Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 period is 4 days late and have been having cramps and dizziness and bit of nausea. I took 4 home pregnancy tests and all are negative and my ChatDoctor blood test result show 0.100. What does this mean? The uncomfortable feeling in my uterus area still hasnt stopped. ### REPLY: Hi, Low Beta  completely rules out pregnancy, so no need to repeat pregnancy tests. Due to the delayed periods the inner lining of uterus is thickened & is now try to expel out of the uterus. This causes severe pain, nausea, vomiting, giddiness & excessive vaginal discharge. It will be relieved after you expel a fleshy mass, which is the inner lining of uterus, not to worry about. If your periods are always irregular, kindly consult a gynecologist, who can evaluate the cause, like Thyroid profile, Serum Prolactin.Also, an ultrasound scan can be done after periods to rule out any polyps within uterus or fibroid, chances of latter is very low. All the best .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My lower back has always felt tight. Freshman year in college, I noticed more and more stress. 3 years later, it continues to hurt more often, and now everything always needs to be stretched. I can feel several knots... not if this is related but I also have to pop my neck a lot more. ### REPLY: Hi, Welcome to . After going through your query I think you are suffering from chronic backache. Treatment of back pain is exercises and analgesics (diclofenac SR). Sometimes strong analgesic(such as attract three times a day after meals) is required. Consulting with treating doctor is advised.  Sometimes vitamin D deficiency is the cause so get your vitamin D checked. If it is low then vitamin D supplementation(weekly with milk) can be taken. Avoid long continuous standing. Sit in a straight posture. Eat milk, fruits and green leafy vegetables daily. I think your stress is related to it as stresses increases pain sensitivity. I think your query answered ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Doc. I am 27 year old female a wife & a mother. i hav got breathing problem. since 1 day i was having excessive pain in right side of my lower abdomen. my family  doc suggested my for sonagraphy also she checkd my bp whicChatDoctore 140/70 is it ok & also i got vibration in my whole body. whn my sonography was done it was examined that i am having acute appendix. i wanted to ask u is it curable by taking medicinal course or should i get it operated. please help ### REPLY: Hi ! Appendicitis is more of a clinical diagnosis and sonogram may be a corroborative investigation in arriving at the diagnosis. However, once you are being examined by your treating doctor and the sonogram also shows that you have got acute appendicitis, then the right treatment for this condition is emergency surgery after doing all other routine investigations like blood and urine test. Not infrequently some physician treat this with antibiotics to control the infection without surgery, but this carries the risk of perforation and other complications related to appendix and so I as a surgeon would not advise you for the same. The Blood Pressure checked for you does not need any treatment for the time being as the upper (systolic) level could be due to the pain in abdomen. The vibration in your body is also not related to your present symptoms of pain abdomen. This might be due to the anxiety factor if no other neurological problem is faced by you. I would suggest you to consult a general surgeon at the earliest for management of acute appendicitis. Wishing you an early recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor , i m a 23 years old female . i am asking about dental local anesthesia i have to get all my teeth filled and crowned , i have been using anesthesia for 7 months nw with approximately 2 injections per week. at the beginning it was going fine but during the past three weeks i am feeling very dizzy and fainting all the time and this feeling increases on the day i visit my dentist . i would like to know if repetitive doses of anesthesia for a long period of time is dangerous and could cause me further problems . thank you ### REPLY: Dear friends, thanks for sharing your concern, local anesthetic (LA) will temporarily interrupt conduction when absorbed into the nerve. A blockade of afferent nerve transmission produces anesthesia and lack of all sensations. Blockade of those fibers transmitting pain, sensation only results in regional analgesia. The perception of heat cold and pressure are abolished by higher concentration of anesthetic agent then are required for interruption for pain. The local anesthetic produces loss of function in following order, pain, temperature, proprioception and skeletal muscle tone .the return sensation in the reverse order is expected.sometimes patient under the effect of anesthesia traumatize their tongue cheek or lips for this reason longer acting agents may be contra indicated. Remember the local anesthetic solution are eventually absorbed in to the general circulation and can have toxic manifestation in over dosage. Yes repetitive usage of local anesthesia have too many side effects like syncope, muscle Erasmus, haematoma, and adverse effects on CNS(central nervous system), and CVS(Cardio vascular system. Therefore I would suggest, minimal usage of anesthesia is best, if required post treatment analgesics could be prescribed. Please donor be apprehensive about dental treatment. If required you can take antianxiety agents like alprazolam. Hope this helps.