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 problem in my back from last 3 years.. its spondolytis(not 100% sure) i feel sever back pain for a duration of 1 month or so then it becomes normal , but after some time it again comes back.. when pain is severe i feel unable to walk and i limp during that period of time... dont know what to do any suggestions ? ### REPLY: Hello, you should get evaluated with MRI of the spine which will give some clue.  Any problem which can be corrected with surgery will also be identified in that. During the period of pain you can take medications to reduce pain. Physical therapy to strengthen back muscles will also help. Any faulty techniques of sitting, sleeping can also cause back pain. These can be discussed with doctor treating you. 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: Hi my boyfriend had 4 nose bleeds last week and one this week why would that be. He resently was at the hospital for blood on his   Mucus  but he got medication for a upper respiratory infection so they had to check is nose and everything else so I there really nothing truely wrong but Im sorry ### REPLY: Howell come ChatDoctorI really appreciate your concern, certain very common condition are there as long as the bleeding per nose is concern and first is cold condition in other word it is the allergic condition and second is idiopathic epistaxis in either of this condition only conservative treatment being given and in severe case hospitalization is must, beside these it is very important to rule out the blood disorders, systemic diseases, and for that numbers of tests needs to be done, hope this information. ### 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: Good Morning, I have been seeing my GP each month for the past 3 months, because my blood pressure was 190/110...he told me to purchase a monitor, & has increased my medication. My reading has now dropped to 136/80 (which I know is good....my pulse is 80, so I am wondering what a perfect PULSE READING IS, for a 68 year old lady? Thank you, Jeanette Hennessy ### REPLY: Hello Jeanette! Thank you for asking on ! I am glad to congratulate your for the excellent achievement, regarding your high BP management. You doctor seems to have found you the right treatment scheme, that fits to you, and obviously exerting a good safety profile. I just would like to advice you, that keeping high BP under control is usually well performed (with doctor prescriptions), but remains to your will and determination to continue the permanent fight against this silent killer (as is ordinarily called high BP). Periodic medical check-ups would guide you to the better BP management (as BP is everlasting changing and dynamic vital parameter, and potential side effects may arise form . Hope to have been helpful to you. Greetings! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear sir,I suffered meningitis at the age of 5. After few years I became epileptic. Presently I am  taking Oleptaal 600 OD twice a day. I have suffered two seizures since August,2012. Now, my doctor has prescribed Tolreva XR 500 twice a day in addition to Oleptal 600 OD. Please comment should I start Torleva? Please comment. ### REPLY: Hello! Thank you for asking on ! Regarding your concern, I would explain that the frequency of seizures is really low. This means that the treatment with Lethal 600 mg twice daily seems to be effective in the management of the seizures. If your blood lab tests are normal and no complications related to Lethal intake have occurred, I would not recommend starting Korea XR, because it is not necessary. Poly therapy (the concomitant use of tow or more antiepileptic .  It can lead to increased adverse effects. You should discuss with your doctor on the above issues. Hope to have been helpful! Kind 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: Should Primibone be taken for parkinsons disease? The side effects seem worse than the slight tremor I have right now, which is why my MD wanted me to try it...Or i m thinking I should wait till my regular app. with my Parkinsons Specialist...Any advice would be greatly appreciated..Thank You.. ### REPLY: Hi, Thanks for writing in. Primidone is prescribed by some doctors to treat the tremor encountered in Parkinson's. However, you are right is saying that the side effects of pyrimidine are more difficult to manage than the tremor itself. Studies have been done concerning giving pyrimidine in Parkinson's, and it is seen that mean tremor amplitudes were not changed by pyrimidine. Also Tremor frequency was unaltered by the medication. Many doctors say that long-acting propranolol is a useful adjuvant therapy for the tremors associated with Parkinson's disease. However, medications are to be changed after asking your doctor. If you feel comfortable and tremors are slight then you can stop pyrimidine and wait for your Parkinson specialist for a more suitable medication to treat your tremors. 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: My hair started falling out when I was about 17, its a good ten years later Ive tried everything from rogaine to getting my scalp tested, all the doctor said was its infected and gave me anti biotics, Ive taken biotin etc, and still no regrowth, half of my hair is missing Im afraid Im going to lose it all, I was told to take fish oil capsoles... what can I do?                                                                                thank you ### REPLY: Hi, Probably you may be having halogen effluvium. It may be due to some cause. Most common cause is psychological upsets like anxiety, worries, tension or depression. Other causes may be thyroid dysfunction, vitamin and mineral deficiencies, anemia, other internal diseases, . .etc. Remember, normal hair fall in adult may be 100 to 150 per day. You consult dermatologist for firm diagnosis and treatment. Blood investigations may be done to find out some other internal cause. I would like to suggest following tips to improve the condition...-take biotin containing tablets for long time-take vitamin E cap-apply mild steroid lotion like beclomethasone lotion on scalp at night. -Mild herbal shampoo may be used-almond oil may be used. -Have patience for the result hope you got my answer. 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: Yes, I had the H1 N1 flu just before Christmas and then ended up having Pneumonia and a Sinus Infection for all of January, and had to be treated with 2 Anti biotics, since the first one didnt clear it up. My question is this: I keep on wheezing especially at night and still have a very chesty cough, however my doctor said that my lungs were clear last week. He thought that it might be from my nasal discharge, but even though Im using a nasal spray that he described for me and I am also doing the sinus rinse twice a day it isnt clearing up. Could it be Trachial Bronchitis or Asthma? ### REPLY: Hello, Welcome to , As you had swine flu for which you have taken treatment and following which you had secondary bacterial infection of the lungs for which you have taken two courses of antibiotics. As you are having sinus infection and cough which is leading to post nasal . I would suggest you1. Steam inhalation with Vapocaps2. Oral Antihistamines with Mast cell stabilizer3. Avoid exposure to dust, mites and pollen. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have just been fitted with an air cast boot as I have broken 2 bones in my right foot by my small toe due to falling down stairs. I am worried about the size of the boot I am wearing due to me giving the wrong shoe size (UK 6 but the boot is size 6 Canadian size as it was fitted in a hospital in Canada) Will this delay or do more harm to the bones healing correctly. I would appreciate your advice so that I will have time if necessary to go back to the hospital. ### REPLY: hello foot fracture bones are aligned right, purpose of boot is immobilization. Only thing is cast shouldn't be loose enough to permit movement of fracture site. If not, then nothing to worry, if loose, then padding or change may be needed, so see an orthopedic doctor. If only crack fracture and no displacement requiring re aligning fracture ends, no worry even if boot oversized-the idea is only to take weight off the foot on standing or walking, it will heal fine. If initial fracture displacement required setting of fracture ends, then do visit hospital to review with check x-ray if alignment is disturbed and may require resetting and correct size snug boot best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had for some time ( a couple of years) pain in my abdomen. This has a lot of different symptoms feeling like wanting to go to the toilet all the time to fatigue, bad breath, upset stomach irregular bowel movements, loose and constipated ( no blood in stools just the occasional tear of rectum which is annoying to say the least. Last night I had pain like never before from my diaphragm down to navel, due to all the problems I have has I have a high pain tolerance I would say this was about an eight on a scale of 1 to 10 which made me feel so bad it almost forced me to vomit Im going for a urea breath test and an ultra sound in a few days any thoughts on what I should ask doctor to look for?Based upon symptoms Im thinking its possibly a h. Pylori infection however I want to rule out stomach/ bowel cancer and am interested in any information you may have this has gone on for to long in my life and is depressing and would like to know if Im either dying or curable so I can try have a normal life. ### REPLY: Hi Thanks for writing in Your information is suggestive of some form of colitis rather than any cancer Yes you may go for urea test and ultrasound, along with it if practical go for a stool examination In the meantime avoid contaminated and junk food, take a probiotic for three to four weeks twice a day Add a OTC antacid and manage stress levels used to consuming alcohol and smoking, avoid it strictly Hope this helped write back in case of concernWishing you a healthy life ahead ### 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 lower left back pain that is below waistline and when I walk is very painful and radiates up the left of my spine. Been to chiropractor 4 times and says its my lower lumbar but treatments haven t helped. not sure what more I can do. Tylenol, ibuprofen/ naproxen is not helping. thinking it may be more seiours. I know what sciatica pain is and its not that. I don t have credit card with me, didn t know I had to pay ### REPLY: Thank you for sharing your complaint, dear friend your low back pain seems muscular pain. You should consult orthopedic/neurophysician nearer to you when you are in your city. Presently if you have severe pain then take muscle relaxant medicine like combination of diclofenac+paracetamol+chlorzoxazon. Exercise and physiotherapy will help you a lot. If possible consult physiotherapist nearer to you.-exercise for low back pain-raise your one lower extremity straight from hip joint without bending from knee after sleeping on back and then put down slowly. Same exercise for another lower extremity. And then for both leg simultaneously. Sleep on abdomen and raise your head and chest backward. Increase this exercise every day. Hope this answer will be helpful to you. For more queries please don't hesitate to ask. Get well soon dear friend ### 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 try staying positive i tell myself lots and lots of positive things each day but it doesn t help, i hate this feeling but i can t make it stop i feel like my mind is being controlled and i don t feel so sad sometimes though. Sometimes i feel really happy and hyper but than it goes away and the feeling is back and i try and try but i can t and when I m really hyper and stuff i feel as though i have very poor judgement and often times it gets me in trouble and than i just have these explosions of anger and i try to control it i really do but i just can t help it and i don t know what to do. I cant stay focused and i zone out often. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. I can see the problem you are in. But positive phrases and statements do good to only those who keep a positive way of life. You must learn life before saying positive phrases. There must be a basic cause of these negative thinking and anger. Some sort of disappointment in life. Such a disappointment or the cause of that disappointment should be ad .  This can be successfully done with the help of a psychologist. Consult a psychologist. Even online consultation should suffice. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further. 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: my husband has lower right back pain he has had kidney stones in the past he can bend up and down but when he twists he gets sharp shooting pains but pain has increased in days this is day 4 he has been icing and heating it ibruprofen and now anti inflammatory none of which help.pain goes into leg he feels sick sometimes and he is sweating more than usual ### REPLY: Hello, Thanks for the query to . Forum. Pain due to twist and renal stone, these two symptoms are related to each other. Excessive sweating is due to pain. When you know that there is (are) stone in kidney, why are not taking treatment ? If taking treatment than mention it ? Size of stone matters very much. Get in urine and well as blood examination for kidney function test. Consult a urologist and get his opinion. 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: My 12 year grandson has allergies he currently takes prescription Zyrtec and prescription flonase. He quite frequently get swollen,red tonsils, dry cough,,sometimes runny sometimes stuffy nose. This time around it has been 2 weeks of him being miserable. And his pediatrician keeps advising some other over the counter medicine. He never gets a fever with this. ### REPLY: Hi...he seems to be having moderate to severe persistent allergic rhinitis, and I am glad that he is on Flonase and Zyrtec which is going on in the right way. If I were your treating pediatrician I would add on - Montelukast, 10 mg per day once daily at 6PM for 8 weeks. It doesn't work immediately but on the long run it is very useful in reducing chronic allergic symptoms like this. Kindly approach your pediatrician regarding this. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 45 female two children one 23 and one 4, had a complete hysterectomy in 2011. my problem started in 2010 after c section with my 2nd child.i had to have an emergency c section with her and had a epidural. I have severe lower back pain can hardly walk when first get up and I have problems with abdominal pain and back pain with bowel movements horrible pain can hardly stand it break out in sweat get lightheaded while sitting almost to point of passing out. throughout my day my back feels like I been punched just sore and have to be careful when bending or reaching for high objects on shelf . ### REPLY: Hello.....(1) I'm afraid to tell you that the problem started because the EPIDURAL Anesthesia given went wrong, its a complication of that because it was not given correctly n injured the nerves (2) what got injured is gone, i mean it can't be reversed but yes, with proper care you can definitely control all the pain n discomfort you are suffering (3) avoid . R. I of lumbosacral spine to see how much region of your spine is injured (4) do exercises to strengthen your lower back muscles, any good physiotherapist can guide you to do which exercises n which 1 to avoid (5) use a LUMBAR BELT while  ### 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 have had labour like pains all day since 4am. Lower back pain accompanies these pains like when I was in labour with my boys. I have had 2 successful pregnancies (one is 5 the other is 3.5 years old) and periods have been normal since I stopped bfing my youngest. Severe labour like pains as if I was in labour, but I am not pregnant. With all this pain all day long, my back is tender to the touch. What could this be? Oh and I have been neauseas this am and have VERY bad diarrhea - it runs out like water. What could this be??? ### REPLY: Hello I have gone through your question and appreciate Your concern. Severe back pain and tenderness need to be investigated. I advise you to visit orthopedic spine specialist And Get MRI spine done.Don't neglect it. Do u have radiation of pain to your lower limbsDiarrhoea may be sometimes due to irritation of nerve roots. General measures to improve back pain avoid bending forward and lifting heavy Weights Lie on hard bed. Muscle relaxants and analgesics will help. Local Analgesic gel for local application. Hot fomentation thrice a day. Muscle strengthening exercises will help in long term. Thanks. U can write me back for any query. ### 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 58 year old male, I weigh 150lbs.  