Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 tying for a baby since 5 months, had a thyroid issues, it got controlled five months back, then got to know have mild PCOS ...since then takig treatment, last month had done folicile study, the result was good enough as it ruptured at 22mm on 17th day however cudnt concieve. Doctor said once again go for folicile study. but some relative of mine is saying that i should get HSG checked this month...wat should i do? as the doctor has said i cant go for both the test together....please suggest? ### REPLY: Hi, If you want to get the tubal patency test done, you should better avoid follicular study in the same cycle as there will be delay in the study owing to the timing of Hysterosalpingogram, as it is done during the follicular phase of the cycle. So, you can ask your doctor to suspend follicular studies in a cycle and go for a HSG test if he finds it reasonable and if you want to get it done. It is always good to exclude problems of tubal patency. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 15 month old just recently started grabbing and playing with her tongue. I don t think there is any swelling. She doesn t seem to be in distress or discomfort but is a little irritable. she has all 8 front teeth, and 3 of her first set of molars have cut through the gums. Is the tongue grabbing a result of teeting or could it be something more serious? ### REPLY: Hi, thanks for asking. I can understand your concerns. First two years of life are the sensory motor stages where child learns by exploring every thing including their bodies. So grabbing and playing with the tongue is normal part of the development. You need to be concerned only if she is doing it whole day and not taking interest in any other play. Otherwise, just ignore it or gently direct her towards the other kind of play. I hope I have helped outrank 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: Im 27 years old and for the last few years Ive noticed a slight pain that comes and goes on my left side. Sometimes I get it on my right side but not as often. A few days ago I noticed a small lump on my left side. Its not noticeable unless pushed on in the exact location of the lump. I ve had mild persistent pain as well. I ve also been having a few more headaches than usual. Should I be worried? ### REPLY: Dear, Thanks for the query to . I studied your query and understood your health concerns. Remedy and cause-of your problem-In my opinion your painful lump on left side with frequent headache -indicates-a-High BP with Anxiety neurosis- which is caused due to lump on the left side of your chest. I would ask you to consult ER Surgeon and Physician. I suggest you following -a-Not to Worry but act fast with Surgeon and Physician.b-Revert to your doctor on this advise-who would help you. This would help you to resolve your query. So act fast and investigate it. Welcome for any further query in this regard. Write review ASAP, with strong recommendations for Me and  to benefit old and new patients. Have a good day. With . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 used Klonopin from my psychiatrist for anew days. He said this may subside however Im a busy mom of two and although today my fibromyalgia is under contr due to good sleep, Im still so fatigued from the Klonopin. What can I take as a stimulant to help me get my work done and drive my kids today without being groggy. I have OxyElite Pro and of course coffe, for which I cant stand the jitters or crash. Do you know of anything that will help me today? ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. No. It's would be better to reduce the dosage of Klonopin or look for an alternative. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I need to find someone who can help me get a diagnosis for my brother. I believe he suffers from delusions of grandeur. My Dad won t be around much longer to support him so in order for him to get the services he needs he will need a diagnosis. I don t know if I can get him to go more than once or twice. It is painfully obvious to family members but I don t think a stranger would see a problem right away so I m concerned. Do you have a name of a psychiatrist that specializes in this? We live south of Detroit. ### REPLY: My best advice would be to call one of the local hospitals and ask to speak to the referral service.  Most hospitals should have a department or operator who can give callers names of specialists who are in your geographic area.  Another source of help would be a local URGENT CLINIC or if you truly believe there are psychiatric issues the local Neighborhood Psychiatric Services Outreach facility.  Again, most of what you're asking about can be found within the setup of any local hospital whether it be a county facility or private one.  Of course, the next step which will be more challenging is to get your brother over to the consult.  All the best.  You may write to me at: www.bit.ly/ .  Please rate this a 5-STAR ENCOUNTER. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 am having persistent back pain for last two three years now. From last one year it has increased manifold. I feel a lot of stiffness in the back, am not able to bend fully unless I do some warm up. Every morning leaving the bed is a challenge, basically things are not as I would like them to be. In the past I consulted an ortho surgeon who advised me to take milk and calcium tablets daily and also do stretching exercises. I tried it for a while, but honestly I could not maintain the discipline and gave up after a while. As for the tablets; They don t really excite me . I really want to come out of my present situation. Kindly show me the way. Regards AAAAA P.S. - I am in the IT industry and work on the computer for long hours, many a times without a break. ### REPLY: Hi, Thanks for posting on . After reading your symptoms I feel that you need to incorporate certain things in your daily schedule:1. Spinal extension exercises, which your doctor had suggested earlier. You must start with them again on a regular basis.2. Local analgesic ointment: If the pain is more, application of any local analgesic ointment will relieve/subdue the pain.3. Lie on hard bed while sleeping4. Physiotherapy: Getting few sessions of physiotherapy will definitely make you feel much better and once you exercise as well the problem should resolve.5. Take walking breaks after every 2 hours while working, stretch and bend if possible to relieve the tension in the lower back. If, after following above-mentioned routine, the pain still persists then you must get a X-ray spine done and revisit your orthopedic surgeon for clinical examination. Hope you feel better soon. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband finished his chemo treatment 3 weeks now for testicular cancer stage 1. He seems extremely fatigued and his hands are more swollen than when he was going through chemo. He had a bad headache yesterday, he said may have been caffeine withdrawal. Is this normal after chemo? ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern from the history given here, I could say that chemotherapy could induce the numbers of side effects, but that is all happens till the patient is on chemotherapy once the course of this is finished symptoms also disappears, and this is nothing to worry, take care of your husband and stop worrying, hope this information helps you, have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear sir, As advised by dr. MRI report of my wife s (41 yr old) pott s spine identified, after their advice i have taken conservative treatment (medication), after 4 months (not relif) they advice to x-ray of DL Spine, / Ap/cal, along with Blood test of SGPT, Uric Acid, CBC, ESR. as per x ray report of my wife (41 yr old) there is compression with minimal destruction of body of D12 noted, there is suspicious soft tissue swelling noted around it, the vertebrac show normal architecture, the vertebrac shows normal alignment, the disc space between D12-L1 is reduced, no spondylolysis or spondylolisthesis is seen, no radio opaque calculus is seen. Remarks: The findings are suggestive of ? Pott s Spine. The clinical corrclation and further cvaluation by CT scan is suggested. ### REPLY: Hello, Usually, patients will present to old with vague back pain later this pain may become troublesome and may not respond to general treatment.  