Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 painful swelling just on the inside of my ankle below the bump. The swelling hasn t increased by much over the past few weeks but by the end of each day it is a bit more swollen. I It is about two inches in length just under the preference and strikes out about even when with the bone. It hurts about a four off or five on the ten pain scale when walking and a out a two when resting. Today I tried an preinflated ankle brace for doing walking and light chores. It felt pretty good. The only reason I m asking if I need to get it checked by the Dr is that I m leaving for a two week trip and don t want to end up in a strange ER. What do you think? ### REPLY: Hello, Thanks for writing to us, I have studied your case with diligence. As per your history pattern there can be persistent tear in ankle ligament leading crunching sound or capsular tightness. I will advise you to consult your doctor. I will advise doing MRI ankle for soft tissue involvement. Till time, you can continue physiotherapy exercises and also use supportive splint or brace. Physiotherapy like ultrasound and TENS will help in early healing. If there is complete ligament tear then arthroscopic ankle ligament repair can be done or if capsular tightness is severe then release can be done. Infection needs to be ruled out. 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. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hii have just come back from a holiday in italy and venice.  I have had quite a few mosquito bites in the last 7 days, and twice i have felt dizzy and light-headed (not sickness) that has lasted for approx 4-6 hours (from waking up til mid-afternoon).  could this be caused by the bites and what should i do? age 38, male, 5ft 10in, weight 14stone, take medication for high blood pressure. many thanks ### REPLY: HIT hanks for posting your query to .  I don't think it is due to mosquito bite unless you have fever (which can be due to mosquito bite).  There are many causes for Dizziness, from simple and easily treatable causes to serious causes. Simple causes are :1. Abnormalities in BP: Both high and low BP can cause dizziness. 2. Abnormalities in Blood sugars: Both high and low Blood sugars can cause dizziness.3. Abnormalities in blood sodium levels. 4. Low Hemoglobin (Anemia)5. Inner Ear problems. Some serious problems are :1. Heart Problems2: Brain problem My advice to you is to get your Blood pressure, Eyes and Ear examination done and if they are normal kindly get the following tests and revert to me.  Hemoglobin, Fasting and Postprandial Blood Sugars, Serum Sodium levels, Serum TSH, Serum Vitamin B12 levels checked and an ECG.  Hope you find this information useful. Any clarification feel free to ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am Taban from Uganda, We have been managing an adult  patient here of 42 years for about a month in a public hospital.Tooth reported to have fallen off while brushing; this resulted into hospitalization in a lower level health facility. Has oral candidiasis. purulent discharge from the socket of upper right jaw(17). next tooth available is 13 which is mobile. examined yesterday, and there is communication with maxillary sinus. Did Full Blood Count on 13/09/2011 results thus: WBC 4.1, LYM 0.8, GRAN 2.8, HGB 9.1, MCH 22.5, MCHC 34.4, RBC 4.06,MCV 65.6,HCT 26.7, RDW% 21.0, PLT 61. ### REPLY: With your query, this is a case with infection.is he healthy without any systemic diseases? How are his built I mean is he well nourished? How about his oral hygiene status?and does he have any adverse habits like smoking etc...? First of all check his systemic health status then periodontal health status with oral hygiene later keep him on antibiotics ask him to have good food fir candidiasis give him some antifungal .  Hope this helps you kindly visit your oral physician for further needful ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am having a very heavy chest pain everytime i get out of bed ,for the past few days i have had a weak arm(left) and shortness of breath.i always see black spots and dizziness.i get panic attacks while sleeping sometimes,wake up struggling to breath.i have seen many doctors and some says its anxiety,once a doc said it was anemia but the blood results were fine. i am very confused. i need help. ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, we should first rule out heart diseases for your symptoms because left sided chest pain, breathlessness are common symptoms of heart diseases. So get done ECG, 2d echo and stress test (trade mill test). If all these are normal then no need to worry about heart diseases. Undiagnosed stress and anxiety can also cause similar symptoms. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You will also need anxiolytic .  Don't worry, you will be alright with all these. Avoid stress and tension, be relaxed and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with pleurisy October 19th & it lasted for only 3-4days....Since then I have had no problem,until now. I cleaned the bathroom with bleach on Monday & since than my chest hurts when I breath & I even had pain in my rib. The pain in my ribs are gone, but it still hurts when I breath. Could this be my pleurisy or something else more serious due to the bleach inhalation? ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of inhalation induced bronchitis is more in your case. Bleach contains chlorine, fluorine etc. These chemicals, on inhalation, cause irritation and inflammation. And these all lead to bronchitis. Bronchitis causes breathing difficulty. Best treatment is inhalation of fresh air and avoidance of exposure. Antihistamine and anti-inflammatory .  Inhaled bronchodilators are needed if patient is having breathlessness. So you need inhaled treatment with antihistamine and anti-inflammatory  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, we had family trip about a month back and following that I had contact hepatitis A infection. How is hepatitis A infection caused? How is it treated? ### REPLY: Hepatitis A is spread by people with an active infection, even though they may not have symptoms. The virus commonly spreads from the stool of one person to the mouth of another. This can occur when an infected person uses the bathroom, does not wash his or her hands, and then handles food that others will eat. Or the virus can be waterborne, meaning it is picked up from contaminated water or by eating contaminated raw shellfish. The virus can also be spread through the saliva, blood, and other bodily fluids of a person with the infection, such as through anal sex. Hepatitis A is contagious for two to three weeks before symptoms appear, then for two to three weeks afterward. Treatment includes bed rest, a balanced diet, and avoidance of alcohol and certain medications that could affect the liver for at least 6 months. Hospitalization is only necessary for more serious cases, or for severe deny .  Persons known to have been exposed to hepatitis A are recommended an injection of a substance called immune globulin, which can reduce the symptoms of hepatitis A. There is also a vaccine available that may provide years of protection against hepatitis A. The vaccine is usually given to people who will be traveling in areas where there is a high risk of contracting hepatitis A, or work in high risk areas, such as healthcare. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife 33 years old premenopausal women 171 cm ht,64 kgs weight had left radical mastectomy & left axillary dissection  20 days before ,confirmed on biopsy grade-2 ductal carcinoma & 12/24 lymph nodes with metastatic carcinoma?.week before undergone full body PET CT scan ,impression is no critical disease any where in the body & no metastatis.But our oncologist says 8 cycles of chemotherapy to be done ,radiation therapy to kill microscopic cells which cannot be detected by PET CT.We are worried of chemotherapy but we do not have option.Suggest please ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  She has ductal carcinoma of breast.  Stage 2 with no metastasis.  She has already gone through surgery.  Noe she should take chemotherapy.  She should also check for ER, PR and her 2 new. If this receptor is positive then receptor specific antagonist treatment is very useful in breast cancer. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been taking blood pressure medicine for about 16 years and I am only 36. When I relocated to XXX, I started having problems with allergies and noticed that I was really short of breath at night. My doc prescribed singular, it seemed to help short of breath, then about 5 years later, my short of breathness got so bad I was put on an inhaler . It now affects me during the day when I m working out and at night. I have seen a heart doc and he says my heart is fine, however I m concerned that I still am experiencing my short of breath during workouts and at night even while on asthma meds; sometimes it feels like the asthma meds makes things worse. I m considering seeing a differnt heart doc, already switched asthma docs (who is concerned about my shortness of breath at night). ### REPLY: Sometime a salt of medicine donor suits youth body is able to resist in young age and as age grows body shows' allergy to same satin my experience if you range salt to other family it might help you your cardiologist will help you to change the group of BP medicines along with don't use broken, paracetamol,disdain if taking stop for time and take antiallergic cough spy you can post after getting salt group of BP medicine changed by doctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I fell down a flight of stairs during the summer, and got a giant bruise on my left butt cheek. I went to the doctors and he gave me something for the pain, and the bruise healed surprisingly quickly. Now, the bruise has been gone for months (almost a year), but I still have a hard lump that s a bit smaller than an egg on my butt. I was told that it would go away, or at least get smaller, but it hasn t. I m feeling very self consious now because my butt is lopsided, and so I haven t been able to wear some things I would like because I m afraid someone will notice. Is there any way to make it go away? Some more information, the bump hurts sometimes, not often, but it does get sore. Also it s kind of far from the surface so it s a bit harder to feel unless you really press down. Please, don t rush to answer because I m sure there are way more serious problems here than mine, but I appreciate the answer when you do get back. Thank you. ### REPLY: Hi! This is very common and please don't worry about this! Often I come across such cases of post-injury bumps here and there on peoples bodies and get few things to learn every time:1. These are old organized hematoma often gets calcification within them so that the swelling doesn't disappear, rather it hardens!2. It can get infected in case of any kind of manipulation resulting in an abscess3. Often these are forgotten, and only some complication reminds of it4. Underlying bone fracture might be there creating re-fracture in remote future!5. Some antibiotics may result in the formation of anti-bigamy and pains on touch due to hardness! But never malignant or any serious disease! Therefore, if still worried, get it to some surgeon for needle biopsy, x-ray and confirmation. Regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have been experiencing shortness of breath and the chest seems to be congested causing me to breathe in more air and stop my regular activity. This started a few weeks ago - before that I had no issues and I was playing regularly without any problems.Now since the last few days I could see that I am not comfortable breathing in and I have to take rest and sometimes my chest freezes up causing me to be immobile for a few minutes, till I get my breath back.I sometimes take Montek LC in the night and I have no issues for a day or so and I could actually feel that my breathing is not a problem. I sometimes resort to Asthalin inhaler for immediate relief.I am male, 35 years old and I usually have breathing problems during cold season and polluted environments.Can you tell me if I use Montek LC regularly, would my body become dependent on this tablet.Thanks-Rahul ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of allergic disease like asthma is more because you are having symptoms after exposure to cold and pollution, and you are improving with Monte LC (anti-allergic + anti histamine). So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PUT (Pulmonary Function Test). PFT is must for the diagnosis of asthma. It will also tell you about severity of the disease and treatment of asthma is based on severity only. Asthma needs long term treatment with Inhaled .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi there my name mary I have been with h.pylori for years.i had triple tablet three time but nothing change,but I do have this symtoms upper abdomen sharp pains and bloated everytimes,iam on nexium tablet for seven months but not improving.is there anything to help me please.thanks ### REPLY: Hi. H Pylori is not the sole cause of upper abdominal pain. As the medium is not helping you, we should go for finding other causes of pain in upper abdomen and bloating. I would suggest in such a patient the following:Investigations:*Routine blood investigations like Complete blood picture, blood sugar, urea, creatinine, liver function tests, thyroid function tests.*Urine -routine and microscopy*Stool: routine, microscopy, occult blood, culture and sensitivity.*Ultrasonography of abdomen, *Colonoscopy All these investigations should be within normal limits for one to say you have IBS. Further treatment will be easy and fruitful if we find the correct reason of your symptoms. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 10 year old son has been have diffuse stomache pain and had a workup things that were out of range are as follow: high absolute lymphs- 3.7 low: alkaline phosphatase 144 high wbs- 9.6 My son is well nutritioned and in the 85th percentile for height and weight. What could the issue be? He has had some constipation which is not normal. ### REPLY: Hi...THE MOST COMMON REASON FOR PAIN ABDOMEN IN KIDS IS CONSTIPATION. The other parameter you have quoted like high counts and low alkaline phosphatase are not related to pain abdomen. It could be constipation. I have certain questions and suggestions for you. Questions:1. Did your kid pass motion or meconium on day one of life?2. Since how long is the kid constipated?3. Does the kid have any bleeding along with hard stools?4. How much milk does the kid consume per day?5. Does the kid eat fruits and vegetables (fiber diet) appropriately? You can get back with answers at the following link - www.ChatDoctor .com/doctors/ .  Natural methods are the best to relieve constipation.2. Constipation is a risk factor for UTI3. Maximum milk consumption per day should not exceed 300-400ml4. Minimum 3-4 cups of fruits and vegetables to be consumed per day5. Toilet training - that is - sitting in Indian type of lavatory daily at the same time will help a lot. 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: Yesterday morning while brushing i vomited and after that saw a very small amount of brown color in my saliva. and after that i am seeing small amount of brown color in my saliva. Most of the time the saliva is not in pure white color.please suggest me what to do? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint vomiting and nausea during brushing teeth is commonly seen in individuals as many individuals have a sensitive soft palate and when brush touches the palate deep or there is accumulation of foam and saliva in mouth there is a gag reflex and some people may tend to vomit. The brownish color that you have seen seems to be traces of blood that might have occurred due to bleeding from the area of throat due to vigorous gagging or can be due to bleeding from throat or pharyngeal region if you have any conditions like acid reflux, chronic upper respiratory tract infection, sinusitis, throat inflammation etc. In case if you experience frank blood or repeated episodes of brown color in saliva you should consult an Oral Physician or an Otolaryngologies and get evaluated and treatment of underlying cause will relieve the symptoms. 