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 UA that was positive for bilirubin and leukocyte esterase. Also had red and white blood cells, epithelial cells, bacteria and mucus. Free hemoglobin was also detected.Was surgically treated for left ureterovesical reflux and periureteral diverticulum, and a right ectopic ureter.  This was in 1996 when I was 8. I had recurrent infection and scarring at the time of surgery. Since then I have had multiple U.T.I.s and kidney infections. Most UAs I take show similar~ results.I have recently found a rather large hard rounded area (lump) directly below my right ribs (3-4in size near liver/gallbladder/kidney area). It disappears under my rib cage when I lie down, and can be manually pushed up (however this feels incredibly strange) but NOT down (painful). The entire right side of my abdomen is harder than the left.Could there be another cause for the UA results? ### REPLY: Good Day! Leukocyte esterase, RBC, and WBC may indicate a urinary tract infection. I would suggest doing a Urine culture since it is the most accurate examination to check confirm an infection, and it also identifies the bacteria and tells us what antibiotics are appropriate to treat the infection. With the bulge on the right side of your abdomen may be a surgical hernia. You may need to see a general surgeon, so he can properly assess the lump. I am considering that there is an abnormal defect in your abdominal wall layers that causes your abdominal contents to protrude outside thereby producing a lump. Yours Truly, .  ### 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 enlarged papillae and the front 1/3 of my tongue and it burns as does the roof of my mouth with everything I eat and drink.  This is ongoing for over a month, my local dentist has had me rinsing with Nystatin Oral Suspension for 2 weeks and it hasnt changed anything on my tongue, but my gums are better (ish). Waiting another week and then perhaps a biopsy. I am also now on a Vit B-Complex once a day.  Suggestions please! ### REPLY: Thanks for your query, I have gone through your query. The burning sensation over the tongue could be because of the candida infection over the tongue or papilla infection. On constant contact of the infected tongue with the palate can cause lesion over the palate called kissing lesions. This lesion can produce burning sensation. Complete the course of antifungal agents and maintain oral hygiene by proper tongue cleaning or brushing. You can continue the vitamin supplements. If the lesion doesn't heal then get a biopsy done to rule out any other pathology. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a small lump in my groin area between my testicles and anus it did not hurt like a pimple however when I squeezed it it popped but it wasnt puss that came out it was blood what could this bee? Im 27 never had anything like this I am around 260lbs ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have perianal abscess formation. You should take antibiotics like cephalosporin or amoxiclav. If it doesn't respond to treatment then you should go for culture and sensitivity test. And then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! At softball 2 weeks ago I was playing catch befor my game and I got hit in the lower shin. It immediately bruised but very minimal swelling. The bruising lasted until a day or two ago, and today I noticed a small bump on where I got hit! I bet it s nothing but I just want to be safe rather than sorry!! ### REPLY: Hi, Thanks for your query. From description, this hard bump most probably formed due to hematoma formation (collection of blood) which might get fibrosis or calcified. It will take few weeks to months to get disappear. I suggest you to consult an orthopaedician nearby for a detailed examination of swelling. You may get the X-ray of the area affected under his/her guidance.Meanwhile, give hot fomentation over it, You can take Tablet Motrin 1 tablet with food as and when required (up to 4 tablets daily). I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Just could not fall asleep. I seem to be salivating excessively and am continually swallowing . I have taken a Piriteze tablet about 1 hour ago, and have just taken a 2nd tablet. I suddenly decided it might be an allergy and am trying to diagnose what caused it. Although sometimes reacting to dust and obviously mould, I did pull leaves of a house plant called (I think) dragon tree. I thus consulted the internet and it appears that this plant can cause an allergic reaction . The plants leaves were dried up and all shrivelled. Would this still have been the cause of my reaction. Luckily the excess saliva is settling down and the need to swallow so frequently has too. Was it the plant do you think. ### REPLY: HI, thanks for using  Almost anything can cause an allergic reaction. This is because persons react differently to plants, animals, environmental stimulants (e.g. dust, pollen, perfume odors), medications, food. What may provoke a reaction in one person may not do so in another. Allergic reactions can present in different ways, the most common ways are skin rash, swelling, post nasal .  In the case of foods some persons may have vomiting or diarrhea, indigestion. Excess salivation is not a common presentation of allergies though everyone is different. If you are noting a decrease in symptoms with the use of the medication then it is possible that it was an allergic response. It would be difficult, however, to say what you are allergic to. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir i have dust allergy, due to which i get continous snezing and flow frm the nose when the climate is cold,even i face the breathing problem. i m faceing this problem frm last 2yrs i have met 3 docotrs who gave me a medicines which is just a temporary relief for just a couple of days,i heard DR.A.MAHADEVAIAH is super in this case,so i request you to suggest a rite doctor to whome should i contact. ### REPLY: Hello. Thank you for asking at . I went through your history and would like to make you suggestions as follows:1. When you have symptoms of allergies, I would suggest you to take montelukast and antihistamines like levocetirizine for temporary relief.2. For treatment of the allergy, I would suggest you allergy testing which will help you to identify the substances you may be allergic to and also to know the measures to avoid them.3. Based on allergy testing results, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to improve allergy symptoms on long term basis.4. In addition to above, I would also suggest you regular breathing exercises and healthy nutrition (adequate green leafy vegetables, fruits, sprouts, etc.) which will improve your lung capacity and immunity respectively.5. In general, please try to avoid exposure to dusts, smokes and air pollution as much as possible. Hope above suggestions will be helpful to you. In my opinion, you should consult an Allergist-Immunologist. Should you have any further query, please feel free to ask at .  Wish you the best of the health. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hihiFrom last one and half year am trying to get conceive... but still got not any positive result ..Done every test likr HSG,Hysteroscopy,thyroid profile, also done husband test...that all tests are normal.... Last month once again done Prolactine level,thyroid profile and AMH Levels test done, In that prolactine levels and thyroid stimulating hormone are high so how to move further on this... Please advise me on this ### REPLY: Hi, The cause of your infertility is hormonal as is evidenced by the high levels of Prolactin. You should see an endocrinologist and get further management to attain normal hormonal status. Meanwhile, please maintain a healthy weight, healthy diet and regular exercise. Do not go for ovulation induction prior to achieving normal hormonal status as this may not be successful. You would need .  Hope you find this information helpful. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 2 year old has stuck his finger in a light bulb socket and got shocked. I do not see any burns on his body anywhere and when asked if anything hurts he says no. He did not lose consiousness or anything and is acting normal. Should I take him to the ER? ### REPLY: Hi, I am sorry for the accident your son has got through. I am happy nothing serious happened to him. If not injured, I advise monitoring his behavior and body for possible post-shock injuries. If you noticed any unusual behavior of your son, then, should send to see his pediatrician immediately or should send to ER. Otherwise, watchful waiting is recommended. As he is very young, please spend more time with him to prevent such undesirable events. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am a 43 year old woman who had emergency surgery (caudai equina L5S1) six years ago and subsequent disc degeneration leading to further herniations of varying severity from L3-L4 through S1-S2. I was left with almost complete sensory loss in all areas innervated by L5-S1 and now am loosing sensation in other areas (primarily at the levels of L4 and S1-S2). I have cervical degeneration as well and compression at C2-C3 C4-C5 but C6-C7 shows central stenosis causing muscle weekness, sensory loss extreme pain etc. I have a neurostimulaor, morphine pump, oral meds etc. Is there any known link between petechiae in the lower extremities in areas where there is prolonged sensory loss? My feet and lower legs (both) are covered in petechiae. If I put my leg under my rear and apply pressure i.e. my body weight I get a cluster or red resembling a bruise that lasts for weeks despite only having applied moments of pressure. thank you for your time. ### REPLY: HelloI may suggest having serum prothrombin time (PT), bleeding time clotting time and platelets counts done for any abnormality there which could point to some other reasons or pathologies. Petichae in sensory loss areas may not be due to nerve sensation deficit, yes long duration sensory loss does make skin vulnerable to bruises and may make it brittle and easy petechial formation may occur secondarily. It is best if sensory loss is suspected as a cause, to massage skin daily with Clemens oil and limb exercises for improving or maintaining vascularity and skin tone to prevent bruising. Take multivitamins, calcium and vitamin D supplements, vitamin A etc. You may consult a physician for your symptoms. Physical therapy is the mainstay for lumbosacral issues, for cervical reasons too, using collar and isometric cervical exercises, unless your surgeon decides for discectomy and fusion surgery 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 am just reading my MRI report again (without contrast) from a year ago that noted asymmetric T2 hyperintensity and punctuate focus hyperintensity. I have been having episodes. Last week I lost control of my legs for about a minute out of nowhere and fell. Arm goes cold and numb here and there. Bouts of dizziness . My right eye has kind of a tunnel vision here and there. ### REPLY: Hello, You need to see neurologist for this sooner. Your symptoms arise suspicion of transient ischemic attack or desalinating disorder like multiple sclerosis. Doctor is very likely to repeat the MRI and get a contrast study done. Last year MRI hyperintensity can be infarct, desalinating plaque or even focal infection. Interval change in this hyperintensity can help doctor to know what it is. 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 a 25 , mother of a 6 year old girl. Got married last year and have been trying to concieve but to no luck.. My GP put me on fertomid but i want to know how it works and if it is successfull.How long do I have to take it before it helps. What more can I do..? ### REPLY: Hi, Thanks for writing to . Fertomid is ovulation inducing agent. It means it helps your follicles to grow properly and mature. It also causes multiple follicles to grow. This increases the chances of conception.  I would suggest you to undergo follicular study which will tell you are ovulating properly or not. If your ovulation is proper you can continue min 3 cycles of Fatimid. If there is no adequate response to Fatimid then you need to add FSH in with that. But follicular study is must whenever you take fertility tablets. I would suggest you to take  in or pride after discussing with your doctor when your follicle size is more than 19 mm. I wish you conceive with this. But if it fails then you need to get tubal patency test. One more thing I want to suggest is you get your hormone test done if not done yet. Like thyroid profile, serum prolactin, FSH and LH. 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: Hello my name is Cartasia Johnson and I wanted to know if I m pregnant and if I took a pregnancy test to early or what? Ok my last period was on the 3rd of Feb. and I had sex on the 14th of Feb. then on the 23rd of Feb. I begain to spot it lasted till the 26th of Feb. then on the 1st of this month I took a home test it came back neg. then i went to the doctor on the next day and it came back neg. so what s them problem? ### REPLY: Hello Dear. I have understood your concern. I will suggest you the best possible treatment options. As your both urine pregnancy tests are negative you are mostly not pregnant.  I hope you have very regular cycles.  As you might be aware that in a woman with regular cycles day 10 to 20 of the cycle is the most fertile period of cycle.  Your unprotected sex activity falls in this period, hence you need to cautious about possibility of pregnancy. I will suggest You to wait for 5 days after your expected date of the cycle and get urine test done.  In case of doubt blood beta  test and USG will be of help. I hope this answer helps you. 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 feel pressure in the back of my head when I cough continuously. My head is also super stuffy. Last week I was diagnosed with Bronchitis but this week it seems more of my head than my lungs. I still have this annoying cough that s been around 2 weeks! ### REPLY: Thanks for your question on . In my opinion you should consult pulmonologist and get done1. Chest x ray2. PUT (pulmonary function test)Since you are not improving with cough, we need to rule out infection by chest x-ray and worsening of bronchitis by PFT.PFT will also tell you about severity of the disease. And this will help in guiding treatment. Coughing raises intracranial pressure. So more coughing will cause more headache. So if we cure your coughing, headache will itself relieved. So consult pulmonologist and first diagnose yourself than start treatment accordingly. You may require inhaled bronchodilators and antihistamines. ### 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 Sir, My last month period was on 1/03/2014. On 30/03/2014, I got dark positive on first sample of the day, then it started fainting in next tests. Today morning, the test line is barely visible. Ultra sound scan shows no sign of pregnancy in uterus (inter or intra). I am not having any kind of bleeding or spotting but sometimes cramps in lower left abdomen. I had 1 chemical pregnancy which ruptured in jan 2014 and one abortion done through DNC due to infection in uterus on 14/05/2012. Now, I am planning for a baby. My beta ChatDoctor which is done yesterday depicts 5.11 mlU/ml I am worried about my health and baby. Can you please guide me further. ### REPLY: Hi, How is doing ? Your history suggests that you don't have problems in getting pregnant, but after you get pregnant the health of pregnancy is not good enough. Value of But don't lose hope. May I suggest the following investigations to see if any problems & get them corrected if presentHusband- Semen analysis at least 2- done 4 weeks apart preferably in an infertility center (examination done by an .  So check with HSG(X-ray with dye), or SSG (Scan with dye) or Laparoscopy apt, ACA (Egg & IGM) & LA - blood tests-these cause repeated abortions these can be corrected if problem all this done & found normal, nothing can stop a pregnancy with Gods will Hope I have clarified your query, do write back if any queries 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 what I think to be two cysts between my leg and vagina. If I press on them the swelling tends to stay below the surface of my skin but it does feel painful and kind of hard at the same time. Any idea how I can treat them and prevent them from flaring up again? I have had them pop up in the same area on and off for months now. ### REPLY: Welcome to . 1. The possible cause could be infective etiology - hair follicular infection with collection with in causing pain and tenderness.2. Another cause could be lymph nodal enlargement which is seen after any infection or inflammation anywhere in the body but generally not painful.3. The remedy and care you have to take - do not squeeze or scratch the lumps, that will irritate and complicated, and recurrence chances are more.4. Avoid clothing that cause the irritation to the area - try using soft clothing that all not affect on the area.5. Maintain local hygiene, avoid shaving the hair until complete healing, use trimmer instead for hair removal as the creams causes irritation.6. Clean when ever possible with antiseptic liquid. That will help to get rid of recurrent infection. If no use then get it examined and treated according to the findings. Good luck. Hope I have answered your query.Anything to ask do not hesitatehttp://doctor. ChatDoctor .com/doctors/ .  ### 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: Hard lump on the back side of your ear lobe dark pink in color .. Thought it was a zit so popped it with a needle lots of puss and blood came out.. Now its very swollen and red and really sore.. Not like any zit you would pop.. What could it be and what can I do to ease the pain and swellimg Thanks.. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some sebaceous cyst or enlarged lymph node.  Enlarged lymph node can be due to reactive hyperplasia., tuberculosis or lymphoma.  You should go for fine needle aspiration cytology or biopsy of that lump.  Then go for histopathological examination.  Take treatment according to diagnosis.  Till that you should take an antibiotic and analgesic .  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: hi i am 23 and from past few days i have a chest pain like someone is poked a needle in my chest. and after few minutes the pain is gone and makes me feel normal but again after sudden time the pain comes again. i thought it is normal pain and gonna be alright in few days but its not getting better so i am worried. what should i do now please give me some suggestion but i dont have money to visit doctor and i dont have any health insurance ### REPLY: Hi welcome to  . You are having chronic chest pain.... Your work up should be done as follows.... 1. . History of referred pain at shoulder and sweating 3.smoking history 4. Auscultation 5. Chest x-ray if needed 6.EKG only if needed According to cause further treatment can be given... Meanwhile, avoid smoking.... If bronchitis or lung inflammation present suitable antibiotic given.... If no significant cause found than it can be just muscular pain... Advise : Consult pulmonologist or nearby doctor for examination....and further work up ### 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: doc pls i had an unprotected sex on the 31-03-2013 around 1 am  n after that i took early morning pill the next day around 10:30 am n i also had an unprotected sex 10 days after n i took the early morning pill again on the day same day n i had my period one 16th of last month(April) n since my period i havent had my period for the month of may n i want to know if there is a possibility that i can be pregnant after my last period? ### REPLY: Hello, Taking I-pill within first 24 hrs of unprotected sex gives protection more than 95% against unwanted pregnancy. You get with .  Following taking 2nd time I-pill, it is quite common to get delayed period for 7-10 days, and it occurs mostly due to hormonal imbalance & mental stress. You need to do one home pregnancy test to be sure if you do not get your period after 7 days. Take cyclic OCP instead of frequent emergency pill. Practice safe sex in the future. Be well. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im doing a report for school and im supposed to find out the disease this one woman has, she has back pain for a week, a burning sensation in her lower chest is 62 years old. She always feels tired, her Cholestoral, triglycerides and LDL are high, can you help? ### REPLY: Hello, I had gone through the case and found that back pain might be due to calcium deficiency and lower chest burning due to hyperacidity or any heart problem as her lipid profile is on higher side. So take Vitamin D3 and calcium and antacid. Also go for heart checkup. For high cholesterol take statin and 8-10 night soaked almonds. Do yoga and exercise daily. Hope my answer will be effective for you. 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 son has been diagnosed with 3mm vsd in echo, he was 6days then, paed cardiologist had put him on furosemide drops, the baby feeds very well, now he is 17days old, but continous urination since past few days bothering me very much since he i7 unable to achieve the desired weight, should i stop the furosemide drop, ### REPLY: Hi, Frucimide is a diuretic so passing more urine is naturally. As he has some cardiac problem, cardiologist advised this medicine to cut down the load on the heart. You can not stop furosemide without asking your cardiologist. Due to diuretic weight gain is definitely hampered but at the same time un usual weight gain is also will be a sign of warning. Remain in regular follow up with your treating doctor. 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: Hello Dr, I had high blood pressure 140/94 last week and relatively high heart beat 90 last week. This week ( 2 days back ) i noticed tiny (0.5 cm) red soft movable painless rubbery lump which has not changed in size near my armpit and one below my ear 0.5 cm) . I have lower back pain sometimes for past 2 days, no sweating and fever, urine like smell sometimes ,little body fatigue and dizziness sometimes when i am resting but it reduces while i am doing some heavy physical, no breathing problem, no itching and rashes , stiffness of neck, clear urine and no chest pain. I s it some kind of kidney infection or lymphoma? ### REPLY: Blood pressure has nothing to do with malignancy. The swellings are very small, <1cms which are not significant. Your low back may need painkillers. You also have no other systemic symptoms suggestive of lymphoma. Keep a followup of these lymph nodes and see for the increasing size. If increases in size these nodes biopsy should be done. You need to undergo routine urine examination to see for abnormal cells or microorganism followed by urine culture to rule out infection. ### 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 wife has gotten lately black and blue bumps in the corners of her mouth only on the lower lip. she has a top denture and a lower partical which are loose but she takes them out at night to sleep.She has no pain with these but they just look ugly. Could this be the start of something we need to seek help with.thank you,Bill from Ill. ### REPLY: Hi, Thanks for writing to us. Blue bumps appeared on the corners of mouth may be due to-allergic reactions from ill-fitting dentures. Either the material of denture or sharp edges of denture can also cause such bumps. Please do visit your dentist and get the loose dentures replaced. Make sure that you are cleaning the surfaces of dentures properly. Also be conscious to chew using both the sides of denture equally. Apply McCoppin gel on the affected area. Use warm saline to gargle frequently. 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: For the past 4 days, my blood pressure has been running anywhere from 130/95 to 120/102. My blood pressure is usually normal (typically 120/78 or so). I have high cholesterol and a family history of heart disease & am 51. What I don t understand is the numbers being close together. My last reading was 119/102. ### REPLY: Hi, I understand your concern and would explain that your diastolic blood pressure values are high and this could indicate the beginning or arterial hypertension. For this reason, I recommend you to closely monitor your blood pressure values in the next days.  If your blood pressure values are persistently high, I would recommend consulting with your attending physician for a physical exam and some tests: - a resting ECG-complete blood count, PCR, ESR for inflammation- thyroid hormone levels for thyroid gland dysfunction- blood electrolytes- kidney and liver function tests-blood lipid profile.  Starting antihypertensive therapy may be needed.  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: Dear Sir, I am kiran from hyderabad, 5days back we came to know that my father is suffering with Liver cancer of stage 4 with fat stomach diluted with water. Is it curable? which hospital is best in hyderabad. pls let me know. it will be very helpful to me. ### REPLY: Thanks for your question on .  When liver cancer spreads and involves distal organs like lungs, kidneys, bones, peritoneum etc. than it is considered as stage 4 liver cancer. And it is inoperable and incurable.  We can only give palliative chemotherapy and supportive treatment. You can consult oncologist for further treatment. He needs PET scan to rule out distal metastases.  