I have a skin rash which is extremely itchy.  I have the rash on my arms, legs and trunk of my body mostly.  I also have it near my ankles.  I have been to the emergency room and also to a dermatologist.  I havnt been diagnosed.  They couldnt specifically say what I had.  The first time they thought it was poison ivory, the second time a reaction to a medicine.  I am taking cephalexin 500mg every 6 hours for 14 days.  A substitute for Keflex.  Also metronidazole 500mg every 8 hours for 14 days and cetirizine HCL 10 mg once a day.  I have been taking these medications for 1 week and no change.  Also Allergy relief tablets.  PLEASE HELP. ### REPLY: Welcome to . Go for complete blood counts. There will be eosinophilic in allergic condition. Stop antibiotic in this condition. Fexofenedine 180 mg. (anti-allergic), local application of calamine will be helpful. Also rule out other condition like diabetes, worm infestation, thyroid .keep proper hygiene, Use medicated soap for bath. If it is recurrent then go for allergy test. Consult your dermatologist for medical management. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor,I am 30 yrs old and I am an asthmatic patient from last 17 yrs And I am under formonide 400 medication but still I feel discomfort while breathing. Wanted to ask you regarding chest tightening. Is there any possibilty that the rib cage increase( chest increase) due to asthma as I observed my shirt size increased in last 6 months. And sometimes also getting pain while breathing ### REPLY: Thanks for your question on . I can understand your concern. Yes, uncontrolled asthma can cause hyperinflation and air trapping. Both these cause larger lungs. And larger lungs when chronic can cause increase in chest wall size. All these are markers of uncontrolled asthma. Your pain is also due to this only. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system. 2. PUT (Pulmonary Function Test) 3. Chest x-ray. PFT will diagnose severity of asthma and air trapping. Chest x-ray will diagnose hyperinflation. You may need additional inhaled bronchodilators and inhaled corticosteroid (ICS). Oral combination of antihistamine and anti-allergic .  So consult pulmonologist and discuss 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 got hit with a baseball pitch in my hand. I went and got it checked out and got x-rays done and they said it was just a contusion. They allowed me to play as long as I could bare the pain, so I continued to play and just dealt with some bruising and swelling where I got hit. Now it s about a month later and I have a hard bump on my hand that feels like bone. It s right below the knuckle of my ring finger, but it doesn t hurt at all even when I press down as hard as I can on the bump. What could the bump be? ### REPLY: Hi, I have studied your case with diligenceGive rest to hand and wrist. You can apply crêpe bandage for support. You may now need MRI of hand/wrist to rule out any minor fracture. You can consult your doctor by taking appointment, apparently it does not seem like emergency. 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: I just received my MRI report and it read as follows. L4-L5: there is 2mm posterior disc bulge. There is mild Ligamentum flavum and facet hypertrophy. L5-S1. There is a slight left paracentral disc bulge with a small associated annular year. There is mild to moderate ligamentum flavum and facet hypertrophy . Mild left lateral stenosis. What does this mean and what kind of treatment is needed. Effect my bowel movement. ### REPLY: Hi, I am .  I have read your question with care and understand your concerns. Let me try to help you Question : What does this mean and what kind of treatment is needed. Effect my bowel movement. Answer : This means that you have mild compression of nerves near your spinal cord. Treatment can be 1. Lifestyle Modifications2. Physiotherapy 3. Exercises4. Tablets If hypertrophy increases, surgery may be needed Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. 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: I had a partial roof canal done yesterday morning. I m 8 1/2 months pregnant. It was abscessed so I have been on antibiotics for 2 weeks, they finally did the root canal. I was ok all day woke up to pain at 2 am. Do much that even when the side of my tongue rubs it it hurts, tooth brush hurts, I put my finger onto to see if temporary filling fell out and that hurt as well. Now I m back to being unable to sleep ### REPLY: It may be possible that the root canal is not yet properly done, or it has some infection below. You need to undergo re root canal treatment, get it open and go for regular antibiotic .  Also get your root canal completed once your pregnancy is completed and not before it. It may be that there is some sharp portion of tooth which has rubbed against the tongue making it sore. Get that rounded off. Take some painkiller and antibiotics with consent of your gynecologist as well. Reach us at www.facebook.com/adentalclinic ### 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 45 y.o. and suffering from severe back pain.MRI shows I have diffuse disc bulging L3/L4 to L5/S1 w/ posterior annular tear at L4/L5 level. and also mild dextroscoliosis dorsal spine.DO I really need to undergo an operation to correct it? THANK YOU. ### REPLY: Hello, Welcome to Ask a Doctor service! Regarding your concern, I would explain that these findings are suggestive of chronic degeneration of the vertebral column. Surgery is not needed, unless the scoliosis is of a higher degree (measured by certain parameters in the X-ray study). Physiotherapy and medicine for chronic back pain would be the main treatment option. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: CAN GALLBLADDER CAUSE YOU TO FEEL WEAKNESS N YOUR BODY...I HAVE HAD STOMACH PROBLEMS WITH HEARTBURN, NAUSEA AT TIMES AT NIGHT....LAST NIGHT I GOT NAUSEA AND WENT TO BED,,,FELT VERY WARM WHEN LAYING THERE LIKE A HOT FLASH...WHEN I GOT UP THIS MORNING FELT LIKE MY SUGAR WAS LOW...I ATE AND SYSTOMS DIDNT GO AWAY AND FELT VERY WEAK IN BY BODY...NOT FATQUIED, JUST WEAKNESS ### REPLY: Hi, Welcome to  forum.  The symptoms appear to be due to the infection, and fever. The heart burn must be secondary to the infection.  I advise you to consult a gastroenterologist for diagnosis and treatment.  I usually prescribe to my patient with such symptoms' omeprazole, risperidone, and and antacid gel. Antibiotic and paracetamol for fever.  Avoid taking spices, junk foods, and oily foods, and also avoid untimely foods Wishing for a quick and complete recovery. 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 incisive papilla is swollen after a deep dental cleaning.It has been 2 weeks now and the bump is still there.my dentist already checked it and he says there is nothing stuck in my gum so it should have healed a long time ago already.he suggests to cut it off because he thinks it wont go away, and it could even grow more.i dont know if i should trust him.what do you think? will it heal by itself? ### REPLY: Thanks for your query, I have gone through your query. The swollen papilla could be because of the inflammation secondary to deposits or any irritation, or it can be a fibrous arising from the interdental papilla. Consult an oral physician and get it evaluated. If it is a gingival enlargement or inflammatory origin then take a course of antibiotics and observe for 1 week, if it does not subside then get it surgically excised. If it is a fibrous then get it surgically excised. 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: Today as I was sitting down I felt a "pop" in the back of my head and then had a dropping sensation (visual and physical) and was very dizzy for about 20 seconds.  I saw the nurse at work and my blood pressure was 138/94 which is high for me ( I am on Lisonopril).  