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 got my wisdom teeth out 6 days ago and pain was fine till yesterday, i cant handle the pain the pain killers dont help what so ever, its to painful to sleep and i keep on crying the pain in that unbearableThe pain is basically on my bottom right jaw towards my ear ### REPLY: Hello there, thanks for the query. I'm a 0ral diagnostician, I reviewed your symptoms, how the wisdom teeth removal or extraction, was a lot of bone cutting involved?? Was there any swelling and infection in the same area previously and was the pain bearable during and post operative?? Post 6 days you are noticing only unbearable pain, I think it is 1) reinfection of the socket area 2) .  Please also u could start antibiotics and analgesics too. ### 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 daughter is 9 years old and is having behavioral issues. She uses her anger and tantrums as a weapon towards myself and my spouse. She is self harming and is now hitting and kicking us. Would you suggest counseling first or medicating first we are lost as to what to do. She says she hears voices but of course we can t be sure if this is true or if she is just saying this.I know she needs immediate help. What do we do first?? ### REPLY: Degree understand your concerns went through your details. Usually behavior issues like temper tantrums, attention seeking etc. can be successfully treated with behavior counseling and Cognitive Behavioral Therapy without medicines. But in your children case, she says she is hearing voices which you cannot hear. This makes he behavior issue complicated. She could be having delusional disorder which needs to be treated by a psychiatrist. In any case, I request you to consult a psychologist first for assessment of the case. 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. Available for further clarifications. 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: Hello, over the last few years I have had a lump on my upper back near spine. It hurts on and off but recently has been causing a lot of pain. Not so much that I cannot lay on it but it hurts to touch. I am going to the doctors tomorrow but would like some idea of what to expect. Laura, 14. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have lipoma, neurofibroma or dermatofibroma.  You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. 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: Is there any skin whitening procedure in India,which is effective and long lasting? Not sure i am seeing reply from the doctors,that people should happy with their skin color. That i am agree with them.But still people wants to change their image. So instead of saying be happy with what you have,try to produce a better and effective procedure for skin whitening,which is safe and valid...else Doctors or physician should accept they failed to introduce this types of products or treatment... ### REPLY: Hello, Thank you for posting on . Complexion of any person is having two components; constitutive, one which is predetermined by genetics and racial factors and usually cannot be changed with any treatment. The other component is due to external agents like environmental exposure, sunlight, use of any cosmetics etc. and is amenable to treatment. You can get a series of chemical peels, which actually remove the upper dead layers of skin and stimulate regeneration of collagen and thus newer layers of skin. Many options are available in chemical peels depending on the requirement and skin type. (Glycol peel, retinol peel, cocktail peel etc.)Also, chemical peeling can be preceded by a simple procedure called microdermabrasion or commonly known as skin polishing to augment the results. Also, at home you can try using cream containing comic acid, betray . Always use broad spectrum sunscreen before going out in sun. Use a plain moisturizer like detail DAM on daily basis for healthy and 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: I have a lump on my left ribcage. It is painful. Ultrasound technician says its a lipoma. I am hesitant to have it removed because it is painful and my upper stomach area is also painful and it feels like there is something there connected to the lump on my rib. I don t want the doctors just cutting to get the lump out without knowing if it is attached to something. I really want an MRI. Am I being unreasonable? The area above the lump is bruised also, it has been like that for at least three months. The lump showed up last April, also bruised and the bruise was gone for about two months but came back. What should I do? ### REPLY: Hi ! Good morning. I am  answering your query. The best way is to go to a general surgeon to get yourself examined clinically and take his advice on the investigation needed to confirm your diagnosis. Usually lipoma is easily diagnosed clinically, and at best by a FNAC (fine needle aspiration cytology). Whether it has got any internal connection or not could be decided by the clinical examination and ultrasound as well. However, in case you are too much apprehensive about this issue, you can consult with the surgeon at the time of clinical assessment on the need for MRI for a lipoma. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### 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: Im on the Mirena birth control, and someone suggested taking Vitex to balance my hormones while using this birth control method. I tried to look up the drug interactions between the two but cant seem to find much information. Will Vitex decrease the effectiveness of the Mirena? Thank you!Hannah ### REPLY: Hi, Welcome to . I am . I will be answering your concerns. Mirena releases about 12 micrograms progesterone in the uterine cavity which mainly acts locally causing thinning of endometrium. A very small amount is absorbed in the blood stream. IRENA does not cause imbalance in your body hormones. So there is no need to use Video. There is no evidence of interaction between video and IRENA. There is no evidence that Video decreases the effect of IRENA. Since IRENA acts locally, I do not see any possibility of Video decreasing its effect. I hope this is helpful. If you have any further concerns do contact me through . 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: my scalp is itching & i,do hane hair fall,i, used to dye my hair,i have not taken any treatment so far. iam, 58 year old male, kindly tell me what treatment i,shoult take ### REPLY: Hi Dear, Understanding your concern. As per your query you have symptoms of itching on scalp and hair fall which can occur due to many reasons like dermatitis, improper hygiene, irritated oily skin, chronic inflammatory skin condition, medication with . Need not worry. I would suggest you to do olive oil massage on scalp. Maintain hygiene by using shampoo often using Salicylic acid shampoo. Avoid exposure to sunlight. You should cut back on styling products, hair sprays, and styling gels. Apply Ant-Man ### 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 have sore gums on the right side of my mouth which developed last week and I discovered a pea sized lump under my right arm pit two nights ago. Today the sides of my jaw and chin ache. I have felt occasional light nausea over the part few days. I have also booked an appointment with my dentist and doctor for this week. I am concerned it could be cancer or even HIV. I am hoping it us just a less serious virus or infection. Should I be worried? Many thanksWilliam ### REPLY: Hello. Welcome to . Thanks for your query. I have gone through your query and understand your concern. Just a sore gum can not be an Oral cancer. It may be due to local infection in base of teeth and gums. As far as your arm pit lump is concerned, it may be due enlarged axillary lymph nodes. The usual causes are infection. But breast cancer also cause the axillary lymph node swelling.Thus, i advice you to have through physical examination by your Primary care physician and then consult a dentist for further management. Chin ache and muscle ache are due to referred pain from infection in gums or muscular pain. Please check ELISA or Western blot to rule out HIV. Hope this helps. Please