Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I am a 52 year old woman. For the past 3 years, i am suffering from a nerve pain at the bottom of my foot. It feels like someone is pulling my nerves inside. I referred to many doctors but they said there is no cure for this and recommended orthopaedic shoes to ease the pain. The pain only occurs at the bottom of my feet and is recurring. Could you please guide here? Details: YYYY@YYYY ### REPLY: I read your question carefully and I'm sorry for your chronic pain. In order to speak about future management determining the cause is the first thing to do. Perhaps you have had exams done which you don't mention, like ENG and x-ray. If you don't I think you should. If the cause is related to nerve damage then there are several treatments for your pain apart from over the counter anti-inflammatory analgesics like anti-epileptics or anti-depressants (not meaning you have epilepsy or depression, its just that some of them, are also used for neuropathic pain treatment). When there is nerve compression surgery is another option. If the exams indicate some other because it should be ad . Hope to have been of some help. Feel free to ask further questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Most of my adult life I have had sensitivity to environmental allergies, and food allergies, Recently I have had three reactions.. that may deal with food and latex allergies ... I feel the redness and burning are causing more and more intense pain. I take Benadryl immediately after exposure. Is there anything else besides an epi pin I can use to decrease the pain level. The intensity of pain to the top layer of skin is very off the chart pains. Do I need to take a precaution ...often I do not know if food eaten or environment is the culprit. I firmly believe it is due to latex. I want to keep from anaphylaxis... what preventative measures do I need to have in place? ### REPLY: Hello, I can understand your concern. It seems that you have allergies to more than one substance, and you do not exactly know what substances are acting as allergens for you. Thus, firstly, I would recommend you to go for a blood test for allergy. It will show in results what food and environmental substances are acting as allergen for you and so you can be alert in your day-to-day routine regarding exposure to these substances and avoid yourself from exposure. This is the best precaution you can take. In addition, you can also keep antihistamine such as Loratadine 10 mg (Forfeits) or Cetirizine 5 mg (Exocet) all the time with you so that as soon as the reaction starts, you can take the medicine immediately and control the reaction. Also, if you are allergic to more than one substance that you can be exposed to routinely, you can talk with your physician about taking an antihistamine regularly as hypertension patients take antihypertensives. Always take care to try new medicines and food items. I hope this information helps. Thank you for choosing . Take care. Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been having pressure in the chest , chest pain, left arm pain I have been really tired and went to the dr and was given a stress test showed abnormal but was told by dr that it could be a panic attack they did blood work heart enzymes were normal should d I get another opinion. I have been under a lot of stress lately. ### REPLY: Thanks for your question on . I can understand your situation and problem. Cardiac enzymes are very sensitive and specific in determining cardiac diseases. Since you are having normal enzymes, no need to worry about heart diseases. You are also having stressful life. So possibility of stress and anxiety related symptoms is more. So better to consult psychiatrist and get done counseling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  So avoid stress and tension. Be relax and calm. Don't worry, you will be alright. 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: Hi, I have renal hypertension & FSGS I also have a few UTIs & kindney stones but they were really small only 4mm. Ive had to keep urinating I could easily go 6 times in an hr I have pain when voiding and also in my bladder when not voiding what would cause this? ### REPLY: Hello and welcome to . As a Urologist, I can understand your concern very well. You should've mentioned your age and present medication, so better expert advice could be given.  Your symptoms are like those of an UTI. The kidney stones can be a focus of Otis. Up to 4 mm stones can be flushed out with fluid intake of 12-15 glasses daily. Also, a medical treatment may be taken. You should get a urine routine and culture, micro-albumin,blood kidney function tests, sugar, and ultrasound scan of abdomen done and see your doctor. You may contact me by name, if you've any other doubt. Get well 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: I have had a migraine/headache for over a week straight. I suffer from them & have tried numerous preventatives which I thought were working. I cannot lay on my stomach & lift my head up without pressure. My speech hasn t been 100% lately. I mix up my words, say one thing but mean another & often times I have to stop & start over. I ve always been an awful speller but lately I cannot even sound words out properly to type them and its frustrating. About a year ago I had an MRI done which showed a lesion in the white matter of my frontal lobe. My nuerologist said it was normal. I m concerned that there is more to it. I keep giving my old phone number & zip code when asked & its been a good 5 years or more since those have changed. Is this normal? ### REPLY: Hi, Thanks for writing in. White matter lesions in frontal lobe are seen in many people in the elderly age group. Since your age is not mentioned, I guess you are in your middle age or elderly. The frontal lobes are most severely affected by subcortical vascular ischemia. In this there is reduced blood supply in the specific areas of the brain and these are more abundant in the frontal region. It is not a serious finding and your doctor might have considered it as a part of normal aging changes in your brain and therefore mentioned it as normal. Such findings have been associated with frontal hypometabolism and executive dysfunction. There is reduced nutrition to these parts with decreased cognitive functions and probably speech at times. The memory problem relating to saying your old zip code shows that you have an intact long term memory, but your recent memory is affected at times. Please discuss this with your doctors, and you might like to remember things using other methods like writing down important things on a piece of paper. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Post my appendectomy, my monthly flow was late. I complained to the Doctor and he downplayed the severity. I later had my monthly flow.And ever since my monthly cramps is more severe and the pain is always situated on the right side. (Never the left side). Though not around the appendectomy scar rather its situated on the pelvic bone, just below the scar.Should I be worried? ### REPLY: HIT hank for asking to ChatDoctorI can understand your problem and I would say that the pain because of the surgical scar is very unlikely, If I would be your doctor then I would treat you conservatively with the "Dicyclomine and Ibuprofen 400 mg" twice in day for few days, and it fails to respond then I would ask for further investigation because, right Iliad fossa have many important anatomical structure beneath, so investigation is necessary, but this regime will eliminate the pain, take care and have nice time. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having pain for a few days now under the right side of my ribs and it goes to my back. All my blood work came back normal and my urine sample came back normal. I don t have a fever and I haven t been throwing up. I had pancreatitis two years ago due to alcohol but I haven t drank since then so that would be alcohol free for two years. I had an MRI done on Thursday this week and I went to the hospital today and they said everything was normal and didn t see anything exciting on it. I m so scared because I can feel something is wrong but don t know what it is. When I take advil it feels better but then comes back after. ### REPLY: Thanks for your question on . I can understand your concern. Since all your reports are normal, no need to worry about major disease. Possibility of musculoskeletal pain is more in your case. So better to follow these steps for symptomatic relief. 