Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 24. Weigh 100 pound and I m 5 1. I was diagnosed with scolosis when I was ten. Last feb I started getting really bad rib pains which a dr. once told me two year prior that I had sprianed both sides of my ribs. So I thought that maybe it was just sprained again and as it would from time to time. Thie time it was stronger. I was on pain meds for it for months everday to alleviate the pain prob from feb- august. The pain got so bad that I couldnt sit, lay down, and breathing felt the worst. Breathing felt so sharp like someone was stabbing me. I couldnt sleep on my side felt like I couldnt breathe well and a sunking in feeling on the sides. I tried massaging it to see if it was so pain ha. What was I thinking I felt ten times worst. Taking a shower was a mission the pain was intense. Rasing my arms while showering seemed to have helped because there was less weight being put on me. The pain finally feels as if it has gone away. I couldnt do anything when I was like this. I would have to lay down and do nothing so that I could recover. The min I did something got worst. Im a very active person and I would love to go back to that. I havent carried stuff really due to this or been active. Is this my scolosis getting worst or did I break my rib ? ### REPLY: Respected user, HiT hanks for using .come have evaluated your query thoroughly.* There is definite pathology underlying which may be - rib fracture - ligament tear - severe Costco . * Lot many narrations have been there for the severity of symptoms but there is no indication of anything done to diagnosis it !* Strongly recommend getting x-ray chest and further requirement may be of MRI if needed.* Without diagnosis, cure is not possible . So get diagnosis and cure. Hope this will help you. Welcome for further questions. 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 sister just came out of hospital for anxiety and stress she was on meds in hospital to cope but since coming out her speech sometimes gets heavy and her tongue feels heavy also she looks like she is smiling because she can t help it what is causing it just till tomorrow i will take her to the dr but i am very worried please help so i can sleep ### REPLY: Hello The complaints of heavy tongue, slurred speech etc. are symptoms of anxiety. Other features like tremors, sweating, difficult respiration, .  Anxiety is easily treatable. Both medical and psychological treatment are available. Medicines like benzodiazepine, SSRI, SARI etc. are very effective, kindly discuss with your psychiatrist for opinion. Psychological treatment like behavior therapy, relaxation exercise, breathing exercises etc. are main modalities. So visit a psychiatrist and take advice. 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: Yesterday, I thought maybe I had pulled a muscle in my back, but today, the pain is more intense and it is localized just above my belt line on the right side of my back. Could this be a Kidney stone or infection? If it is a kidney stone, is there anything I can drink or eat that might help? ### REPLY: HiT hank you for asking ChatDoctorI have gone through your query. The pain one site you mentioned can be from kidney stone also. A physical examination with your physician can give clue for this. A pain while deep palpation is characteristic for kidney stone. Superficial can be a pulled muscle or strain. An ultrasound examination and urine routine will rule out this. In case of kidney stones if smaller ones . Cranberry juice and barley water is also helpful in alkalizing urine and losing stones. In such case you should avoid excess meat products calcium oxalate containing vegetables and excessive tea or coffee. Hope this may help you. Let me know if you have any further query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have been suffering from a chest infection since mid October. In this time I have been prescribed four different anti biotics ranging from 750 mg daily to 2.5g daily and have been given steriods. The chest infection does not seem to go I have had clear chest X-ray and the iron in my blood was fine. I am in agony with pains in the front back and left side of my chest. Any suggestions ### REPLY: Thanks for your question on . I can understand your concern. Best treatment of chest infection is identification of causative organism and giving appropriate antibiotic according to the organism. For this we need culture and sensitivity report. So send sputum culture and sensitivity report. If sputum is not available, get done bronchoscopic evaluation and BAD (bronchoalveolar lavage) culture and sensitivity report. This will guide you about effective antibiotic treatment. By this way, we can reduce the overuse of antibiotics and so resistance and side effects can be reduced. This will also speed up the recovery. So consult your doctor and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello I was diagnosed with a UTI on Sunday night and given Bactrim. My conditioned worsened so the Dr. Put me on Cipro. I had 102 fever with lower back and side pain. After 2 doses of Cipro the fever went down and the back pain subsided. My stomach is bubbly and distended, the side pain has returned but no more back pain. The need to urinate and burning has gone away. I am also constipated. Should I be concerned of appendicitis? Would the urine test have picked this up? ### REPLY: Hi and welcome to , You should not be concerned of appendicitis.  UTI suffering patients doesn't have appendicitis.  Appendix is not located in urinary tract, to get inflammation.  Do you have abdominal pain in the region of umbilicus associated with nausea or vomiting, anorexia?  Nothing to worry, if necessary please take ultrasound of abdomen to rule out appendicitis.  Wish you speedy recoveryThanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 infection and was prescribed augmentin I have been taking it and started getting symptoms of a yeast infection, I took one day treatment miconazole but it didnt relieve the symptoms so I now have purchased 3 day treatment but at 4% I used it last night but when I used it it seem to make it worse the symptoms do feel a little bit better is this normal ### REPLY: Hi. Thanks for the query Augmenting is an antibiotic and many a time taking antibiotics can cause yeast overgrowth due to reduced resistance to infection as the antibiotics can kill the good bacteria along with the bad ones. This can cause overgrowth of opportunistic organisms like yeast. So it is better to get a prescription of antifungal medications after getting a proper prescription from the Physician. You should also eat more of probiotics like Yogurt and garlic.  Hope this helpsRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an allergy test yesterday.  The scratch test, which consisted of dipping a multipronged plastic device into the allergins and then pushed hard on my forearm, produced large welts on my arm and allergy was noted.  I was given reactin at the time.  The swelling and redness has continued and worsened since yesterday.  I went to a walkin clinic and was prescribed a steroid topical and benedrl which I have used since last night.  The redness and swelling have increased and the itching is unbearable.  Might this be an infection?  The technician was new, I was her first ever patient!  Thank you for your help! ### REPLY: These are TH allergens we inject in body you are exposed to large number of allergens and if you have many allergies the condition become like this it takes 3 weeks to subside allergy when exposed to allergen to which you are you start with doxycycline 100 mg BD for 5 days to counter infection if any continue local application as many times as you want start with antiallergic fexofenadine 120 mg BD for 2 waif not controlled take short house and taper it of oral steroidsdont worry it happens in many cases ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 suffered from anxiety from very early on in childhood many years now and depression for about 15 years now. I have tried many different antidepressant medications . I have recently read about brain scans/imaging technology and trying to find the closest place to me to be treated. We dont have that technology in XXXX. Do you know of any resources to help me find a place with this technology? ### REPLY: Hello and welcome to . Thanks for your query. I'm sorry to hear that your anxiety and depression problems are persisting despite trying different anti-depressants. Though a majority of people respond well to anti-depressant medication, there can be a small proportion of people who do not have an adequate response. Usually in such treatment-resistant cases, the management approach first involves investigating for any causes for treatment resistance. Common causes include recurrent or ongoing stress, personality issues, or even certain medical causes, like thyroid problems, certain vitamin deficiencies, etc., which can cause treatment resistance. These complicating factors have to be looked into and treated appropriately, in order to improve treatment outcome.  