Depending upon X-ray or MRI DL spine will be advised if it shows vertebral collapse which is due to Potts spine which means tuberculosis of vertebral body with surrounding soft tissue inflammation which is clearly seen with MRI.  Usually, they need 18 months of antitubercular treatment, if they have weakness of legs surgical fixation may be needed. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m concerned that I have appendicitis. My symptoms are excruciating cramps in the middle of my lower abdomen. The pain is in my lower back as well. I have nausea that comes and goes, I have not thrown up, but I feel as though i could. I m on the fourth day of my period with an extremely light flow, and my periods usually last no more than 5 days. I have never had cramps this late in my period. I took Aleve about an hour ago. The pain has subsided now for the first time in 3 hours. Can you advise on whether or not emergency care is necessary? ### REPLY: HI, thanks for using  Appendicitis would normally present with pain in the right lower abdomen. It would be associated with fever, loss of appetite, vomiting. The diagnosis of appendicitis would require examination of your abdomen looking for certain signs of this infection. The fact your pains are in the middle of your local abdomen, and you are present having your period would more likely point to this being a cause of your pain. If you remain unsure, you can visit your doctor for an evaluation. 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: Hey Docs, For a few days now i have been having swelling on my gums behind the last tooth on the bottom row of my teeth on the right side.It is painful and a pale white color.It feels a lot better after i brush my teeth but the pain eventually comes back.I rinse my mouth with warm salt water and peroxide but the pain will eventually come back.Any advice? Anything would be great. ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint you are suffering from PERICORONITIIS which is inflammation of the gum flap that covers or lies behind the wisdom tooth and the inflammation occurs as a result of food deposition in the area between the gum flap and the wisdom tooth and inflammation leads to swelling and pain. As when you brush your teeth there must be a reduction in infection in that area which provides you some relief but eventually the bacterial count increases and there is more acid production leading to recurrence of pain and swelling. You should consult a dentist and get evaluated and along with it if your wisdom tooth is not completely erupted an x-ray of the wisdom tooth has to be done.First an antibiotic course is to be taken like Augmenting 625 mg thrice a day, Ibuprofen 400 mg thrice a day and Pantoprazole 40 mg once in morning empty stomach. Take for 5 days and along with it do warm saline gargle. Chlorohexidine gargles are also relieving. In case if the condition resolves it is fine or else if it recurs then x-ray will help in deciding the treatment as if the wisdom tooth is completely erupted then OPERCULECTOMY that is surgical removal of the gum flap is done under local anesthesia. In case if the tooth is impacted Operculectomy can also be done, but in that case extraction of the tooth is the best possible treatment. Hope this information helps. If you find the answer helpful please give me a Five-Star Review and click on found the answer helpful as a token of appreciation. Thanks and regards. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I accidentally bit the inner part of my mouth. It bled internally, turned black then really red (filled with blood). Problem is it is now hardened, causing me to have a lump of hard-rock blood clot on my mouth. The colour is pink, same as the colour of the inner part of my mouth. Should I see a doctor? ### REPLY: Hello, Continue to keep the area clean by rinsing with warm salt water. Tissue can go through various stages of healing. Depending on the amount of inflammation, I hope the size will continue to decrease with an additional healing period. I do not think there is an urgent need to see your dentist from your description. Taking Anti-inflammatory medication such as Advil or Tylenol may help you to continue to heal. Consider scheduling a dental visit if the location and size are a functional problem, or you continue to reinsure the area. A clinical exam would determine if a surgical procedure is an option or necessary. There could be excess tissue that could be removed. Thank you for your inquiry. Do not worry and make sure to provide all details to your dentist at a future routine exam to check on the healing. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 uncle is having pancreas infection and got the surgery done twice to remove the infection but still not cured.he was treated in Surat and now moved to Saifee hospital,Mumbai under treatment from Dr Prasanna Shah.What are the chances of being cured? ### REPLY: Hi, I had gone through your question and understand your concerns. It would have been great had I examined your uncle on my own.What I can make out from your description is that your uncle may be suffering from chronic pancreatitis with calcifications and dilated pancreatic duct. Chronic pancreatitis can be treated by medications like pancreatic enzymes like Creon and surgeries like Bestows operation, Whipple's operation, distal pancreatectomy depending on the percentage of pancreas involved. I would suggest you to write back to us with a more detailed history, a bit of O. T note, last CENT abdomen. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing your uncles good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 24yr old female who has neurofidbramatosis type 1 (nf1). I have been having horrible pain in upper left abdomen that goes into my back between my shoulder blades. Also anytime I eat or drink anything I am either sick to my stomach in horrible pain or both. I even throw up a lot after eating. I can not live like this anymore the pain nausea and vomiting is ruining my life.  Its been going on for two weeks now the pain has been getting worse. ### REPLY: Hello! Thank you for the query. Such upper abdominal pain which radiates to the back is usually caused by gallstones. Sometimes pancreas inflammation can give such symptoms however the pain is usually so strong that forces patients to visit a doctor. If it is gallstone issue, your symptoms should get worse after fatty foods spicy foods or alcohol. Sometimes similar symptoms are present with stomach issues like peptic ulcer. I suggest you to do not wait any longer and visit your doctor. Abdominal ultrasound, blood work, liver tests should be done at first. If gallstones will be confirmed, laparoscopic surgery should be done. If nothing will be found, gastrostomy is necessary. In a meanwhile please avoid fatty foods, spicy foods, coffee and alcohol. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had blood in my urine with my uti. two weeks after drugs i had just a little pink so i called dr and he put me on a three day dose. he was an on call dr over the phon nd he said it could be bladder cancer   he scared me so much i am almost sick  i will be seeing my dr on thrus. ithink his comment was way out of line   do you?  this is my firat uti. ### REPLY: Hi, Thanks for writing in. Cancer of the urinary bladder is evaluated in a step wise approach. First there may or may not be blood in the urine. This is evaluated by doing an ultrasound scan of urinary bladder as a basic investigation. If there is any cancerous area withing the urinary bladder then it requires a cystoscopy. This is an investigation by which the inner lumen of bladder is directly visualized with the help of a fine tube like endoscope. If any mass is confirmed then a biopsy is also done and the material sent for pathological analysis to the lab. The pathologist in the lab will confirm if there is cancer on the suspicious area or not. If a cancer is confirmed then further detailed examination like CT scan, MRI scan and PET scan might be required to know the stage of disease. As this is your first UTI, please do not get worried and take treatment for your UTI first. Get the ultrasound scan done to clear doubts of any mass in the urinary bladder. 