I continue to heave a headache but no other symptoms. I went to the doctor today but she had no explanation and recommended an MRI- any thoughts? ### REPLY: Hello! Thank you for asking on ! Your symptoms could be related to a TIA (transient ischemic attack). For this reason, I agree with your doctor on recommending performing a brain MRI. Other tests to consider would be : a Doppler ultrasound of the cervical arteries to examine the blood flow to the brain, a Holder ECG monitoring for possible arrhythmia, blood lipid profile, fasting glucose, kidney and liver function tests and blood electrolytes. In the meantime, I recommend taking baby aspirin daily. Hope to have been helpful! Kind 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, recently my wife undergone a ceasserian baby delivery.She is under control of all spicy and oily foods and feeds breakmilk to the baby but baby is having loose motion and gold colour water like stool. I took the baby to doctor twice she said this is normal.My query is how to prevent it and what kind of food to be given to baby s mother and to prevent baby s anus blisters and to stp crying the baby as some insect is biting in her stomach. plz suggest me sir/madam ### REPLY: Hi.... Mothers food is not at all related to the babies' problem. Do not restrict mothers dirt regarding us. What your kid is having is not a diarrhea and is only a gastronomic reflux. It is quite common for babies of this age group t pass small amount of diarrhea or loose stools soon after feeds. This need not be treated as diarrhea and especially antibiotics are not indicated. When the baby takes milk, the stomach expands - then when it is contracting it sets off a wave form which moves down the intestines and when that wave reaches the lower down rectum, a small quantity of the stool is evacuated out. This is the basis for gastronomic reflex. Do not worry. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. 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 aching like bruised feeling just under the centre of my ribs ,I have a lump there that whilst I was pregnant earlier this year my gp thought may be a hernia...somedays it was fine but other days gave me grief as tho id been stamped on...my baby is 18 wks now and the past 6 days iv had this feelin again like iv been punched around the stomache area...I remember feelin slightly similar to this in the past when I had a swollen stomache,but I don t think it s that as when I had this I had sickness with it ### REPLY: Hello Thanks for writing to us; I have studied your case with diligence. This can be abdominal hernia or rib Costco . Avoid sudden movement, take rest, use rib supportive belt. Ultrasonography abdomen and pelvis along with blood LFT will help in diagnosis. I will advise doing HRCT chest consulting your treating doctor. Medication like muscle relaxant and analgesic will reduce pain along with it use rib support belt. You may consult physiotherapist for pain management. He may start TENS, or ultrasound which is helpful in your case. You may need to take rest for early healing. 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. If you find this answer helpful do not forget to give rating at end of discussion. Wishing you good health. Take disregards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has stage 4 cancer that has metasisized to his spine c7, lungs, lining of his brain, mandible and maxilla bones. Original cancer was found in sinus cavity, S.N.U.C., which was surgically removed, followed with radiation and chem. His arms twitch, is that from the tumor on the spine. This is awful to say, unfortunately, he has a fowl odor,....is that the cancer? ### REPLY: Hi, I can understand your concern. Sorry to say SNC has got very poor prognosis even after best modality of treatment application. Now your history suggests a loco regional and distant failure of disease. His arm twitching is definitely due to the spinal cord Mets. Fowl odor is due to super added secondary infection in the local failure in the loco regional site. Still there is some effective palliative measures left. Consult a palliative care specialist. ### 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 Doc, I have been on medications for treatment of Hepatitis C and have recovered from the virus as it has not been detected in my blood sample since last one year (frequently checked HCV RNA- Quantitative & Qualitative). My SGOT (AST), SGPT ( ALT ), GGTP & ALP levels are at 170, 114, 331 & 184 respectively. Kindly guide me as to why these levels are so high and what should I do to bring these levels down. I am 43 years old. ### REPLY: Hello, Usually liver enzymes come down to near normal levels after therapy against hepatitis C, particularly if you were cured. However, if there was a significant amount of inflammation prior to treatment, and your liver enzymes were even higher, then it could take some time for them to come back down. I would definitely recommend you following up with your doctor to make sure there are no other causes of abnormal liver enzymes, such as fatty liver or other problems (such as autoimmune liver disease, other viral hepatitis, hemochromatosis, etc.). Avoid alcohol. ### 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 10, between about 1.3m to 1.2m, weigh 24kg and I haven t had any major illnesses, apart from being knocked out for a few seconds (I think) after a fall when I was around six or seven. I don t get thirsty, even when my friend, who is the same age as me, was extremely thirsty. I m also really thin, with not much muscle or fat. Is this dangerous? If so, what can I do? ### REPLY: Dear, You are absolutely fine and feeling less thirsty is not a problem. 60% of our body is composed of water and intake of 2 to 3 ltd of water per day is good. Please try to see that you are taking at least 2 to 3 ltd per day water, buttermilk or any home fluids. Your weight of 24 is less for that age. You should be 30 to 34kgs. So, please see that you take high energy dense food in small quantities more frequently, like black gram and Jagger powder, groundnut , jaggery and ghee powder, boiled and cooked pulses. ### 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 MRI shows: L3/L4: 4.5mm diffuse disc bulge & annular fissure with mild stenosis due to disc bulge. L4/L5: Severe central canal stenosis due to 10mm posterocentral disc extrusion and 13mm cranial migration. Indentation on bilateral L5 traversing nerve roots. Moderate bilateral neural foraminal stenosis due to disc bulge. Is there anything that can be done without surgery...or is surgery the best route? If surgery is needed, what type of surgery? ### REPLY: Hello, The need for surgery is assessed based on the neurological deficits that the compression is causing. If it is causing any weakness then surgery is definitely recommended. If pain is uncontrolled then also surgery can be considered. Other methods of treatment are strict bed rest and physical therapies. Sometimes injections at the local area can also give prolonged relief. The type of surgery is determined by the location of the disc bulge. Basically the part of disc which is compressing on the nerves is cut and removed. 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: hey I have a fungus between my (pinky)toe recently I was treating it with a antifungual cream, for some reason I have a foound it hard to walk on this foot and swelling has occured on the top of my foot and along my little toe. All of this has made it very hard to walk with a pair of shoes on. PLease help. ### REPLY: Hi, It seems that there might be having supper added bacterial infection giving this problem. Go for one antibiotic medicine course for 3-5 days. Apply triple action cream. After finishing antibiotic medicine go for one oral antifungal medicine course like Fluconazole 150 mg once in a week for 4-6 weeks. Keep inter digital spaces clean and . Avoid wearing socks and shoes for some time. Ok 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: hi i am 36 weeks and 3 days pregnant. i have two internal exams and never bled. but i think i lost my mucus plug and i have been having some bleeding to brown discharge for two days some mild cramps and painful surges in my uterus area what should i make of all this ### REPLY: Hi, Yes, it is very likely that you are in early labor, Especially since you have lost your plug and getting mild pains. These pains get more frequent and more intense as delivery approaches. Best to get an examination done by your midwife/obstetrician to know how far long into labor you are.Also, a NST(non-stress test) to know the condition of fetal heart would be helpful. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i want to know about DTP vaccine. my baby is of 1.5 month. please suggest i should go for painless or painfull DTP vaccine. I also want to know what all problem baby suffers from if i go for painfull vaccine? please suggest what will Painless vaccine cast me? ### REPLY: Hello, The painless DPT vaccine contains cellular pertussis and has fewer side effects in terms of fever, swelling, pain etc. This vaccine came into use a few years back, but now recent data suggests that this vaccine is not very effective against pertussis (whooping cough). There have been several outbreaks of whooping cough in America and now this vaccine is no longer routinely recommended. You should get your child vaccinated with the whole cell pertussis vaccine or the so-called painful vaccine. The commonest side effects of this vaccine are fever, pain at injection site, swelling at injection site and irritability. There are other extremely rare side effects like fits, shock. The painless vaccine is now recommended only for those child .  The cost of painless DPT vaccine is around INR 1500 - 2000.  Hope that helps. Preeti ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband had blood in his urine last night and a drop of blood on the tip of his pennis at the end. he said he did not have any pain while urinating. He has been feeling sick to his stomach the past couple of days though.. I know he needs to go to the doctor, do you think this is somthing we need to worry about. ### REPLY: HelloThanks for query. Hematuria and pain while urinating can be either due to stone in kidney or UTI and needs to be investigated. Please consult qualified Urologist for clinical examination and get following basic tests done to confirm the diagnosis. 1) Urine routine and culture. 2) Ultrasound scanning of abdomen and pelvis In the meanwhile take antibiotics like Ciprofloxacin and Nitrofurantoin with urine alkalizer like Catwalk twice daily. Further treatment will depend upon result of these tests and final diagnosis.  . . ### 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: Back pain below waistline. Constant. Intensifies if standing, walking, Severe pain with exertion, like carrying groceries, especially with pushing an object like cart, or vaccuum. Throbbing pain, & also muscle spasm when walking, or when going to stand up or sit down. Better when laying down but still constant. Hurts more if cross legs. Diagnosis, Treatment ?? ### REPLY: Thank you for writing to us. I think that you have a muscle injury. This is a soft tissue injury which is causing the pain and the spasms in you. Here are a few things that you can try which will help you:Ice the area for 15 mins 3 to 4 times a Hayward the area by using a hot water basis the above do not help, then you can also take ibuprofen cream to help release the pantry these for 5 days and then follow up. All the best and wish you a speedy recovery. I hope this helps 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: My mother is 50 years old and having swelling on her face and hands started; and she is also not having urine at time and properly. You please suggest, what do i do ? Also, 10 years back, she was diagnosed from kidney problem. That time also, her body was fully swollen. ### REPLY: Hello, I just read your query. The symptoms you have mentioned here are suggestive of kidney dysfunction. You need to perform kidney function tests(blood urea, serum creatinine) of your mother and consult a nearby reputed nephrologist, on basis of tests he can prescribe you the treatment and can advise you whether she needs to perform more tests.* Sometimes the changes are reversible and with the help of medications she can revert to normal condition, sometimes kidney might be damaged more than expected, and she may require dialysis. * So do consult a nephrologist as soon as possible. * I hope you find my answer helpful. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 2 yr son got his blood report which indicates Red blood cells exhibit mild microcytosis Mild leukocytosis with absolute lymphocytosis is evident, occasional activated lymphocytes are seen. Advised :Haemoglobin electrophoresis. his neutrophils are low -15%,his MCV-75.9 fL ,MCH-24.3 pg .please tell me this what it means...... ### REPLY: Thanks for your query. Microcytosis means his red blood cells are a bit smaller than usual & the common causes are iron deficiency & thalassemia trait (both are common non-serious conditions)Mild leukocytosis means the white cells (White blood cells, or leukocytes are cells of the immune system involved in defending the body against both infectious disease and foreign materials) are increased in number. Lymphocyte is a type of white cell. Lymphocytes (increased lymphocyte count) & activated lymphocytes are commonly seen in viral infection in child . Hemoglobin electrophoresis will confirm the thalassemia trait if that is there. There are no reasons to worry and should wait for electrophoresis report. Hope you find the explanation useful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, My daughter is 10 and I had her in the ER this past thursday with abdominal pain, the ER doctor did an exam and was concerned that the pain was her appendix, however the cat scan was negative, my daughter has been running a low grade fever since then, the doctor admitted her over night for observation saying she did have a swollen gland on the right side of her abdomen and that since she was running a fever and the pain combined, they were concerned that this could turn infectious which in turn affect her appendix. When her normal pediatrician did rounds the following morning she felt that the stomach pain was due to her lactose intollerace and to modify her diet, however I am concerned because she still has the fever and some abdominal pain and her diet has drastically declined over the last few days, I am not sure how to procede from here to handle this, or am I just being overcausious. ### REPLY: Hi. You are not overcautious, you are right. Thanks for elucidate history and is definitely suggestive that the pain in a 10-year-old child unless proved otherwise in this case is due to the Inflamed lymph nodes on the right side of abdomen. I would advise going for blood tests - CBC for infection (WBC), Typhoid, a course of an antibiotic and anti-inflammatory medicines for 7 days, Review with ultrasonography for size of the lymph nodes. IF same size-for for lymph node biopsy. IF responding to the treatment, continue medicines for three weeks. Also see for ENT - to see if whether has ENT infection, which on swallowing goes to the terminal intestines and affect the payer’s patches, which in turn enlarge the nodes - also called as Tummy Tonsils. No lactose intolerance can give lymph nodes. ### 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, The last two days my one year old had a very bad cold and needed me to hold him all the time while we were both lying down (I never lay down or rest this much).  I have had a slight pain in my lower back but much more pain in both legs, like they are being squeezed very hard ever since.  What can this be? ### REPLY: Pain in back and pain in leg this could be related to each other, or it could be separate issues also. You can check one thing lying position on your back legs straight. Now when you lift your leg up straight (anyone leg) then how is your pain in leg and back. If you say pain is more in back and at the same time in leg also then it can be associated to each other, and you have problem at lumbosacral spinal level. Now if there is pain only at back and there is no pain in leg follow the another test. Long sitting position that is sitting only but keeping your leg straight ask someone to hold your calf muscle bulk and squeeze it or press it hard and check do you have pain in leg. If you say yes then it can be due to problem with blood circulation in legs.However the conformation can be done by only specialist like or tho or physio, and you may need to undergo for MRI of back as well Doppler study for legs if needed. And based on result of physical examination and MRI or tho doctor for mild to moderate issue will suggest taking physiotherapy treatment and exercises along with medication. For major damage at spinal level he will suggest for needed surgical correction. Now if there is circulation problem in lower limb here doctor may ask you to visit a vascular surgeon or some medications again for it. Doing exercises suggested by physio for back pain radiating to legs along with use of hot and cold pack at back also gives good relief. 