Don't get frustrated or dejected since there are still many treatment options available, like trying a combination of anti-depressants, thyroxine supplementation, augmentation the anti-depressant / antianxiety medication with other psychiatric medication like an anti-psychotic or a mood-stabilizer, etc. When medication is ineffective, psychological therapies like Cognitive Behavior Therapy (CBT) can also be effective. Regarding, your query about brain scans. Imaging techniques, you must understand that these are only diagnostic instruments and have no therapeutic role. However, there are certain treatment methods like Transcranial Magnetic Stimulation (TMS), which can be effective in treating depression. So, I would advise you to discuss further treatment options with your psychiatrist. Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was recently diagnosed with an insect/spider bite on my foot by a doctor in Italy. I am now in Greece on holiday. The only symptom is swelling and redness on the foot. Today, however, I discovered a lot of blood in my stool. I have no pain, no fever. Only slight discomfort and swelling in my foot ### REPLY: HI, thanks for using  The spider bite and the lesion on your foot should not cause blood in the stool, the two are not likely related. Blood in the stool can be due to different causes including : (1)as a result of straining and constipation(2) anal fissure, this however would normally be painful(3)hemorrhoids(4)diverticular disease(5) benign polyp in the colon(6)cancer of the colon(7)infection(8)Crowns or ulcerative colitisExamination of the abdomen and anus, analysis of a stool specimen and imaging may be needed to identify a cause. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: ok for the last three days i have been having anxiety to the point where i cant sleep.  I began taking more vitamins and a,b,c,d,e, b complex, this is in one small pill.  I started taking omega 3,6 and 9 and this has provided great relief but in the day time a foggy headache that comes and goes.  I think its hypertensionwhat can i do to get my pressure down even further i am not a big fan of pharmicuticals ### REPLY: Degree understand your concerns went through your details. I can understand your feelings. Please understand, anxiety is not related to lack or deficiency of vitamins or minerals. Anxiety is simply due to external circumstances and cognition or perception. Your condition needs to analyze. Are you stressed? What could be the reason for your anxiety? There are many questions needs to be answered by you. If you think, you may have hypertension, you should immediately consult a physician for treatment. Treating your hypertension or anxiety yourself can do more harm than help. You may post a detailed question here with all the details of your anxiety, or you may consult a psychologist for treatment. 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. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had my last period on March 7, and as of right now, I am 8 days late.All home pregnancy tests have come back negative. My period on March 7th was my first in over 2 years due to a pregnancy, and then nexplanon insertion along with breast feeding. I am having some pain in my abdomen, but not what I would call severe pain. I have had 2 ectopic pregnancies in the past, one in each tube. My left fallopian tube was removed after my second ectopic. Do you think I should be concerned, or do you believe my body is still just trying to adjust after all of the hormonal changes of the last few years? ### REPLY: Hello.thanks for trusting the  doctors for your health related queries. Firstly I want to tell you that delay menses having many causes, one of the most common causes in your age is pregnancy, but as u told that it UPT is negative then pregnancy is ruled out. Delay in menses having many causes like endocrinological and pathological causes in the body mainly in ovaries, one of the most common cause of PCs (polycystic ovarian syn . As per your information ectopic pregnancy can also cause irregular menses, so don't worry, relax. With above discussion u can try out my suggestions-1. Relax, menses will be regular with time, u can wait.2. If u r in hurry then visit nearby gynecologist. He/she can help you. Good luck regards-  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had my wisdom teeth removed about 3 months ago. Lately the (healed) spots where my bottom two teeth were have been sore. Last night I noticed something hard and white protruding from the surface of one of the spots. Thinking it was just a bone fragment, I tried digging it out..  It seems too big, and deep to be a bone fragment, and I couldnt get it to budge in the slightest. It doesnt hurt (only the gums around it), and feels just like bone. Utterly confused. ### REPLY: Hello, Healing often occurs months after an extraction. Bone can become more prominent as the tissue heals and shrinks around the extraction area. Possibilities most likely include either a fractured piece of bone or root remaining that would act like a splinter causing inflammation around the tooth or trauma to the tissue at the extraction area. If the piece is large or deep, this may explain your experience. Consult your dentist and obtain an X-ray for a diagnosis. Rinsing the with warm salt water and keeping away from the area while sticking to a softer diet will give the area a chance to heal if trauma is the cause of your discomfort. Tylenol or Advil can reduce inflammation. Try not to irritate the area further and if symptoms persist or worsen, consult your dentist for treatment recommendations. Hope this is helpful and you feel better soon. Thank you for your inquiry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 2ND  SGPT test result this month is 68. I am female, 51 pounds, 5 ft and 3 inches in hieght, 47.5 years old.  I am worried about my SGPT test result.  Need your advise what needs to be done.  Are there medicines for these? What food should i avoid.I just have my fissurectomy/spincterectomy last September 2010, colonoscopy last Feb 2010, and TAHBSO and hemmoroidectomy last January 2010.  I am currently taking remifemin 20 mg 2x a day and taking c-lium during breakfast as i am constipated.  My procto advised me to avoid being constipated due to my bleeding of my spincter.  until now, if i move when constipated, bleeding occurs on the first wipe on the tissue paper.I am not an alcohol drinker.  I drink rarely before but  only small amount. ### REPLY: Thank you for posting your query. You need NOT worry as its a1.  MILD increase in the enzyme level and 2. IF your Epic viral serology is negative and Lipid profile is normal.it is may be due to use of a medication, or maybe a false positive result. Your advice:- LOW or fat free diet should be followed-Moreover, less activity should be carried out (no sports). - use lemon juice (lemonade) once in a day-recheck liver enzymes after 4 weeks. If level continues to rise, visit a hepatologist asap. Wish you good health. Further queries are welcomed. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .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: Hi Doc! My x ray result is questionable opacities seen in the right upper lobe. Heart is not enlarged.Diaphragm and sulci are intact. Bones and soft tissue.Outline is unremarkable.Interpretation Questionable opacities, right upper lobe. Suggest lordotic view for further evaluation.What does it mean Doctor? ### REPLY: Thanks for your question on . Normal chest x-ray is taken in the PosteroAnterior (PA) view. In this view apical positions of the lung are overlapped by bony structures like clavicle and first 2 ribs.  So any lesion in apical part of lung is not clearly visualized.  