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: Tired, weak legs during the day with rls at night. Can t seem to get good night s sleep, but sleepy during the day. Two weeks ago after going to bed had jaw ache with some pressure around my chest like a belt tightening; didn t last long, maybe 2 minutes and was able to fall asleep afterwards. Also sometimes feel like I blank out for a split second. I have COPD and take Advair, Spiriva, Daliresp daily, along with Effexor for depression; Pravastatin for my cholestoral; and Anastrozole of which I have to take for about 4 more months for total of 5 years. I also have sleep apnea, but hate to use the cpap--so I don t. My current personal life is pretty stressful. I have a 19 yo daughter diagnosed schizo-effective and has a drug habit. Been out of work for 6 months and have lots of debt. Gee, I just noticed your last name! Seriously, I want to crawl in a hole and not come out. ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. Tiredness could be a manifestation of depression which will require regular treatment. The . Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link: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: Hello , My Red Blood Cells are Normocytic and Hypochromic , Total Leuocyte Count is within normal limits , Differential Leucocyte Count is within normal limits , Platelet Counts are reduced , No Haemoparasite or immature Cells seen.  Whats happened to me and what should I do now. Pls, help me.. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have mild iron deficiency.  No need to worry about that.  But your platelets count is reduced.  It may be seen in viral infection. You should keep close watch on that.  Bleeding can occur if it goes below 10000.  If you have any signs of bleeding then consult your doctor urgently.  If it is viral infection then you will recover within short time. 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 m female 25, TTC. My periods is late by 10 days. Im regular with a 30-32 day cycle. And I have pregnancy symptoms like nausea,fatigue, headache, constipation, food cravings & smell aversions..I took 2 home pregnancy tests.. Both were negative.. Today I went to the doctor. She again took a urine test and it was negative too. She has prescribed Regestrone 5 mg tablets for 3 days. Is it safe to use ?. May I still be pregnant ?. What is happening in my system ?. How should I proceed ?. ### REPLY: Hi there, I have understood your concern. I will suggest you the best possible treatment options. 1) First do not panic. 2) With multiple negative pregnancy test results, you can assume that you are not pregnant. In your case, Tab Progesterone will not be harmful to you. But it will be helpful to induce periods. 3) I will suggest you to get USG done to know if polycystic ovaries is a cause for your irregular cycles. If it is so, then please contact your gynecologist to get proper treatment for treatment of polycystic ovaries and for getting pregnant. 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 have a 5 yr girl she was fine before going to bed she got up an hour ago and her temp went from 101 to 104 in she was initially shivering and shaking but she has calm down now ... we gave her fever reducer when she was at 103 but has risen to 104 what should we do ### REPLY: Hi... Thank you for consulting in . Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. 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: Iwas reclined watching tv with a werthers caramal hard candy with soft center anyway i dozed off with it in my mouth and it got sucked into my lungs. I went to ER for xrays but nothing showed up. I know its in there im a little light headed can you help? ### REPLY: Thanks for your question on . I can understand your situation and problem. You are having foreign body aspiration. Candy will not show on chest x-ray because it is non-metallic structure. For diagnosis of foreign body aspiration, bronchoscopy is must. Bronchoscopy will also helpful in removal of foreign body if at all present in lung. So it is both diagnostic and therapeutic intervention. So better to consult pulmonologist and discuss all these and get done bronchoscopic evaluation. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i m mary..age is 27...height 5ft 6 ....weight is 48kg..married two kids...i ve breast 30...want to firm n enlarge without medicine n surgeory....cant afford....n i m too weak... ### REPLY: Hi... Kofta., Thanks for choosing ., Enlarging breast without medicine and Surgery...is not possible., But Breast exercises gives little effect....20 to 30%These are... Swimming, Placing weights above shoulders., Wearing of sports Bra, when going to jogging., it gives tone to Pectoral muscles that will give good shaped breasts., Without Surgical., some procedures are available...,1) MARYLAND... Injection of Stabilized Hyaluronic acid into Breasts., it provides natural framework of collagen and gives smooth shape., duration of treatment is 60 to 90 MTS... Simple...get immediate result., It will last around 2 years...cost about 40,000 rupees.,2) Wearing of BRAVE..., It comprises two rigid domes with Silicone rims, by suction effect, it will enlarge the Breast., no side effect, no painful...cost around 10,000 rupees .ok bye., good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir i am taking losacar a and zabesta 2.5mg in the morning and losacar 50mg and zabesta 2.5 in the evening for long time now my blood urea is 12 and the cretnin level is gone to upper side means 1.16 (normal values of cretnin is 1.20) please suggest me why my cretanin level is gone to border line. ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Creatinine level is only mildly elevated, and this level usually do not point towards any renal pathology.2. Increased muscle mass or a protein rich diet can cause increased creatinine. 3. Any level above 2 is significant. If you have any doubts, get a glomerular filtration rate test done, which should be definitely normal for you. Continue with regular intake of medications and maintain blood pressure within the normal range to avoid any damage to kidney. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had my cavity filled but it still hurts. Even when i drink water. What does that mean  and again wen  to the doctor he prescribed me NICIP PLUS for tooth and gum pains, the gum was enlarged due to cold... i got relief but after some days it started again, tooth pain, then i took 3-4 NICIP PLUS daily, so, now what to do plz tell me ### REPLY: Hello, Welcome Thanks for consulting , Have gone through your query, as you have toothache after cavity restoration, don't worry this can be due to caries exposed to pulp. For this you should consult dentist and go for Radiograph X-ray of there is secondary caries or exposure of pulp then go for Root canal treatment, or if it can be due to periodontal problem then go for curettage. Do warm saline gargle two - three times a day. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter gave birth in early Nov.  She had trouble with milk production, so doctor prescribed reglan, which she has been taking since then.  Last week in a blood test on Jan 3rd, her liver enzymes were high; they were even higher in a second blood test on Jan 6th.  She has been drinking a lot of gatorade to stay hydrated after giving birth.  Could this be part of her problem?  Tests have ruled out Hep B & C.  Doctor has taken her off reglan as of Jan 6th.  She has also started having dry heaves in the morning and sometimes nauseous in the afternoons.  She is not pregnant. ### REPLY: Hi ! I had gone through your question and I understand your concern. Yes using to often for a long time Gatorade may cause high liver enzymes. This supplement may cause hipervitaminosis A that cause these symptoms;cause, . . I would suggest to measure vitamin A level to confirm the diagnosis. The treatment is just stopped the supplement (Gatorade) . And after 2 month check again liver enzymes. Wish your daughter good health ! If you have any additional question feel free to ask me. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive just did my HSG. Result: acutely retro flexed uterus. There is a suggestion of uterine myoma. There is right hydrosalpinx with no spillage. The left fallopian tube is patent with free peritoneal spillage of contrast. However, there is some pooling of contrast noted around the left tube. So how can I conceive? ### REPLY: Hi, As per the report, the right tube is blocked and this can be relieved. The left tube is patent, but the spill could perhaps be slow as evidenced by pooling. These findings suggest a past infection of the tubes. The acute retroflexion, though uncommon and hence an unfavorable position for conception, can be overcome through adoption of proper postures after intercourse. The size of the MoMA and the associated symptoms indicate the need for further interference. Conception is possible through proper monitoring. Laparoscopic chromopertubation would be better to relieve blocks as well as better diagnosis. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello. i am 31, 179cm in height, about 59kg,asthma,cysts on lungs,arthritis, several pneumothorax,minor heart problem-not sure what its called.over half the time i drink alcohol i get pains going through out my entire body. i end up in the fetal position due to the severity of the pain. panadol etc do not help with the pain one bit. there is a know history of, if i was told correctly hodgkins/parkinsons. Does alcohol cause the pains due to having some form of hodgkins or would there be some other factor involved. i get the full body shakes and have increased over the last 2 years but i believe come and go or just eases a fair bit. hands shake as far back as i can remember. i have been told by my gp that i have chronic anxiety but does not explain the aches through out the body. i suffer from copd with cysts on my lungs and have been for surgery for it in 2006. the pains started before the cysts on my lungs were found but noticed changes in my voice when i was 20. i wondered if the pains had to do with my underlaying lung problem,arthritis, hodgkins or what ever could be causing it for it does get very uncomfortable and i do enjoy a drink time to time but something i can give up permanently. i dont drink much alcohol with maybe a 6 pack a fortnight. half to one beer will cause the pains and i think is associated with it on occasions chills and sweating. curious about any advice you might have ### REPLY: Kindly ask your problems in brief and specific rather than righting whole story or narration. If you're having so n so problems then first u must curtail your alcohol intake completely, yes alcohol intake reduces our tolerance to pain causing more pain after full . As you're a problem with asthma, COPD,arthritis, etc. u need to consult physician for thoroughly investigations rather than assuming Hodgkin's or Parkinson's by yourself. ### 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, Ive been smoking meth for about 2 years on about almost an everyday basis and now when im trying to quit, I cant even go two days. Why does it make me feel really sleepy, makes me dizzy, unbalanced, dream like foggy vision when im awake, suicidal thoughts, fatigue, cant even answer any simple questions accurately, agitated, and completely unhappiness towards anything? Will I be like this for the rest of my life? Is there any medication available for symptoms? ### REPLY: Degree understand your concerns went through your details. Quitting meth addiction is no children, and it takes time and courage. The given symptoms are common with any sort of addiction, and you should not fall prey to the physical and mental symptoms which makes you to relapse the addiction habit. In two days, these symptoms will be prominent. Once you practice for a week, symptoms subside. Best method is to completely quit today (now) and sustain with the help of your mind power. Mind power building therapy, motivation therapy etc. should help you to do so. Please consult a psychologist / psychiatrist. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband has had a by pass 10 years ago  in 3 major veins he also had a stent put in one of his veins lately. HE ALSO HAS DIABETES.He stopped all his heart pills except those of diabetes.He is now spitting blood especially in the morning. Do you think that this is because of the stent? Thank you ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. Spitting of blood may be due to many reasons.  He may have cirrhosis of liver or some problems in lung. You should go for ultrasound abdomen and x-ray chest.  Search the cause and take treatment accordingly.  It's not due to stent. 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: Hey I have been having chronic cough and yellow mucus in my throat and nose for three weeks now. I used to smoke 1 pack of cigarettes each day but for 2 months have cut down it to less than half a pack each day. This is the first time I am feeling so. Havent had any such problem earlier. Can it be lung cancer ??? I am really tensed have taken tried antibiotics, cough syrup and nasal spray. I have been on them for 3 days. The mucus is still building up in my nose but seems to get settled in my chest as I cough real hard but very little mucus comes out.age : 21 yrs (male)Weight : 68 kghave been smoking for 4 years. ### REPLY: Thanks for your question on . I can understand your concern. Possibility of lung cancer is very less because lung cancer is uncommon at your age of 21 years. Possibility of bronchitis is more because you are smoker. Smoke irritates airways and cause inflammatory changes (bronchitis). So better to first quit smoking. This is the most important thing in treatment. Also consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x-ray (to rule out lung cancer) 3. PUT (pulmonary function test) for the diagnosis of bronchitis. PFT will also tell about severity of the disease. And treatment is based on severity only. You may need inhaled bronchodilator and inhaled corticosteroids (ICS). Don't worry, with proper treatment, you will be alright. But first quit smoking. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have lower back pain result of muscle spasm and trapped nerve. Have been perscribed Amitriptyline 10mg tab ulm to be taken anhour or 2 before bedtime. Will this help untrap nerve or is it just pain killer? Am also on solpadol 500mg 4 times a day and find pain under control...so why do I need Amitriptyline? ### REPLY: Dear friend neither of the two . You may discuss with your treating physician and explore the option of stopping Salvador as it contains an opioid analgesic instead try a combination of muscle relaxant and NSAID say thiocolchicide or chlorbenzaperin or chlorzoxazone with diclofenac and paracetamol, this combination will help release the muscle spasm and also pain. Intensive back physiotherapy along with it will certainly help you recover completely.  But please make sure the condition does not have any other causative reason. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had a miscarriage last nov.2011 and that was my first baby and after that iam trying to conceive from past 2 months but not successful and moreover since iam trying,my period flow is less than usual and my cycle decrease from 28 to 26.is this normal?? ### REPLY: Hi, I guess your concern is about conceiving and decrease in menses cycle, right? Coming straight to getting conceived. You have not shared the information about your age. Was it a late marriage? Women of age 18-40 years are of reproductive age, where chances of becoming pregnant are more. Women of above 50 years, chances of pregnancy are nil, and 42-45 years, its transitional zone, chances are not as high as reproductive age nor as low as above 50 years. I would like to focus on term fertile period. It starts from 10-16th day of menses cycle. Here sperm fertilizes ovum and women get pregnant, chances of getting pregnant are high at this time, so it's called fertile period. I suggest you and your husband to have sex/coitus during fertile period (scientific reason I have told above) for 3-4 months. If there is no improvement with your menses or above suggestion not working you have to visit nearby gynecologist for further help. If you are in hurry and your age in transition zone, then I strongly recommend you not to waste time and visit a nearby gynecologist or infertility specialist for further. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a tooth extracted and five weeks later it hasn t healed properly. I went to the dentist who put me on antibiotics for 5 days and I have one day left of this but there s still a fizzing sensation and nasty metallic taste in my mouth. The pain is reduced but it still feels like somethings wrong. ### REPLY: Hi, Understanding your concern. As per your query you have symptoms of metallic taste in the tongue post tooth extraction. Need not worry about it. Visit ENT specialist once and get it examined as dyslexia could be another possible cause for your condition. Go for citrus food to stimulate your taste buds.  .  Keep brushing twice daily and use Listerine mouthwash. Do floss twice a week at least. Hope your concern has been resolved. 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: Hi my husband had a brain tumor removed a week ago. It was located near the cerebellum and now he is suffering with weakness of his left arm and left leg and needs rehab he smokes marijuana I am concerned for him smoking because I feel as if its going to hinder his recovery. He is depressed also and says he need to smoke. Is this going to affect him and his recovery or do anything to his brain . ### REPLY: I read your question carefully, and I understand your concern. That being said if we are speaking about his recovery from the brain tumor surgery I don't think that either marijuana or smoking will have a big impact. The effects of marijuana on the brain need still further studies. There are indications about changes it can produce, but for long term use ones, don't apply to your worry about the recovery from the surgery in the next months. There is no data to indicate any effect on brain tumor. Smoking, while dangerous as it is one of the main risk factors for stroke, cardiovascular and respiratory disease which can affect the brain in the long term future, carries no short term risk about his recovery. So bottom line while both smoking and marijuana are two dangerous addictions which I strongly recommend him to quit due to their long term use consequences, I don't think you should panic about their current use inhibiting his recovery. Perhaps he should be evaluated and if necessary treated about his depression though. Hope to have been of help to you, feel free to ask further questions. ### 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 son is having heart palpitations for the last couple of months. His blood work came back fine and the EKG. He has an upper left side rib that is out of place and he went to a chiropractor 3 times and is still having problems with rib out of place. He is also having problems with the heart palpitations. He is not short of breath and blood pressure is normal. We recently went to a cardiologist and he is now wearing a holt monitor for 48 hours and then an echocardiogram scheduled for the 19th. My question is could the rib being out of place in the upper chest cause this problem of the heart issues?? ### REPLY: Thanks for your question on . I don't think improper rib attachment in upper chest cause palpitations in heart. It will cause pain but not palpitations. Palpitation can be due to arrhythmia, thyroid diseases, anemia or stress and anxiety. So to rule out arrhythmia holder monitoring (24 hour continuous recording of ECG) and 2D Echo is necessary. If both of these are normal than get done1. CBC (Complete Blood Count) to rule out anemia. 2. Thyroid function test to rule out thyroid diseases. If these are also normal then it must be stress and anxiety related. So ask him to avoid stress and tension.  Be relax and calm. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a chest xray and my doctor with the VA says I have an infection in my lungs..I feel tired, have tingling in my lower body. I have a caugh, some joint pain in my fingers and wrists. I feel like I have no energy when I get out of bed. I m taking Bupropion HCL for depression 100 mg/day and Clonazepam .5mg starting to cut back to .25mg on Clonazepam/day. The VA said they are sending Sepra or something for the infection. If my caugh doesn t clear up in 10 days, I m to go in for further examination. I m taking Mucinex to control my caugh. My wife has had the same symptoms and still has a caugh. ### REPLY: Thanks for your question on . In my opinion you should consult pulmonologist and get done chest x-ray first. Infection in lungs is known as pneumonia. And treatment of pneumonia is antibiotics. But we first need to identify the organism which is responsible for the pneumonia. And then the sensitivity of the antibiotics to be done. This is known as culture and sensitivity. If sputum is available then get done this with sputum, otherwise get done bronchoscopy and BAD (Bronchoalveolar lavage) analysis. So antibiotics are treatment of choice, but need to give specific antibiotic which is effective against causative organism. Consult pulmonologist and discuss all these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello my name is Yahaira and I am a little worried because I have not gotten my period. I am 3 weeks late, I have brown spotting discharge, cramping, back pains, and weight gain. Would you know what is going on with me? Am I pregnant? Did I miscarraige? Or is it something else? ### REPLY: Hello Welcome to ... I am really sorry for your worry but I'm definitely going to help you out. Thanks for posting your query here. I being a surgeon, we encounter so many such cases day in and day out. I read your question completely and have understood it well enough. Furthermore, I will analyze all your points and provide necessary information. 1. How were your previous cycles? Delay by 3 weeks is definitely not normal but is sometimes seen in few patients that come to us. 2. The symptoms that you tell brown spotting, cramp, backache doesn't 100% suggest pregnancy. This can be seen as a normal disease ailment. 3. We cannot comment about miscarriage at this stage. Please note the following few facts. A.  Please get a Urine pregnancy test. Uproarious kits are available and can be done in your home itself. No need for any doctor to read this test. Two possibilities, if its negative then chill, you'll be fine soon. If positive then, yes it's a confirmed pregnancy. B. If UPT is positive then don't stop there. Get a radiology obstetric scan done. This will tell us, if there's Intrauterine, or ectopic pregnancy. Exact date. And many other things. C. Miscarriage or incomplete abortion etc. We can see later how to go about after all these. Hope this helps you, in case you need further assistance, please let me know. Take care and God bless. ### 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, about 3 days ago I noticed that I was having pain in my bottom gum. When I look at it, there is what looks like a small hole there in just that one spot. It looks to be a little swollen there too. I also recently got my tongue pierced before I noticed the pain. I was wondering if that may have anything to do with it. The pain is bearable, its just irritating because Ive always had healthy teeth, never had a cavity, nothing. Is this something I can take care of at home or should I make a dentist appointment? Thanks ! ### REPLY: Hello, Thanks for consulting ChatDoctorRead your query, as you have hole in gum with swelling don't be worried so much see gum pain can be due to some reasons it can be due to poor oral hygiene, inflammation of gingival, enlargement of gingival due to deposition of food debris sublingual region of gums, or .  Hole in gum can be sinus opening due to periapical or periodontal abscess. I will suggest you to do warm saline rinses two - three times a day, you can apply ointment like stolen gum paint to reduce inflammation of gums, use regular mouthwash chlorhexidine. I will also suggest you to consult dentist and go for examination of gums and its treatment, if needed go for oral prophylaxis also. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I experience a sweet and light pain on left side of chest ( unlike the stabbing and acute one ) once in a time.during it I feel uneasy and start walking and drink water.after some time like 4mintues the pain is all over as if nothing happen .I am 25 years old and am lean weighing about 67 kg and 6.00 feet high.and study in university.your help is needed in diagnosing the problem. Regards ### REPLY: Thanks for your question on . I can understand your concern. Possibility of simple muscular pain is more. But since it is left sided chest pain, we can, should definitely rule out heart diseases first. So get done ECG. If ECG is normal then no need to worry about heart diseases. Apply warm water pad on affected areas. You can take simple painkiller like paracetamol if pain is for longer duration. Avoid movements causing pain.Don't worry, you will be alright but rule out heart diseases first. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I am on Seasonale but my insurance changed and they won t pay for brand. So I got switched to the generic Jolessa. Been on Seasonal for 5 years now and had the first Jolessa pack in late October. I am on the placebo pills this week and no period (day 3). Not pregnant unless you are really a devout catholic and believes in immaculate concepcion. I used to spot a week before with Seasonale a week before my period but nothing at all with Jolessa. I feel all the usualy bloating , cramping. Does it make a difference changing from a brand to generic? What if I am done and still no period? Should I start the next 3-month pack? Thanks! ### REPLY: Hello, Thanks for the query to . Forum. You changed your brand seasonal (levonorgestrel + ethanol estradiol) to Odessa (levonorgestrel + ethanol estradiol), As the salt is same in both contraceptive . In my opinion cramping and bloating may be due to new brand as it will take some time to adjust in body. In my opinion first wait for normal menses and then start Odessa, no harm. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir, I am prasad, My sister suffering from throught cancer She taken radition treatment for one month in Hyderbad. Now She cant eat anything. She drink with pipe only. Now She was very lean. How we save her life We don t know. I am working here one of the ngo office at R.T.Nagar. We are scanring about her life. She has two daughters her husband left. Now I am looking all those her treatment. Pl. telme. and save her life. And save my life also prasad, YYYY@YYYY ### REPLY: Hello Prasad, there are some diseases in our world which is out of our knowledge and ability. The disease you told is a very devastating disease. It has a very much higher incidence of metastasis in other areas.  So, in this situation, prognosis of this disease seems to be very poor. There is little chance to save her. This is a very hard truth for you.  So, donor expect much just keep carrying on the treatment and keep praying.  That's all, we can do. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a salpingo total abdominal hysterectomy in jan 2012complained from day 1 I had trouble emptying bladder Was taking zanex for anexiety from all the pain I was in.  After surgery I had lost a total of 45 lbs between july of 2011 to september of 2012. no one could figue it out why?blood test after blood test, nerve test for weekenss and pain on left side. complained of feeling of beinig kicked on left side, frequent urnating, in night, vertigo, nausea early am when using restroom.pelvic pain, cant lift heavy things still, dark uring.fatigue, urine comes out when sneeze or caugh, sharp pain in side or abdomen signals me to urinate urgenty. pain after sex. lowerbelly swollen always?fast and slight streems of urnie..what is going on.  I have been persistant. with docs till I got tired of complaining. and just deal with it now.   now i am worried ?? ### REPLY: Hi ! Your symptoms are pointing towards a chronic urinary tract infection which could be due to a persisting systole. Loss of weight could be due to chronic urinary tract infection if you do not have diabetes and your HIV status is non-reactive. Coming out of urine while sneezing is possibly due to the weakness of your pelvic muscles. You can try Keg gel exercises to improve on it. You should avoid lifting heavy weights to avoid developing a vault prolapse. Furthermore, you should go for a urine routine test, and also a culture sensitivity of the urine sample. In my opinion you should see your gynecologist or surgeon again and discuss the problem with them. Wish you an early recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Esophagus cancer. 1mm cancerous lesion removed from esophagus. 4 inches of high grade long-segmented dysplasia. Oncologist said that area is high risk for turning cancerous. He recommends removal of entire esophagus. I am very active. Personal trainer. No symptoms. Is there alternative treatments? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You should go for surgical removal of esophagus.  You already have esophagus cancer with longs segment of high grade dysplasia.  Sooner or later it will turn in to cancer.  So you should go for surgery followed by chemotherapy or radiotherapy according to need and type of cancer. Consult your doctor and 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: I have a friend, Who had kidney stones and right now cathetere is attached from her back side. But the problem is that her tube blocks bcz of sticky fluid and some times small stones. Sometimes she had sticky urine . Although she is under doctor guidance, but still wants to know, fhow sticky fluid coming from tube attached to kidney and what cure can be for that. She will soon have a open surgery to remove stones as all the other methods not worked.Pls help us in this regard. thanks.Dinesh,New Delhi,India ### REPLY: Hi, more details are required. I think your friend had a blocked kidney tube due to stones and so a tube has been put into her kidney from the flank to .  This is done to reverse the kidney swelling and prevent further kidney damage due to blocked kidney tube. It is also done in case the urine in kidney is infected or pus-like (hydronephrosis or infected IN). If tube gets blocked, check that it is not getting twisted or kinked, it is not getting compressed while lying down. If still gets blocked, probably changing to a larger size tube will help. Her urologist will be the best person to help. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir my mother is 54 and is not feeling well these days, she had been a depression patient. is suffereing from ortho has undergone surgery for utrerous removal she is complaining for some pain and unconsiousness these days i got her to delhi for a complete health check up the most worry i have is that in my maternal history many of the family members are cancer patients i want to know what should i do ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. The condition of your mother is normal in the population of females whose uterus is removed. This depression could also be related to the depression of menopause. The negative thinking and loss of self-esteem and self-respect during this period results in mild to moderate depression. Motivation is what she needs and provide her with abundant amount of motivation. She shall be alright within around two months. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a vasectomy 14 days ago. It was a no scalpel coterized open ended type of vasectomy. My testicles are still pretty tender and I must be careful not to bump them with my hand or something as this causes pain. When I am resting, I don t feel any pain. Is this normal after 14 days? Is so, how much longer till this issue goes away? Also, when my ball-sac hangs loose, it looks a bit deflated since having the procedure. Is this normal? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Pain after vasectomy for such a long period is abnormal. NSV or non scalpel vasectomy will never cause loose or deflated testicles. So pain may be because of the infection or some other thing. I suggest you should examine yourself with the doctor for pain in the testicles. Only visible examination and direct examination can diagnose the condition directly. And can help you cure. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I got my tragus pierced like 2 months ago, and lately its been itching and hurting...I guess I havent been properly cleaning it...but anyway, today I woke up with pus on my ear where the tragus piercing is...I cleaned it with sea salt & water and the pus was like yellowish/greenish along with some blood...its also very painful to the the touch. Is it infected? ### REPLY: Hi Dear, Welcome to . Understanding your concern. Thanks for your query. The symptoms you mention in query are pointing towards infection. Sometimes during piercing the instruments used are not clean enough or not sterilize which causes infection and leads to formation of pus and pain as well. Conditions should be highly septic and instrument should be adequately sharp otherwise there will be minor skin trauma which leads to infection. I would suggest you to :-- Take Advil or Tylenol for pain.- Apply ACIDIC ACID cream to treat infection.- Clean it properly. Consult doctor for proper examination. Doctor may prescribe antibiotic course for 7-10 days. Hope your concern has been resolved. 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: Hi Doctor, My father is a COPD patient and is hospitalized since last 9 days, right now on ventilator in ICU. The doctor says that he is having sever chest infection because TLC/DLC count varies from 12000-16000. Right now they are providing him some antibiotics like MEROPENEM 1GM (2-4 quantities) daily but still the infection is not controlled, can you please suggest some very effective medicine which can be easily available. I am from Delhi, India. Thanks. ### REPLY: Hi & Welcome. I can understand your concern for your beloved father. He seems to be suffering from hospital acquired or nosocomial pneumonia and the prescribed antibiotic Reopened appears to be not effective in eradicating the infection. To select the most appropriate antibiotic his blood or sputum should be tested for culture and sensitivity. Based on the result he needs to be given the most sensitive antibiotics like Ninefold or Definite which are the most sensitive antibiotics to eradicate the hospital acquired chest infection associated with ventilator. Hope the advice would be useful in getting him treated with proper antibiotic. 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 head tremors. Side to side. Last couple weeks saw neuro am having a mri tonight.dr said some left sjde weakness also. Severe mid upper back pain when lying down. Think i should have spine mri also. To check for possible tumor..your thoughts  what could this be tremors frequent ### REPLY: Hello! Welcome on  ! I recommend performing a cervical spine MRI too, besides the brain MRI. It is also important checking thyroid hormone levels for possible thyroid gland dysfunction and blood electrolytes. Do you have any medical history for tremor? What is your age? Do you suffer from high blood pressure or diabetes? A nerve conduction study is also necessary. Hope you will find this answer helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife recently had discomfort on her left side, beneath her left arm pit. She saw her doctor and he had a d dimer blood test run. Normal range is under 250 we understand. Her result was 5036. Our doctor ordered a ct scan, which was performed a few days later. The results were negative. Our doctor then said to let him know if the pain didn t go away,or got worse. There was no additional information provided as to the cause of the elevated d dimer number. My wife has RA, which we understand might effect the d dimer number, but no one has told us anything additional to calm our fears which are born out of our ignorance of the situation. Can you offer any possible explanations in this matter? ### REPLY: Dear patient elevated d divers level is sign of acute pulmonary embolism. This.may happen in patients with increased susceptibility for clot formation in blood i.e. increased clotting factors in blood.  Steroid intake for long time may have side effect of increased commutability in blood. Since some of the patients suffering from rheumatoid arthritis are prescribed steroids this may be reason. Are you taking steroids? Ct scan of chest will help to confirm diagnosis of pulmonary embolism. So that may be the reason for ordering ct scan. Pain in arm pit may be the due to minor embolism episode. I think have solved your queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Could degenerative back disc desease be an oncoming symptom of prostate cancer? My husband was diagnosed with stage 4 (Gleason score 10) prostate cancer 5 years ago at the age of 53. He had previously been diagnosed with degenerative back disease at the age of 34. Throughout the past 15 years his lower back pain very gradually increased, which is the pain that lead to him making several visits to the emergency room and his doctor the year before he was diagnosed with prostate cancer. He experienced severe increasing lower back pain throughout the last 5 years of his life; and within the last year, frequent painful urination and blood in his urine and lymphnode/groin swelling and lesions. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. He has prostate cancer with Gleason score 10. His has long history of back pain dud to degenerative disease.  However, prostatic carcinoma is known for metastasis in vertebrae.  So there CZN BD bony metastasis. He should go for MRI spine. His difficulties in urination, blood in urine and lymph node swelling all are due to prostate cancer. He should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Every single night my fiance has been having severe night sweats.  This has been going on for quite some time.  I have been with him for over 2 and a half years and its been getting worse.  Around 2 to 3 am I wake us up, completely drenched in sweat.  Every night we have to take our bed sheets off, take a shower (again), and get cleaned up. The entire bed is soaked and we feel like we just got out of a swimming pool.  I talked him into going to his doctor last month to see what the problem is, but she said there is nothing wrong.  The doctor did several blood tests and everything came back as normal.  He is on a very low prescription of antidepressants and has been for several years, but nothing has been changed lately.  Other than that, he is very active, healthy, perfect weight, etc. He never gets sick and seems perfectly normal otherwise.Not only is this an annoyance to have to wash bed sheets everyday and get cleaned up at 3 in the morning, I am really beginning to get scared something is wrong with him! :( Im not sure what it could be or what steps to take next.  I am even having a hard time of sleeping at night because I am constantly waking up or checking him to see if he is getting close to having a night sweat.  HELP!!!! I am desperate for answers....its 3 am and it happened again for the 6th time this week! We are currently down stairs in the couch and recliner because our bed is soaked.  I usually have two sets of plastic protectors on, but I cant keep up with the laundry due to the frequency of these night sweats. ### REPLY: Hello! Welcome and thank you for asking on ! I understand your concern and would explain that these symptoms may be related to many disorders (inflammatory disease, metabolic disorders, infection diseases, etc.). What are the blood tests that he has performed? Have you measured his body temperature, blood pressure and heart rate during the nights? I recommend consulting with the GP for a careful physical exam, a resting ECG, a chest X-ray study, an abdominal ultrasound and some lab blood tests : -complete blood count-PCR, sedimentation rate-blood electrolytes-kidney and liver function tests -thyroid hormone levels (thyroid gland function)-cortisol plasma levels (a .  