Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Daniel, I have been having problems, with my right eye and low jaw, just half of my face, sorta of can t feel it, the right side I tried to whistle like I always do, but now I can t my lips like goes to the side is there something I can do, I have cure or treatment... ### REPLY: Hello, Judging from your description it sounds like facial nerve palsy, otherwise called Bells palsy.  In most cases it is benign and most patients improve spontaneously over several weeks. Medication with steroids and antivirals may help regeneration if started in the first few days.  However, in some cases, it may be in the setting of a neurological condition or metabolic issues like diabetes.  So you must be checked by your primary physician or a neurologist for other possible signs which would warrant MRI imaging as well as testing for diabetes.  As I said in most cases it is isolated and improves spontaneously with tests turning out normal, but you should be seen to confirm the diagnosis. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I hAve been sick on and off for at least ten months. When I start on antibiotics I start to feel better then as soon as I m off of them for a few days I start getting sick again. I have bronchitis I ache all over I am so tired. I have to take breathing treatments twice a day. I was bite by a tick months ago, could this have something to do with it? I feel so sick ### REPLY: Thanks for your question on . In my opinion you are having bronchitis due to lower respiratory tract infection (LETI). Infection is the most common cause for attack or worsening of bronchitis. And your other symptoms like body aches and tiredness etc. are also due to infection. So better to consult pulmonologist and get done1. Chest x ray2. PUT (Pulmonary Function Test). And start antibiotics and inhaled bronchodilators. Tick bite is rarely causing such delayed symptoms. So very fewer chances of this. Better to consult pulmonologist and discuss all these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What is the best way to care for a mentally sick loved one?  We cannot keep her permanently in an institution and if we bring her home she makes everyone misrable.  She will not take medicines at home (because she feels she is well and does not need them). Please Help. ### REPLY: Hello, If you have taken her to a psychiatrist and have a diagnosis-then you can ask the doctor to prescribe liquid formulations of the . ) refusal to take meds and to go to a psychiatrist is a common problem in psychiatric patients. Many a time a psychiatrist can be requested to make a home visit and talk to the patient indirectly-thereby examining and interviewing her. So, try to take her to a psychiatrist once (may even require force to dose) and then one may give meds mixed in food for some time. With proper meds taken regularly for some time, patient shows good improvement and many times starts accepting the oral meds. Hope the reply is useful for you. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello...since I ve been diagnosed that I have TB, my life has been miserable then..I veen unemployed because everytime I am looking for a job and when the medicalt result will come out, they rejected because of the spot or scar they saw in my xray..From then I feel so hopeless and worthless because they always rejected me..thats the reason why I cant reach my dreams..feeling very down..pls help me and give mesome advise..thank you.. ### REPLY: Thanks for your question on . In my opinion you should consult pulmonologist. As tuberculosis heals by fibrosis and this is seen as spot on x-ray. And this will remain as it is throughout the life. So you need to complete the full course of treatment.  Get done CT THORAX as CT gives better idea about the lesion. You can also go for Bronchoscopy and BAD analysis. If both of these are not suggestive of TB than you are not having active TB. X-ray spots are due to old healed lesion. So better to consult pulmonologist and discuss all these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hiya I ve had really bad knee pain all my life since I was a child and always been told it s growing pain my brother also suffers with the same thing and he gets told the same and my little boys also complain about there knees hurting too it gets so bad sometime I can t move and I m just stuck I can t go to the toilet get dressed or anything I m just stuck and I was wondering if you had any idea as to what it could be I m 19 years old but have a very high pain threshold Thank Louise ### REPLY: Hello, I have studied your case. As per your age and history there is possibility of soft tissue injury in knee. Most commonly meniscus injury occurs may be associated collateral ligament injury. If pain persists then you may need to do MRI knee to see for any functional defect. As per your symptoms you need to do physiotherapy and knee exercises to improve range of motion. Rest and ice fomentation along with supportive brace will help to reduce swelling and pain. Small meniscus tear can be managed conservatively with physiotherapy with USG and TENS. Meniscus injury can be managed by arthroscopic repair. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just had my wisdom tooth on bottom left removed on Monday.  Its Thursday and I still feel lightheaded at times, Ive gargled with salt water as told. I took one Lortab for pain on Monday.  Hadnt really been in serious pain since but just some soreness and tenderness. My problem is that I cant sleep.  Everytime I try to drift off into a sleep and Im awakened by involuntary shiver or a jerk. I have never done this before taking that med. I also have felt like a burning sensation across my chest (not painful)--when I sleep.  If Im up and moving Im fine.  Although last night I felt a little sweaty and light chills.  Any insight would be helpful.  Thank you. ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, you have undergone extraction of wisdom tooth now you feel like lightheadedness, chills, sweaty. Don't worry these symptoms are seen in patients as side effect of anesthesia given during extraction and also due to Anemia or Malnutrition. You should wait for few days you feel better and consult your dentist and take vitamin B 12, B6 supplements, folic acid supplements tablets. Take nutritious diet on time, proper sleep of 8 -9 hours. Hope this will help you. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband was recently in the hospital with multiple blood clots in his lungs and was put on blood thinners. He has been home for a month but is extremely tired. On sunday, we went out to dinner and his hands started shaking for about 10 mins and stopped after he ate some food. Is there anything to worry about? ### REPLY: Thanks for your question on . I can understand your concern. Since he is having Pulmonary embolism, following are the causes for his tremors in hands. 1. Hypoglycemia 2. Vitamin b12 deficiency 3. Hypocalcemia (low calcium level) 4. Hypothyroidism etc. So better to consult doctor and get done sugar estimation, vitamin b12 level, calcium level and thyroid function test. If any abnormality detected than he needs supplements. Don't worry, he will be alright. First diagnose himself and then start appropriate treatment. Hope I have solved your query. Wishing good health to your husband. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have total alopecia areata. Is there any kind of natural herbs that I can take to heal my immune system? Should I see a nutritionist for help? I was diagnosed at 9 and had treatments throughout my elementary and jr high school. I went totally bald at 20 after I got married. I am now 51 and would like to see if it could be reversed at this time. Thanks for your opinion. ### REPLY: Hello Welcome to  As alopecia errata is an autoimmune condition, and it is a condition that causes a persons' hair to fall out.I'd advise you should see a dermatologist and follow what treatment he recommends, meanwhile you can try:1. Rosemary, which is a useful hair tonic and conditioner2. Green tea (Amelia kinesis), 2 cups per day, and saw palmetto (Serena repent), 100 mg twice a day3. Good home remedy for alopecia using Onion: Round patches of baldness appear on the scalp when hair fall off in bunches. Onion juice should be rubbed into such bald patches regularly for some time. It will help the hair to grow again. I guess this should suffice, if you have any more questions, you can write back to me, or you can close the discussion and rate me.