So proper reporting is not possible. To overcome this lordosis view is needed. In lordosis view x-ray is taken in such a way that bony structures will not occlude apical parts. So better visualization of apical area is possible. And due to this better reporting of the lesion is possible. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my name is kathleen I have found a pea size hard unmobile lump on the left side of neck and its also round. Been having alot of neck pain along with headaches its about two fingers above collor bone some times if i press on the lump it gets alittle pain full it seems like its near the musel. I had breast cancer a year ago called her 2 new they said that my cancer can come back with in a year or two and it can go to the lungs liver or kindeys. iam 53 years old should i be concerd? ### REPLY: HI, Dear -Kathleen. Very Good Morning from India. Thanks for your query. I understand your concerns. I studied your query in depth.-I would advise you not to worry. In my opinion its -mostly an infective lymphadenitis, as it's far from the breast. If it had been -CANCER REGROWTH-it would have been hard but painless-at the pea size stage, but being painful, its mostly infective lymphadenitis for SURE.-Treatment- a-I would advise-Tb-Antibiotic for 5 days time with Tb-NSAIDs, The pain would go and swelling would reduce in 5 days time.-b- If it persists and does not regress with Antibiotic treats-then FDG PET scan guided-FNAC Biopsy of that Lemonade would fix the cancerous nature of it.-c-PET scan would also study the spread all over body- and would rule out the cancer fear and would relieve you.-Oncosurgeon-consultation would be of a lot of help to you.-Hope this reliefs your worry-some query. Welcome for any more queries in time to come. Have a Good Day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i recently had reconstructive shoulder surgery after a broken humerus below shoulder joint, the dr put unconventional metal implants in the shoulder to try to shore it up i guess,before i left the hospital recovering from post op pain I began having wide spread joint pain in totally unrelated areas, ie both hips an old femur repair in left leg, my lower back (old compression fracture location and scoliosis in thorasic spine due to old car wreck) my buttocks right thigh muscle, calf muscle, knees, cramps in totally unrelated parts of body, It has gotten so severe I can barely function and am now in nursing facility at 60 yrs old no longer ambulatory in severe pain all over, this had to be caused by the referred problem of the shoulder surgery, im not aware of what type of metal implant but also causing muscle atrophy im totally lost as to what to do, I approched orthopedic surgeon who did the shoulder and ask him for help and he said i was not a good candidate for further surgery or proceedures could this be infection, allergy what. Please if you have ever encountered anything like this give me a straw to grasp my life is essentially over at this point due to severe pain and very limited mobility, please help if you can thank you Kirk R. ### REPLY: Hello, I have studied your case. Impingement can lead to tear of rotator cuff muscles. It can be rotator cuff injury which may need MRI for confirmation. If MRI shows severe impingement or rotator cuff tear then arthroscopic shaving and repair will help. You can send me your reports so that I can help you better. Medication like tender and analgesic will reduce pain; you can take them consulting your treating doctor. You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case. Strengthening exercises according to MRI report will help in early recovery. You may need to take rest for early healing. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take disregards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, 3 days ago I got a tooth extracted. My face was swollen as soon as I walked out if the dentist office & hasnt gone down since. I now have a red rash on my cheek, its hard & hot, & my extraction site is painful. I have already figured out that its infected, but since the office is closed for 2 days, what can I put in it to minimize the infection? I use salt water already. Is it safe to use Dr. Tichenors or clove oil? I dont want to make it worse, but I need to try something since I still have 2 days before seeing a dentist. ### REPLY: Thanks for using . Read your query. The symptoms which you are depicting suggest that there is an infection in the mouth which would require antibiotics.(you have not mentioned whether you are on any medicines right now). For the pain you can take Tab Ibuprofen (if you are not allergic to any medicines). Cap amoxicillin 500 mg Three times (if not allergic) and tab Metro lag 400 mg (I would advise you to call your dentist and start the medicines). Continue saline gargling. Do not apply hot bag on the cheeks to relieve pain. You can apply an ice bag intermittently. Visit your dentist or any hospital and get it reviewed as soon as possible. Hope this was useful. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have been to the doctor five times in the past year for sinus infections. I went two weeks ago feeling sick again, this time my legs felt weak and lymph nodes on neck swollen. He says it sounded like a virus because my throat was raw. I have finished the steriod pack and still antbiotics. I had a knot come up on my lower jawline and its immovable. Yesterday, I had one come up on my esphagus and one come up at my cheek by my right ear. Back in October, I noticed a hard knot, immovable, under the skin, attached to my skull, on my forehead. The doctor told me tokeep an eye on it but I want to know what it is. It doesn t hurt and feels smaller at times but is not going away. It feels hard like bone. Since I don t have insurance my doc doesn t want or feel the need to do blood work. Please give me advice. I am 29,with a 9 year old daughter. ### REPLY: Hi, Dear thanks for the query to  virtual clinic. I studied your query in full details updated from you. I understood your health concernsBased on your query data, In my opinion, Dear You seem to suffer from Frontal Muscle in early stage. Repeated history of sinusitis is the cause for it. Treatment-Would be to get the X-ray Skull and Check with ENT Surgeon. He would do the endoscopic decompression of this muscle under antibiotic cover, as if not done would affect your vision and more complications with it. Hope this reply would help you to evaluate your case and treat it with your doctors in time to come. Hope this would resolve your query and worry and Anxiety accompanied by it. Welcome for any further query in this regard to ME. I would love to help you out.Awaiting any further query. Wish you fast recovery from this intriguing health problem. Have a Good Day. . N.M.S. Genl-CVTS -Senior Surgical Consultant ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, of 15 years, whom I recently discovered has had not only an affair with an old girlfriend, but also signed up for an online, romantic dating network, initiated sex with me, and there was a bump at the tip of his penis, next to his urethra opening. Im nervous about std. How do I know if he is infected? ### REPLY: Hi thanks for contacting ... Here your husband can have STD as having extramarital relation.... Still examination of swelling needed for giving more opinion .... It could be wart like infection from human papillomavirus or can having condyloid like infective condition ..... Serological testing can be done for it .... Urine also should be examined for pus cells ..... If discharge present from urethra it could be gonorrhea or chlamydia like infection.... . ..... Avoid excess spicy foods .... Consult physician for this ... Take care .... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have abdominal pain, did s pelvic scan.The report is as follows :Bulky retroverted uterus with AP diameter of 5.2cm,endometrium is expanded with thickness of 18.6mm.No fibrod,cysts or cysies found.Ovaries myometrical textures are normal.Uterine outline regular.Adnexea free,pouch of douglas free.Abdominal pain still severe. ### REPLY: Hello, Thanks for the query. I have gone through your ultrasound report and I can understand your concerns. As per your scan report, there is no fibroid or other masses are detected. Your uterus is slightly enlarged and bulky. The only thing that concern me is your endometrial thickening. The wall thickness of uterus is increased(normal being 11 mm) to 18.6 mm. You don't need to worry too much regarding this as it is quite common among in middle-aged women. You may require a dilatation and curettage followed by a biopsy to rule out some diseases. I suggest you to consult a gynecologist and get evaluated. 