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: Sir, I got my Lever Enlarged in my sonography test. I am a reguler Alcholic person. Sonologist suggest for Fatty hepatomegaly Grade 2. I feel slight pain in left part sometimes. In the morning my stomach becomes Swolen after morning walk of 4 Km. Pl. Brief the problem and suggestive measures. ### REPLY: Brief Answer:Quit alcohol altogether and follow a healthy - fat free and low cholesterol dietDetailed Answer:Hi. Thanks for posting query at .you're advised to also have Liver function test and monitor the values accordingly. Usually ALT or AST values higher than "two times the upper normal limit", is considered abnormal (in some countries, ALT or AST values of more than 100 are considered abnormal). Value of AST or ALT greater than 85 or above maybe investigated further. Alcohol ingestion and obesity are common causes of fatty liver disease. Advice for fatty liver:- abstinence from "Alcohol" - LOW fat diet should be followed, AVOID junk food and beverages-decreased oil consumption (oily food)- NO red meat-green vegetables should be ingested daily-use lemon juice (lemonade) once in a day-reduce weight if overweight/obese-"recheck liver enzymes after 6 to 8 weeks" and/or ultrasound. Any further questions are welcomed. Hope to answer your concern. Wish you good health. Regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my name is alyssa. i have recently relocated to washington state because the second half of my army training is here 2 days ago i began experiancing itchy palms and then it stopped. the next day i went outside and in 2 min my palms started hurting and then later they got really itchy and i broke out in hives but just on my hands along with that i have started to have difficulty swollowing and green foul smelling stools. ### REPLY: Hi, Thanks for writing your query. It would be helpful if you could undergo complete hologram, electrolytes and stool examined (Routine/Microscopic, ova,cyst and for Occult blood). Swallowing difficulty could be as result of throat infection which can be cured easily by antibiotics course. You can take Metronidazole 400 mg thrice a day, antihistamines (tab.evil or cetirizine available over the counter) along with an antacid like Sanitizing 150 mg twice day and a probiotic preparation. Antibiotic like Ciprofloxacin 500 mg twice a day, if needed can be added according to the report of the stool examination. Take care of your diet. You should eat light food, prepared in hygienic conditions. . If the problem persists, get yourself examined clinically by gastro-physician. I hope this is helpful to you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am forty -one in good health. I just took three lumbar x-rays (a vest was not used) for some back pain and I am also scheduled to complete a renal ultrasound for further analysis. I am not pregnant. I want to become pregnant this year. 1. Do you think my eggs could have been damaged by the xrays? 2. Should I complete the ultrasound? ### REPLY: Hi thank you for trusting ChatDoctorI read carefully your symptoms and understand your concerns could be more helpful if you described more carefully your symptoms Anyway first be calm as eggs won't be damaged from radiation as it is in small dosage Ultrasound is to be done as it rules out abdominal and renal causes it is normal you should schedule a lumbar MR (a CT would be fine, but it has radiation as well)Lumbar examination will determine the diagnosis Hope my answer will be helpful Please feel free to ask for further information or doubts 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: Please write your query hereif my normal temperature is 97.9 would 99.4 be considered a fever Im also feeling hot plus Ive got salva gland blockage had it for yrs every so often it blocks and swells and is painful could that be whats making me feel feverish?? ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have mentioned that you have blockage of salivary gland since long time, now you are feeling fever, yes it can be due to that or may be due to viral infection also, Don't worry go to Dentist and get investigations, Seismography done and go for proper treatment, For fever you can take medications One Tablet Paracetamol three times a day for 5 days , One Capsule vitamin B complex once daily for 5 days, Then go to Dentist and get treatment done.  Hope this will help you.  Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I want to know that either pregnancy happens in dates or not? The semen was come out after urination from vagina.....when she go to washroom right after intercourse. She was in periods, and it was 4th day of periods. More over, what are the symbols display with in first 1 week if pregnancy exist? ### REPLY: Hello dairy understand your concerned not worry. Period is not possible when you did sex during the time of the period. During the period there is no ovum is released during this time, so no fertilization will occur. It is very difficult to predict the pregnancy in the first week. In the majority of case there is no noticeable symptoms during first week. Following are the early symptoms of the pregnancy: tiredness, fatigue, enlargement of the areola and breast, darkening of the areola, urine frequency, implantation bleeding, white vaginal discharge. But I do not think you will be pregnant as you did sex during the period. Take healthy diet and avoid stress. Use safe sex practice to prevent the pregnancy. Hope this may help noncontact  for further health query Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my right testicle is has become stiff and swelling for a few days now,it happened the day after i worked out my abs and chest at home,i usually workout on regular basis but i haven t been working out for about 3 weeks,so my question is what s going on down there? it s painful and my lower back hurts and i feel like someone is squeezing my kidneys ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. The kind of pain that you are describing could be for trivial reasons as vague muscle aches, or it could be a serious concern as well where in your might have rotated your testis. Then this condition is called torsion of testis.You need to get the testis examined by a doctor. If it is a torsion testis then you need to get a Doppler test done, and it could be an emergency as well. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doc my semen analysi is count is as follows please let me know the result:Age = 31Viscosity = ViscousLiquefication = More than 2 hoursVolume = 1.5mlReaction = AlkalineMicroscopic Examination:-Sperm Count=56 million/ml,Sperm Motility:-Active = 20%Sluggish=30%Non Motile = 50%Microscopic Description:-Pus Cells = 3-4/hpfRed Blood Cells = nilEpithetial Cells = Occasional/hpf active 20%, sluggish 30%,non motile 30% ### REPLY: Hi, thanks for writing. I understand your concerning normal semen, viscosity is absent, liquefaction At least 40% should be actively motile, motility is lessons cells and epithelial cells will be absent. Treat with antibiotics and repeat semen analysis. Avoid tight .  Take tablet with multivitamin, minerals, lycopene, L- carnitine which is available in various trade names. Hope I have answered your queries. Feel free to ask any doubts. 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 was recently hit in the stomach on the left side about 2 in hes below rib. I have some bruising on my stomach. The pain felt like it traveled toward my lower back.but now it has moved to my left lower abdomin. I feel as though I bruised my intestines. Have been constipated lately ### REPLY: Hi! Good evening. I am  answering your query. Considering your symptoms following a trauma, I would refer you to a general surgeon who might after a general physical examination specially of the abdomen go for an ultrasound/CT scan of the abdomen to rule out trauma to the internal organs of the abdomen. It might not be possible to opine on your problem without a thorough physical examination. 