Hope to have been 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: Hi Doc,              My husband has some veesing problem.He had primary complex when he was a kid.But got cured after medication(though he suffers a lot whenever he has cold.).He took Asthalin for few days.now stopped that also.But the problem persists.What should be done?Thanks in advance!! ### REPLY: Hi, he should keep on taking Stalin if breathing difficulties persist, rather he should meet a physician and get examined physically, X-ray chest should be taken to assess the disease progress, should go for pulmonary function test to diagnose the disease whether COPD is present or not. He should avoid exposure to cold and allergic environment, other medication which reduces respiratory tract inflammation can be taken like montelukast, sodium chomoglycate and even methylprednisolone but all under guidance of a physician. And when the inflammation is received then he can with . Wish you 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: Hi. I ve had chronic shivering/judder type of symptoms since i ve been young. Everyone around me notices that when my hands , or arms are active, for instance when passing lightweight (not even heavy) objects to someone, my hands will tremble. I notice this in my legs too. It often always occurs when my body is active, even slight gentle movements cause it. When i was younger i did not worry so much & assumed i may overcome it. However, i m 25 now and it effects me socially as well. I want to find out whether it s something associated with my nerves internally, or if it s psychological. I m a healthy 25 years of age female individial, don t smoke , don t drink, healthy weight, i ve never had any other health issues. I have a fairly healthy diet too. Take vitamins sometimes as well. I don t drink coffee, just tea. If you can provide any possible directions, or ideas for me to consider, i will appreciate it ### REPLY: Hi, Welcome to  forum. I understand your concern. Fine tremors are associated with few medical conditions such as nervousness, thyroid overactive state, vitamin deficiencies especially vitamin B12 and rarely neurological condition.  If you haven't yet seen a doctor for this problem, I would encourage you to visit your physician. A little blood test will help us to know about your problem completely. We can then manage your condition accordingly. The test performed would include tests for vitamin deficiency, thyroid levels, other hormone assessment and neurological evaluation. A small dose of beta blockers can be prescribed to treat tremors and improve your quality of life. Hope this answer is informative.  Wish you good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive had a really sore tailbone for nearly a week no, i assumed i banged it in the bath. there was a growing bump around it, and today it started weeping. i drained it, and it took about 10 mins, still very sore and weepy. should i see a doctor or just assume its a spot? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint a sore lump on tailbone can be due to most commonly formation of a Colonial cyst that is seen to be commonly caused due to either an ingrown hair or traumatic injury in the lower tailbone area. I would suggest you to consult a General Surgeon and get evaluated, and he can commonly clinically diagnose the lesion while can also advise blood test for confirming. Treatment that can be advised you are commonly surgical by Incision and . . Marsupialization can also be advised to you. As of now you can sit in a tub of warm water to reduce pain and shrink the lump. Take Ibuprofen to relieve pain. Put gentle pressure to  ### 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 redness in the distal/terminal area of my left foot (top) between my fifth and fourth toes (baby and ring toe) that I beleived might be related to wearing tight ski boots and athletes foot in the small toe area.  It has been very tender to the touch and sore for three weeks now.  I have treated my althletes foot with an anti-fungal cream and spray (for five days now), but the area on top of my foot between the forementioned toes has become sorer, redder, and has come to a head (white and painful).  I carefully puctured it with a sterilized instrument and white/grey pus ozzed out (but it has relieved the pain and pressure somewhat).  I have put an antibiotic (bactricin) cream on it, pressed all the pus out that I could, and would like to know what you might recommend from here.  Thank you. ### REPLY: Hi. This looks to be an infection which has now spread under the red skin. As the history is of 3 weeks, I would suspect the slough of dead tissue underneath, which needs to be excised and the incision and .  I hope you do not have associated diabetes / you are not using any tobacco products. Do not put any creams on it as it may obstruct outflow of pus and may cause super-infection. Visit a Surgeon and request him for a proper surgery to open up the abscess and do debridement. ### 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 went to the doctor in early october after expieriencing similar symptoms of pregnancy. my doctor tells me after testing that im not pregnant. but im not so sure. it would be my 2nd trisemester if i was and im starting to have fluttering in the area under my belly button. could i be pregnant or do i have diabetes? ### REPLY: Hello dear, I understand your concern. In my opinion the first sign of pregnancy is missed period. The other signs of pregnancy are nausea, vomitings, increased urination, sore breasts start at 6 weeks or 2 weeks after missed period. But any of the above signs should be associated with a positive pregnancy test. So in case of pregnancy there will be positive pregnancy test. And the fetal movements are perceived around 5 months of pregnancy. Anyway definite confirmation is done by ultrasound. If nothing is seen in ultrasound and negative pregnancy test the pregnancy is ruled out. Sometimes the thought of pregnancy also makes one to feel the pregnancy symptoms. So relax. 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 stubbed my toe on a piece of furniture, it was bent pointing outward, i have extreme pain in baby toe, right side of foot up into my calf.  I tried to put the baby toe back in place, it hurt like hell, i taped it to the other toe but i am still having alot of pain ### REPLY: Hi, You have a fracture in your toe. It needs to be stabilized with a plaster, which will be applied on whole your ankle. Till then, you are not supposed to take weight on the toe or ankle. You need to take rest, apply ice, use a compression bandage and elevate the limb to reduce pain and swelling. If you had been my patient I would have suggested Ibuprofen twice daily for 3 days and then once till pain subsides. Hope this helps you. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i was in the shower the other day and i slipt and fell and chiped a tooth now 3/4 of that tooth is gone and the past two weeks i have noticed that a lump thats hard as a rock is growing bigger and way mor painful the pain is spreading also to my throat. ear and head and eye what should i do? ### REPLY: Trauma to the teeth and gingival can cause symptoms similar to what you're saying. If it only a soft tissue injury you can get away with some analgesics or painkillers but the only doubt that has to be cleared in such a situation is to rule out a fracture with may need expert medical attention. The nerve that run in close association with area causes the symptoms you are experiencing. So do visit you dentist or an maxillary surgeon to rule out the above. In the meanwhile analgesics should give u relief ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hey my girlfriend and me are trying to have a baby but theres this thing in her vagina its like a lumpy thing i can move it round and push it also feels like theres a hole on the end! Weve tried many of times to have the baby but its just not happening, would this be the probelem? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Lump in vagina can be due to some cyst or tumor.  But it will not cause infertility.  If you have problems in having baby then first you should go for your semen analysis.  If IR is ok then go for ultrasound abdomen of your wife and then hormonal study if required.  First search the cause of infertility and take treatment accordingly. Vaginal lump has no relation. 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: Dear doctor, I have splenomegaly and I went through different tests including blood tests, liver s fibroscan, CT scan, Sonography, Color doppler of port vessel, etc. Unfortunately the doctors could not diagnose the reason for abnormal spleen size. Can you help me? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. There are Hun .  