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: Me and my boyfriend have been together for almost five years and are ready to start thinking about having kids, however in the past we have not been careful and have never used protection. I have never gotten pregnant and according to a couple doctors I have a severely tilted cervix. How can I increase my chances of having kids, or what can I do move the process along? please, help. -Katelyn ### REPLY: Hi, A tilted uterus, also called a tipped uterus or introverted uterus, is a normal anatomical variation. It shouldn't interfere with your ability to conceive. In most women, the uterus tips forward at the cervix. About one in four women, however, have a uterus that leans backward, or tilts, at the cervix. In the past, it was thought that a tilted uterus may contribute to infertility. But experts now know that the position of the uterus doesn't affect the ability of sperm to reach an egg. You and your hubby also need thorough evaluation for not getting pregnant. Most important test is semen analysis. Thank you for choosing . I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well. Please do not forget to accept it. Thank you, Wish you good health. .  .com/doctors/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir, Recently I have gone medical checkup, it was noticed that Liver size is normal with increased echopattern. The IHBR aree dilated. No focal SOL is seen. Portal vein is normal in callibar What it means, what are the symptons normally we see in this regards. what do you suggest, whether is it serious in nature. ### REPLY: HelloIncreased echo texture of liver may indicate fatty changes in liver. It may be due to many reasons like obesity, sedentary lifestyle, hepatitis,alcohol intake, altered lipid profile, diabetes mellitus, medicines etc. You may need few more investigations like routine hologram, random blood sugar, liver function test, lipid profile. Other findings in liver are normal. Intrahepatic biliary articles(IRS), portal vein are normal. You should increase your physical activity and avoid fried and fatty food. Fatty liver is a reversible condition. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 27 weeks pregnant i have lots of sharp chest pain in the middle of my chest sharp stabbing like pains mainly when i breath in and sometimes will continue through my right arm into my back this has been hapenening since before i got pregnant so its not a new problem , from my research it seems to be pleuritis and my question is .... if it is pleuritis or some other chest problem is it safe to have a c section with a chest issue? keep in mind i have had pnemonia twice in three years and several resperitory infections ### REPLY: Thanks for your question completely understand your problempleuritis means inflammation in the pleura, that can cause pain definitely but if its pleuritic may be associated with effusion also, cause has to be figured out. Pleuritis can be caused by tb, pneumonia and many other causes. As u r in third trimester of your pregnancy u can have a chest X-ray done after discussing with your bog. Rest and best u can do now is having tablet paracetamol 500 for pain. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 58yrs old and suffering from psoriasis fr last 15yrs hv taken a lot of medicines but could get only temp relief my skin has gone dry with flakes peeling off from all over the body would u kindly advice  medicines fr the same  my ht is 5.9 wht 86kg ### REPLY: Hi, As you said you suffer from psoriasis... I would like to say few things about psoriasis.... Psoriasis is a chronic relapsing and autoimmune disease. You may be having scaly plaques on various parts of the body, scaly lesions on the scalp. Exact cause is not known. Genetic tendency, autoimmunity, stress, . .etc. may be responsible for precipitation and exacerbation of psoriasis. You consult dermatologist for firm diagnosis and treatment. I usually recommend cap accretion 10 mg twice a day along with methotrexate 15 mg weekly in three decided doses 12 hourly...for psoriasis. This may be taken for long time till good response. Blood tests may be done to monitor the treatment. For itching, you may take antihistamines like levocetirizin... Avoid steroid, as there may be severe flare up after stopping it. You may apply mild steroid cream or calcitriol point on the lesions on the psoriasis lesions. You may apply moisturizer to improve the skin texture. She should avoid soap bath for few weeks. And you should be free of stress and worries as that might worsen psoriasis. You might get good result. You contact nearby general practitioner and ask him for experienced dermatologist ....OK hope you got my answer. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have pain in my left part of my stomach area around my left hip and going up slightly it is a sharp throbbing pain, but not disbilitating wish i had spell check on this page. It has been coming and going since Friday afternoon. I do not think it is an appendix because It is on the wrong side of my body. No fever but I am very tired. ### REPLY: Hi. Thanks for your query and an elucidated history. The commonest cause of such intermittent pain on the left side of the abdomen can be due to severe for of colitis. You can have a 5-day course of an antibiotic and metronidazole, probiotic, anti-spasmodic and see the results. If the symptoms are not abated go for colonoscopy and ultrasonography of the abdomen along with the routine blood, urine and stool tests. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: How long does it take the body to return to a normal state after antidepressants with drawl? My Doctor is excellent had we been slowly whining me off prisqic . I get those shocks in the head every few days. when will the shock zaps stop? Doctor is slowly whining me off over a few weeks, Do the zaps in the head cause brain damage ### REPLY: Thank you for your query. Discontinuation syn . These medications increase the availability of happy chemicals in your brain which help to ward of depression and anxiety. When it is gradually weaned off and stopped, the happy chemicals return to its original state. This triggers certain feedback mechanisms and other not so happy chemicals which may cause symptoms till the balance has been restored-usually about 2-3 weeks. Depending on the type (long or short-acting) medication, the incidence, time taken for the symptoms to appear and disappear may vary. Symptoms include fatigue, flu-like stuffy nose/myalgic, vomiting, sleep disturbances, nightmares, jerking movements of particular parts of the body (tremors) and electric shock sensations(as you described it). These are basically nerve signals returning to its premeditated state and do not cause brain damage. If you continue to experience these symptoms after 3 weeks, or you experience severe mood disturbances enough to prevent normal life and routine, talk to your doctor regarding medications which help you ease through the process. Hope this helps. Wish you good health, and please contact us if you have any 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: I have a torn shoulder ligament which I have had extreme pain for several months. After trying Arnica, cold compresses, tens unit aroma therapy and a cortisone shot over 2 weeks ago, which helped a little, but the pain has returned with a vengeance. Hurts so much, I have to drive with my left hand. Can t get appt til next wed and I can t keep my sanity until then and going to a clinic and waiting around to be seen would be intolerable. I have no allergies and have taken pain medication before, no side affects. What are my options? ### REPLY: Hello there, I have read your problem carefully, As you have mentioned torn shoulder ligament, but on what basis you have mentioned this, if its MRI, than which particular ligament is injured? And how did this injury happen to you? And if it's you guess that you have injured your ligament, then this could be a wrong guess. As other than ligament in shoulder joint there is possibility of labrum tear. You have mentioned . The best option available here for you is visiting a Physio/Orthopedic get the proper assessment done (if not done earlier)and get start with physiotherapy treatment as you have mentioned TENS, Steroid injection, but they