permanently injured my kidney? ### REPLY: Hi, Thanks for writing in. It is unlikely to feel a kidney pain for 10 months after a fall. The kidney is a well protected organ located in the retroperitoneal region at the level of Horace lumbar vertebrae T 12 to L 3. They have a capsule and surrounded by perianal fat to protect from mild injury. It is best to get an ultrasound scan of abdomen to know if there is any pathological condition in or around the region of pain. Such a pain for 10 months is uncommon. If required an X-ray can also be done to see for any bone deformities due to the fall. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am getting fear at night when the surroundings become silent and also am getting fear when am going outside at any time my heart is beating very fastly and iam not getting what to do and at last i am getting that i wanna die to slove this problem am getting fear when i am alone and anybody going out of my home i have this problem since 6months ### REPLY: Hi, It appears that you have been suffering from some kind of phobia for 6 months. It is good that you have realized that the fear you experience is not reasonable. Sometimes fears and phobias arise due to some incident in the childhood, the fear may develop and present as phobia in adult life.  Don't worry, just learn to take control over the things that cause your heart to beat. Avoid staying alone at night, try to challenge the negative thoughts that cause you restlessness. Meditation regularly will help you get relaxed. Yoga and breathing exercises will help you stay cool and take control over the fear.  However, if you think things are not improving, talk to a counselor/psychiatrist. Probably you may be suffering from some type of personality disorder that needs immediate attention, the type and degree of the fear and phobia should be assessed and treated accordingly. Treatment in time will help you stay healthy both physically and mentally. I am always there for you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Long story but to make it short, I had my period on June 14 through the 18th. Never on birth control; Had sex on the 27th. Boyfriend ejaculated in me three times. Pretty much unprotected sex. (The sperm might be very strong because my boyfriend hasn t been sexually active for about 2 weeks. ) Took Plan B on the 28th. After 24 hours..What are the chances of me being pregnant? No side effects yet but my vagina is a little itchy. Please HELP! ### REPLY: Hi, I understand your concern. You have unprotected sex in fertile phase of period. You took plan B pill after 24 hours. It has up to 85% effective in preventing pregnancy. It has 0-15% failure rate in your case. But pill can cause earlier period, delay in period by 1 to 2 weeks and excessive bleeding can occur. I would suggest to wait for period. If period will delay by more than 2 weeks then go for urine pregnancy test and or blood  test to confirm pregnancy. If you will be pregnant then you can still terminate intrauterine pregnancy by abortion pill under advise of gynecologist. Meanwhile, avoid stress, take healthy diet, . Hope this may help you. Contact further if follow up needed. Best regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I believe I was bit by a spider about 3 weeks ago I had 3 bites under my arm with visible grey fang marks surronded by red. and it started pussing after a few days. I couldnt put my arm down it hurt so bad. a week after it healed My eyes were blood shot for a few weeks. i took some eye drops and now a week later i went to The ER due to my hands, feet and arms being unbaribly itchy, swollen and red. My arms look like they have rug burn and my finger tips have an extreme tingleing in them such as pins and needles. I dont know what type of spider it was. But in the ER they gave me predisone and benidryl and perscribed it to me for the next 3 days. ### REPLY: THE ALLERGIES BEHAVE LIKE THIS MUST HAVE BEEN HAVING PROBLEMS OF SLIGHT ALLERGIES WHICH GOT The WORST BY SPIDER ATTACK ONCE YOU TREAT ONE PROBLEM IT WILL SHIFT TO NEXT ORGAN LIKE SKIN EYES AND OTHER PARTS IN YOUR CASEY TAKE ALLEGRA 120 MGM BDT AB ZINE TAC 150 MGM MORNING EMPTY STOMACHS YP PRISON 1/2 SF NIGHTLY CALAMINE MIXED WITH MOMETASONE OINTMENT MORNING EVENING IN AFFECTED AREACHROMAL FORTE .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: On a life insurance exam, I had AST of 53, ALT of 82 and GGT of 154.  I do drink alcohol, but had a ultrasound in 2008 because of high enzymes.  Everything was normal.  I have been taking Milk Thistle for the past few months in order to get levels down.   I have not re-tested.   I also take 20 mgs of Lexapro a day.  Please give me your opinion of these numbers.  Should I be alarmed?   After the 2008 scare, it really makes me nervous to be tested.  Probably wouldnt have if not for the life insurance exam.  They did approve me on a standard rating. Thanks so much ### REPLY: Hello, Yes alcohol consumption can cause these altered Alt/ AST levels and more specifically GGT levels, if you had similar elevations in the past and was on Silymarin (Milk thistle), and your present examination still shows elevated levels, yes you need to be completely examined and tested, you have to first abstain from alcohol, check your liver, get an ultrasound done, so that the baseline Liver status can be known, depending upon your test results you please consult your doctor so that further treatment plans can be discussed.  