reply for further queries. Wishing 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: My two year old son has a discharge from his right ear. From where I can see, the edges of the ear canal are covered in a very hard crusty like substance that is stuck to the sides of the canal. I ve picked it off and with the help of a q-tip.. Also, when I finish cleaning that ear with a q-tip, I ve noticed the q-tip has a very watery cream colored wax. He had tubes when he was about 10 months old. Should I be concerned? ### REPLY: Hi, Welcome to , Discharge in an ear is always a matter of concern especially if it's in a child who had tubes in ear, then It's very much a concern. Your description tells me that your child has ear infection and that needs to be taken care of urgently. It has to be seen by an expert and started in antibiotics and may be cleaning depending on condition. I would suggest you to consult an ENT surgeon soon. Take care. Wish your child a 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, My brother is being treated for testicular cancer. The description in the Diagnosis from the current hospital lymphs or nodes in his abdomen. It started from the end of past January and its spreading. Can you tell me if there is hope that he can live (or he can live longer than the worst expected) ? Any kind of treatment to improve his condition? ### REPLY: Hi, Thanks for writing in. There are many types of cancers which primarily arise from testis and involve lymph nodes in abdomen. When testicular cancer has metastasized to distant areas like abdominal lymph nodes then the 5-year survival rate is 71%. It means that out of every 100 patients who have this cancer there will be 71 of them who will survive for 5 years or more when given recommended treatment. In testicular cancer the survival is better than most other cancers and aggressive chemotherapy and radiation therapy are recommended for treatment. It is suggested that you regularly follow up with his doctor and get his condition and treatment reviewed and ultrasound and CT scans done as required to know response to treatment. Please do not worry. ### 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 was wondering if you could tell me if black mold could cause costochondritis? My fiancee and I are currently living in a house with black mold in the bathroom and other rooms in the house. We took her in to the ER twice in the past week and a half because of chest pain/tightness and numbness in her extremities. Shes 22, ~180 lbs, and has a history of kidney stones/infections. The ER doctor diagnosed her with costochondritis but had no idea what caused it and it doesnt seem to be getting better even with Antiinflammatories (Relafin) and painkillers (only work for a SHORT time, IE <20 min, when shes limited to 2/day). ### REPLY: Hi I can understand your concern... Costochon . ... It may also be occurred as part of osteoarthritis... Sometime viral or fungal infection of rib joint can lead it... So yes mold can affect it sometime.... It is inflammation of costal cartilage.... Apply hot pads over affected area. Take broken for few days.... Avoid heavyweight lift and strenuous work. Proper sleep posture. Chest muscle stretching exercise useful.Finally, if available TENS like treatment that is transcutaneous electrical nerve stimulation useful.... Take care... You will gradually recover... ### 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: Im scared please help im only 12 i accidentaly put shamppo in my penis are on i dont know but it was on the hole bit and i washed the shampoo of with ater then it started to sting i went to take a pee to take it the shampoo out or something but it stung while peeing ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. The incident you are quoting is quite normal. Shampoo and soap entering into genital mucous area is quite common. They do irritate a bit because of the chemicals involved. But they don't harm. The get washed away with water and urine. You did was the area thoroughly and therefore stop worrying. The irritation might be there for one or two hours. That's all. Don't worry. Hope this answers your query. Available for further clarifications. 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: I had Cervical disc fusion and bony spur removed on Thursday 29th. Two days after surgery I swelled about size of a marble at the incision site, by Monday night it had grown to a golf ball size, tender and sore. I went to ER, they said it was normal, nothing to worry about just some inflammation. They said to call my surgeon today and maybe they would try to get me in, well I didn t call. Tonight, not as sore but still as big as golf ball at the incision site. They seem not to care, so I have just resolved its the way it is? ### REPLY: Hello, Postsurgical swelling can occur.  The importance of the review by the ER doctors is that they likely determined that it was neither an important bleed nor infection.  It sounds benign.  Everything else goes away on its own and the assurance of that is the fact that the area is not as sore as 24 hrs. Ago.  If it starts to get red, warm to the touch, pus developing or oozing, or clearly painful to the touch or light compression then, something is not right, and it will need to be looked at. 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: hi,my mother was suffering from carniophryngioma.She was operated in aiims on 18 jan 2011 but the surgeon left a part of tumor attach from brain stem.after the surgery she regain her health but now she again suffering from the symptom like anorexia,dizziness,loose body balance.Aiims neurosurgeon suggest us radiotherapy treatment i want to consult how much effective it is and what is the cost of treatment..and which one is the best radiotherapy center ### REPLY: Thanks for your question on . I can understand your situation and problem. By your history and description, in my opinion, your mother is having local brain recurrence of craniopharyngioma. It is known to cause local recurrence. Her symptoms are mostly due to compression and pressure on surrounding brain areas because of tumor mass. So better to first get done MRI brain for the diagnosis of recurrence. And yes, radiotherapy is the only option for her. AIMS is best Institute for radiotherapy, so consult radiation oncologist and start appropriate radiotherapy. ### 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, After a fall down the stairs and a large (entire upper leg) sized bruise, I now have a large slightly painful lump on my hip that hasn t gone away after a month. The bruise color itself was gone after about two weeks. Should a doc look at this? Don t want to have a permanently lumpy thigh.... (30 yrs old). ### REPLY: Hi.yes, it is best if you consult with a doctor, preferably an orthopedic or a general surgeon, for physical examination and clinical evaluation, especially if the lump is persistent and is associated with pain. It may be a fibrotic tissue formation secondary to the inflammatory reaction you had during the time of incident. But other lesions, such as tumor type, must be ruled-out. Diagnostics (x-ray, MRI) and management (medical and/or surgical if indications are found) will be directed accordingly. Hope this helps. Good day!!~ .  ### 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: Have a 5 year old grandson with coughing, running nose, and spitting up mucus when he coughs.....would love for him to be able to sleep good tonight! Will be giving him a good warm bath before bed and used the humidifier last night. I also used Vick Vapor Rub on his chest. Any other suggestions for him to sleep? ### REPLY: Hi... Thank you for consulting in . Cough and cold are viral 95% of the times in child .  