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 am a 23 year old female that had a c section 4 months ago (first child). On and off since he was a month old I have had upper back pains that lead to tightness in the upper chest/upper abdominal area.. would the surgery have anything to do with that? The chest pressure makes me sweat, and feel very nauseous and faint. ### REPLY: Hello, Diagnosis: Fibromyalgia & Reflux Esophagitis & Error in Metabolism Treatment: It is not due to surgery per se. Take plenty of water & adequate salt in diet. During involution, take suitable supplements & in particular cited for minimum 6 weeks along with supportive & antacid gel preparation for ingestion. If no relief, get USG of abdomen done & SOS endoscopy, consult gastroenterologist.  I wish you good health.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son is five years old and eight months, he has asthma for the past three years, but now the severity of attack has decrease, now he has another attack, at the hospital they gave him nebulization- asthalin and budacort, the chest is not yet cleared, i want to nebulize him again what should be the dosage, he has27kg ### REPLY: Hi, If your child has been diagnosed with asthma already then he would require bronchodilators like beta receptor agonists (albuterol or terbutaline)and anticholinergics (ipratropium bromide or aminophylline) in MDI with spacer as child cannot synchronize himself. You can give him nebulization with Stalin and decor 3 times a day with 1 ampule containing 2.5 ml of Stalin 5 mg/2.5ml. In addition, antihistamines and mast cell stabilizers are also had a useful in the treatment of asthma but for all this treatment you must see pediatrician rather than giving him just self 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: My mother has been diaignosed with pulmonary arterial hypertension, resp. failure and now with adenocarcinoma. She has has accumulation of fluid around the heart and lungs and I believe that is caused by the cancer which was found in tissue samples from the pericardium. We have been given the option of hospice or comfort measures in the hospital. I think there may be something more for someone to do rather than just giving up on her. Is there a way to help her illnesses? ### REPLY: Hello dear. I appreciate your concern for your mother. From your details it appears as she is suffering from advanced stage of cancer along with other co morbid diseases. So primary aim will be to stabilize her chest and cardiac condition, If she improves then only definite treatment for cancer can be done as it will be extremely difficult for her to tolerate the treatment otherwise. Hope that makes it clear. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a laparoscopic removal of my appendix and gallbladder three weeks ago today.  Saw the doctor a week ago for my follow-up; my incisions were a bit red, but he said they werent infected and said everything was healing fine.  A couple days later my whole belly started itching and have been ever since.  Call the surgeon, said use 1% Hydrocortisone cream and Ive been using that 2 or 3 times a day.  However, over the past couple of days, my largest and lowest incision (the one in the muscle) has gotten more red, though it is not hot, swollen, and Im not running a fever; I feel fine.  Do I need to worry?  Everything is just itchy!!! ### REPLY: Hi and welcome to . Thank you for your query. This is nothing uncommon, and it seems like to be minor wound infection. I wouldn't even apply cortisone cream, it should heal by itself. Just keep it clean and .  If you notice out discharge or wound dehiscence you should seek help, but till that don't have to worry. Fever shouldn't be related to such a small wound infection. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mother is 80 yrs. detected with vulva cancer. vulva is swollen red ,around discolourisation, white growth now extending to rectum. biopsy shows keratinizing squamous carcinoma vulva(welldifferentiated,invasive).she is little asthmatic, has cervical spondeolytis . ### REPLY: Hi, dairy have gone through your question. I can understand your concern. She has well differentiated keratinizing squamous cell carcinoma.  If her general health is good then treatment of choice is wide excision of carcinoma followed by chemotherapy or radiotherapy if needed. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi! I am 52 yrs old, a mother of 5 & currently undergoing investigations for cervical cancer. I had lower abdominal pain on & off with vaginal discharges (watery) since few months. Accidentally it was found out during an abdominal ultrasound: Uterus normal sized measures 6.2 x 5.1 cms. Endometrium - 1.31 cm with hypoechoic shadows most likely blood. Rt. ovary - 2.01 x 1.87 cms. Lt. ovary - 1.67 x 1.15 cm. No adnexal masses detected. No free fluid in the cul de sac. Cervix appears normal The fluid in my uterus was removed by D&C wherein a biopsy was done & here is the finding: Uterine cervix, cervical biopsy from cervical growth: - Invasive moderately to poorly differentiated squamous cell carcinoma with glandular extension. - No definite vascular invasion seen in this biopsy specimen. My OBG told me that it is a stage 2 Cevical CA. She ordered for me CT scan & MRI, both with contrasts. here is my CT result: Impression: Bulky uterine cervix Multiple non-enhancing lesions in both lobes of liver ? cysts ?? metastasis. Ultrasound correlation is recommended for differentiation Low attenuating lesion of fat density in the right renal lower pole possibly lipoma My MRI will be resulted after 2 days. I am very anxious & afraid about this. Can you help me more on this? What is the next best thing to do? ### REPLY: Hi, Thanks for writing in. You have a cancer in the cervix of uterus that is still in early stages. The biopsy report shows the cancer cells which are of invasive moderate to poorly differentiated type squamous cell carcinoma. This is a type of cancer involving the cervix. It is important to know the exact size of the cancer area and the CT and MRI scans will help in this. I understand your concern at having multiple areas in the liver which have been given as cysts. A cyst is a fluid filled structure that is harmless. It is important for you to have a detailed review of the liver so that there is no confusion and doubt of disease spread to liver which will then change the stage and treatment decision and might be bad for you. The MRI scan will also show the areas and can be compared with the CT scan to get a better picture of the cysts being harmless. The kidney lesion is confirmed to be containing a fat component and this is a benign lesion. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently had several attempts at a blood draw. Each cite has a very dark, large and painful bruise . Four days later, I had 2 more pokes , and again, both of these have very dark and painful bruises. The bruises all exceed 3 inches in diameter. Because this is happening every time I have a blood draw or an IV, should I be worried? ### REPLY: Hithanks for your query can feel your concerns would like to know if you have any history of bleeding or bruising spontaneously or at any other siteMoreover do you have any family history of blood disorder? If no other issue, then usually it is due to faulty technique. And need not worry.it will resolve in few days.However, if persist then you need to see your doctor, and may need some blood tests to rule out low platelet count or any bleeding disorder am available for your help regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my name is ayana (yahni) my boyfriend has a form of testi cancer....germ cell... his mass was orginally found in his chest ....chemo was done ...he had a seizure and it spread to his brain...radiation was done and it spread above his spine...surgery was done and now its intertwined in his actual spinal ..... ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  He has testicular cancer with widespread metastasis.  So it is considered as stage 4 cancer.  