1. Avoid heavyweight lifting. 2. Avoid strenuous exercise. 3. Avoid movements causing pain and bad postures in sleep. 4. Apply warm water pad on affected site. 5. Start painkiller and muscle relaxant .  You will mostly improve in 1-2 weeks. 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 am a healthy 54 year old male with normal weight and bmi of 24. i recently had surgery to repair a tear in my left lateral knee meniscus from skiing. i had significant swelling and both clear and yellow thicker fluid that the surgeon drained and cleaned up. My doctor suspects gout and is sending out to a lab to test. Can you shed any light on this. i have had some mild pain in my big toes that flares up from time to time. i have also alerted my primary physician. Wondering if i need to be on an antibiotic.thanks ### REPLY: Hi, thank you for providing the brief history of you. A thorough musculoskeletal assessment is advised. As mentioned in history about the pain in the great toe which is on and off. It is true that any once will suspect as a gout arthritis. So a urinalysis is needed to help further. Also, this gout can be controlled by medicine. But in case if the test comes negative, the. it's a something else. Which may be related to the spine. As the L5 - S1 nerve root supply there. Well, you may need an MRI as well. Also, if it is gout then during the time of surgery all the tests are performed, so they would be able to catch that time. But well, for time being, get the test done now, and see if the result comes positive. If not the other option I already mentioned. Regards. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there So im a little concerned here about possinle pregnancy. I have a regular 28 day cycle i had my period june 16th 2015 it finished on june 20 i had unprotected sex on june 22 i was due to ovulate june 28th (according to my ovulation calender) it also said my chance of getting pregnant at this time was medium. For the past few days ive been experiencing slight cramping and pulsing feeling on the left side of my body. I have had a milky white and sometimes clear discharge for the past couple days as well. Could this be pregnancy ? I am just concerned because i had an ectopic pregnancy 2 years ago and im just a bit nervous. My next period is due july 12th 2015. ### REPLY: Hi, How are you doing ? Pregnancy symptoms are very varied, each lady has a different experience. Only way to confirm would be, have a urine pregnancy test on 2nd or 3rd day after your expected periods. If this is not conclusive have serum Beta  to diagnose even the smallest of pregnancy, anywhere in the body. Don't worry, once you have tubal pregnancy, risk of recurrent tubal pregnancy is higher than normal population (8 per 1000), but need not always be. You can still have an intrauterine normal pregnancy. Just prey well, you will do well. Hope I have clarified your queries, do write back if anymore queries the best .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I found out about a week ago that I have a kidney infection and was put on antibotics. Since then I have had sex twice and both times have bleed during sex. I had an ablation about a year ago and dont have periods anymore so I know its not my period. ### REPLY: Hello and welcome to . As a Urologist, i can understand your anxiety. To confirm kidney infection, after examination by Urologist, do these tests :1. Urine routine and culture.2. Blood routine, RBS, creatinine, LFT,uric acid and platelets.3. Ultrasound -PUB or ACTIVE. According to reports, treatment is advised. . If you've any doubts, send the reports to me, as a direct question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a very bad toothache and i took two tremadol 50 mg about an hour ago the pain didnt go so about 15 mintes ago i took two 500mg of co-codamal, the pain is still there slightly. I looked online before i took them and on everything i went on said it was ok to take them together. would there be any major side effects later, or in the morning? ### REPLY: Thanks for your query, I have gone through your query. The severe toothache can be because of the tooth infection secondary to decay. Consult an oral physician first, and later you can start with these medicines. The tramadol is narcotic analgesics, it works well for the tooth pain. But it is an addictive .  Cocodamol is a combination of codeine and paracetamol, which is again a narcotic analgesic. You can take only one of these two tablets not both, because they both belong to same group of  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 many nodules, two of these have been biopsied with negative results  ... (one - 2 yrs ago)  New symptoms have surfaced now although maybe it is something else ... what? ...... gingivitis around several teeth, mouth sores, sore throat and glands.  Also I believe one nodule must be enlarging... What are the throat and mouth sores all about?? ### REPLY: Thanks for your query, I have gone through your query. The gingivitis can be treated with scaling or oral prophylaxis. After scaling maintain the oral hygiene by brushing your teeth twice daily, and you can rinse your mouth with mouth washes. The soreness in the mouth and throat could be because of the authors or herpetic ulcers. Consult an oral physician to rule out above said causes and treat accordingly. The nodules can be rebiopsied and get it examined by a good oral pathologist for a proper diagnosis and management. I hope my answer will help you, take care,. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr., I am 37 week pregnant and this is my first pregnancy. I m having pain in my back and lower, i had discussed with my dr.,but they suggest me if your pain will increase in  that case we will delivery, but my pain didnt increase in between 2-3 days.and now they gave me medicines to stop pain but no more effect after taking medicines. This time i am in pain but not able to understand is this my delivery time or not. ### REPLY: Hello, I had gone through the case and found that normally back pain occurs during late pregnancy due to enlargement of uterine size. If pain is unbearable and also contracting pain in lower abdomen or any kind of leakage like fluid or blood then immediate go to your doctor because this is delivery phase. But you must wait if none symptom is present. Do the deep breathing relaxing exercise. It will be good for the fetus also. Hope my answer will be effective for you. Thanks & Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have severe depression for more than 8 years , and I went to 4 doctors but nothing helped , I live in Egypt and I did not find good doctor , I searched for online psychiatrist but they are so expensive for me , I lately had three suicidal thoughts but I resisted them , please help me find free online psychiatrist or recommend any books or articles that help ### REPLY: Dear, I can understand your emotions. You need to understand your anxiety disorder and suicidal ideation first. Please understand, anxiety is part of your bodies defense mechanism, and therefore it cannot be cured. When you feel excess anxiety due to your own physical and mental overtures, it is called anxiety disorder. Due to anxiety disorder, you are depressed, and therefore you feel despondent, dejected and feel like committing suicide. These are normal. Treatment is management. Because you cannot exist without anxiety and therefore complete anxiety cure is impossible. Understanding the symptoms, accepting the symptoms and learn to live with it, manage those symptoms is the treatment. Even medicines are not required. Psychotherapy, lifestyle changes and relaxation therapy will help immensely. Go to www.excelatlife.com and read articles and hear audio files. Hops this answers your query. I am available for father clarifications. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am a regular runner, but lately have had pain in my left knee. Having felt the knee there is a small lump on the knee cap itself, does this mean anything? Or just paranoia?! I was taking Terbinafine for a nail infection and had read that sore joints could be side-effect. ### REPLY: Hi, Swelling over the knee along with pain suggests bursitis, pain in prepatellar bursitis, (type of bursitis in which there is swelling over knee) occurs while doing flexion or on putting direct pressure over the knee cap. You need to get an MRI done to reach a diagnosis. In the meantime, start doing icing over the swelling, and take some anti-inflammatory medicine, along with prevention of any type of pressure over knee cap. 