Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 always been a person who goes to bed around midnight and up at 6 eager to face my day. The past 3 weeks or so, I have felt tired and lethargic. Going to bed between 9 and 10:30 awake at 6. but back to sleep until 8. Getting out of bed feeling exhausted. I am 56 years old. I have recently experienced some lower abdomen issues (cramping and loose stool) That seems to have passed, but the rest remains. I do have a family history of heart issues, as my Father and all his brothers died of heart attacks. ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  You are 56 years old, usually sleeps at midnight and wakes up at 6 am, recently you became tired and lethargic, sleep timings became irregular, You had some lower abdominal issues, cramping and loose motions. You have a family history of heart disease, M.I. At the age of 50+. People will have a decline in hormones level, It can cause tremendous changes like this.  You had stomach pain and loose motions, with these symptoms anyone will get the weakness, for this medication and infusion of the fluids are required, if not treated properly can have such changes.  Heart issues will be presented with different symptoms, so don't worry about it, if you go on thinking about it, you can get the symptoms of heart disease, though not the disease. So try to avoid it.  I advise you to consult a doctor for diagnosis and treatment, with medicines and infusions.  Wishing for a quick and complete recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Need help...my aunt is suffering from blood cancer from the last 2 month hello sir, Actually my aunt is suffering from blood cancer from the last 2 month. The blood formation is not so regular in her body and in every 10-15 days she requires blood,she already visited to VELLORE but DR. told that they are not going to give the blood any more. Right now she is in the hospital(Bokaro general hospital) from the last 8 days...now please suggest me where to go nd how will she become normal in her life again.??? ### REPLY: Hello it is sad to hear about your aunt, but you must know that there is no cure for blood cancer. There are multiple treatment options for different types of blood cancers. Giving blood may not help for long and hence doctors must have decided against it at some stage. With your kind of information it is difficult to predict the course of disease, but all types of blood cancers are bad to have. Any good tertiary care hospital can guide you about the disease and plan of management. Hope this is helpful ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 14 and Im going in for a physical. How much genital hair should I have? And last time my doctor gave me a prostate exam and felt my genitals for a long time and got a sperm sample from me and he was the one doing it then he tought me how to check for cancer in testicles and he did it on him so I saw him naked will this happen again? ### REPLY: Hi, Thanks for writing in. The signs of testicular cancer are the following(i) Increase in the size of one or both the testis(ii) Firm to hard testis on palpation(iii) Painless lumps in the groin which might be lymph nodes(iv) Non-healing wound over the scrotumGenital hair at 14 years age differs in every person, and it is the start of puberty and therefore even a small amount of hair might be normal for you. A prostate exam is unlikely to be done every year in a person at your age. The sperm sample is also not a regular test done in child .  Please discuss this with the doctor and proceed as recommended. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 these episodes that begin when i feel i need to have a bowel movement. I get severe stomach cramps and find it hard to go. At the same time I start experiencing my heart rate elevate as well as my blood pressure to the point I feel as if someone has tied a rope around my neck. My eyes feel as if they are bulging and my ears feel like they are about to explode. I turn bright red from the neck up and the inside (roof) of my mouth becomes numb. This lasts only for a few minutes, some times longer depending on the severity of my cramps. After wards I experience extreme headaches, tiredness and pain. ### REPLY: The answer to your question is not completely clear. A few pieces of information will be needed. Specifically, the episodes have to be reviewed with respect to the timing of the straining that often accompanies the urge to defecate. The description that you provide is awfully suggestive of just that. However, if he is two cannot be tied together, there may be a concern. Your best option is to describe these episodes to your family doctor with special attention to your actions at the time of discoloration and if flushing or discoloration ever occurs without any of the other associated symptoms. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Noticed 1 1/2 months ago a lump on the left side of my navel.  Push on it, but theres no pain.  I have changed my eating habits to small portions, and no useless carbs, and have lost 10 pounds.  Lump seems to be closer to skin, enough to faintly see it, but easy to touch.  Its the size of an egg.  At times, my whole belly seems to double in size after eating.  Feel full often in the mornings and have a sensation of being sick to my stomach. No vomiting or pain. ### REPLY: HI, thanks for using  The bloating that is occurring in relation to your meals and in the early morning may be related to : (1) HERD- gastroesophageal reflux disease, this would be treated by using small meals and avoid fried/fatty/spicy and acidic foods. The weight loss would also help. There is medication available that would help treat HERD. HERD would also cause indigestion and upset stomach.(2)lactose intolerance- (3)certain foods can are associated with bloating-broccoli, turnips, beans, cabbage, Brussels sprouts(4)constipation can also cause bloatingThere are different lumps that can occur on the body, accurate diagnosis would require examination by your doctor who would look at the location, size, shape, consistency, tenderness and the overly skin. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a ongoing health condition for an number of years i was diagnoses with veinous stasis and i am now having a hard time getting around due to this leg condition i just recently had a ultrasound and the results were that i also have a bakers cyst behind my kknee is this cyst connected to this veinous stasis what type of doctor trears a bakers cyst? i was told to go to a rothopediset doctor for this cyst is this the correst doctor to go to see for this??? ### REPLY: Hi, Thanks for writing in. Bakers cyst is a benign swelling in the popliteal fossa (back of knee) region due to collection of fluid in sac like structures (bursa) around the knee joint. They are usually self-contained and appear as a swelling between muscle tendons at the knee joint. On rare occasions the cyst can rupture. Bigger cysts need to be surgically removed, and smaller cysts can be observed for a while for symptoms to develop and increase in size. In your situation, the cyst might be causing pressure symptoms on the venous .  This is mentioned in the report. Your surgeon will examine you completely and then decide on the course of treatment as per your symptoms and after a venous Doppler of your lower limb. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father having Parkinson last 15 Years   he takes Sandopa 275mg (6tablets)  Sandopa c r  (5 tablets)  Ropark  (4tablets) now his Problem is illussion  he  Sees Some One Sitting in our room under the bed People Sitting what we Shoul d   do   he is having  7 0  Years  NO other health Problems ### REPLY: They are called HALLUCINATIONS and not ILLUSIONS to begin with.... Hallucination is seeing something that's not there whereas ILLUSION is misinterpreting something that is present for something else.  In your fathers' case the first thing I would check would be an urinalysis to make sure he didn't have an infection since this is extremely common in elderly patients who do not move very well for whatever the reason.  I might also look to any NEWER medications he's been taking for a short period of time before these HALLUCINATIONS started to see if this could be influencing.  It is not uncommon for Parkinson's patients to have hallucinations but then, this may suggest he could be having a variant of Parkinson's disease as well...or that he may be suffering the earlier stages of dementia which can accompany Parkinson's patients in about 25% of cases.  