So palliative chemotherapy and nutritional and pain management is the only option. Stage 4 liver cancer is inoperable and incurable. . ### 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: Both of my ankles have been slightly swollen (for years), and at times they begin to have a pinkish to red look only on the lower part of my legs...(right leg worse). Now the redness last couple of days evolved into a darker red like spots (as if a rash, but the skin is a bit rougher, and I was told it was stasis dermatology. My question now is that my cheeks on my face also from time to time become quite reddish (when i m more emotional, or have had even only l glass of wine, wake up after sleeping under warm covers....sometimes one ear is completely red. Are these two situations related or separate? ### REPLY: Hi, Swollen ankles and swollen feet are common and usually not cause for concern, particularly if you have been standing or walking a lot. But feet and ankles that stay swollen or are accompanied by other symptoms could signal a serious health problem. A possible cause is lymphedema, is filtered through the lymph nodes, which trap and destroy unwanted substances, such as bacteria. When there is a problem with the vessels or lymph nodes, however, the fluids' movement can be blocked. Untreated, lymph buildup can impair wound healing and lead to infection and deformity. Lymphedema is common following radiation therapy or removal of the lymph nodes in patients with cancer. If you have undergone cancer treatment and experience swelling, see your doctor right away. 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 .. redness and etcChatDoctore on my ankle after using new hicking boots for a country hike for about 3 hours .. That was about six month ago but for some reasons it just not going away .. I had seen my doc who gave me anti-flametary medicine and oitment for outside, but my redness is spreding. Tried aftershave, vinegar and salty bath.. but no success.. Would you have an answer to this ? Thanks ### REPLY: Hello, I read carefully your query and understand your concern. The symptoms seem to be related to contact dermatitis. I suggest avoiding using the same boots again. I also suggest using Calamine lotion for local application. Furthermore, I suggest continuing the medications as prescribed by your doctor. Hope my answer was helpful. If you have further queries feel free to contact me again. 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: I have one hypo plastic kidney and my BP is always fluctuating it goes upto 140/110. I am on medication for the same. I have cardace H 10mg 2 tabs per day, cilacar 5mg and 10mg 1 each daily moxivas .3mg 1 tab and ecosprinAV 75mg 1 tab but still I have little swelling in my foot , dullness and tiredness. Please help and let me know what is the problem ### REPLY: I am sure that you must have been given this diagnosis after thorough evaluation. To put in simple terms, you are having CKD-Hypertension. You need to take the . I would therefore like to alter your prescription as under-1. Change over Candace H to Selma 40 mg BD2. Change over Clear to tab Gladstone 25 mg OD3. Tab Am dip 10 mg OD4. Stop Moxavas5. Titrate doses to attain target BP - _6. Most important will be restricted Salt intake to 4 gm daily & fluid intake to around 2.5 lit daily feel all these measures shall be able to both adequately control BP & take care of other symptoms you have. Best of luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I changed my tooth brush from one electric to another. 2-3 weeks later, I am finding black deposits in the upper surface of some teeth. No bleeding from the gums,there is 1 kind of a small blister on upper gum it doesn t bleed either. I cant scrape or brush away the black marks? Possibilities? ### REPLY: Helloi have gone through your query. You have not mentioned your age. Black discoloration of teeth can be due to various reasons. Do you have any habit of chewing tobacco or smoking. Black staining can be due to high iron content in the water. . Sometimes black discoloration can be a tooth decay also.is there any pus discharge from the blister or any pain related to the nearby tooth. If I was your treating doctor i would recommend you to have a full mouth scaling (cleaning) and polishing done. Aftercare would include use of mouthwash and maintain good oral hygiene .if this doesn't work then it could be a case of intrinsic staining or cavities would suggest you to visit a dentist and get it chekedHope this ans helpsRegards ### 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: Over the last few weeks i have been experiencing pain (not headache) mostly on the right side of my head. Sometimes the left. These are quite sharp pains and often causes me to be a bit dizzy and a little cloudy. Could you please shed some light on this as i am getting a little worried. ### REPLY: Hi, Thanks for writing in. Dizziness on one side of the body can be due to decreased blood supply reaching that part of your brain. It can be a pre stroke symptom, and you should consult your doctor and get completely examined. The blood supply to the brain from the heart is through the carotid and vertebral arteries. It is important to study the blood flow at the neck level and look for any narrowing or stenosis in the carotids and vertebral arteries on both sides. This is done by doing a Doppler study. You might also require a brain scan like CT scan or MRI scan to know if there is any condition inside the head causing your symptoms. It is important that you also tell your doctor of any heart conditions and medications you are taking for it. This is because there are many heart conditions which lead to symptoms in the brain like dizziness as a complication. ### 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 almost every disc is almost completely degenerated.... Stenosis, foramina Noramal (cant spell it) and other diagnosis regarding messed up back..... starts at base of skull and goes all the way to tail bone..... X race car driver..... I have recently been getting goose bumps from pain in upper back / neck region.... Is this normal..... I have been chronic pain patient over 15 years ### REPLY: Hello! Welcome on  ! Your complaints are related to chronic degeneration of the cervical spine. Unfortunately there is not too much to be done in this clinical situation. But, I would recommend performing a cervical spine MRI study to exclude possible spinal canal stenosis in this region, which may need surgery. A cervical collar can help reduce the pain. Hope you will find this answer helpful ! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have fainted twice in the last two days for seemingly no reason. has happened in the past before but have never gotten an answer to why. i eat well and have been drinking plenty. but since my last faint my energy levels have really dropped and i am constantly tired with a constant heache and neck ache. it is worrying me now. what could the problem be? please help me! ### REPLY: There are a huge number of possibilities. Ideally you should be admitted to a hospital The evaluation needs to be extensive workup needs to include CNS, CVS, rs, and even blood profiles. The differential is quite extensive.I will just mention some important possibilities this may be a case of seizures. An EEG and MRI brain may help this may be a Tia. A detailed history and MRI DW may help anemia, altered electrolytes, and hypoglycemia may cause the same symptoms. Even fluid deficiency can cause similar problems. Best of luckless let us know more details of other symptoms, and the tests if any .  ### 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 I have been feeling some pain in my stomach sort of a mixture between cramps and gas pains, I went to the bathroom and as I was about to flush I saw a red string in the toilet looked a bit furry, I wasn t bleeding at all I did notice a small bright red on my toilet paper but very very tiny, I have no idea what this could mean ### REPLY: Hi welcome to  forum.  Thanks for calling . F.  As you describe there was mild pain of abdomen, like cramps and gas pain. When you go to bathroom there is tiny blood on the tissue paper.  The cause could be fissure in ANO, meiosis, or some infection of intestines. I advise you to consult a surgeon for diagnosis and treatment. You may need to have photocopy for confirmation.  Wishing for a quick recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my newborn baby boy was born with a lump on r/h/s of rib area with a lump, diagnosis by doctors at time was a long name which i cant remember. However was told its harmless and the body will rid of this. the lump flatened out and shrunk over 8 months however now part on lump is reapearing along with redness. Any idea? ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  Your baby may have some hematoma or congenital lesion.  It is congenital condition and disappear within few months.  If your doctor said that it will disappear by itself then nothing to worry.  No, any treatment is required for that. Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 34 yr old female, suffering for 8 months now unexplained weight loss , recurring low-grade fever 99.2 - 99.7, WBC , RBC , and platelets are lowest end of normal in CBC, blood pressure very low 99/66, general weakness, very tired, enlarged lymph node in left armpit and several in groin....abdominal ultrasound found small cyst on kidney, pelvic showed collapsing hemorrhagic cyst on right ovary, chest x-ray normal. Nobody has been able to figure this out....I am very worried. ### REPLY: HI, Wecome to ChatDoctorUn explained weightless of 8 months along with low grade fever, generalized weakness warrants urgent attention, I hope you have been examined and investigated simultaneously. A Low blood count of WBC, RBC and Platelet is called Pancytopenia along with enlarged Lymph nodes possibilities may be some kind of hematological disorder like Plastic Anemia, Mylodysplastic syn . Kindly Consult a Hematologist and Surgeon and go for Lymph node excision Biopsy I hope it will give clue to diagnosis. If required a Bone marrow Biopsy may be performed Once cause is known treatment may be planned accordingly. Best of 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: A week ago on floor dental office, felt a bite or sting. saw three bumps with punctures. Sores on neck . Sores got larger, with some red around them, glands swelled up.. Took zpack given to me by Dentist incase of infection. glands are down, now I have 3 flatish sores, red black. not painful, but not healing fast. Put topical antibiotic on it, alcohol, aloa, anti itch cream incase I got poison ivy in woods ### REPLY: Thanks for your query, I have gone through your query, the multiple bums with punctures could be multiple abscess with sinus that secondary to tooth infection or infection of the bone(osteomyelitis) or because of actinomycosis infection. Consult your oral physician and get radiographs done to rule out any teeth or bone infection. Get a complete hologram done. After finding out the cause we can treat with antibiotics and analgesics. If teeth are involved we can restore it or remove it. I hope my answer will help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was in a MVA in 2000 and am on various medications. I am wanting to have a child. I currently take klonopin 0.5mg prn, Tordal 10mg prn, Clomipramine 25mg qhs, Propranolol ER 80mg qhs (using for PTSD not blood pressure issues), Demerol 50mg prn and Duragesic 25mcg qod. The pain Duragesic I can t do without but the others I could if I needed to. My pain doctor says I can get pregnant and it will be fine as long as I stop my meds a month or two before my due date so the baby isn t born with addiction. Doing that, yes my baby won t be addicted but what the effects of the drugs as my baby is developing. I know taking anything is always a risk and sometines even when you do everything right something may still go wrong regardless. My question though is what is the probability of permanent harm to my baby by continuing my meds. ### REPLY: Hello, I understand your concern and yes the medications which you are taking could be harmful to the fetus if you continue taking them during your pregnancy. Most of your medications are for a psychiatric or neurologic condition, so it would be unwise to stop them suddenly. You can ask your doctor who has prescribed these medications to change them to safer medications if possible, that is, which can be taken, which do not have any harmful effects to the fetus.  Also, please take folic acid tablets at least one month prior to conception itself. Warm regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had my appendix removed in Nov. 2013. I had gang green infection that set up afterwards; six days after the initial surgery, I had to have a drain put in the top part of my rear to remove that infection. I have experienced some tenderness and slight swelling in my left groin area since then. My stomach feels bloated and I feel like I can press on my left side area and feel something swelled. Should I be worried, and try and contact my doctor, or is this common after having such a serious surgery and recovery? I am a female; 47 years old; never sick other than sore throats etc. ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. Slight tenderness after the surgery in groin area is common after such a large surgery. Consider it as a normal process. Gas in the stomach may be because of acidity. Taking the appropriate . You can take tab pantoprazole for the acidity. Taking it half hour before meal can help you reduce your gas. Diclofenac sodium can be taken for pain and tenderness. Please take all above medication under doctors guidance. I will be happy to answer your further concern, you can ask me on bit.ly/ ### 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, may I answer your health queries right now ?  Please type your query here...I am suffering piles from since last 8 year please write here what is the natural treatment for piles my piles is very painful and blooding can you write me immediately I am waiting for your answer ### REPLY: Thank you for contacting ChatDoctorI am sorry to hear that you are suffering from piles. Piles are also known as external hemorrhoids. These are veins that are enlarged around the rectum. Hey are caused from straining and pushing with having bowel movements. Once they are present I strongly recommend that you use either stool softeners or fiber laxatives to make the passing of stools easy. Any straining will cause them to reappear. You can also use over the counter creams like preparation H to help reduce the pain itching and swelling. Keep the area clean with wiping after each bowel movement with wash cloth or baby wipes. I hope this helps reduce your pain and improve your hemorrhoids. Remember any straining will aggravate the condition ### 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/Maam,I have Avascular Necrosis on both my hip joints. Stage 2 and Stage 3 respectively. I April 2010 it was diagnosed in MRI. Since then i am asking homeopathy medicines. Now the recent MRI report showed that there is an advance in disease. I want to know will will cow urine therapy actually works for AVN on hip joint and are there any other alternative treatment for AVN apart from surgery.Regards, ### REPLY: Hello. The general treatment protocol account to modern med for Avascular necrosis is surgical management. There r many times tested Ayurvedic medicines which I can assure would give u symptomatic relief if not full cure. In order to advice u a good treatment schedule I would need to know more about the symptoms and signs you are having along with duration and severity. Also, the details of the investigations done by 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 brother had been admitted to hospital due to appendicitis and offered surgery straight away.he was asked  if he have moved his bowels during post operation assessment and he told the attending doctor that he moved bowels but is quite loose.after more than 24 hours he was discharge as he was up and about.But the problems arise, on the night of his discharge when he developed vomiting of bile fluid and abdominal distention and he complained of feeling bloated.no foods are being retained if he tries to it.what do you think must have happened?was there a fault in his surgery?he is now readmitted and we were told that it maybe is a mechanical obstruction and need to have tube in his nose to drain the fluids in his abdomen.will my brother be in danger? ### REPLY: Hi ! From the history you have mentioned, it could be just that starting of oral food was early, and so there is persisting paralytic illus due to which the present problems arose. It may get relieved of its own by conservative management. One perplexing finding is of loose stool post sportively, which usually occurs due to any kind of peritoneal irritation to the colon. I am not sure, but there could be some fluid accumulation due to very many causes resulting in peritonitis which caused the secondary bowel obstruction. The vomiting of bilious fluid points to obstruction of the intestines. The treating surgeon is the best judge, and he may go for some investigations like complete blood count, ultrasound abdomen, X-ray abdomen in erect posture to exclude pathological processes in the abdomen. If diagnosed as a mechanical obstruction, he may be in need for a relook surgery in the hospital. I wish him an early recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 7+ weeks pregnant. My doctor has advised me to take Duphaston 10mg 4 tablets in a day and susten vt 200mg twice a day via viagina.. I had slight bleeding at 5 week. Doctor has advised me to take them till 12 or 13 week of preganancy. is it safe to take these pills during preganancy? I am also having viaginal itching and white discharge because of susten vt. ### REPLY: Hi, Yes, these medicines are considered to be safe during pregnancy. Based on the history you seem to have features suggestive of suspected miscarriage for which your doctor has advised the medicines. Phaeton and Subtenant are synthetic forms of female hormones' progesterone which are useful in supporting and maintaining an early pregnancy and also to prevent miscarriage and preterm delivery. Ask your doctor for the treatment of vaginal itching or white discharge which could be due to fungal infection. 