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 name is Mamtha, and I am 28 year old. I have been married for 3 years now. From past 1 year we are trying for a kid but seems to be no joy. I did get medical test done and report shows that I have no problems and all are fine to conceive. Its the same with my husband. Please suggest as to what can be done next. ### REPLY: HELLO.HOPE FOR THE BEST.IF YOU ARE TRYING TO HAVE Babier THAN FOLLOW THE ADVICE GIVEN BELOW:1. Cakculaye your menstrual cycle days.  IF 28 days cycle than the ovulation day of yours will be 13th/14th. Try to have sexual relationship while your fertile days. So, roughly 10th to 18th day of cycle are fertile days.2. Your Husband should not have To back habits which make sperms Less motile.3. FOLLOW Fertile day method for 3 to 4 months if no results.4. FOLLOW Ovulation induction with closed and monitor cycle with ovulation study and have trigger for ovulation, your Gynecologist can guide you more in this technique.5. With Gynecologist advice and under care have continued ovulation induction with followed GUI- intrauterine insemination. This method will improve chances to have pregnancy.6. If above all fails consultant IVF CONSULTANTTHANK YOU ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 58 year male, caucasian. I have better that average medical knowledge as I am a veterinarian. I have had two creatine tests done the last month. The first value was 1.28. The second value 3 weeks later was 1.24. Normal value from Emory university lab is .7 to 1.2. Associated with the creatinine of 1.28 my BUN was 15, normal value is 8 to 25. The GFR was calculated to be 58. Do I have kidney disease? ### REPLY: HI there, as you have rightly stated both your creatinine levels are beyond the normal range. Along with it your GFR is reduced, the normal level being between 90-120ml/min. The decreased GRF along with rinsing creatinine does indicate that you are going into chronic renal failure. Tho it is not absolute, but you do need to get a renal profile done and visit your general physician who should be able to guide you to the next course of action. Do take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 33 years old woman, having one daughter of 4 years old and i want to plan another baby now but i have very low hemoglobin level -7.9. what are the ways to increase my hb apart from medicines and what would be the consequences of low hb if it does not increase during my pregnancy? ### REPLY: Hello, The commonest cause of low He is the deficiency of iron. The normal He is above 12 gm/DL. So you have a very significant anemia. Raising the He to normal levels with only iron rich food would take a long time and should not be the only way as with a pregnancy, the He will come down further and you and your baby would be at risk. If you cannot tolerate oral iron, injectable iron preparations are available. If your doctor feels that your He has to be raised immediately, there is the option of packed cell transfusion. It is usually not required.Also, you should see a doctor who will check you causes of loss of blood like excessive menstrual flow or loss in the motion. Take Care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I am 29 years.I have been haveing period like cramps from the 15th of this month. My period date was 23rd but I did not get my periods so far.I have cramps in my abdomen and lower back. My nipples are sore and erect and breast feels some pain.My husband and I are trying for a baby for the past 4 months.In the month of Feb as well my periods were delayed by 7 days but  at that time I did not feel much cramps.Could it be possible that I am pregnant? I have not takes a test yet.Thanks,SS ### REPLY: Hello for the confirmation of pregnancy you will have to go for urine pregnancy testy can be pregnant but you didn't mention that what was the house of not getting pregnancy in the previous month, and also how long time you have got marriedCramps and abdominal pain are not usually associated with early pregnancy. This may be due to some other cause, if it persists consult to a Gynaecologistoktake 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 doctor,   Im am using lomela 18g cream for hyper pigmentation on my face for two week.. i got colour changes all my face except my cheeks and temporal areas... All my friends fearing me it must be a rash... wat can i do?/ further continue the cream or stop it at once... and also black heads also turned to pale ou... is the cream safer or has more effect to cause side effects in furtur? ### REPLY: Lomela cream contains a mid potent steroid mometasone, HY .  It should be prescribed by a dermatologist who knows which condition to start it for and when to stop. We do not recommend it daily for more than a month following which we taper it and stop and add on a non-steroidal lightening cream. Moreover, it is used in commentary disorders like plasma and not for improving skin tone. Long term use can cause steroid induced Rosacea, Acne, Thinning of skin, Redness and increased sensitivity to sunlight. Use a sunscreen with SPF 30 or more every 2-3 hrs during the day even if you are indoors. Avoid sun exposure as much as possible. Apply non-steroidal lightening cream containing comic acid at night. Hope this helped 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: Dr. My daughter is 2 year n 2 months old, she very underweight with 6.2 kg. She was born normal. In age of 6 months she fell sick n later diagnosed with mitocondrial complex 1 def. She has milestone delay. Doctors say that underweight is not related. She does not drink milk with bottle or with spoon n does not eat. Anything fed she vomits in jelly form.. Gave her medication also but nothing is helping Plzz suggest I m really worried. ### REPLY: Hi, thank you for choosing . Sorry to hear about your daughters' diagnosis. The not gaining weight may not be related to her disease, but both are interrelated and as she has developmental delay she won't be able to feed on her own and will have frequent regurgitation of feeds which intern lead to frequent pneumonia and weight loss. Kindly consult a developmental pediatrician as they can assess the degree of inability to take feeds and advise regarding a proper method like feeding tube or gastronomy tube etc. Hope this has been helpful to you, kindly feel free to contact again for any queries. Kindly rate the answer if so. 