Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 diagnosed with myopathy recently, my brother has also same disease from last 15 years, but he can walk but not properly. Same with me I can walk (I am a toe walker) so had knee pain and difficulty in upstair climbing, running, jumping from last 2-3 years. What treatment I have to take ### REPLY: Hello, What it appears to me that the best solution is to undergo a physical therapy session for a few days and later reduce the number of sessions.  Post which you can learn the exercises needs to be performed in regular basis to improve the lifestyle and avoid injuring the major joints like knee, hip, spine etc. As in myopathy, there is more of secondary changes in body and pain arises. So one needs to focus of strengthening the muscles which are weak and also correct the posture to the optimum for avoiding injuries. Hope I have answered your query. Let me know if I can assist you further. Take care 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 33 years female. I quit smoking on 31 of december. I have a tingling on my left arm, on my left leg, on my foot and a bit difficult to breath. I dont have a pain in my chest, but its not easy breathing as always. Ive mitral valve prolapse but its a stable condition. ### REPLY: Thanks for your question on . I can understand your concern. Smokers are at increased risk of bronchitis (inflammation of airways) and bronchitis can cause chest pain and breathing difficulty. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test).PFT will not only diagnose bronchitis, but it will also tell you about severity of the disease and treatment is based on severity only. You will need inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone).Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 50 year old, I was working in Iraq 1 1/2 yaers with the post office,every day I was lifting 70 pounds , one day my back,was hurt a lot. Now I am in the United Sates receiving treatment, but not getting better. I am having pain in my lower back, right buttock, numbmess in the right foot, pain radiate down the back of my thigh, when I am turning left and right, and straightening up was very painful. I was in therapy for about 10 months, some days was less pain than others. I went for a surgery consultation and the Dr. said no surgery is recommended, but the MRI impression are mild to moderate central stenosis and lateral recess narrowing, minimal annular bulge with facet arthropathy,L2-3, L3-4 AND L4-5. I am very fustrated because very morning when I have to come out of my bed, the pain still there, my right leg feel numbness and my lower back pain is chronic. THANK YOU FOR YOUR HELP.... ### REPLY: Hellowelcome to ChatDoctorsir, actually you are suffering from 2 different conditions, however both these conditions are connected to each other, these 2 conditions are (1) PROLAPSE INTERVERTEBRAL DISCS which is causing pain and stiffness in your lower back region(2) SCIATICA on right side i.e. compression of the sciatic nerve on the right side which is causing pain in buttocks / back of the thigh along with numbness both these conditions are chronic and quite hard to control, surgery is usually done in extreme cases when there is no other option available because spinal surgery carries the risk of some potentially unacceptable complications if I were your treating doctor, i would have advised you the following treatment and instructions- (1) if the pain is very severe take INJECTION THIOCOLCHICOSIDE INTRAMUSCULARLY two times a day for 3 days(2) TABLET IBUPROFEN three times a day after meals(3) TABLET TIZANIDINE 2 mg three times a day after meals(4) CAPSULE GABAPENTIN 300 mg 3 times a day(5) ICING in the painful region for 3 days followed by HOT FOMENTATION for 15 minutes in the region of pain 2-3 times daily for 1 week(6) use a LUMBAR BELT throughout the day specially during .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 cardiomyopathy and sleep apnea. Four years ago, I was implanted with a bi-ventricular pacemaker with 3 leads to the heart. Recently, I have been diagnosed with ischemia. My beta blockers have been doubled to 25 mg. twice a day. What does that do to my life expectancy? ### REPLY: Thank you for choosing ChatDoctorHaving cardiomyopathy can significantly affect your life expectancy. The medication that you are on is correct, and I do not think that you should worry. The best way to know the function and the effectiveness of the heart, you will need to get the heart checked up. You should see a Cardiologist to get an Echocardiogram and Technetium scan which will help find out if the heart is working properly. Please follow up after the results of the ECHO and the scan are back. All the best. Hope this helps you. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My boyfriend has been complaining about a lump at the bottom of his sternum. He keeps pressing it and touching it which is only making it sore. He did research and it sounds normal, what should we look out for to determine if its something that needs medical attention? ### REPLY: Hi, Dear,Good noon from INDIA. I studied and reviewed all the details put forth by you and understood your health concerns. Treatment-for your sore lump in the sternum-a-Check with the family doctor.b-Get the help from on the following guidelines-i-Tb NSAIDs x for 5 days would resolve the issue of your boyfriend.ii-This is given to relieve Xyphoidalgia/Xhphodynia/Typhoid Syn . Iii-To rule out the liver and heart ailments with ER Doctor, who would help you accordingly. Wishing you fast recovery....and have a Good Day. Well-come for any further query in this regard. I would love to help you till you get relieved from the current fiasco. If you get relief, write strong review to help your friends and foes and those visiting-my  clinic. Revert your info Sopwith 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 Doctor, I have pain in my left abdominal. It s started 3 days before. It s mild pain and will become intense when i go for urinal. But when urine starts to flow, the pain is not there. Also sometimes i bent down, i feel same intense pain. Could you please tell me what problem i have? i had taken medicine dolokind, but condition remains same ### REPLY: Hi. Thanks for your query. Read your history and understood your problem. The most probable reason for such of pain in left side of abdomen which gets intensified while passing urine and relieved by urine flow can be :Diverticulum of the urinary bladder. Reflux of the urine from the bladder to the left lower ureter. Stone in the left ureter. This can be easily diagnosed by:Routine blood and urine work-up. Ultrasonography of the abdomen and cysto-urethroscopy helps for the diagnosis. Mutilating cystourethrogram under Fluoroscope again can be of a help to see for the dynamics of urination and any anatomical defect. The treatment will depend upon the findings on investigations, which may be a surgical intervention. Wishing you all the best for early diagnosis and proper treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I ve been in and out of my doctors office 9 times in the last 3 months. The majority of it was every 2 weeks over a 6 week period. Every time he said it was allergies. Gave me an antibiotic and steriod shot along with Rx. This week, I have developed back pain which is keeping me from sleeping. (I also have a 23 month old who doesn t sleep through the night). Every time I go in, he takes my blood and says my WBC is high. (The passed few times he didn t know what was wrong with me. Just that my counts were high and it s a sign of infection). Yesterday I went in with feeling exhausted, back pain, and naucious. He just said I had an infection somewhere and gave me more antibiotics. Then this morning, I woke up with a coldness in my chest. My lungs hurt. And the back pain is significantly worse. Could this be pneumonia? Should I go to an internist instead of a gp? ### REPLY: Hi, Yes,it could be because of pneumonia, bronchitis(allergic or infective), pertussis, seasonal asthma etc. You may undergo routine blood count, ESR with X-ray chest and pulmonary function test. You might require antibiotics (quinolones or accolades or amoxicillin with clavulanic acid) with cough suppressants (antiallergic antihistamines or mast cell stabilizers) and anti-inflammatories or analgesics on as and when required basis. You must consult your pulmonologist instead of general practitioner to get diagnosed first and then treatment. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 5 years old and a cpl months ago he developed a huge knot on the left side of his head I figured he bumped it playing on the playground and I didn t worry about it until 3 weeks later I notices it was still massive and still there so I called a triage nurse and she said bring him this n this n she said if it goes away don t worry about it. Well the next day it disappeared like completely gone so I didn t worry about it. Well here we are a cpl months later and last night I noticed that spot looked red I asked him of he d hit his head etc and he replied no to all questions of and bout injury so I waited figuring it would go away maybe he scratched it. Well I noticed today at about 330 when he got home from school that he had that massive knot that just appeared over night and when I say massive I mean massive. He says it hurts but doesn t complain doesn t itch no fever no injuries nothing so I m scared and worried and desperate for answers. I called his Dr and they have absolutely no clue what it could be so maybe you do ### REPLY: Thank you for following up. I need more details, how much cm is it? It could be swollen lymph nodes. This can occur with throat infection, previous rubella in latent form, irritation of head skin, herpes infection(Epshtein-Barr infection, cytomegalovirus, 6 type of Harper virus) etc. Please get himself checked to make sure his lymph nodes are not affected. To begin with, blood test with platelets and clotting, ultrasound of liver and spleen. If he were received changes in blood formula you would better visit hematologist.  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 am Atul, 28 yrs old, i am having problem that i am not able to remember(forget) things in daily routine, lice name and address of client, personas name of visited client office, something ask by family to bring home while coming from office.... this creates lot of issues in my personal as well as official life, i am not understanding what to do.....i am totally stuck please help me to get rid on this. ### REPLY: Dear Adult way you have quoted instances it depicts that your problem is not lack of memory, but it is lack of attention. Many a time you pay partial attention to minor issues and engross yourself with major projects thereby you remember all minute details of major projects and all such petty household works names of some slip your memory. sometimes anxious personality of the person also contributes to such lack. Relaxation by yoga or morning walk helps to pave way to develop interest in everything under your care. Memory can be enhanced and concentration power can be increased by use of some well documented herbs like Brahma shankhpushpi etc. Mental and cap. Bravobol will cure it. A procedure in Ayurveda called shirodhara in which medicated oil is .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have a 1 year and a half old son that has a normal WBC count, low rbc count, low hemoglobin and normal platelet count. He has fevers as well and has experience seizures. The IMP is normocytic normochromic anemia with mild eosinophilia. His urine exam is as follows Albumin- nil, sugar- nil, pus cells 1-2, rbcs-nil, casts- nil, crystals-n, epithelial cells- occasional and bacteria- nil ### REPLY: Hello and welcome to , Normocytic normochromic anemia refers to type of anemia in which the shape and size and chroma of red blood cells is within normal limits. As you have mentioned that your red blood cell count is low, this may be the cause of low hemoglobin and thus anemia. Eosinophilia refers to elevated eosinophil counts in blood. Eosinophils increase in cases of parasitic infection, allergies, . Consult your primary healthcare provider to assess the cause of low red blood cell count and raised numbers of eosinophils. Thanks and 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: Dear sir, I am Munish Sharma resindent of Ludhiana working in a marketing Job for TATA my concern is about my hairloss, i had lost my hair by almost half in recent four years. What to do?Also is there any relation of smoking with hairloss?(not a chain smoker but usually take 2-3 a day) ### REPLY: Hi, As per your query you have symptoms of hair loss which seems to be due to fungal infection, hair follicle infection leading to folliculitis, side effects of any medications or allergies to certain shampoos or hair cosmetics. Need not worry. I would suggest you consult a Trichologist and get evaluated, and he can advise you treatments depending upon the exact cause of the problem. In case of fungal infection, antifungal shampoos along with steroid lotion massage can relieve. In the case of Folliculitis or Impetigo, antibiotic ointments and oral antibiotics can be advised. Maintain cleanliness of scalp. 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: Three days ago my cousin picked me up from behind to pop my back. He weighs about 250 pounds and I weigh 120 pounds. My back popped loudly in several places. Now The middle of my back feels very bruised and the pain radiates down to my upper buttocks. I mainly feel this pain when I stretch my back or when Im sitting down. I am an active 29 year old female. Please help! ### REPLY: Oops... Popping could go dangerous if not down properly. Pain radiation might be due to disc. Thrust could cause the spine to go hyperextension which can put the impact on disc.  Well, apply ice to the low back area and run down the ice to the buttock too. Sleep on the side or lay down in the floor with the legs resting on a chair. Apply ice for 15-20mins for 2-3 days. You would feel better. Cheers. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 58 year old husband has had cancer and has be in treatment and surgeries since 2010. He recently had scan and goes for results tomorrow. he has a temperature of 92.7 and his body feels extremely warm. He had a bad day yesterday and is going to the doctor tomorrow at Roswell in Buffalo. I am concerned about his low body temp but he feels VERY warm to the touch. The only medications he is currently on are Hydrocodone for pain and Gabapentin Should I be concerned as I am? ### REPLY: Hi, Thanks for writing in. Please re confirm the body temperature again. If the body feels warm and the reading is low then there is a possibility of instrument malfunction. It will help to calibrate the thermometer and then check the temperature again. Usually people taking treatment for cancer will have a normal body temperature. You, too, confirm this after touching him. Please do not be concerned, and you can wait until he goes for his follow-up tomorrow. It is possible that he might be having a flu if there are symptoms like weakness and pains since yesterday. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am in th emiddle of a period and my left labia minira feels sore and actually has two peas sizwed lumps and its really uncoftable to use tampx lately .I thought it might be piles cos i have had this a few times in the last year but this month i can see small lumps and it feels like an irritationalmost a bruise ### REPLY: Hi, Dear thanks for the query to  virtual clinic. I studied your query in full details updated from you. I understood your health concernsBased on your query data, In my opinion, Dear You seem to suffer from Bartholdi Cystitis of labia minor or Cystitis of Scenes gland. Both need medical treatment with Antibiotics and NSAID Motrin, which would relieve the pain and lump in few days time. Proper hygiene is advisable. Team of GP and Gyne-Surgeon doctor would be needed to treat your health issue. Hope this reply would help you to evaluate your case and treat it with your doctors in time to come. Hope this would resolve your query and worry and Anxiety accompanied by it. Welcome for any further query in this regard to ME. I would love to help you out.Awaiting any further query. Wish you fast recovery from this intriguing health problem. Have a Good Day. . N.M.S. Genl-CVTS -Senior Surgical Consultant ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi for the past few days i have been suffering with very severe abdominal pains aswell as vomitting very high fever feeling dizzy and fatique i have taken iburofen but it does not seem to effect i am having trouble sleeping at night due to over heating and then being very cold! ### REPLY: Hi ! Good morning. I am  answering your query. Considering your pain abdomen with high fever and dizziness, I would advise you to report your self in the ER of your nearest hospital at the earliest for a proper clinical assessment, related investigations and an appropriate management to avoid any further complications. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a reocurrent yeast infection for the past 3 months... The first and second time I used monisant7 n it went away but it came back like 2 weeks after. This month I had it a week before my peorid n I did a home treatment n it went away. But now 2 days after my peorid I have the same burning sensation down there and the lip of my vagina is red and swelling. Is it something i m using or is it stress cause I read that if ur stress out u can get yeast infection very easy ### REPLY: Hello, Welcome to , Your history and symptoms are suggestive of fungal infection, and it is more common in this area, as these are the normal comedians of this area which will be kept under control by helpful organisms. Whenever there is an imbalance in the environment it will multiply and produces its symptoms. I would suggest you to follow1. Keep they are clean and . Topical application of antifungal cream like Ketoconazole cream3. Oral single dose of Tab Rifleman, 150 mg.4. Oral anti histamines. 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: Ive recently had the flu - as Im allergic to Penicillin, my doctor prescribed me Erythromycin. Since Ive been taking this drug, Ive felt a very strange feeling in my upper abdomen. I rang NHS Direct, and also went to see my GP - neither of which could provide a sufficient diagnosis. My GP assumed it was just a side effect of my illness, but was quite dismissive of the pain and wasnt very helpful. Ive stopped taking Erythromycin hoping this feeling would disappear, but if anything it has just got worse. As Im now almost better (flu-wise), Im doubtful that it is just a symptom of this. It is painful/very uncomfortable when I breath in deeply, and feels as if there is some kind of bubble inside my stomach. The feeling has similarities to both stitch, and trapped wind, but is not in the right area of my stomach for either of those pains. Any thoughts you may have on this will be so helpful - Im getting very nervous about it. ### REPLY: Hi. Thanks for your query, read the history and understood your problems. The trouble on deep breathing is suggestive of a problem either in the lower lungs or the pleura (the coverings of the lungs). Auscultation by a Physician by a stethoscope can understand the problem better than the investigations, which help in confirming the diagnosis. It looks that in your case the flu caused the secondary infection by causing pleurisy, inflammation and this pain is now referred to the upper abdomen. Also get an X-ray of the Chest and CT scan of the chest to confirm. Get a proper treatment and you will be fine. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 gall bladder surgery 5 days ago and I keep Getting involuntary breaths for no reason like when a baby Sobs they do that breath its just quickness of breath I m just Wondering what this could be as I didn t have this Problem before I had my gall bladder removed. Really confused any information will be great. ### REPLY: Hi, thank you for providing the brief history of you. A thorough Musculoskeletal assessment is advised. As you have undergone the surgery, the abdominal muscles are weak due to the incision. So for which most patients post abdominal surgery is are advised to undergo physical therapy for respiratory and muscle weakness. Patients respond well to physical therapy and the healing of the tissues are faster. You can learn breathing exercises from a physical therapist who can help you learn the exercises which you can Perform at home as well. I see patients with post surgery of abdominal muscles and the implementation if physical therapy provides the early recover and balance between the respiratory system and the muscles. 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: 8 year old boy chewing on his toy laser pistol and swallowed a bit about 2.5cm in diameter and 2cm long, started to choke his older sister (I was out) helped by hitting his back and he swallowed it down. I am a little concern about how big it is. he felt fine,and a few hours later has gone to bed now sleeping. ### REPLY: Foreign body ingestion is common at this age group, since the object is not radiopaque which means it cannot be located by x-ray, development of symptoms by the child direct doctors what to do if this toy has no sharp edges and has magnetic piece in it and smaller than 4 cm, it can pass through stools within a day or two with subsequent consequences if you kid start to have abdominal pain especially below his mid-chest, that means it got stuck at the esophagus and must be removed by endoscopy I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 30 year old female, 380 lbs, 5 5 ,...having tingly hands, sore arms, sore breasts, no period, swelling of legs and feet, tired a lot. No other issues in past other than gallbladder removed in 2009. On Paroxitine, changed birthcontrol 6 months ago, stopped taking it a month and a half ago. ### REPLY: Hello, Your symptoms are suggestive of a metabolic disorder. I would recommend consulting with your attending physician for a physical exam and some tests:- Complete blood count for anemia-thyroid hormone levels for thyroid gland dysfunction- Blood electrolytes- PCR and ESR for inflammation- Kidney and liver function tests-Vitamin B12 and vitamin D plasma levels should discuss with your doctor on the above tests. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Sir I think I have a ACL tear (ligament tear in the knee .. I just found out its name .. apparently ) for more than 6 months now My general physician advised me to do exercises and not stain the knee too much .. for some weeks .. to get this tear healed or something I did rest and exercise for 2-3 months, and when I felt that I could run a little and comfortably , I started going out for sports. In retrospect, it was a bad idea. I fell down a few times .. sometimes with excruciating pain , and would come back to my room cursing my knee. Then I again resumed playing few weeks down the line (how stupid!) But now, I think I am totally fed up and disappointed in myself, that I cannot play the easiest of sports without faling like a dud. I dont know what to do. Please help me ### REPLY: Hello, You have quoted the term ACL Tear. I want to put light on this so that you can have good understanding of that. The ACL is short form of Anterior cruciate ligament. This ligament binds thigh-bone with leg bone at knee. It is a strong ligament and prevents anterior displacement of leg bone in relation to thigh-bone or in other words helps in getting stability at knee.  In case of its rupture you will feel giving away feeling or unstable knee during walking / fast walking and during staring up or down. If you are not feeling instability at your knee then most probably you may not have ACL tear. If your symptoms line up with above description you should have an MRI scan to rule out your pathology. Very early stage tear can be managed conservatively while gross tear should be operated. 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: My son is almost 4. he vomited 2 days ago and ever since over the last 48hrs his temperature is going up and down and up to the high 39 degress. We have been giving him liquid panadol and nurofen over the past 36rs but nothing has changed.  He is very hot and his body is aching. No sweating. ### REPLY: Hi... Thank you for consulting in . Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an exercise stress test the other week due to repeated chest pains, Had MI 18 months ago with 3 stents fitted since the exercise test I have felt much worse. My Cardiologist has booked me in for another angiogram in a couple of weeks but i feel much wors. what should I do. ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain and give you my opinion. As you mention, you are a person diagnosed with ischemic heart disease because you previously had an infarction, and you had a percutaneous intervention with stents. When a person with this diagnosis complains about heart pain than we should exclude the possibility of active ischemic heart disease, meaning that might still be a problem with coronary arteries, new ones or those treated before. In these cases we recommend a street test. If your doctor has programmed you for another angiography this means that he might have seen something in your stress test that rises his doubt in what I mention before. But, if your chest pains are more intense now in their severity or duration this means that the angiography should be prompt. So, my opinion is that you should refer these symptoms to your doctor, because this changes in the intensity of pains are reasonable to accelerate the angiography. During this time don't make big efforts, take your medicament regular and just meet your doctor. Hope I was helpful. Wish you good health. 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 been told that my wbc count has been rising for over the past 6 yrs after giving birth to my daughter. As of the last year it has been rising quite significantly and I am currently on the wait list to see a hematologist. I am curious as to what they are going to possibly tell me is going on ### REPLY: Hi, dear. I have gone through your question. I can understand your concern about your WBC count. But please kindly give information regarding your WBC count. Exactly how much count you have. There are many causes of high WBC count. Simple infection can lead to that. much leukemia also have high WBC count. So you need to investigate. Go for CBC and PS examination. It will give you cause of high count. Consult hematologist, investigate properly and then take treatment accordingly. Hope I have answered your question, if you have any doubts you can ask me further. I will be happy to answer you. 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: my child is 5yrs now. can she be diagonsed with asthmaAsthma runs in my familypresently she is coughing badly and always gets worsen during seasonal change. some experts says she has tonsils and few others says she is allergicPresent Doctor has advised for CBC, Gbp and AEC test Pls advice ### REPLY: Hello. Thank you for asking at . Childhood asthma can be present at this age, especially when there is family history of asthma. If your child has recurrent wheezing episodes, requires nebulization, nighttime cough, symptoms associated with seasonal changes, I would first think of asthma. Asthma can be allergic and non-allergic. The investigations suggested by your doctor will help, but if they are negative, it will not mean your daughter has no allergy/asthma. There is not a single test to diagnose asthma at this age. Detailed asking of symptoms and pattern of symptoms only will suggest asthma. However, there are tests available for diagnosis of allergy, I would additionally suggest allergy testing and serum IGE levels for allergy. Hope this will be helpful to you. Wish your daughter the best of the health. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I smashed my fingertip in a car door Tue afternoon. As of Thu afternoon, the fingernail has gone completely blue with some slight white spots and the end of the finger is swollen enough that I cannot bend the most distal joint. I still have capillary refill in the skin around the fingernail and in the pad of the fingertip, and feeling, although it s a pins & needles feeling. At what point do I really need to be concerned? If I lose feeling, I presume I should go to the emergency room right away? ### REPLY: Thank you very much for contacting . You have problem of pin and needle like pain at fingertips that may be because of nerve problems. Diabetic neuropathy may cause pain like pin and needle like. Check your blood sugar level. Nerve compression may cause this type of symptoms. Nerve injury may rule out. MRI is helpful for further diagnosis. Proper physical examination and history give exact idea. Consent a physician for further diagnosis. I hope my guidance is helpful to you. . Take care. Thank you very much. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mouth issues for a year. A couple cavities very swollen and impacted wisdom tooth. Mouth hurts bad at night. I noticed a couple white dots on my swollen wisdom tooth and also on the top front of my mouth again only two. What is wrong with me? ### REPLY: Hi, Thanks for posting the query, I would like to tell you that wisdom tooth is the last tooth to erupt in the oral cavity and often impacted, tilted in position this area is difficult to clean and leads to caries formation, swelling of the surrounding gums known as PERITONITIS. I would suggest you to get a checkup done by an Oral Surgeon, take an OPG radiograph and plan for its removal. Take a course of antibiotics and analgesics. Take lukewarm saline and antiseptic mouthwash rinses. Take care! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a problem with my left knee. I have been told that this knee is bone on bone. I do not particularly want to have a knee replacement. I have heard that stem cells injected into the knee may be better than replacement of the knee. Can you tell me more about this new procedure? Barbara W. ### REPLY: Dear patient if your left knee is showing bone to bone on X-ray total knee joint replacement is the best option. Stem cell therapy is the new edition to the treatment of early osteoarthritis and those patients with local cartilage defect.  Bone to bone on X-ray means near complete loss of joint cartilage which cannot be replaced. Total knee replacement has now excellent results and is time tested surgery. You should not be worried. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Today I had a sharp pain that started in the back on the right shoulder blade and came around to my front and hit my chest, I could not breath and it brought me to my knees with my face red. My husband was very worried and took my blood pressure. It was 120/83. I have never experience this pain in my life. What could this be? ### REPLY: Thanks for your question on . I can understand your concern. Sharp right sided shoulder and chest pain with breathing difficulty is commonly seen due to lung infection (pneumonia). Pneumonia actually cause pleurisy (inflammation of pleura). This is the reason for Sharp pain. So better to get done chest x-ray first. If chest x-ray is normal then no need to worry about lung infection. Sometimes sudden muscle spasm can also cause similar symptoms. So take painkiller and muscle relaxant .  Apply warm water pad on affected areas. Don't worry, you will be alright, but first rule out lung infection. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have been taking Duromine for over a year. My Husband & I would like to start to try to conceive. How long do I need to be off Duromine before I start to try to get pregnant. I have asked two doctors this question & have been given two different answerrs. 1. the first doctors said I should be off Duromine for a least 3 months.  2. The other doctor said I can start trying to get pregnant as soon as I stop taking the tablet. Which is correct?  Thanks ### REPLY: Hi, Thanks for the query. I understand your concern. Bromine is an appetite suppressant. So to avoid possibility of nutritional deficiencies . I support your first doctor... yes you should stop it at least 3 months before getting conceived.  These three months are used to get a balanced, vitamins, calcium & iron rich diet while caloric intake restricted(to avoid weight gain). Exercises also continue as routine.  Taking folic acid 5 mg & vitamin E 200 mg daily by both the partners helps healthy conception.  