Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was sitting watching tv when it felt like I breathed wrong and then I could not breath at all. I could not breath in or out. I could not talk. It was like I had something blocking my airway but I wasn t eating anything. I did the heimlich maneuver on myself which expelled air and I was able to catch my breath and start breathing again. There have been similar times this has happened but usually I start choking and cough and my breathing starts again. What could cause this? ### REPLY: Hi Dear !! Thanks for your query to . Read and reviewed your query and health concerns. You seem to suffer from -Choking and coughing caused with HERD with acid /or mucus aspiration. Obesity with central abdominal and mesenteric fat, pushes up diaphragm, while sitting for TV and could cause-Acid reflux reg urge in windpipe with choking-which is-caused in HERD patients. Hope this would help you to plan further care of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following  link-Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at  services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 3 year old daughter has really smelly snot  I took her to the doctors on Friday but to be honest he was hopeless and said it might be a infection , I told him I can see some thing tissue like up her nose he had a look and said its most likely muscus and gave her some piraton . Im not happy still and I dont think that its muscus because I can still see it . I have got her to blow her nose a few times but its not moving to me it looks like its attached to her nose and I dont think its an object or food . Have u any ideas what it may be ### REPLY: Thanks for asking in  Forum In Short: Foul smelling discharge from one nostril may be a foreign bodyExplanation: In child .  So, foul smelling discharge may be because of this.  You have already shown to a doctor, but you are not convinced. So do one thing, visit a ENT specialist who can look it very well through their special instruments and convince you accordingly.  Good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Dr. has given me duratics, beta blockers, calcium channel breakers and ace inhibitors together for treating hbp. With all this medication my bp readings are 150-160/80-85. I have a very healthy life style I do one hour exercise also. My question is  why I am taking four types of pills from all from group of treating HBP.? and what could be the best prescription for treating hbp. ### REPLY: Hello, The best combination for you would be combination of ace inhibitor and calcium channel blocker and optimize the dose of each to max. Level. If still not controlled a diuretic and lastly beta blocker. So I would consider increasing the dose of individual medication mostly ace inhibitor and CCB and if necessary add a diuretic.  Still if it's not controlled multiple medications from different group may be tried to bring blood pressure under 135/85 at all times. An alpha blocker like prancing would be good alternative In spite of such healthy lifestyle you may still need to take medication if the pressure are controlled, because you may be prone to higher blood pressure genetically.  Hoping I could 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 daughter is 2.5 years old, weight 11 to 12 kgs approx.She had eaten some macronni n chicken from a sandwitch shop on Sunday post which she got a fever on Sunday afternoon. I visited her pedeatrician who said that the fever is low grade as her feet are cold whereas her torso, neck & forhead was warm, fever had gone upto 102.2 on a couple of occasions. He prescribed Crocin which did not give results & Combiflam syrup had to be given post 3 hours...he also prescribed Entrogenia solution, 6 vials for 3 days, however her fever keeps reoccuring post 7 to 8 hrs.Now he has prescibed azhithral 100, 5 ml once a day for 3 days and said that if fever comes give Crocin 7 ml....need to know if this is a right diagnostics ### REPLY: Hi... Thank you for consulting in . Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics (LIKE AZITHROMYCIN OR LITERAL) at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have tingling in my left arm, pain in my elbow and twinging in the top of my shoulder when in move my head down, to look at my toes for example. The tingling just started a couple of days ago, but the elbow pain has been going on for 6 months. The shoulder twinges just started yesterday. ### REPLY: HelloYour symptoms may indicate nerve involvement, and it may be due to problem in cervical spine. You may need clinical correlation and further tests. Investigations include routine hologram, random blood sugar, vitamin B12 estimation, X-ray of cervical spine(AP/Lateral view).MRI cervical spine may be needed after assessment. Only MRI can assess nerve root compression etc. You may need to correct posture, and you may be advised for physiotherapy initially. Further treatment plan depend upon clinical findings and investigation reports. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have recetly got a swolin bump near the base of my penis and its not big and its not noticable at all but it does hurt and i was wondering what might have caused it ? I mean i only masterbate about 2 a day n i did have some sexual contact where my partner cumed on me do you think the bump is the result of a std or is it just a normal hair bump ? Please help ### REPLY: Hello can understand your concernLooking at your history this could be due to STI or local injury or inflammation during rough serif you can upload me a complete medical history and a photograph I will be able to guide you better meanwhile you can consult your GP for examination a day a battery of tests like blood for CBC liver and renal function test urine culture you may require a course of antibiotics under supervision of your doctor have plenty of fluids maintain good hygiene thanks for your question wishing you good healthRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i have been taking alendranate 70 mg 1 a week,biut notticed a slight ache in my left jaw,i wear dentures so no natural teeth,is this ok or should i see my gp,istarerted it 2 months ago due to 2 fractures in my vertrabral,i was on it for 3 months in 20 13 but stoped taking it ,as sore gum but went to see maxi facial dr and had xray it was normal,just would like your appinion,as dont want this happening again as its still very painful after 4 months kind regards philomena cassidy ### REPLY: Thanks for your query, I have gone through your query. The pain in the jaws can be because of the trauma or laceration or ulcers caused by the denture. The other possible cause can be because of the temporomandibular joint, which can be secondary to any causal problems in the denture. So consult an oral physician and get it evaluated. If it is a laceration or ulcer, you can use topical analgesics like choline salicylate. If it is problem with the denture it has to be corrected. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has had persistent groin pain for over 2 years.  He had hernia repair 4 years ago that was done with mesh.  Since then, he has never been completely symptom free.  He was recently RE=EXAMINE  by his primary care doctor who found a "new" lump in his groin.  Ultrasound indicates it was not a new hernia.  I want him to have a CT scan to make sure we know what is going on...I am fearful that something more serious has been overlooked for quite some time because his MD was thinking is was related to the original hernia ### REPLY: Hello, As per my surgical experience, there can be various reasons for lump over the operated site of hernia as stitch granuloma, inflammatory collection or others. In my opinion, MRI of the groin will reveal all the details in fine with an emphasis on soft tissue evaluation rather than a CT scan. Would like to assist further with the reports in details during follow up the conversation. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 18 month old started having large red welts.  Yesterday one perfect round welt on buttock, this morning his entire check on face.  