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: hello doctor,                    three days back i had a bite on my toe from some creature i doubt it was a rat during my sleep at night, i thoroughly checked the part but there was no wound or bleeding...do i need   to consult a doctor or to take any precautionary medicines? ### REPLY: If you are sure that if you are not having any wound or abrasion like lesion at your toe the need not worry about. Furthermore you are not sure about the creature who has bitten you and already three days had elapsed, so it does not have added advantage in going to physician and spend unnecessary fees. If at all you get any symptoms such as fever, change in the color at the site of bight or pain swelling etc. you should seek a doctors help but otherwise no need of that. My suggestion to you is that if you have not vaccinated with tetanus toxic it is advisable to get vaccinated earliest. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 past year I have had what I call funny turns. Without warning i become tingly all over and a feeling of numbness sweeps over me and i find it difficult to speak. I become a bit shaky and then it seems to pass. I can have up to five episodes a day or it can drop to once a month. After an episode it feels like everything has slowed down and i find it very difficult to get my words out & think of the most simple vocabulary. My brain doesn t work quickly and i feel removed from reality. I think these episodes are now becoming more frequent and increasing in duration. I have had an ECG but that was fine.Could you help with a diagnosis? ### REPLY: Hello there, Based on your symptoms you seem to be having TIA(transient Ischemic attacks). Your brains blood vessels are not allowing enough blood through them and that leads you to have episodes that affect different parts of the brain. This can be detected if we can visualize the blood vessels supplying to your brain through a digital subtraction angiography and also a CT to study any areas of low blood supply in the brain. Since these tests are expensive I would advise you to consult a neurologist before proceeding further. Other possible differentials could be focal seizures of the brain or raised intracranial pressure. Hope this helps, Please feel free to ad .  I will be happy to answer them ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 about two weeks and a half weeks into taking the ChatDoctor injections for weight loss when I became very sick. I have been sick for aver three weeks now. I went to my doctor a couple of days ago and my liver count is very high. I have had brown urine, fever etc. I have to go in tomorrow for more blood work and a ultra sound. Is there any chance that the ChatDoctor caused this? ### REPLY: HI, Welcome to , ChatDoctor injections for the indication of weight loss is not FDA (Food and .  You must immediately stop it. Your side effects could be due to  injections. As rapid weight loss along with restricted diet disturbs your electrolytes, give overload on Gall bladder and Kidneys. You must also report these side effects to your Doctor who has advised you to take injections, and to www.fda.gov/MedWatch/report.htmEven if you have above symptoms due to some other illness, In  is contraindicated. I hope I have answered your question. If you need any further assistance, do not hesitate. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Due to the alcohal doctor diagonos on UGI endoscopy on 17/08/2012 me ALD,CLD,PHT WITH ASCITES after that I stop alcohal but due to the some time! use in btw 1100ml acitic fluid was done report on that time my latest LFT report is  Total bilirubin 4.1Direct bilirubin 2.6Indirect 1.5SGOT(AST) 185.3SGPT(ALT) 153.4Total protein 7.6Albumin 4.2Globulin 2.5A.G. ratio 1.64Alkaline phosp 153.4B urea 21.4Creatinine 0.8My age is 46yrs ,othr functions are nrml presently taking livfit and udiliv and sorbiline syprp and aldactone 50mg all both time plz suggest.. ### REPLY: Hi, Thanks for posting your query. I am . You are affected by a condition called decompensated chronic liver disease due to alcoholism. It is a condition in which the liver is damaged, and the liver tissue is replaced by scar tissue. Though in your case it is due to alcoholism, tests for Hepatitis B and C should be done as these are the other common causes. This condition can lead to complications like blood vomiting, black stools, fluid collection in the abdomen called ascites (which you already have developed), leg swelling, altered sleep pattern due to involvement of the brain, kidney failure and infection of the fluid collected inside your abdomen. Hence, you need to be under constant follow up with gastroenterologist/hepatologist. Few tests need to do which include the following -1. HBsAg2. Anti HCV3. Ascetic fluid analysis4. PT/INR5. Upper GI endoscopy need to quit  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 female, aged 23 years. I have been having pigmentations below my eyes from last five years. Dermatologist has suggested melaglow for me and i m using it from last week. How effective it is and is there any side effects. What are the best treatments of pigmentation. ### REPLY: Hello, Thank you for posting on . Dark circles under eyes or under eye pigmentation is a challenging condition to treat. Its seen commonly in people having stressful life and irregular sleep and diet. It's also seen among people having atomic dermatitis and asthma. Sometimes its genetic due to deep sunken eye sockets in skull. Most of the OTC products are not very useful. I would advise you to apply tacrolimus 0.03% ointment at night and AVA RTA eye cream twice a day. Take oral It C regularly. Additionally, a series of chemical peels like arginine, lactic acid etc. from a certified dermatologist can help a lot. Melaglow cream though helpful for pigmentation on face, but I doubt it will be of any help in under-eye pigmentation. Try to de-stress your life and maintain a healthy schedule. Hope you will be fine to Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a mole about an inch from my anus thats been there my whole life, but used to be flat. Its now raised and swollen, has red and tan patches, and today it was bleeding. Im hoping it might have just been irritated but should I go to the doctor? ### REPLY: Welcome to  .1. It's an infection with collection of the pus near the anal region - possible cause could be hair follicular infection.2. It can be treated with a course of antibiotic if normal condition, if complicated will leak and recurrence a small incision and . 3. You should not touch, press, scratch the area, as it will complicate the healing process.4. If any possible clean will antiseptic liquids that will help in heal better and quicker.5. You can't ignore it as it will complicate, ant communicate internally with anus and internally which needs major procedure to treat. Good luck. Hope it helps you. Wish you a good health. Anything to ask ? Do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am having ejaculation within 5 minutes of insertion of penis inside vagina, sometimes it is very erotic and exciting experience so i can not push and wait and act for more longer pleasure. I had undergone circumcision before 5 years. I think it has helped also me and i can have more control than the previous. But still i need to have longer control time in which i can satisfy my wife (as women tend to get excitement slowly and orgasm few times and mostly the male ejaculate before the woman reaches the pick). I would like to controll till the woman reach orgasm or say alteast 15 minutes of to and fro push while acutal intercourse . I also tried sqeeze and jelqing and keegels exercise to have more control ,long size of penis or say thick(mine is 13 cm long).Please give me advise ### REPLY: Degree understand your concerns went through your details. I think the thought pattern and over excitement about performance are causing the troubles. Your penis length is enough. Even a 5 cm penis will be able to satisfy any woman across the world because the pleasure nerve endings are available only up to 5 cm within the female vagina. You donor have to try harder to satisfy any woman. Because thinking about satisfying your partner in itself triggers performance anxiety. There are many psychological methods to keep our attention away from position and delay men orgasm. Diversion technique and squeeze technique are some of them. You may talk to a psychologist online or in person for counseling.  