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my dad is in hospital at present and we dont know what is wrong. they have checked him for urine infection,gaul and every thing has come back clear. he is 73 but has been complaining of pain in his back lately. after 2 days in hospital he is no better and seems confused and doesnt even know he is there. any ideas.thank you ### REPLY: Hello, I have studied your case. There can be possibility of malignancy or metastatic lesion leading to disorientation and confusion. I will advise doing MRI spine and brain, and urine Ben Jones protein, and electrolyte. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi this is rajkumar..and my wife 27 old, got pregnancy in 1 month 9days while urine test with a bit of period spot on day 1 of cycle, consulted the Dr.she said wait for more 15 days there s no evedence of SAC. but pregnency test was positive.now we following the medicine and injections(DIROGEST-200), ECOSPRIN-75DUPHASTON*, FOLIC ACID TAB, ALLYLOESTRENOL TAB PROZA DPF OD TAB FOR warmtings. is it the correct advise from the doctor to protect the pregnency to my wife. when (at what time )the baby will appear while the Dr scans.can u suggest me with brief explanation how the condition is and what is going to happen in the next 2 weeks(10th). and precations about our participation in sexual things at bed. ### REPLY: Hi greetings. Your obstetrician has given you proper guidance to wait 15 days to confirm pregnancy by ultrasound scan and medicines to protect pregnancy if she has conceived.Sometimes gestation Sac will not be seen too early and may have to wait for 5 to 6 weeks. Once it is confirmed can continue the medicines after the direction of your obstetrician. She has given those medicines because of the mild spotting she had on the expected date. After confirming pregnancy and if no spotting or infection intercourse can be done. But your wife can take the opinion from the obstetrician treating her to know of any contraindications. Proper hygiene is very important during sex and positions should be comfortable to her. Avoid lying directly over her Tommy. Hope my answer helps 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: I have a strong pulse in my neck and the left side of my brain sometimes hurts in unison with the pulse. My blood pressure is also higher than normal, at 145/82. Is this tricuspid regurgitation or something else bad? Do I need emergency care? I get this every few days but lately it s almost every day. ### REPLY: Hello, I have studied your case. I think that you might be having migraine. It causes severe headache with pulsatile feeling and some time vomiting. I do not think that you need emergency care, but you have to make sure that your blood pressure remains in control. If your blood pressure is higher than you need to take tablet for it. Avoid sleep deprivation. It can also cause such symptoms. I hope this answer will be useful for you. Let me know if there is any other followup questions. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,    Im an 18 year old female, and I have been having some problems. Im constantly sick ,tired all the time, and eating less. I got a monospot and bloodwork done. The mono spot came back negative. But, MANY things came back low or high. Im just concerned if it means or points to anyhting. All the things to are low are WBC, Hemoglobin, Hematocrit, MPV, Absolute Neutrophils, Absolute Monos, Neutrophils, Monos, Creatine, Bilirubin Total. I had high readings in Lymphs, Ast, and Alt. I just want to make sure its nothing serious, because it was a lot of things that was off. I know Im anemic, but if it means anything else I would love to know. Thank you,Brandi. ### REPLY: Based on your query and findings, my opinion is as follows.1. Low Hemoglobin means anemia. There is also a low hematocrit which is suggestive of anemia.2. Low WBC is most often seen in viral infection especially with increase in lymphocytes. 3. Decrease in neutrophils is due to a relative increase in lymphocytes.4. Counts will come to normal with control of infection.5. You need to get evaluated for anemia thoroughly and start with medications to correct anemia.6. AST and ALT raise is not significant, which will settle with control of infection. Hope this helps. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 31 year old female, and I have been taking phentermine on and off for several months.  In the past few weeks, I have had a swooshing heartbeat sound in my left ear.  It comes and goes but it mostly occurs when lying down.  I feel really tired all the time and even right now my bones/muscles just dont even want to type.  Im having chest pains and lots of pressure on the right side, sometimes it feels like a brick is sitting on my chest.  I also the middle right side of my back hurts very often.  I went to the Dr. they said my ears and heartbeat was fine.  I have read that Phentermine can do things to your arteries and heart, and now Im really concerned. ### REPLY: Thanks for your question on . I can understand your concern. Yes, determine can damage heart and blood vessels. Phentermine is symphathomimetic .  It stimulates lymphatic system. This will in turn cause rise in blood pressure, vasoconstriction and tachycardia (palpitations). So better to consult doctor and get done blood pressure monitoring, ECG and 2d echo. If all these are normal then no need to worry about determine related heart damage. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with anemia on march 5 and they prescribed me iron which I taken3 times a day. They determined it was due to my periods. I went to obgyn and pap smear is normal but they did a pelvic ultrasound and saw a mass on my uterus and they said my uterus was enlarged. They have referred me to obgyn oncologist which my appt is monday. I have cramps my back and leg hurt every time I stand and my ca 125 level was 300. Is there a good chance this is cancer. I want a hysterectomy because for the past year I have dealt with my periods being so heavy I have to sit on toilet ### REPLY: Hello, thanks for using . Ca 125 as you already know is a marker for cancer. It increases in cancers of the digestive system and those of the reproductive system including the ovaries, fallopian tubes, endometrium of uterus etc. It is highly used in the diagnosis and follow-up of ovarian cancer. Ca 125 is not specific to a particular disease and does not necessarily indicate a malignant disease. It could be elevated in benign conditions such as uterine fibroid as well. From your history; heavy menses, anemia, enlarged uterus etc., there is a good chance that what you have is a uterine fibroid. The only problem is that the ca 125 level is far above the normal which is 35 (300 in your case). The appearance of uterine fibroid on ultrasound is particular, and you should see your ultrasonographer to say if the mass was not well round and with borders and characteristic of fibroid. If it's a fibroid or none metastasized cancer, hysterectomy will be just fine. Best regards and hope this helps. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Doctor , iam leaving in california. iam having kartageners syndrome-situs inverses. iam suffering with cough, sputum and runny nose. iam married women, iam trying to conceive from past 2 years. but i didn t conceive yet. I was consulted to Gynecologist here. she did Ultra sound and hysteosalpingogram and some more tests. she told everything is fine. what precautions i have to take to conceive..and if iam choosing for IVF how much i have to pay here from my pocket. mine is greatwest Cigna 80:20 insurance. Pls give me your valuable sugessions to me Thanks & Regards USHA ### REPLY: Welcome to  Regarding cough and sputum you could be having long term infection which can cause Bronchiectasis which is irreversible damage to the lungs. You need to get complete checkup to rule out Bronchiectasis and also Cystic fibrosis. Yes. Karabiners syn .  The cost depends on from Clinic to Clinic. You can approach Clinics who will accept the insurance and find one with best charge. In USA average cost of IVF is $12000 to $15000. Keep this in mind and e where to get it done. GOOD LUCK !!!