For cold, you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15 mg/kg/dose (max ceiling dose 500 mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. For cold, you can use Cetirizine at 0.25 mg/kg/dose every 12 hourly for 3 days. For nasal block, plain saline nasal  ### 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: 32yof, 51; hx of root canal/crown placement of right front tooth in 1999; now have palpable raised area between right nostril down to gums- beneath gums- not externally visible; tender to pressure/percussion; no fevers; throbbing pain/pain with pressure to tooth; abscess? cyst? tooth or sinus? ### REPLY: Thanks for using . Read your query. Re-infection of the root canal treated tooth can be the cause for the swelling, tenderness and pain in the region leading to the abscess formation. I would advise you to visit your endodontist and get a radiograph done to see the status of the root canal treated tooth. If needed, carry on the re-treatment. If not periapical surgery can also help you. For the pain take ibuprofen tab (if you are not allergic to any medicine). Antibiotics may be required like amoxicillin 500 mg and metro lag 200 mg on prescription by your dentist. Hope this was useful. Thanks and 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: Doctor says my 3-year-old granddaughter has large leukocytes and blood in her urine. They re waiting for the cultures to come back, but they seem very concerned. Could this be a sign of diabetes or leukemia or something that could be corrected surgically? ### REPLY: Hi, By large leukocytes I think you mean many leukocytes. If so, coupled with blood in her urine it probably means she has a urinary infection that can happen in a little girl. I am sure your doctor will be able to manage the infection with appropriate antibiotics when the report of culture comes. Only if required other tests may be conducted. Regarding Leukemia, I hope a routine blood examination was done which would have ruled it out. Similarly, for Diabetes a blood sugar if not already done will be done. But it seems unlikely since the urine does not show any sugar. Please do not worry. 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: LATELY MY HEART HAS STARTED BEATING SO HARD SOMETIMES IT FEELS LIKE I HAVE BEEN RUNNING OR GOT REALLY SCARED. NOTHING SEEMS TO HELP IT. MY BLOOD PRESSURE REMAINS NORMAL BUT MY HEART RATE GOES UP TO HIGH 90S, AND IT IS USUALLY IN THE 50-60 RANGE. DO I NEED TO GET WORRIED ABOUT THIS, BECAUSE RIGHT NOW IT IS SCARING ME TO DEATH! ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion. You should know that this fast heart beats has to do with rhythm issues. There might be different electrical rhythm issues that might noise fast heart beats. It might be just a sinus tachycardia meaning that the heart beats in normal sinus rhythm over 100 beats for minute. It might be an extra systolic beat that you experience like a palpitation KR filtering sensation. Or it might be a different kind of arrhythmia like atrial fibrillation, supra ventricular tachycardia etc meaning that the heart beats in a chaotic way not in normal sinus rhythm. The causes might be different to simple stores to different pathologies like anemia, hyperthyroidism, electrolyte imbalances, cardiovascular disease. If I was your treating doctor I will recommend some examination like an electrocardiogram, a cardiac echo, a full blood analyze to exclude anemia, hyperthyroidism and a holder rhythm monitoring to evaluate your rhythm tendency. Only after this we can better understand what we are dealing with and how to treat it. Hope I was helpful. 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: Hi I have a rash on my arm and chest only and only on the right side of my chest. They look like raised red bumps and now are starting to scale over on my arm looking violet in color. I am brown skinned so the red shows up but now that it is drying up it is looking purplish in color. There is a bit of an itch too on my arms and chest area where the rash is. This occurred about 3 weeks ago. What is it? ### REPLY: HiT hanks for posting on ChatDoctorThe rashes you describe could be caused by two possible thing:-Shingles(zone varicella). Zona rashes occur only on one side of the body, may be very painful and evolve as you describe. Occur only on one side of the body and do not cross to the other side.-Another possibility is reaction to a bite even though less likely. If caused by a bite that may give rashes as you describe, a more systemic response will be expected. I will suggest you see the Doctor to confirm diagnosis. If shingles, your Doctor may prescribe acyclovir tablets and cream to help you get over faster. You may take an anti-histamine like loratadine for itches. Hope this will help 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: Hello, my name is jhjknkr and I have been noticing a kind of weird feeling in my upper left abdominal area. I don t feel any pain for the most part but it has me wondering if it could be a Hiatal Hernia or just inflammation. When it comes to these kinds of topics I am quite the hypochondriac, please if you can get back to me. Thank You. ### REPLY: Hi ! Good morning. I am  answering your query. From your history, it might not be possible to judge your problem. I would advise you to get yourself assessed clinically along with investigations if any like an ultrasound abdomen, by your family physician to rule out any organic problem in your abdomen. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### 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 partner had a triple hernia op yesterday morning 29/1/2013..his appendix was sitting in between two of them and there was one on the other side in the same position...they were removed and he had mesh put in..what sort of pain should he expect when he coughs on a scale of 1 to 10 ...he is 56yo and 30 a day smoker thx Wendy ### REPLY: Hi welcome to  forum.  Thanks for choosing . Forum.  Your partner got operated for triple hernia surrounding appendix, on 29-1-13. He got operated perfectly by putting the mesh.  As his age is 56 there is always a possibility of getting pain on straining and coughing etc. So he must use light food, and see that he passes stools daily, should take more of water, and fruits and juices.  Hi should avoid smoking completely so that there is no cough and related pain.  Wishing for a quick and complete 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: My son has been suffring in FIts since lst two years. He is about 4.6 yrs. Fits moment is just abt 2-3 minutes. we have under gone MRI scan in Kalinga hospital . But cound not able to detect the exact cause. is there any way out to have the remedy....... ### REPLY: Dear friend, the reason behind this recurrent fits attack can be many including epilepsy or plain seizures. See MRI in some cases can detect the cause if particularly there is any structural deformity is there. As MRI could not clinch the diagnosis I would say u should go for EEG study on him. An EEG can diagnose the electrical activity of various part of the brain. So, if there is any defect in the activity of any part in the brain causing fits, an EEG can throw some light on that. So under any pediatricians prescription you should go for an n EEG for your child. 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: Hello, I ve been to ER over a hundred times in 3years: seen many doctors and keep getting diagnosed with costochondritis. I m scared there over looking an underlying condition because I have icy cold hands and feet, leg pain, back pain, jaw pain, and rib pain. Doctors say I m don t have circulation problems, heart problems, or any defeincy. Can you please help me ### REPLY: Hello, Due to compression of this nerve root there is pain radiating to your arm, leg. Diabetes and smoking leads to constriction of blood vessels leading to infection and weakness. So it is advisable to do color Doppler limb to see vascular status. Medication physiotherapy with TENS and anodyne therapy may help. For these symptoms analgesic and neurotrophic medication can be started. I will advise checking your it B12 and it D3 level. There is possibility of transient ischemic episode or stroke leading to motor weakness on arm and leg. You may need clinical examination to confirm neurological weakness, BP and other vital parameters. MRI brain will rule out stroke in case of suspicion. 