Today he woke up from napping and had large welts all over his body.  They are raised and are no longer cicular but larger and ramdombly all over his body. ### REPLY: Hi....by what you quote I feel that what your kid is having is an urticaria or a simple skin allergy. You can use HY .  Most important thing to be remembered is that it has a propensity to recur (called as second crop) within 10-14 days. If this happens, you can start using the same medicine, but I suggest you get the kid evaluated with your pediatrician. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive been having a tight chest and numbness in my arm or leg sometimes.  I feel like im having shortness of breath also.  Constantly feeling fatigue.  Blood test does not reveal anything wrong.  What could it be? Scared of going out because of these symptoms. ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of stress, anxiety and panic disorder is more in your case. But better to rule out heart diseases first as heart diseases also cause similar symptoms. So consult doctor and get done blood pressure monitoring, ECG, 2d echo and stress test (trade mill test). If all these are normal then no need to worry about heart diseases. Sometimes uncontrolled stress, anxiety and panic disorder can also cause similar symptoms. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Don't worry, you will be alright with counselling sessions and anxiolytic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: MRI BRAINMRI of the brain was performed using T1 & T2 weighted sequences in multiple planes.There is no signal abnormality detected in the cerebral parenchyma.The brainstem and cerebellum are normal.The ventricles, cisterns and sulci are normal.Intracranial vessels display expected flow void.Both the 7th-8th nerve complexes appear normal. No abnormal thickening or mass lesion is seenalong their course on this unenhanced scan. The visualised vestibulo-cochlear apparatus appearnormal.Polyp / retention cyst is seen in the left maxillary antrum. ### REPLY: Hi, Your MRI reveal retention cyst in left maxillary sinus. Retention cysts of the maxillary sinus are an incidental finding on radiographs. These cysts usually appear as rounded, dome-shaped, soft tissue masses, most often on the floor of the maxillary sinus. Most retention cysts of the maxillary sinus spontaneously regressed or showed no significant change in size over the long term. , in the absence of associated complications, "wait and see" may be the appropriate management strategy for these retention cysts. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is actually 6yrs old.  She has been complaining of stomach pain for almost 2 yrs now, lost alot of weight now weighing almost 36 lbs. and is 43 inches tall.  We have seen several doctors and no answers, they told us possible IBS but we followed diet and pain was still there.  She also got tested for appendix, etc. and nothing on the CT scan, they do upper GI and she had some inflammation but not bad. She is now on a pill that stops the stomach pain so she can eat.  But lately its fever, pain, and loss of hair. What is going on with my kid?? The school is calling me 4 out 5 days. And none of this is social problems, she is a straight A student and tons of friends. She was born premature~could this have any effects on her at 6? ### REPLY: Hi. Thanks for your query and an elucidated history and want of finding the proper diagnosis. First - forget about pre-maturity and relation to the present problem; there may not be any relation at all.  You say: CT scan was normal and is suffering for the last 2 years; and lately→ fever, pain, and loss of here hope Tidal test for Typhoid is negative. She has been treated for worms too, Tuberculosis has been ruled out. There are rare problems:: like abdominal epilepsy and so on- Gabapentin works- but you have to discuss this with a senior and well experienced Pediatrician / Pediatric Surgeon... Also go for enterocytes. CT alone is not sufficient in few cases. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 smoked weed the weekend and im 14 and had loads of fags about 15 the most in one weekend? now I have bad pain in my chest witch feels like my heart I have shortness of breath and have to keep to take deep breaths I don t want no one to find out about the weed and fags I am now going to stop smoking anything and these is the third day since and I am still feeling like this? ### REPLY: Thanks for your question on . In my opinion you should first get done ECG to rule out cardiac cause for your chest pain because smoking can cause cardiac damage. If ECG is normal than no need to worry much for cardiac cause. Chest pain and shortness of breath in smoker can be seen in pulmonary causes like bronchitis. So consult pulmonologist and get done chest x-ray and PFT (pulmonary function test) to rule out bronchitis. For the treatment, smoking cessation is the primary thing. You have to quit smoking as soon as possible. You may also require inhaled bronchodilators. So consult pulmonologist and discuss all these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Every month or so my 13 year old son gets major diarrhea and vomits once. He does not run a fever during this time. He also complains of having a rotten egg taste in his mouth or of burping rotten egg taste. What is this and why does it keep recurring? ### REPLY: Dear user about your question I would like to tell you that recurrent diarrhea has some causes in this age of your son.......allergy to food cause the intestinal movement to increase rapidly so causing diarrhea and vomiting.......so you should notice if there is food that if he eats symptoms increase to avoid that food second if your son had intestinal infection of the past or had severe gastroenteritis that may cause damage to intestinal epithelium and so digestion and recurrent diarrhea occur, and it will need some time to improve gradually as it is self limited if your son eat unhealthy food or fatty food or spicy food that may cause these symptoms also you should do stool culture for him and tidal test to detect if there is salmonella infection causing typhoid or another intestinal infections the intestinal infection viral or bacterial should be managed to end of this problem hope that helps you wish you and your son happy life ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 1 next month. He has a large red sore on the roof of his mouth no white or yellow though. he seems slightly off his food but will eat something if persuaded enough. im not sure to the cause of this or whether to see my doctor or allow the red spot to heal on its own ### REPLY: Hi, Thank you for asking question on . Probably he injured himself by putting a spoon or accidental injury when you are feeding. Mouth ulcers heal rapidly. Only hot milk or food, spicy food he can not tolerate. Give cold and sweetened food or . You may locally apply Byte liquid or denote once or twice daily. If it does not heal within a week you contact your doctor. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my last period was December 23, 2013. My period usually last about 6 days. On the sixth day of my period boyfriend and I had sex but the condom broke and he ejaculated inside me. Within 12-15 hours of the incident we bought the Next Choice One Dose pill. Now 6 days after taking the emergency contraceptive I believe Im spotting due to the fact that Ive had dark brown almost black discharge. Am I pregnant? ### REPLY: Hello dairy understand your concern No chance of the pregnancy because did sex on last day of period, and it is completely safe period of the cycle. You also took emergency contraceptive pill with in hours, and it is highly effective in preventing the pregnancy. The spotting and discharge is due to hormonal imbalance caused by the pill only. It is due to progesterone with .  