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I had a wisdom extraction about 5 1/2 weeks ago. I was sedated by the IV the dentist inserted in my arm. I noticed my vein had damage which is common from an IV insertion. It was a little hard and of course bruised. I expected the swelling to go down by now. Instead, the lump which is the width of my vein has slowly moved up about half an inch. It has increased in firmnessand aalmost feels like there is a tube almost an inch long in my vein. When I press on the lump it moves and feels like there is an edge to the lump at both ends. I have received bruising after pressing on it. When I bend my arm or flex my bicep it feels like its pushing against my bicep. I am a phlebotomist and draw blood mainly on geriatrics for 7 years. Ive seen veins with scar tissue and hematoma, but never anything like this. Also my veins are very prominent. Could there be debris or something left behind from the IV? ### REPLY: Hi, Thanks for asking the query, Your clinical history suggest that you had developed a sweeping at the injected side of your arm which you are feeling as hematoma. If you are comfortable with your day-to-day activities it is advisable to apply a bandage at the side, so that the hematoma resolves faster. If the skin over the hematoma is showing any signs of unhealthiness, it's better to consult a physician and get the checkup done. Follow the post-operative instructions given by the Dentist properly. Maintain a good oral hygiene. Hope this helps out. 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 I gave plasma a week ago, now I have two pea sized swellings under my arm that are tender to touch under both arms.. Are these nodes?? And if so, is it possible its from the plasma donation since there was bruising at the donor site of injection?? ### REPLY: Dear Sir/Madam have gone through your query and read your symptoms. In my opinion, these swellings are nodes and are sign of infection, but possibility of it being from the donor do occur if you have received the plasma, but don't be scared, consult your doctor, and he will start you on antibiotics, and get you cured. I hope that answers your query. If your want any more clarification, contact me back. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive just been diagnosed with severe iron deficiency anemia.  A few weeks ago I developed a vision problem wherein it looks like a field of translucent balloons fills my vision.  This has never gone away since it first appeared and is gradually getting worse.  Is it possible the vision problem is caused by the anemia problem?    End of question. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have iron deficiency anemia.  You should take treatment of that.  Furthermore, you should take injectable or oral iron supplements.  Furthermore, you should take iron rich food like dates, green leafy vegetables, .  Your vision problem is likely to be due to some other cause.  Consult ophthalmologist 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: Im having some issues with my heart rate.  It will sometimes get as high as 130 beats per minute while I am just standing still.  I used to be very active, but now every time I run my pulse goes up to 180 and it makes it hard to breathe.  I am also experiencing black out spells and getting very dizzy. ### REPLY: Hello! Welcome and thank you for asking on ! I understand your concern and would explain that your symptoms could be related to POTS (postural tachycardia) or cardiac arrhythmia. For this reason, I would recommend consulting with a cardiologist for a careful physical exam and some tests: - a resting ECG and cardiac ultrasound and a resting ECG- an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm for a prolonged time and exclude cardiac arrhythmia-thyroid hormone levels for thyroid gland dysfunction - complete blood count for anemia-blood electrolytes for any possible imbalance. - a Head Up Tilt test may be needed to investigate for possible orthostatic intolerance, including POTS. You should discuss with your doctor on the above tests. Hope you will find this answer helpful! Wishing good health,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have swollen lymph nodes under both arm pits. My doctor just ignors when I mention it. I have been this way several years. Now they are getting very painful and I burn and itch severely under my arms and I use a c-pap machine yet I am exhausted all the time ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint swollen lymph nodes in the armpits that are painful and causes burning and itching can be due to infection. As the lymph nodes are not so superficial and not easily palpable, so there is also a possibility that the painful palpable lumps in armpits are boils or can be inflammation around the sweat glands in armpits also known as HY . . I would suggest you consult an Infectious Medicine Specialist and get evaluated, and he can advise you to get an FNAC or Biopsy of the lumps done to rule out the exact cause of swelling and treatment can be planned accordingly. As of now do cool compresses over the lumps. Take Ibuprofen to reduce pain and swelling. A short course of antibiotics can also be taken. 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: sir, my husband semen count details mentioned belowPH - 7.5Rapid progressive motility: 31%Slow/sluggish Progressive: 38%non Progressive motility: 6%Immotile: 25%Viability Test : 83%Sperm Morphology:Normal 49%, Head Defects 20%, Neck and Midpiece Defects: 7%, Tail defects: 5%, Cytoplasmic Droplet: 19%.Cellular Contents: 4-5/HPFI have problem in pregnancy so the doctors advised to take the above test for him and my previous doctor said its absolutely fine and after few yrs now i have seen a new doctors she said my husband has 31% of count its too low for getting pregnant. Pls. advice me whether she is right/wrong about this diagnosis. My husband is little upset. ### REPLY: Hi, Welcome to .First, the seminal report was not a complete one. It lacks the total quantity of to ejaculate, liquefaction time, viscosity, color and total sperm count etc. Regarding the total cellular count whether it is white blood cells or something else was not mentioned. How many days' abstinence was observed before collection of semen. That is also very important. With the available data, if the rapid progressive motility of the sperm is more than 60%, it will be a good quality one to make you conceive earlier. Similarly, the normal sperms must be 70-80% and not less than that. By a detailed examination of your husband and with other investigations we can find the reasons for this mild defects. Repeat the semen examination in another good laboratory with 3-4 days of abstinence. Wish you an earlier pregnancy... . Morgan ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Eratical disfunctional problem i can keep upto 2 to 4 minutes only. can i increase the time period for more satisfication. and can i know what is the normal period of sex. and what is the maximum we can extend by mdicine. and what is the healthy time period.please reply me to email ID:  YYYY@YYYY ### REPLY: Hi welcome to the  It's not duration but quality of sex that is important in intercourse Aim of any sexual relation is to reach orgasm 4 to 6 minute sex also can be enough if female reach orgasm If erectile dysfunction present then following report done.... _serum cholesterol _blood pressure measurement _smoking history _prostate problem _depression, stress _diabetes etc... Foreplay important during sexual relation, so also try it before sex Sildenafil . .  But taken only after doctor advise if needed Consult nearby psychiatrist for counselling regarding sex if needed To Hope your concern solved 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, my husband was told he has a staph infection with drainage. The staph infection is located below the knee and wanted to do a small incision but we had an expericence last year with my sister in law and ended in an amputation of her foot. So we are afraid of those incisions. Is it good that we pinch the pus out or should we not squeeze it out? If we don t squeeze it, it won t drain by itself. Thank you. ### REPLY: Hello there, I can understand your apprehensions after what happened to your sister-in-law. But every case is not the same. In a majority of cases an I&D or Incision and .  