If you still need my assistance in this regard, please use this link. http://goo.gl/aYW2pR. Please remember to describe the whole problem with full detail. Hope this answers your query. Please feel free to post follow-up queries. Available for further clarifications. Good luck. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI, MY BABY IS 7 MONTHS OLD AND I VE JUST STARTED HER ON FORMULA LAST MONTH. SHE DOESNT SEEM TO LIKE FORMULA (AS SHE WAS FULLY BREASTFED BEFORE THIS) HER WEIGHT WAS 7.4KG LAST WE CHECKED (AT 6 MONTHS OLD) NOW THAT I HAVE STARTED HER ON CERELAC, WHICH SHE LIKES IT A LOT, SHE SEEMS TO REFUSE MILK (BOTH BREAST MILK AND FORMULA) EVERYTIME SHE ONLY DRINKS 3 OZ ABOUT 3-4 TIMES A DAY AND WE FEED HER CERELAC ONCE. IS IT ALRIGHT AND IS THE NUTRITONAL VALUE OF CERELAC SUFFICIENT? ### REPLY: Hi... Thank you for consulting in . Your kids birth weight and current weight are absolutely superb. My congratulations on it. At this age you can start giving Carla stage one rice or Nestum rice stage 1 etc. All are same in calories and energy. Only thing is palatability which is subjective for each kid. Other home-made food options will be - 1. Deal and rice well cooked and made into a oatmeal along with ghee2. Boiled apple or banana and mashed into a paste.3. Any made cereal oatmeal preparation with additional ghee added. Remember certain principles like -1. Add one food material / cereal or fruit per week. This will be useful because if he develops vomiting or diarrhea, we will know what to avoid.2. Add vegetables and fruits made into a paste surely to avoid constipation.3. Do not add too much sugar as it may cause diarrhea. 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: 2 years ago during an mri the doctors found a brain tumor. It is a 8x16mm diameter meningioma with homogeneous enhancement an sharp circumscription along the inner table of the left frontal bone. 5 years ago I went through chemo with breast cancer and 25 years ago I had uterine cancer. When I research this brain tumor it says that it should be removed but the doctor is saying that until more of a problem we should leave it alone and do another mri in 1 year. When research I have all the issues that you can have with this tumor and yet the doctor says systems not so bad let s wait and watch. I have been trying to get an answer on a number of issues that seem to just be getting worse and I just keep getting handed another pill. What can I do? ### REPLY: Hello. I have been through your question and understand your concern. Meningiomas are benign conditions and with very slow growing pattern. That is the reason that unless they do not have any clinical correlation, it is better to have a conservative approach with wait and watch strategy. This is because at this point surgery risk outweigh the tumor itself risks. Hope this helps. Wish you the best health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 36 years old men. Since 2002, I am suffering from Fatty liver probelm. In 2007, I underwent the GI Endoscopy and diagonised the H Pylori infection. I have taken the necessary medication for the same. Since last two year I am also suffering form High BP, High Cholestrol and now this week also diagonised with starting Diabetic Glycosylated Hemoglobin 7.3 Glucose 113 mg/dl Total Cholesterol 312 Triglycerides 244 HDL 45 LDL 204 VLDL 63 HDLC Ratio 6.9 SGOT 33 SGPT 61 Blood Urea 26 Serum Creatinine 1.00 Vitamin B12 241 My current ultra sound report shows normal report but with Focal hypoechoic area of size 20X14X17 mm is seen in left lobe of liver. Liver is normal in size (13.4cm) amd shows increaed echogenicity. I am suffering Hypertension, body fatigue, and body pain. No freshness in body. ### REPLY: Hello, Your reports suggest dyslipidemia with pre-diabetes (if sugar level of 113 is fasting value) and low levels of IT B12. Body fatigue could be because of this problem or may be associated hypothyroidism (get your thyroid also evaluated) . You should start taking medications and do the following... Calorie reduction and reduction of weight.(be in your range of BMI) Regular exercisesAvoiding sweets,deep-fried fatty foods, transfats, junk foods like pizzas and burgers and avoid colas. Consume more of fresh fruits and green vegetables. Get few injections of IT B 12 as advised by your doctor. Your cholesterol, high liver enzymes and fatty liver shall be all right in 4 to 6 months time. Quit smoking, if any. Target of your LDL should be below 80 Target of your triglycerides should be below 150 BP should be below 120/80. Keep your fasting blood sugar below 90 Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My testicles and inner thighs have itched for months and nothing cures it anti fungus creme works for while but it comes backs daily have to keep it on there all the time to stop it from itching and some burning what can i do please help it effects my daily routine everyday ### REPLY: HelloYour symptoms may indicate fungal infection. It is usually due to candida infection. You may need clinical examination and investigations. You may need routine hologram, random blood sugar. You may need clotrimazole ointment or powder to apply locally. I also prescribe antihistamines like tablet cetirizine(10 mg) twice daily for 10 days. Try to maintain personal hygiene and don't keep private areas wet. 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 got a minor nail scratch in my arms, caused by my dog, which is not vaccinated. is there a possibility for acquiring rabies?the scratch is not bleeding, but when I first cleaned it with soap and water, it felt a bit painful. then afterwards, it is not painful anymore. is my situation fine? thankyou! ### REPLY: Dear Friend. Welcome to . I am . I have read your query in detail. Furthermore, I understand your concern. If your dog is a Rabid dog, you can get Rabies. However, the bite you had is Grade 1, so you should get Rabies Vaccination done. Keep a watch on your dog. If your dog survives after 10 days, get it Vaccinated too. This is my best advice for you with the available details, if you have any further query, please ask us. Stay Healthy ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was sitting and doing my daughters hair, my foot fell asleep and I didnt realize it. I stood and instantly began walking. On my second step my foot came back down on its topI felt and heard a really big pop. There is no swelling today and I can walk on it. It does hurt when Im Walking, but not so much when Im sitting. And it hurts really bad when I touch certain spots. Is it broken? ### REPLY: Hello, Most probably it is not broken. It needs a more high energy trauma for it to break such as falls or car accidents. I think probably you had some muscle or ligament sprain or tear. It needs some kind of immobilization such as brace or elastic bandage or a boot, though. If after 2 weeks you do not have improvement at all consult a doctor for x-rays and MRI. 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: Hello, I am a 17 year old male and recently I was in the shower and I found a lump on my lower right shaft of the penis. Its skin color and kinda hurts when I touch it. It has gotten smaller over these past couple days. I looked up what It could be and I found lymphocele I think its called. Says it happens after masterbation or sex. I am not sexual active and haven t had sex before. I masterbate about 3-5 times a week. Wondering if you can help me and how to get it to go away or if I need to go see a doctor and get it checked out. ### REPLY: HelloThanks for query. The lump on shaft of the penis that you have could be either a staphylococcal infection of hair follicle or a Sebaceous cyst.However, this can be confirmed only on clinical examination by a qualified General Surgeon. Take antibiotic like Doxycycline for a week . If it does not subside consult surgeon to confirm the diagnosis. He would be the best judge to decide whether it needs to be removed or not. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had a complete hysterectomy 9/3/14 for uterine cancer. 17 lymph nodes were dissected. She is still having lymph drainage every day from 800-1000 cc s. The doctor has shot medication in the JP drain 2 different times (1 week apart, 4 1/2 hrs the first time and about 2 1/2 hrs the 2nd time) but it has not decreased the drainage. She is still outputting so much lymphatic fluid they cannot remove the drain or the doctor said it will cause an absess. Do you have any ideas about what we should do. ### REPLY: Thanks for your question on . I can understand your concern. This is common complication after hysterectomy. Surgery for the removal of lymphatic system should be done in this type of complication. Patient should also avoid high protein diet like milk, milk products (cheese, butter), non-vegetarian food etc. Radiotherapy can also be tried for ablation of lymphatic vessels. So discuss these therapeutic options with your doctor plan accordingly. Hope I have solved your query. Wishing good health to your sister. 