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: I have had three shoulder surgeries on my right shoulder. The first was in 1991, second one was 2004 after a fall on an outstretched hand, and the most recent was in November 2017 where they reattached two tendons ( supraspinatus which was retracted 5 cm and the infraspinatus which was also torn but not retracted). I also had a tendosisis of my bicep tendon. The bicep did heal, but the two tendons did not heal as it was explained that the retracted tendon was there for several years and fatty tissue filled in the space and reduced the integrity of the tendon. It is now suggested for me to have a reverse should replacement but I am concerned that my surgery will not be a success. I also am wondering if I will have full range of motion and strength in the arm afterwards. I am 63 and otherwise in good health, but do have some arthritic tissue. What is the success rate of this surgery and my expected ability to function afterwards? ### REPLY: Hi, Reverse shoulder replacement is designed for rotator cuff arthropathy like in your case where muscle repair is not successful. It's a good procedure. Though you will never have a full range of motion, you will be able to do all your daily routine activities. You are 63 years and your shoulder will never have that strength that you had in your young age after any surgery. So you should have realistic expectations, and can go for surgery. 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 30 years old married man  and i  enjoyed my sex life in nice way but now i`m not happy bcoz of lack of strength and small size of my penis.this is bocz my married life turned in worse condition so you pls suggest me ,what should i do and what medicine should i take to overcome this worse situation. ### REPLY: Dear, We understand your concerns went through your details. Please be specific. What is the erect size of your penis? You must understand size seldom matters. Even a two-inch-long erect penis can provide complete pleasure to any woman across the world because the vagina has pleasure endings only up to two inches from vagina opening. Your lack of penis strength during erection must have been caused by your apprehension and anxiety about the length of your penis and general sexual anxiety. You should not indulge in sexual activities for a week. Read as many articles as possible and understand the given clarifications. Then you can have renewed sexual relationships. Your problem will be solved. Please consult a psychologist for counseling. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome. Good luck. Happy New Year. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 34 weeks pregnant and my baby has been 3lbs 10ozs since i was 32 weeks along. Is there something wrong? My doctors say to be very careful but wont give me any information on what is wrong. They also say that my placenta is too small and sound all concerned but wont answer any of my questions? Can you help me? ### REPLY: Hi, Low baby weight and small placenta at 34 weeks require detailed evaluation and an ultrasound Doppler to check for blood flow in placenta. And if changes are present delivery can be planned and considered either immediately or by 37 weeks depending on the babies condition. Also baby growth weekly and amniotic fluid levels need to be checked along with fetal heart tracing. Contact your obstetrician immediately. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doc, My USG shows hepatomegally and fatty changes in liver. Everytime i feel my liver is enlarged while walking and even bending My bolld test shows sgpt / sgot increased.60 and 43 respectively Bilirubin 0.92 although everytimes its found to be more than 1.0 Everytime I am feeling nausia and vomiting tendency. Pricking pain in liver / sometimes burning sensation also present. My problem is about 3 yrs old. My urine is never clear and white. A new doctor has prescribed UDILIV 300 BD for 1 month and od next month what should i do ### REPLY: Hi, Thanks for posting your query. Your liver function test is normal (as figures mentioned by you) except slightly raised GOT/ SEPT. Are you an obese person? Fatty liver is a common ultrasound finding and deranged GOT/ SGPT may be due to fatty liver. Your pricking pain doesn't appear to be due to liver pathology. What was your gall bladder status? You should also go for endoscopy. You should consult with internal medicine specialist / gastroenterologist. 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 having the most difficult time concentrating, have nausea periodically, have really weird urination patterns (sometimes when I drink lots of fluids it all stays in my body and other times it all comes out), often have headaches, dealing with depression, get flushed for no reason, my heart starts beating hard and fast for no reason at least once a day...what could this possibly be? I have also started to lose what seems to be a lot of weight... ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. I sincerely opine that the problem you are facing now is of your own creation. This is a mental disorder named health anxiety or health phobia. You are worrying a getting anxious about your health so much that you always look for body and health symptoms of your body. You always find something is wrong with your body even though there is nothing to worry. I suggest you to visit a psychologist for expert advise. 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: My right arm is numb and tingly and the veins in my right hand have come to the serfice a lot and look like little balls on my hand. I have been dealing with a lot of stress lately so it scared me, I thought I was going to have a heart attack or stroke. I m 40 years old. ### REPLY: Hello, The numbness in the right arm could be related to a pinched nerve. The visible veins are not concerning about anything serious. So, there is no reason to panic or go to the ER. When the situation of coronavirus will be over, I would recommend consulting with a neurologist for a physical exam and performing nerve conduction tests to examine your nerves. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i was told yesterday i have schramsberg disease, i suffer from hive breakouts several times a month. this past saturday i had hives, heat stroke (i believe) and fainted. As a result i got this breakout on legs that sat. evening. My question is do these two things have any thing in common. and how can i manage them...? ### REPLY: Hi & Welcome to . I appreciate your concern for the Chamber disease & hives. As such they are not related. Schambergs disease is a chronic discoloration of the skin which usually affects the legs and often spreads slowly. It is caused by leaky blood vessels near the surface of the skin, capillaries, which allow red blood cells to slip through into the skin. The red blood cells in the skin then fall apart and release their iron which causes a rust color, this accounts for the orange tint of the rash. Hives (urticaria) are raised, often itchy, red bumps on the surface of the skin. They are usually due to an allergic reaction to food or medicine. When you have an allergic reaction to a substance, your body releases histamine and other chemicals into the blood. This causes itching, swelling, and other symptoms. There is no cure for Chambers disease; the itching can be controlled by a cortisone cream on the affected area. For hives treatment may not be needed if they are mild. They may disappear on their own. Avoid the triggers for the allergic reaction. To reduce itching and swelling:Do not take hot baths or showers. Do not wear tight-fitting clothing, which can irritate the area. An antihistamine like Defense .