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: My 4 year old recvd 4th DTaP, 1st Varicella and 2nd Hep B Vaccines 9 days ago. He has been waking up in the middle of the night with hot itchy feet, also happened sporadically throughout the day. Going on for 4 days now. Do any of these vaccines have such a side effect? ### REPLY: Hello, Welcome to , The most common side effects of Hep B vaccine includes pain, soreness, redness, swelling at the injection site, fever, headache, tiredness, sore throat, nausea, diarrhea, loss of appetite and dizziness. Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome. 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 name is Vipin Pandey. My brother, age 30, got blood clot and underwent decompression surgery after that in may,2012. His brain isin it s normal size now. But he is out of his memory , can t see and most importantly, his left leg and right hand starts limping with pain after 6-7 hours of taking anticogulant (Acitrom 3 and 4, alternate days) which lasts for 2 hrs. please advise something for these symptoms ( blindness and limping). Thanks. ### REPLY: Hello, It is not clear from your description regarding the type of clotting that has occurred in your brothers brain. Depending on the area of damage, deficits are seen in patients. In your brother probably the area needed for vision has been damaged. The pain in hands and legs needs to be examined by a doctor for any conclusion. It is however unlikely to be related to citron. Once damaged, the brain recovers function slowly over months. You need to give him regular treatment and medical care. 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: One of my friend was your patient and you have reffered him for Liver transplant surgery couple of years back to another doctor and his surgery was successful and he is now in very good health. I have my cousin who needs Liver transplant on the the recommendations of his doctors in pakistan. Do you take international patients for liver transplant if yes what will be the procedure and how spould I contact you. ### REPLY: Hi and thank you so much for this query. I am happy to know your friend succeeded in getting your treatment thanks to a referral from this site. I am happy for such positive feedback. The best way to get back to this doctor would be to personally get at least the hospital and doctors contact from your friend. Otherwise, we cannot for sure tell which hospital and who the doctor was to direct you to. However, if you had wanted a referral to a doctor who can do such, then it would be easier as there are many facilities around that can help you out. From there, you would be able to ask the specific follow-up questions. I hope this helps. Talk back with your friend and get the specifics to contact the doctor/hospital. I wish you well in the pursuit of solutions to this liver disease. 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: after popping a pimple, i now have two large sores that are indented on my forehead between my eyes and nose. around the sores i have red peeling dry skin that burns & the skin is tight feeling. the scabs dont seem to be filling in the dents, im worried theyre going to scar as an indention. ive tried neosporin, clobetasol, desoxmetasone, and alot of oher creams to make it heal but nothing is working. what do i do please help! ### REPLY: Hi, I have gone through your medical history carefully and understood your concerns. A photograph of the sores is requested to evaluate them and give a more specific opinion. I advise not to apply anything for the moment, Wash your face with warm water and salt. Apply only Betadine locally for a few more days. Give time for the soreness to subside. If no improvement, then, can apply tetracycline cream locally for a few days until clear up. All the best! .  ### 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 Doctors, As I a child I had the bad habit of stool withholding( once for entire month) , now I am an adult and my body below average BMI and I have too much cramps and was diagnosed with partial villous atrophy and my doctor insist It s celiac disease while I think it s IBS, now linking my current tests with my children history , do you think it s Celiac or IBS ### REPLY: Hi! Good evening. I am  answering your query. One could label it as IBS only after excluding other organic causes for your other symptoms like low weight and many cramps along with a partial villus atrophy, which could occur in celiac disease. You might have to undergo some biochemical investigations, some endoscopic biopsy of the intestinal mucosa, and a hit and trial way of excluding all food items containing gluten as their constituents with the consultation of a gastroenterologist and a dietician in your area. Till then, I would advise you to go for a high roughage diet, and enough liquids, with avoidance of food from outside specially the fast food, and complete NO to consumption of alcohol if you do. I would also advise you for an anti-spasmodic along with a proton pump inhibitor . I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### 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 grandson is 4 months old, and based on his stool exam he has: E. Hystolytica cysts: 1-2/hpf PUS cells: 15-20/hpf RBC : 3-5/HPF what does it mean? Is this curable? Does he need to confine in the hospital? Is this serious desease for a 4months old baby? ### REPLY: Hello. I have gone through your question and understood your query. Entamoeba histologic is also known as meiosis. It is an infection acquired through food or water. It can be easily treated by oral medicines. Infection can be prevented by avoiding feeding bottles or proper sterilization of feeding bottles. handwashing with soap before preparing feed or prior to feeding baby. Also use phenol contains disinfectant for floor. Person feeding child should be screened for amoeba histologic as well. ### 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 im 22 years old,weigh 68kg and im 1.58m,experience painful sudden accelaration of heart beat and i started experiencing this burning sensation when urinating and even after that i always felt like i needed to urinate but i started using gyna guard and i didnt feel anything until i stopped using it,i am sexually active so it might be an infection because the intimate wash product could have just been suppressing it and i sometimes have thir dry brown discharge which looks like the things after a menstrual cycle but im usually not on my periods at that time...so any ideas? ### REPLY: Hi, This is . Increased heart rate & palpitations can have a lot of causes. It can be normal sinus tachycardia due to anxiety or stress, or it could be abnormal supra ventricular tachycardia. For the diagnosis, you need to do ECG at the time of palpitation & tachycardia. If the duration of palpitations are short enough to reach a nearby hospital, we put a 24hr ECG monitoring (Holder Monitor). You also need to do a 2D Echo & thyroid function test to see for any associated abnormality if any. Infection & fever can also increase the heart rate. 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: iVE RECENTLY BEEN DIAGNOSED WITH DISOSSIATIVE  DIISORDER IWTH PSYCOSIS   AND BI POLAR AND I NEED COUNSELING BUT AM NOT WILLING TO INTERGRATE ALL OF ME  i LIKE MY BROKEN PIECES AND WAS JUST LOOKING STUFF UP i AM CURRENTLY TAKING RESPRIDAL AND IT SHUTS ALL OF THE VOICES AND I FOUND MYSELF IN A FUGUE LAST MONTH SO ITS ALL NEW TO ME.  JUST LOOKIN AND SORRY ABOUUT THE SPELLING IM SURE YOU CAN FIGURE IT (MY SPELLING) OUT.  tRYING NOT TO BE PERFECTIONIST TOOTRACEY ### REPLY: Hello..... Thanks for your query. Treatment for bipolar psychosis should take precedence over dissociative disorder in your case. The treatment for bipolar disorder includes mood stabilizers like lithium, valproate as well as antipsychotics with mood stabilizing properties like risperidone. Hence, you discuss these options with your psychiatrist. Maintaining a normal sleep-wake cycle as well as avoiding use of alcohol/other substances of abuse is likely to benefit you. Wish you speedy recovery. 