Please rate this a 5-STAR ENCOUNTER and write to me at www.bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having large itchy red bumps the last three days. They get so itchy swollen and hard and have been itching for a few days. Some of them as big as a fifty cent coin. There are also small groups of them in a bunch that seems to increase in numbers after scratching . In the center of some of them there is sometimes water. ### REPLY: Hello, Thanks for the query you might be suffering from an endogenous eczema. Treatment with oral steroids is required. Oral anti histamines can be helpful. Please meet a dermatologist to confirm diagnosis, Let me know if you have any other doubt. You can ask a direct question to me on this forum, following the below link.https://urldefense.com/v3/__http://www.ChatDoctor .com/doctors/ . 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 hit my head on a steel fence post last week and had to have two stitches. I was told the cut went to the bone. Since then I feel like I have no energy and at times my head feels fuzzy or like there is fluttering movements inside my head. I don t want to see a doctor if it is not necessary. So what could this feeling I am having be? ### REPLY: Hi, Thanks for writing in. Since you had ahead injury and still having fuzziness, it will help to get a brain scan if not done earlier. Please consult your doctors explaining your symptoms in details and ask for a scan if you can get one. Since you had to get two stitches, the wound might have been significant and there can be occasional confusion and fuzziness even with a slight head injury. If your scan is normal and your symptoms persist then you are having concussion injury. This takes time over a few weeks to recover completely. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there Doc im having a problem with std and im taking cefelexin right now, ive been taking it for 18 days now..its not working is there any stronger antibiotic that you can prescribed that i can take it for two days and be free of symptoms...also with my condition gonorrhea is it okay to masturbate? ### REPLY: Hi, thank you for quarry, As you mentioned you are diagnosed case of gonorrhea, if such patient came to me, I will give following medication. Ceftriaxone 250 mg I'm stat dose.azithromycin 1G PO stat dose one injection and INE tablet is the treatment, also educate and treat the sexual partner for the gonorrhea avoid sexual contact. Masturbation is not harmful. Hope the answer will help you. Feel free to ask any quarry regarding your health. Wish you a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello my name is theresa I I was in the hospital lastweek they thought i had gallbladder problems such as vomiting ,diarehha, severe pain in my right upper quadrant and everytime i eat it hurts worse and everytime i take a deep breath it rally hurts. they did a hida scan that was normal my ultrasound said my bile ducket was very inlarged. so they did a endoscopy with a few biopsys they found that i have a ulcer and gastritis and also duodenitis . long story short. how long with duodenitis will it take before the pain stops? its very draining on me its like a knife under my right rib cage thank you for your help theresa ### REPLY: Hello Tammy, Thanks for posting, Per your description of the location of your pain (below the right upper qua .  Since from the scan you apparently do not have gallstones meaning that the origin of your cholecystitis is probably not due to gallstones, your treatment will be purely non-surgical with antibiotics (for infection), low-fat diet (when food tolerated) and pain medications (avoid NSAID) such as paracetamol or better still stronger tramadol or opiate derivatives such as Conan, and it may be associated to antispasmodic medication such as myosin butyl. Also required will be antiulcer medication to treat both the ulcer and the duodenitis such as proton pump inhibitors such as omeprazole and/or antacids. It will be worthwhile to discuss treatment options with your doctor after he is settled with the exact cause of your pain. Hope this helps and wish you 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 was poking my teeth when suddenly a piece of my front tooth yanked-out. At least, I think it was a piece of my tooth. I can feel a whole in the back of my teeth, but you cant see a whole in the front. The piece I pulled out had somewhat of a chalk-like feel to it. ### REPLY: Hello, Thanks for consulting ChatDoctorRead your query as you have broken front tooth from palatal aspect don't be worried so much chalky tooth can be due to condition like fluorous or due to nutritional deficiency. I will suggest you to consult oral surgeon for examination of teeth and go for oral prophylaxis. If this can be restored so for tooth colored composite restoration. Inmeantime maintain proper oral hygiene. Do warm saline rinses 2 -3 times a day. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello.. This is SOM, male-23yrs from bangalore India. I am having big MAM-Breasts. The overall structure of my body is very good, 5 10 height and 75 KG weight. but onlything is that I have big boobs. I can t pay for surgery, can I go for Gynaxine tabs and simultaneuos exercise??? please suggest me as I don t have any confedence upon me for my cheast (breast-in actual) ### REPLY: Dear, We understand your concerns went through your details. You do not need any medicines. Just engage in physical exercise like jogging, aerobics, push-ups and pull-ups, squats and some weight training. Your chest will become tight. You will have confidence once you have tight and high chest after exercises. 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 detail possible. Hope this answers your query.  Further clarifications are welcome. 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: Hello I have recently come up with a rash all over my body I went to my doctors and all he done was gave me cream for scabbies even tho he wasnt sure what it was. He also suggest an allergic reaction. It seems to be getting worse and recently it is now on my vagina lips and Im too embarressed to go speak to this about my doctor ### REPLY: Hi. It is very difficult to know the exact clinical picture without examination. Is the itching more at night? Are their any other family members affected? What is the distribution of the rash?if the answer to the above questions is yes, then most likely you suffer from scabies. Scabies is a hypersensitivity reaction/allergic reaction to the mite. Apply 5% permethrin cream after a scrub bath at night over the whole body except face, leave it overnight. Itching will persist or a few days even after you have applied the medicine properly. Take an antiallergic tablet like cetirizine once daily for itch relief for a week the condition still doesn't improve after a week or so, then review with your dermatologist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 25 year old female..I am having psoriasis symptoms at starting age of 15.. then i had treatment in allopathy ... then later in homeopathy ..up to age of 17 only . then i quit the treatment. then i only using the oinment Zincoderm-G and Clonit-S up to till date whenever it reappear.i have that psoriasis symptoms at inner hand , inner legs, and above ear .. it creates itching and if i rubb it, blood is coming..how to cure completely... what type of food i want to avoid it.. what are the steps that i want to take.. then my father had same problem.. now i am married. whether it will affect my child when i am pregant.. ### REPLY: YOU HAVE DIED MANY THINGS MUST TRY MY WAY OF TREATING PSORIASIS IT IS DUE TO CONSUMPTION OF FOLLOWING THINGS WHEAT, MILK,CHINA, RICE.EGG, MILK,POTATO GINGERY GET YOUR BLOOD SERUM TESTED FOR SPECIFIC ANTIBODIES FOR THESE AFTER RESULTS JUST POST I WILL Tell YOU TREATING IT WITH SLIT THERAPY FOR PERMANENT CUREMEANTIME STOP ALL ILK AND DIARY PRODUCTS NO USE OF MUSTARD COCONUT WALNUT GROUND Not SODA OIL USE SOAP NIKE OIL AMLA/OLIVE FOR BODY COOKING OIL OLIVE SHAMPOO NEURAL NO CREAMS/OINTMENTS AT THE MOMENT ======================================= 2-3 GLASS OF WARM WATER EMPTY STOMACH AND TO BE REPEATED BEFORE SLEEP AT NIGHTMARE METHOTREXATE 2.5 MGM ONCE WEEKLY DOSE RHINITIDINE IN MORNING TAB ALLEGRA 120 MGM NIGHT DO FOR TIME YOU GET RESULTANTLY SALICYLIC ACID PLUS CLOBETASOL COMBINATION AND ALTAR OINTMENT MIXED WITH PETROLEUM JELLY AT NIGHT ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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,Last night I had an electric shock which I didn t feel, my partner did but once everything was turned off I had sharp stabbing pain on left side of chest and the whole left arm went cold and numb with pin and needles sensation all the way through to finger tips. Arm still hurts today. Do I really need to see a doctor, very tired today but apart from that I feel fine. ### REPLY: Hello, Thanks for the consult. Brief answer, Pain in the chest and numbness of arm after electric shock is due to muscular twitching. Detailed Explanation, 1. I read your query, and I am happy to help you. You mentioned that you had chest pain and numbness of arm after electric shock. 