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 QUERY ABOUT THE PREGNANCY FR THE LAST 3 MONTHS WE HAVE TRIED BT NO RESPONSE TILL I HAVE NO IDEA ABOUT INTERCOURSE STRATEGY MY AGE IS 27 AND MY HUSBAND 28 I HAVE A IRREGULAR PERIODS NT PREDICT OVULATION CN REGULAR SEX REGULAR SEX HELPFUL AFTER MENSTURATION ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern look the coitus is the natural instinct that does not need any special instruction or training, now for the pregnancy certain necessary condition are there and that should be fulfilled, ovulation, normal numbers of sperm, coitus at the time of ovulation, keep trying for this, you will be succeeded, hope this information helps you have nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Dr, Im shampa, want to get pregnant, the problem is my husband having ESBL urener track infaction. i dont know wheter Ill conceive it or not . today is my 25th day, last period was 15th Nov. pls advise, what is the time takes for get the result? ### REPLY: Hallow Dear, Home pregnancy test on urine is reliable when performed about a week after the missed period. On day 25 of the cycle, it will not give reliable result. Since your last menstruation was on 15th of November, you should perform the pregnancy test on overnight morning first urine sample any day after the 22nd November. This test gives the result instantly. If you want to know the pregnancy status earlier, you can opt for Beta  test. This test gives reliable results 10 days after the conception; i.e. 10 days after the unprotected sex. You have not mentioned when did you have your last unprotected sex. You may perform this test 10 days after the last unprotected sex. Furthermore, you can get the results of this test from the laboratory, generally on the next day. Urinary tract infection may change the Millie intern ii of the semen and may affect the quality of the sperms; hence may cause problem in conception. Please get your husbands urinary infection treated first before attempting for pregnancy.  I hope this helps you to resolve your dilemma.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, My brother aged 57 had swelling over the chest wall since 4 months, no pain. CTscan chest;Soft tissue swelling over anterior chest. Biopsy diagnosis ;Diffuse Large Cell Lymphoma |  Which is the best treatment for Lymphoma?  Wheather  Amway products like Perselienium-E[Tablets], Protein powder and Bio-C[tablets] are recomended for improving the cells and tissues. please tell me the stage of deases. ### REPLY: Thanks for your question on . I can understand your concern. First let me clear you about his disease. He is having diffuse large cell lymphoma. It is very rapidly growing and life-threatening cancer. For accurate staging, PET scan is needed. So first consult oncologist and get done PET scan and determine staging. Only treatment optional for lymphoma is chemotherapeutic .  Amway products are herbal products. They are supportive in nature, not curative. So better not to take give only Amway products. Consult oncologist and start chemotherapeutic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a tooth that was behind my adult tooth.  it fell out today about 30 mins ago, and it left behind a bloody ball type thing behind my adult tooth.  the tooth that fell out was holly and had a chip in it( a hole actually) when i had chipped it a few months back is this ball something i should be worried about?? ### REPLY: The tooth that gad fall out would be a supernumerary tooth... A supernumerary tooth is a extra tooth apart from the tooth which should be there in the oral cavity...it looks like a normal tooth in shape and size. They are generally located behind the normal tooth but can found anywhere Buccal, Lingual, Palatal, Distal or Medial... Now if it had fallen of its own....bloody ball may be just residual plug which was left after tooth fell off. The plug actually contains blood, soft tissue remnants .... I would suggest you to visit a dentist so that he or she will curettage the socket...and clean did Betadine in order to avoid further infection. Hope this will help you... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor. I am currently on fertility treatment. And had my 1 cycle of serophene but at 11 dpo the test came negative. As I have irregular period, i have to take primolut before the 2nd cycle begins. I am taking primolut but do you think i may have tested too early during the first cycle? ### REPLY: Hi, Thanks for writing to . Ya you have tested too early. After confirmed ovulation you should check after 14 days. In some it may take 3 to 4 was after ovulation for pregnancy test to come positive. I suggest next time take ovulation inducing .  Keep a track on follicle size. Once it ovulates then wait till your next cycle comes. If one week delay is there get pregnancy test done. If you ovulate then there will be no need to take any  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my daughter is 3 years old and her complesion is dark and it looks like bluish in color although me and my husband are very fair.someone told me that due to intake of hypothyroid medicine and iron suppliments her complexion is like this. Is it true? and is there any way i can lighten her complexion :( ### REPLY: Thanks for asking via , bluish color of skin is due to -The lungs are not getting enough oxygen. Since oxygen is what makes blood turn red, blood cells without oxygen remain blue ("cyanosis"). The underlying blood is moving sluggishly, so the normal veins underneath that carry blue, oxygen-poor blood back to the heart are more noticeable. Consult your pediatrician, get examined. If every thin is OK then do nothing at this age. 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: Yes please! I am 38 years old and for the past year I experienced a bout of extreme left stomach pain that went into my back, muscle aches where I felt as if I had arthritis in my arms and legs and my head throbs and nausea. I notice sto Ach pain more after i eat. I am 112 lbs and 5 foot 2 inches . Fortunately these bouts last about 2-3 weeks but unfortunately when I go from pop to GI specialist to test the pain is gone. Colonoscopy showed redness but nothing. Endoscopy showed ? Barrett but nothing. Ct shows kidney stone on right and some enlargement but just repeat ultrasound in year. Smooth muscle antibody positive but repeat test in 6months. My last bout was in April, then out of the blue about 4 days ago it hit! I am so fatigued, my muscles ache and my head throbs in addition I have terrible left side pain. I am very active with two children 17 and 3. I can t stand feeling this way, otherwise I feel good, I can do things as daily living but I am in pain, I say to myself only about 2 more weeks. I had an ovarian cyst in past that ruptured and required surgery, pain too high for that, I had appendix out and gallbladder out. Please we help ### REPLY: Hello! Your symptoms may be caused not by an abdominal disease but by a backbone disease. If there is a spinal cord constriction pain appears, and its localization is dependent of the sick backbone region. This pain is often associated with headache and hands/legs numbness.  So an MRI of a backbone might be advisable as all others tests showed nothing. Another disease that gives joints and abdomen pain is Crohn's disease or other immune dependent intestines' disease. According to all tests you have mentioned, there is no small intestine examination. That is why CT Enterocolitis might be necessary to rule out any small intestine disease. In ruling out other, rare disease there should be Hepatitis A and porphyria included. To rule it out liver enzymes and porcine metabolites in blood and urine should be tested. Hope this will help ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor, my child is 4years 6 months old.She has nasal block, snoring and decreased appetite. Recently it is diagnosed that she has enlarged adenoids.We have consulted a pediatric ENT surgeon. Is there any possibilities that because of this problem they get temper tantrums frequently and for longer durations like 45 minutes. ### REPLY: Hi, Welcome to . Thank you for your question. Yes, usually toddlers get cranky and throw temper tantrums whenever they feel uncomfortable. Your child is more likely to be irritable due to lack of sleep and hunger. If I was your children treating doctor I would have given medicines for symptomatic relief such as saline nasal .  