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 was electrocuted with 270V for almost 2 minutes 6mo ago. I has 3rd degree burns on my extremities but no sign of organ damage and the burns have since healed fine (scar tissue looks ok). I have been experiencing fatigue and joint pain (worse at night). I just had CBC/thyroid/liver/kidney blood work done and they were all fine. Is there any chance this can be related? What should I ask my doc? ### REPLY: Hello, Welcome, and thanks for sharing your concern I went through your query, and I feel, that there is less possibility that the electrocution would have caused all this, there could be other reasons and your investigations should be followed by proper examination. I hope my advice would have been useful, in decision-making regarding your treatment, still if you have any clarifications or doubts feel free to contact back. 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: I did my kidney transplant a month back. I hd leg edema and scrtal swelling from day one to  two weeks post op day .In the last one week i have noticed a painless,non hot non tender sweelling of the rt testis. i have no problem in micturation .What will be the cause and how can i get treated?I am 50 yrs old, 1.67cm in hight. dibetic for the last 15 yrs on insulin,hypertensive for 4 years controlled after transplant. I am taking cyclosporin,cellcept,predinsolone ### REPLY: HelloThanks for query.swelling of the testicle that you have after renal transplant surgery is due to retrograde secondary infection of the Testis (Orchids) due to catheterization, Get urine culture done to trace out causative organisms and take appropriate antibiotics as per culture report. You need to continue antibiotics and anti-inflammatory medications like Serropeptidase twice daily for 2-3 weeks. Ensure to . This will get resolved soon. ### 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: Im worried about my abcessed tooth. I am on the seventh day of antibiotics, but I think the infection is getting worse. My face feels swollen and numb. I went to the dentist and without even looking at it they only bumped my root canal up to next week and then sent me off saying it would be fine. What is the risk of it infecting my lymph system before I get in to that appointment? ### REPLY: Thanks for using . Read your query. Since the antibiotics is already taken for a long time, the swelling and numbness will reduce only when the treatment is initiated. I would advise you to call or visit the dentist office and take an early appointment or start with the emergency treatment of root canal. Do salt water gargling and avoid applying hot bag externally. Hope this was useful. Thanks and 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 just experienced some serious anxiety at a meeting I was attending that was very stressful and my heart actually JUMPED in my chest...no pain but it jumped.  It felt like it was in the left side of my chest, not in the middle.  I am 48 years old and recently had a stress echocardiogram done because I was told years ago that I had a mitro valve prolapse.  The results showed nothing with my valves except what they described as a very very minor prolapses, no leakage.  What could this jumping in my chest be cause by. ### REPLY: Hello, This is called as palpitations and most likely occurred in you due to anxiety and panic.  If this is occurring repeatedly, one ECG during the episode will be helpful or else holder monitoring to rule heart arrhythmia should be done. Also, get one thyroid test done.  You can get tab Collar LA 20 mg once a day prescribed from local doctor which will decrease these palpitations. Try relaxation techniques like yoga and meditation for your stress. ### 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 just come home from my 6 th hospitalization this year. 4 have been pneumonia related, 2 were from new A-Fib which I developed from my first bout with pneumonia on 25th of Jan. in April, I checked into ER with A-Fib again. 3 days later I had bilateral pneumonia. When I went to ER, I didn t even have tickle in my throat. My question centers around my oxygen. After 3 weeks in April in Chandler Mercy Hospital, they sent me to a therapy Hospital. When I went I was at a flow rate of 15. After 3 weeks I was back down to 2 during the day and 4 in pm. My oxygenation is 96/97 with oxygen and heart rate is 65/75. If I go off the oxygen, I drop to low 80 s and even 70 s with heart rate in 90 s. Doctor am I able to look forward to getting off oxygen? Prior to this year I be not been in hospital since 2001 for appendix and 2004 for pneumonia but no oxygen! ### REPLY: Thanks for your question on . In my opinion you should consult pulmonologist and get done1. CT THORAX2. Bronchoscopy and BAD (Bronchi Alveolar Lavage) analysis3. PUT (Pulmonary Function Test). Pneumonia can happen in both lungs, but it is not common. I think we need to rule out interstitial lung disease (OLD) and chronic congestion first. As possibility of these are high. So CT THORAX and PFT is needed to rule out this. If in CT pneumonia is seen than get done Bronchoscopy and BAD analysis for identification of causative organism and start treatment accordingly. So better to consult pulmonologist and discuss all these. ### 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 a whit milky discharge with a low order for a while. but before that i had a mild infection and my doctor gave me some medication and told me that it should clear up ina week or two. since then its cleared but i still have this discharge. should i talk to my doctor again should i be worried? ### REPLY: Hi, Thanks for posting in . Vaginal candidiasis (yeast infection of vagina) is known to cause white milky discharge. You can use topical antifungal pessaries or vaginal tablets containing clotrimazole. You can follow one to three days regimen depending on the severity of infection. In case the infection is severe, you can add antifungal medications containing fluconazole to be taken orally. Take care to keep the area clean and under good hygiene. Wear loose undergarments to keep the area ventilated till the condition gets cured completely. Hope the information provided would be helpful. All the best. ### 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 woke up this morning with pain in my right side, abdominal area, it is very extreme when I take a deep breath, cough, sneeze, or laugh. It is tolerable when I am sitting, but it is very painful when I stand or walk and somewhat more painful when lying down. I have had my gall bladder removed already and I know from recent blood tests that I have a very fatty liver that I m awaiting to see a specialist for. Should I go to the ER? Or should I just call my doctor tomorrow morning? ### REPLY: Hi. Thanks for your query. You should immediately go to ER. The pain in abdomen which increases on all the activities you say is an indication that there is a severe process of inflammation going on either in the abdomen like appendicitis, right kidney abscess or some problem in the lower lung or pleural cavity. You need urgent investigations:"*Hologram, urine tests.*ultrasonography*X-ray of chest. You need an admission:Intravenous fluids and antibiotics. Proper diagnosis And treatment as indicated by the investigations ### 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 Rachel!I have a 8weeks old baby boy and he is breastfeeding and has not passed any stools for 2days now so I thought maybe he might be having stomach cramps coz he has a fever around the abdomen and when he cries he pulls his legs towards his stomach and is now developing a rush around the face!I have given him Panado syrup for the fever and Hyospasmol syrup for cramps!What could be wrong with Him??? ### REPLY: As a pediatrician I would like to examine the baby... Crying episodes for 2-3 hours daily in infants less than 6 months old is normal in many cases... Some infants pass stool only thrice weekly... That is also normal... If baby is taking breastfeed properly... Baby dent have vomiting... Baby is passing urine 5-6 times in 24 hrs... Then doesn't need medications... However, baby needs clinical examination by pediatrician to see everything is normal... So visit a pediatrician.... ### 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 20 year old healthy male that has all 4 wisdom teeth and I had two root canals on my lower 28. Unfortunately I will have to extract the lower 28 after all the work ive done