It will go off in next 2-4 days. Your next period could become early or delayed due to hormonal imbalance caused by the pill. Avoid stress, take healthy diet,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 an infant who is 5 months old. She has been exclusively breastfed since birth. I started her on baby food at 4 months old as told by my Pediatrician. She started out eating only one 2oz container of baby food. She now eats three 2oz containers at her dinner feeding. Is this excessive? And is it bad for her health? ### REPLY: Hi Welcome to the , and thanks for asking your query here An infant should be on Breastfeeding Alone at least for 6 months and even water is not recommended As pediatrician has suggested the formula food and as much as baby is tolerating and digesting it well, as much as baby is healthy and eating well there should be no problem with much or less quantity however I would still advise you to breastfeed the baby as much as possible as giving large amount of baby food will subside his hunger and baby will be deprived of mother milk which is the best food for her Development at this stage Finally I would strongly suggest you to consult it further with your pediatrician I hope it helps thanks for the question again ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! I am 21 years old male student. 2 weeks ago i noticed slightly swollen lymph node beneath my ear lobe . i felt slightly sick and i went to the doctor . Doctor gave me antibiotics and i had sore throat to in the throat wall which resulted severe pain while swallowing. the fever was below 100 not much. I went to another doctor and he said it s viral pharyngitis but also told to continue the anti-biotic in case if it is strep. Within a week my sore throat gone , lymph node came back to normal. And again my doctor checked my throat and he said it s fine. The next suddenly my left tonsil got slightly bigger (not that much big). I don t feel any pain while eating neither it s sore. But the left tonsil is swollen i think. I have taken the antibiotics but the tonsil is not coming back to normal and i am too much worried. I also feel dry throat and have to drink a lot of water. I am really worried about it and recently i have developed hypochondria and anxiety by searching the symptom all day in internet. Please help me and give me some suggestion ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  You may have tonsillitis, abscess or other lesion on tonsil.  It leads TP reactive hyperplasia of lymph node also.  You should go for examination.  If needed to take a course of antibiotics like azithromycin or amoxiclav.  It is prescription based medicine so 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: warfarin (5 years)for couple of DV thrombosis..recently discontinued neurophen cos of sore stomach...past history of ... colitis/diverticulitis....recent very small amount of red mucous on toilet paper.and occasional v small blood traces ... does warfarin cause Large bowel thinning...? ### REPLY: Hi, Warfarin is unlikely to cause large bowel thinning. Warfarin is an oral anticoagulant (blood thinner) commonly prescribed to treat and prevent clot formation such as in deep vein thrombosis. Its common side effects include bleeding, necrosis of the subcutaneous fat, and a number of .  Based on the history you seem to have bleeding from the large bowel apparently caused by warfarin. I advise you to consult your treating to adjust the dose of warfarin to prevent bleeding from the bowel. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have been diagnosed with frozen shoulders of which I have had since April this year and now for the past week I have been suffering similar pain down my left leg which is an aching, stabbing pain. This pain can shoot up my leg to the knee or down to the foot. There is no obvious swelling or redness. Look forward to your reply. Many thanks, Diane Scott ### REPLY: Hi Diane, The reason for the pain could be a pinched nerve, the one supplying your legs. Once a nerve is pinched at its origin from the spinal cord, the symptoms may be felt along its course too. This pinching can be caused due to many reasons and to find the reason you would have to get an MRI scan of your lower back or the lumbosacral spine. The frozen shoulder and this pain radiating to knee and foot are not related. Provided the MRI scan shows the reason for the pain, it can be managed with medications and physiotherapy and in case it doesn't help, you would require a surgery at a later stage. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Usually during the night I get a strange and somewhat painful feeling in my heart. ((Sometimes when Im trying to sleep and other times when Im just sitting and doing nothing)) Sometimes it feels like its tightening. Other times it just feels . . . strange. Sorta like its not pumping correctly. Im not sure how exactly to explain it. Im an 18 year old girl. When I mention this to my parents they just tell me to calm down and suggest that it might be a panic attack or the beginning of one. though Im sure it isnt a panic attack since Ive experience those and they are not alike. ### REPLY: Hi, welcome to . Thanks for writing to us. It is very unlikely to have the pro . In some particular group of people there may be cardiac symptoms at such a young age, such as:1.persons with previous history of some cardiac disease.2.athletes3.cocaine abusers It may be a case of panic attack, but you should go for the following preliminary tests in order to rule out any cardiac cause:1.EKG2. Routine blood investigations including CBC, serum urea, creatinine, lipid profile, random blood sugar.  If there is any abnormality in the test results you can consult your doctor. Hope I have answered your query. Stay fit, 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: I have developed a small grayish, slightly raised line on the back of my hand, about 1/4 inch long, that sort of burns when it is touched or brushed. It is not cut or burnt, in and of itself - looking on the web, it seems it might be a mild form or stage of scabies? Or something else? Looking more closely, there may be other lines elsewhere on the back of the hand, some curving but some straight, but not as raised - if scabies, earlier burrows, not active now? ### REPLY: Welcome to . Most likely it might be due to some insect bite there or beginning of fungal infection. It is not the sign of scabies. Scabies lesions usually start in between the fingers with severe itching. Apply antifungal / steroid containing cream. Start NSAID, levocetrizine to subside inflammation and redness. Keep proper hygiene. Consult dermatologist for further guidance and medical management ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 found a lump/bump on towards the top part of my nut sack. It is visible sometimes and it doesn t hurt to touch. It is not attached to my testicle. It kinda is on its own and is only visibile when my nuts sag. Not sure if this is relevant but I currently have mono. No pain really just occasional discomfort for a couple seconds. ### REPLY: HelloThanks for query. A painless lump on the scrotal sac could be mostly a Sebaceous Cyst. The scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Take broad spectrum antibiotic like Augmenting along with anti-inflammatory . If it does not subside within a week you will need to consult qualified General Surgeon for clinical examination to confirm the diagnosis and further treatment. If needed he may advise you to get it excised in Toto (Completely along with the sac). ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 62yrs old & he is suffering with diabities,blood-pressure problem for the last 22 yrs, for the last 4 yrs he is suffering with a increase of creatinine level, from the last year his level is constant between 2 to 2.70...He is taking proper medicine as prescribed with resource renal powder..he is avoiding proteins diet as it may harmful to his kidney...Pls adivse me is there any special treatment to cure this creatinine prob. or any other advise ### REPLY: Hello and welcome to . As a Urologist, i can understand your anxiety. Your father has diabetic nephropathy, with renal failure and hypertension. He needs to be tested to know the cause for his chronic renal failure. He needs to see a Urologist for prostate enlargement and do these tests:1. Urine routine, culture and ACR.2. Blood routine, creatinine,PSA, electrolytes,HbA1C,and LFT.3. Ultrasound-KUB, with residual urine and THUS. These reports will give an idea, about cause for renal failure. If you've any doubts, send the reports to me, as a direct question. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: ive had psoriasis on my scalp since sixth grade, and im a senior in high school now. for the past 2 months or so ive noticed my *downstairs* area been extremely itchy. i decided to get a mirror and look, and it was red, and had peeling clearish skin. it has to be psoriasis, so i was wondering if my nystatin cream will work to get rid of it. ### REPLY: Hi, Diagnosis might be revised. It might be seborrhea dermatitis. Stress, worries,poor hygiene, poor immunity, nutritional deficiencies.etc. may exacerbate the disease. Antifungal tab. , antibiotics, folic acid.etc. may be taken. If there is itching, take antihistamines. If the condition is severe, take steroids in tampering dose. Combined steroid and antifungal cream application improve the condition. Cleanse the scalp with ketoconazole containing shampoo. Consult dermatologist. I hope you got my answer. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,Doctor I was diagnosed with thymic cancer two and half years ago.I underwent radiation and chemothrapy. Then 20 months ago it was revealed that I have had a heart attack and three of my arteries had been blocked.Doctors unblocked the main one and placed stent.Now I have developed pericardial and pleural effusion which has caused many problems such as severe tiredness,shortness of breath and irregularity of the heartbeat and many other troublesome symptoms.I understand that from my doctors point of view nothing can be done regarding my health status and age.Would you be kind enough to tell me if there is any hope for me?Your advice will be greatly appreciated. With my best wishes, Ahmad ### REPLY: Hi, Thanks for writing in. The pleural space is a free space between the lungs and thoracic cane. Similarly, the pericardium is a free space between heart and its covering. These are potential spaces for collection of fluid in disease. As you had thy mic cancer and heart problems, it is important to know the type of fluid getting collected as pleural and pericardial effusion. Little amount of pleural fluid can be taken out with a needle and tested for its nature. If cancer cells or any infection is found then treatment must include medicines for it. If large amount of fluid is collected then it must be .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, I am a 33 year old female. Recently I had an episode of severe pain in the left side of my chest that radiated to my neck and arm. It hurt badly to breath in. I went to my doc yesterday and had an EKG that came back normal. No sign of a heart attack but my d-dimer test came back slightly elevated. They are scheduling me for a c scan. What are the chance that I have a blood clot ### REPLY: Thanks for your question on . I can understand your concern. D dimer is very non-specific test. High d dimer can not 100%suggests pulmonary embolism (blood clot in lungs). Apart from pulmonary embolism, high d dimer is seen with muscular injury, skeletal injury, infection, inflammation etc. So I don't think you are having pulmonary embolism because you are not having cough, breathlessness. But better to get done CT scan to rule out pulmonary embolism. If CT scan is normal then no need to worry about pulmonary embolism. Possibility of simple musculoskeletal injury and related pain is more. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,My mother 80 years of age has chronic bladder infections and along with it comes an abdominal burning sensation below the navel. Is it possible that she could have h-pylori in the bladder.She has been on Nordloxacin 400 mg 1 a day for 3 months.Thank you for your help.Chris ### REPLY: Is she a diabetic? Does she have constipation? Mostly bladder infections are due to Ecol bacteria and most common in diabetics. If she has recurrent and chronic bladder infections better to go for urine routine and culture sensitivity tests, Depending on sensitivity of bacteria to the antibiotic u can start that particular antibiotic.Meanwhile u can ask her to start Augmenting DUO 625. Hope it may help her. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 iam suffering from psoriasis from several years now in winter it get worsen up iam not able to face the people and talk to them directly i think i have some big problem and iam hiding from the people would u treat for only psoriasis or can u suggest me to a doctor u is speciliased only in treating psoriasis ### REPLY: Hi, As you said, you suffer from psoriasis. It is a chronic and relapsing skin disease. I can understand your anxiety for your disease. But, you have to keep patience. You might get relief slowly. And due to some factors it might relapse. Remember it is a controllable disease. You consult eminent dermatologist for firm diagnosis and perfect treatment. I would like to suggest accretion 25 mg daily along with methotrexate 15 mg weekly in three decided doses of 5 mg 12 hourly. Blood tests may be done at regular intervals. Steroid with salicylic acid point may be applied twice a day on the psoriasis lesions. Soap bath should be avoided. All precautions may be taken to avoid .  Winter might worsen due to  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my father has recently been diagnosed a diabetic; this week he hasn t had a bowel movement in 3 days; his stomach was sore last 3 days hasn t felt like eating; hasn t eaten anything out of the ordinary has been losing some weight but not from his middle mostly from shoulders and chest; suffers from high blood pressure also a long time; history of family; his father diabetic died from stomach cancer age 67 my father is 74 ### REPLY: Hi and welcome to . Thanks for the query. His symptoms are nonspecific, and it can indicate various gastrointestinal disorders including cancers, so it would be wise to do more detailed Gastroenterology work up including endoscopic procedures to rule out cancers. However, most commonly these symptoms suggest just gastritis or IBD but as I SIAD more serious diagnoses should be excluded.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: I am scheduled to see a specialist on Monday. The doctor who did my lower gi called today and said the blood test showed an elevated white cell count and I thought he said some of the cells were squashed? Does that make sense? He contacted the specialist and set up the appointment. I think if I heard him correctly is that I may very well have leukemia and they need to find out if it is accute or cll. I am a bit worried. ### REPLY: Hello and welcome to , It is important to know your age. However, based on the findings mentioned by you-elevated white blood cells and squashed cells, a diagnosis of chronic lymphoid leukemia (CLL) is most likely.CLL is a leukemia of elderly. It is characterized by increased proliferation of mature lymphocytes or to put it in simple words, it is uncontrollable growth of mature lymphoid cells.Some cells rupture during preparation of peripheral smears. These cells are called squash or smudge cells. Increased proliferation of leukemia cells in bone marrow can replace the normal elements in the bone marrow causing anemia and thrombocytopenia (reduced platelets).CLL has slow progression and very effective treatment options are available. The next step in the confirmation of CLL is monoclonal studies. You need to consult your hematologist for next set of tests and chemotherapy. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have this strange pain in the back of my head, like pressure, and it isn t a migraine , it hurts even more when i press against it and i ve searched online and from what i ve seen i should get it checked. I saw that the pain i feel is in the frontal lobe , and the symptoms described all match to what i feel. Changes in personality Swearing or behaving in a way that you normally wouldn t (loss of inhibitions) Losing interest in life (apathy) Difficulty with planning and organising Being irritable or aggressive Weakness in part of the face, or on one side of the body Difficulty walking Loss of sense of smell Problems with your sight or speech they all apply to me but i have been in therapy for a while and diagnosed with depression , anxiety, bipolar and they even checked me for schizophrenia as i hallucinate and hear voices. Could this be linked and should i be worried? ### REPLY: Hi there, Thanks for asking. You have a careful observation. Change in personality (and also aggressiveness as you mentioned), as well as change in smell, may be induced by tumors (benign or malignant) in front part of the brain. Weakness in one part of the face and on one side of your body are also important focal signs which may contribute to a mass effect (like benign tumors) or vascular event (like shortage of circulation to your brain). It is necessary that a full neurologic examination will be done by your doctor to see what issue might be responsible for your problem. Headaches due to a mass are often more prominent in the early morning. Vascular problems are often seen in hypertensive people who may also have high cholesterol level and diabetes. It is useful that your ESR level be checked to assess any possibility of inflammatory problems. I wish the best health for you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have an enlarged spleen and have been having upper abdominal stomach pain... I am nauseous, in pain and I am not sure what to do. I was in Nassau (Bahamas), Tortola (Britain Virgin Islands), and St. Thomas (USVI) the last week of May, but had this problem before I went. ### REPLY: Hi ! Good morning. I am  answering your query. With all the findings you have listed in the history, I would advise you to see a medicine specialist (Internist/Physician) soon who would apart from assessing you clinically would also might go for a variety of blood and radiological investigations for an appropriate diagnosis. In the meanwhile I would suggest you to refrain yourself from alcohol and smoking if you do. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 24 years old female, my weight is 52Kgs and height is 5 1 . I have PCOS problem and i get irregular periods usually with cycle of more than 32 days. I am married for 13 months now and we have been trying to conceive for last 5 months. I saw a gynecologist 3 months back and she had put me on Siphene 50 mg last month. Even after having siphene, my pregnency results are negative. Please let me know if it is fine to continue siphene for another cycle or is there a better medicine available for conception? Also advice a medicine for getting regular periods for women trying to conceive. ### REPLY: Hi friend, Welcome to  You need time / patience... You are young; married just over a year; you have a lot of time! The dose can be increased and/or the . .but the first one has to be given reasonable time.  There are other aspects of PCs - What is your blood sugar? / Are you on Metformin?There are other options to conceive... It is presumed the spouse has been investigated?? Take tarnishing speedy recovery God bless 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: on my lower back where about someones dimples would be is a small pea size ball that when push lightly fells like a pushbutton an it hurts an some time when pushed makes a funny felling in my uper leg an makes me almost fell that my legs gona give out ### REPLY: Hi, Thanks for posting your query. The lump is more likely to be due to soft tissue (usually fatty tissue) in the location that you have mentioned. Fat tissue grows through the holes in the facial layer over time forming fatty lipomas. Some days they may not hurt and some days it hurts to even walk. Hence, the lump get larger over time it can also cause referred pain in the buttock and down the leg. Hope this will help you. Please do write back if you have any additional concerns. 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: Hi, Age-25 , Married 2 years and there is no pregnancy . Heard about sukumara lehyam for betterment. Please tell me exactly what is sukumara lehyam Thanks ### REPLY: Cellophane you for your query. Sukumara Lehman is an ayurvedic medication that is sometimes prescribed by ayurvedic practitioners for various ailments, including infertility. However, no scientific / allopathic studies in medical literature exists to prove its efficacy for conceiving. You should be consulting a Fertility specialist now, as you are trying to conceive for 2 years. Your husbands' semen analysis should be done. Your ovulation studies and hormonal profile needs to be studied. Patency of your fallopian tubes has to be assessed. Random intake of any medicine can only cause harm. Please go by evidence based practice. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have this pain in my stomach and I cant breathe with out it hurting or walk and I feel like Im going to collapse and the pain started today about 8 hours ago and got worse and worse and now my body wont let my move or walk or anything and it hurts soo bad I couldnt do anything an I just started crying because the pain got so bad tears started pouring out of me and I nee this is go away it feels like Someone has stabbed me 9 times in the stomachs ### REPLY: Hi. Thanks for your query. Noted your history of > pain in my stomach and I can't breathe without it hurting or walk, and I feel like I'm going to collapse, and the pain started today about 8 hours ago and got worse and worse and now my body won't let my move or walk or anything, and it hurts so bad I couldn't do anything and I just started crying because the pain got so bad tears started pouring out of me and I née this is gone away it feels like Someone has stabbed me 9 times in the stomachaches indicates peritonitis meaning inflammation of the peritoneal surface that covers the internal abdominal wall. The causes can be pus or perforation of the intestine causing the intestinal contents to spill into the peritoneal cavity. Or can be due to Pancreatitis or inflammations of internal organ with perforation like of gall bladder. I would advise you the following:Urgently to rush to ER or a Hospital and get admitted. Stop anything orallyX-ray of the abdomen in the standing position to see for gas under the diaphragm. Ultrasonography Relevant blood tests Clinical evaluation by a General Surgeon for an early diagnosis and proper surgical management. Timely surgery will help to get a cure. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hllow how r u?ill ask for u 1stly is masturbation with cucambor leads to deadly or chronic diseases? Can u propose plz t side effects and causes of masturbation? And finally is maturbation leads to penis skin cancer without any sexual relation with a partner? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Masturbation does not lead to penis skin cancer.  Masturbation has no relation with any related disorder.  It is a physiological phenomenon.  It's just like a sex in absence of other partner.  It is due to your routine sexual need.  So don't worry about that. Just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a problem I have a problem getting off quick during sex I last like 40 mins. Yes I get horny and I do not have a problem erecting its just getting off quick. My partner can not handle me being inside of them that long and also my penis gets irritated and I use lubrication and tried different lubes. Is there any perscription or anything to shorten my time. I am 21 years old. ### REPLY: Degree understand your concerns went through your description. I suggest you not to worry much. When there are so many people who are asking for more sex time, you are different. You are asking to lessen the time of sexual erection. You want ejection factor reduced. For both the cases, there is minimal physical or clinical reasons. Mostly it is psychological. You can have your wish just by making sure that the penetration at the right time and not to worry much about it. You might need psychotherapy and other cognitive behavioral therapies. I can help you through telephone. Please do contact me through customer care of www.ChatDoctor .com for a telephonic consultation session. Hope this answers your query. Available for further clarifications. Good luck. Merry Christmas. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have had my ovaries removed. Bilateral breast cancer and I have multi centric castle mans. all is suppose to be in remission. I have been swelling in my lower body....very much on my right side.....lower feet. Small pain in lower right grown area. I have began to have vaginal bleeding. Any thoughts? ### REPLY: It's important for me to know what medicines you are taking, your age, stage of your cancer and past history of treatment. Your vaginal bleeding raises suspicion of developing some problem in your uterus especially if you are taking or have taken tamoxifen(novae). This can also explain swelling in your lower body and pain in groin. I would recommend a complete gynecological examination as soon possible. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 home from work tonight and my chest from my heart to the top of my throat started to feel very uncomfortable, also my neck and back are in pain and i hear popping noises on different parts of my head/neck like a vein or something. should i go to the hospital or is this just the start of an extremly uncomfortable chest cold? ### REPLY: Hello rearward welcome to .come have evaluated your query thoroughly.* The symptoms of potential chest infection include variety of symptoms in co relation with each other or separately as :- Difficulty in breathing which may be moderate to severe-Tightness feeling-Excess perspiration, lethargy-High grade fever-Severe weakness - Others * In your case, this seems respiratory infection with manifestations from underlying anxiety. Hope this clears your doubt . Wishing you fine recovery. Welcome for any further assistance. Regards dear take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ? Please type your query here...My husband had a mental breakdown he is now living with his mother he has been taking diazepam for 4 years he has changed from a loving husband to a stranger is the diazepam affecting his thinking. ### REPLY: Hi dear, Thank you for your query.First your husband is taking diazepam for what reason and what in what dose? Normally diazepam is used for sleep disturbance and sometimes used in epilepsy. Is there any other medication he is taking? Diazepam has little effect on cognition but for that detail history and mental status examination is required. Consult psychiatrist for detail history and mental status examination. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor, Ive been reading this and other forums in reference to the normal triglyceride count and whats condidered to be elevated.  I recently completed my physical exam and was adviced to lower my triglyceride count which is at 245.  I weight 195lbs, 5-10 and workout everyday (Active Duty military).  I dont smoke but drink a good wine at least every other weekend.  We consider ourselves a very healthy family since we dont fry anything, we dont eat fast food out and we are all very active.  What could be the cause of this elevated levels? ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Yes, your triglycerides are high. 2. Difficult to identify the cause, but it is only slightly elevated. It could be alcohol. Alcohol commonly raises triglycerides.3. Check for triglycerides again after a month. If high, you can try taking vibrates or niacin to help in triglyceride control. Include more omega 3-fatty acids in diet. Avoid alcohol. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 4 month old has been having loud stomach noises after swallowing some breast milk most mornings. It doesn t happen at any other time of day and he eats 2-3 times at night with no problem. But around 7 am after he swallows, his stomach gurgles, he arches his back, pulls off and cries. I try to burp him, but don t usually get one out. After this happens a few times he won t feed anymore and then needs to be calmed down. We know that he is intolerant of dairy and soy and I ve been on a strict diet for almost a month now. He had specks of blood in his stool, which are looking better. What is causing the stomach pain? ### REPLY: Hello, Thanks for writing to , According to the information provided I conclude that mostly baby is having some element of Gastroesophageal reflux. What is babies weight? Is growth fine? You may please try keeping him in position with head up 30-40 degree and legs down after a feed. Best would be place babies mattress on a small wooden plank and elevate the headed by 30-40 degree. Also in case he is on outside feed, start thickened feeds. 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: sir,        for a patient on t.acitrom for post mvr ( ttk chitra valve).assymptomatic at present .now posted for hysterectomy.inr is 1.33.how long should i stop acitrom.should i give heparin.what is the target for patient undergoing  general surgery ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  You should stop citron before surgery. INR should be around 1 at the time of surgery. After surgery, you should start your anticoagulant.  INR should be maintained between 2 and 3 afterwards. 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 m  30 years, male.I m suffering from chronic Urticaria from last one year.I feel etching and rash on whole body.I have taken many anti allergy medicines, but it only provide me temporary relief.Is there any permanent treatment of this disease?Plz help me in this regard, I will be very thankful to all of ur team members.Best Regards,Ahmed ### REPLY: Hello, Thank you for posting on . Urticaria is an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues. Its proper management requires thorough history, clinical and laboratory work-up. You may have to go for specific tests like patch test, food prick test, IGE antibody levels etc. As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering foods from diet. I would also advise you various antihistamines for long duration(at least 3 months) with or without oral corticosteroids. For non-responding cases there are many other .  Hope this will help you in resolving your query. Thank you  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Back in the 70 s j had to have a kidney out, up to the operation I was prescribed morphine tablets, they were fine gave me great pain relief, last year I had a bad water infection and was given morphine it made me sick and had bad dreams that even frightened the staff, what was the difference? and why? ### REPLY: Hi, Thanks for writing in. Morphine is an opioid analgesic and can cause hallucinatory effects in sleep in some patients, and you are among them. There can also be hypnagogic hallucinations occur when falling asleep or waking. The dose of morphine might have differed or its preparation and potency was higher last year when compared to your earlier time. In such cases, the patient may be put on alternatives like oxycodone for pain relief. This is also highly potent but has lesser side effect than morphine. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 lot of little tiny lumps under my armpit. Sometimes I can feel them and sometimes I cannot. My armpit is always tender and sore. My right breast is larger than the right is that normal? I just felt a stinging sensation on my armpit. I am 20 years old can this possibly be breast cancer? I did an ultra sound a year ago but it came back negative. I am extremely worried ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You may have some lymph node enlargement in axillary areas.  You should go for fine needle aspiration cytology of that lump.  Chances of breast cancer is very rare in your age.  No need to worry about that.  You may some other pathology.  Consult your doctor and take treatment accordingly. 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: Himy mother recently have squint in her eyes..she is a diabetic patient.according to doctor suggestion we had a MRI of brain.the report says;-acute lacunae infarct in the facial colliculus-Old lacunar infarcts in bilateral basal ganglia internal capsule and thalami, bilateral periventricular white matter and pons.