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 9 1/2 month old daughter has a temp of 39.2 and a runny nose. She is happy to sit and let me wash her down with cool water. But she is fairly happy within herself. She has a little cough which she normally seems to get when shes teething , and she is teething just now. She is talking away and drinking water. I have given her some baby paracetemol (calpol) to help bring her temp down. Do u have any suggestions?? What it could be? ### REPLY: Thanks for asking I have gone through your question. Your 9.5 month daughter having fever of 39.2, with running nose. She is playful Most fever with running nose are due to viral illness. Generally it takes 3-5 days to recover. If I would your pediatrician, I advised you what you're taking already baby paracetamol. Dose of paracetamol is 15 mg per kg per dose. Can be given up to 4 times per day. I baby is having discomfort with running nose I would suggest spy cetirizine 1.25 ml twice a day for three days.  It is myth that people correlate symptoms of loose motions, fever or running nose with teething, There is no correlation found in modern medicine. Process of teething is continuous generally from 6 months to 2.5 year of age.  Your child should recover with above mention medicine. And not to forget to MMR vaccine that should be given at completed 9 months of age 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: Hey, I m a 19 years old student. I weigh 56 kgs and am 172 cms long. My periods are regular and I exercise regularly. Whenever I am really excited on occasions before I go to speak on the stage or attend a function, my hands start shivering uncontrollably. It causes me a lot of embarassment as when I have to hold the mic in my hand, it moves vigorously much to the notice of the audience. What can I do to stop this shaking? ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through.It's a phobia disorder and will require graded exposure and systematic desensitization. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was recently diagnosed with pneumonia with plurisy. I received IV antibiotics in the hospital. I am home. My pain has pretty much gone away. I saw my primary care doctor today and he did a chest xray. It has only been less than a week. He said the xray still showed pneumonia and for me not to return to work. I feel much better. I need to go back to work. ### REPLY: Thanks for your question on . In pneumonia symptoms appear before x-ray findings (infiltrates, consolidation). And same is true after treatment. After appropriate treatment, improvement in symptoms is earlier than x-ray improvement. So if you are symptomatically improved than no need to worry much. X-ray improvement will take almost 2-3 weeks atheist. Sometimes it will take almost 1 month for improvement. So better to consult pulmonologist and discuss all these. If you are symptomatically better than you can get back to work. Get done chest x-ray after 20-30 days, it will improve. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 4 years(18Kg) old. He is having fever around 99-100F and having frequent cough for last 2 days. He has been given Ambrolite Levo Syp 3.5 ml and Sinarest AF Syp 3 ML. Does he need to take any antibiotic. The Pediatrician to whom we visit for my son s illness is out of town so I am asking for opinion. ### REPLY: Hi, Thank you for asking question on . Fever along with cough suggests infection. I usually prescribe Amoxicillin and clavulanate combination 2 times daily. You may add paracetamol 15 mg/kg/dose for control of fever. All other medicines you may continue as prescribed by your doctor. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care . V. Subrahmanyam MD;Disassociate professor of pediatrics ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a pain around my kidneys for the last 4 weeks the Dr said I had a kidney infection but the tests came back clear I had two corses of antibiotics Ive been taking pain killers ( Paracetamol and Ibprofen . )I went to another dr and he said I had a back pain I never had this pain before Last night I awoke with the pain around my kidneys again. could it be Kidney stones, ### REPLY: Hi ! Yes it could be due to a stone in the kidney. The pain of kidney stone may be a dull aching to excruciating one if it blocks the flow of urine. Ultrasound is the best modality of diagnosis for kidney stones. Try to take enough liquids in your diet. You should discuss with your treating doctor and go for an ultrasound abdomen including kidney, ureter, and bladder with prostate to arrive at the diagnosis. If excluded, then you may consider back pain and consult an orthopedic surgeon for an opinion and management. Take care and 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 was in california for about 5 days and one day gotten like 20+ bug bites (not sure if spider or mosquito) on my left arm and it is mainly on the backside of my hand. some of them gotten big and popped on their own and started to ooze yellow like liquid for 2 days straight now and they itch and burn everynow and then... What could I do to get rid of it? ### REPLY: Hi, Thanks for the query. I understand your concern.  Mostly its spider bite/crush on your skin... For mosquito bite does not cause discharge . As you are having. This mostly heals with symptomatic treatment. Only.if you scratch it to expose raw area underneath .it gets. Exposed to bacterial infection.  