on it. I hate the fact that i will have to walk around with a titanium rod in my mouth for 4-6 months. I was wondering if it is possible that I Remove 3 wisdom teeth along with the lower 28, then got braces to move over my other teeth and make room for my wisdom tooth (on the lower right not coming in compacted) to come in and act as a molar. If this is possible I would rather do this than have a false tooth in my jaw. I ask online because I dont want any bias from my dentist or the surgeon. ### REPLY: Hello, thank you for consulting with . Yes it is possible to get extracted all wisdom tooth, but it should not be done on the same appointment. But if the dentist is mentioning that 28 needs to be extracted then there must be some infection left in the apical region of tooth which will create problem in the future. Better you should go with the dentist as he must have diagnosed all the conditions. Hope it will help 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 have a lump on the side if the back of my butthole it feels like there s a lump underneath it. It s sorr and itches. What doctor should I see for this? Gastranologist, OG-GYN or my regular doctor? I know it s something but I just don t know where to go. Please help it s not getting any better. Thanks for your help. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some piles or perianal abscess.  No need to go to gynecologist or gastroenterologist.  Just consult your routine doctor first.  Get primary diagnosis and start treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. 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 trying to understand what is meant by - right upper lobe 5 mm non-calcified nodule and suggestion of a vague subcentimeter satellite nodule versus focal inflammation or fibrosis; although the nodule may be inflammatory/granulomatous, a pulmonary metastasis or early primary neoplasm the result of a baseline CT study following Chemotherapy after surgery for ovarian cancer. ### REPLY: It means a 5 mm lesion (shadow) seen on the CT scan in right lung in its upper lobe (Right lung has three lobes: upper, middle and lower). Since the nodule size is very small 5 mm (half of a centimeter), the radiologist has not been able to give an exact diagnosis, and he has given a differential diagnosis (meaning it can be one of the following) of the following:1. Inflammatory/granulators lesion: secondary to infection or foreign body etc2. Pulmonary metastasis: metastatic disease to lungs is a possibility since you have a primary ovarian cancer3. Early primary neoplasm: A primary lung cancer in its very early stages because of the small size. Since the size of the lesion is very small, a biopsy would not be possible to confirm the diagnosis. I would suggest a repeat CT scan after 2 months to see if the nodule size has increased. If the size remains stable, It's likely to be benign. If it increases to > 1 cm, a PET scan or a biopsy can be done. I hope I have answered your query. I would be more than happy to answer if you have any further queries. ### 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 i have a small lump on the right side of my lower wasteline. Im sure im overreacting but i would like to make sure its nothing serious. Its right where the doctor puts his fingers and says does that hurt . Its painless. But sore to the touch. I am very active. Let me know something fast . ### REPLY: Hello and welcome to , Lump anywhere on body should be investigated. A painless lump can be due to soft tissue swelling like lipoma, fibrous, hematoma etc. Thus, get an aspiration cytology of the lesion. Aspiration cytology samples cells from the lesion and the cells are examined microscopically. This investigation determines the site and nature of lesion. Thus, consult your doctor for these investigations. Thanks and 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 dad is in the hospital for a pulmonary embolism. He is now getting accu checks and insulin coverage for blood sugar over 200. He has never been diagnosed with diabetes so why are they suddenly checking and giving him insulin. The highest it has been in three days is 227. Just not sure why he is being treated for that. Does it have to do with the heparin and Coumadin? ### REPLY: Thanks for your question on . Pulmonary embolism is life-threatening condition. And in any such conditions or severe infection glucose levels tend to fluctuate a lot. So it is not recommended to use oral glucose lowering .  So insulin is preferred.  Because action of insulin is immediate so better to control sugar spikes and avoid delayed hypoglycemia. And high sugar levels are not due to heparin or Coumadin. So no need to worry about this. No harm in insulin injection for high sugar levels. ### 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 had a sinus infection and them bronchitis for the last several weeks. My doctor gave me two rounds of antibiotics for sinus infection, but I still have bronchial irritation and shortness of breath . she then gave me Qvar, but that has not seemed to help much. Do you think I need another round of antibiotics? ### REPLY: Thanks for your question on . I can understand your concern. No, another round of antibiotic will not help you. Inhaled treatment is the best treatment for bronchitis. You are taking only var (inhaled corticosteroids). Mainstay of treatment in bronchitis is inhaled bronchodilator (formoterol or albuterol). So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (pulmonary function test). PFT will tell you about severity of the disease and treatment is based on severity only. You may need additional inhaled bronchodilator along with var. Don't worry, you will be alright with appropriate treatment. 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: HelloI have dust allergy, off late it is becoming worse, especially at my home (it is on the 1st floor with roads nearby not tarred and with rainy reasons things have become more worse...i am fine when i am in office (i do not sneeze once and there is hardly running nose), but when i am in office both the symptoms are there.regardsSunny ### REPLY: Hello dear, The symptoms as mentioned in your post suggest that you might be having Allergic rhinitis. Management includes:1. Antihistamine preparations like Allegra can be taken for symptomatic relief.2. Montelukast preparations- as a maintenance therapy to relieve symptoms of seasonal allergies.3. Maintain adequate HY . 4. Also make sure that you are well protected from cold, dust & other allergens. Wishing you a good health. 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: Im a 39 yr old female i got real sharp lower adomonil pains from center to left around 2 hours ago i was sweating and got light headed and felt nauseated with it i took 2 extra strength tylonal the sweating stopped and i still get a little light headed when i stand, as long as i sit i dont feel the sharp pains but when i get up or cough i feel a stabbing pain,  my urine is fine and i have went to the bathroom --- is this something i should worry about ### REPLY: Hi. Thanks for your query. You have got sharp pains from the center of the abdomen to the left around 2 hours. There is associated nausea, lightheadedness and sweating, and you took already 2 Tylenol... The sharp stabbing pain is coming only if you are getting up or coughing, urine is fine... The probable cause can be a hernia. I would advise you to get examined by a General Surgeon and get the necessary investigations as advised by him. Final diagnosis will lead to a proper 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: So I have a baby tooth that is only hanging on in the mouth by a piece of gum. The adult tooth is already there but I dont think that its fully grown. I tried pulling it out but I couldnt. It bled a bit but I cant say if it was much or not cause when it comes to blood the smallest amount is the biggest for me. What should I do? ### REPLY: Each tooth follows a distinct pattern of eruption and shedding and while it towards the end of its shedding stage even a slight provocation like brushing, eating or sneezing expels the tooth out, which hasn't happened in your case . The tooth you have mentioned is already out of its bony wall and hanging by a piece of gum. My suggestion to you is to visit a dentist and get the tooth removed as it is really easy to tweezer it out of a tissue cover by a professional. I would not hesitate to mention that a sudden jerk or eating anything hard can lead to accidental ingestion of the tooth as well and bleeding from the soft gum tissue as well . I also advice you against doing it yourself. 