Prognosis is very poor despite treatment. Surgery is not useful in this stage and chemotherapy or radiotherapy as many other complications. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: After 8 days ovulation my temperature is same from last 4 day it is 98.1...what does it means??is it infertility sign ### REPLY: Hi. Ovulation most commonly occurs on the midcycle and the basal temperature rises on that particular day of the ovulation. Following the ovulation the temperature gets back to a normal. Infertility occurs due to multiple reasons. Normal ovulation, normal uterus functioning, and other male factor contribute to infertility. So right now, if your periods are normal and if the ovulation is happening normally, then you may not be infertile... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been getting a sharp pain in my lower right abdo and i dont know if it is appendictis, as i have read on symptoms onlineyesterday i had a moment when i had to walk dodgey as i had that pain when i walked and then it wentand when i went to eat in the resturant i had a feeling of neausea and then it went after a couple of hourswhen i go to the toilet for a stool, i can feel that pain when my bowels satrt to move ### REPLY: Hellman in lower abdomen may be due to many reasons like colitis, appendicitis calculus, etc. You need clinical correlation and investigations like routine hologram, urine RE/ME and Ultrasound of abdomen. Ultrasound of abdomen is most important in your case. It can exclude many possibilities. Proper treatment depend upon findings. You may need antispasmodic and antibiotics. 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: my 5 year old daughter has had high fever ranging between 100 and 104 since thursday night. I have been giving her children s tylenol at the correct intervals and even contacted her pediatrician. She has no other symptoms and is playful, eating lightly, drinking and urinating fine. Should I be concerned; Because I am.--Jen ### REPLY: Welcome to  If baby is otherwise well (playful, eating lightly, .  You continue with Tylenol as prescribed, you can do tepid sponging for fever if it does not come down. Do consult your pediatrician if fever does not come down in 48 hrs. But at the same time be careful to contact doctor/ emergency if your baby is dull, poor urine output, poor oral acceptance, freq vomiting, headache, seizure. Hope I answered your query thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I had a cold for 2 weeks with severe coughing. The cough has gone away. But now i am left with a pain in my ribcage whenever i breathe in deeply. I thought i fractured my ribs when i was coughing. But the problem is that the pain is moving around. It is now making its way towards the sternum ### REPLY: Thanks for your question on . I can understand your concern. Coughing is a process in which ribs and intercostal muscles have to work hard. Since you had severe coughing, possibility of musculoskeletal pain due to straining on ribs and intercostal muscles is more. No need to worry about rib fracture. Do following things for better symptomatic relief. 1. Avoid heavyweight lifting and strenuous exercise. 2. Avoid bad postures in sleep. Avoid movements causing pain. 3. Take painkiller and muscle relaxant .  4. Apply warm water pad on affected areas. Don't worry, you will definitely improve in 1-2 weeks. If not improving then get done chest x-ray to rule out internal damage. 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: My huband, 40 years, is suffering from slip disc. He is undergoing traction, physiotherapy since the last 15 days but no results. Pain is severe in the right side lower back moving through the thigh & left leg. Completely bed ridden. Please advice. Local doctors adviced injection dynapar AQ 100/Hifenac p/Fibrogesic/ pAntium 40 & myoril ### REPLY: HiT hank you for your question. Pain from a pinched inflamed nerve can be severe at times. Dynamic/Higher are painkillers and will definitely help. Other options are1 Pregabalin and Gabapentin are nerve specific medications that help to relieve articular pain like this. 2 Oral steroids like methylprednisolone can help reduce acute pain if there are no contraindications like diabetes.3 Epidural injections can be done directed to the specific nerve. See a spine surgeon to discuss this. These modalities are helpful for alleviating pain in most of the patients. However, if it persists for long time surgical decompression of the nerve is needed. Wish you the best 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: My 6 yr old granddaughter has had chronic constipation since infancy. In the past week she has had intermittent abdominal pains, loss of appetite, fatigue, and stool smearing. in the past 48 hours she has not responded to pediatric laxatives. She has been running a low grade fever today. Should she be seen? ### REPLY: Dear Sir/ Madam, Thank you for posting your query at .contour granddaughter requires intake of plenty of fluid in the form of water, fresh fruit juices, warm soups, tender coconut water, along with these she should be given light meal like oatmeal, curd rice, boiled pulse and rice. If she does not respond to this than she should be given laxatives. In case, the condition worsen she should be immediately taken to pediatrician who will assess and prescribe the medicine as per the requirement. Hope you find this informative. Your vote of thanks is very much appreciated!!! With best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am a 29 year old female doctor by profession married for last 5 years. due to some reason(not medical) i had to undergo MTP 1 year back. i had also taken i pill twice near that period only. but all the time my periods were normal. now for last 2 months i am trying to concieve but not able to do so.shd i go for some tests? ### REPLY: Hi, Just trying for two months and not able to conceive doesn't warrant immediate investigation. That fact that you have previously conceived, indicates that you are fertile. Also, only after 1 year of trying and then unable to conceive, would it be right to go for further tests. The chances of pregnancy after 1 year of trying are more than 85%, so please be patient and take folic acid, and hope we hear some good news soon. Get investigated only after 1 year of trying. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have high blood pressure and was placed on a second medication called metoprolol. I smoke marijuana daily can it cause problems with medication? Iam a 31yr old female with one child 11yrs. I have no other health problems and currently take HCTZ 25mg. It is hard for me to stop my marijuana use any suggestions ### REPLY: Hello, Marijuana is certainly not good for health, it also increases your BP. So as usual advice it should be stopped.  If you are not able to stop it or even otherwise, then you should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. If BP is persistently more than 140/90 MMH, then BP medicine should be increased, and potent medicine should be started like telmisartan.  Regular exercises like brisk walking, jogging according your capacity at least 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lump under my skin. It is on my right side lower back next to my spine. It is at waist level and feels like it is on the muscle. It is not painful and I can t seem to move it. It is not really noticeable to look at but you can feel it. No bruising and no discoloration. I want to say it has been there for awhile but I guess because I noticed it again I started to worry about it. ### REPLY: Hi! Thanks for sharing your health concerns with ! Well, your condition is very common with many of our regular patients and as per my experience of needle biopsies of different lumps, I would suggest following possibilities for the subcutaneous, mobile, painless and colorless lump next to your spine:1. Neurofibroma or lipoma like benign skin tumors2. Benign cysts like inclusion cyst or sebaceous cyst3. Muscular or stromal noduleTherefore, this one is not a thing of worries, but the diagnosis should be confirmed by a simple needle biopsy; please get it to a doctor. Regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir,      I am 20 years old but my penis size is not as per my age. It might be due to my tight skin over it because my skin is difficult to pull back over it and takes efforts. But the time i take my foreskin back the head, the starts paining or we can say it is sensitive when it get into any physical contact with the inners as well. I know size doesnt matter but how to reduce that pain? I dont want to go from any surgery so can it be reduced by any other means?? ### REPLY: Hello Penis size depend upon many things like age, race etc. You need proper clinical evaluation. You may be suffering from fibrosis. It is a surgical condition in which prepuce can't be retracted over glans penis. You may need circumcision. It is a small operation in which excess skin over glans penis is excised and skin is tied over coronal Julius. Before this you may try combination of steroid and antibiotic ointment under prepuce twice daily for 2 weeks. It may dissolve the adhesion under prepuce. You should consult surgeon. This condition need immediate attention otherwise it may cause surgical emergency. 