2. Due to muscular twitching during electric shock leads to shoulder pain and chest pain.3. Heart attack pain is usually retrosternal and there are no chances of heart attack unless the electric shock is strong4. Take mild muscle relaxant with anti inflammatory medicines. No need to worry. Hope this information helps you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my sister has been diagnosed with gland TB and is under treatment for about two months but there is no improvement. lately the swelling developed on her back contained some pus which was removed surgically. still she suffers from intense pain. can you kindly advice on further treatments, pleease. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. If the TB treatment won't respond to you with in a two-month period than it must be . I advise you should take the Inexpert test done. This test will give you a result within few hours and let us know the possible resistant amongst the bacteria. If the resistant detected second line of therapy should be adopted and treatment becomes easy and responsive to the therapy. Please take good care of wound created because of surgical exploration of the pus. Do good  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 name is Eddy Somerville. I had a grapefruit size hernia that was operated on Dec.6th. The operation went well, but my scrotum was swollen and it still is. I was told a doctor to elevate the scrotum, but I don t know how. Can you pleaser give some suggestions? Mt email is below. I m on google. ### REPLY: Good Day, and thank you for being with  ! To elevate the scrotum you need to wear tight-fitting underwear to support it. When lying down and sleeping, put a rolled towel under the scrotum, so it will be raised. We do this to prevent edema and fluid from accumulating in the scrotum.  I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.ChatDoctor .com/doctors/ .  Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My right side back having pain since jul-12. I went to doctor he told me that I have problem of kideny stone . Yesterday I gone to some other doctor, and I explaind about my problem that I feels pain when I am sitting in a perticular positioin. He told me that you have muscular problem and advice me to take the following medicin. zerodol th & cyra. Pls advice. Thanks ### REPLY: Hello Surya and welcomes better first to diagnose your disease and then take the requirement treatment according to the disease. In my opinion go for sonography of abdomen to see whether stone are present or not, urinalysis can also help. If that gives you a clear picture than you can start the above said treatment with hot fermentation and local application of anti-inflammatory gels. The treatment of renal stone and muscular spasm is totally different. Other thing which has to be rule out is Lumber spondylosis. Hope I have answered your query. Best Wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my friend recently checked up his heart because he was feeling pain.the doctor said him that he has a hole in the heart which is at a starting age.not to worry just dont eat too many oily things and stop smoking.the hole will automatically repaired naturally.kindly help me please.what to do? ### REPLY: Hello, Hole in heart is usually not treated till the age of 3-4 years if hole is small. In that case, It's likely to get automatically closed. However, in adults it usually doesn't close on its own. If its small then closed by minor procedure through vein and if its Large then needs open surgery. You should take patient to cardiologist for the same. Hope this helps you and get back if you have any doubts. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my name is neha Patel I report my pelvis last month and my report said I have 10 follicles on left overy and 7 follicles on right overy so my gynecologist suggest me few tablet but she did not tell me about this 2 tablet which is ENDOGEST 100 and another one is CCQ 50 and when I try to contect her she is oversease right now so please help me when and which time I have to take this two tablet and one more thing I am not pregnant and my period date is 22 October so please suggest me how to take this both tablet and when I can take this tablet ? Please help me for this problem ### REPLY: HelloThanks for your query.CCQ is camphene which is given to women who have difficulty in ovulating. It is generally taken from the 2nd day of the cycle for 5 days. You cannot take it by yourself. You have to undergo a baseline ultrasound and then follicular monitoring after taking this medication. Endogest is progesterone which is given after ovulation to support the pregnancy in case you conceive.Get in touch with a gynecologist and take the medication with prescription. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi sir my mother is suffering from slip disc problem in her lower back. she is been using ayurvedic medicines for that .since last year she had a problem in uterine system so it was removed and supplemented with drugs nw again she is suffering pain in her back so doctor consulted to take zodone 4mg for hypercalcemia but didnt workout so am confused whom to consult for this. many are telling may be she is affected from TM so wht to do plz help me through this she is aged 47 years ### REPLY: 1. What exactly you or Doctor meant by Slip Disc (Herniated, Ruptured, or Prolapsed)?2. What was the cause of slip disc: Injury, Occupation or Weight?3. Any pain, numbness,tingling, weakness around the damaged disc or area supplied by the nerve?4. On what basis is the diagnosis of Transverse myelitis (TM) been made, any history of cytoplasm pneumonia, Multiple sclerosis or other Autoimmune disease?5. TRANSVERSE MYELITIS occurs in combination with declination of other parts of the nervous system, is Neurological examination been done, maximum time TM is associated with Multiple sclerosis, so treatment should be directed towards it, is Examination of spinal fluid and MRI brain and spinal cord carried out?6. What was the cause of hyperkalemia, for which Zone (Role . 7. Avoid gluten diet, sugar,dairy products, and use of Immunomodulators and Ayurveda panchkarma (Pizhichil, Shirodhara), consult for the same with your doctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good Morning to you! Doctor, i seem to have this Phlegm in my head which i feel it in my nose and throat just anytime i take in water or finished eating...But sometimes it causes me some cease of breath and sometimes makes me fall sick starting from Headache...and this has been bothering me 3yrs now! pls i need to know what or which medicine can cure this???? Thank You ### REPLY: Hello, Welcome to , The history and symptoms suggests me that you may be having chronic sinus infection of allergic origin that is why you are getting all these problems. The allergens can stimulate the mast cell to release the histamine which is causing all these symptoms. For my patients I would suggest them to follow1. Steam inhalation with Vapocaps2. Oral Tab Monte LC, once in a day for 30 days.3. Syrup Ambrosia S4. Oral Antibiotic like Tab Autoclave, 625 mg, twice daily for 5 days. 