For you.  To relieve pain & itching(due to allergy to saliva of spider) ice pack, pain killers anti-allergic pills over the counter should suffice. . So if you find it taking long time to heal with pus discharge... suspect bacterial infection. You need to add antibiotic to other pills you are already taking . In such case It's advisable to consult your family physician & get the most suitable & effective antibiotic for you (depending on your health & severity of infection. Along with cleaning & .  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: In my chest x ray showing Lung fields are hyperinflated with no active parenchymal infiltrates. The heart is normal in size. The aorta is unremarkable. Diaphragm and bony thoracic cage are intact No other remarkable findings. IMPRESSION: PULMONARY HYPERAERATION... Thank you in advance... ### REPLY: Hello dear, thanks for your question on . Hyperaeration is also known as hyperinflation. And it is seen in following conditions. 1. Normal individual if chest x-ray is taken after full deep inspiration. 2. Old age people. 3. Smokers due to COPD (chronic obstructive pulmonary disease). So if you are smoker or symptomatic (cough or shortness of breath) then get done PFT (pulmonary function test) to diagnose COPD. And if you are not having any symptoms and not a smoker then no need to worry much with this x-ray report. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My boyfriend and I are both in college Im 21 & hes 22. We had some to drink and went further than we usually do. We didnt have sex but we he did rub his penis on my vagina. Im freaking out a little because Im always very careful. How likely is it that I could get pregnant? Also, it happened the day after my period ended and I have a regular flow. ### REPLY: HelloThanks for writing to ChatDoctorPregnancy is not biologically possible in your case as you had intimacy on the day just after completion of period, considering period as regular. Ovulation occurs on 14th day counting from first day of menstrual period. So fertilization is not possible. You don't worry at all. You should be cautious during next act. Pregnancy can occur even with contact of genitals because pre ejaculation secretion from penis contains sperms and sperms has tendency to swim upwards. Only one sperm is required for fertilization, so take precaution during next act. Hope I have answered your query. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: When stepping on the ball of my left foot I get severe pain across the top of my foot. It started as just annoying pain whenever I was on my feet for long periods of time ( I am a waitress) Now I cannot even make it three hours into my shift without it becoming unbearable pain ### REPLY: Cannot say what in your particular case without direct examination. But I can say everything that is in the foot includes bones, joints, tendons, circulation, and muscle. With a lot of pressure there can be stress fractures of the bone. They give intense, constant pain. The joints and tendons can get strained. This occurs most in the part of the foot with the most bend (the middle at the top or in the arch). This area goes up and down in pain during the day. It goes up with use, It hurts when that part is bent either by flexing the foot or by directly moving that area. Muscle can hurt; they have a particular muscle ache. There are no prominent muscles in the top middle of the foot, more joints and tendons. Circulation can make the whole foot ache and there has to be signs of poor circulation. The pain comes either with use, with blue swelling, or with lack of blood, being pale/white/cold and achy with use but would be the whole foot (really, really doubtful in this case). Joints and tendons are helped with changes in shoes and activity, with aspirin like .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 ~ Had orthognatic surgery - lower jaw only to correct overbite. It s been 8 months now and I am still feeling a terrible burning sensation on lower lip and chin. Feeling is coming back but skin is extremely hipper sensitive. Teeth hurt when chewing and muscles feel very tired and tight when talking. Can this burning sensation be something permanent? How long could it take to do away? I ve heard all sort of answers from if it hasn t yet it never will to it can take up to a few years -2,3,4 or so . Thank You ### REPLY: Thanks for your query, I have gone through your query. The burning sensation can be because of the nerve injury during orthographic surgery called hypermnesia. The recovery time may vary from months to years. But cannot predict exact duration or time of recovery. If I am your treating doctor, I would have suggested you to take nerve regenerating . The pain in the jaw and muscles is not related to the surgery. It can be because of any malocclusion or TMJ disorder. Consult an oral physician and get it evaluated and treated. 