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: Hello doctor! I am suffering from the aftereffects of overmasturbation. I am 22 years old and i masturbated for 9 long years continuously. A year back i started feeling many problems due to this addiction and i started trying to quit masturbation but u know that addictions arent easy to get rid of quickly. Finally almost after a year now i havent done it for 20 days now and i am planning not to do it ever again but the problem is that i am not recovering. I havent noticed much improvement in the past 20 days. I just need to know whether this damage can be fixed by refraining from masturbation or not. Tell me about any specific diet that i need to take and any specific routine or rest schedule. Following are the major symptoms: - My pelvic muscles have become weak. I feel light pain in my groin, lower back, theighs etc. - I feel tired and feel lack of stamina. I get tired after 5 minutes of running spree. - I have weak erections and even when i get erect it lasts for just a minute if i stop touching my penis - I dont have morning erections as i once used to have. - The size of my penis has been reduced when erect from almost 7 inches to like 5 inches. the girth has been reduced as well - My penis is no longer that sensitive to touch. I have to struggle to get an erection. - I have also developed concentration problems like lack of focus, loss of memory - I also have an inconvenient feeling in my prostate region and i heard that overmasturbation causes enlarged prostate. Kindly tell me what to do besides refraining from masturbation. Just to let u know that physically i look healthy but internally i am sexually and psychologically exhausted. In the past 20 days of abstinence i had WET DREAMS twice. Tell me how to stop wet dreams and dont lose any further energy. Thankyou in advance. God bless you! ### REPLY: Hello dear, Masturbation is a normal phenomenon, and does not have any side effect on body or mind, unless you get addicted to it. Since you are feeling that masturbation is interfering with your normal functioning, you can try out the following measures:1. Improve your social life by spending more time with friends and relatives.2. Keep your mind active and busy at all times either through curricular or extracurricular activities.3. Have a diet rich in fruits, vegetables, fish, nuts & honey.4. Avoid fast foods & lipid containing diet.5. Avoid smoking & alcohol.6. Keep away stress, think positive.7. Exercise regularly & practice meditation. These measures will be helpful in improving your health & build up the confidence level. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father is taking morphine for pain. He has been diagnosed with bellini duct carcinoma. He just had chemo and the pain now does nto subside even with 30 mg morphine dosage 3 times a day. Our doctor suggest mobizox because he is getting pain twinges in lower back when he moves. Can anyone corroborate this? ### REPLY: Hi, Thanks for writing in. Bellini duct carcinoma is a cancer involving the collecting duct in kidney. He is getting sufficient dose of morphine, but sometimes patients develop what is called tolerance and then the pain relief does not happen with the usual dose of morphine. Mobizoz contains a combination of pain relievers and muscle relaxants for relief from boy ache after chemotherapy. It contains chlorzoxazone 500 mg, diclofenac sodium 50 mg, paracetamol 500 mg which are helpful to reduce pain. Please give him this medicine after food to avoid gastritis. Pain and twitching can be due to the chemotherapy and usually improves over 3 to 4 weeks. Please give pain medicines only when necessary. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi.. Need answer to my question very very urgently...My father in law (appox age, 67 yrs) was put under medication 10 days back by a psychiatrist in XXXXX. He is having Arip (20 mg) and Zolfresh (10 mg) daily. for the past couple of days, he has been having hallucinations and talks incoherently and I feel that he is not aware of his surroundings. Today while sitting on the sofa, he urinated and passed stool . He is talking in a very abrupt manner. If asked a particular question, he answers something completely different. Please advice as soon as possible. I am really worried... Please help.. ### REPLY: HI neha2000. THANKS FOR YOUR QUESTION. FORTUNATELY I AM DOING MD IN PSYCHIATRY NOWADAYS. FROM THE MEDICATION IT SEEMS THAT YOUR FATHER IS A PSYCHOTIC PATIENT. FOR LAT FEW DAYS HE BECOME VIOLENT, AGITATED,INCOHERENT TALK CONFUSED, INCREASED HALLUCINATION THIS TYPE OF CLINICAL FEATURE IS SEEN IN DELIRIUM AND AGGRAVATION OF HIS PSYCHOTIC SYMPTOMS.AS DELIRIUM ARE MORE COMMON, LIFE KILLING CONDITION SO WE TAKE THIS CASE AS DELIRIUM UNTIL PROVE OTHERWISE.SO MY OPINION EITHER STOP OR DECREASE THE DOSE OF TRIP TO 2.5-5 MG, STOP FRESH AS IT HAVE SIDE EFFECT OF DELIRIUM AND ADD SMALL AMOUNT OF LORAZEPAM I'm/SOS.BUT FIRST GO TO YOUR PSYCHIATRIST TELL ALL THE THINGS AND ACCORDING TO HIS SUGGESTION YOU PROCEED. 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: What are the side effects of coiling a brain aneurysm ? I was after my brain aneurysm and a check up and things but after two years after Ben having a lot more pressure in my head and feeling feeling dizzy and things so I had a angugram done and it looks fine they say but don t know why I m having them , I think it might be brain spasms because I was on mess for a little while I had my brain anersym ### REPLY: Hi, I am .  I have read your question with care and understand your concerns. Let me try to help you Question 1 : What are the side effects of coiling a brain aneurysm? Answer 1 : Side Effects include Rupture of Aneurysm, Partial Obliteration, Thrombus etc. But, in your case, since the angiogram has been done and since that looks fine, you need not worry The dizziness can be due to an unrelated simple reason like Anemia or some cardiac problems need to have a basic Blood Investigations with Cardiac Evaluation first before trying to think about complications related to Brain 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: earlier this afternoon i accidently cut myself on a rusty piece of metal. i went to the bathroom and cleaned it up with soap and water and then got a bandaid for it. it is a small puncture wound and from the outside it looks clean. i am up to date on my tetanus shot and i am just wondering what i should look out for. thanks for the input. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you got a cut from piece of rusty metal wound which could cause puncture wound and rusted metal injury, as your immunization is up-to-date you need not worry about. Tetanus is usually taken once in 5 years. You should go for booster dose of immunization if injury is there. You should visit general physician / surgeon once and get it examined. Surgeon will examine your wound completely and start treatment as per requirement. Maintain area clean and .  Cover area to prevent any debris exposure. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 6 year old son has had stomach cramps for about 5 days off and on day 4 he started diareah, now loss of appetite and the cramps are happening more often, besides tyelnol what can i do or give him. The cramps seem to only be in the pelvis area he says he doesn t feel it anywhere else. ### REPLY: Common causes of abdominal pain and diarrhea are infections, food allergies, food poisoning etc. Serious causes of sucChatDoctorplaints may be Appendicitis, Intussusception, inflammatory bowel disease etc. Probably your son is suffering from bacterial infection. You may ask your doctor to add dicyclomine with paracetamol for abdominal cramps, ORS solution for preventing deny . For any further query you may consult me at . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my granddaughter is scared to stay where her mother is staying ,( which is with my ex-husband ) he is not my daughter`s father ( her stepfather ) and is the stepgrand father to my granddaughter, when i take`s her home she start`s crying , say`s her mom wont let her sleep with her , make`s my granddaughter sleep`s on a chair in the frontroom near my husband`s bedroom and my daughter is at the other end of the house and can`t see are hear her if she need`s her for help. my granddaughter has been at my house since school has close and it`s about time for it to reopen again ,and she don`t want to go back there to stay , saying he touch her , when i ask who she talking about , she say`s granddaddy is , i have tried to get her help and everyone is saying i am lying about it , and the mother tell`s the child she is lying to . i am not understanding why she is calling the child a lie , when she herself was raped at the age of 3 by a 13 year old boy that playing with her brother`s and other kid`s ( when she was a child ) i told her never call a child a lie and she is telling the truth . this child is having nightmare`s bad that i can`t sleep at night , only in the daytime. if he is touching her it wouldn`t be by penis ,, (, his mouth are finger`s only ) how can i tell ? she cover`s up across her breast if a man are boy stand`s near her , that is what got me watching her more closer when other people`s are around her , ( she is 8 years old ) and will be 9 soon , how can i help her ? i left my husband because he was abusing me and when i left him 3 years ago , that`s when i ound out my daughter move in with him , she has another little girl 2 year`s old and i fear for my grandchildren`s. but noone believe`s me on anything i say , i know what my husband is doing , and what he will do . can you give me some in put , ### REPLY: Hello, It is a very difficult problem you and your granddaughter are facing. In today's world, the incidence of child abuse has gone up very much. Hemophiliacs as they are called, rarely admit to abusing a child. The child should be taken to a child psychiatrist for counselling and the atmosphere should be immediately changed. The mother should be convinced of what had happened, if needed, by counselling. Legal security can also be acquired as per the rules and the accused can be tried. The child needs lot of moral support from an understanding and dependable adult like you and would come out of the trauma in course of time. Any physical injuries should be attended to. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother just called me from Florida and mentioned when she was coming home from eating that her legs had like pins and needles a dnher calf was hard and her feet were swollen. now she mentioned her calfs were not as hard but her feet are still swollen. What should I tell her? ### REPLY: Hello, You can advise her to undergo physiotherapy sessions as with exercise the symptoms will come down. As age progresses there will be a weakness in the body and some physiological changes on the unexpected side of musculoskeletal issues.  Having doing regular exercise will help her to be fit and active. In my clinical practice of over 12 years, most cases have been referred to exercise, and they improve the overall quality of life. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...Our family is starting to worry about my father. He is 73 and has become very emotional. He seems to cry at the drop of a hat. Sometimes it is something as simple as someone getting killed in a car wreck but yesterday my cousin (who we dont know very well as they live far away) miscarried and is in intensive care and he couldnt stop tearing all morning.  We had people scared enough that they thought something had happened to our immediate family. He had been like this once before and had gone on Testosterone and seemed to get better but then he stopped taking it.  He is taking it again but I dont know how much. Should he go to a doctor and what kind.  What questions do we need to ask? He is also very easily distracted and also has become very forgetful. We cant tell if this is partly because he has a radio in his ear a lot or if he just doesnt remember. Thank-you very much for helping, Bonnie ### REPLY: Hello and thanks for writing in. I understand that you are very concerned about your dads recent emotional problems. You have mentioned that he is becoming more emotionally labile, having crying spells and forgetfulness. These symptoms at this age could be due to two possibilities:-Dementia, specifically when the frontal lobe is involved.- Depression would advise you to take him to a psychiatrist for a detailed evaluation. He will also need to have a detailed neurocognitive assessment and an MRI scan of the brain. Further treatment will depend on the diagnosis. So, please take him for an evaluation as early as possible.  ### 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 feel very tired dizzy and feel hungry after discharging spam even my cock become small after every intercourse and very next day I feel tired and pains remain in my chest and in abdomen. Headache also grips.This situation prevails more   than 4 days and after taking heavy and rich foods, feel a bit relax and withinthattime I can not make any physical relation. Pls   adv to overcome these problems and I am very much anxiety about heat pains. ### REPLY: Thanks for asking in  forum I understand your concern. Feeling of relaxation, tiredness sometimes is found normally after ejaculation/sexual intercourse and the penis will obviously lose its attained girth and length after ejaculation/intercourse.  So, you need not worry about these are completely normal in all. Your tiredness and pain in chest may be due to some other reason. Hence, please visit a psychiatrist for counselling and further information on this. 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: My husband has had autonamic dysfunction for 20 years and recently his heat stopped twice.  Once at home the other in the hospital.  He is so tired and weak and sleeps a lot lately.  He also has shortness of breath.  His doctors said his heart is getting weaker.  All blood tests are normal.  What could be causing this?Thank-youB.Finley ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion. Weakness can come from different reasons. They might be cardiac, metabolic, endocrinoligic causes sect. To cardiac problems I would mention heart function or rhythm problem. If a person has a low cardiac output, meaning an insufficient heart and if he is untreated he might feel week and have different in breathing deeply. Also, heart rhythm problem might house weakness. Low heart rhythm, heart pauses or electrical system problem might be responsible for weeks, fainting etc. Electolit imbalances, thyroid gland dysfunction also might cause such symptoms. So, if I was the treating doctor I will recommend some examination like a cardiac echo to evaluate heart function and walls, a full blood analyze to exclude electrolyte imbalances, anemia, hypothyroidism and a holder rhythm monitoring to see your rhythm tendency during day and night. After all this we can better judge how to treat the problem. Hope I was helpful. Best regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had gallbladder removed in Jan. 2012 (functioning at 3%) and a week later diagnosed with severe gastro paresis, but I never vomit.  Since then, each month I have problems that are progressing to almost debilitating.  Every day I feel as if someone is pressing a sweet gum ball below my right breast near the gallbladder region.  The pain goes all the way into my back.  These areas get worse during ovulation and after my menstrual cycle.  The pain becomes so severe and often feels like burning in the back.   It hurts to place my back against a chair, and it flares up greatly during the night, so I find myself sitting up most nights crying.  This month the pain is so bad that it feels as if someone has beat my back to the point of severe soreness.  I feel as if I have a knife in the upper right back shoulder and sometimes left one.  I have also pain in my right lower back and front upper side, under the rib cage.   