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: Only when the temperature drops in the fall, winter, and spring do I get sever pressure on forehead, sore throat , dry cough, and pressure and congestion of chest and lungs. I have seen a neurologist who found no abnormalities but suggested I see an ear, eye, nose or allergy specialist. Antihistamines help. These symptoms disappear in warmer temperatures in the fall, spring and in the summer. Right now my head feels like it going to explode, have a sore throat, dry cough and my chest and lungs feel pressure and congestion. Is this an allergy, what medication can I take, and is this condition curable? Can you make a diagnosis and if I can t see a specialist tomorrow what medicine if any, can I take? ### REPLY: Hi, The diagnosis is possible by skin prick test performed in your forearms skin or specific IGE tested in your blood. These symptoms might be from house dust mites or/and mold allergy which in fall and winter are much more present in the house or other environment, so the symptoms are more severe. The allergy from these allergens can cause the symptoms that you described. Apart the allergy you might have sinusitis, so you should see an ear, eye and nose specialist. The doctor will recommend you an X-ray of your sinuses. Until you have your appointment with your doctor you can take antihistamines, it will help. I hope this answers your query. I remain at your disposal in case further medical assistance is needed.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Help...I am concerned with the quantity of prescribed drugs my 48 year old daughter is taking.  If I list those drugs (10) several for the same thing, will you give me your opinion ?  She has become confused, sleeping too much, dizzy, loses her balance, memory loss.....thank you, a very concerned mom...I didnt realize I had to pay for an answer...I dont have the money..I am on social security..sorry, I wasted your time.. ### REPLY: Hi.First, you won't have to pay  for asking questions at the public forum, so rest assured. You have not mentioned the names of the medicines your daughter is on. If they are psychiatric medicines, a number of them might cause .  More severe side effects might also occur. Please consult the psychiatrist (in case she is on psychiatric medicines) regarding these side effects and consider the possibility of dose adjustment with him/her. 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: Hi I m a 41 year old woman who lives in Sweden. For some month ago I lost feeling on the outside of my right foot . When I touch the side of the foot I can t feel it. Then I started to have lower backpain on the right side of the spine . Sometimes it felt like cold water were running outside my right leg below the knee . Now it started to feels like someone is poring cold water on the outside of my LEFT foot. I m getting scared! What is wrong with me? ### REPLY: Hello, Abnormal sensations or loss of sensations in a particular area of the lower limb which is associated with low backache, suggests pathology of the sciatic nerve or its branches. Usually the pathology originates in the spine most likely disc disease or some other cause which is putting pressure on the nerve and causing the abnormal sensations on that particular area of nerve distribution. The area involved in your case is S1 dermatome. Sometimes loss of sensation in partial area can occur. Better consult an orthopedic doctor and get an MRI of the lumbosacral spine. 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 there,  my husband and son take Lamictal for mood disorders and my son takes Seroquel also.They both have terrible muscle spasms mostly at night and I have read that this is a serious side affect and can be permanent.Their doctors ( PCP and psychiatrists) dont know what to do to stop this...do you have any suggestions? I am very worried about both of them....thanks! Terri well, didnt know there was a charge, cant afford that but thanks anyway ### REPLY: HiT hanks for using  Capital contains Aborigine, and it could lead to muscle spasm. In that case, better to change them to another mood stabilizer that would help to control mood as well as muscle spasm. I would suggest either lithium or valproate. In case, you would try to stop capital, do it gradually to avoid any further side effects. In case, you need further help, you can ask. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have a lump on the palm of my hand,my doctor gave me the name,but I don t remember..she asked if my fingers have lost range of motion,which they hae not...My brother-in law has the same but his fingers have pulled back..what is it called and what percipitates this? thank you.... ### REPLY: Welcome to health care mainly name is . . Palmer lumps can be of different origin depending upon the -onset /duration -features of the lump like soft, firm , hard mobilityconsistencyfluctuation etc. one of the common condition which exists on Palmer aspect of the Hand is Dupuytrens Contractureother pathological conditions include cysts abscesslipomas which are benign fat collectionganglionand off course callus which results from repeated pressure on your hand mostly due to unusual work with tools now how to manage ...your GP will access the nature of the lump and decide whether you need conservative treatment or surgical assessment and management then you will have to follow the directions and treatment accordingly hope this answer covers your question do let me know if anything still now clear 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: NEVERMIND I DID NOT REALIZE THAT THERE WAS A CHARGE. THANK YOU ANYWAY My husband just returned from the Dr. w/these diagnoses for today could you tell me what they stand for? CAD, BMS of RCA Left Ventricle-Dysfunction SYSTOLIC Old Myocardial Infarction--inferior Hyperlipidemia Also, he is having blood work for; BUN/Creat/Electrolytes what does that cover? Thank you, Cindy Robinson ### REPLY: Hi, I am here with trying to explain the terminologies in simple understandable words.- CAD: (Coronary Artery Disease) blockages in blood vessels of heart (coronary arteries)- BMS: (Bare Metal Stent) stent used at the site of blockage for restoring blood flow.- RCA: (Right Coronary Artery) one of the main artery of heart supplying blood to conducting system, inferior (lower) wall main chamber (left ventricle) of heart.- BMS of RCA: Bare metal stent of right coronary artery.- Left Ventricle: Left lower chamber of heart which is considered as main chamber of heart as it pumps blood in to aorta (big blood vessel originating from heart supplying blood to whole body).- Systole: contraction of heart chamber.- Left Ventricle Systolic Dysfunction: It means decreased pumping of left ventricle or decreased blood volume that is pumped in to aorta from left ventricle.- Old Inferior Myocardial Infarction: Old heart attack involving inferior (lower) wall of left ventricle.- Hyperlipidemia: Increased blood level of different types of cholesterol.- BUN: Blood Urea Nitrogen.- Great: Creatinine.- Electrolytes : It includes Sodium, Potassium, Chlorides.- BUN, Creatinine, Electrolytes together represent Kidney function. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 some ovarian cysts which causing the problem in pregnancy. My doctor has advised me for GLYCIPHASE 850 mg daily two tablets. I want to know the side effects of this and how will it help in pregnancy?age:27 yearheight: 5 feet 3 inchweight: 53kgProblem in regular periods ### REPLY: Hi I think you have a PRO problem. In this condition periods become irregular. The glyciphase medicine is given to regularize the periods. It helps in some cases.  Regarding side effects it can reduce the sugar levels sometimes. So you can check your fasting and post breakfast sugar levels at regular intervals. It helps in decreasing the insulin resistance which is one of the causative factor in PRO patients. It helps in ovulation. So it can increase chance of pregnancy. 