-old microbleeds in left parasitical occipital lobe, bilateral thalami and left basal ganglia.-age related cerebral atrophy with sub cortical and periventricular white matter ischaemic changes. please suggest diagnosis and remedial measures.thanks ### REPLY: Hi, Based on the details your mother is diabetic, and MRI brain revealed multiple infarcts in brain the acute one being in facial calculus (brain stem) which is producing squint, with old microbleed, with small vessel disease of brainSuggestions for her are1) control of diabetes strictly2) diabetic diet3) esprit 150 mg daily post lunch4) Statins 40 mg bed time5)Anti-hypertensive ideal covers plus once daily6) citicholine 500 mg twice daily 7) fluids 3 l/ day8) exerciseCheck her cholesterol levels, thyroid functions and kidney function You should consult neurophysican for further management and treatment planRegards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sister had a right lower lobectomy for a small growth in the lung. She has gone downhill everyday since Mon June 9. Dr states she should have been up and out after 3-4 days. She could not tolerate Incentive Spirometer, did not want to walk or deep breath and cough post op. We tried to encourage her to do what she needed to, but she was not cooperative. She now is on a respirator, has a pic line in for meds. She is getting epinephine for low blood pressure. Respirations have finally come down to 20. She is on propofol IV to calm her. today they told us it is possible she has a blood infection. Dont know what to think. ### REPLY: A blood infection is a strong possibility. They should be able to diagnose that for sure in a day or 2. Pneumonia after any surgery is always a concern; that is the reason for incentive spirometry and deep breath and cough- to prevent pneumonia. I suspect she may have developed pneumonia as she wasn't cooperative with the preventive treatment, and now the infection has gotten into the blood. This would cause the blood pressure to .  I presume she is receiving an antibiotic combination as well while they are waiting for the culture results to come back. Blood infection, also called sepsis, is a very serious condition and can be life-threatening. Hopefully the doctors will get it under control soon. Hope this answers your query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Never had anything like this before. Around 2pm today (almost 12 hours ago) I started having discomfort on my left side (in my lower ribs). Any type of movement causes discomfort as well as inhaling deep breathes. There was no injury to the area at all. I work nights, so half way through my shift, when standing, I noticed that there is a had lump that seems to curve underneath the rib. This lump is very tender, and when presses causes sudden stabbing pain for a few seconds. It isn t visible, you have to feel for it (it appears to be on the end of the rib and curves underneath) Any ideas on what this could be? I am at work until 4am (should I go to the ER afterwards or wait until tomorrow and go to a walk in clinic? ### REPLY: Hi, thanks for the query and the concerns shown for the chest-lump on Lt of your body. Dear In my opinion-it may be because of the -work-trauma-in crouching position but as that history is not there from you, I would label it to -Hepatitis-which you have to check up with your doctor in ER. Another possibility could be inspiratory catch-of myogenic or pleuritic origin, which needs to be ruled out after checks with the ER doctor. Thanks and Welcome again. Hope this resolved 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: Lately I been having these unusual feelings. Sometimes I think that it s just my imagination and I tend to ignore it. Through out the day I feel weak, fatigue, and just tired all the time. Around night I get this rapid heart rate, I can almost feel it about to come out of my chest and my head feels heavy. I get pressure on the back of my head and also near my eyes and nose. I begin to get shortness of breath. I also get these intense headaches , almost as if my head is pouding ### REPLY: Thanks for your question on . I can understand your situation and problem. By your history and description, possibility of stress and anxiety related symptoms is more. But better to rule out cardiac diseases. So get done ECG first. If ECG is normal than no need to worry about cardiac disease. You are mostly having anxiety. Better to consult psychiatrist and get done counseling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  So avoid stress and tension. Be relax and calm. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I exactly dint hav sex and my boyfriend has the condom on his penis he tried to insert in bt cudnt we used 3 condoms but as far as i checkd it dint tearafter a mnth i checked wid prega news 2ce both the times it was negative about my pregnancy is there anything to worry now.??? ### REPLY: Hello dairy understand your concerned you have done sex once your period will delay by more than 7 days then urine pregnancy test will give true positive test. But Condom was not broke then no chance of pregnancy. If your period will not come then it could be due to hormonal imbalance and ovulatory dysfunction. It can be induced by progesterone pill. But no chance of pregnancy if you did sex 7 days after delayed period. Avoid stress, take healthy diet, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 my gallbladder out on June 30th of this year, I still have the same pain from right under my rib cage to my hip area over to my belly button, along with feeling nauesea. I had a ultrasound done a couple days ago and they found a cyst that they say is a simple cyst. Will this cause the pain that I m having or should my Dr be looking for something else going on? I m tired of hurting please help me in the right direction. ### REPLY: Hi.noted history of cholecystectomy, current experience of abdominal pain and cystic findings on ultrasound. May I ask where specifically is the cyst located? Is it in the liver area? Post-operative pain/discomfort usually occurs, even after several years of surgery, but the pain is tolerable and spontaneously resolving. If your symptom is persistent and getting more frequent, it is best if you consult with a doctor, preferably a gastroenterologist or a general surgeon, for physical examination and clinical evaluation. It may be coming from the cyst if it is located in your liver (especially if it is increasing in size). Diagnostics (such as ct-scan, tumor markers, liver function tests, etc.) and management (medical and/or surgical if indications are found) will be directed accordingly. Hope this helps. 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: I am hurting very badly after my knee arthroscopy done on 6/03/14. The pain is now worse 2 days post-op; its not feeling like its improving, it feels exactly the opposite. I hurt much more right now; and one of the incisions/stiches on lower right portion of knee has begun to steadily ooze blood. GM ### REPLY: You need to check out with a close by specialist for your lower limb muscle strength. Improve your muscle strength in your gluteus, qua .  