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: Hello ive always seemed to have had heart pains and use to suffer from panic attacks they how now been gone for over 2 years. The doctor put them down to stress .But the last 3 days I have been having pains again its like when I push out my chest of cough my muscles around my heart area and at the bottom of my ribs really hurt, but around the heart seems to have been there constantly for last 3 days like a dal aching pain. Also I have been really hot to touch and also feel like im burning but about 3 or 4 times a day I am really hot to touch but I feel freezing and my hole body ache I can only describe it like im in dream / spaced out and feel shakey and unstable on my feat. I also have been coughing more than usual and my vision seems to be abit blurred. ### REPLY: Thanks for your question on . In my opinion we need to rule out cardiac cause first. So get done ECG and 2D Echo to rule out cardiac cause. If these are normal than most probably your symptoms are due to anxiety and stress. So consult psychiatrist and start treatment for anxiety. Get done counselling sessions for identifying stressor in your life and find solution for it. Newer anxiolytic . So consult psychiatrist and start treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been feeling unwell for 5 weeks now, it started with me losing my voice, coughing badly, so much so that it hurts my chest and I am gagging when Im coughing could this be from cleaning products being inhaled because I clean outside my house about 13 hours per week. I have been to my doctor twice he gave my two lots of antibiotics but neither has helped me. Please Reply     Vicki ### REPLY: Thanks to  I can understand you issue I came to know that you are working on house cleaning here cough is coming not only from infection , it may be due to irritating allergens in dust .please try to avoid that type of work for few weeks ,or otherwise wear mask and do moreover a lot of antibiotic will spoil your health , have a chest x-ray once ,CBP and ESR.tests you can use antihistamines like levocetrizine 5 mg if not montage LC for 5 days with low dose antibiotics moreover be away from cold and cold items ok don't worry it will subside ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 doing garden work in very hot weather and I started to feel exhausted.  Came in and took my pulse.  It was 137.  I am female and 70 yrs old.  Is this rate harmful?  I put cold water on my face and laid down with my feet up.  What is a healthy non-resting heart rate? ### REPLY: Hello and welcome to ChatDoctorI have read your query hope this will alphabet rate of more than 100 beats per min is called tachycardia. Yes in your age it could prove to be harmful as it can precipitate myocardial ischemia. Tachycardia has got many causes and vigorous physical activity is one of those. I would suggest you to avoid working in hot weather as it promotes fluid loss via sweating as a result heart rate increases to compensate that also physical activity increase heart rate. There is not to worry much at the moment however next time when you visit your GP do have an ECG. Thanks .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 22-year-old female and I do smoke, but this morning I noticed a slight burning on my tongue, when I looked in the mirror I noticed a sore and slight yellow blotches also noticed when I put a light on it yellow tint on the roof of my mouth and my throat. tonsil swollen on the left side,nausea, dizziness with a headache only on the right side of my head as well as muscle stiffness. With lower back pain. ### REPLY: Howell come to ChatDoctorNonspecific lesion of mouth is very likely, tonsil sometime look little bigger, but that may not be due to any infection, chances of dermatitis may be very likely, this could be allergic or due to infection, if I would be your treating doctor then I would treat this case with the following medicines, 1) Tab Amoxicillin 500 mg three time in day 2) Tab Folic acid three times in day3) Tab Risperidone 30 mg three times in day this is nothing to worry, everything would be fine soon, have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: So I am a 22 year old male, and I had what looked like a pimple near my nipple/areola. I popped it since there was a white head forming. Now, it is very sensitive and it has turned into a hardend lump. Is this normal for males my age? I just want to make sure I have ruled out the idea of breast cancer. ### REPLY: Firstly, lumps in the male breast are common in the pubertal age of 13 to 19 years. This is called Gynecomastia. But they do not have a white head, which is suggestive of a Sebaceous cyst which you have burst. Did some secretions come when you popped it. Secondly, on popping it, the cyst cavity becomes susceptible to secondary bacterial infection which might be the case with you now specially if there is redness and pain in that area. You should take a course of antibiotics like Tab Augmenting 625 mg thrice a day along with Tab Ibuprofen 400 mg twice a day for five days and put warm compresses over the area, and you will feel better. Let me know if you don't feel relieved. 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: Why does my lower abdomen and anus hurt when I sit, walk, cough, or sneeze? I m not constipated I eat a very good diet. I m not overweight and I don t have any medical issues besides asthma. even though I do go to the bathroom on the regular it hurts to push at all, its not like I have to push but you know just the regular going to take a bowl movement hurts. Also, I don t have hemroids. ### REPLY: Here you might have problems with kidney(kidney stone) or hemorrhoid since you yourself are comfortable for passing urine and little problem while passing stools I suggest do not diagnosed on your own and take specialist opinion. If there is no problem as per doctor then you can use hot pack at your painful area to have relaxing effect on soft tissues. Here some more details are missing from your end1. Since when you have this problem?2. How many times a day you need to go for bowel and bladder movement.? That is for urinate or for passing stool.3. Do you have any burning sensation while passing urine?4. Does your pain go down after passing urine or passing stool? Based on this as well with physical examination only a doctor can evaluate your problem So I suggest get it evaluated properly and go for treatment as per that. 