My blood pressure is normally 120/70; however the bottom number is now at 94-97.  Therefore, my back of my head feels burning and I have a nagging headache on and off.  I am nauseated and have diarrhea, which never happens for this constipated person.  I feel as if I am about to pass out.  I have had numerous tests done this past year: colonoscopy, EGD, ECHO cardiogram, stress test, liver enzymes tested, pancreatic enzymes tested, full blood work up (whicChatDoctore back with abnormal written by a couple), vaginal sonogram, and a handful of CT tests from various doctors, one including a dual phase CT of my pancreas and appendix.  What is wrong with me? ### REPLY: Hi I had gone through your query and understand your concerns. I would come up with two chances to fit your condition.these include1.the first one may be ACID PEPTIC DYSPEPSIA;possible causes include;-suppressed strong emotions like anger, worry etc have caused the inflammations they will not get better until these feelings have come out into the open.-irregular dietary habits,-taking too much NSAID-sedentary lifestyle are some causes2.second possibility is, RENAL STONES;ultrasound scanning for PUB may confirm the diagnosis. I hope this is helpful for you, thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sharp ache in my brain during ejaculation ### REPLY: Hi. Few individuals especially men experience headache during sex. It happens due to multiple reasons. Some known causes include, over exertion during the act, quick climaxing, strenuous posture and so on. Apart from this dilatation of the blood vessels in the head can happen triggering the headaches. You need to work on the above said factors to prevent such headaches, or you may use painkillers an hour before the act. No sexual activity for some time may be a few weeks may also help... ### 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 had diarrhea for last year. He also has developed an umbilical hernia and now has the feeling of a lump in his throat. A blood test a few weeks ago says he has a slight problem with his kidneys but nothing serious but last night he wet the bed ! We are both worried sick as to what is wrong with him have you any reassuring answers please ? ### REPLY: Hi, many thanks for the query! You haven't mentioned reports of the blood test that you had few weeks ago. Nothing much to worry, you should do- FT, USG PUB, Urine (R/M) to know more about, if someone told you that you have, a kidney problem. Also do Stool (Culture & Microscopy), CBC, ESR & get physically examined for the lump in throat, whether these are enlarged lymph nodes or what. After examination, if necessary, do FNAC of the lump to know histopathological diagnosis. For Umbilical hernia, you need to get operated, if fit. Wish you a good health. Take care. 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 50 weigh 9.10 for years i have had hair coming out of my head my hair was always thick it feels much thinnr no w - i took up hill walking and my legs feel like led and i need to stop and rest every 200 yards. i am always cold and sufer constipation i am chilled to the bone and need baths to warm me. ### REPLY: Hi, It may be halogen effluvium. Kindly consult the dermatologist for the perfect diagnosis and treatment. There may be some internal disease. Have proper examination and investigations. If some internal problem is found, let it be treated. Anemia, vitamin deficiencies, thyroid dysfunctions... might cause halogen effluvium. I would suggest...- treatment of internal diseases-biotin 10 mg tab daily-vitamin E 400 mg cap daily-avoid tension and stress-apply minoxidil 5% solution on scalp twice a day-if Dan . . 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: First Name: sanjayLast Name: kumarI am a: Patient, Family member or FriendEmail Address:  YYYY@YYYY Subject: sperm analysisComments: result of my semen analysis. SANJAY KUMAR 28 YEARS MALE 30JUN2011. SEMEN ANALYSIS Time of collection :2.05 pm Time of examination :2.35pm PHYSICAL EXAMINATION Volume :1 ml Colour :Grey opalescene Appearence :Clear Consistency :Hypo Viscous pH :7.5 FRUCTOSE Present MICROSCOPIC EXAMINATION Microscopic examination reveals morphologically normal spermatoza along with pus cells (1-2/hpf) and epithelial cells. Forms with excessively long tails are also noted. Sperm Count :8 Million/ml of fluid motality 05% shows rapid linear progressive motility. 15% shows sluggish linear progressive motility. 20% shows non-progressive motility. 60% are non-motile. SIR, what is my report? could i made a father? plz send me details. ### REPLY: Hi thanks for writing to . I have gone through your report. Your semen analysis shows less than normal sperm count 8 million is below normal, 20 million at least. Decreased motility. You should investigate for this. Ultrasound of scrotum to rule out varicocele. Varicocele is the commonest cause for male infertility. But u can become father with this report also. There are so many techniques in this era. Like semen wash out and many more. Consult a urologist and he will advise you further. Have a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i,m suffering from type 1 diabetes last 10 year when i was 19 years old nw im 29 .but last one week my diabetes is continue high. im taking 3 time insulin in a day in the morning 14 unit  humansulin regular same in the afternoon and in the night 14 unit humansulin 30/70 but still my sugar fasting report is 280,256 what should i do....please reply ### REPLY: HI, I agree your fasting glucose levels are very high. There can be 2 reasons why the morning glucose level is high. One possibility is that your night dose is not adequate (we call it dawn effect). The remedy for this is that we increase the night dose of insulin. The other possibility is that your night insulin dose is very high than needed and because of that your sugar levels become very low in the midnight when you sleep and your body tries to compensate for this low sugar by breaking down complex stored sugars from your liver into blood. (we call this osmosis phenomenon). For this effect, we need to check the blood sugar at midnight around 2am or so. If this midnight glucose level is very low, then we have to decrease your night insulin levels. Therefore, the best for you is to go immediately to your treating doctor and adjust the insulin dose you are taking. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son was in wrestling practice and someone pulled his shoulder forward. The coach moved his shoulder around and said there was nothing wrong with it, but he cannot lift his arm in front of him or up from his side. He can lift it behind him slightly better but not all the way. I have given him ibuprofen and put ice on it for 20 minutes but it did not seem to help. What should I do? ### REPLY: Hello, i have studied your case and I think that your son may be having shoulder cuff tear. It can be diagnosed with the help of MRI. If there is partial tear then it can be recovered with rest and physiotherapy. If there is complete cuff tear then he might need surgery for this. In both cases an MRI is must. I hope this answer will be useful for you. Let me know if there is any other followup questions. 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 had met with an Accident severe injury on my leg on June 29th 2013 due to sleep insomia arising out of anxiety I got married on My 29th.But still it was okay I was having a hope doing well affter recovery as I had a future plan ,but during this time ,I was in a state were I was not speaking or taking decissions as I do when I had not met with Accident as I was still under the stress influence I had an incident where I hurt my partner who is very Nice and a trustable partner who is very career oreinted , that incident was rotating in my brain and has brough me into a full night sleep discorder and I feel I have lost al my emotions physical health , I have been consulting a psycologist it gives me temporary relief but again gets back after a few hours ### REPLY: Hi and thanks for the query, It is important to be very sure if you never experienced none of these symptoms before you had the accident. This is important to be sure the accident is at the lone origin of this. Understanding the recent changes you have had at professional level, social level and if you changed where you live lately is important. Any stressful events lately need to be carefully identified. Psychotherapy from a psychologist and medication, based on the case and response from psychological counsel could be initial steps. Kind regards ### END