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 DOCTOR SAYS MY ALCOLILIDE PHOSPHATES IN MY BLOOD IS HIGH AND THAT THERE IS A PROBLEM IN MY LIVER . SHE WANTS TO DO A SONAGRAM ON LIVE R . WHAT DOES THAT MEAN? AND IS THIS SERIOUS? MY INSURANSE WONT PAY FOR THIS AND I AM GOING TO HAVE TO PAY IT OUT OF POCKET. ### REPLY: Hi there, Thanks for using . One of the causes of elevated alkaline phosphatase is obstruction to the bile flow. This obstruction could be either inside the liver substance or in the bile duct. In these cases the liver panel would be abnormal. There would be a raise in the bilirubin level especially the direct component. An ultrasound scan may show dilated bile ducts. If the obstruction is inside the liver substance the ultrasound scan may not show it and a liver biopsy may have to be done to confirm it. This obstruction could be harmless as in gallstones in the bile duct or may indicate serious conditions like malignancy, primary biliary cirrhosis etc. There are other causes of high alkaline phosphatase also. Bone disease can cause an increase in alkaline phosphatase level. Pregnancy can cause a raise in alkaline phosphatase. Is this answer 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: Most of the time when i speak i have shortness of breath especially when i have to speak long sentences . i don t smoke and my chest xray is always clear when we have our annual physical exam so it may not have something to do with my lungs. Although i have to say that i get anxious most of time since i m a worry freak. I really need to have this check as it affects my job as a recruiter. Please advise whom i need to consult. ### REPLY: Thanks for asking your question completely understand your issue breathlessness while talking in case, if all your investigations come normal can be due to anxiety. You need to see a psychiatrist to evaluate yourself for social anxiety disorder, but u need to consult a pulmonologist also to evaluate yourself first for any organic lung disorder. Thanks / regards feel free to ask more questions may god bless you with 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 20 years old and 5 9 and was 125/130 pounds when I started taking Adderall in February. I have been this weight the past three years, plus or minus a few. However, since starting my percription I have experienced a weight gain and am around 145. When researching the relation of adderall to weight gain i only saw things saying that adderall was actuall a appitite supressor and is related to weight loss. When i do take adderall i sometimes experience bloating but it doesnt stop me from feeling hungry, im just uncomfortable. should i stop taking this perscription? ### REPLY: The cause for weight gain could be something else such as hypothyroidism. You should not stop taking the medicine on your own without consulting the doctor. There is no evidence that Adderall causes weight gain. Though it can suppress appetite and cause weight loss, not every person taking Adderall will experience these effects. You should consult the doctor who prescribed you Adderall. She/he will examine you and may order a few tests to find the reason for your weight gain. I hope this answers your question. ### 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 diagnosed with clival mass - chordoma -- adjacent to the brainstem and about the size of a grape. I m being referred to one of the medical teaching schools for further evaluation. Can they biopsy this? IF it is benign, what is repercussion of not doing anything with it... or is that an option? ### REPLY: Hi, Thanks for writing in. The lives is part of the bone in the inside of the skull. This is a small bone that has a pea sized area in front where the pituitary gland is found. The lives is a bone located behind the pituitary, A Cordoba is a tumor of bone origin and is regularly noted in relation to the lives. It is part of a family of cancers called sarcoma, which include cancers of the bones, cartilage, muscles and other connective tissue. Chordomas are thought to arise from remnants of the embryonic notochord and might have cell origins since birth and start proliferating at a later age. They are usually slow growing and recur after treatment. Because of their proximity to critical structures biopsy is difficult and requires skilled approach. Often it is diagnosed on CT scan or MRI scan and treatment is given. Having it evaluated in a teaching school will give you more options of treatment and cure. ### 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 just examined my pelvic area, and i noticed a medium size lump, and I felt a dull pain. I work often like sit-ups and I run often. So can it be a hernia or something worse? i don t have insurance, and I am currently unemployed, I do not have the means to go see a doctor. What could be going on??? ### REPLY: Hi, what is your age? Please let me know the exact location of the lump. Is it restricted to above your groin crease or is it descending to your scrotum. Can you differentiate it from your testicles? Does it increase in size on straining or coughing? Is it soft to touch? If the answers are yes, then it's probably an Inguinal hernia. The only treatment is Surgery. It can be confirmed by getting it examined by a Surgeon or you can get an Ultrasound done. Until you get a job and insurance, you should stop any exercise involving strain on your abdomen and avoid any strenuous exercises. Take care and feel free to ask any clarifications. You can also contact me on Ask a Specialist icon. .  ### 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 a 37 year old female. I have no idea what this is and I am really scared! Its been happening for awhile now but only in the last few days has it increased. I have heart palpatations almost constantly. It beats faster normal. Its possible Im feeling shortness of breath and just today Ive noticed a tingling and numbing sensation in my left arm (below elbow) and in my fingers. My hands are also shaky. More the left one than the right. I cant always keep my hands steady especially when I am writing or gripping something. I also have an achy back on the left side near the shoulder blade and some in and out pains below the left breast (top of the rib). Some of these pains have been on the right too but more on the left. I also experience nausea sometimes too. I am sooo scared of what this is and I am very young for this to happen to. I dont feel like this is something I should rush to the ER for. Especially since I havent blacked out, fainted,  or had worse symptoms but I am still very freaked out by this. Dont know what to do or if this is gonna go away or get better or what. If anyone has had the same thing or can ease my mind in any way, Id appreciate any help, thx! ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have palpitations and shortness of breath.  You may have some problems in heart or lung.  Your back pain and pain in left arm and finger may be due to some neural involvement.  You should go for x-ray chest, electrocardiogram and blood pressure measurements.  Then you should take treatment accordingly.  Don't wait for worst symptoms.  Consult your as early as possible and start treatment. Hope I have answered your question, if you have doubt then I will be happy to answer. 