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: My Dad is 86 and has dementia and gout. He has been on donepezil for a month and started having musical hallucinations. He has been off the med for about 3 days now but is still having these hallucinations. How long does it take for these things to go away? ### REPLY: Hi, I am .  I have read your question and understand your concerns. Let me try to help you Question: What causes hallucinations in a patient who has dementia and gout? Answer : Dementia itself in an 86-year-old male can cause Hallucinations Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. Let me know if I can assist you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a concern and its worrying me, Im having irrititability, concentration and focusing problems, sleep issues, shakiness, feeling like Im blank, having problems remembering things, pain as in hurts to touch me, going to the bathroom more often then normal, I feel bloated, wanting to cry, things just getting all my nerves, feeling dizzy and frankly just weird does this sound like my bi-polar and aniexty level could be out of whack and should I see a doctor about this I have other symptoms as well, but these are the major ones ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. The given description points fingers towards depression. This could also be simple disappointment. Disappointment which arises out of unforeseen life events do bring such symptoms like sadness, irritation, anger, lethargy, lack of interest, lack of appetite etc. Please understand this fact and make sure to introspect. Talking to your friends, outdoor activities and being creative should give you relief. Find the reason for your disappointment and consult a psychologist if need be. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. 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: Hi, i recently got an infection on my vulvar skin. I visited a gynae and she said that its nothing except a skin disease. she has treated me with ointments and capsules. But i would like to know something from you. I went physical with my partner about 2months ago. Though we didnt had any kind of sexual intercourse but we certainly had a contact on the genitals. I couldnt say this to the doctor as my mom was present over there. I would like to know if this has affected me. Also i have masturbated myself many times. Can this be a problem either? About my infection- theres little bumps with white faces which were small but now have grown up with lot of pain. these eruptions are present on the skin joining the labia majora and the minora. also these are present just at the opening of my vagina. But there is no such irritation while urination but when the urine or water touches those bumps. it itches at times. All i want to know is that the possible causes for this infection and also that whether it is affected by my sexual activities and does my partner play any role in this? ### REPLY: Hi, Thanks for posting in . I understand your concern. Infection or inflammation of skin of vulva could be caused due to abrasions caused during foreplay by rubbing the genitals or due to friction during masturbation. This generally happens when there is lack of enough lubrication during the act. Based on its severity, it would cause a variety of symptoms, and some of which you are experiencing. Kindly keep the area clean and hygienic by washing with warm water and mild antiseptic solution. You can apply Aureomycin with HY .  Wear loose fitting cotton undergarments till the infection subsides. Hope the information provided would be helpful. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having right upper quadrant pain on and off. The pain feels almost under my rib where it meets the sternum and at times it radiates to my upper back near my scapula. Whenever I have this pain my stool is green. Could I have a problem with my gallbladder? ### REPLY: Hello Right sided abdominal pain may be due to many reasons like liver, gall bladder pathology, renal pathology etc. It is also important to exclude cardiac and musculoskeletal causes of pain. You need clinical correlation and investigations like routine hologram, random blood sugar, liver function test, renal function test, urine RE/ME, ECG in all leads, stool RE/ME and ultrasound of abdomen. Upper GI endoscopy can be done if needed. It may be related to dyspepsia. Proper treatment depend upon findings. 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 had really bad pain in my stomach, kind of in the middle in between where the rib cage starts.  It woke me up at 4am, i couldnt stand straight.  On our way to the ER, as my wife was backing up i felt something, cant really explain it, maybe when something unglues itself, and it went away.  The day went by and it was pretty painless, but now if i press on it its pretty sore, not sure if its still there or its just sore from whatever it was.Ill be glad to provide any other needed info,Thanks in advance ### REPLY: Hi. Thanks for your query. Noted your history of bad pain in the stomach, in between the rib cage, which woke you up at 4 am, and went away suddenly. There is still soreness on pressure. I would advise you the following in such a case:X-ray in the standing position. Barium meal for stomach in head low position. This is so as there is a possibility of gastric volumes or intestinal obstruction or internal herniation and so on. You really need a proper clinical evaluation, examination and investigations to get a correct diagnosis as there is always a chance of recurrence. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 injured my shoulder by falling on it in a rugby match,my shoulder was numb with a burning pain. It was like that for weeks. Now after 2years when i tried to lift some wieghts in the gym i realised my shoulder is very weak and there is little movement on my collarbone where it meats with my chest. What can i do to get my shoulder stronger and how long will it take. I must say there isn t any pain . ### REPLY: Hello, Welcome to the magical world of health care, I went through your query, and I feel you have developed neural weakness in your shoulder, in such cases, the effect of improvement is time bound, and you should see your doctor at the earliest, because if the critical time is lost than things will not be in your control. The problem could stem from, spine or the nerve, but that can be made clear only by examination. I hope my advice would have been useful, in decision-making regarding your treatment, still if you have any clarifications or doubts feel free to contact back. I hope a 5-star rating if you feel guided in your treatment, 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 was immediately diagnosed with malaria after having no appetite n vommiting and alt levels raised to 210mg/dL. after a day the lft was repeated n it showed an increase to 1410mg/dl. after two days the test was repeated n it shows 1040mg/dl of alt. how can i help decrease it fast as itis causing severe nausea and vomitting. ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. You are possibly suffering from malarial hepatitis, which is the reason for the increased ALT levels.2. The nausea and vomiting is at present due to liver damage and once the malaria or other cause for hepatitis is evaluated and treated, you nausea and vomiting will come down. 3. ALT level to fall will take 3-4 weeks. The symptoms of nausea and vomiting will reduce once the causative agent is removed. Liver biopsy is necessary. Avoid taking alcohol or other hematologic .  