Hope I could help you. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my period is due in 3 days. Me and my husband are trying for a kid, for the past 7 months but with no luck. This month also we had regular sex every other day. Yesterday soon after intercourse I had a slight bleeding or rather spotting (it could be some 13 or 14 days past ovulation now, not sure). Is there anything to worry about. ### REPLY: Hi, There should be nothing to worry about, just wait for your period and if you miss it go for a pregnancy test with a fresh early morning sample of urine, 3-7 days after the missed period. If pregnancy is confirmed, it could be an implantation bleed; if not, it is the premenstrual spotting. If you wish for an earlier confirmation, you can get serum beta-ChatDoctor assay as it is more sensitive and specific. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For years I have had a pain under my armpit, it seems to travel from there up through my jaw and into my ear. Recently the pain has been in my top right back instead of armpit. It causes a great deal of pain and no position makes it any easy. I comes constantly and can last for a hour or more. ### REPLY: Dear patient what it could be1) angina: It is rare but true that anginal pain may refer to jaw and ear. Get an EKG and a 2d echo to confirm. Echo can help rule out Pulmonary stenosis as well which may be a possibility2) Swollen lymph nodes: swollen lymph nodes may impinge nerves or infected lymph nodes may result in radiating pain. A simple examination of lump nodes by you GP should rule this out3)Vasculitis: Giant cell arthritis is an inflammatory disorder of the subclavian vessels which can involve its branches as well. Diagnosis will be by LFT showing elevated ALP, raised ESR, c reactive protein and platelet count3) Neuropathic pain: A pain of neurological origin either due to stress on my facial trigger points or due to soft tissue impingement of nerve. A MRI scan will rule it out MY advice to you is make sure angina is ruled out first and foremost. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my name is Missy. I am 21 years old, weigh about 220 and about 5ft tall. I have been experiencing jolts of dizziness for a few months and also shortness of breath. Occasionally with the jolts of dizziness I feel a sharp or mild pains in the center top to back of my head. I also have a lot of mucus that has been sitting in my throat for months probably from seasonal allergies, but it is to the poit where it is gagging and I constantly cough and choke along with the shortness of breath. It is to the point where I cannot walk down the hallway of my house from the bedroom to the kitchen and be able to breath at a normal rate. I have tried allergy pills to help get rid of the mucus, but it does not help. Something else I have been experiencing: normally I would appreciate a cool, air-conditioned environment during heat waves, but I cannot stand being in my air-conditioned house. I feel too cold and miserable and would much rather be out in the heat. The heat usually bother s me and obviously makes me uncomfortable and over-heated. But now I feel this way with ac s on. I feel sick and cold (chills), sniffles, shaky, etc. Have any suggestions? Could these symptoms be related? ### REPLY: Hello! You seem to have Bronchial Asthma which is an allergic response of your airways to cold, dust and other allergens. The airways temporarily constrict and make it difficult for air to move in and out of your lungs, making you feel a tightness around your chest.  The mainstay for treatment is bronchodilator and steroid medications in inhaled form - either pressurized MDI (metered dose inhaler) or rota caps.  The dosage needs to be decided after eliciting detailed history and examining you.  If too severe you might be prescribed a short course of oral steroid.  Do steam inhalation, warm saline gargle, protect yourself from cold, dust and other allergens.  Consume only warm fluids. Before initiating treatment your doctor would prefer to get a complete blood count with Absolute Eosinophil Count (the cells that increase in response to allergy) , Chest x-ray to rule out other causes of your breathlessness, EKG to ensure your heart s working fine and a Spirometry pre- and post-bronchodilator medication. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have postherpetic neuralgia--I had shingles for about 2 weeks in August 2013...and since then have been suffering unbelievable pain 24/7 with no let up...pain clinics are nt pain clinics, they ask questions and dont know what the hell they are doing....have you dealt with this post shingles chronic pain...I am 84 years old.... ### REPLY: Hello dear, Welcome to . I have read your query and understood your concern. Postherpetic neuralgia is really a bothersome condition usually found in old aged people. Various . Topical medications like lidocaine, capsaicin also provide relief to some extent. You may discuss it with your doctor. I hope he/she will agree with my opinion. If you have further queried, you may ask me. Stay healthy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband who is 47 had a CT scan which showed a dark spot on his kidney Is this usually always cancer? ### REPLY: Hello. Welcome to . You will have to tell us the medical terminology mentioned in CT scan. There can be numerous causes... if the dark spot or description in your report signifies, hemorrhage, it is not related to cancer. These days, a guided FNAC under expert hands can accurately provide diagnosis even in deep internal organs like kidney. You can discuss the same possibility with your clinician and radiologist. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my husband works inside a cooler stalking drinks steady 3 hours straigt without coming out then the rest of the 7 hours in and out now he is experincing back pain near the lung area he says it feels like antsy in the same area with stiff and constant back pain as well what could it be ### REPLY: Dear-thanks for using our system and I understand your concern about your husband. His back pain most likely is secondary to the position that he has to be in order to stalk all the .  I know that he is inside the cooler but that shouldn't give him the back pain but the weight he is carrying. I recommend him to use a back support a try to protect his back flexing it with care. He might have a herniated disk with pinch nerve giving him this pain. It could be just muscle spasm but that will usually go in few days of relaxation. I hope my advice will be helpful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,my daughter is 20 now.She is suffering from allergy(running nose,watering eyes and sneezing all the time).So one doctor suggested to take odimont-lc.She has been taking this for the past 1 month but she also feels drowsiness for the whole day.As she has exams to come ,kindly suggest as per the need. ### REPLY: Cellophane You for contacting . Allergy should have subsided by now as your daughter has taken medicine for a month. I would suggest you following things:> Observe what particular things is causing allergy. It could be from dust, pollen or particular food. This is very important for long term management.> Take cetirizine one at night for 5 days. (sedation will only occur at night)> Take montelukast one daily for one month. Research has shown that it decreases the allergic symptoms considerably. I would also suggest her to undergo allergy testing at allergy clinic if it does not subside. It will tell that her that she is allergic to what specific thing. The results will help an allergist to prescribe you immunotherapy to that specific allergen, and it will improve the problem. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. Wishing her good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctors.I just got married.when I tried to have sex with my wife, my erection goes down and some times semen release soon.i dont no what is my problem.but I get strong erection on other time even I get erection while hugging or kissing her.I dont no what is my problem.?please do help me. ### REPLY: Degree understand your concerns went through your details. Erectile dysfunction and premature ejaculation are common for just married men and there is nothing to worry about. This happens because of the stress, anxiety and performance related anxiety. Men always want to perform outstandingly and satisfy their partner. This thought acts as an obsession and results in performance anxiety. You just have to wait for another couple of weeks. Do not try to overcome this problem forcefully. Because each time you forcefully try to overcome this problem, the situation worsens. Wait and watch. Be sure that the problem will be cured as time passes. You may consult a psychologist online or offline for counseling. If you still need my assistance in this regard, please use this link. http://goo.gl/aYW2pR. Please remember to describe the whole problem with full detail. Hope this answers your query. Please feel free to post follow-up queries. Available for further clarifications. Good luck. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a six year old with a virus, running a temperature of 102.3 with Tylenol, Motrin and childrens cough medicine on board. The biggest issue that is not currently controllable is her unproductive constant cough. Any suggestions. The virus started yesterday AM. The room is not overly dry. ### REPLY: Cough and cold with fever is most often caused due to certain viral infections. Tylenol is effective in relieving fever. Motrin (Ibuprofen) should be given only if Tylenol is not effective in reducing temperature. Child .  Rather give some anti-allergic syrup like levocetirizine as there is generally an allergic component involved. Give steam inhalation. Water in the form of vapor will reach deep into the lungs and help in relieving the cough by making it productive. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir,My name is sourab banerjee, in last few days i am realished that my heart is not feel good, when i am sleep in the night i was not feel well and i was getting up Age 23+ height 171 cm last 10 years my body is physically fit so i am not going to any doctor. ### REPLY: Thanks for your question on . I can understand your concern. Such type of chest discomfort in night is commonly seen with heart diseases. You are too young (23 years) for heart diseases but better to rule out heart diseases first. So get done ECG and 2d echo. If both of them are normal then no need to worry about major heart diseases. Sometimes, acute gastritis, stress etc. can also cause similar kind of chest discomfort in night. So avoid stress and tension if you are having stressful life. Avoid large meals at night. Avoid hot and spicy food at night. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i had typhoid fever about a year ago but still i feel tired pain in head abdominal pain and weakness and stiffness in the muscles and having lymph nodes at the right side of my creases and on the other side no lymph nodes but i feel discomfort some time its painful got grastric issues and stool color some times its black and some time its green in color and constipation problem as well some time urine burning but physically i am putting on weight but feel weaker from inside the body ### REPLY: Hi welcome to  forum.  Thanks for choosing . F.  You had typhoid fever 1 year back. During typhoid the intestines and liver are effected badly probably that is the reason for your weakness, Abdominal pain, associated anorexia, hence stiff less of muscles, change in stools color, etc. are all suggest intestinal effect.  Sometimes you are getting burning sensation of urine, may suggest urine infection, Or metabolic acidosis due to above reasons.  I advise you to consult a gastroenterologist for diagnosis and treatment. You may have to take U.S.scanning besides other routine tests for confirmation.  Wishing for a quick recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a tooth pulled three weeks ago and it seems to be ok , just saw dentist yesterday to have stitches pulled.  Also have gotten some kind of sinus thing that had subsided and come back worse a few days ago. I just looked in my mouth and the roof of my mouth is noticeably yellow.  Its towards the back and on the sides in the back.  What could this be? ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, you have undergone extraction, see what happened is after extraction healing of socket take time of 2 weeks, after extraction we have problem in maintain oral hygiene so as you said you have noticed yellowish at roof of mouth so, it can be opening of minor salivary glands, or it can be due to poor oral hygiene also So, you should do Chlorhexidine mouthwash 2 times a day, brush twice daily, do warm saline gargle, and if you feel some problem like burning sensation or pain at roof of then you consult dentist.  Hope this will help you. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am in the process of weaning of bisoprolol . I will percribed a 2.5 mg over 6 weeks ago which I ve reduced to a 1.5 mg over the past 2 weeks . I was treated with this med - due to a episode of rapid heart beat - suspected SVT . Or a virus attack on my heart muscle . I ve only had the one attack . And a further scan , indicating a normal heart . My heart enzymes returned to normal after the attack . I ve had a ECG 24 hour test and that s normal . I ve yet to have my out patient appoint with my cardio specialise in April . I just want some medical advise that I am weaning correctly . As I want to stop ASAP due to the side effects . I am thinking to reduce it further . My ? what is the lowest does to reduce to - before completely stopping . I am on a 1.5 now , I want to half the dose this week . Is this the right way to wean . ### REPLY: Hi welcome to . I understand your query and concern. Rapid heart rate needs quick assessment for any arrhythmia. Radiofrequency ablation offers excellent results, I advise you to have a baseline 2 dimensional echocardiography, ECG and lipid profile to assess the basic cardiac reserve of your heart. Restrict the intake of salt to less than 6g/day. Regular physical exercise in the form of brisk walk for 20 min a day for 5 days a week is pretty useful. . Reduce the intake of fatty and fried food. One pomegranate a day will help to keep your heart at good pace without clot formation. You can continue 1.5 as of now for optimal results. Consult a Cardiologist for further expert management. Post your further queries if any. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a left spontaneous pneumothorax two months ago, pain on the left side continues and as of a week ago my right side has started to hurt. I have a (tolerable) sharp pain in my right side and my two of my ribs are look as if they are caving in. I have never noticed this before and I dont know if I had it in the past. I have not hurt myself or been in an accident. I do not have shortness of breath, or extreme back pain as I did with my first SP. Should I be concerned? ### REPLY: Thanks for your question on . I can understand your concern. Yes, you should definitely concern about these symptoms of back pain and shortness of breath. You already had spontaneous pneumothorax 2 months back. Pneumothorax can be Recurrent. So you're all present symptoms can be due to pneumothorax. Hence, consult pulmonologist and get done clinical examination of respiratory system and chest x-ray. Don't wait at home as pneumothorax if untreated can be life-threatening. So get done chest x-ray to rule out pneumothorax. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am 13 years old and healthy but yesterday night after I walked around a lot I have chest pains on my left side along with  my left arm and its been a day and still it hurts. It feels like pressure and seems to get better when I lay down? My heart is fast? Help, what do I do? ### REPLY: Hello thanks for posting here. Seems like muscular pain to me because of prolonged walking leading to generation of lactic acid. But other causes should be excluded. One is heart disease, which in view of your age i don't suspect. Second is a lung infection which can cause above symptoms. You have not mentioned any cough or fever history or any weight loss so I presume they are not present. Still i would advice you a chest x-ray to see if there is any lung involvement. Meanwhile, you can be on a short course (5 days) of painkiller medications and antacids. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello sir.... Actually sir we are trying for a baby from 7-8 months.. But I ve periods every mOnth.. I consulted doctor in between... He told me to got for a course of tablet ovacare for 3 months... I did it... But no response of pregnancy..... Now I am very frustrated..... So I want to ask you that can I ve sex in my 3day of period to conceive ### REPLY: Hello dairy understand your concerned you have regular period of 28-30 days then your fertile phase is 10th to 18th day of cycle. Do sex daily in fertile phase of period. So avoid sex during your 3 days period. Sex during period increase chance of infection. If pregnancy does not occur then both partner need to consult infertility specialist and undergo reproductive hormone analysis, USG scan, ovarian follicle study, HSG scan and semen parameter for female partner. Specific treatment will require on test results. You can take metformin, camphene and  injection for maturation and rupture of follicle. Avoid stress, take healthy diet, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir,My name is Amit(22 yrs old). I am suffering from back ache for the past two years. I have been using tablets for that. Recently when i went to checkup doctor told me that I have only one kidney after doing ultrasound and ct scan tests. And he also mentioned that the one and only kidney that I have is big in size.Is it possible? How many people do generally have this? What I have to do now since I am very much depressed? ### REPLY: Hi, Thanks for writing in. I have seen people with once kidney from birth and leading normal lives. These are incidental findings and when doing routine ultrasound, we come across such patients. Studies show that single kidney is compatible with normal longevity and does not predispose the existing kidney to greater-than-normal risk. There is no need to get depressed. 1 in 1441 people in normal population might be born with single kidney. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there I was diagonised by acute bronchitis do I have been coughing for ovrt three weeks, when I cough it feel like my breath is taken away I gasp for air . Doctor prescribed celery isle dosage is 2 tabs for times a day and brazenpam 2 three times a day ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. In my opinion you should consult pulmonologist and get done1. Clinical examination of respiratory system. 2. Chest x-ray. 3. PUT (pulmonary function test). Chest x-ray is needed to rule out lung infection. PFT is needed to for the diagnosis of bronchitis. It will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and antihistamine .  So better to first diagnose yourself and then start appropriate treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Help Please. My 5 yr old broke out in hives for the first time 11 days ago, they seem to get worst rather then better. she has them in most of her body including swelling of hands, fingers, toes, lips, and around eyes. They eventually fade away and appear in different areas almost immediately. She took oral steroids for 6 days, and steroid shot 3 days ago. She takes benadryl , zyrtec, advair, and singular every day. She is asthmatic & allergic to milk protein & soy. She had a piece of pizza the day she broke out, but the doctor believed she had overcome the allergy since she was born. So I gave her milk products gradually. Can that cause hives for this long? Could she possibly be allergic to something else? Her hive are horrible even in her private areas and itch very much so. Please help... ### REPLY: Dear miRNA join all such cases the cause of allergy can be external or internal. You have noticed external causes as allergic to milk products or soda but rule out internal causes where intestinal worms are major factor. Get her stools examined. Increase the immunity of the baby to prevent recurrent attacks with Swamla i SF BD. to cure hives Ayurveda offers cure with Hard .  And tab. Gandhak Malayan 1 BD. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I experience anxiety and shakiness and feel as if Im nervous, but dont know why. It seems to get worse if I become sick or have to take meds. Otherwise Im fine. Not sure what brings on the shakes or the lightheadedness. I will feel tired and irritable and get a very dry throat. I am so tired of going to the dr to be told I am depressed or have anxiety attacks. I realize I do get anxioTx, Terilynneausing this. I have had stomach issues in the past as well, an ulcer in my stomach at age 11. I thought at one time it could be blood sugar lows or even some heart issues just wish I could find answers!!!! ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. You went to a doctor, and he opined that you have anxiety issues. You did not accept that doctors version. Why? Are you not confident about that doctor? If so, consult another doctor. Make sure you are satisfied with his diagnosis. For that you find a doctor who is credible. Then ask him to diagnose you properly and accept his diagnosis. Make sure you are accepting it. Otherwise, you will never be satisfied with your health issues, and that will add up to your anxiety issues. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END