Give your child lots of fluids, soups. I would suggest you to discuss with your doctor regarding further treatment options. I hope this answers your query. Good luck. With best regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good day my name is fidelis,Presently am on medication for typhoid fever,about bouts of antibiotics and other drugs were given to me through the vein in the hospital I was discharged,presently I no longer feel the fever,buut there is this stomach pain not very sever though,and when ever I eat feel this kind of indigestion,like it doesnt move down my lower stomach,Want to know if this is common with tyhpoid fever and will it go away with time,or it requires another special medication ### REPLY: Hello welcome to  thanks for your query are taking antibiotics for the treatment of typhoid fever... The treatment may include painkiller, antipyretics also,they cause gastric irritation so much. Because of this gastritis you may feel pain in the abdomen,heaviness in the stomach... To avoid all these take proton pump inhibitors like antacid.it should be taken at least half an hour before breakfast in the morning...daily 1 tab.with in 2/3 days you may feel free from symptoms Hope you understand my suggestionThank 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, the roof of my mouth has been burning ever since I got my braces put in, but i m not sure if one has to do with the other. Everytime i eat or drink something it burns and it feels as if the roof of my mouth is raw. What can i do to get it to stop burning ? ### REPLY: Hi, Getting braces and the burning could / could not be connected. It could have been due to some food trauma as you might still be getting used to your new braces. In a similar scenario, I would advise my patients to stop eating any spicy food in the meantime, start with warm saline rinses 4-5 times a day. Apply topical McCoppin gel or a similar formulation before having food. Try this for next 1 week, and you should be fine. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 5 weeks late for my period for the first time EVER, 2 pg tests, neg, ChatDoctor blood test neg. I have been feeling all the typical pg symptoms, the past 5 days, i have been spotting pinkish/red, but no accumulation on pad. I ve had a bad lower back ache most of the past 4 weeks. I have had no pms symptoms at all. ### REPLY: Hallow Dear, Urine test for detection of pregnancy as early as five days after missed period may give false negative results sometimes. You may repeat the test after 5 more days to have reliable results. The other option is to go for Beta  test which is very specific and sensitive. This test gives reliable results even 2-3 days or even earlier after missed period. If all these tests reveal that you are not pregnant, and you do not get your menses, you may take Devilry pills for 5 days. 4-7 days after discontinuing Every, you should get your menses. I am sure this helps you.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a dental fistula for several months now, every now and then it allows to drain the puss through my gum.Can I leave it like that or should I proceed with oral surgery as my dentist recommends. The root canal procedure was done about 20 years ago but about 3 years ago this tooth started to give me problems, pain and infection that got untreatable with antibiotics till this fistula has developed and the pain is gone since then. ### REPLY: Thanks for your query, I have gone through your query. The pus discharging sinus tract can be secondary to the gum infection. Since you are giving history of previous RCT, it does not look like tooth infection. It can be secondary to deposits around the tooth, or it can be secondary to infected residual cyst. Consult an oral physician and get it evaluated. You need to take a radiograph to confirm the diagnosis. If it is a gum infection, then get your teeth cleaned(incision and . If it is because of infected articular cyst, then get the cyst enucleated. Get the tooth treated as early as possible because if the infection spreads, it can involve bone and result in osteomyelitis. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: am having pimples and dark spots all over my face for many years,pls i need ur help on what to do make my face to be smooth or what to use to make my face to be smooth,pls i need ur assistance urgently,thanks pls i took postinor two tablet at once two times in a week,does it hv effect on my womb,will i be able to give birth again ### REPLY: Hi Sump...., Thanks for writing in to  ! Posting is levonorgestrel used for morning after pill emergency contraception. It would not affect your ability to conceive in the future, it causes short term hormonal changes only. The pimples are due to collection of fatty secretions, local acid formation and bacterial infection which leads to formation of comedones-the black heads. Best method is to wash the face with lukewarm water and soap(you can use medicated soaps like-savlon/detail) but not the face wash or other very soft preparation. You should . Then apply the cream Benzoyl peroxide(Pernod/Person 2.5% gel) twice a day for 45 days. Avoid fattening foods, fried foods and fast foods for best results. If you have any further query please let me know I would try to answer it for you. Wish you a great 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 baby was born with severe billiruben levels which have now at 14 weeks gone back to normal, hes has test after test scan after scan to find out why his liver ensymes are still high, they are comin down but are still high, because every test is comin back clear as is the scans he is now booked in for a liver biopsy tomarrow to find out what it is, hes on medicines to help the liver as its inflamed, if it was somethin serious or a tumour wouldn they have seen it on the scan and wouldn my baby have other symptoms as he is fit and well and is perfectly happy ### REPLY: Thanks for consulting at . Though your baby looks absolutely normal to you, but abnormalities in his liver function tests have prompted your doctor to advise live biopsy. Liver biopsy is essential for histological assessment of liver and serve as a significant method in assisting clinicians in therapeutic management decisions. Liver biopsy can diagnose homeostatic liver diseases, stenosis, vascular abnormalities, infectious diseases, and infiltrate or storage diseases, autoimmune hepatitis etc. and accordingly your doctor will decide further course of treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my Mother in Law has cancer of the Pancreas that has spread to the liver and lungs. She has lost a lot of weight and in the last 5 days has gone from having pale skin colour to being very badly Jaundiced. At what stage of this particular cancer does the jaundice happen and what normally happens from now on with this cancer. As she is my Mother In Law I dont want to interfere but I lost my own mum 7 yrs ago from Overian cancer, so I just want to be strong and supportive for my husband and family. ### REPLY: HelloWelcome to . Pancreas cancer that has spread to long and liver is stage 4 diseases and unfortunately outcome is very poor for this stage. Jaundice a start in this stage at any time. Main problem she will be facing are pain, jaundice , fluid in abdomen. There are strong pan medications like morphine which can help her. For jaundice, she might need stenting to bypass biliary obstruction. Palliative chemotherapy or targeted therapy(Marcela) can be an option if she is in condition to tolerate treatment. Hope this answers your query. 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: Started with Heartburn at night then burning and dull ache in Stomach and very mild dull ache in lower abdomen/groin.I am now on triple drugs for H pylori and now have no stomach issues or heartburn.Pain has now increased in lower abdomen and has been that way for about a month.please helpIan WilsonIab WilsonPlease help ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  You had heart burn at night, then burning and dull ache in stomach and very dull mild ache in lower abdomen and groin, It appears that you have gastric hyperacidity due to peptic ulcer, or irritant foods. Which then may be referred to the lower abdomen, or vice versa.  I advise you to consult a gastroenterologist for diagnosis and treatment. You may need to have gastrostomy, besides other routine tests for confirmation.  Wishing for a quick and complete recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: So I have a question I just had a baby in Feb 2015 took suboxone the hole pregnancy and he is healthy as can be. now I m 6 months pregnant and am now on subtext and my ultrasound technition is saying there is signs of soft spots witch could mean dowsindrome is that caused by taking suboxone or subtext ### REPLY: Hallow Dear, You have to seriously think about the need and indication of Suboxone. Please try to understand the indications and risks for Suboxone. Suboxone contains a combination of buprenorphine and naloxone. Buprenorphine is an opioid medication. An opioid is sometimes called a narcotic. Naloxone blocks the effects of opioid medication, including pain relief or feelings of well-being that can lead to opioid abuse. Suboxone is used to treat narcotic (opiate) addiction. It is not for use as a pain medication. It is not known whether Suboxone will harm an unborn baby. If you use buprenorphine and naloxone while you are pregnant, your baby could become dependent on the .  