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 being having pain on my lower back and front of my left side. they did testing no stones... kidney and other organs looks fine. but blood in the urine is getting worse... and now the right side is starting to hurst too...They did rx, ultrasound, urine culture. ### REPLY: Bellflower back pain may be due to many reasons like musculoskeletal causes, pelvic pathology, genitourinary causes etc. Kidney stones may cause pain, infection,hematuria(blood in urine)etc. You are rightly advised for ultrasound and urine culture and sensitivity. You need proper clinical examination and routine investigations. Investigations include routine hologram, renal function test, urine RE/ME, ultrasound of abdomen. Ultrasound of abdomen is important in diagnosis and treatment. It can exclude many causes. It is important to exclude urinary tract infection(UTI)in your case. Proper treatment depend upon findings. You should . Get well soon. Take Care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, a friend of mine is having a freak out because yesterday, her boyfriend ejaculated inside her, and they were not using proper protection. She took Plan B and is experiencing spotting and clotting in her urine . Is this a normal side effect of Plan B? Also, how long does it take for Plan B to work, what are signs that it is working? ### REPLY: Hi, Thanks for the query. The spotting she is having could be due to post-coital tear or could be a side effect of the emergency pill, as that can cause menstrual irregularities. The plan B to be taken within 72 hours of the act. Earlier you took the pill, the possibility of protection will be more. Experiencing symptoms like bloating sensation of the abdomen, breast tenderness etc. can indicate the effectiveness. But exact evidence is absence of pregnancy and resuming normal menstrual flow. For more details:http://srsree.blogspot.in/2012/08/emergency-contraceptive-pill-short-term.html 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 64 year male on Atrovastatin 20mg x10 years, hypertensive on lisinopril 20 mg amlodipine 5 mg. Last 6 months have lost 6kgs, Lft are deranged, since last 4 months have stopped Atrovastatin, CBC 4months back normal, All viral studies including HIV negative, Liver biopsy shows grade 2 hepatitis and stage 2 fibrosis with lymphoid proliferation.TSH 14.3 started Levothyroxine 50 mcg 3 weeks back,repeatCBC shows Lymphopenia, Decrease HB and Platelets, ### REPLY: Hi and welcome to . Dear sir you have obvious liver damage ant its cause must be evaluated. If this isn't viral it can be alcoholic, metabolic, autoimmune or toxic hepatitis. In your case you should rule out some autoimmune disorders because it can cause liver damage and hematologic abnormalities as well. Consult your doctor about it. Till that you must follow hepatoprotective diet, avoid alcohol, fats and smoking. Do frequent liver US and liver enzymes. Your blood picture will improve after liver heals. 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: hi,my husband had a stage i stomach cancer dectected in late sept.2010.he had 2/3 stomach removed after a month and the doctors said he  does not need chemo or radiation  but must review once a year.Till now is is fine n eats everything.At this rate how long will he live?.He is 50.thank you ### REPLY: Hi, dairy have gone through your question. I can understand your concern. HEMPAS stomach cancer of stage 1.  And he is treated by surgery at very early stage. So life expectancy is very good.  Don't worry much about that. Just be relaxed.  Just go for regular follow up. 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: my dad had a single episode of a shock feeling in his heart awakening him from sleep 4 days ago, he has had some new confusion and unsteadiness and was diagnosed with a UTI, He had not told us about the episode with heart til yesterday...do you think some of the symptoms may be related to this episode as well? He has a Pacemaker but no AICD ### REPLY: Hello! Welcome and thank you for asking on ! I understand your concern and would explain that a heart disorder can not be excluded, even though this type of pain (shock like) is not typical of cardiac disorders. A musculoskeletal pain (from inflammation) can not be excluded too. The UTI infection, would not explain his confusion and unsteadiness. Did he have fever? I would recommend consulting with his physician for a careful physical examination, a resting ECG and some blood lab tests (complete blood count, inflammation tests, blood electrolytes). If the confusion persists and all the metabolic tests result normal, I would recommend consulting with a neurologist and performing a brain CT scan and an EEG. Hope to have been helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I had an MRI performed and the conclusion was: Single sub centimeter T/2FLAIR hyper intense focus in the left frontal peri ventricular white matter. Differential diagnostic considerations include a single demylwlineating focus versus sequels of small vessel ischemic disease. Clinical correlation recommended. 2. Otherwise, negative non contrast MRI evaluation of the brain. What does this mean? My doc basically sent me to the cardiologist for further treatment. I had fainted for the first time in my life was why the testing was done. Thank you for your time. ### REPLY: It would be useful if you told us your age as well. The older you are, the more likely is small vessel ischemic disease rather than a debilitating focus. Demielinating diseases are a group of diseases of which the most famous is multiple sclerosis, highly unlikely if you are over 45, so since your doctor seems not to think that is the diagnosis I won't elaborate more. By sequel of small vessel ischemic disease, it means a small stroke, what we call a lacuna. It means a small blood vessel is narrowed till it was closed and the small brain area it supplied was damaged due to lack of blood. In itself it may bring no major consequences if not in a critical area, but small vessel disease is almost always a more spread disease, meaning more blood vessels can be affected and cause accumulative damage over time. There are multiple causes of small vessel disease, but in most people the main culprit are factors like high blood pressure, diabetes, smoking, high cholesterol, obesity. So the best preventive treatment is ad . I don't know why you've been sent to the cardiologist, perhaps to be evaluated for your blood pressure, or perhaps to check for a cardiac origin of your fainting, like abnormalities of heart rhythm or other heart structural abnormalities. I don't think the fainting was directly caused by that brain focus, it is an incidental finding. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 doctoryesterday my friend family dog bitten me on my back, its a scratch but it was bleeding, i used detol to clean it and my friend said no need to see a doctor we have given injection to dog.  do i need to take injection for rabbies. now already 2nd day. i am afraid of this thing. ### REPLY: HelloWelcome to . Rabies is 100% fatal, but it is 100% preventable by proper and adequate treatment.  Dog is a known reservoir of rabies virus, and it can transmit rabies by biting the humans. According to WHO categorizes of animal bite it is categorized into cat III. Would suggest you to take1. Cleaning the wound under running water.2. In TT, 0.5 ml3. Active immunization with antirabies vaccine on days0,3, 4 and 28.3. Passive immunization with anti rabies serum around the wound.4. Oral antibiotics like Tab Augmenting. Than 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 fatty liver,i took livolin for 1 month only instead of 2 months because i feel nothing more heart burn, then after 2 month i felt again the heart burn, i took again livolin but at second time it not works ,what can i do to heal my fatty liver ### REPLY: Hello Fatty liver is a reversible condition and most commonly it is due to obesity and sedentary life. It is also related to alcohol intake etc. I suggest investigations like routine hologram, Random blood sugar(RBS), Liver function test(LFT), Lipid profile to my patients. You may need upper GI endoscopy for heart burn. It may take 8-10 months to reverse fatty liver. Empirically you have been prescribed right medicines like violin. It is a hepatoprotective . You should take less oil and got for regular walking. 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 being treated by my dentist for an abscess and have been on antibiotics.  I was scheduled for a root canal today, but I am not able to open my mouth due to swelling and tightness in my jaw.  He indicated that there are times even though the abscess is being treated with antibiotics, the infection can settle into the jaw muscle and cause it to tighten up and that is likely causing the problem.  He prescribed a muscle relaxer to see if that will loosen up the jaw muscle.  I have been taking OTC pain relievers to help with the swelling and pain but wondered if you could tell me if there is a name for this condition and if there is anything else I can do to help myself or help speed up the healing process?  