Many infections like malaria, Salazar, leukemia, lymphoma, storage disease, congestion all can lead to splenomegaly. You should go for bone marrow examination. It may help you to search the cause. Then you should take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at 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: i fell 1 week ago and still have trouble with deep breaths(pain) hurts to lay on left side, head aches and sore ribs. i fell and hit just below left breast. been diagnosed years ago with copd so i am concerned if i damaged my left lung. feel like i can t get it to inflate.hurts to laugh hiccup take a deep breath. ### REPLY: Hi there, as you had a fall and got hurt on your ribs it would be wise to get an x-ray of the chest done to rule out any injury to the ribs. If you hurt your head and had any loss of consciousness or vomiting then a CT scan of the skull is also recommended. The soreness of the muscles and areas where you got hurt will be relieved by taking painkillers. It would be better if you got a complete physical exam by a clinician to rule out any other internal injury. 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: This past week i ve had bad diarrhea and went to the hospital saturday and got tests done and an xray because of bad stomach pains but they said it was just a virus but tonight when i went to the bathroom i had a pinkish color on the toilet paper when i wiped. So i took a pregnancy test but it came out negative, should i have waited to take it or is it right? i m just so confused because when i looked it all up it says pregnancy but the test came out negative. ### REPLY: Hello! Thank you for the query. Pinkish color on the toilet paper can be caused by intestine imagination (intussusception). It causes strong abdominal which can suddenly disappear if the intestine comes back to regular state. Sometimes it is very hard to diagnose it. Abdominal ultrasound during the pain should visualize it. Viral intestinal infection is also possible especially if your pain won't happen again. However, if your symptoms will come back again, diagnostics should be done including abdominal ultrasound, colonoscopy, full blood work. Hope this will help. 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 a very dry mouth , particularly at night, sore tongue and small lumps appearing under the tongue, and a sore on the top of tounge, with generally a dirty tongue. Dry nose and throat, headache, inflamed throat, congestion in lungs, mostly clear or white very sticky mucous, glands are up, stiff neck, voice is affected. I am 53 yrs of age, about 90kg, female. Not on any medication. ### REPLY: Hi Dear, Welcome to . Understanding your concern. Thanks for your query. As per your query sore tongue, lumps and inflamed throat is due to viral infection. Usually the symptoms go away in few days by its own. I would suggest you to do warm saline gargles 3-4 times a day. Maintain proper oral hygiene. For pain and inflammation take aspirin or ibuprofen(if not allergic). Give warm compresses externally. Meanwhile you can use topical anesthetic like lidocaine and topical analgesic like choline salicylate. Consult ENT specialist (ear, nose,throat) for proper evaluation of condition and rule out causes like strep throat or acidic reflux. Maintain proper oral hygiene. Doctor may order throat swab test or blood test to confirm the diagnosis. Doctor may prescribe steroid medicine, anti-viral (acyclovir) or antibiotics depending upon diagnosis. Avoid hot and spicy food. Hope your concern has been resolved. 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 parents are both ill my father was diagnosed with tb meningitis and my mothers cancer came back after beng in remission for 4 years...She has non hodgkins lymphoma. Is there any way where they can so I would take care of them and get paid at the same time? ### REPLY: Hi, Thanks for writing in. Sorry to hear about your parents. TB meningitis is the infection of Tb causing organisms in the covering of the brain. Treatment includes a course of anti TB medicine for months with .  Most people make complete recovery with treatment and good patient care. He should be given good nutrition and supportive care for early rehabilitation. Non Hodgkin lymphoma is a malignancy of the lymph nodes. Since it is a recurrence, it requires being aggressively treated with chemotherapy and radiation therapy as recommended by her doctors. You might talk to the health service providers and your present employers for jobs which can be done from home and at flexible timings. Since you have not given details, it is difficult to tell which way you can take up a paid job and care for your parents. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is about to have another MRI on his lower back but found the last one very stressing I know you can be sedated but my question is can they do the MRI by putting him in backwards to scan the lower back.   He has large shoulder where he feels he is squashed in the unit ### REPLY: Hi there, welcome to ,.thanks for your question. Yes it would be possible to place him backwards and do the MRI of lower spine. But it would be more uncomfortable than the usual position. With recent advances in imaging techniques it is now possible to do MRI in standing and sitting position also. Such Standing MRI centers are fast becoming available in most of the tier1 cities across the world. And of course there is always the option of MRI under sedation. Hope this answers your question. All the best. Thank you with 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: On July 30th my husband was out side most of the day, it was quite warm, we had been doing some music for a picnic and he was a little active, he is about 300lbs. 6 foot tall. when we were done with the music and putting away the equipment he became dizzy, light headed and felt sick, well ever since then he has the same symptons and he canr stay up for very long, what could be wrong? ### REPLY: Hi, welcome to our site. I am , MD. Read your query. That is a very significant question and I appreciate your problem. I will try my best to answer your Quertle chances are that his fluids and electrolyte status has been disbalance. A good fluid and electrolyte replacement regime may help him. The fluids are important in maintaining the blood pressure. When the fluid is low, one may develop orthostatic hypotension- a condition in which the blood pressure may fall when a person gets up to a standing position from a resting position. It is of course in view that other systems are not involved, and he has no other symptom. Getting an ECG, Echo and FBS would be a good idea. I hope this helps you. Inform the reports mentioned above/if any other, so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. Please do understand that some details could be extracted from a detailed history and examination. Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck. . MBBS, MD (Internal Medicine), CC (Diabetes Mellitus), DNB (Neurology)Consultant Physician and DiabetologistJS Hospital Apollo Hospital, Delhi Baileys Hospital, Noida ### 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 friend of mine told me black seed will reduce blood pressure, cure arthritis and diabetes. If I boil and drink it. my question is, how much dose should I drink? Also, I am on TRESIBA for diabetes. I am also on LISINOPRINE for blood pressure as well. Is it safe to use BLACK SEED while I am these medications? ### REPLY: Hello, I understand your concern. While black seed is widely used as a cure for many ailments, its interactions with most medications have not yet been fully studied. Black seed (Nigeria sativa) is known to lower blood pressure, so combining it with Lisinopril is something to be tested extremely carefully first. I suggest that as you continue taking your recommended dose of Lisinopril, you should keep track of your blood pressure measuring. If the measurements you get are not satisfactory, then you can try and add very low amounts (like half a teacup per day) of the boiled black seed and see if and how much it affects your blood pressure. Keeping a diary with all the BP measurements for easier comparison is a good way to do this. And of course, making amends to your diet, exercise regime and lifestyle is quintessential. Wishing you good health and all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a swollen collar bone have been complaining of neck pain and middle back pain. Also have sharp pain in right chest sometimes. I have an under active thyroid which my dr. doesn t want to treat right now. Why I don t know. I m tired all the time feel dizzy and have no strength. What could it be ### REPLY: Hi, In my opinion, the swelling in your collarbone does not appear to be related to underactive thyroid (hypothyroidism) although all other symptoms are pointing towards hypothyroidism. In my opinion, if you have hypothyroidism then you should start taking treatment for it. For collar swelling, I would recommend X-ray of the affected shoulder. 