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 31 weeks pregnant and have just been very sick. I have been a little sick every other day for about ten minutes but never this late at night (2300 hours). Also, normally the sick is white/yellow but this was brown and some of it was black. I am also itching and shivery. Is this normal? Thank you Wendy ### REPLY: Hi there, It looks like you are having an infection and the cause of which has to be determined urgently. This is because in the final weeks of pregnancy a fever with infection could harm the pregnancy and the baby. Also, these infections are more difficult to treat. Please contact a doctor immediately, if required get admitted and get tests, blood tests, urine tests and ultrasound for the baby done immediately.Also, antibiotics will need to be started. Do not neglect these symptoms as this could be serious. Get 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: 59 year female,known case of hypertension on amlodepine,complaining of right loin pain,acute in onset,colic in nature,associated with dysuria,feeling incomplete of voiding. on UA protein +1,blood trace .on USG showed pc dilatation right kidney,no stones seen.no fever,vomitting,diarrhea. ### REPLY: Hello, I have gone through your query. Thanks for using . Your urinary complaints and reports are suggestive of obstructive myopathy involving right kidney. You should consult neurosurgeon for further evaluation as there is no stone causing dilatation of right renal system. Your Amlodipine is sufficient to control hypertension. If needed you may increase the dose of amlodipine to maintain your BP below 140/90. My best wishes .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a bit concerned as I have been having burning cramp like pain in my abdomen . I have currently got a horrible cold and finished my period on the 2nd but have had the odd day of spotting yesterday which is very usual for me. I am confused as to whether all the symptoms are because I have a cold ? Abdominal pain and burning sensation is a real worry. Pain is worse when lying down, getting mild acid reflux too. What should I do? ### REPLY: Hi welcome to  forum.  Thanks for choosing . Forum.  You have got burning cramp like pain in abdomen. Pain worst when lying down. There is acid reflux as well. You had period on 2nd, and had spotting on 26th. It is usual for you. You had cold also.  The sporting could be suggesting ovulation, cold is separate entity, with cold medication you will be fine.  The pain I suppose in the upper middle stomach. Is suggestive of peptic ulcer, or gastric irritation due to some irritant foods.  I advise you to consult a gastroenterologist for diagnosis and treatment. You may have to get gastrostomy besides other routine tests for confirmation.  Wishing for a quick and comfortable recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr, I have been having this sharp piercing pain around my lower abdomen just close to my navel, which seems to radiate down to d point around my genital. This comes and goes away but can be felt when ever I sit down and sometimes when I stand. The confusion is I had an appendicetomy when I was barely 17 yes and 17yrs later I begin to have these pains. What could possibly be wrong with me? ### REPLY: Hi Thanks for asking . What ever symptoms you have written may not be related to your previous operation. But you should get your ultrasound done to confirm the diagnosis. Though till then you should take plenty of oral fluids' fiber rich small and frequent fiber rich diet. You can take antacids SOS and add mild laxatives if constipated. Consult your doctor with reports if not benefited. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife Has A problem of Kidney Multiple Stone . Size of stone are 19.6mm,17.8mm,7.8mm and 5.8mm. but she never feel pain. She have cough problem since 3 months so Dr. advise us for ultrasound. Stones are shown in ultrasound..Should we have to do surgery or not. we dont want to do surgery/ please give a solution. ### REPLY: HelloThanks for query. Your wife has been detected to have multiple large stones in her kidney. Though she does not have pain or other symptoms related to stone these stone suggest kidney disease and if left untreated may cause further damage to kidney. In view of the size of the stones being large there is no option but to get them removed by an endoscopic procedure called Per Cutaneous Lithography (P. C, N.L.). Consult qualified Urologist for clinical assessment and further treatment. You will need to get some more investigations like I.V.P done before deciding to get operated. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 my semen report.It is showing following data Quantity:02 ccAppearance: Turbidcolour: Greyish White Sperm Count: 63.4Motality Of Spermatozoa : 60%(50% of spermatoza shows active motility + 10% of spermatozoa shows sluggish motility)abnoraml cell : 10 %  Please can you let me know it is noraml(specialy quantity).if it is not then provide me medicine and diet which i need follow ### REPLY: Hai, sperm cell is called as spermatozoa. As your report is absolutely normal. Your total count(63.4) is normal (20 -200 million)your active motile sperm (60%)(active motility should be more than 50 %).all other parameters also normal. Your semen report is normal. No need for any medication. Follow healthy food intake. Add more nuts, fruits and vegetables. Avoid junk and fried foods, caffeinated . Do exercise or walk 4 to 5 kilometers. Thank you Hope I answered you query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there,I have been having some sharp pains in my chest, on Tuesday I was told its Pleurisy, I am now on my 3rd day of anti biotics but still in a lot of pain which I believe is getting worse. Also I appear to have a rash on my chest (as from today) is this normal ?? ### REPLY: Hello! Thank you for being wit Hus on ! I understand your concern, and would like to explain that for pain relief you need to try any anti-inflammatory medications, like naproxen, fetoprotein, etc would recommend a careful physical medical examination coupled with eventual chest X-ray study to rule in/out the first diagnosis of Pleurisy, and to differentiate with other possible etiological causes, as it may be shingles:Herpes Zoster (cutaneous rash is suggestive of such a disorder), etc. Some additional lab tests may be necessary, like complete blood count, PCR, etc. Hope to have been helpful to you! Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been told that I have Atypical cells on my bronch tube located right where the lungs split, therefore making in inoperable. A biopsy was take during a bronchiescope (sp) and was told it was not cancer but obviousely could become cancer. I got pneumonia in Sept 2013 and it still has not cleared up. Theory being those cells are blocking the infection from leaving the lung and allowing good air in, basically operating on one lung. I an using oxygen, 2 lpm. Should I consider radiation? ### REPLY: Thanks for asking your question I completely understand your issue actually you have involvement of the Carina .so first a bronchoscopy should be considered and a biopsy can be taken from the area. All atypical cells are not malignant biopsy will diagnose the lesion and if it is cancer or malignancy the typing can be done after typing is done chemotherapy or radiation or both can be considered because each type of cancer have different .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 October I had a large Sacrococcygeal Teratoma removed surgically, and I have an appointment later this year to see if it is returning. My coccyx is painful when I put pressure on it, and I am worried the teratoma may be returning. I also have mild spina bifida, and am not in a wheelchair. The MRI showed that my coccyx is deformed, and I am looking for alternative ways to eliminate the teratoma, before there is any chance of my coccyx being removed - although if this is the last resort, then it has to be done. Is there any alterntives?< ### REPLY: Hi, Thank you for posting your query. There are good chances that your sacrococcygeal teratoma has not recurred, as there is no visible swelling or lump in the area. Pain can also be due to other causes. However, if it has returned, then surgery is the best option to prevent it from recurring in the future. I hope it helps. Please get back if you require any additional information. Best wishes, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am suffering from vertigo since last 15 years. I m 31 years of old.Vertigo occur when I change my position specially when I move my head. I feel stroke on back of my head for a few seconds. When I want to sleep in night or get out of bed on morning, I also feel diziness which lasts for 5 to 10 minutes. My hearing ability is very poor by birth. It worth mentioning here that situation got worse when I do some work or exercise (either heavy or low). Please suggest what should I do? ### REPLY: I had the same problem for several years. I checked by several doctors. They ordered so many tests like MRI, CT-Scan, Blood test, Diabetics, celestial, Etc... I spend so much money going to several doctors and doing so many tests. At end none of them made me feel better. I started to become Vegan, Veteran. I changed my diet. It is almost one year that I am not feeling like that anymore. I don't eat meat, chicken especially food that are made by a restaurant for package food. I mostly eat greens, grain, and simple food. Make sure not to eat any MSG. Most causes have MSG especially the hot cause. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: MRI of Lumbar spine. 43 yr old female. work as EMT. due to start paramedic course in 8 weeks. My quesion is, afetr 2 weeks of severe pain and restricted sitting, standing, walking, i feel much better past 5 days. I now only have numbness right foot, sore achilles, numb back of right thigh, transcient, tingling, r leg and occasional lumbar spine pain(mild). Can i start gentle exercise?if so, what?.im usually fit, and do spin bike classes, and weight classes. Can i swim? should i do stretches yet? i have been told by g.p to sat off front line a+ e work as an emt for at least a month. Do you agree i need this much rest to heal? thank you Carole B. P.S i had slipped epyhises as an 11 yr old . I still have pins in both hips, with slight laft leg shortening. Will this play a factor in my back?, posture, alignment???? T1weighted, T2 weighted and inversion recovery sagittal images were obtained, in addition to axial images. At the L5/S1, there is degenerative disc disease and a large right paracentral posterior disc extrusion. The extruded disc material measures 1.5 cm in diameter and it is compressing and displacing posteriorly the right S1 nerve root as it exits the theca. There is also compression of the anterior theca but no significant compression of the left S1 nerve root. At L3/L4 level, there is a very small left paracentral posterior annular disc tear and bulge. No significant thecal or nerve root compression is seen at this level. The signal intensity and height of this disc are preserved. No abnormality of the remaining lumbar inverterbral discs has been demonstrated. No intrathecal abnormality is seen. There is a mild scoliosis of the lumber spine convex to the left. Conclusion: 1. At L5/S1level, there is degenerative disc disease and a large right paracentral posterior disc extrusion as described. 2. Very small left paracentral posterior annular disc tear at the L3/L4 level. 3. Mild scoliosis, ### REPLY: Since you have persistent numbness and tingling over the feet, and you recovered from an acute sciatica, it's better to avoid exercising now. You can start spine extension exercises after the pain and everything is gone for at least 3 weeks. The L5-S1 paracentral disc extrusion could be irritating the nerve root exiting there and supplying the outer border of the sole and back of the leg and thigh. Do you also feel weakness in plantar flexing/dorsiflexing the ankle and great toe? ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 child is 18 month he had pneumonia two weeks ago Nadal had three shot two days later he had diarrhea first It has been 9 days know the color is black his but Bottom does not look good what should I do he was seen by the Dr they did take stool culture should I call the Dr now ### REPLY: Hi, Thank you for asking question on  .the Pneumonia shots have no relation to diarrhea. The black color in the prick area may be due to subcutaneous hemorrhage. Local application of rash free ointment may help. If diarrhea does not subside within 2-3 days you may go for stool culture. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care . V. Subrahmanyam MD;Disassociate professor of pediatrics ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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..Ive had h pylori since 2003..I was on anti biotics for 2days only the pain I felt was horrible....suffered a few months lost 20pnds my final weight was 99lbs and a range of symptoms from severe anxiety depression....my question is I have been 8yrs without any symtoms..is the pylori dormant?....I know i still have it being I never followed through with meds..will the symptoms become active again? ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  You may have H pylori infection.  It can be in dormant stage. It can again be activated and produces symptoms of gastritis.  So you should go for H pylori test.  If it is positive then you should take a complete course of antibiotics. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I gave blood in last week . from day before  yesterday,  I started go to gym and lifting weights. but i felt only left hand starts paining through which i gave blood  ... is that common ????   right now not big pain but is any chance of  real pain in future????? ### REPLY: Hi, I don't want you to worry. Sometimes blood donation causes some pain usually due to irritation of tissues and veins by the needles and cannulas used especially for longer period of time like while donating 500 cm blood for a period of 10 minutes or something. Usually that is thrombophlebitis which happens normally with some persons. Some torn tissue causes muscular inflammation that is sometimes painful. I think the pain will fade away soon with the use of some topical antibiotics or gels and some hot massages. The pain won't take long. Hope the above information helps you. Any further clarifications feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 3 year old son has a hard skin tag under his tongue that looks reddish purple. I am not sure what caused it. Its been there for more than a week. He doesnt complain of pain, but I am very concerned about this. He pediatrician has asked us to wait and watch. Can someone please tell mw what this is? Thank you. ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concern. As per your complaint a hard skin tag under the tongue that looks reddish purple can be most commonly be a Muscle that is a mucous cyst and is formed due to ruptured duct of the salivary gland leading to accumulation of mucous into the soft tissues and thus forming a lump or due to clogging of the duct of the salivary gland leading to formation of a mucous filled lump. Other cause can be hematoma formation that can occur due to traumatic injury under the tongue. Both are completely harmless and also self resolving. Make him do salt water rinses. In case if it does not improve in a week then you should not worry and move ahead to get it removed surgically without any problem. Hope this information helps. Thanks and regards. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my name is Becky and I exasberated back in Sept with heavy pneumonia in my right lung...... the last few months I have experienced tremendous hair loss and breakage--it is so thin I only have about 1/3 of my hair left but no bald spots. I also have a big lump (or bulge) about 1 inch above the base of my hairline on the back of my head. It goes all across the back of my skull. Any advice? I thought you were here to help....... but hell no....... everybody wants my money....... which I don t have. Thanks alot ### REPLY: Hello, After a long chronic disease, there is hair fall present, it is normal, but you have a lump, and it is back, maybe it is a lipoma or subcutaneous abscess. You have to investigate all these things like serum biotin level, zinc level, FNAC of that lump after USG. Till then take tablet Stymie M forte for three months at least and biotin-rich foods. 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: my small grandson has had a upset tummy and being sick for a week now he has a large red rash around his belly button ### REPLY: Hi.dear motive., Thanks for choosing ., Red rash around the waist in the child . .,usually due to IRRITANT DERMATITIS., This irritation is due to silver waist thread., or Elastic thread in the underwear suit., So evaluate it and try to remove or avoid.,,1) Topical application of ... Calamine lotion in morning times., Dexamethasone and gentamicin cream nighttimes.,2) Syrup...levocetrizine 2 spoonful 3 times daily.,3) Syrup. Ofloxacin 2 Spoonful 2 times daily., ok...than ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 59 year-old-male who was diagnosed with CLL about one and one half years ago.  No symptoms at this time except possibly a little fatigue.  I also suspect that I may have a low testosterone level because I dont have much hair on my legs any more, energy level is down, weight has increased a bit, and sexual desire is a bit diminished.  