The root canal has been put on hold for a week in the hopes by then I will be able to open my mouth/jaw enough to do the procedure.  Thank you for your time. ### REPLY: Hello, It looks that you are suffering from a condition known as Erasmus, and it is the cause for difficulty in opening mouth. It can occur due to infection and abscess formation and can also be due to muscle spasms. You should continue taking antibiotics and muscle relaxant and also try to gently open the mouth as much as you can. Let the infection get reduced as it will help in reducing swelling and then the mouth opening will also get improved. 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: Dear Doctor, when ever i am eat some thing. it create gas in my stomach. and whe gas is formed .pain in my stomach. plz suggest me ### REPLY: Hi, if your gas pains are caused by another health problem, treating the underlying condition may offer relief. Otherwise, bothersome gas is generally treated with dietary measures, lifestyle modifications or over-the-counter medications. Although the solution isn't the same for everyone, with a little trial and error, most people are able to find some relief. DietThe following dietary changes may help reduce the amount of gas your body produces or help gas move more quickly through your system: * Try to identify and avoid the foods that affect you the most. Some of the worst offenders for many people include beans, onions, broccoli, brussels sprouts, cauliflower, artichokes, asparagus, pears, apples, peaches, prunes, sugar-free candies and chewing gum, whole-wheat bread, bran cereals or muffins, beer, sodas and other carbonated beverages, milk, cream, ice cream and ice milk.  * Try cutting back on fried and fatty foods. Often, bloating results from eating fatty foods. Fat delays stomach empty ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 32 years old male. I have these symptoms for as long as I remember. Lifelong premature ejaculation ( 3 to 5 seconds ) Excessive sweating Heat intolerance Hair loss from body Tiredness Depression Recently I have had a blood test and I came to know that I am vitamin d deficient. I am taking 10,000 IU daily for last one month. But I have not seen any changes so far, what could be the possible reason for all these problems ### REPLY: HelloPremature ejaculation in your age may be due to overexcited state etc. You should try relaxation technique and avoid provocative literature and videos. You should try to be calm and try to engage yourself in your job. You may need psychological counselling if needed. You are rightly taking vitamin D supplementation. You may need antidepressant medicines if symptoms persists. It is important to evaluate thyroid profile. Altered thyroid status may be the reason for tiredness, depression etc. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am Sivakumar of 32 years old. My height is 5.7 feet and weight is 65kgs. I am taking Trika forte (0.5) for anxiety disorder. I was taking Serataline 100mg and lonazebam for the same. Now for few days i am not getting proper sleep in the night. Please advice me the reason and solution for that. Thank u. ### REPLY: Hello Mr. Sivakumaran. In Erika there is alprazolam 0.5, while previously you were taking Clonazepam?/Lorazepam?(Dose not mentioned). Alprazolam is very mischievous .  While lorazepam and clonazepam are not causing so much dependence though they cause somewhat. Why you shifted to other medicines also not mentioned. Alprazolam initially helpful for sleep but as time passes same dose will not be effective that's why you are not getting sleep. Remedy for that consult the doctor and shift to clonazepam or lorazepam. SecondSecond thing anxiety disorder(exact diagnosis not mentioned as there are many anxiety disorders) can be cured by addition of psychotherapy specifically CBT. With help of psychotherapy later on you can stop medicine. So consult psychiatrist or psychologist for 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: Hi,My father had a CABG last week and after 2/3 days he has started showing partial hiccups that tend to cause abnormal movements of the stomach [noticeable] and thus affects his sleep. Also his voice breaks significantly during this. The hiccups are partial in the sense that the cause movements of the abdomen region. Is this common? Can u please suggest what I must do ? Is this something related to diaphragm inflation? ### REPLY: Hi noted all his details don't worry hiccups can be because of slight irritation of the diaphragm (not inflation)a CABG surgery requires opening of the chest wall our body is a closed system, so if any new changes to the body environment is there, body will take some time to cope with it and get adapted to incomplete bed rest after CABG and limited mobilization can also be a cause as gastritis hiccups abnormal abdominal moments once as he will start to ambulate these problems will settle down 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: ok this is embarrassing but I had sex for the first time with my girlfriend for the first time and 5 min. in I couldnt keep my erection. We tried again a couple days later and it happened again. now im worried that i wont be able to get an erection. could it have anything to do with my penis size im 4.5 in ### REPLY: HIT hank for asking to ChatDoctorerection and the size are nothing to do anything with each other, you have taken the side of your penis seriously that might be causing erection problem, you have to forget it size is not the matter in intercourse, again I am advising you that you have to forget it, stop paying attention, otherwise this will create more panic, hope this information helps you, take care and have nice time. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a thing under my armpit, and its really bothering me. It has a white head, and it looks kind of like a pimple, but it wont pop, or if i try to pop it, it wont. i put alcohol on it and it made it stop hurting but it hurts alot. what can i do to get it to go away? ### REPLY: Hi, Dear,Thanks for the query to . I studied your problem in depth and I understood your concerns. Treatment of the armpit lump-In my opinion the lump under the armpit is not resolving as its with perifolliculitis with boil and is unripe with only pointing head, rest is hard painful lump. At this stage you should consult ER Surgeon and treat it with anti-inflammatory and antibiotics and hot fomentation which would reduce it fast and would vanish in 5 days time. If it grows still ER surgeon would treat it by Surgical . Please avoid poking that lump. Consult your ER Surgeon if need be, who would treat it accordingly. So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to  and be comfortable to resolve your health issues. Welcome for any more query in this regard to . Write good resume and Click thanks if you feel satisfied with my advice. 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: Hello I am a 41yr old woman. Suffering from pain in left knee since last 7-8 mnths. Got an xray done. which shows ligament inflamation. Doing exercises as per my doctor suggested. My queries are what all exercises i can do which wont affect my knee, like cycling, swimming or any other cardio. I have always been a gym enthusiast. Because of no exercise feeling very low and putting on lot of wt. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have inflated knee. Well there can be many reasons for symptoms you mention in query like damaged Menisci, tendinitis, osteoarthritis, gout, bursitis, bakers cyst or Chen .  I would suggest you to consult orthopedic surgeon for proper examination. Doctor may order certain tests like CT scan, MRI and physical examination. Doctor may prescribe muscle relaxant along with anti-inflammatory and recommend physical therapy. Doctor may also recommend exercises according to your condition after proper diagnosis. Doctor may also recommend surgery in severe damage or to repair the meniscus. For now apply warm compresses, take proper rest, do not message and take ibuprofen or acetaminophen for pain. You can also apply anti-inflammatory and analgesic cream like Volta. Do not exercise of your own without the advice of expert. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: feel a lump sensation when i breathe in, around the apex area of my heart, it feels super dull in that area when i feel it, and i threw up my lunch with severe nausea and stomach cramps , when the whole episode starts i get extremely lightheadness , pale, and get clammy skin with cold sweat. ### REPLY: Hi, This lump could be a simple lipoma or some lymph node. Definitive diagnosis can only be made after physical examination. So visit your doctor for the same. You need at least a Chest X-Ray, ultrasound & 2D Echo first. The episode you have mentioned looks like your BP has also fallen to very low level during the episode. So do remember to check it often. So meet your doctor for the diagnosis & I can also be available after the reports. Feel free to contact me. Wishing you a good health. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: gud morning doc i have problem my prostate my sperm with blood but theres no pain in my body thres no fever also what im going to do  i go to the doc he gave the midicine for me after 3 days nothing and after 5 days i did not tke mdicine is returning back?can you please gve some advice about my problem thanks and GOD BLEES U doc. ### REPLY: helloThanks for query. You have not mentioned your age in your query. Hematospermia is mostly due to infection of prostate or enlarged prostate and needs to investigate in detail. Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.1) Semen examination and culture 2) Ultrasound scanning of abdomen and pelvis3) Serum PSA. Further treatment will depend upon result of these tests and final diagnosis. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 having chest pain for over five years now. I have had many ekgs, had 2 stress tests. Im 38 years old. I have no gallbladder. I also get severe abdominal pain with this and it radiates into my upper back on left. I have been to the drs so many times and seems like no one can figure it out. ### REPLY: Dear friend, you can take omeprazole/pantoprazole with simple painkiller like paracetamol or combination with ibuprofen for temporary relief. You are facing this problem from more than 5 years so I suggest you for yoga, exercise-physiotherapy and homeopathic line of treatment. If you are interested in homeopathy it will be much helpful to you. So please consult a good homeopath nearer to you or in your city. Hope this answer will be helpful to you. For more queries please don't hesitate to ask. Get well soon ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My feet are swelled up, as well are my legs......my feet are numb and i have blisters on my feet, some of my blisters busted , I had on socks and they where soaked with blood and brown fluid. This happened due to walking on them maybe to much. So I was just wondering what could be wrong. ### REPLY: Dear patient Swelling and blister on foot and leg may be due to inflammation and trauma to involved leg. Too much activity to which we are not accustomed may lead to this. Since oozing is brown colored blisters are hemorrhagic. Impending compartment syn .  Strict limb elevation is advised. Avoid wearing shoes for 1 week. Ice fomentation every 2 hourly for 2 days and then less frequently.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 this question, i have a bump since a few months there were two and now i can see / feel one near my lower cheek in line with my mouth, it feels like a whitehead, once a week approximately the bump comes up, when i burst it, yellow liquidy type puss comes out and  it smells really bad. What is this? ### REPLY: Hi ! Good morning. I am  answering your query. It seems that you have got a benign cyst over your cheek, which off and on gets infected and causes the discharge to occur. You have to see a dermatologist/general surgeon in your area for a proper diagnosis and further management which could be simply antibiotic cover or a small minor surgery to remove the cyst in total. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 blood work done last week and I just got results that I have hpylori positive, I have to go back for breath test , ? im scared now, I looked it up and it says that you can get stomach cancer from that, and my cholesterol is 238 I never had that in my life, I exercise everday and it is not heredity, I am not overweight, I am a 58 yr old women, any suggestions, thanks ### REPLY: Hi!welcome to ! H.pylori infection is mainly the cause of peptic ulcer disease and gastritis, although it has also been associated with gastric cancer and mucosa-associated lymphoid tissue (MALT) lymphoma. A blood test checks to see whether your body has made antibodies to H. pylori bacteria. If you have antibodies to H. pylori in your blood, it means you either are currently infected or have been infected in the past. A urea breath test checks to see if you have H. pylori bacteria in your stomach. This test can show if you have an H. pylori infection. It can also be used to see if treatment has worked to get rid of H. pylori. So be relaxed, go for this test and if present take full course of treatment to get rid of H.pylori.high cholesterol can be controlled with diet alone. Take care! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I herniated a disc in my spine three weeks ago. Pain is being controlled by amitriptyline, diclofenac, diazepam and codiene phosphate. My partner and I had hoped to try and add to our family in the new year. Im now concerned as to how long we should wait after I finish taking medication before trying to conceive. Any advice please? ### REPLY: Hi, Thanks for the question. I can understand the seriousness and difficulty of your situation that you are facing.  It's safe to conceive while you are on this medication, but you have to be careful as stress on lower back can exacerbate your pain.  Disc prolapse is not a contraindication unless you have sign/symptoms of spinal cord compression that are urinary/fecal retention or incontinence.  Hope you have got your answer but if you have any query, feel free to ask me. 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: 65 y/o female acute onset during flight. bad headache. face and lips numb,vomiting, pins and needles feeling in legs, cannot sit up leans to one side and cannot straighten up. rise in blood pressure, cannot keep food down. r/o stroke and tia with cat scan and mir. just returned from the Middle East last night. taken off plane and transported to hospital. ### REPLY: Well come to ChatDoctorThank for asking, Really appreciate your concern, your symptoms could be related to central nervous system it may be due to TIA (Transient Ischemic Attack), it could be due to nonspecific reasons, it may be due to wrong or monotonous posture for long time, for the better differentiation CT brain is must, and it can only R/O the possibility of cerebral pathology including stroke, hope this information helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had treatment for Non TB mycobacterial infection for 8 months with DOT medication and now it is four months without medication . Can i now go for IVF tratment ? what is the sucess rate after the tratment ### REPLY: Hello, welcome to  thanks for the query it's very important to diagnose whether the uterus (endometrium) is involved or not. So it is important to have a biopsy from the uterus If the biopsy from uterus is positive for TB on histopathology, then your chances of conception with IVF is less.  If it comes negative then there is good chance to conceive after IVF now the success rate of IVF is more than compared to the past take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello I have a mild cough only when im seating foe maybe more than 1/2 hour or when I,m in bed and lay on my back with a pillow...this is happening to me for 6 month already, at the beginning my cough was more pronounced but now is mild and sometimes is only the sensation to coughing. Also some sneezing in the morning or during the day, some time I felt like asthma symptoms with a little short of bread but maybe three or four time during the last six month. Not  smoking for the last 20 years, semi retire, 63 years old, walking four times a week, other ways healthy. ### REPLY: Hello, The symptoms described by you are typical of a condition called "post nasal .  