are not effective on long term. So US therapy, Laser therapy could help you in healing process. Taking painkillers dose will damage your kidney, so wear a shoulder race until you visit your doctor, give yourself some rest. Thanks and regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! Happy new year to all doctors.My problem is I was alright 15days before then I had fever for 1day, followed by cough and greenish expectoration.I had levofloxacine 500mg for 5days with Brozedex cough syrup.Sputum became watery and scanty and cough persisted without fever. I had cetrizine and syrup dextromethorphan & tripolidine. Cough with little watery sputum persisted.Then I had cefixime 200mg bid 5days.But symptoms not resolved.Please give me your expert advice. Thank you. ### REPLY: Hi, Dear,Thanks for your query to . Dear I read your query and reviewed it with context to your query facts. I understood your health concerns and feel Concerned about them. Based on the facts of your query, you seem to suffer from-Chronic Cough? Of 2 weeks period. Remedy-Reduce on Anti-tussives and anti-histaminics-Plenty of floods Zirconia x 10 days time. Blood tests for eosinophilic and Stool for Ova Cyst to rule out worm infestation. Antibiotics would not help if no relief after 5 days course. Shift to above regime. If no relief Review case with your doctor, Who would consult Specialist -Chest Physician-and get Sputum AFB done with IRA blood test rule out any old TB infection in your case. Hope this would help you to resolve your health issues in the best way possible. Welcome for any further query in this regard. Good Day!! . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a friend that has had a headache for about a week now. Along with vomiting, dizziness, and at some points forgetting what they are doing. Such as changing a garbage bag and then forgetting what exactly it is they are doing. Should they be concerned? ### REPLY: Hi dear, your friend who is having headache vomiting dizziness and forgetting. But you didn't mention that such symptoms occur episodically or continuous. If such symptoms occur episodically then think for the seizure as in post seizure phenomena such signs and symptoms occur. otherwise think for some brain related pathology. So first go for MRI brain. And first start with simple analgesic and antacid then see for the cause. Such features also occur in migraine. For that Tab amitriptyline 25 mg HS and also Tab Propranolol 40 mg sustained release. Also Tristan for SOS pain tenement ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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! For the last month or so it feels like I have somthing stuck in my chest. It is in the sternum area, I have also have burping and coughing sometimes. I have had my gallbladder removed and have celiac so I have had many weird symptoms over the past few years. Just wondering if you have any suggestions. ### REPLY: Thanks for your question on . I can understand your situation and problem. By your history and description, possibility of HERD (gastroesophageal reflux disease) is more. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of burping, central substernal chest pain etc. So avoid stress and tension. Avoid hot and spicy food. Avoid junk food.  .  Start proton pump inhibitors and prokinetic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am off my pill and my period has been pretty regular each month. I just had my latest cycle last week..it ended on Friday. To make a long story short, my ex-boyfriend and I ended up having sex Satruday night (he pulled out), Sunday night (pulled out first time, ejaculated inside the second time) and then again on Monday twice - both times ejaculated inside.. is it possible that I could be pregnant? ### REPLY: Hi actually there is a small chance of pregnancy throughout the cycle. But you can take some emergency contraceptive for that after consultation with a doctor. At this time a pregnancy test will not help. You will have to wait for your periods.  If your periods get delayed check a urine pregnancy test. If they come in time, no need to worry about. Hope I have answered your question. If you have any other query I will be happy to help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dr I am on tablet isotretinoin 20 for my acne along with biotin 5 mg. I would like to know what precautions or care I should take to minimise the side effects. I am married and 40 years old.Have a 15 year daughter. No more planning a baby. Applying cetaphil moisturiser and Olay sun screen. Using petroleum jelly for my lips. ### REPLY: Dear Kaavya97 1. Isotretinoin is highly teratogenic(deformation to the baby) , even tough you don't have plans of extending the family, it would be appropriate to use contraception while on the .  In few patients have increased triglyceride and the cholesterol levels, thus if u could take a lipid profile test prior to treatment, it would be of value to you and your treating physician, for deciding the future course of treatment . 3. the rest of the preventive measures that your adopting (detail moisturizer, sunscreen, petroleum jelly) will definitely take care of the side effects 4. In advent of a) depression b) visual problems - please bring it to the notice of your treating physician hope I managed to answer your doubt thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A few days ago I had a series of pricking sensations in my left chest . The pricking has happened many years over the last few years and my jaw is numb and my left arm begins to ache. The numbness and arm ache usually goes away over night. I have called this to the attention of both my cardiologist and neurologist . The cardiologist says he believes it to be nerve related. The neurologist says its not due to the neuropathy I have. The problem here is I have had the discomfort in my arm and some jaw numbness for four days. Any ideas? They both have run several tests all of which were negative. ### REPLY: Hi here we donor know your age as well as other risk factors for heart disease like high BMI, family history, high cholesterol, stress, addictions etc. Considering the nature of complaints it will be advisable to undergo1 blood tests like BSL, Lipids 2 ECG3 Stress test4 Color Doppler study of heart If all the things are with in normal limits, then we can be reassured that this is presently not due to heart problem. Thx ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr. My 21/2 yr old son keeps getting dry cough almost everymonth, it is never completely gone. I have started giving him asthalin inhaler one dose twice a day....but i ononly give him on the days he is coughing more then i stop. is that the right way to give that medication or do i need to continue for few days... ### REPLY: Hi... Thank you for consulting in . Greetings from Chennai. By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever? If your answer is yes for any of the above questions, your kid might be having viral associated wheezing or multi triggered wheezing, and I suggest you meet a pediatric pulmonologist who is near your place. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my uncle is very religious person his married 16 yrs now n have 2 kids, he is nice to everyone but he doubts everything specially his wife n gets violent with her. n after few hours he gets normal says sorry. N persuade her to b normal now she wants that he should b treated so pls help her, is this a disease n can it b treated ? ### REPLY: Hi, Having excessive doubt, suspicion and violent behavior indicate presence of some severe psychiatric illness like delusional disorder. In such cases counseling only, do not help.  Several time excessive alcohol use may lead to similar symptoms, so stop alcohol use (if present). But, do not worry as effective treatment available and seek psychiatrist help as soon as possible. I hope this information has been both informative and helpful for you. Wish you Good Health.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My face feels like its on fire even my lips I took my blood pressure it was 161/89 plus 101 then I laid down and took it again later on it was 160/69 plus 99 I do take blood pressure pills but I was told blood pressure don t do that that a stoke would ### REPLY: Hello! Thank you for asking on ! I understand your concern about uncontrolled BP and stroke risks, but first I would suggest a visit to your doctor (GP or internist) for a comprehensive physical examination coupled with some lab blood tests, ECG and eventually cardiac ultrasound, to determine the possible consequences of your high BP, any secondary etiology, and to judge about your actual treatment strategy. Uncontrolled high BP may justify your clinical symptoms, and even more severe healtChatDoctorplications. So my advice is to run to your doctor for a careful check-up. Hope to have been helpful to you! Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is 64 years old. He has had the persistent dry cough for over 7 months. He refuses to go to the Dr. and if anything was wrong with him the nurses at his work would have found something when they gave him his yearly physical at work. That physical was done last Nov. His father died of a type of lukemia as was his half brother. Should I be worried or not. My husband today told me to quit pestering him. I want to know what you may think. Thank you in advance. Ellen ### REPLY: Thanks for your question on . I can understand your situation and problem. In my opinion you should consult pulmonologist and get done 1. Clinical examination of respiratory system. 2. Chest x-ray. 3.  PUT (Pulmonary Function Test). Because constant cough for 7 months seen in chronic lung infection like tuberculosis or bronchitis. So chest x-ray is needed to rule out lung infection. PFT is needed to rule out bronchitis. And treatment is based on the diagnosis. So better to first diagnose himself and then start appropriate treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI,i am 28 years old and have been trying for pregnancy since last one year. i have taken  fertyl 100 mg (day 2 to day 6) along with duphaston ( day 22 to day 26) for 3 continuous cycles and i have still not conceived...what could be the reasons ? i am diagonised with a poly cystic ovary 3 years back. what is the next step? ### REPLY: Hi welcome to . I have gone through your question. You took these medicines but I would advise that they should be followed with follicular scan to see whether follicles are developing our not. Again I would advise doing histosalpingography SG if not done to rule out any tubal blockages. And also make confirm that POD(polycystic ovarian disease) is not there as it's a prime cause for infertility. Make confirms that your husband has normal semen report, so if not done then get it done. Hope I answered your question. Would be happy to help you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Is it o.k to take doxycycline hyclate and rifampin at the same time? I have just been diagnosed with MRSA. i HAD A TOTAL KNEE REPLACEMENT IN JANUARY BUT THE INCISION HAS NEVER HEALED. FINALLY, MY DEMATOLOGIST TOOK A CULTURE AND I JUST GOR THE RESULTS NOW. ### REPLY: Hi, It is not safe to take these two antibiotics together. Vitamin is one of the most powerful liver enzyme inducers which is given along with doxycycline will increase its metabolism and increase its clearance from the body thus decrease the effects of doxycycline. Contact your doctor for a dose adjustment of these medications or to prescribed alternate effective antibiotics for the eradication of MRSA. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Why is it not good for older adults to take seroquell I have nervous tics which were diagnosed as very mild torrents and took it for years under names Triavil and seroquell but they stopped giving it. I can not take any of the SSRI or other serotonin drugs so I need something for depression and tight muscles and my anxiety. It worked for all these ### REPLY: Hello, and thanks for your question. A good medication for depression for you that avoids acting on serotonin specifically is mirtazapine. This is classically used in older adults, does not act on serotonin directly, and is very effective. I recommend discussing this with your doctor. Please remember to rate and close this answer thread when you are finished and satisfied. In the future, for continuity of care, I encourage you to contact me directly at my private web ad .  After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 read some where that the body decreases in production of a certian chemical which may cause increase in blood pressure in the evening?  Do you know what it is...or can you tell me what may cause increase in blood pressure in the evening? Even on bld pressure meds my bld pressure sky rockets at night. ### REPLY: Hi XXXIX if u have increased BP in evening that is not normal but u should b sure about it n to b sure u have to do few things-is you BP machine is working fine-have you not done any physical exertion before checking your BP- you don't have fever now if everything told above all are not with u and your BP is high in the evening then u have to compare it with the morning BP n do it in a routine n make flow chart with time n date increased BP in evening can be due to-kidney disease -diabetes - nervous system problems - thyroid problems- cardiovascular disease n other contributing factors are:-night duties-tobacco/ caffeine use-stress- anxiety ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, Last three four days my daughter Muskaan Age 1 year 2 month , suffering from fever. Last one month we went doctor he suggest me take sumo medicine. Please told me this medicine will be fine or not if yes, his side effect or not. Thanking you C,S Bhatt PA to GM Rudrapur ### REPLY: Hi dear, I had gone through your question and understand your concern. I don't recommend you to use combination of Paracetamol and Nimesulid(Sumo) to your small child. Sometime this medicine can cause inflammation of intestine with diarrhea, can affect liver and kidneys. I suggest Cal pol (syrup of Paracetamol), it is very effective, but it should be used only when temperature is more than 100F. In other cases, keep her HY . Wishing your baby good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 16 month old daughter is suffering from vomitting and loose motions since past 4 days. The vomitting is controlled by giving her Ondem syrup 4ml twice a day. For loose motions i have been prescribed to give one vial a day of enterogermina, and if motions exceeds 5 times, 2 vials a day. I was advised to start Diof anitbiotic syrup if motions continue beyond three days without any change, 5ml twice a day. we have accordingly given her DIOF syurp in the morning, but immediately after consuming it she puked it out. The no of times she has passed motions today has increased compared to previous two days when she showed signs of improving. The food/water intake is normal, she is active and playing and does not show signs of fatigue. My question is what determines that her infection is bacterial and not viral, as no tests have been conducted before prescribing the medicine. The only details asked was consistency color and odor, which was watery, green and odorless. Do these details suffice to determine nature of infection as bacterial as opposed to viral? My only concern is not to give an antibiotic without being sure, especially to a child. Kindly advice ### REPLY: Hi, Your infant has gastroenteritis (vomiting and diarrhea).  Viruses and bacteria can cause gastroenteritis. In either case without good handwashing technique GE is very contagious.  Bacterial gastroenteritis is usually more severe than viral gastroenteritis (GE). Bacterial GE is usually associated with fever and sometimes the diarrheal stool is bloody. The danger with GE is that the child can become deny .  My recommendation is not to give an antibiotic until a stool specimen is obtained to take to lab for culture.  Then it will be known if she has a bacterial cause.  If there is a bacterial cause for her GE, the lab will also determine which antibiotics will kill the bacteria. From what you have shared, I believe she will be okay without the antibiotic at this point. 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 am a 25 year old male, 5"10, 160 lb, i have a broken wisdom tooth which is abcessed, i went to the er and was prescribed penecillin and motrin, my chest also hurts almost like a pain in my heart sometimes, i have shortness of breath especially when going to sleep, and feel fatiged very often.I have had chest tubes from an accident almost four years ago, could this be from the abcessed infection, what should i do ### REPLY: Hello, You have been informed of an abscessed tooth which indicates an active infection. You must eliminate this infection. Treatment involves a root canal or an extraction. Most likely you will choose to extract a wisdom tooth. You describe a complicated medical history and must discuss these details with your dentist or oral surgeon before any extraction is planned. You are explaining systemic effects of an infection. I cannot rule out your other medical conditions as contributing factors. Continue to take anti-inflammatory medications. You may need an additional prescription of an antibiotic to control the spread of infection. Please do not continue to delay treatment. Rinse and avoid chewing in that location as well. Keep well HY .  