So I would urge you to go to a good hospital and have it incised under sterile conditions and local anesthesia. The reason is that even though Staphylococcal infections seem innocuous some of them are resistant and do not resolve on their own. And if the staph infection proceeds deeper and enters your blood circulation then it would be very difficult to contain. So the sooner your husband is free of it the better. Thank you for your 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 MY NAME IS DEBBIE I FELL ON A WET FLR. AUG 8-10 HURTING MY RT HAND,LT , LT KNEE XAYS SAID I HAVE A VERY BAD  SPRAINS, I HAD HERNIA SURG 6-10-10 AND MY STOMACH HAS BEEN RELLY HURTTING THAT NIGHT OF THE FALL COLUD I HURT THE MESH IN ME OR THE HERNIA? ### REPLY: Hi Debbie. Thanks for your query. Read and understood your problem. On felling the muscles of the abdomen also go into sprain and spasm, stretching over the fibrous tissues around the hernia repair and the mesh. It is likely to get healed well provided you take proper treatment. The right hand and left knee will also heal well as there is no fracture on them. I would suggest you the following:Strict bed rest-this is the most sure shot way for early recovery. A course of an anti-inflammatory medicines like Ibuprofen in proper full dosages as per your body weight and after full stomach. You will be fine soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My aunt, about 50 years old complained of breathlessness and broke out in a cold sweat last night around 2.20 a.m., while sleeping. We immediately took her to the hospital where she was administered certain tablets 6 of them after which she was kept under observation and had an iv attached to herself. In the morning her blood pressure was 135/80 and the doctor diagonosed it as heart attack. What are the things to be done in order to prevent further attacks and besides that what other things need to be done immediately? ### REPLY: Hello, I would explain that first it is important performing a coronary angiogram, in order to examine the blood flow in her coronary arteries and treat (with stents or bypass surgery) the blocked arteries if necessary.  Other prevention measures to consider would be: - taking antiplatelet agents (aspirin, clopidogrel, etc.)- taking statins in case of dyslipidemia- follow a healthy lifestyle (low fat diet, regular physical activity)- try to lose some pounds if overweight-maintain fasting glucose and blood pressure values under control.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I m feeling pain under my right rib cage for 3, 4 days now. It s not very strong but it is there. I m a bit worried because I was partying for two weeks and drank a lot, so I m worried that it could be something with my liver. But otherwise I drink rarely, is it possible that liver reacts so quick? Could it be something else? ### REPLY: Than for using  .as per given history it may be muscular pain. Have u other symptoms like fever, vomiting, headache, feeling weakness then it could be liver related problems, u have no any symptom above then don't worry it may be muscular pain use muscle relaxant . I am sure u get relief in 7 days. Hope u r satisfy with these answered.u have any problem write back to me, I would like to help u.regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a small lump on my posterior cervical area of my neck. I haven t noticed it until about a couple of weeks ago i was feeling sick and went to the doctors who put me on antibiotics for strep throat and i figured my lymph nodes where just swollen because of the infection. its been 10 days and i am done with my antibiotics but the lump is still there. should i be worried? ### REPLY: HI, Dear,Thanks for your query to  virtual Clinic. I studied your query in all the details put forth by you. I understood your health concerns about the Cause of unrelieved lymph node in posterior of your neck. Treatment -I reviewed your case, and in my opinion your doctor has rightly treated you.It's normal to have lymph nodes even after 10 days of antibiotic course.Don't worry about the lymph nodes, as it usually takes 3-6 myths to really reduce from its enlargement to normal size. If You are still suspicious of it being Cancerous, a Second Opinion from another ER ENT Surgeon would resolve your worry. I would advise you to consult ER ENT Surgeon in your case, only if it recurs and increases in size and increases in numbers. As I don't have any first-hand information or the photograph of the lump, its advisable to get checked and treated from your doctor. Hope this would help you to plan treatment as fast as possible with your doctor. If you feel satisfied with this reply, dont forget to hit thanks and write excellent review comments, which would improve my rating for new needy visitors to . Welcome for any further query in this regard to . Have a good day. With . N.M.S. Genl-CVTS, Senior Surgical Specialist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hai i m over 50year and i m a businessman who has to move out at regular intervals in order ot keep a good track on my business. RECENTLY I M SUFFERING WITH SEVERE PAIN IN MY BONES AND NERVES CAN YOU RECOMMEND ME WAY TO REDUCE THIS PAIN EITHER THROUGH DIET OR TO CONSULT A DOCTOR ### REPLY: Hello, As you been travelling a lot and your age is 50 where you mentioned pain in bones and nerves, I think this will be the degenerative changes in the spine which may be either the cervical or lumbar one. Based on the clinical symptoms you maybe assessed for the cervical or lumbar region. Post which medicine can be prescribed by the physician. But this will be a symptomatic relief and post medication gets over you may have the pain symptoms again for which there is a possibility on the upper side.  I will advise you to meet up a physician, get assessed, of MRI is recommended please take it, and later physiotherapy may be advised to you for the same for better and long-lasting results. In case if you think to avoid the whole process it's totally up to you and later the income you make will unnecessarily get spent into the health. So to have good productivity in business health matters a lot. Focus on health, and it will save your lot of financial stress and improve the business also which might have got affected due to this nerve and bone pains. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my dad is 56 and he recently fell and hit his head and has gotten 14 stitches on his forehead. Lately,  hes been feeling dizzy when his blood pressure is over 130, when normally it is usually below 120. Any suggestions why this is happening and is there any over the counter medicines we can use? ### REPLY: Hi, Dizziness at his age does not occur which such a slight increase of BP. It can occur with fall in BP. It can be because of arrhythmia called as heart block in which heart rate tend to decrease to a very low level. He needs to do an ECG to rule out this condition. Other causes can be ENT disorder causing giddiness. So also get yourself evaluated from a ENT doctor. 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: Hey doc, landed on my hip today on concrete while skateboarding. On the initial fall the pain was very sore but i could still move around it was just a very sharp pain that subsided after a minute. it s been about 2 hours and I can walk, but it is a little painful and i walk with a limp there is a little red mark from where my hip impacted, it s not painful when I touch it but I can feel it. What do you think I have and what is your reccomended course of action? , I hope it s nothing to serious because im leaving for a holiday in a week! ### REPLY: Dear Patient, Welcome, and thanks for sharing your concern I went through your query, and I feel, the recommended course of action for you should be to get an X-Ray of the hip done to see if there is any bony injury to the hip or the pelvic blade region, if that rules out negative than you will need to take some rest and let the soft tissue heal, also take anti-inflammatory medications, and see the effect. I hope my advice would have been useful, in decision-making regarding your treatment, still if you have any clarifications or doubts feel free to contact back. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! 6 yr old son is recovering from gastroenteritis, just started eating again yesterday after five days without food. He s eaten banana, ham, grapes and peanut butter (all usuals from before he got sick). This evening he s come out in hives on face, back, legs, arms but not stomach. Mildly itchy. Not feeling nauseous again. Possible contact reaction to lying on a leather sofa which he vomited on yesterday and was cleaned with hot water? Any other ideas? Thank you! ### REPLY: Hi.... By what you quote it should be an urticaria or a simple skin allergy. You can use HY .  But, skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a Lump on my leg, i noticed this 2 days ago. I think it may be cancer after looking up on the internet about what the lump looks like and its size. I want to know what symptoms of cancer are as i have been feeling ill (signs of sickness) and also in pain (aching limbs and stomach pains). The lump is on the top of my Right thigh, and my right leg seems to be muscle related but aches continually. ### REPLY: Hi. This is called a cancer phobia. The lump which you have noted just 2 days ago is very difficult to be said as a cancer. This looks to me as in infection as per the symptoms you have described. Consult a Doctor, get a clinical examination and start the treatment as advised by your Doctor to get cured. The lump you have described is in the upper thigh, so it is most likely to be a lymph node. And an antibiotic cover will get you OK. The stomach pains can be due to an intestinal problem and may be unrelated to the lump you have noted. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: MY DAD HAS PLATELET COUNT IN THE RANGE OF 7000 - 18000. WE ARE WORRIED AS THIS DOES NOT INCREASE. HE WAS ON THE TREATMENT OF PEGASYS AND INTERFERON WITH RIBAVARIN FOR TREATMENT OF HCV. OFF LATE HE HAD LYMPHAGITIS AND HAS SEVERE SWELLING OF THE LYMPH NODES IN THE LEG AND HE CANNOT WALK. HOW TO TREAT HIM FURTHER ### REPLY: Hi, Thanks for asking. The platelet count is reduced due to Pegasus/interferon side effect. Pegasus affect the bone marrow causing suppression of the marrow elements and one of the present complaint is thrombocytopenia. Pegasys is being given for HCV treatment. I can advise you two things:1. Platelet transfusions.2. With . Platelet count is too low, and there is a possible risk of internal bleeding and platelet count needs to be improved. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have severe joint pain. Pain on my sternum and the ribs on my left side can hurt so bad I feel like they are broken. Complete lack of appetite have lost close to forty pounds in three months and absolutely no energy. G.I specialist has ruled out everything on his end. ### REPLY: Dear I can understand your concern. On the basis of the information that you have given to me there is strong possibility of some malignancies such as multiple myeloma or leukemia or any bony tumor etc. Apart from this any chronic illness can do all this. We need complete history and examination and if needed certain lab tests to reach the exact cause. In my opinion you discuss these issues first with your physician, as he can see and discuss whole body not only stomach and after that if he refers to you any super specialist then and only then go to that. Hope this will help you. Thanks for contacting . If you have any other concerns please feel free to message me. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I am concurned about my boyfriend John. He is 16 years old and I fear he may be undiagnosed bipolar. Ive researched online and I am almost convinced but i think i need an expert opinion.He suffers from extream depression and has terrible mood swings that can occur at almost any time. Ive had to talk him down from a suicide attempt twice in the last 3 to 4 months.He feels extreamly agitated and hopless, and is constantly anxious. He has what looks like panic attacks and he is also has trouble sleeping most nights.His anger causes him to act out and snap and yell at people. Earlier this month he flipped off the dean to our school! His behavior is unpredictable and quite scary.He used to cut and burn himself, but ive managed to get him to stop that, and he still occasionally abuses Marijunana, but not as much as he did at one point.his parents are in the dark about his problems and are not very involved with him. Hes afraid to confront them about anything, because they do not see eye to eye. Im concurned and frightened, but I am also, only 16(almost 17). What can he do and what can I do as his girlfriend and best friend to help him?Thank you,Mariah ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. I sincerely opine that your boyfriend could be troubled by schizophrenia, not bipolar. He is showing the classical symptoms of the depressive side of bipolar disorder, but not showing the exhilarated state. In any case, he needs psychiatric treatment. First take him to a psychologist who can help you to assess and diagnose the correct problem with the help of psychometric tests. Then psychiatric medicines should help him recover. Please do not delay any further. If you still need my help, please describe the whole problem in detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to overcome your problems. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,I am 10 weeks pregnant and twice i have noticed 2drops of brown stains..we went to the doc and she said things were perfectly normal the baby had indeed grown and the heartbeat too was fine now my question is we plan on a holiday say end of 12 weeks as it is my husbands annual leave...kindly let me know if it cud be safer to travel.... ### REPLY: Hello dear, I understand your concern. In my opinion as everything is normal like growth of fetus the brown spotting might be a cervical bleeding. Nothing to worry. Avoid physical strain, intercourse. Take good rest. It is always better to postpone any journey to 2nd trimester. But if it is a smaller distance with good roads then you can go as you are saying it at the end of 12 weeks. 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: halo im very helthy sports man 60 years old i like to now one thing im on trt meny years but throw time of meny flebotomys my feritin levels when low i reduse my trt dosege end i take iron tablets to bring back my feritin levels but but after 8 weeks of iron pils my hemoglobin levels when to hige now i stop iron pils my question is how loong time take to com down the hemoglobin levels natruly without flebotomy thenk you ### REPLY: Treatment of elevated hemoglobin levels is phlebotomy (blood-letting). The goal of phlebotomy is to keep the hematocrit around 45% in men and 42% in women. Initially, it may be necessary to do phlebotomy every 2 to 3 days and remove 250 to 500 milliliters of blood each session. Once the goal is reached, maintenance phlebotomy can be performed less frequently. A commonly recommended medication for the treatment of polycythemia is called HY .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Three weeks ago, I went to the washroom and saw that my stool was pale colored (NOT white but like a pale-ish very light wood color). I became terrified because Ive read via the internet that it can be a variety of the things. The most popular reason is the possibility that my bile in my gall bladder duct is obstructed by a stone(s) or might a serious liver problem.  I have been a drinker of alcohol for many years, have had a bad diet that has consisted of a lot of greasy fatty food, and have also been taking Prilosec for my acid reflux (for a very long time) due to this sedentary lifestyle. A year ago my doctor had found that my bilirubin levels had increased by a little, therefore, she was not concerned at all but that I should cut out my drinking, which I did but, only for 5 months.  Fast forward to one year later and this happens; I immediately call my doctor to tell her what occured but she told me that she wasnt very concerned or worried because I didnt display any abdominal pain, black tarried stool or brown colored urine and no other accompanying symptoms, and she said that it was possible that my diets the culprit.  She also said that if Im really concerned that I should set up an appointment for blood work but to not be worried. It is now the fourth week, and I have changed my entire diet for the better. So, far my stools are back to normal. No pale stools. No nothing. Can someone with experience shed some light as to what might have happened to me that day? I am still a bit nervous. Is this reversible? Why would my doc say she isnt worried about this? Why is it that I should be worried ONLY if I have abdominal pain, dark urine, or jaundice? Please help! ### REPLY: Hello, balls, Thank you for contacting  with your query. I am glad that you admit abusing alcohol and I hope you are completely staying away from it. If you already have signs of liver damage from alcohol, this is the first step. Alcohol can cause what is called fatty liver where liver cells are loaded with fat and they can't function properly. If a person continues to .  