My question is whether or not testosterone therapy will have any effect on CLL. ### REPLY: Hi, Thanks for writing in. Testosterone therapy is unlikely to influence development and progress of CLL. Once you have CLL it is better to get a follow-up done since it has been one and a half year from detection which is not many days back. Please get your blood tests and ultrasound scan done to know if you have any features of CLL. Diminishing of sexual desire is present in many patients of CLL during recovery, and you appear to have had CLL only recently and recovery is taking place slowly. However, your fatigue requires to be investigated and if you need to continue treatment for CLL. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear doctormy mom was recently diagnosed with glandular TB..though she never showed any symptoms of cold,cough,fever,loss of hunger or weight except a small painful lump in her neck area...shes a heart patient n 69 yrs.of age..being alone she lives with me in chennai...im her daughter n juvenile diabetic..the doctor here told me that its not contagious so i neednt worry..are there any precautions that we need to take? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your mother has tuberculous lymphadenitis. It is not contagious disease. So don't worry about spread of infection to others. She should take a complete course of anti-tuberculous treatment. Take high protein diet and healthy food. No need to worry about spread of infection. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What to check out next. I have had chest pains, more of an ache, going on since an emotional event in February. The pains aren t necessarily induced by stress, as they happen more at night and position doesn t matter (sitting or laying down). They have gone into my back and down my left arm to twinge between my index and middle fingers as well as in my wrist. I have taken my inhalers before thinking it was related to asthma, no effect. I have taken an antibiotic for the full 10 days as doctors thought it was bronchitis, no effect. My BPs were up (160-158/102 -98) so I have been put on atenolol 50 mg to help. I have been battling high cholesterol for 12 years and recently went on a statin (zocor 20mg) for that. I am termed pre-diabetic with my lab results and my liver enzymes are noted to be high but said to be ok ? I have had a good EKG, good stress test (7 mets reached without issue) and clear cardiac cath but since the cath 2 weeks ago, I still get the chest pains but they are quick and almost like a zap. It can feel like my diaphragm is getting punched up into my heart/chest and goes away just as fast. Over the weekend I have had 2 sets of 3 zaps right in a row, like a pulse. And Thursday before last I had 12 such zaps to the center/left of center area of my chest where the first four zaps felt the strongest but the 4th zap being the strongest of the first four, then each faded but I counted 12 in all. (would that be a cluster?) I ve tried Prilosec OTC also to see if it was related to heartburn but that also had no effect. Could this be Printzmetal s angina? ### REPLY: Certainly this can be primeval angina. Instead of taking atenolol for your BP you should take calcium channel blocker like diltiazem or nifedipine, so it can take care of high BP and may resolve angina if it is primeval type. U should try to get ECG done during the episode. If it's a frequent episode then u can go ahead with holder monitoring so that detect the ECG changes associated with episodes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir i have a of leakage of semen after urine and even if i take any heavy thing then again leakage happens. the fluid whicChatDoctores out is cloudy and thick and 5 to 10 drops leakage after when i urine .... kindly tell me what should i do. my age is 24 years weight 59 KG, height 5 feet 8 inches ### REPLY: Degree understand your concerns went through your details. Semen is a waste product. Body produces semen whenever you are sexually triggered or aroused. Such produced semen is stored in the groin. Body is supposed to throw the stored semen out. If you do not masturbate or indulge in sex and throw the semen out, the body does it automatically either through nocturnal emission or as .  When you life weights, the groin area is squeezed resulting in the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr, I ve female child of 3yrs old, she has got white patches on right cheek since 2 months, went to skin specialist, he consluted to use mixture of emoderm and ketoconazole creams in equal amounts, but still the patches didn t disappear. Please help out with a good treatment. ### REPLY: Dear Sir/ Madam, Thank you for posting your query at .this is common thing in a growing child of that age. Generally, it goes off as the child grows. There is no question of infancy or infection. Ideally keep the area moist with modern. One hour before bath you can apply paraffin liquid, after bath expose the child to sunbathe. If you have any further question, kindly revert, will be happy to assist you. If you find my answer informative, thank you note will be appreciated!with best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was given a Lupron injection a few weeks before Radiation for prostate cancer. Aprox 9 months after Radiation testosterone level is great but I m experiencing nervous trembling in my chests,arms and now legs. Along with the trembling,I m having nite sweats and a few hot flashes during the day. Am I going thru male menopause? ### REPLY: Hi, A side effect of Lu pron can be reduced sexual interest or pain in the testicle, chest pain, weakness & fatigue.  Lu pron also interacts with many .  Radiation therapy often results in Neurotoxicity. Neurotoxicity may affect the central or the peripheral nervous system which causes symptoms like trembling, fatigue & weakness of the limbs.  Visit a neurologist & get all the nerve phi+unction tests done along with a cardiac check-up to rule out any developing pathology.  Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a large ventral hernia repair in 1995. Now a pinhole has developed where the umbilical cord used to be and green stuff is constantly oozing out of it. I have to keep a gauze pad on it all the time. Is this something I should be concerned about? ### REPLY: Hello, THX to contact us. I understand your concern. If I am your doctor I advise you that yes it is serious, You should visit to the concerned surgeon to see what it is. It is suspected Pseudocodes aeruginosa infections ice green color fluid is coming out, also there is possibility of bile coming out of the opening. Exact diagnosis requires visual examination. I will be happy to answer more of your concerns, kindly know me, Wish you a very good health at . . Infectious Disease. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive had stomach pain for years that feels like being punched in the stomach, along with a bloaty feeling. For the past few weeks, its been more frequent and is bloated all the time. Ive also gained about 20 in the last three weeks(which has never happened before) and its been 60 days since my last period. Im not sure whether to be concerned or not. Any advice is welcome. Thank you. ### REPLY: Hi. Thanks for your query. Surely you should be concerned as per the history of pain in abdomen, bloating, gaining weight. You need to consult a Doctor to get a clinical evaluation, physical examination, investigations of ultrasonography, x-ray and CT scan along with the investigations of blood, urine and stool... The treatment will depend upon the reports of the clinical examination, and investigations. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 hus age is 29 years .his sprem count is/ml 24.5 total sprem count in ejaculate 44.1 Morphology Head deffects 30%,Mid piece defects 15% and Tail deffects 05%. Motility (a) Fast progression Immediately after Liquefaction 15% 1hr after Liquefaction 10%, (b) sluggish progression  Immediately after Liquefation 10% 1hr  after Liquefaction 15% (c) No progession  Immediately after Liquefation 75% 1hr after Liquefaction 75% .please tell me is it ok to become my pregnant and aslo wants to know that i got pregnant when i got married immediately but fetal pole wasnt come and dr recommaned me to DNC and after that im waiting to get pregnant plz suggest me. ### REPLY: Hi, sperms count of your husband is normal, but the motility is not good. It may be one of the reason why you are not getting pregnant.  