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: Dr, Im 40 year old, my semen analysis report is  quantity:- 2ml. Colour:- whitish. Consistency:- viscid. Reaction:- alkaline. Actively motile:- 65 -75%. Puscell:-present:- 3 - 5 / HPF. Morphology:- 60 - 70 % normal forms. Total count of spermatozoa :- 68 million / ml of semen.please can u tell me this report ok for fritility. Another question:- I have 3 children , I was in abroad 6 years.my is was not with me. After 6 years I come back to my family . Last two month we are trying to another baby but my wife had start period (bleding) please tell is there any problem me or my wife. My wife is 36 year old. ### REPLY: Hello, Your semen analysis report is absolutely normal with good counts and normal motility and normal morphology. Few pus cells are normal to be found. As far as difficulty in conceiving is concerned, it is too early to comment on this, since you are with her for past 2 months only.Moreover, there are various things essential for conception to take place, which means... Sex on ovulation days. Proper ovulation of your wither tubes should be open.Moreover, as the age advances in female, ovarian reserve dwindles. It becomes really problematic for a female to get pregnant after 35 years.However, two months are too early. Wait for six months and try doing sex multiple times around ovulation days and if you still don't find any success, you may consult a fertility expert. 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: my mom had a hospital stay of 5 days with low sodium from a uti infection last week.she has lost all her strength in her legs.she walked 3x a week prior too this.she is at a n home getting therapy how long until her mind and legs come back she is in great health for 80 yrs old thank you. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. She has low sodium secondary to urinary tract infection.  She should complete the course of antibiotics.  Furthermore, she should take saline transfusion.  In old age recovery takes some time so no need to worry.  She will recover soon. Take treatment according to your doctors' advice. 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 have been experiencing a heating sensation in my lower abdomen and back. In march it will be a year that I have dealt with this issue. I had an EGD done and it was determined that I had Hpylori. I took the prev pack medications and it was determined that the Hpylori had cleared up, but Im still dealing with this heating sensation or inflammation as well as gas. I have been to see two different Gastorenterologist and they told me that my blood work , stool samples, and CT of my abdomen/pelvis were all ok. I have tried carafate and a couple other meds, but no relief. I have asked about the possibility of it being chrons or celiac, but both said it would have showed up in my blood results. At this point Im scared that my health is on the line and I dont want something to be hiding and have to suffer later. ### REPLY: Hi. Thanks for an elucidated history. Gone through all. Seen by 2 Gastroenterologists- undergone tests its results - medicines..... The problem is heating sensation in lower abdomen and back. I would suggest you the following medicines after / with consultation with your Doctor after discussing your problems and findings. I would advise you to go for an MRI of the lower spine. Amitriptyline: start with lower doses and increase gradually. Or Gabapentin may help. You need a prescription for such medicines. I hope this will help solve your problem as all the investigations done do not show any other positive findings as the heating sensation can occur in neurological problems too. Please let us know about the effectiveness ### 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: Why is it that if I believed doctors I would have already been dead three times? Now I have prostate cancer two doctors told me only surgery, and other suggested radiation . I refused all of these, and took two herbs that stopped the symptoms in three weeks that I had for more than a year. Yes, I could die in a couple more years as they expected, but I would rather die than have surgery. ### REPLY: Hi, I am extremely sorry to know the condition. I want to assure you that prostate cancer is slowly progressive disease. The treatment depends on the stage. You have not mentioned any detail of investigation. Specially serum PSA, Gleason score, and invasion size and lymph node status to be mentioned. In early stage if life expectancy is more (like more than 10 years or 5 years depending on additional criteria) radical treatment is offered. As they have offered surgery or RT probably your disease is at early stage. Anyway if you do not want surgery then go for radiotherapy. Radiotherapy can be given Dy image guided technique and is non-invasive. Minimal toxicity is there. Adjuvant hormone therapy will be prescribed also. There is a good chance of total tumor control. Consult your radiation oncologist. ### 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 that works full time for an Internal Medicine Doctor s office. It gets very stressful at times as I am the only Clinical Nurse in the office that sees 25-40 patients a day. On 10/14/11 all of the the sudden I had tremendous (1-10 pain scale it was at least a 9 or 10) pain under the mid section of the rib cage.At the time of the onset of this attack I was in an exam room taking a patient s vitals & going through the normal routine of allergy, medications, etc. updates with the patient, nothing stressful. I had these attacks before but never as bad as this one, and the last attack was about 4-6 months ago & again, was doing nothing stressful at the time. The pain finally subsided after about 15-20 minutes (down to about a 3-4 out of 10). I excused myself from work & drove myself to the hospital (the hospital is 1/8 mi. away from my work). I went into the E.R. & explained to them what was going on, they immediately took an EKG & CXR that showed nothing. After talking with the E.R. Dr. & telling her about the last attack but that there was pain in my back associated with that one. The E.R. Dr. said it sounded like a classic case of gallbladder stones. They performed an U/S of the Gallbladder & it showed no stones however it was enlarged & dilated from what they said. Next, they performed an MRI w/o contrast that showed the gallbladder as distended for the patient s age , again no gallstones. I was D/C from the hospital & was told to follow up with a G.I for an Upper GI Endoscopy and to go from there. I have a history on my mother s side of her sibling s having their gallbladder s removed but at a much older age. I wanted to speak with a hematologist in regards of my lab results but on the same token give a bit of history as to which led up to the lab work being performed. All of the results came back in normal range except the following: WBC: 11.6 H ; RBC: 3.86 L ; MCH: 33.4 H ; Neutrophils: 80.0 H ; Lymphs: 15.4 L ; Monocytes: 3.7 L ; Neutro Absolute: 9.3 H & Glucose: 100 H Should I be worried about anything regarding the lab results & what do you recommend about the gallbladder situation? I extend a big Thank You in advance for your time and help in regarding my situation! -Theresa P. ### REPLY: Hello,1. Gallbladder with small calculi should be removed by laparoscopy as small stones bring risk of bile ducts obstruction and acute pancreatitis.2. Chronic liver parenchymal disease most likely means that you have fatty liver. You should avoid alcohol, fatty foods, spicy foods, medicines involving liver to reverse fatty liver process.3. Mild degree of splenomegaly should be consulted with hematologist as this can be a symptom of many diseases including leukemia, liver hypertension, infectious diseases.4. CBD borderline dilated can be caused by sludge or small stones inside. I suggest you to have liver tests (AST, ALT,GTP, AP), lipase, amylase, bilirubin checked. You should be operated anyway as small stones are more prone to move to bile ducts and cause acute pancreas disease. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have degenerative disc disease up and down my entire spine. If back is not properly supported for more than l or 2 hours, I get pain. I need tips on airplane travel, and hotel room accomodations for those like me who need good back support, from my neck to my sacrum. ### REPLY: Hello. The position in which your spine is least loaded is the lateral decubitus position, where in you lie down on your side with your legs folded 60-90 degrees at the hip and knee joints. Make sure to support your neck with a firm pillow to keep it straight. I suppose you could be comfortable travelling this way in business class. About the accommodation... I think the type of mattress ...firm/soft doesn't really matter much. Otherwise, things that are proven to help your pain in the long term are exercises, physio-TENS and acupuncture. 