There are also lots of complications such as bleeding from ruptured enlarged veins in the esophagus and stomach, build up of fluid in the abdomen and swelling of the legs and feet etc. You mention pale stool and your internet search showed you what the causes are. Yes, bile duct obstruction or blockage from gallstone or stricture from inflammation can lead to this. Stool is usually chalky due to lack of bile. Sometimes, the blockage can be inside the liver, the smaller channels that bring the bile to the gallbladder. That can happen with liver disease. I would suggest that you get a complete set of blood tests, including blood count, liver panel, and also a sonogram of the liver and gallbladder. Eat a healthy meal with whole grain cereals, nuts, fresh fruits, vegetablesand plenty of fluids. Exercise regularly at least three times a week. I also want you to take a good super B-Complex tablet daily along with Vit-C1000 mg. daily. Hope this helps you. I 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: When I stand up I get light headed my vision goes black and then I see spots then I get very weak and have have to grab something so I don t fall over. And get really diszzy I get savear head eachs. That last weeks sometimes even months ... and then on the other hand I m not has hungry as normal I m always sad and.moaping I m always tired I feel guilt I blame my self for everything I just want to be alone and deppressed ### REPLY: Hello and welcome to . Thanks for your query. You seem to be having prominent depressive symptoms. However, you also need a detailed medical evaluation for your physical symptoms such as vision problems, dizziness and headaches. I would advise you consult a psychiatrist for a detailed evaluation and further treatment for your depressive symptoms. There are effective treatment options - in the form of medication or counselling / psychotherapy which will help you overcome your problems. Wish you all the best. -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor, this is PreethaChandar from India. Recently i have been diagnosed with PCOs on both the ovaries with multiple peripheral follicles (stroma appears echogenic on right ovaries). My doctor prescribed with METFORMIN 500gms - 3 tablets a day. Even after taking the prescribed tablet i not getting my periods.Little worried about periods. I am married 2011, diagonsed pcos 2012 march and planning to get conceive in 2013. Kindly help me. Thank you. Have a good day ### REPLY: Hi, PCOS is usually associated with an ovulation i.e. absence of ovulation. Usually overweight, increased carboy . Metformin ins treatment of choice for PCs. You should do an ovulation test and if found you are not ovulating then your Sync may prescribe Clonidine citrate for induction of ovulation. Irregualr periods may be corrected by having hormonal pills like norethisterone etc. which can be prescribed by your Sync after examining you. Bye ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father is a patient of carcinoma prostate .in his x ray he got D7,D8 pedicles are not clearlyvisualised?bone sclerosis.what does it mean? sclerosis noted in D10,D11 andL2 vertebra-suggstive of bone secondries. sclerosis of left ischium and L3,L4,L5 vertebra and left ala of sacrum-suggestive of sclerotic bone metastases ### REPLY: Hi and sorry to hear about your dads condition. Prostate cancer often metastases to the bone, especially the vertebrae. At this stage, surgery no longer has any added advantage. The main stem of treatment is hormonal treatment to suppress the levels of testosterone. This only last a while and there is often an escape phenomenon. Also, managing his pains is going to be very important. Let him benefit from the best and most powerful available painkillers to keeps his pains away. Above all, he needs your love and continuous support. Be there for him. Comfort him and let him know he's loved. Over all, the prognosis is not very promising. Hope it helps.... Let us know if there is anything more you wish to know from us. Wish him 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: my father is 60 year old and he had a heart bye pass surgery last year and after that he again had angiyoplastic before 4 months, he is suffering for chest heaviness from last six months and all the reports are ok, he feels like lots of weight put on his chest and also lost hope for treatment and wants to die.  plz help us and suggest some treatment so we can same him... ### REPLY: Hi, Thanks for writing to , I am . Chest heaviness may indicate some prob like stenosis going on again BCS your father aging history of HD with CABG n angioplasty, if he was my patient I would like to do proper exam n history that is this heaviness really symptom, or he is just feeling BCS of fear that he already had symptoms of HD n will do X-ray to make sure it's not pulmonary after it will do ECG n ETT to see it's not ischemia again or Anglo to see whether some artery is blocking or either stent is going to block BCS it can be . I would like to make sure that no serious damage is occurred n do echo too to see is there enough ability of heart to pump blood n optimize TX n advice him for lifestyle changes like not smoke if he is, not eat fatty food etc .version is coming in ch diseases BCS of multiple  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: PLEASE READ!!! I have been taking pain medicine and somas for years. I ve never had any problems. I am currently taking 30ml oxycodone and somas. I ve been taking these particular medications for a little over a year with no problems. But recently, I ve had heart pain for the past 11 days. From the second I wake up, until the moment I go to bed, my heart hurts bad. Its a sore/sharp pain. The pain has not gone away for even a minute for these past 11 days. Could this be caused by taking somas and the oxycodone s, or just by taking the somas alone? And if so, what could be the problem specifically? Or could this constant, consistant heart pain be caused by something else? If so, any ideas of what could be causing it? i take around 6 somas a day. And I take them for pain, not to get high. because of my tolerance, I barely feel anything anyways. So im not all messed up when I ve been having this heart pain. Its just constant pain for 11 days now. Someone please let me know if this can be caused by my meds, and why.......coz im FREAKING OUT!!!!!!! ### REPLY: Hello! Your symptoms are probably related to tolerance from sodas and Oxycodone. You should know that these .  For this reason, I would recommend consulting with your attending physician and discussing the possibility of switching to Pregabalin or Amitriptyline to help control chronic pain. It is also important to stop gradually some and Oxycodone. Another treatment option could be Duloxetine. You should discuss with your doctor on the above treatment options. 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 m 26 years old n 26weeks pregnant, last week my urine was tested and there was a trace of protein...i was later prescribed amoxicillin caps which I started taking yesterday.. my questions are; (1)will it affect my baby in any way and (2)is it safe 4 me to still have intercourse with my husband? ### REPLY: Hello dear, I understand your concern. In my opinion when there is albumin in urine the high BP is to be ruled out. If the BP is normal there is nothing to worry. You are prescribed amoxicillin capsules may be for urinary tract infection(UTI). It does not cause any harm to the baby. And yes you can have intercourse with your husband. Usually intercourse is best avoided during the first 3 months and in last months of pregnancy. I just want to say a few things regarding UTI.UTI is the most common infection seen in pregnancy. It should be treated because untreated UTI cause irritation of uterus leading to preterm pains. And taking adequate fluids up to 3 liters per day prevent UTI. So I suggest you to take adequate fluids and also rule out any high BP. As such nothing to worry. Hope this helps. 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: My 21 yo. son has a two week old pain behind his right earlobe in the soft area of area of his skull. It is more painful or noticeable when he walks. No bump present. Is breathing freely, does not hurt when he tips head down below waist. Ho history of any infection or bug bite. No fever. Says it feels more inside his head than on the skin. He has not taken anything for it. On no medications. Jaw does not click when he eats or talks. What do you think? ### REPLY: Hi I did review your concern. Such a pain can be due to mastoid ear infection.I would recommend consulting a ENT doctor and get his ears evaluated and see if there is pus or abnormality in the tympanic membrane. A CT scan of head may be required if inside the skull is to be examined, and it may be warranted in this case to see if the pain is due a cause inside the skull like a blood clot or unwanted growth.I hope this helps Wish you all the Bethany your for choosing . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: respected sir,good evng i am from XXXX, i having giddines in some times while bending the head. before 3 years i had a head injury and followed by seizure. i consulted the dr,they took the ct brain, the report showed normal findings.during last 3 years i experinced giddines twice. what may be the reason for this condition ### REPLY: HelloWelcome to ChatDoctorYou suffered head injury about 3 year back, and it was followed by a seizure episode. Your CT scan came normal at that time. The constant giddiness that is occurring can be due to long term sequel of head trauma. If you are able to control the symptoms then there is no need to take medicines otherwise there are a lot of medicines that can be used in such situations like Betahistine, Linearizing, Vermin etc. These medicines provide symptomatic control of symptoms. Consult a doctor for detailed prescription. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a kidney transplant March 30, 2010.  My new kidney is working perfectly with a creatinine of 0.9.  It started working immediately and has worked beautiful.  I have been on Glipizide since the transplant (5mg twice daily) to control blood sugar.  I was not diabetic before the transplant and feel like if I loose weight, I could control it with diet.  I weigh 165 lbs now and would like to be back to 140 lbs.  Can I do the ChatDoctor diet? ### REPLY: Hello and welcome to . As a Urologist and kidney transplant surgeon, ill never advise a  diet. Your kidney graft is working well so far, then why not exercise regularly and reduce diet intake daily.  diet isn't safe or effective and has side effects.It's not recommended by FDA, as  diet advises to take 600-800 call/day. The side effects of electrolyte imbalance, edema, depression,irritability, etc, are not advised for any patient. You've to be more careful than other people. If you've any doubt. You may send it as a direct question, to me. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have, over the last 2-3 years, been getting sick frequently and with increasing severity. Most recently I have had the flu 3 times in the last year, and bronchitis twice. It seems like every other month I get sick. Every time I see a doctor I ve been told that they can t find any abnormalities. Is there anything that could be causing this, and is there something that I should ask about at the next doctor visit? ### REPLY: HelloWelcome to  Thanks for posting your query I understand your concerns. As you are getting recurring attacks of flu from 2-3years, your immunity has come down. You would have taken lots of antibiotics from past couple of years. This would have further weakened your bodies immunity. So I would suggest you to have good and healthy diet in the former of green leafy vegetables and lots of fruits. Also take a course of BritisChatDoctorplex capsules and iron tablets for 3 months. Hopefully I have answered your query. 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: HI, I am newly married and my wife has become pregnant. we had the intercourse session before 2 weeks.hipati She used a pregnancy tester to confirm and it says yes. We actually planned to have kids after a year. Now, can we stop this pregnancy without any side effects in future. do we have any medicine that stops her from being pregnant. ### REPLY: Hello dear. Understand your concern.first you should confirm the pregnancy by blood  test because its more reliable method.than you should do USG for confirmation of intrauterine pregnancy, because . You can abort fetus by medicine up to 9 weeks of pregnancy. You should do it under supervision of doctor, its more safe. You can take ragout kit, which contain 5 tablets. Take 1 tablet of mifepristone 600 mg orally, after 36-48 hours of it take another 4 tablets of bisoprolol 200 mcg placed in vagina one by one.at that period take proper rest, food,maintain hygiene, take tab.meftalsaps for pain. Hope this will guide you. Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a sore tongue with what looks like a red cold sore under the bottom of my tongue, the two strands of connective tissue (veins) under my tongue are white, one little white pimple like is close by as well, just a dull pain, I do know I bit my tongue while eating so I am not sure if that is connected or not? ### REPLY: Hello, A red sore on the underside of the tongue with a white sore on the lingual papillae that is painful along with sore tongue is indicating towards Authors Dermatitis. At times eating something very spicy, hot and acidic can cause such symptoms. Other causes can be a deficiency of iron and vitamin B12, stress, physical trauma to the tongue, allergies, acid reflux etcetera. I would suggest you consult an oral physician and get evaluated and a thorough clinical evaluation and investigations like blood tests can help in diagnosis. Treatment of underlying cause will relieve the symptoms. As of now, you can start gargling with a numbing mouthwash containing Lidocaine to relieve the symptoms. You can also take a multivitamin tablet daily. You can take an anti-inflammatory painkiller like Ibuprofen. Suck ice and do cool water rinses. Avoid spicy food. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I was on the birth control pill for an extended period of time and just recently went off about to months ago. My last period was from July 12th-16th 2012. I was sexually active three times following that period. I was two days late on my next period, projected date august 2nd, when I had unprotected sex, august 4th. I then took the morning after pill within approximately 12 hours. It has been two days since then, approximately 5 days late on period and two days of morning after pill with no spotting or bleeding. When can I take a pregnancy test and how accurate will it be? ### REPLY: Hallow Dear, You have multiple issues for discussion. Let me solve them one by one. 1. Pregnancy test on urine is reliable after a week of the missed period; earlier, it may report false negative results. Alternatively, you may opt for Blood test for Beta  10 days after the last unprotected sexual relations. 2. Morning after contraceptive pill is very effective when taken within 72 hours of the unprotected sex; you have taken it within 12 hours. So you are protected against the pregnancy due to that intercourse. 3. These pills have some after effects:a. Few days after the pills, some vaginal bleeding occurs which is mistaken as menses. It is normal and does not need any medical attention. b. The period following the morning after pill may get delayed by few days to about a weeks period. Wait for a week after missed period before you take any action. If the pregnancy tests reveal that you are not pregnant and still if you do not get period even a week after the missed period, please report to your Gynecologist.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 26 years old and have been having extreme back pain.At one point I could barey move. I went to the emergency room and they gave me vicodin and valium as well as ibuprofin. None of this helped. My pain levels have been the same. I went to a back doctor and he told me it was probably a herniated disc. He prescribed physical therapy and some pain killers. These meds still arent working and I am not getting sleep. The Valium puts me to sleep initially but I wake up in the middle of the night from the pain. I am in constant pain especially when sitting at my desk or in the car. Walking not so much. Today I was massaging my back when I noticed a firm knot about to fingers width wide on the lower right side of my back near where my dimples are. This is also around the area that hurts the most when I move or reach for something..Does anyone know what this could be? Any help is greatly appreciated because I am in alot of pain and the meds only make me sleep or feel high with no help on the pain. ### REPLY: Hello, Thanks for your query. After going through your query I came to know that you are probably suffering from lumbar disc prolapse. It can be confirmed by MRI scan. There are two treatment options. First option is rest in position of relief(generally lateral position with both hip and knee bend), neurotopics such as mecobalamin and analgesics (Diclofenac three times a day after meals is effective). Sometimes strong analgesic(such as tramadol three times a day after meals) is required. Omeprazole before meals prevent acidity caused by analgesics. During rest for disc prolapse walking and sitting is not advisable. It is rather strict bed rest. Second option is go for surgical operation(Discectomy). You can discuss with your treating Doctor about it. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sometimes my hands and feet get so itchy and then turn red the swell very very big and I feel dizzy, Just now i took off my shoes and they immediately turned red started to swell and itched for such a long time my feet itch so bad alot and my blood sugar is great all the time please help me figure out what this might be. ### REPLY: Hi. Thanks for posting your concern at ChatDoctorYou seem to be suffering from Hives OR urticaria would definitely advice that you visit a dermatologist for a proper assessment of the rash. Urticaria OR hives can occur due to various causes like(to name a few) infections(bacterial, viral, fungal), .  A few cases have no underlying cause and are known as idiopathic urticaria. I would advise you to get few basic lab tests like Hologram, stool for ova/cyst, Urine routine, Chest X-ray. An oral antihistamine like Fexofenadine OR Loratadine once or twice daily for a week would be suitable. They are non-sedating and won't affect your alertness level.a topical soothing lotion like calamine would help you symptomatically. If your Urticaria still doesn't get better you might require a short course of oral steroids. 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: SHOULD I BE CONCERNED FOR MY 14 YEAR OLD SON WHO HAS BILATERAL L5 PARS DEFECTS WITH GRADE 1 ANTEROLOSTHESIS AND DEGENERATIVE DISC DISEASE AT L5-S1. SIGNIFICANT RIGHT FORAMINAL STENOSIS WITH SUSPECTED MASS EFFECT UPON EXITING L5 NERVE ROOT? MY SON CURRENTLY PLAYS FOOTBALL WITH HIS SCHOOL. ### REPLY: Hi, as you mentioned the anteriolisthesis and the disc degenerative disease at L5 - S1. First we need to see if he has any symptoms. Usually, MRI scan has to be correlated with the Clinical symptoms. Also, you can take him to physical therapy, for learning the exercises which will help stabilize the spine. Besides, this exercises he needs to follow in future to avoid recurrent back aches. Exercises like - core stability, spine Strengthening, pelvic floor Strengthening etc. Based on the weakness of the muscles the exercises will be guides.Also, the anteriolisthesis has to be controlled because the listless has only one direction - that is progression. Usually performing regular exercises will help to keep the muscles intact and stabilize the listless.Also, if ignore now may lead to recurrent back aches which may not allow him to perform well. Besides contact sports has to be avoided for time being. Since he plays football - the mobility of the spine is high and also the weight applied on the L5 - S1 level. Once the muscle is strong the load of the stress will be borne by muscles or else the joints. For more details you can ask me directly I will be happy to help you. Since your son is 14 years old I am a bit concerned.regards. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently bruised my ribs (6 days ago) doctors at a&e were happy my organs were OK. Today, I started feeling rattling on left side of chest, right below my breast. I can feel it when I out my hand there too. It only happens when I take deep breaths, in and out. I do a lot of running and exercise, which I m adament I won t stop doing. Is there any need to worry about this? ### REPLY: Hello I have read your query. There is possibility of rib Costco .  Neurotrophic medication like pregabalin and methylcobalamine can be started consulting your doctor. Physiotherapy like IT And TENS will help you. Another possibility of rib contusion. CT scan will help you in diagnosis. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. 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, My partner has Myeloma. He has had 2 transplants and he has now refracted. Revlomid has brought the paraprotein level down to 16, but his platelets, white blood cells and haemoglobin are all regressing downwards. Yesterday he had a bone marrow biopsy and 3 transfusions of platelets etc. Could you tell us honestly what the next few months should typically hold? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Prognosis of multiple myeloma is very poor despite treatment. Pancytopenia, various infection, bleeding, bone involvement and fracture, kidney involvement and chronic renal failure are the complications. Life expectancy is not good. Bone marrow transplantation is helpful in some cases. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have allergy problem..during winter season i get severe running nose ..some times wheezing and breathlessness.. i used seroflo inhaler during night but for the past few days my nose is blocked in the upper portion and i cannot take air through the nose..i used nasal drops i get relief and again aftr 6 hrs the problem repeats again.. what should i do? ### REPLY: Hello, It is very likely you suffer from house dust mite allergy and will need either blood tests or specific IGE tests to confirm this. Other aeroallergens such as molds, animal dander (if you have pets) should also be checked. You need a combination of long-acting antihistamines such as Fexofenadine 180 mg in the morning, mometasone furnace nasal spray 1 spray per nostril once daily, Montelukast 10 mg at night for the winter months (3 months) to see the benefit. Obviously the best decision on duration & time of treatment will be decided as per the results. 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 ex husband is visiting my daughter. He lives in Costa Rica now. Has had a cyst on the back of his neck.They wanted to remove it but to close to his spine??? He has been treated with many antibiotics. She hasn t seen him for awhile. Says he looks terrible. Lost a lot of weight. not been feeling well for months. ### REPLY: Hello I have studied your case Your infection has subsided now. You can excise cyst consulting your doctor, you may need pre-operative investigation like ultrasonography. You can get weakness due to infection and nerve involvement around cyst. So improve your diet take vitamin supplement. If required later on you may need to do blood investigation for prognosis and recovery. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have co start headaches and they keep getting worse and worse I was told I have an enlargement of the putuitary gland and I have been having these head aches for 3-4 yrs and just getting worse I do black out and feel like my vision is getting worse I have SLE and still lactating I have a 5 yr old daughter which I stop breast feeding since she was 2 1/2 so I have been lactating ever since and I have had 2 miscarage a I need help should ? Could I get my putuitary gland remove ? Would my head aches go away? Will I be able to carry a child again? ### REPLY: Hello. I have been through your question and understand your concern. It seems you have the signs of a Prolactin secreting pituitary gland adenoid. I recommend the following1. Serological test for hormones, especially prolactin2. Visual field examination3. MRI for the seller region4. Endocrinological consult5. Neurosurgical consultancy you follow these steps, you will have all your questions answered. Hope this helps, please feel free using  for further questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had teken microgynon 30 for about 9 years but then I stopped and started on it again on sunday. but since monday i feel sick every morning as if im about to vomit but nothing comes out and i ve also got loose bowel movement, watery type and also since tuesday i have been feeling so cold, and i never ever get cold ever. on tuesady my whole body ached. since july last year my bowels have changed, i used to have solid bowels as in the shape but after a bout of constipation and bloating but bowels never back to the same and are soft. ### REPLY: Hello, Yes Micrigynon have some side effects those are:- Feeling sick-Abdominal pain-Headache- Breast pain or tenderness-Slight bleeding or spotting between periods in the first few months-Lighter periods or sometimes stopping of periods-Mood changes-Fluid retention cold and body ache you need non-steroidal anti-inflammatory medication. Certain health and nutrition problems can cause constipation:- Not eating enough fiber-Not .  ### END