So, I would suggest going through GUI. In this the semen sample of your husband will be processed and count and motility will increase to a great extent.  You will be given some medicines like camphene for the growth of your eggs.  Your follicles will be tracked by ultrasound and when your follicles is more than 17 mm, then one injection will be given to rupture the follicles.  After that, the processed semen will be instilled into your uterus the next day. You will be given progesterone to support the pregnancy for next 2 weeks.  After that a pregnancy test will be done. You can try like that for 3 to 6 months.  Hope I have answered your question.  If you have any other query I will be happy to 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: hello sir, thanks for providing this service  to all of us.  my sister is 41 years old she is suffering from typhoid  for a week ago.  what are the quick recovery steps she has to take from this disease.  height is 5 inches and weight is mostly 60 above.  she has more responsibilities regarading household work with her three children.  please suggest her.  thankyou. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. As you know it is a bacterial infection so taking antibiotics in good schedule is very important. I advise you should take ciprofloxacin tablet as antibiotic, pantoprazole as acidity prevention, under your doctors' guidance. Taking a . Diet should be taken small and frequent. High protein diet and low fat and low spicy food is necessary. This will prevent perforation from the previous ulceration. Please complete the schedule of the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife is Pregent for 12 weeks and find in TORCH: (A) Rubella IgG 76.59 (B) Cytomegalovirus IgG 10.60 Baby is OK in Ultrasound at 10th week. Dr. said this is a big problem, but i want to know which period this problem can be solve or minumam risk. Regards ### REPLY: Hello, I have gone through your query and understood the concern. Egg antibody presence indicates past exposure to the infection or vaccination, while IGM antibody presence signifies recent or current infection. In this scenario, the test may be repeated after 2-3 weeks and if there is a rise in the Egg antibody titles, recent infection must be suspected and further management planned accordingly. If there is no rise in tires, regular follow up is to be done with periodic sonograms to detect any anomalies early on. Vaccination should not be done during pregnancy. The baby is also tested at birth for evidence of infection and appropriate management done. 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: I have been having pain and tightness in my chest for approx 20-30 mins feels like a huge cramp going from honey area between breast and straight through to back   helps a tiny bit if hold my breath but not even have no indigestion to my knowledge burping just fine ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. Your symptoms like central chest pain and burping are suggestive of HERD (gastroesophageal reflux disease) more. But better to first rule out cardiac cause for your chest pain. So get done ECG. If ECG is normal then no need to worry about cardiac cause. HERD appears more. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. Try to follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid stress and tension. 3. Avoid large meals, instead take frequent small meals. 4. Start Proton pump inhibitors. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in bed to prevent reflux. Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ve been told by my psycho-pharmacologist to take Deanxit to control my anxiety level in the phase that my depression hit and affected me badly. i want to inquire about Deanxit, how long it takes to affect the body, what happens if a person consumes alcohol of any kind,what are the changes that occur if the medication is stopped, and how long does it take to notice these changes? thank you. ### REPLY: Hi there ~ Density is one of the many benzodiazepine groups of medications that is helpful with anxiety.  However, there are studies that indicate that depression is made worse by benzodiazepines.  Density has a very short half life, i.e., it is eliminated from the body rapidly and also has a quick onset of action, usually anywhere between 5 and 30 minutes.  .  Your body may have become used to the medication, and you may need to go off of density slowly by a tapered dose method.  Please consult a qualified psychiatrist for doing so. I hope this helped.  Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi .. Doctor! i am 19 years old guy . i am addicted to masterbation . I use to do this almost 3 times in a week. I am doing this from last four years of my life . Now i want to quit this because my health is being down day by day . I am so weak . I want my healthy life back . so please suggest me something to improve my health and fitness ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have been indulged in frequent masturbation since 4 years and now worried about your general health which you attribute it to be due to masturbation.First there is myth in a mind of common man that excessive masturbation is the reason of all sexual problems But I would like to state that it has been discussed in scientific forums all over the world and proved scientifically that masturbation does not have any negative effect on any organ or system in the body. All the problems that you are facing now are mind related and due to anxiety. Following measure will help you to boost up your confidence and improve your general health.1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc3)Take anti oxidants like Almonds 5-6 every day.4) Avoid alcohol and smoking. Engage your self in some activities like sports, reading,listening to music so that you will not get free time to masturbate. This will gradually help to reduce the frequency of masturbation. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 suffering from fever from last 7 days ...got checked in a nearby hospital...as per blood test report my platalet count is 1.51 n malaria n typhoid is negative m still struggling to get well ....my mouth has alot of ulcers now n doesn t let me eat anything..i m drinking juices only ...for last 3 days...! ### REPLY: Hello and welcome to ChatDoctorYou are probably suffering from seasonal viral infection. Kindly take all the symptomatic treatment.  Try eating semi-solid food like meshed fruits, liquid lentil, boiled and meshed rice and DAL, curd, butter milk, sweet. You need energy to fight the infection, and it will come with diet. Viral (flu) infection generally takes 7 to 10 days before recovery. Get well soon and take proper 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 age is 33, weight 77 kg, height 5 10 and blood group A+. My wife s age is 29, weight 59kg, height 5 6 and blood group AB-. We never smoke and drink. our medical history is normal. We are planing to have first baby. I want to know will there any complication due to age and our blood group mismatch? Do we need to consult some docto for this? I am not sure of the precaution and planning for the pre-preganancy. Please suggest the things (Diet,medicine etc) we have to follow for pre-preganancy phase. Thanks, Pawan ### REPLY: Hi, I don't seem to think there is an age mismatch 33 and 29 years are perfectly normal age to consider having child . Blood group of AB negative needs attention. Your wife will require anti D injections at 28 weeks of pregnancy and after delivery. Also, if she has certain complications during pregnancy she may require anti D. Rhesus negative pregnancy usually do not cause a problem in first pregnancy, but if anti D is not considered and given in first pregnancy it can cause problem in the next pregnancy. In the pre-pregnancy, she should have healthy diet and lifestyle and also take Folic acid 400 micrograms daily till she gets pregnant and continue it till 12 weeks of pregnancy. She should inform her treating gynecologist about her negative blood group. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Lump remains after bruise subsides - I fell on our front steps 2 months ago - ridiculous, multi-colored bruising and soreness of shin gradually went away within a couple of weeks.  Its completely fine now - no pain, no discoloration, but I have a big lump on my shin.  Will this, too, eventually go away?  Or should I get it checked?  