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 was barefooted and a heavy metal pogo stick fell on my foot. It bruised almost immediately and there is a lump and redness in the area with the bruise. The bruise is in what I think is the 1st metatatatsal bone. It doesnt hurt when walking but it hurts if touched. Should I see a doctor ### REPLY: HI, Dear,Thanks for the inquisitive query to .1-I studied your query in depth.2-In my opinion, post-traumatic lump on the 1st meta-tarsal, is due to the "Bony contusion with post-traumatic Cellulitis" and there appears to be no-fracture in 1st Meta-tarsal bone-as It's painless while walking but is only tender to touch-suggesting the bony contusion there.3-I would advise you to take -NSAIDs and wait for 2-3 days-if it subsides, then you need not worry 3-a-But if the swelling and pain persists, then you are advised to consult orthopedic surgeon-as it needs X-ray of the foot to confirm and treat any probable fracture in the foot.4-Wellcome for more queries to me On .5-Thnks once again for your inquisitive query. Have a Good Day.!! ### 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 19 year old girl and lately i have many pain in my under belly and I went to the doctor today and asked him what was that pain(at the bottom left of my belly.). and he told me that my ovaries were so hurt. And I was so scared, because it really does hurt. I must tomorrow go to my house-doctor. And he will send me to a specialist. I have for many years, had a pain in my belly under. The pain came 2 to 3 times a year, but so hard, that I once went to the hospital, and did ECO-test and many tests, but probably I never had anything. Until now approximately 4 years after all of the strange pain that only comes so suddenly, they tell me that the pain in my ovaries may be. Now the question is ... what could it be because Im really scared .... And I had pain for many years under my entire belly, but know is it specifically on my lower left abdomen. ### REPLY: Hi ! Good morning. I am  answering your query. If I were your doctor, I would advise you for a routine/microscopic/culture and sensitivity test of your urine, an unsuspected UTI being one of the common causes of such chronic and recurrent pain in the lower abdomen. Once this is excluded, then we could go for other investigations like a complete blood count, and an ultrasound/CT scan of the abdomen during the period when you get pain. Till that you could go for an anti-spasmodic .  Further management would depend on the results of a clinical assessment by a gynecologist, and reports of the related investigations. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### 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 small white spots on my inner cheek following a molar extraction 5 days ago.......  Is this infection or allergic reaction.....  I was using table salt to rinse not realizing Im allergic to Iodine and the salt contained a LOT of that.....  I switched to sea salt yesterday but the spots are remaining, they are SORE ### REPLY: Thanks for your query, I have gone through your query. The white spots on the cheek could be because of the biting over the cheek when the cheek was numb that has resulted in frictional keratitis. Or the possible cause could be because of the allergic reaction to salt resulting in licensed reaction. Consult an oral physician and get it ruled out. If it is because of allergic reaction then you have to take topical steroids like triamcinolone acetone (0.1%) 4-5times daily for 1 week. You can also take topical anesthetic and analgesics like Anabel gel for the pain. I hope my answer will help 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: I am taking talsartan 40 R (telsartan 40 + Ramipril 5) and Nebstar-H (nebevolol + Hydrochlorothyzide) last two months. But I have a severe side effects when I walk. My both upper arms pain and chest discomforts occurs when I walk. My has gradually increased and now I cannot walk fast now even for 100 m. Please help. Suggest alternative HT medicine. My B.P is under control by the said medicine(130/80) but walking I cannot avoid. ### REPLY: Hello, Thanks for posting your query on  ...* Brief Answer: Take care, your chest discomfort may be a symptom of ischemia.*Explanation: My opinion is that as long as your blood pressure is controlled, it is not preferred to change your medications. Your complaint may be related to another condition. Chest discomfort or pain especially with exertion plus or minus sweating and nausea are manifestations of ischemic heart disease, and that you should be aware of.  I suggest my patients the following : general and local cardiac examination, electrocardiogram and echocardiography be needed. The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about age and smoking history.*Conclusion: I suggest you check with your general physician and do the investigations I suggested.  If you have any further questions I will be happy to help, If not, you can close the discussion and rate the answer. 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 have welts on my arms and legs. I had a couple on my stomach too. After I scratch them is when I notice they are there. They just show up one by one randomly. I havent done anything new. I use the same soap shampoo laundry detergent and havent eaten anything that I am allergic too that I know of. They are so itchy so I cant stop scratching them. They start to scab a little. Whats up with me? ### REPLY: HI, thanks for using  Urticaria or hives refers to the formation of these welts on the skin. There are types of urticaria that can occur in response to the pressure on the skin or stroking the skin. This may the case for you. It is also possible that it may be related to a particular allergen. You may want to consider allergy tests to see if there is a particular allergen that is causing the reaction so that your exposure can be reduced. I 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: some days ago i got a pain in my chest so i get a chest xray and an ecg.both were normal.then i met a dr.who is the spesialist of heart after got checked he told nothing wrong with you.last three months i am walking,exercising there is no problem.but the problem is that i feel something is moving,some time some sensation is this due to gas ### REPLY: Thanks for your question on . I can understand your concern. Yes, this kind of sensation can be due to gaseous distention of stomach. Since your chest x-ray and ECG are normal, no need to worry about heart and lung diseases. Gaseous distention of stomach can cause similar kind of moving sensation in the chest. So take proton pump inhibitors and prokinetic .  Avoid stress and tension. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Go to walk after meals. Quit smoking and alcohol if you have these habits. 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: I am 6 1/2 months pregnant. Woke up this morning having chest pain. I didnt pay mind to it and continued with my day. Afternoon I took two Tylenol thinking the pain would go away and it hasnt. The pain is my dead center chest, in between my breast. Feeling like I cant breath. Like my chest is Caving in and someone punched me there a few times. What is it????? ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of musculoskeletal pain is more likely. But better to rule out cardiac chest pain first. So get done blood pressure monitoring and ECG. If both these are normal then no need to worry about heart diseases. Apply warm water pad on affected areas. Avoid movements causing pain. Take painkiller and muscle relaxant . Don't worry, you will be alright with all these. 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: I am pregnant my ChatDoctor level went up almost doubled then I started spotting brown discharge... when I went back my ChatDoctor level droped 250 less then the following day after me visit I got cramps and started bleeding with clots and 2 times I saw a kinda thicker clot then usual it slowed down now Im back to spotting brown dark brown cou I still be pregnant??? ### REPLY: Hello, and I hope I can help you today. You're falling  levels definitely mean your pregnancy is not viable and at some point may result in miscarriage. Depending on AON how many weeks along you were, you can have bleeding, even with clots, before you completely pass the pregnancy. So I recommend you follow up with your GUN Doctor, so they can perform an ultrasound and check your  level again to make sure all the pregnancy tissue has come out. I hope this adequately answered your question and that my advice was helpful. Best wishes,  ### END