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: My partner had throat cancer staqe 2 and the radiation.chemo worked to remove the main site it tranverred the throat to the other side and got lymph nodes involved for 4/11 being removed in the shoulder surgery which had a lot mass removed.Today they said the CT Scan showed a shallow in the throat but nothing to be worried about but to a repeat CT Scan in three months.  They also did a deep camera view of his shoulders height to his neck.What is a scam and why it is not visble with the camera exam tody and wy another CT scan in3 months ### REPLY: Hi, The exact meaning of throat cancer is unclear. Throat has several subsides. Anyway chemoradiation is the treatment of choice in most of the cases depending on the disease stage. Probably post RT neck dissection has been performed. Now the scan is done as a routine follow-up procedure. Nothing to worry about. This can early detect the recurrence if any and proper treatment can be given. Do not worry at all. Follow your doctors advise. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir i have been diagnosed by a Dermatologist for my foot cracks as psoriasis and have been give udiliv 300mg and FOL 5 and ointments . will this have any side effect? I am already a Diabetic for the past two years and my Fast /PP levels are within the limit and have undergone hysterectomy in 2009. ### REPLY: Hello, I can understand your concern for psoriasis. It is a long-running disease and needs proper treatment. I would like to ask that if the entity is being diagnosed by a dermatologist or any other doctor. I doubt if it is being diagnosed by a dermatologist as Adílio is not the main course of treatment. Methotrexate is the basis of the treatment but has its own blood and liver related side effects. I suggest you to take dermatological advice and take proper treatment accordingly. 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 have gastric , especially when after eat. My pain is cramp , n i suffering pain till feel dizziness . I go specialist check, have endoscopy. In scop, dr say i have GERD and h.pylori bacteria . So dr give me medication of nexium, gaviscon, and 2 type antibiotic(klacid). But seem no recover, still same situation happen. I when back see the dr, he advice me take 1 month nexium.But just few days when on, I suffer pain till non stop,is continuely especially is nite time. Until cant sleep because stomach is cramp. I meet back the dr., so the dr do ultrasound for my abdomen. But seem nothing. What should be happen?i suffering pain, is continue pain non stop. I be given another medicine, pariet 20mg, buscapon and gaviscon. but seem not work..What should happen with me??May dr give some opinion. I will be suspect stomach cancer? Latesly my dad also get stomach cancer, but when we know is too late. is already spread to his whole bone. So he pass away. My percentage should be high or not? What test i need to do?? ### REPLY: You have severe acute gastritis with acid reflux. You have not mentioned your age, but if a proper endoscopy has been done, you do not need to fear about cancer. You need to go on a proper diet control. Avoid spices, oily food and fast food. Eat smaller but more frequent meals. Never let your stomach be empty. Avoid tea, coffee, alcohol and smoking totally. Try Canton Total once daily and Socratic syrup 10ml three times per day. Take plenty of fluids, vegetables and fruits. Above all, don't take mental stress. Relax. ### 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 14 year old daughter just got re tested after 2 yrs for a peanut/tree nut allergy.  She is still testing positive.  She developed this allergy at age 12, but had gastro problems at a younger age.  Could this allergy have been missed early on, and at a later age when she developed throat swelling and eyelid swelling at age 12? ### REPLY: Hi, Thanks for writing in. Your daughter is suffering from hypersensitivity to peanut. This might have gone unnoticed in earlier years because of limited exposure to the allergy causing agent. When a patient is exposed to the allergy causing agent the first time, it usually doesn't cause a significant reaction. When there is the second exposure, there will be severe reaction because by that time antibodies have developed against the allergy causing agent. That is why she is testing positive subsequently while it might have been missed in early days. 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: Hello doctor I am married for three years n no child yet!!! I took treatment in London as I live here!!! They told I have Pcos and prescribed clomid for 6 months and I have scan plus my ChatDoctor trigger shot every month with follicular study... I have good 2 to 3 follicle every month and 7 to 8 mm endometric thickness. What is the further treatment ?? I have stopped treatment for two months. And during clomid I had several side effects . I get Brest tenderness n painful Brest before periods and I get itchy vagina before one week of periods.why is it so?? And after I stopped clomid I did not have any of these symptoms .. Please answer my question. ### REPLY: Hi, Thanks for writing to  . I would suggest you to go for GUI along with closed. GUI is intrauterine ingestion of sperms. Here sperms are washed and processed, and healthy sperms are placed in uterus. This will increase chances of conception. Here problem of ascend of sperms is solved, and also sperm penetration will be better. You can try 3 to 4 cycles of GUI.  The symptoms which you are telling after taking closed are its common side effects. Those are not serious and can be ignored. You can continue for 3 to 4 months further. After 3 cycles of closed take rest for 1 or 2 cycles. Hope I have been helpful. 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: Dear Doctor. I hope you could kindly help me. I am 56 years old female and have asthma , sinus and allergy . At a young age I had asthma but when I was 12 years till 45 years I was asthma free but at the age of 25 start to have sinus attack but not acute till late 40s and about 2 years back, start sneezing non stop with watery eyes. The GP told me I have allergy and was given zyrtec. Now almost 2 months I stop taking zyrtec because I don t sneeze that often and moreover zyrtec make me very lethargic.A few weeks ago I had asthma attack but after taking cough mixture and accuhaler it got better but reasonly I start feeling itchness inside my lower throat and upper chest. What causes these? ### REPLY: Hello, Thanks for posting, Well from your description of itchy throat it is very likely that you have developed viral pharyngitis (given your past history of URI) or you have post infection irritation of your throat. A laryngoscopy could be done to determine if any inflammation. If bacteria throat infection is also possible. Clinical evaluation will be necessary before you can take any treatment. Maybe you could allow some few days before you go see a doctor to see if the itchiness can clear off on its on. Possibility of another allergy developing inside your throat is possible, hence you will require another antihistamines (if you have developed side effects as a result of Zyrtec it is better you ask your doctor for another prescription).  Hope this was 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: My penis is going small and weak due to much masturbation last 8 years and my penis skin hide my penis skin.Due to this i much worried about such problem because my parents want to marry me very soon but i m refuse due to this problem. Please suggest me some treatment regarding as mentioned problem.... Thanks ### REPLY: helloThanks for query. You alleged to have your penis being small and weak. The penis has dual function 1) In flaccid state as a tube to pass urine out of the bladder 2) After getting hard during erection it functions to have intro vaginal sex with female partner to have sexual satisfaction. The size of the penis in flaccid state has no significance at all. It is hardness of the penis on erection that is important for sexual satisfaction of both the partners. The size of the flaccid penis of 2 inches in length and 4.5 inches after erection is adequate to have enjoyable sex. Consult qualified Urologist for clinical examination and to confirm the size of the penis in both the states. This will help to allay your anxiety. Please note that there are no medications that can increase the size of the penis . . ### 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 dull, constant pain in the back of my head, on the right side just above my neck. It is sensitive to the touch and feels like I hit my head at some point but I didn t. I ve had this for a couple of months. Should I be concerned? Should I see my dr.? I m 41, 5 7 , 185lb female, non-smoker. Only on-going medical issues are hypo-thyroidism and pernicious anemia which are under control. ### REPLY: Hi, Read your complaints. Dull constant pain in the head can be due to various reasons. first try to focus on your posture. When you are at work try to maintain an erect posture. Even while sleeping you should try to sleep straight using a low-lying pillow.  