It will help support the knee better. Focus on regular slow rhythmic exercises. Operation is not always a remedy but a help for the joint. Kindly visit a good physical therapist to make an exercise plan, or you can contact me through this forum to help u better ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 niece is 4 years old. she is suffering from a disease which doctors here are unable to diagnose till now. actually when she was about one year old she fell from bed 2-3 times when she was sleeping. Nothing happens at that time but after 3-4 days of that incidence she started to bleed from nose. doctors did every effort to stop the flow of blood but it all went in vain.after the Haemoglobin test doctors found that her Hb is very low (3-5)and adviced that she needs blood. as her haemoglobin increased after blood transfusion we found that bleeding stopped from her nose. After that whenever she gets ill her Haemoglobin falls down to 3 and she starts to bleed again. This all was continued till she got 3 years old. For last 6-8 months she is bleeding from her gums instead of nose and all this happens after she get ill specially when she suffers from fever, blood starts to come out. Another problem with her is that whenever she gets injured even very small injury cause a very big stain at the spot of injury or wound even when mosquito bites her there is a very big stain of about 5cm at that spot. I have all her reports that doctors here adviced us. Plz give me the email address where i can send these reports so that you can study her case in detail. I shall be grateful to you forever if you help us out from this problem. THANK U ### REPLY: Hi, I think your child has hemophilia or on Hildebrand deficiency, such symptoms occurs in this condition. I suggest you to do PT, APT, Platelets, factor 8 and factor 9 assay, on Hildebrand antigen test. Since blood has all the factors, that's why your child improves after giving blood. A follow-up reports is necessary to make accurate diagnosis. I hope this has helped you. Wishing your child good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a tender lump on the surface of my breast above the nipple. In the centre is a black spot. The lump is actually very painful to touch and it is inflamed. The black spot as been there for years. But recently over the last 5 days it has become painful. ### REPLY: Hi, I have gone through your medical history and am sorry for the situation you are in. Depending on your age, and what you are describing, it might be infection of breast glands. However, as the black spots have been there for years, if I was your caring doctor would advise to run:- physical examination by oncologist-breast ultrasound abscess is confirmed, antibiotic therapy is advised to start orally and should discuss with surgeon for possible .  Wish fast 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: Well i was playing basketball i came down on myleg and heard a pop in my knee, swelling came after and i put ice on it for two days and i can walk on my knee and everything but I m just scared to put major pressure on it bc i don t know if its sprain or torn. My email is YYYY@YYYY ### REPLY: Hi, What I feel is there might be a ligament injury which can be called as a sprain or torn ligament. Which usually occurs in the knee joint in major sports. Getting it assessed by an orthopedist on a physical examination basis should help reveal more about the injury. Ice is used to reduce swelling and pain but for improving the healing we need hot ware fermentation and immobilization of the knee for 2-3 days at least.  Post which is no major injury is diagnosed then a graded exercise prescription is provided by which the sports activity can be regained with confidence. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: After a week (5 days) of drinking to excess 12 drinks/day avg.  How long will it take approx for my liver enzymes to return to normal levels in a blood test.  I have a history of drinking, however past 2 months blood tests have all been normal for liver enzymes. ### REPLY: Hi thanks for contacting ,. Your liver enzymes can be high because of high alcohol . .... Alcohol and its metabolite aldehyde can affect liver and damage hepatocytes, so liver enzymes can be high..... It is best if you avoid alcohol.... But if you want to take it never take it above normal safe limit .... Up to 20 gm / days is safe limit .... Take healthy and balanced diet with more fruits..... The elevated enzymes by alcohol will come down to normal range within few days too few months depending on severity.... Take carrot, avocados, spinach, mustard green, Indian gooseberry like good food for liver..... Hope your concern solved... Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ill give you some background over the last 2-3 weeks. I was on a antibiotic for a uti, third day in I had symptoms of a yeast infection, took one diflucan, I wasnt getting much relief so started a seven day regimen of monistat 7, The fourth day in to the medicine I had developed swollen labia redness around the vagina ,no itching, no bad odor, I did have a warm burning sensation, and a whitish yellow thin stringy discharge. I took a yeast screening test and I had a ph of 6.0, which it said could be either bacterial or trichamonis vaginitis. Ive been married for 25 years, we both only have sex with each other so i assume it would be the bacterial. I quit the monistat7 and started on vh essentials bv treatment increased my probiotics by adding Fem dophilus, so a total of three pills. I started having bloating and stomach cramps which developed into constipation with full feeling in the rectom and a shap stabbing cramping, I didnt have a bm for a day and a half, which i wouldnt have worried about if I didnt have the horrible cramping and fullness. So i took two pills of a laxative 6 hours later i had a normal bm, but still cramping and uncomfortable and 7:30  this morning started having diarrhea. Im not sure whats going on with my body and would love to hear your opinion. ### REPLY: Thanks for your consultation at  !  I have gone through your entire history, in context of your scenario, you have got altered bowel movements secondary to alteration in gut flora due to excessive use of antifungals and antibiotics... what you do is that you should use probiotics and start with the simple oral diet with plenty of water.regular use of Isfahan husk after meals. Avoid fast food and beverages, try to consume more green vegetables this will help you build your gut flora and will help you relieve symptoms... Use the . .  Hope your quarry is adequately answered if u still get one feel free to ask... Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had the mirena iud for 3 months with approx 6 days of no bleeding here and there. Mostly its been a tolerable spotting, for the past week I have been on a heavy period which is becoming lighter. Although Ive had clots throughout the periods today I have seen a somewhat large size the length of a small tampon. Should I be worried? I have also been becoming lightheaded when I get up from laying down or sitting down in my own mind I think this is maybe anaemia? ### REPLY: Hello, Welcome to . Yes you may have anemia. But this needs either iron tablets or injection depends on your hemoglobin level in blood. Regarding your spotting and heavier bleeding, It is very common with IRENA IUD for initial 3 to 6 months.Thus, your body needs adjustment for the IRENA IUD. After these 3 to 6 months, your body may adjust and your periods may resume to normal. So you do not need to worry too much about this. If you are my patient, I will prescribe iron tablets for 2 months after checking the hemoglobin concentration in blood. I ask you wait for 3 more months and review. Hope this helps. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: After having a persistent pain in my lower abdomen I went to my doctors and he said i may have a ovarian cyst, i had a ultrasound and there was in fact a cyst in what my doctor said was my left side. He said to wait 2 months to see if it goes away. It s only been a couple weeks but i am experiencing a pain in my right lower abdomen even though the cyst is in my left ovary. ### REPLY: Hi ! Good morning. I am  answering your query. If I were your doctor, I would have advised you with a routine stool test for ova and cyst to rule a colitis. I would have also done a general physical examination of yours with special attention to the abdomen particularly when you get pain in the abdomen. In case there is any finding in the stool, appropriate treatment would cure your problem. In case of persistent and increasing episodes of pain, I might advise you either for a CT scan of abdomen to know the status of your appendix, or a diagnostic laparoscopy which might also be converted to therapeutic one in case of any such laparoscopic finding. Till then, you could go for an antispasmodic and a proton pump inhibitor . 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