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: Last night i started feeling some pain around my upper abordmen( assuming relating to Kindey or overies) then today i have been having a feeling cold and mucles are arching for the whole day. I havent been to the doctor as yet could you please give my an indication of what could be happening ### REPLY: Hi, From history it seems that you might be having some infection in your Genitourinary tract giving rise to cold feeling and might be having some temperature. Consult your doctor and get examined. You might require one antibiotic medicine course for 3-5 days.Meanwhile, take some antispasmodic medicine with paracetamol like Metal spas to get relief from pain and cold feeling. Take plenty of water. Ok 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: I fell from a ladder last week and injured my lower back and buttocks it is still really sore and hurting. This morning at 4am I woke from a sound sleep because everything was spinning, it stopped and I went back to sleep an hour later the same feeling woke me up and my back is hurting worse. What happened?  Is it a pinched nerve? I fell straight on my butt and my backed popped like I was a the chiropractor and I couldnt move for a few minutes. ### REPLY: Hello and Welcome to , Thanks for writing to us. The symptoms you have described are more likely to be symptoms of muscles strain. To get relief from the pain and for quick healing:1. Do hot fomentation at the site.2. Apply local anti-inflammatory gel 2-3 times a day.3. Take anti-inflammatory . 4. Do not lift weight or try to do exercise that involve painful muscles. Give proper time for the injury to heal. Hope this helps you. Wishing you good health... Regards.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son has red swollen gums and has a couple white patches. When i brushed his teeth today his gums began to bleed heavily. He has had a fever between 101.6-103.2 since monday. The fever broke today. I brush his teeth everyday but have not been able to since monday morning when he start to complain of pain. He is 20 months old ### REPLY: Hi. Can understand your concern. Inflammation of gums during teething can also have the following symptoms but the fever more than 101 degrees is alarming and is not mostly caused due to teething. Your kid may have teething symptoms as well as high fever can be due to viral infection while if the patches you described are in the form of small sores it can be Herpes virus infection causing cold sores. Swollen gums along with white patches can occur due to fungal infection known as Thrush, but mostly fever is not a common finding. I would suggest you to consult a Pediatric Dentist and get evaluated as without a proper clinical evaluation diagnosis cannot be made, and treatment plan can be advised accordingly. You can give him Acetaminophen to reduce fever and ice packs over the gums can relieve inflammation, but the complete treatment needs a thorough checkup. Hope this information helps. Thanks and regards.  . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am a 35 year woman whom is experiencing finger tremors and muscle twitches. Furthermore, I experience off and on night sweats and fatigue and constipation.The worst is the hand/finger tremors and the muscle twitches for I hope no one notices.I have been to a neurologist approx. 2 years ago because that was my first experience with the tremors.MRI brain was performed which was normal Any ideas what may be causing this because no one said what is causing these symptoms ### REPLY: Hello, I had gone through your question and understand your concerns. Looking at your problems I am thinking of following possibilities01) Over active thyroid(hyperthyroidism) : All your symptoms are consistent with this condition. A thyroid profile test will help in diagnosis. I02) Alcohol abuse/with .  A battery of tests like blood investigations (CBC, ESR etc.) Liver function tests, USG abdomen will help in diagnosis. A MRI of brain rules out any kind brain related problems. It is advisable to consult your doctor and get yourself examined for above conditions. Additionally, avoid mental stress if you have any. Include fruits, vegetables in your diet. Hope this answers your question. You can ask any followup question or any other queries. I'll be happy to help. Wish you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 51-year-old female and a social smoker/drinker.  About a month ago, I started experiencing a sensation of my heart flipping, with an urge to cough.  I have had breast cancer (2002) and radiation treatements where they attempted to not involve my heart or lungs, yet they were unable to avoid them completely.  I have been nauseated as well as lightheaded as well during some of the "flipping" episodes.   I work for a Mayor, who is also an MD (GYN).  Should I have him recommend a specialist? ### REPLY: Well come to ChatDoctorThank for asking Your concern being appreciated, of course you can seek higher opinion as long as the history of malignancy is there, but it is not the cough that needed such opinion, but it could be allergic condition, if this is the not chronic one it may not be due to the heart unless you have some valvular heart disease, even the nausea and lightness may not be the serious condition and related with the malignancy, but it could be acid peptic disease, anxiety depression, hypoglycemia 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: siri checked my PP is 225 all my age male 56 i am healthy as on date no bp since my gums are week one by one my tooth is falling my dentist says remove rest put artificial but he says it will take 15 days to attach i cannot be without tooth for such a long time? ### REPLY: With your query, situation what you have us called a periodontitis which is nothing but inflammation and destruction of tooth supporting structures and with this you are also medically compromised. Depending on the remaining teeth and condition your dentist will decide the best treatment because sometimes to maintain the causal harmony and integrity t would be good to extract the remaining teeth go for complete dentures or with good support of bone even implants can also be done. Hope this helps you. After extraction healing Jul take 7 to10 days. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A few weeks ago I was hospitalized for SOB, chest pain radiating to my back. Completed a series of tests (stress test, EKG, EGD & colonoscopy) of which all came find. Last night I suddenly began having chest pain in the center of my chest along with breaking out in a sweat, nausea, leg weakness, headache and low grade fever. The chest pain is sharp and feels like something is lodged or blocking something. I called my primary care and he suggested the ER. Any thoughts on what could going on? ### REPLY: Hi, thank-you for providing the brief history of you. As you had certain symptoms for which you were admitted, and you have undergone all the test which turned out to be normal. There is a possibility of having all test normal when performed as there will be a time lag between the arising of the symptom and also the test measurements done. Now to understand one more happening here is that post all the major cardiac tests including the treadmill there are possibility of arising the symptoms back as the treadmill testing is a strenuous load for the heart and may feel such symptoms again. This is very common I have seen in patients visiting to hospital and the complaints are similar as well. Following the proper cardiac physician guidelines in that duration has helped many patients at our hospital settings. Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi ,..im 20yrs old .today when i urinate sperm out with my urine ..this is happen many times bt i notice dis today ..before 1 month acording to my report a stone is observed in my left kidney ..is dis happen bcoz of my stone or any other reason..i feel dull n very weakness i always feel sleepy .n headache pain in legs hands n in backbone..wat should i do plzz reply me ### REPLY: Hi AparT he problem from which you are suffering is regarded as spermatozoa and let it be very clear that it is not due to the presence of stone in your kidney. Renal calculus can cause acute pain, but this is not generalized but mostly restricted to renal angle region. This colic can be associated with vomits also. The pains you are having apparently are linked to debility. I believe you are not in habit of regular exercise and as per Ayurveda this leads to excess of oaf in body which is responsible for lethargy and sleepy feeling. To get rid of stone tab. Sheet Prabhat is good. For spermatozoa tab. Neo and for generalized pains have tab. Triodashang GGUL. God willing you will be fine in very short 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: Hi My name is Omar, Iam a 26 years male - 180 cm - 115 kg. Iam married from 9 months, the first 2 months my wife was taking pills to delay pregnancy, Then we used condoms and safe period for extra 3 months, after that we tried to have a baby from about 4 months but we couldnt, so she went to her doctor but he told her that everything is ok with her, so i went from 2 days to make a semen analysis and here are the values; Colour: Greyish White OpalescentVolume: 2.0 mlMethod of Production: MasturbationReaction: 8Consistency: ViscousCount: 3,200,000/mlTotal Count: 6,400,000/mlLiquified after: 30 minsSperm Vitality: . Motility after 30 mins: 60%Motility after 1 Hour: 55%Motility after 2 hours: 50%Motiity after 3 Hours: 35% Rapid Linear Progressive: 30%Sluggish Linear Progressive: 20%Non Progressive Motility: 10%Immotile Sperms: 40% Abnormal Forms: 25%Abnormal Head Forms: 10%Mid-Portion abnormalities: 10%Tail abnormalities: 5%Spermatogenic Cells: 0-1/mlRed Blood Cells: 0-1/H.P.F.Pus Cells: 2-4/ml Thanks,, ### REPLY: Hi welcome to . I have gone through your question. As far as your semen analysis is concern, has normal color, normal consistency, normal pH. Has normal count (20million/ml should be at least). Normal motility and normal morphology. Normal liquefaction time. So all parameters are normal of your semen analysis. Hope I answered your question. Would be happy to hello you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 64 years old weighs 100kgs 5ft 11inchs my pressure readings yesterday was 180/100 I was taking ATEN-25 for some time  but, I had stopped taking the tablets for the past 3months. as I ran out of stock as I cant find the drug in the UAE I visted a doctor in the UAE and he precribed COVERSLY 5mg But I did not take it thinking the change in drug would effect me. This morning my readings are 164/90 should I continue taking the tablets for BPWhat 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 you something and give you my opinion. You should know that we talk about hypertension if we have mean value that exceeds 140 / 90 mmHg. A person might have high value during emotional and physicals trees so It's mandatory to judge on mean values during day and night. Hypertension is divided into two groups. Essential hypertension is a chronic disease, without an identified cause, and it should be treated all live long. Secondary hypertension is common in younger ages, and it means that it has a secondary house of it. This might be a renal disease, an endocrine problem or a cardiovascular anomaly. So, if your doctor has previously prescribed you blood pressure medication than they probably have diagnosed you with essential hypertension meaning that you should treat it live long. At this moment, as you have been without treatment for a long time, if I was your treating doctor I would recommend some examination like a cardiac echo to evaluate heart function and walls, a full blood analyze to check renal function, electrolyte and a pressure holder monitoring to evaluate your values during day and night. After all this we can better judge what is the most adapt . Hope I was helpful. Best regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, can you please help me to understand what this means it came up on a scan after being test for my Gallbladder to be removed. What does this mean Coarsened Hepatic Echogenicity, compatible with a component of Hepatic steatosis or other Hepatocellular disease ### REPLY: Hello Thanks for writing to ChatDoctorLiver is normally homogeneous in echo texture. Coarse hepatic echo texture indicates liver parenchymal disease. It may be due many reasons like excessive fatty deposition, cirrhosis etc. You need proper clinical examination and investigations. Investigations include routine hologram, RBS,LFT, RFT, Lipid profile, elastography. Further investigations can be done if needed. Proper treatment depend upon clinical examination and investigation reports. Hope I have answered your query. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell friday afternoon, landed on my elbow, it turned dark green was swollen and sore. But I could move it fine. Its a lil less green today but still swollen and very sore, I can t touch it, because of the pain. Should I get it xray d for give it a few more day s? ### REPLY: Hello, As per your history, it may be due to blunt trauma. For pain, you can take tablet acetaminophen. Apply diclofenac gel or ointment locally. Heating pads will also help. For further assessment you may require X-Ray of that affected elbow after orthopedic consultation. In case of fracture you may require surgical intervention after consultation. Restrict your movements Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I got stitches 18 days ago to close a knife wound between my thumb and forefinger, and had them removed 8 days ago. The area is healing well, except there is what appear to be a red lump (blood blister maybe?) in the center of the closing scar. Should i be concerned? Is this normal? ### REPLY: Hi, If I were your treating Doctor for this case of wound gaping I would like to consider wound infection and go for a microbiological test to find the offending microbe! Possibilities, these include: if this one is tiny and just red / fresh, then nothing to worry; but if secretions oozing from it with smell and pain, you have to take oral antibiotics; so please see your doctor for an examination! Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Iv had a problem with my tooth for 3 weeks iv been feeling light headed, sleepy and had a bad stomach in the mornings also i get headache. now the tooth has been removed i feel pain on the whole on my right hand face and feel dizzy and sick more what can this be i was fine until  got the tooth ache ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have undergone extraction of tooth now you feel dizzy, headache don't worry this can be effect of anesthesia in some patients. Take proper nutritious diet.proper sleep for eight hours.  