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: A 24 year old female c/o inability to take a deep breath, feeling somewhat short of breath with minimal exertion.  Desaturates in office 99 to 84.  No fever, not coughing, no wheezing,not anemic, not anxious,feels well otherwise, recent EKG, echocardiogram normal. ### REPLY: Hi welcome to the  According to history anemia and cardiac cause seems first in mind as first impression, but they are not as per history No stress history present, so panic attack seems less likely Hence now do work up for respiratory problem by. -Auscultation -Chest x-ray -Spirometry If specific cause found than treated accordingly Avoid smoking if having habit Take care Consult physician or pulmonologist for examination ### 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, iam a brown skin tone person .male 28 . my problem is i have facial pigmentation frequently appearing . i consult with a skin doctor and they administer a chemical peel over a year. each time when they administer it goes with in a week . but it reappears in a month. is there any permanant solution for my problem . i have a another question . does masturbation or dandruff cause facial skin to get hyperpigmented around my nose and in forehead . iam so worried please help me with this problem. my mail id YYYY@YYYY ### REPLY: Hi, Thanks for writing to us. Masturbation has no role in inducing pigmentation over faceSeborrheic dermatitis can lead to pigmentation over face which us known as seborrhea Melanesia. As far as the recurrence of pigmentation is concerned, you may prevent the same by using a good sunscreen and applying a mild cream like Comic acid, albumin and vitamin C based cream over your face daily. These are safe creams having no ill effect even if used for long. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,Im Vj Iam 13 yrs old, 55 and 53 kilos... iam a badminton player but i stop because of heart enlargement, my mother decided me to quit in our badminton team... Now this year i want to join to our team, so give me an advice on how to get rid of this heart enlargement... thanks! i hope you  may help me ### REPLY: Hi VJ, in athlete heart enlargement is physiological.  It's called athlete s heart, if you have stopped training for 3-4 months, get an echo done again, if your heart is normal you can start playing and with training if it enlarges again, no need to worry as its normal to have dilated in athletes.  I'd there is another cause of dilation then we have to tiger your exertion.  Do send me your 2d echocardiography report and I will guide you exactly about the kind of sports you can pursue.  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: DR,MY SON 15 YEARS OLD. NO FAMILY HISTORY OF WHEEZING. LAST ONE YEAR HE IS HAVING THIS ISSUE.ON TAKING ROMILAST B10  HALF TABLET TWICE A DAY HE IS COMFORTABLE.  CAN IT BE CONTINUED  WILL THERE BE ANY SIDE EFFECTS, OR WHAT IS THE ALTERNATE FOR THIS PLS ### REPLY: Dear FriendWelcome to . I feel taking Dominant should not be the first concern. First concern should be that is he having a Bronchial Asthma, Allergic rhinitis or bronchitis. If yes appropriate treatment would be decided. And if not no point in giving the medicine now. I suggest a clinical examination and if required Chest X-ray and Pulmonary functions test. Be sure, get treated correctly. Discuss with us when you get the reports. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 39 with a family history of heart disease...with that said I have been having a dull pain my chest with pressure and a constant fluttering that feels like it takes my breath away for a second.  I have not changed anything in my diet at all lately. I am concerned because of family history and i am kindof afraid to exercise because of it. I am 6 foot tall, 178 lbs... ### REPLY: Dear patient thank you for your question If your having family history of heart disease you have to care about yourself... Your just 39...so much is there to do... Here is few heart diseases run in families 1. Arrhythmias, 2.congenital heart disease, 3.cardiomyopathy, 4. High blood cholesterol.  5. Coronary artery disease leading to heart attack, stroke, and heart failure can run in families, indicating inherited genetic risk factors. Don't neglect your chest pain just get it done ECG, Serum cholesterol, blood sugar, TMT, urine examination, Serum homocysteine etc.... Your doctor will advise right medication to you... Meanwhile continue regular exercise, low fat diet, eat green leafy vegetables.... ### 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 Doc... I am geeta from India 31 yrs old.... married and trying to conceive  but no success... we generally have sex on weekends as we both lives in a different city as of now..and meet on weekends.. so this time... my periods started on 13th Sep and ends after 2 days which is 14th by 15th i bleed but lil bit... we had sex on 15th night... are there any chances that i may conceive? ### REPLY: Hello, Unprotected sex just after period over is very much safe and there is no chance of pregnancy at all. To maximize chance of pregnancy, you have to unprotected sex on ovulation day (14 day prior to next due date) or fertile days (12th-18th day of each 28-30 days cycle). You can use ovulation prediction kit in the mid-cycle. Take balanced diet with Vitamin-E & folic acid supplements for 3 months, avoid mental stress and take sound sleep. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have a lisfranc injury happened 14 weeks ago just confirmed injury this week with consultant. He said this it is mild but would require surgery, I believe it is the ligament. He said that if we do it now he could use 2 screws after scraping the bone or if I wait 3 or 4 weeks he would have to fuse the bone. What should I do and what is the difference i.e. the long term outcome. Would a few weeks make so much difference. Thanks Anna ### REPLY: Hello Anna, Lisfrank injury is dislocation of foot bones, and it is not a soft tissue injury. It needs to be tackle as soon as possible. And your doctor is right in thinking that it may need screws fixation. So I would suggest you to go for this surgery as soon as possible.  Delaying this make this problem more problematic. I hope this answer will be very 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: HAD A TRANSVAGINAL SCAN TODAY A 1ST SCAN WHICH REVEALS AM 6-WEEKS PREGNANT( I THOUGHT WOULD BE 8 WEEKS LAST MENSTRUATED AROUND 16TH DECEMBER) BUT THERE WAS NO HEART BEAT OR FETAL POLE AND HAVE STARTED TO BLEED LIGHTLY RED BLOOD INTERMITTENT SINCE YESTERDAY THAT WAS WHY I WEANT TO THE A/E LAST NIGHT THEY TOOK A SCAN AND SAID I WAS AROUND 5-WEEKS AND THIS MORNING THEY SAID 6-WEEKS ANOTHER SCAN SCHEDULED FOR NEXT WEEK ### REPLY: Hallow Dear, The calendar method calculates the period of gestation from the date of last menstrual period (LMP). Actually, the conception takes place about 2 weeks after LMP. Ultrasonography scanning measures the length of the embryo to assess the age of gestation. Hence, in early stages of pregnancy, a lag of 2 weeks between calendar calculations and scan assessment may be observed. Probably, 5 weeks is too early to appreciate the fetal heart activity. Please wait for a week to 10 days more and then get another scan done. If even then the fetal heart activity is not noted and the baby is not growing, it may suggest non-viable baby. In such event, you may have to terminate the pregnancy. Since you are having some amount of spotting, till the status of baby is ascertained, please take some Progestational preparation with the advice of your Obstetrician to stabilize the pregnancy. If the baby is viable and if the babies heart activity is noted, you may continue the Progestational preparation with the advice of your Obstetrician. I hope this will help you. ### END