This can cause life-threatening with ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 been sick for almost a week now, but thats not what really concerns me (although it might be the issue).  The last couple days the left side of my chest has been feeling cold in the inside even though I am warm on the outside (or sweating from physical labor).  I was curious if this was just because of being sick or is there something else going on.  Its also cold on the left side of my back, but not as much as my chest.  Not really much pain, just feels funny.  Any ideas? ### REPLY: Hello rearward welcome to .come have evaluated your query in details .* This relates to psychosomatic manifestation of underlying stress, anxiety issue ; still one time physician check up for vital parameters evaluation and ruling out any underlying issue is advisable. Hope this will help to clear your doubt . Wishing you fine recovery. Always welcome for any further assistance anytime. Regards . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, we have a friend who is acting unusually and has become obsessed with an idea to start a business, which to us sounds rediculous but to her is the perfect solution to solving world problems. Her sense of humour seems to have gone, especially when talking about this subject. She is hyperactive and not sleeping properly. She has even given up one of her jobs to work on her project. We dont think it is drink or drugs because her behaviour is unlike anything weve seen. We are concerned that she might have some kind of delusion. We dont know how to help her. What do you think? Thank you. ### REPLY: Hi, Thanks for choosing . I have read your query carefully and understood that your friend is having complaints of disturbed sleep, being hyperactive and expansive ideas. I would like to let you know that her symptoms suggest Hypomania/Mania. I would advise you to take her to a psychiatrist near you for proper evaluation and treatment. Hope I answered your query, let me know if you need any further information. 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 hepatitis C and today I got resultants for TPHA, CMV, HSV and all is positive TPHA show positive =320 what mean this? CMV + positive HSV 1+2 IGG is (+44) HSV 1+2 IGM is (17,7) The doctor did not have time to explain me about test result I need to go there after one week. Please give me some answer :) have cure for this or I gonna die soon. I m 30 years old and mother on one child 11 years old I never had any problems with my health but since I got merry second time I got this? Thanks ### REPLY: Hi, thank you for writing to . I have gone through your query and understood your concerns. From the results of your lab tests, you tested positive for Hepatitis C, syphilis, cytomegalovirus and Herpes. All these infections are sexually transmissible, but the good news is that all of them can be treated (although some might be a little expensive). You will be placed on antibiotics and antiviral .  You will get better if you take the treatment. I hope that answers your query.  If you have additional questions or follow-up queries then please do not hesitate in writing to us. We will be delighted to answer more questions from you. I wish you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 8 and doesn t normally suffer from headaches. he woke about 10pm (Australian time) with a blinding headache at the back of his head, he was thrashing about and acting like a 2yr old throwing a tantrum. he goes in and out of sleep but keeps wimpering and clutching his head when he rouses. Can anyone please give me some advise. thank you. Tonya ### REPLY: Hi, I guess there are no other symptoms like fever / vomiting / visual disturbance. Acute onset headache, that too severe and awakening from sleep is something to be evaluated in detail. After examining him including blood pressure and a detailed neurological examination, we may need a brain imaging. Kindly take him to doctor. Meanwhile, you can give paracetamol/ibuprofen for temporary pain relief. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been having tailbone pain for about 10 months now mostly on the left side and about a month ago, the pain has started in left leg. It s sometimes painful to move my leg to a next position.Where the pain is in my tailbone also seems to be swollen as well.It s extremely painful to sleep on my back and get up once I ve sit down. I don t know what it could be. My last horrible fall was years ago and the pain didn t last long at all. I m also 21 and a female if that helps. Thanks in advance. ### REPLY: Hi, thank you for providing the brief history. As the history suggest that due to the fall in the past there will be some bony pathology which subsided in the past and also have a way for the soft tissues like the intervertebral disc to land into pathology which is one of the commonest reason I find in my clinical practice. Having a thorough clinical examination and MRI of lumbar spine will help further study of the lumbar and sacral spine along with the soft tissues. Treatment of choice will be simple medication for pain relief and physical therapy like therapeutic ultrasound therapy and TENS therapy. Exercises will be recommended to improve the muscle strength and stabilize the spine. Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Im 24 and I have back pain all day near everyday. Ive just started football training and this brings on more pain to the point I can hardly walk. Running seems to bring on the pain straight away then my legs get really stiff to the point I have to lay down ### REPLY: HiT hank you for asking ChatDoctorI have gone through your query. As you are having a back pain, stiffness and pain to legs I suspect a lumbosacral spine injury. The neurological deficits or signs suspecting that can be obtained from physical examination. After that an X-ray lumbosacral spine and MRI if needed can rule out the condition. Muscle relaxants analgesics and physiotherapy might help you to relieve the condition. It is better to have a consultation with orthopedic. Hope this may help you. Let me know if you have any further query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im going through post concussion syndrome and Im worried about a tooth extraction Im due for soon. I dont need to get put under anesthesia, just numbing the mouth, but Im worried my rise in blood pressure during the extraction will cause issues with my brain.Is it safe? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint in case if you are suffering from post concussion syn . . As far as rise in blood pressure during dental extraction is concerned, the extraction will be carried out only after proper evaluation of your vital signs like monitoring of your blood pressure, heart rate and other general signs. To avoid blood pressure complications the local anesthesia that will be given to you will be free from A ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 symptoms similar to adhesive capsulitis in both shoulders and the pain in my upper arms is making sleep difficult. I had therapy for adhesive capsulitis years ago, one shoulder was affected at a time, but this time is different. I do not have the same weakness in my arms, just a limited range of motion and a lot of pain, sometimes shooting down both arms. I have been under heavy stress lately, moving my 94 year old mother 1300 miles. Could this pain and stiffness be just a result of tension from the move, can I treat this on my own without therapy? I am 69 years old. ### REPLY: Hi, thanks for the brief history. As you mentioned you had a capsulitis in the past for which you have undergone the therapy and now you're facing same pain in both shoulder. Since the pain is in the arms as well it is to be checked once. There are a couple of possibilities like - adhesive capsulitis, bicep ital tendonitis, trapeziums, pinched nerves. Only on examination we can come to a conclusion. Since you mentioned you have a restriction of ROM of the shoulder it can be due to stiffness of joint or may be a muscle stiffness/weakness. Also, you can perform some slow neck exercises to strengthen the muscles of the neck. Perform ROM exercises for the shoulder while lying down on the floor as it will be free of gravity and the ROM will be a bit easy. Post that slowly strengthening the shoulder girdle, arm muscles and then chest with upper back muscles will help produce more input to your overall strength. If you find difficult to perform than you can take the help from a physical therapist, and later you can perform at your own. With the grace of God I wish you a speedy recoveryRegardsJay 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 am 62 years old male and i have pac from 3 years ago .what must i do?i am 56 kg and 160 cm .no smoking.i have migraine for 30 years and propranolol 10 mg bd.cholestrol280 and triglycerid 300 other examination normal.i have deppresion and anxiety for 32 years with no treatment. ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion.First, to know how to treat extra systolic beats we should exclude any causing factor. Premature heart beats might happen because of stress, pathologies like anemia, hyperthyroidism, electrolyte imbalances, cardiovascular disease etc. So, in my opinion, if I was your treating doctor I will recommend some examination like an electrocardiogram, a cardiac echo to evaluate heart function and walls, a full blood analyze to exclude anemia, hyperthyroidism or electrolyte imbalance, a stress test to exclude ischemic heart disease and a holder rhythm monitoring to evaluate your rhythm tendency and the frequency of extra beats. If this result normal than we can say that is just stress or the anxiety problem that you suffer. If its just anxiety, propranolol is a good choice, but you might rise its dosage to minimal 40 mg a day. But you might discuss this with your doctor. Hope I was helpful. 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 had stomach pain on and off for over a year i go to the doctor and they tell me its a small amount of fluid over my uterus. But the pain is no where near there its closer to my rib on the right side and under my rib it puts alot of presure and shoting pain. I dont have insurance so i dont want to keep goin in if there not going to help me. Can you? ### REPLY: Hello, Pain under the right ribs can be due to following reasons:- Inflammation of liver- Inflammation of gall bladder-Stones in gall bladder- Pleuritic or infection of covering of lung-Lung infection you are having unrelieved continuous pain under right ribs then I will advise you to have a USG (whole abdomen) with routine blood examination to rule out pathology. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI Dr. Stephen, My daughter has been having problem with her knees for sometime now they are swollen and she s always complaining that they hurt the bone in her knee be a littlte hot.She has never played any sports.I m trying to understand what this could be.I hope that you can understand me but ask me anything. ### REPLY: Hello! Thank you for writing! From the signs, swelling, pain and warmth of the knee it may be an arthritis. When has the pain appeared? Are other joints involved? Does your daughter have stiffness when she wakes up in the morning? I suggest you to see a rheumatologist doctor. Diagnosis is made by clinical examination from an appropriate health professional, and may be supported by other tests such as radiology and blood tests, depending on the type of suspected arthritis. All arthritis potentially feature pain. Pain patterns may differ depending on the arthritis and the location. Rheumatoid arthritis is generally worse in the morning and associated with stiffness; in the early stages, patients often have no symptoms after a morning shower. Osteoarthritis, on the other hand, tends to be worse after exercise. Elements of the history of the disorder guide diagnosis. Important features are speed and time of onset, pattern of joint involvement, symmetry of symptoms, early morning stiffness, tenderness, gelling or locking with inactivity, aggravating and relieving factors, and other systemic symptoms. Physical examination may confirm the diagnosis, or may indicate systemic disease. Radiographs are often used to follow progression or help assess severity. Blood tests and X-rays of the affected joints often are performed to make the diagnosis. Screening blood tests are indicated if certain arthritis are suspected. These might include: rheumatoid factor, antinuclear factor (ANF), extractable nuclear antigen, and specific antibodies. Wish your daughter good health. Thank you! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a lump on the very middle of the back of my neck i have noticed it come and go over the years but now seems to be biggest ever about the size of a marble hard and stiff and is painful to touch or move my neck i also found another smaller lump the same on my scalp and on side of neck no sure what to do or what it is i am also getting new moles all over my body sudenly ...helpp ### REPLY: Hi, dear. I have gone through your question. I can understand your concern.  You may have some benign or malignant lesion.  However, getting new mole all overate body is the grave sign for malignant melanoma.  You should go for biopsy of that lump and go for histopathological examination 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: Hello Doctor! I had five stent put into my heart eight months ago. Now, every time they do an ECG, the T-wave is inverted. I do suffer a bit form short breath and a tight chest from time to time. Could you tell me whether this is normal after the stents, eight months out? Thanks Pieter ### REPLY: Yes, the persistent of the wave may remain, many a time when you open the main arteries smaller side twigs get pinched causing the inversion, which is not dynamically changing should not be bothered about.  However, is high time when you can get a treadmill stress test, whereby if the symptoms you describe occur with exertion or a change in your ECG with exercise, one can evaluate further based on the report of stress test Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi.My daughter is 1.5 years old.she got her leg burnt in February this year.alternate days dressings were done for 20 days.There were 2 deep burns.I consulted the skin doctor of behl institute.He told me it was keloids and suggested kelocote gel for that.there was a little improvement in one of the burns.now the doctor says that it can not be opertaed without steroid injection,but i have read that steroids are harmful when they enter the body.Plz suggest me what shud i do and which doctor shud i consult in delhi?Im really very much worried for my daughter as i hv read that keloids expand.Plz tell me a good doctor. ### REPLY: Keloids are formed due to exaggerated wound healing response of the body. This is the reason your doctor suggests steroid injection (near the scar I believe) before operating. This would decrease the chances of repeat keloid formation. Though that is always a possibility and steroids are not fail-proof. As far as the steroids is concerned, adequate dose adjusted according to children and weight shall be given. You might want to meet any good plastic surgeon to excise the same. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HiyaI have some chest pain. It feels like I have an obstruction just left of my right breast but behind my ribs. When I lie down at night the pain gets much worse and I get shooting pains across my chest and then up to my neck. It does not feel like a pulsating pain with my heart beat, but while I am sat here now I can feel what I deem to be a blockage in my osophagus, and some shooting pain... I am really worried about this... ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of musculoskeletal pain is more likely. So do following things for better symptomatic relief. 1. Avoid heavyweight lifting and strenuous exercise. 2. Avoid movements causing pain.3. Take painkiller and muscle relaxant . 