As the name suggests that there are certain secretions from the back of your nose that are trickling down into your throat provoking cough especially when you lie down or sit for long time. This is seen commonly individuals with nasal and respiratory allergies like you have described (sneezing and asthma like symptoms). Since the root cause of your cough is nasal secretion that should be the target of treatment. You could try the following:1) Plain steam inhalation twice a day especially after you come back home from outside and also before going to bed. After taking steam for 10-15 mins clear your nose and hawk and cough out the phlegm in your throat. This will help to prevent nasal allergies as well as night cough. Steaming can be continued indefinitely as it is a natural remedy.2) Anti histamines like cetirizine before bedtime will prevent nasal secretions and prevent sleep disturbances.3) you could also try out steroid based nasal sprays containing fluticasone or mometasone. These are very effective in reducing nasal hypersensitivity to whatever induces you allergies, thus reducing sneezing, postnasal  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 done sex with my wife by using condom but due to fear she takes an ipeal tablet after two hours and next day at evening she takes another I peal after three days we done sex again by using condoms and she taken an ipeal after one hours but her period comes after seven days at her actual time and during that time she has fever and headache so it wants to know why it happens and anything is getting wrong? ### REPLY: Cellophane you for trusting  as your preferred destination for online healthcare.i-pill is a hormonal .  Also, its categorized as "EMERGENCY CONTRACEPTIVE". You have to use it only when there is protective sex by chance which could not be prevented. Your wife is taking an overdose of the pill. After taking i-pill, she should get her periods within 7 days. But you should avoid using it this frequently. There are other methods of contraception like condom, Copper T and many more long term contraceptives are now available in the market. Please visit a gynecologist and get an appropriate and convenient option selected for you two. Please note i-pill is not a usual contraceptive and has lot many side effects. It should be used only, and only in emergency. Wish you two best in futureThanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 37 years ,my height is5.4feet and my weight is 55kg i am married in 2011 since then i having problem for my pregnancy, my right tube is block but doctor told you can conceive with one , i tried so many medicine and injection but no use . thanking you, please help ### REPLY: Hi, welcome to  forum.I understood your problem.your one tube is blocked as you told, its true that you can conceive with the other tube, but the chances will be less, not 100% because it's a natural phenomenon and we being doctor, also don't know that through which tube you can conceive. So according to my opinion it will be safe for you to undergo surgery for the blocked tube and then keep on trying .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 boyfriend just realized that the veins in his scrotum are extremely dark and there is a large one on the left that is pretty much black.  He is a 36 year old caucasian guy with a vasectomy 5 years ago.  He is feeling some discomfort in his testicles.  I am trying to discover possible explanations without completely freaking him out.  What could be the cause?  We saw a movie a couple hours ago. ### REPLY: Hi, Dear,Thanks for your query to . Dear I read facts of your query and reviewed it in context to your health issues submitted in your query. I understood your health concerns and feel Concerned about them. Based on the facts of your query the reply of your query is-Your current health issues seem to be due to -Congested Testes post-vasectomy after the erotic movie. Possibility of undetected Varicocele needs to be ruled out as the cause for this discomfort which you noticed after the movie. Or it could be from sensitive vasectomy site also.Hence, Other causes-as cited above-need to be ruled out, by verification with Surgeon and Urologist. Dos-Consult with Urologist / Surgeon who would investigate history and physically examine to fix the cause of testicular itchiness.USG scrotum with Color Doppler Study would fix either of these causes in your case. This would fix the cause of excessive itchiness in testicles, amongst the above or other possibilities. You need to treat it with Urologist/Surgeon, which should be done on priority and urgently to avoid further complications. This would resolve the complaints of yours. Constant follow-up with local family or specialist Urologist / Surgeon for long term would give you long remissions of such pains in time to come, which would depend on meticulous follow-up treatment of your health concerns. Just don't worry and be patient and co-operate with your doctors, till you verify with your attending doctors. For early recovery-please follow above dos which would resolve your complex health issues. Hope this would help you to treat your health issues in the best way possible. Welcome for any further query in this regard to following link-http://doctor. .com/Funnel?page=askDoctorDirectly&docId=70229Wishing Good Healthy Life!! . 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 was recently ,well 5 months ago rushed to hospital and admitted to ICU for drug overdose. , from Barbituates,Meethedone,TCA .I can assure you I take none of these drugs .I am very interested in finding out what TCA stands for ? I will say I take serequel,at the time was taking lyrica ,I felt very depressed right after taking that medication. I am inremission frim stage 3 non-hodgekins lymphoma also have cryroglobulin vasculitis hep.c an neuropathy .Ialso found out that serequel can interact with other med. to look like TCA please help me ### REPLY: Hello and welcome to . Thanks for your query. I understand that you are going through a difficult time due to your problems. Now, I'm not sure in what context the abbreviation TCA was used, but in regard to psychiatric medication, TCA stands for Tricyclic Antidepressant. Tricyclic Antidepressants are a class of anti-depressant medication used in the treatment of depression. You have also mentioned that you are taking Seroquel (Quetiapine) - which is an anti-psychotic medication and Lyrics (Pregabalin) - which is an antianxiety medication. Since you have mentioned different classes of medication and since you have provided very little information about your symptoms, it is not possible to arrive at a definitive diagnosis for your problems. So, please discuss with your prescribing doctor regarding your diagnosis and the indication for your medication. Wish you all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Pregnancy Possibility & or Possibilities? I have a 21 day cycle. I haven t been regular for December 2012 (8) days late w/ Normal flow. January 2012 (11) days late w/ Abnormal bleeding. Brown/light in color, very minimal. Bleed for (8) Days. Normal flow is (5) Days. I am now in February (2012). I have not had a menstrual cycle, yet. I have taken (3) Home Pregnancy Tests. They were All Negative. I tested January 29, 2012. This was (1) day before Brown/light blood began. Second test, after abnormal flow (8) days long. They were Both (-). I recently took another, Pregnancy Test. This month, February 26, 2012. The test was also (-). I became sexually active, again on December 30, 2012. In A Monogamous relationship. After (10.5) years. I was diagnosed with Endometriosis, in: April 2012. U had Laproscopic surgery in April 2012. To remove Large Cysts on my Ovaries. I still have my entire reproductive organs, Entirely. I also, have Lupus SLE. I WAS diagnosed in: February 2012, I also Waa diagnosed with: IBS, IN 1996. I was diagnosed with:,GERD IN 2012. I had my gallblatter removed 11/ 03. ### REPLY: Hi, .  I welcome you to  VIRTUAL CLINIC. I have gone through your question, and I think I have understood your concern. Furthermore, I will suggest you the best possible treatment options. 1) First do not panic. 2) possible chance of getting pregnant depends on the amount of ovarian tissue present after the surgery .3) I will suggest you To get USG done, preferably vaginal one to know about ovarian volume.  On day 2 of the cycle blood test for FSH, LH, AMH will be helpful to understand ovarian response to basic natural hormonal secretion and ovarian egg reserve. With all favorable and in the range reports, you stand good chances to get pregnant. I hope this answer helps you Thanks  ### END