Continue to practice good daily dental hygiene. Thank you for your inquiry. I am available to answer additional questions. Please plan a dental visit soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Recently I have been experiencing a dull pain in the center of my chest. I had attributed this to stress. Today I experienced it much harsher and it seems to be effecting my jaw, almost like this pain is causing an odd tingling sensation in my jaw, more specifically near the bottom of my front teeth. I was wondering if there was anything I should be concerned about. ### REPLY: HelloYour symptoms may be due to many reasons like cardiopulmonary causes, acidity,musculoskeletal causes etc. Firstly it is important to exclude angina, and it is important to know your age. You may need clinical correlation and few investigations. You may need routine hologram, random blood sugar, liver and renal function test, lipid profile, chest X-ray (PA view), upper GI endoscopy, ECHO,TMT, ultrasound of abdomen. Further investigations may be advised after evaluation. Proper treatment depend upon findings. 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 Doctor I was suffering from severe back pain and did physiotherapy treatment for one month but without any results.Later another doctor advised me to stop physio and he prescribed me some medicines. After having those medicines I got full relief within 2 days - sudden relief. But now the thing is in morning time I cant walk or stand for not more than 5 mins, but I can bend my body and touch my hands on the floor. What I observed is if I sit for 1 to 2 hrs then I can walk and stand for longtime and in evening time I am able to do excercise like pushup and situp .Kindly please advise me ### REPLY: Hello, I have studied your case with diligence. There can be possibility of ankylosing spondylitis. Ankylosing spondylitis typically involve spine and hips with other large joint also. There is reduced chest function in this disease. Stiffness in spine is increased you have such stiffness in spine? Clinical examination is also required to diagnose it. You can do blood test for HLA-B27 to confirm it. MRI spine will help. If all tests are normal you may need proper exercises and lifestyle modifications. You can consult me at my clinic also. Till time continue medication and physiotherapy. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a cold and have been coughing a lot. Yet for the past day or so, the coughing has been violent, and sometimes I want to cough, but can t, or I get a gag reflex like I m about to vomit. I fear that a splinter may be stuck in my throat when I chewed on a wooden stick around 7 years ago, and it may be making my cough worse. I have never seemed to have a problem with this and somewhat doubt the splinter s existence. I do theorize that if it does exist, it became dislodged by my cold. Is there a way a normal medical exam can check for this? ### REPLY: Thanks for your question on . I can understand your concern. Possibility of bronchitis is more in your case. You are having cough and cold since 7 years, so bronchitis is likely diagnosis. But better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test) for the diagnosis of bronchitis. If obstructive airway defect is seen on PFT than bronchitis is confirmed. And you need inhaled bronchodilators and inhaled corticosteroid (ICS). So better to first diagnose yourself and then start appropriate treatment. Consult pulmonologist and discuss all these. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m a 21 year old female I m 5 5 and about 150 and the last few days I ve had abdominal pain been told its from acid reflex and also sometimes its tender to touch left and right hip bone and I ve had diarrhea all day can someone help I ve had stomach problems for almost 3 years about a year and a half ago I got my gull bladder removed from being almost 80% full of stones stomach pains stopped for a while after that then started up again my doctor just keeps telling me its acid reflex but I m not sure sometimes I go a few days without pain then it starts again then also on my left bottom rib cage there s a knot like thing on it but my doctor said its normal that some rib cages change over time but it hurts and sometimes is sore to touch can someone help or are these doctors right and its all just in my head ### REPLY: Hi, thanks for query. Acid reflux can not lead to pain on hip bones. Frequent abdominal pain along with off and on diarrhea, raises the possibility of Irritable bowel syn . This has got relation with anxiety also. Means when ever you are anxious the problem increases. Take light diet, plan your diet, try some stress relieving technique like meditation etc. Avoid stress if you can. Continue with the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my daughter just turn eight months old and she started with diahrea and some fever and was very fussy. i thought that everything was gonna be fine but now its been almost two weeks and the fever came back and its been almost 2 weeks and her fever is getting worst the diahrea stop but now she has been having diareah for almost 2 or 3 days now i dont know if it is cuz of her teething or if it can be a viral infection? ### REPLY: Hi, Fever and loose stools suggest acute gastroenteritis. Mostly these are viral and need only paracetamol to control fever and fluids like ORS solution to prevent deny .  But since this is the second episode in 2 weeks and its already 3 days now, we may need evaluation and treatment with antibiotics, zinc and probiotics. Kindly take her to your pediatrician. Meanwhile, give paracetamol and frequent sips of ORS solution to prevent deny ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had a wisdom lower right wisdom tooth removed 10 days ago.  It was causing me a lot of pain, so I went to the dentist and he cleaned it out and packed it 3 days ago.  It is still hurting a lot and their are white spots on the gum (on tongue side). Is this normal?  He said the packing should help the pain go away quickly.  This doesnt seem that quick. ### REPLY: Hi. Can understand your concern. As per your query pain caused by wisdom tooth extraction is common finding after extraction of wisdom tooth and not to be worried about it. The white colored skin around the gums may be a healing lesion and not any infected condition if you do not have any heavy pain or discomfort. I would suggest you to continue your medicines as prescribed by the dentist but if you have any pain or discomfort you can consult your dentist again and get check-up done.Otherwise, continue medication and follow other instructions given to you by your dentist. Do warm saline gargles. Avoid hot, sharp and spicy food substances. Hope your concern has been resolved. Take a good care of your health. Get Well soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i am 40 yeas old  my weight is 107 kg and height 6 feet i wore tight shoes due to my foot nail become black i cut half of the nail myself and clean with alcohol that s why my foot allergy increase now i am taking klavox tablet  and applying mebo ointment please reply what should i do ### REPLY: Hello, Welcome to , Looking after the history I would suggest you to undergo investigations like FBS, PUBS, Blood routine, blood culture and pus culture. These investigations will help to make proper diagnosis and based on that we can treat you appropriately. For the present condition I would suggest you to follow1. Keep they are clean and . Donor clean with alcohol but clean with providing iodine.3. Topical application of TB act cream. Based on your investigations we can plan the future course of treatment. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir, me and my gf were intimate a few days ago. it was 3 days after her periods were over. i was wearing a condom and there was no intercourse. she took off my condom and gave me oral sex but i DID NOT EJACULATE. i then kissed her and then gave her oral. is there a major chance of her being pregnant by the pre ejaculate that might have gone into her through her mouth then mine and then into her?? i had masturbated 2 days before this and had peed several times. please help. thank you. there was no semen and only a little bit of pre ejaculate on my lips. ### REPLY: Hallow Dear, Semen can impregnate women only if the sperms from semen reach the egg of woman. The only natural way for the sperms to reach egg are through vagina →uterus → Tubes → egg. There is no access to the egg or reproduction system of woman through gastrointestinal tract. Hence, even if man ejaculates in the mouth of woman, and/or even if she swallows the semen, there is no risk of pregnancy whatsoever. For conception, it has been penetrative peno-vaginal sex with ejaculation. I hope this helps you.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir, my 25 yrs old sister is facing problem like unbalanced walking(she can walk herself),her face is shaking and her head spins sometime.she has long constipation problem also. she has undergone blood, BP , urine test, ecg and MRI ..all the reports are normal.. still she is having this problem for last 10 days.. she used to study late night. i m not getting any clue.... could u pls send me ur valuable advise thank u sir ### REPLY: Welcome to . All reports are normal and still symptoms is there, than it looks to vertigo due to imbalance in vestibule system. It is called Deniers disease is a disorder of the inner ear. Oral Betahistidine 8 mg. will be helpful. Eat good nutritious high fiber diet. Isabel will be helpful to relieve constipation. Avoid late night study, take proper sleep. Keep in touch with your doctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having pain numbness and tingling down both arms, hands feet and legs, mostly left side. My vision goes blurry periodically throughout the day, I have headaches with pressure in ears, and severe fatigue. Every time I eat, which I don t have much of an appetite, I have diarrhea and have a lot of heart burn. ### REPLY: Here there are a couple of possibilities with your symptoms, You have symptoms of numbness and tingling in your hand, arm and feet more on left side of body, also headache, and heart burn after you eat, severe fatigue, as well sometimes blurry vision for entire day. As per this you need to take following steps.1. Check your eyesight and no. It can also cause headache if there is weak eye sight.2. Check your blood pressure and blood sugar. This can be region for headache as well fatigue.3. Visit a euro physician for proper examination for headache issue. If needed to go ahead for MRI scan.4. Visit an orthopedic in case if numbness is also associated with pain in neck and back spine. Orthopedic will do certain physical test and may ask for some more scaling or x-ray and will give you treatment as per that.5. If you always get tired withblittle walk, and it used to be along with breathing difficulty then you need to do ECG and treadmill test for checking out heart health. If there is any issue then visit cardiologist.6. If nothing wrong with heart then heart burn could be just due to acidity and have anti acid tablet as or your physician suggestion. You can also improve your lifestyle by having food at right time and changing food preference ti healthy and balance diet. Also do regular walking exercise. I am sure you will feel better when you follow all above things with proper evaluation and treatment. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am recovering from a severe cold and upper respiratory infection...spent a night in the hospital receiving breathing treatments, prednisone, etc...my cough and congestion has cleared up considerably...i have also quit smoking...my question is will a dehumidifier help or hurt in my situation??? thank you so much for taking the time to read and respond...Pat ### REPLY: Thanks for your question on . I can understand your situation and problem. Yes, dehumidifier will definitely help you. Since you are smoker, your lung defense system is already weakened. In humid air, microorganisms grow faster and cause respiratory tract infection. The incidence is even higher in smokers. Dehumidifier extract humidity from the air and keep it .  So microorganisms are less in  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have been under a lot of stress lately and I ve noticed I bleed when I m under a lot of stress. For example I noticed spotting while I was under stress, then it seemed like my period. Then it stopped like it came suddenly. Then I get stressed out shortly afterward and I was bleeding again that night while I was asleep. Is this normal? ### REPLY: Hi, Welcome to  forum.  As you describe, you have spotting, when you are in stress, or when sleeping.  The reasons may be the anemia, infection, hypertension,etc. Stress may increase the B. P, and there could be bleeding.  I usually prescribe to my patient with such symptoms' fluconazole, cifixime, ornidazole, and hepatitis to correct the anemia and infection.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 17 years old and never touched alcohol. While pain in the abdomen underwent for USG for whole abdomen on 15/09/2017 and there was no stone in the Gall Bladder. At the same time Liver Function Tests were done twice and result were normal for all parameters. Later, endoscopy detected that he was having gastric ulcer and treatment started. Due to his pain in the both back side for the last three months, on 17.06. 2018, USG of the whole abdomen was done again. The USG of Gall Bladder revealed chronic calculus cholecystistis. The Liver Function Test at the same time revealed increased SGOT, SGOPT, GGT and ALP. I am very scared for this rise in Liver Enzymes. Kindly guide. Regards, Debasish Joardar ### REPLY: Hello, You'd need to do a lot of tests. First, they seem to have done the visualization tests such as ultrasound.  Second, the pattern of the enzymes generally means a lot with ALK for being associated with a blockage outside the liver and GGT and OT and PT being associated with liver cells dying off (like with viral or parasite infection). Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My 87 yr old Mom has lung stage iV cancer. One Doctor recommended to take a tablet manufactured by Roch (maybe $100 per tablet) per day. My Mom is very thin as she does not have appetite to eat. My Geriatrician friend advised us not to take the tablet because of side-effects. Palliative care is her recommendation. My question then is that, can medicinal marijuana be used for my Mom to alleviate pain instead of taking pain medicine or for pain management? Thank you ### REPLY: Thanks for your question on . I can understand your situation and problem. Stage 4 lung cancer gives a lot of pain. And pain management is integral part in palliative care. Yes, you can give medical marijuana. You can also try transdermal patch of tramadol. It is also centrally acting painkiller. Its action last for 72 hours. And given especially in terminal cancer pain. So ask your doctor about it. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 29 yr old female. I am having health issues at the moment and schedualed for surgery in 3 days to remove my appendix and right ovary.my concern is my pulse. It has been running between 129 & 180 bpm while laying down. Is this normal and what could be causing it. It makes me dizzy short of breath and feel faint. ### REPLY: Hi, This can be a cardiac arrhythmia like PSVT or atrial fibrillation, in which heart rate suddenly goes up and also suddenly decreases. Blood pressure falls during these episodes and one has dizziness, fainting, blackouts, sometimes syncope. Usually ECG is normal as it is usually done in between the episodes. ECG done during episodes will show abnormality. You will need 24 hour holder monitoring. So visit nearby cardiologist for this investigation. Also, hemoglobin and thyroid test should be done. Ln order to abort such episodes you should try to cough hard. Is there any stress or anxiety associated. Till the time your evaluation is complete, you can ask your local doctor for tab collar LA 20 mg once a day. If none of the above is successful then last option is of electrophysiologist studies which is invasive test which can diagnose and treat the arrhythmia permanently in most of the cases. Hope I have answered your query. Let me know if I can assist you further.  ### END