Watch out for anti-malarial  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been on my birth control for 6 months now (gildess 1.5/30). I have been talking it around the same time every day (8:30-9). Last month, I had light bleeding during my active pills the week before the placebo, but no bleeding during the placebo. I have never missed a pill and I just had sex with my boyfriend two days ago, but he did not ejaculate in me, am I pregnant? And will the time frame increase my chances of pregnancy? ### REPLY: Hello dairy understand your concernThere is no chance of the pregnancy as you are on the regular use of the birth control pill. It is highly effective in preventing the pregnancy. It has just 0.5 -1% failure rate. Mild bleeding could be due to birth control pill only. So do not worry, it will not cause pregnancy. Take pill regularly at the specific time by putting reminder in the mobileAvoid stress, take healthy diet, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 blood fluke infection which was finally diagnosed this week at for almost two years I have fought and been improperly diagnosed by three derms one infectious disease doctor 4er visits and  a reumatologist and finally if it were not for my pain management dr i was about to end my life.i had spent for months of2012 in M iexico with my family making the new film with Robert Redford . My wife and I met in LA but live in Florida with three kids.The disease has almost killed me. I had open sores on my lower legs and both my fore arms and on my scar fro a hip transplant,which is loose and needs a revision but that is another story.As I said the nerologist saved me the truth is i saved myself i went on a juice fast on the30th and only ate garlic two cloves aday on sat jan 4 i passed live worm and one started to come out a lesion on my arm on monday the 5th i gave quest stool samples i had purchased a microscpe and first thought was hook worm the  reality of blood fluke came apparent on thursday night i got a perfect specmen from my arm.my doctor started me vermox which we found unavailable and put me on albenza 200mg twice a day today i have read about praziquantel and its one day use for blood flukeworms Should i have him switch or could i take both.? ### REPLY: Welcome to ChatDoctorI have read and understood your query Hope it may helpPraziquantel is the most effective treatment for blood fluke infection or schistosomiasis.However, as are concerned a lot because of so much delay in your diagnosis, you can take both. It won't have any adverse effects. I will be happy to know if it was helpful. You can approach us anytime with another queryRegards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 aunty underwent a cardiac surgery ( valve replacement) 3 months ago. All her health issues got recovered. She was perfectly alright after surgery. But for last 1 month, problem came by another way. She is suffering from severe sleeping disorder for more than 20 days... even after taking heavy sleeping dose she is not sleeping. she is not able to rest her head in the bed even just 5 min. how to get over this problem? which doctor i can contact in chennai? ### REPLY: Hi, I understand your concern and would explain that it is important to differentiate between heart failure and a sleeping disorder, which can mimic this clinical situation.  For this reason, I recommend consulting first with her cardiologist for a physical exam, a cardiac ultrasound and NT pro BNP levels. It is also important performing pulmonary function tests and a chest X-ray study in order to exclude a possible lung disorder.  If all these tests result normal, I would recommend starting mirtazapine in low doses in order o help with sleep and anxiety. You should discuss with your doctor on the above tests.  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: We are trying to conceive, I am on ay 49 without a period, but 3x -ve pregnany tests. Last cycle was 45 days, 29 before that, then 3 x 35 before that. Being trying for nearly a year, am 35 yrs old. Ovulation sticks have shown -ve everytime. Had initial blood tests, all normal . Waiting for appotinment for pelvic ultrasound . In the meantime, what can I do to bring my period on? I don t feel stressed, but suspect I am by this whole mess! ### REPLY: Hello. Thanks for writing to us. If the ovulation sticks have come negative every time, then pregnancy is unlikely. The delay in your periods is likely to be due to a hormonal imbalance. You need hormonal tablets of synthetic progesterone to have a with . I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, this month i have came off my pill and had been using condoms instead, until one drunken night, he did not ejaculate inside me. that was last friday and i was due on my period today but have only had a few cramps and no blood.... do u think i could be pregnant and could i do a clearblue test today?? thank you ### REPLY: Hello dear, I understand your concern. In my opinion the chances of pregnancy might be less in your case. Because the intercourse was protected with condom and also the Friday where it comes under safe period. So nothing to worry. The cramps could be premenstrual phase related. Anyway in order to clear the doubt of pregnancy a urine pregnancy test can be done a week after missed period for accurate results. If negative wait for spontaneous onset of periods. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a sharp pain in left chest at bottom of breast line that some times is on right side. It feels like gas Ihave had a ekg and that was good. I have a henita hernia small. I also takenexium for years. If I don t take it heartburn bad.this has sent me to emergency more than a few times over the years. This comes and goes I work out buy running an d riding my bike I am 52 years old and not over weight. ### REPLY: Thanks for your question on . I can understand your problem. In my opinion you are having HERD (gastroesophageal reflux disease) associated chest pain mostly. No need to worry much for cardiac cause as your ECG is normal. For better control of HERD, along with . 1. Avoid hot and spicy food.2. Avoid stress and anxiety.3. Avoid large meals, instead take frequent small meals.4. Go for walk after meals.5. Keep 2-3 pillows under head in bed to avoid acid reflux. Small hiatal hernia can also cause poor control of HERD symptoms. So consult gastrosurgeon and if needed get done operation for hernia. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have just been diagnosed with a kidney cancer - size is 2.3 centimeters - major surgery said to be only option because of previous gall bladder surgery was done horizonally instead of vertically so scar tissue and mesh are problems.  I dont have any symtoms - am 74 years old and everything is working okay. I am very concerned that surgery will fix something that is not broken. ### REPLY: Hi, Thanks for writing in. I am sure your doctors have made you aware of your kidney cancer after confirming diagnosis. Cancers are easy to treat and curable when detected early. You are in a better position to be detected with a 2.3 CMS cancer. Further delay may enlarge the cancer and make the treatment process long and painful. The incision is best decided by the operating surgeon as you already have a scar. 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 I have a malrotataed Kidney on the left side of my body. It was found due to blood being in my urine. My urologist who treats me for incontinence. He has done another scan using lasix and it hurt. Thought I had a kidney infection on the left side the right hurt some. He told me I have a blockage but he is not sure in which one. Or if the left one even works anymore. I am 42 and have MS. So does it or could it still work. I have only had 1 kidney infection my whole life. and thought I had one 6 months ago in my left one but my Family Dr told me it was to high so it must be my back. ### REPLY: Hello and welcome to . As a Urologist, i can assure you, allocated kidney, is only a birth variant.It's not predisposed to infection, any different from a normal kidney. Without seeing your scans or reports, It's really very difficult to comment. However, a lasix scan will cause pain, if there's an obstruction in kidney. MS doesn't cause any infection in kidney either. For my expert opinion, please send all your urine, blood reports and scans, including Ultrasound, ACTIVE/MRU, to me, as a direct question. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello my wife is 21 years old female all of the sudden she got pains all over her chest, sharp pain when she move, breath she cant even hold our 5 month old daughter as her chest really hurt she says..Ramin ### REPLY: Hi thanks for contacting ... If she had history of heavy weight lifting or any unaccustomed activity then pain could be musculoskeletal pain... For which rest needed. Simple analgesic if needed to be given... Avoid strenuous activities.... Heavy exercise restricted. Hot pad application useful... Second physical examination done... If calf swelling present then rule pulmonary embolism like causes... If pain radiating to arm and constricting type pain then angina and ischemic heart disease like condition has to be ruled out... For above condition investigate with....-ECG -echo-tread mill stress test if needed cough and fever like resp symptom associated resp cause searched for like bronchitis and pneumonia by chest x-ray ... Take care. Keeping this in mind consult physician... Hope your concern solved. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been getting heart palpitations on and off over the last few years,never any pain.Blood test showed my thyroid was playing up,however the last few test show nothing.I now in the last few days am having palpitations on and off and also more saliva in my mouth than usual ### REPLY: Hyperthyroidism, that is excess thyroid hormone is the body can cause both palpitation and excess Alive along with increase in appetite, weight loss, sweating. The best way along with S. Tsh which is routinely done to rule out thyroid pathology. Get free T3 / Free T4. They are end hormones and more specific for ruling out excess or decreased hormones. Another cause is anxiety.  Hopefully I could help. Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am Bhagirath Bhandari. AGE 41.Dr prescribe me ccq 25 .because my semen is low.i want to be a father. I take this medicine 80 days.but now my pressure is 100/70.I am very week. I not sleeping in night and suffer anxiety. Please help....now Dr. Prescribe me escitalopram10mg,clonazepam 1mg.can I take this medicine for cure please tell me this email address - YYYY@YYYY ### REPLY: Dear serve understand your concerns went through your details. Clonazepam and Escitalopram both are antianxiety and anti depression medicines. You need to consult a psychiatrist in person for a prescription. 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: Hi,I have asthma  from second hand  smoke. I want to know how to improve  my health and look at the problem inside my body.   I dont know how to explain it any better. ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern, if they know the cause of your asthmatic attack then you better avoid this thing that would be the first thing you need to do and this would prevent the future attack of asthma, as you said this is happening due to the smoking then you need to quit this, most probably you won be in need of medicine, try this, hope this information helps you have nice 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: about a week ago, my son was in his car and he stretched and his chest below the left nipple started to hurt and it was difficult for him to breath fully in and out.  I told him to take 4 to 5 deep breaths to see if that would help if it was gas.  He says that it has gradually stopped hurting as bad, but still hurts some when he breaths and when he bends or stoops over.  He is also coughing, but no mucus.  could he have bronchitis? ### REPLY: Hi there, This could be bronchitis, but most likely this is due to atelectasis, or collapse of the smaller airways in the lungs due to his inability to take deep breaths. I'd recommend he really work on talking deep breaths, which will cause him to cough and will open up his deep airways.  The other possibility is that he has a partially collapsed lung (pneumothorax) which would also cause him to cough. If he continues to have coughing and this is not improving, I recommend he undergo a chest x-ray, which is a good test to show any abnormalities he may have incurred secondary to the car accident. I hope this answers your questions. Please feel free to contact me should you have any further questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have recently got infected by jaundice and my marraige is due next week. i am taking regular medicine for last 3 days and follow a stick diet by excluding oil and fat. how much time will it take to come out of jaundice and what further precautions to be taken after marraige. please advise. ### REPLY: Hi. Thanks for posting query at . It may take few weeks for the jaundice to come down provided your "not" suffering from fatty liver disease or HBV; CV. Though you mentioned jaundice but did not mention liver enzyme values. Usually ALT or AST values higher than "two times the upper normal limit", is considered abnormal (in some countries, ALT or AST values of more than 100 are considered abnormal). Value of AST or ALT greater than 85 or above maybe investigated further. HAV, HBO, CV, Alcohol ingestion and obesity are common causes of liver disease. Advice :- abstinence from "Alcohol" - LOW fat diet should be followed, AVOID junk food and beverages-decreased oil consumption (oily food)- NO red meat-green vegetables should be ingested daily-use lemon juice (lemonade) once in a day-reduce weight if overweight/obese-"recheck liver enzymes after 6 to 8 weeks"any further questions are welcomed. Hope to answer your concern. 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: Hello about 2 weeks ago i noticed just above my cheek bone was sore like it was a bruise but it wasnt. When i touch it is pain beyond pain. I get shooting pains to my eye and a severe headache righ after. Its horriblebut i have tmj also could that be an issue ### REPLY: Hello, As due to inflammation at the TMJ there will be trouble to the facial nerve and this could be the reason for the cause do the symptoms. I will advise getting it examined. Also, there is one more factor which works here is the trigeminal neuralgia which is little different from the facial nerve symptoms, but that also is excruciating pain. Getting it examined by a neurologist will be of advice and sooner medication will be advised. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Last night I felt a lump about the size of a pearl on the inside of my lip. It didn t hurt when I touched it. I pressed it...no fluid came out. It went away but this morning I have a purple bruise on the inside of my lip. What would have caused the bump? ### REPLY: Hello there, Thanks for your post on HralthcareMagic. I carefully read your query and able to understand your point of concern.Don't worries its no a serious issue. I think it is a muscle. Which is caused by accumulation of mucous escape from salivary duct following local trauma. Usually it is painless and spontaneously resolve in a short time. You wrote that you have a brush, I think it is due to local trauma by bite on muscle. Please don't be panic. My advice is rinse your mouth with salted water with help to resolve that muscle. If persist for more period of time than you may consult with a dermatologist for laser treatment or surgical intervention. Hope it will help you. Wish your 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: I am having trouble with the side effects od Blood Pressure meds. (tiredness,lethargy to the degree that it is effectingmy life. Am usually an Up type of person.  Have been on lotrel and diovan.  When I stop the b/p meds I feel great.I am a 71 year old female.  I am also taking singulair and flax seed oil.  I am not overweight and I exercise moderately.Stopped smoking 10 yers ago.  Is there a natural product I could take to lower B/P ???? ### REPLY: Hi Welcome To ChatDoctorI have gone through your query regarding your bpm eds, giving you trouble and without that you feel fine ? It is a matter of concern. I would like to suggest you to consult your doctor immediately to discuss what you to feel & to ascertain whether you real need them, as you know these have side effects should not be continued without relevant prescription. It is good that you are not overt. Doing exercise and taking herbs also.IT would be better that you add a few more things to your regimen .1. Do Panama - Deep Breathing - Inhale -Hold -Exhale - Hold 15-20 times .do Slowly to begin with .2. Calamari - Sit straight in easy position , close mouth, eyes & ears with your thumb , take deep breath Release your breath by humming sound through your nose , Repeat 3-5 times 3. Sit as before, take deep breath, hold & release through your mouth while chanting LOUDLY OU--O-M. 3-5 TIMES .4. Lie down with closed eyes, like a log, hands beside your body. Keep your body loose & mind cool. Lay in this position for 5 minutes All this, & meditation will release stress off your mind leave you mention free. BP certainly goes down. Dietary supplements ingredients may include vitamins, minerals, herbs, amino acids. Which is taken regularly, tend to increase resistance to body from diseases giving strength to immune system. If you take care of your diet, regular exercise and rest . Take balanced diet - fiber, fruit, green leafy veges preferably raw form, include garlic, liner in all meals, coconut water and all antioxidants, Turmeric powder A level Spoon with hot milk. , at bedtime lowers BP, *Olive or olive leaf extract: Some BP lowering effect. Has other benefits such as cholesterol lowering, reducing heart attacks and heart disease, and reducing risk of breast cancer and, odd, rheumatoid arthritis. Potassium: Reduces systolic 2-4 mm and diastolic 0.5 to 3.5 mm. Controls cardiac them. ### END