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 my last period was on 12th feb I took conseptive bills but I had bleeding so instead of being 8 days it become like 11 so I stoped using the bills day 11 then I have another bleeding wich last 9 days now i feel some pain in the left side of my tummy and the period didn t show up ,, should I be concerened or is it ok to be late ? ### REPLY: Hi, thank you for your query. What you were experiencing is called as breakthrough bleeding. This is a common side effect of the OCS. Breakthrough bleeding (BTB) is usually referring to mid-cycle bleeding in users of combined oral contraceptives, as attributed to insufficient estrogens. It may also occur with other hormonal contraceptives. Generally it is associated with abdominal pain and cramps or uneasiness. Delayed periods is also a side effect of OCP usage. Generally breakthrough bleeding resolves on its own. Breakthrough bleeding that does not resolve on its own patients are advised to try different pill formulations, or to switch to a non-hormonal method of birth control.I think the current pill is not suiting you, hence I advise you to consult your OB/GUN to change your pill. Thank you, wishing you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 13 years old and complaining of his heart "feeling "funny"...has been saying this for a couple of weeks at different times. I am an RN, trying not to panic.  It bothers me that he feels it.  It is not palpitations, or rapid beat... It is like an extra beat at different intervals and he feels it. ### REPLY: Reclothe symptoms you mentioned is suggestive of premature excitation. This Premature excitation may be arising from ventricle or atria. I would suggest you to get an EKG done when he is symptomatic or else get a holder monitoring(ambulatory 24 hour EKG) done if it is infrequent. He may also need an Echocardiography to rule out any congenital or acquired heart disease. Medications like calcium channel blocker or beta blocker may be needed after reviewing the report. 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 suffering from wheezing problem for last one month. I have consulted the Dr. He prescribed deriphilin , cetrizene and asthalin inhaler. Also he told to continue the medicines for 3 years. Then willl automatically decrease. Is he correct? or not?Answer please! ### REPLY: Hello. Thank you for asking at . I went through your history and would like to know more about you like - What is your age? Since when you have had asthma? What is the frequency of symptoms? Do you have any associated nose problems - nose allergies, sinusitis, etc.? Do you smoke or are you exposed to dusts or air pollution? Does anyone from your family have asthma or allergies? Etc... From your history, I would like to make following suggestions to you:1. I would agree with your treatment at present.2. Were I treating you, I would add montelukast in your treatment as it helps both nose and asthma symptoms.3. If you need to use Stalin inhaler more than twice a week, I would suggest you to use daily inhaled corticosteroids. Asthalin inhaler is to be used on as-and-when-needed basis. I don't recommend it to be used regularly.4. Once your asthma is under good control, I would first start reducing deriphyllin, as it has many side effects compared to other . 5. I would also suggest you to avoid exposure to dusts, smokes and air pollution as much as possible.6. Regular breathing exercise and a balanced diet (adequate green leafy vegetables, fruits, sprouts, etc.) will help you in a long run.7. I would suggest you allergy testing which will help you to identify the substances you may be allergic to.8. Were I treating you, I would not suggest you to use all the medicines for 3 years. I usually call my patients every 2-3 months and then decrease/change medicines as per their symptoms. Asthma is a dynamic disease which worsens and improves with time, season and other factors. So it is difficult to predict duration of treatment. Hope above suggestions and information will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My foot fell asleep while I was sitting down and when I tried to stand up I could not stand upright and walk, so I ended up falling in an awkward way. Less than 5 minutes a rather large lump had grown on the top right side of my right foot, just below my ankle. How should I treat this throbbing aching pain and reduce the heated swelling? ### REPLY: Hi, As per your history it appears that by saying sitting, you mean crossing legs and sitting. It is very common to have this after we age a bit, and the cause for it is stoppage of neoplasm flow in the nerves because of compression. This is not a disease but a common occurrence only that occurs with advancing age and with weight gain. Swelling is caused by stoppage of venous outflow while the arterial flow continues.the only remedy is to stop sitting by crossing your legs. Take care. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My Dad, 89 years old had a seizure and his speech is not understandable and he sleeps all the time in the hospital. He s not diagnosed as having a stroke. What are the chances for his recovery? I realize his age is against him and each person is different. He has a pacemaker but no other issues. ### REPLY: Hi, Thank you for posting your query. I have noted your fathers symptoms. It is not clear why he sleeps most of the day. A single seizure should not lead to excessive sleepiness. We need to look at his anti-seizure medications. Some of them can lead to sleepiness. Also, he needs to be stimulated, made to watch TV, talk to relatives, sit up, etc. Hospital stay, especially in a dark room away from sunlight could contribute to his sleepiness. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi .couple ears ago I had ECG done, whicChatDoctore out as -QTC 447, LVEF55%, mild MR+PR, which I been told is normal , but recently been experiencing some heart rate abnormalities, which felt like heart was beating extremely fast for couple of minutes , then all of a sudent felt like heart cant beat for few seconds , and would start beat and would go to normal in short period of time . All this lasted no longer then 3-5 min , just felt quet sick ( nausea ) , and short of breath at the same time . Is this something I would need to worry about ? Many thanks ### REPLY: Greetings. Welcome to , and thank you for your question. I understand your concern. The episode you are describing is more like a bout of arrhythmia. What arrhythmia is this, I cannot be precise without some tests done. I see from the prior EKG you have done, there is a very slight prolongation of the QT interval (0.36-0.44 being the normal range). This talks about delayed repolarization and may be a trigger for arrhythmias, sometimes serious. I would recommend, at this moment, an EKG to be done and, then, a 24-hour rhythm monitor registration, to precisely decide what kind of arrhythmia is this. I would recommend you that the EKG should be done as soon as possible. Also, blood electrolytes should be checked, because electrolyte disturbances sometimes give rise to potentially serious arrhythmias. I hope I was of help. 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: So I am 15 but since the time I was 7 I always had problems with my ribs and back. It wasn t until about my 7th grade year that I was diagnosed with Slipping Rib Syndrome. My ribs would constantly slip under and over each other and it was very painful. It still happens to this day, but there is a catch. The left side of my ribs in the top section is curved like a hill on a math graph. And no one has been able to tell me what is going on with that. ### REPLY: probably you have hypermobile joints which may be genetic in origin. The mobility may be excessive with ribs too. For structural abnormality, there may be calcium and vitamin D deficiency during childhood to cause this deformed ribs. Your doctor may like to advise to test blood levels of calcium, vitamin D and phosphorous if needs be and may cover any deficiency with prescribed supplements, medicines. You must have a physical therapy, expansion of chest exercises, breathing exercises, built up of chest muscles exercises to somewhat check hypermobility of ribsListen to soft music during exercise sessions and be happy best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For over a week now I have had a pulsating sensation in both legs along with twitching and pulsating in my feet. I don t have a doctor right now and I am very concerned as to what this could be. I am a 76 year old female witChatDoctorpressed discs in my back and bone on bone in ankle. When this pulsing first started it was very strong in my left outer leg. ### REPLY: Hi, thank you for providing the brief history of you. As you mentioned you have compressed disc in your lumbar spine the symptoms you are facing is because of the disc irritating the nerves. This is my opinion. What you should understand here is that the spinal muscles and the core muscles are weak, so you need to focus on strengthening the same which will help you on a longer run. Since your age is 76 I will always be worried because at this age little pain is like hell out of cry.Let's take a talk about the symptoms you have and how to. Reduce it. There is McKenzie extension position which is taken will centralize the pain in your back. Post that you can use hot water bag to over the Lower back region to reduce the pain. Later on the exercises for spine, core, should be initiated. You can take a help of a physical therapist. Strengthening the body muscles is a natural way of healing the pathologies related to muscular injuries. I wish you get helped by this. With the grace of God I wish you a speedy recovery 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: Im an 18 year old female who has always had flawless skin. No history of acne or any other skin issues. I recently found some bumps on my upper back (about 10) that look like little white tipped bubbles. I tried to pop one (not the brightest idea) & it started to bleed. They dont hurt or itch. Any idea what they migh be & how to get rid of them? ### REPLY: Hi! Good evening. I am  answering your query. This needs a proper clinical examination before providing you with any solution, and so you would need to get a consultation from a dermatologist. Till then, you could go for an anti histamine, and some kind of OTC available skin antiseptic cream for local application.] 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. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i suffered with low platelet count of 11000 during feb 2010 and i was given steroid which increased the count to 93000. After 15 days again platelet dropped to 13000. My physican advised for bone marrow test and the result revealed that  Production is normal and destruction in enroute he advised to take steroid 10 mg for one month. After that also count is only 55000. Now i am taking steroid omnacartil 5 mg and azoron 100 mg daily for 90 days with fortnightly blood test. Still my count is only 55000. i am expecting your suitable advise. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You have immune thrombocytopenic purpura. Your immune system causes destruction of platelets.  Steroid is helpful to suppress your immunity, and it will lead increase in platelet count. You should continue with steroids, or you can also take immunoglobulin according to need.  