Have a good sleep - 7-8 hours and be relaxed. Do some mild exercises especially neck muscle stretching exercises. You can even take some painkiller if needed. However, if you feel you are not improving then you need to get yourself investigated. Get any eye check-up done and also imaging (MRI)brain. 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 age 51 was diagnosed with pnuemonia in the right lung.she was hospalised for 5 days on antibiotics.she came home.pain at the back was gone.only thing she struggling with is coughing,fatigue,decreased appetite,short of breath.what can be wrong with her? Sputum was send away came back negative.no blood when she coughs. ### REPLY: Hi, I am sorry for the situation your mother is in. I am also happy to know that her pneumonia has gone, and no blood was when coughing. Cough is a remaining symptom after pneumonia or other respiratory tract infections. She might not need to take antibiotics anymore but symptomatic medications :- Multics to dissolve and clear off the sputum (e.g. carbocystein or acetylcystein, etc.)- anti-hystaminic . g. Ben ### 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: 48 year old male, 215 lbs, exercise several times per week, take blood pressure reducing supplements such as garlic, coq10, olive leaf extract, vitamin e and many others, but blood pressure still remains around 140-170 over 90 - 105.  No history of kidney or liver problems and in fairly good physical shape.  Had bad accident almost 20 years ago with rods, plates, pins, wire wraps, etc. in legs & arms and had a direct drip into heart while in hospital.  Could any of that be the problem? ### REPLY: Hello,Most of the time it's an age related problem, and along with healthy lifestyle you'll need medicine like telmisartan 40 mg. So you can these prescribed from local doctor. You should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, jogging according your capacity at least 30 min a day and 5 days a week. Eat lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. im 22 years old, male. 3 years ago i had my first panic attack, i wasnt able to breath properly. 1 year later (and after maaany panic attacks) i felt my heart skipping a beat. 1 year later (actualy before 9 months) i had a painful panic attack. with pains at my chest and back. and my heart started skipping beats again. since then, when i start thinking i have sum kind of desease, i start feeling the symptoms. most extreme was that, when i read in a magazine about lemphoma, i felt like my lymphnodes got swollen. (the same night) and now, 2 months now, i can feel my lymphnodes -by touching them- on my neck and groin . Can someone please tell me if hypochondria and anxietty can couse enlargment of lymphnodes (they are around 1cm now -3-) ? thank you! ### REPLY: Hello, Thanks for choosing  for posting your query. An enlarged lymph node can occur due to many many reasons and most of the reasons are very trivial. Even a simple pharyngitis or ulcer in mouth can also cause increased size of the lymph nodes. Lymphoma comes very down the order. Considering you previous history of anxiety disorder, you shouldn't worry much and start taking treatment for the anxiety by visiting a psychiatrist. Coming to your specific question:No! Anxiety and Hyperion .  I will be more than happy to help you if you need any further clarifications. In case if you want to discuss with me directly you can use the link:http://www.ChatDoctor .com/Funnel?page=askDoctorDirectly&docId=64634Wish you 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: I have a large lump on my right shin that has been an ongoing issue since feb or march. I have been through 2 rounds of prednisone and a round of Penicillen Vk. the lump is still there and painful. it covers 1/2- 3/4 of my shin and there was a biospy done 8/11 the site is still not healed. WBC is up. Dr says I have staph in my blood. but hasnt rechecked it since the atb.  which kind of specialist should I see ### REPLY: Hi, Welcome. Based on the facts of your query, You need to check with your dermatologist and Surgeon if need be, as you were on medicines since Feb. As the lump is painful, and still not healed, I suspect-Varicose Eczema with painful infected bumps, as you have 1/2 -3/4th shin involved with it. Treatment-A second opinion from Surgeon, would fix the cause of your lump. And would treat it accordingly along with your dermatologist team. Hope this reply would answer you query and would help you to take care of it. Contact with a Followup Premium question to ME. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Welcome with any other further query in this regard. Good Day!! . S. Genl-CVTS ### 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 recently had an EKG and an echocardiogram. I have been having chest pain that comes and goes. Sometimes its on the right side....sometimes its on the left. I drink a lot of soda. Im 23. My doctor said he doesnt think its heart related. I am on coumadin for a DVT I had when I was 17, and my INR is fine. Wht do you think it could be? ### REPLY: Thanks for your question on . I can understand your concern. Yes, your doctor is right. Your chest pain is not from heart diseases. In teenagers, undiagnosed stress and anxiety can also cause similar kind of chest pain. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Application of warm water pad on affected areas of chest is also beneficial. You can also take simple painkiller like paracetamol or ibuprofen. Don't worry, you will be alright with all these. Avoid stress and tension, be relaxed and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A few days ago, I stepped out of my car and felt a piercing pain in my foot-- more like my toes. A piercing, cramping. I was wearing new flip flops. I kind of massaged it out, but still felt pain/discomfort. Kind of limped my way through the grocery store. Just yesterday, I discovered that my two two (the smallest and the one next to it) are numb and tingly, like when your foot falls asleep, when the novocaine from the dentist starts wearing off. Now, the sensation has crept up my leg-- no so much the numbness, but tingling. Is this something to be concerned about? ### REPLY: Your symptoms sound consistent with something called Morton's neuroma.  This is a situation where the nerve bundle located around your 2nd and 3rd toes is irritated or compressed causing pain and sometimes numbness in your toes.  Normal recommendations for Morton's Neuroma include resting your foot, using something called Metatarsal pad inside your shoe which takes pressure off the nerve bundle, and occasionally anti-inflammatories to decrease the pain and inflammation.  You should consider consultation with a specialist as you have pain that is shooting up your leg which may be a sign that the nerve is extremely irritated. ### 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 19 years old and sexualy involved with my aunt(sister of my mom)who is 46 years old .i cannot stop doing sex with her can u suggest me wt to do and our any chances that my aunt would get pregnant at the age of 46? ### REPLY: Hello ABH;welcome to  The relation that you are at present having to be precise is called INCEST. My advice is since you are 19 yrs please stop it immediately as because it is in family later you will face a lot of problems. Presently you cannot resist having sex is because you are infatuated with sex and enjoying it, but later you will also have guilt feeling, and it may lead you to depression, so it is better to stop ASAP. Right now concentrate on your studies and career. Take care. Thanks ### END