Might it need to be drained or something?  I exercise regularly without any difficulty. ### REPLY: Hi, Dear,thanks for your query. A big lump on the shin-persisting -after 2 this your issue. This appears to be firming up clot on the shin -2 myths back-post trauma. As it's not painful still, means its recovering without any infection in it. But still upload photograph of the shin and more info-if it's with fever off late. You need to get the surgeons' opinion- to fix this issue. Wait and watch-if nothing painful, this might regress over next 3 myths time. Tanks. Hope you are satisfied with the reply.Welcome again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son who is 45 years old has asthma from the last 40 years.in the last 3 months he had severe attacks which was very near to DEATH  and was dangerous.THE FIRST ATTACK WAS WHEN HE WENT TO TOILET - HE GOT AN ATTACK WHICH WAS LIFE RISK.   HIS FACE TURNED BLUE - LOST HIS CONCIOUSNESS.ACCIDENTALY BY THE GRACE OF GOD ONE FAMILY MEMBER GAVE MOUTH TO MOUTH RESPIRATION AND SAVED HIS LIFE.    MEDICALLY NOTHING WAS FOUND.HE WAS TRATED BY NEBULIZER IN A HOSPITAL    HIS LIFE WAS SAVED.THE SECOND FEW DAYS - SOON AFTER GETTING FROM BED HE WEN TO URINAL.   WHEN HE WAS ALMOST EMPTYING HIS URINE HE GOT A SEVERE ATTACK OF ASTHMA - BREATHLESSNESS .THE THIRD ATTACK WAS A DAY LATER EXACTLY THE SAME WAY.  FIRST THING IN THE MORNING AS SOON AS HE GOT OUT OF THE BED IN THE EARLY MORNING IN THE END OF URINATION HE GOT HIS 3RD ATTACK - SAVED BY NEBULIZER.CAN YOU HELP ME - CAN YOU DIRECT THE TREATMENT- I AM SENDING THIS MESSAGE FROM   I N D I AEMAIL  -  YYYY@YYYY                 YYYY@YYYY ### REPLY: Hello, Thank you for asking at . I went through your sons history and would like to know more about him as follows:a. He has asthma since childhood. How it was treated? What were the medications used? What are the medications he is currently using?b. Regarding 3 episodes of fainting, what were his symptoms? How did he lose balance? Did he have black out? Was his blood pressure measured at that time? How much time it took to completely recover? I want to know this as such things could be due to postural hypotension or anaphylaxis, a more serious form of allergy.c. As all 3 episodes of fainting occurred in washroom, is there anything special about washroom? Is there mold inside washroom? (mold is a very common allergen) Does it contain fumes of acids/cleaners, etc’d. How are his asthma symptoms in between? Does he have breathing difficulty, cough or wheezing?e. Are there any seasonal variations?f. Does he have any other medical conditions? Does he take any other medications regularly/frequently?g. Does he have nose symptoms? - nose congestion, sneezing, running nose, etc.?h. Does he have any digestive problems? Constipation, acidity, heart burn, etc.?i. Does he smoke? Any other exposure to dusts, smokes or air pollution?j. Is stresses an important factor in his life? Does stress worsen his symptoms? Above details would help me to know more about his health and therefore to make more specific suggestions for him. At present, from your provided information, I would like to make more specific suggestions for him as follows:1. I would suggest him spirometry with post-bronchodilator reversibility testing. This will help to know his lung capacity, status of his asthma as well as it will also help to better choose his medications.2. I would also suggest him allergy testing for common allergens. In addition, I would also suggest him serum total IGE and baseline serum treatise levels. (serum treatise levels are done only at a few centers in India at present)3. If such further episode occurs, I would also suggest you to get him examined by a doctor as soon as possible, get his blood sugar and blood pressure measured. 4. As he has severe asthma, I usually suggest my such patients regular use of inhalers like inhaled corticosteroids. For in-between asthma symptoms, I would suggest him to use albuterol inhaler on as-and-when-needed basis. Further medications can be suggested only after detailed information.5. In general, I would suggest him plenty of fluids during day to maintain HY .  I would also suggest him to not immediately stand up after awakening in the morning. He should sit upright in the bed for a few minutes and then slowly stand up and go to washroom. This may help if he has postural hypotension. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish your son the best of the health ahead. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is 19 years old. Since the Middle of November, she has been experiencing chest pain. She says she wakes up in the morning with the pain. It started right around finals time November 15th. It has continued with several episodes 2 x s a week since November 15. Now this is happening everyday. The pain starts at her left collar bone and goes over to her left shoulder. Then drops down about 5 inches over her heart. She pain also shuts down her left arm and sometimes wraps around her wrist. This occurs when she wakes up. IN November it would stop after 25 minutes. Now it is lasting 1.5 hours. Could this be stress? She has left college this quarter. ### REPLY: Thanks for your question on . I can understand your daughters situation and problem. In my opinion we should first rule of cardiac cause as he is having left shoulder and arm pain. Her age (18) is too young for cardiac disease, but better to rule out it first. So get done ECG. If ECG is normal then no need to worry much for cardiac cause. Stress and anxiety can be the cause for her symptoms. So consult psychiatrist and get done counselling sessions. Try to identify stressor in her life and start working on its solution. Ask her to avoid stress and tension and be relaxed and calm. She may need anxiolytic .  Don't worry, she will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had an mri scan which i would appreciate your help understanding mechanical left lateral recess stenosis due to left paracentral disc extrusion at L5 S1 with impingement of the traversing S1 nerve root . Annular disc bulge at L4-L5 . I have had symptoms for 9 months slow onset, I have had a caudal epidural and currently take gabapentin for neuropathic pain (pressure, heaviness up back). I have altered sensation in seat area, scatica (no longer painful altered sensation) and sitting ot walking a distance are problematic for me. I have been offered another epidural or surgery after a 1 month further increase in medication. Is this scan result minor or a concern, should I just continue, I am struggling to work Thanks ### REPLY: Hi All, If your symptoms are sciatica on the left side, it corresponds with your MRI scan and the operation has a statistically greater probability of giving you good relief of the sciatica. In fact, in studies it has been proved that the major benefit from surgery is early return to work. However, the choices on the table include surgery, interventional pain procedures like the epidural or continuing with painkillers etc. In the long term, none of these 3 choices have a particular advantage over the other. So you'll need to think through the pros and cons of all the options and choose what's best in your specific situation.  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: I have a small bump near the opening of my vagina/anus. It appears almost monthly, in the same spot, before or after my period. I have been tested for a panel of STDs but all came back negative. It will go away after time but it always comes back. Is this something I should worry about? ### REPLY: Hi, Dear,Good Morning. Thanks for the query to . I studied your query in details and understood your concerns.@My impression of your lump removal-is as follows--Its a recurrent-Boil in the Perineum near vagina.-Recurrence problem is due to re-infection and due to incomplete treatment.-Treatment-I would suggest consulting ER surgeon and test blood forces / PPS -levels.-Surgical . -Or Under antibiotic cover for 2 days-Surgical Excision and Primary suture of the died down boil could be done from ER Surgeons would help you to plan treatment with your doctor.@Hope this would resolve your worrisome query. Welcome for any further query in this regard, and would love to help you to resolve this problem till it is solved to your satisfaction.@ One Small Request to you to Write strong recommendations promoting my services for the benefit of my new and old patients at  clinic. Wishing you fast recovery.!! Have a Good Day. With Regards, ### END