You can take one tablet Multivitamin once daily for 15 days. Do warm saline gargle two - three times a day Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My blood pressure is 102/52. It was taken at the doctor s office. Is this normal? If it isn t, can this be the reason I m having a hard time sleeping? I ve been like this for years. Normally my blood pressure won t even register the first time it s taken. Manually or with a machine. It usually takes at least 2 times. ### REPLY: Hereafter going through the medical details provided by you, I would like to tell you that the normal recommended range of BP for adults is less than 140/90 mmHg. So accordingly your BP is quite normal. I would like to suggest you to start doing meditation as it will help you improve your sleep and also keeps you mentally focused. You can also take the help of a psychologist for sleep problem. Kind Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have had a terrible pain in my right arm at the front of my elbow where my arm bends, it comes and goes very randomly but when I do have the pain every time I bend it fully or straighten it fully the pain is unbearable but sometime with abit of fiddling about with my hands the pain goes into I bent it again Any ideas would be wonderful ### REPLY: Hi, The location and movement of a pain gives clues as to what is going on. Going from an area in a line implies nerve and the funny bone is actually the ulnar nerve which runs over the outside of the elbow in a groove there. Rest and anti-inflammatories often help, but sometimes very slight surgery to relieve pressure is needed. Cannot say in your particular case, but generally, this would be true. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have being seing blood stain in my saliva when brushing which i noticed is not from my teeth,also i have been having a feeling in my forehead which looks like an ache and has been preventing me from thinking fast.Also i notice i now forget things faster than i used to and my eyes always make me feel like i want to sleep. ### REPLY: Hi, thanks for using  Blood in the saliva would be related to lesions in the mouth or throat. It can be associated with :(1) gum disease (2) infection of the throat or mouth(3)allergic rhinosinusitis- inflammation of the nose and sinuses (4) troubadour other symptoms of headache, fatigue, difficulty concentrating may or may not be related to the blood that you are noticing. You need to consider assessment by your doctor. This would include physical examination of your mouth, heart, lungs, assessment for possible anemia (would cause fatigue). Investigations may be suggested depending on the findings. 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: Area between top two front teeth has remained irritaited ever since an aggressive sonic cleaning of my teeth about 6 months ago. I would guess it is slightly swollen and always feels like something is stuck between the teeth. I remember right after the cleaning the area behind the two top teeth felt raw. I ve been in for a few different check ups on it, the area has been re-cleaned a few times, scanned for a cyst , been to my dentist and a peridontist (sp?). My dentist mentioned she has another patient with the same problem but no clues how to resolve it. I assume the initial irritation was done by the cleaning (more aggressive on the top two front teeth then usual) but it won t calm down. Wonder if it is caught in a cycle - irritation leads to swelling leads to irritation etc. Darrell ### REPLY: Hi Darrell, since the time period written in your is long i.e 6 months. If it is because of irritation, then it would have gone after deep cleaning. Swelling usually subside in 3-4 days maximum after removal of irritants. If you still feels tucking sensation in your upper interdental papilla you need to go for gingival re contouring, or you can say gingivectomy procedure.  In this procedure they will reshape your gum line and remove the thick pad of gingival in between the tooth area.  As you had already seen a periodontist, consult him again and go for re shaping of gums. 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 father is currently in a hospital and was admitted due to an infection in his foot. They have that under control and clearing up however since Saturday my father has slept 90% of the time and on Sunday a special team was called in to try and wake him up. With out success they took his vitals which were all normal and said he is in a deep sleep and they font know why and I gave tried to find out why with no luck. Can you please tell me what could be causing this to happen and when he foes wake up he says off the wall things he actually thinks he is at home instead of the hospital ### REPLY: Hello, Welcome to ChatDoctorI am  answering your query. I can understand your concern. It may be because of following,1.side effects of medications.2.hypoglycemia,3,Infection spreading up to meninges,4. May not be related to present condition, but some other cause of brain involvement. Treating doctors are in better position to explain his condition. You may discuss my points with them. Hope this suggestion will help you. 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: Dear, sir im suffer ocd ,depreesion,panicattacks in 3 yrs, i hv taken sertraline50mg, clomipramine25mg clonazepam ,bromazepam,up to 1.5yrs. my doctor stop my medication in 5 month.then my symtomp is come back. then he is start escitalopram in 2 months but i hv not imporved. last he start sertraline 100mg and clonazepam.5 .its continue 5 month i think my mood and ocd thinking is slightly improve. how much time i taken this medication in dose. pls reply 4 me. thnx ### REPLY: Hi There, Thanks for asking. The dose backs to the clinical improvement. The medical treatment for OCD is usually long term, but if the clinical improvement is reached, the dose can be decreased to the minimal level. If you wish to discontinue the medication, you should take advantage of behavioral therapy for your compulsions. The advantage of behavioral therapy is that does not have any possible side effect and also its positive effect (when is achieved) is lifetime, because it is a skill which you learn. Its concept is easy, and it needs several weeks to practice. You can ask your doctor to guide you to the person who can work it with you. Please let me know if you have any question in this regard. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mom was diagnosed 2 years ago with colon cancer.  she had radiation and chemo and surgery and was told there would be no more cancer after all that.  she then found out last march that it has spread to her liver and lungs....they suspect it spread before she even knew she had the cancer in her colon.  she did not want any more chemo....she is 80 years old, has a very very small appetite now, pain and is sleepy allot....how long can this go on? ### REPLY: Hi, Thanks for writing in. Unfortunately multiple liver lesions cannot be treated completely. Colon cancer causes liver metastasis in half of the patients even after surgery. CEA test is to be done regularly to know the progressive increase and possibility of a recurrence of the tumor and spread to liver. Colon cancer might cause liver spread and this also has to be looked for by doing an ultrasound scan and CT scan if required. Since you know that the condition has become palliative, there is a possibility to extend his survival by giving chemotherapy which will reduce new blood vessel formation and also inhibit growth. With the best treatment and supportive care she might survive for about one to two years. It is important to discuss with your doctor if she can take chemotherapy. Radiofrequency ablation is another procedure for colon cancer patients with liver metastasis, but it is not for all patients and requires certain criteria to be adhered to for response to treatment. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there. I m wondering about my 6 year old son. I noticed when he was in the bath that one of his testicles is almost not there at all. Is this normal? He had a hydrocele when he was about 2. It went away on it s own. It doesn t hurt or bother him at all. ### REPLY: This is absolutely a normal phenomenon.  During sudden temperature change there is testicular muscle and ligamenta contracture which pulls the testes upwards. The question is why one is seen and one not actually this protective mechanism is still developing and will become fully established at the age when sperms need to be preserved inside testis. So nothing to worry, if the testis comes back and disappears. ### END