4. Apply warm water pad on affected areas of chest.Don't worry, you will be alright with all these. Avoid stress and tension, be relaxed and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i have a lump under my arm almost in the breast area. I had it checked a few years ago and they said it was fine nothing to worry about. I could have it removed if I wanted to but it was not necessary. It was not causing any discomfort then so I just left it. now it is causing a little discomfort when I move a certain way.. should I be concerned? ### REPLY: Hi, Dear thanks for the query to  virtual clinic. I studied your query in full details updated from you. I understood your health concerns. Based on your query data, In my opinion, Dear You seem to suffer from-Fibroadenois with hormonal imbalance of pre-menstrual syn . Check if you have impending menstrual period date in few days time. Remedy-you need to be concerned about it and need to treat it as follows-with Surgeon/Gone Doctorow compresses, Vit E x 3 mthsTab-Danazole- x 3 myths. If the lump reduces, watch for Fibroadenoma with repeated checks by palm of hand for self-examination or by 6 they Mammography. Hope this reply would help you to evaluate your case and treat it with your doctors in time to come. Hope this would resolve your query and worry and Anxiety accompanied by it. Welcome for any further query in this regard to ME. I would love to help you out.Awaiting any further query. Wish you fast recovery from this intriguing health problem. Have a Good Day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Son is 15 years and he is suffering from liddle s syndrome since his birth. Now he is taking medicines regularly and he is ok. I wolud like to stop his medicine and give him a more comfortable life. Can you suggest me some good treatment in any part of the world. If you can give the contact number of doctors who are specialized in liddle s syndrome. Is there any special doctor for the syndrome (like pediatrcian for children.....). Thanks ### REPLY: Hi, Middle syn .  It is happening due to the maturation of the gene, a condition called autosomal dominant disease.  The main goal of treatment is to control the high blood pressure and manage the hypokalemia.  A kidney transplant may sometimes give a permanent result, such case could be managed anywhere in metro city or world.  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: The white matter of brain shows gliosis surrounding area of encephalomalacia right temporal lobe. Mild gliosis is also seen posterioly in the right frontal lobe.several areas of high signal are present in the white matter of the brain suggesting probable small vessel vascular disease. These measure up yo 8mm ### REPLY: HelloThanks for writing to ChatDoctorGliosis with encephalomalacia in brain is an irreversible condition and it doesn't require any specific treatment. High signal intensities in white matter of brain may be related to ischemic changes resulting from involvement of small blood vessels, demyelination, gliosis etc. Ischemic changes resulting from blood vessels changes in diseases like hypertension, diabetes mellitus, dyslipidemia. So, you need monitoring of conditions that leads to ischemic changes like hypertension, altered lipid profile, diabetes mellitus so that further progression of disease can be halted. You need investigations like routine hologram, RBS,LFT, RFT, Lipid profile, ultrasound of abdomen. Proper treatment depend upon findings. Hope I have answered your 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: my aunt is 40 year old.she got paralyzed 1 month back.she is not able to speak and coundn t gain her sense for normal routines.she repeats what we say but no gained her common sense to talk.Doctor says it will take time but with her very slow progress i am worried ### REPLY: You are not saying what was the cause for the paralysis. I'm assuming it's a stroke. If that is the case usually most improvements are expected during the first 6 months, given her young age you can expect a better outcome. However, how much of her functions will she recover is hard to say without knowing the exact extent of the damage. While you should conserve hope as it is a several months long process, if the damaged area is big you should also be aware that some disability may persist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 4 1/2 weeks post posterior colorraphy I had one sore area swabbed at 2 weeks for pain and weeping. Swab grew normal skin flora. The stitches are now dissolving and starting to come out but there is a horrible odour. Is this infection or do dissolving sutures smell? ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. In my opinion it should be infection. Because horrible smell from the suture site is the indication of infection always. I advise you to do Grams staining, culture and sensitivity from the wound discharge. It gives you idea about the possible pathogen and its sensitivity. Taking .  You can also applies ointment of antibiotics sensitive to the organisms locally. Please maintain hygiene as it can clear the infection equally do antibiotics do. Suture sites are the potential infection prone site wearing a cotton garments can also help to heal the infection. Please do  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yesterday evening i began to experience a weird fluttering sensation under my right rib cage. I was very hungry as i hadnt eaten in some hours, so i put it down to that. but it has continued into today. It comes and goes and lasts only a second or two. Could you please tell me what this is? ### REPLY: Hi Dear !! Thanks for your query to . Read and reviewed your query and health concerns. IN the given situation, You seem to suffer from-Hunger Cramps with ? Gastritis with peptic ulcers / or could be from accompanied Sinusitis / asthma/ or Diabetes/ or from bulimia. You need to investigate with ENT/GI Physician/ and psychiatrist to rule out other causes and fix the cause of flattering sensation under the right rib cage Hope this would help you to plan further of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following  link-http://doctor. .com/Funnel?page=askDoctorDirectly&docId=70229Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at  services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a cough with a choking sensation especially when trying to sleep. It feels as if sand is in my throat . My Dr. Said its probably sinus problems, so I take Flonaise. Initially a little relief, but it s back. What causes this? I admittedly am a 4 cig/day smoker, which I m trying to quit. I m afraid it s throat cancer or something more serious. ### REPLY: Hello! Thank you for the query. Smoking makes you prone to many lungs diseases including severe inflammation, COPD (Chronic obstructive pulmonary disease) and lung cancer. Throat cancer is also possible. All this diseases give cough so without additional tests you are unable to rule them out. That is why I suggest you to visit pulmonologist, have chest X-ray (or better chest CT) and spirometry (blow test). Palynologist can diagnose throat cancer. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been having many health issues for years due to a septhis infection in my blood stream @ AGE 5, I AM KNOW 50 LAST JULY AFTER SUFFERING 7 UTI;S & 9 MOUNTHS OF ANTIBIOTICS, IT SUBSIDED, HOWEVER I AWOKE WITH CHEST PAINS & FEVER OF 104 ADMITTED TO HOSPITAL BECAUSE THEY FOUND IN, SEEMFLAMMATION IN THE LUNG AREA, CALLED IT A NODULE MY WBC IS VERY HIGH, 2+ BLOOD IN URINE AND LECTOL HIGH HAD 4 ABNORMAL BREAST ULTRA SOUNDS, 2 BIOPSY;S AND I M SO TIRED & I HURT ALL THE TIME I NEED SOMEONE S HELP!!! I AL1MOST READY TO GIVE UP!! I DONT WANT TO KEEP SAYING I DON T FEEL GOOD ALSO HAD PLERUSY IN LUNG & NOW THEY SAY I HAVE ASTHMA PAIN IN BACK & SIDE IS AWFUL. 3 TOTAL HIP REPLACEMENTS DONE FOR THE EARLIER SEPTHIS INFECTION!!! PLEASE HELP!! ### REPLY: Hello thanks for posting here. I have gone through your history. I would like to further know what did the biopsy results show. Since you are worked up for infection parameters and have received antibiotics with no relief, I suggest you should get worked up for autoimmune pathologies i.e. processes in which the body attacks its own cells.  Two diseases which affect both lungs and kidneys which can cause high ABCs and fever are granulomatosis with polyangiitis (Wegener) and Good pastures disease. I suggest you get following blood tests done. ANA, ANNA, Anna pr3 and anti GBM antibodies. I hope you will get your answer with the above tests. Regards ### END