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: Dear Doctor , i am 18 years old and i am suffering from too much bad breath for last few years.i have consult many doctors regarding the matter but no one able to help me.i have read about bad breath on internet where many people post that one does not no that he has bad breath.but my breath is so bad that i clearly smell it.its too bad.Dear Doctor,i am so much tensed and worried about this extreme bad condition.i am from pakistan.kindly help me and recommend me something so that i could relieve from this problem.regards ### REPLY: Thanks for your query, I have gone through your query. The possible causes for the bad breath could be the gum infection or deposits, pus discharge. Consult an oral physician and take an opinion to rule out these causes. These causes can be treated by getting your teeth cleaned and maintaining oral hygiene. If these causes are not there then, it can be secondary to respiratory disorders like sinusitis or gastrointestinal disorders. Consult a ENT and Gastroenterologist to rule out these causes. Also get your blood investigations done particularly, blood sugar level, because even in diabetes you can have halitosis. 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 wife have fatty liver .. last month she diagnosed Hep C ... some alregic medcine doctor advised stop all the medcine until alergic gone.. so she not taken any medcine for last month.. before last month SGOT/ SGPT is 89/98... but now it is 250/220.. what was the reason how increased this levels... please advice ### REPLY: Dear Rajesh, Your wife is diagnosed to have Hepatitis C with probably high viral load. In that case gastroenterologist gives treatment to control multiplication of Hepatitis C virus in body. The specific medicine given to control virus multiplication in body may cause some allergic reaction so it's strongly advisable to contact/consult gastroenterologist to know actual cause of allergy. The rising level of GOT/SGPT may be due to active multiplication of virus in body, is another reason to consult gastroenterologist to start appropriate treatment of hepatitis C virus.  Wish your wife a healthy life.  . Com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there, I need to determine whether or not my brother girlfriend is pregnant with his baby.  On the date of the test her ChatDoctor levels were 800 and informed him that she was three weeks.  I have read up and according to some sites the ChatDoctor levels on three weeks sould be 0-50.  PLEASE assist ### REPLY: HI, I understand your concern.  I feel there is confusion in counting the weeks.  -  at 3 weeks from is 5-50 flu/ml -  at 3 weeks pregnancy (about 5 weeks form LMP) is 18-7240mlU/ml.  However It's not possible to determine pregnancy duration/ father of the baby ... by , as the levels vary with pregnancy & the person.  * So to know the duration of pregnancy by USG in early months can help in calculating possible paternity vaguely( by comparing with the day of sex) - Paternity can be confirmed only by chromosomal analysis.  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: Our 15 year old daughter had a sore throat, which started on September 12. It turned into a cold, however, a week ago Sunday (today) she woke up to her jaw involuntarily moving up and down, like a tremor. It went away late that morning but then in the middle of the night, Monday, she woke up with the tremors again (she woke up to get water and noticed the tremor was back). It has been constant since that time. We were first told TMJ. All of the blood tests that have been run by a family doctor and neurologist have been normal except her Vitamin D was low (20). She s periodically nauseas throughout the day, doesn t eat much and takes small cat naps, which she hasn t done for years, even when she s been up late with friends. The tremor of her jaw is constant unless she clamps her teeth together and it is less if she opens her mouth really wide. ### REPLY: Hello! Welcome on  ! I read carefully your question and understand your concern. Vitamin D deficiency may trigger this clinical situation. Anyway, I recommend performing a brain MRI and an EEG to exclude possible seizures (although her tremor continues through the day). Blood electrolytes (including copper, magnesium and manganese). As all started after a sore throat, I would also advise performing antistreptolysin O antibodies, to exclude possible Chorea Minor.  If all these tests result normal, I would recommend consulting with a psychologist or a psychiatrist. Hope you will find this answer helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,  My sister aged 53 yrs is suffering from OCD since childhood which seems to be getting worse as she is growing older. She is currently on Olimet 2.5mg (Once a day) for the past 3 -4 years. However there does not seem to be any improvement in her OCD.  The doc here has now asked me to start her on Sertraline 25mg (twice a day). Will this help control her OCD t some extent ?  Would homeopatChatDoctoredicine help her ? ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through.aliment 2.5 mg and sertraline 25 mg will not help her with OCD. The treatment of OCD essentially requires the medications in high dosages. Lower dosage won't help. OCD is a very common illness and effects many. It can be mild and sometimes unrecognizable, and sometimes it can be severe. You certainly need to be treated for OCD. Although there are plenty of options available like clonal, fluoxetine, Escitalopram, fluoxetine, sertraline etc. all in high dosage my best option for my patients is fluoxetine in higher dosages. If at all sertraline is used, it has to be used above 200 mg. Also, there is an option of cognitive behavioral therapy. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Five years ago I had gastric bypass and now for the past year I have been experiencing very low sugar levels. As low as 31; but usually between 42 and 46. I can tell when it begins and usually will eat peanut butter or a slice of cheese to pull me out of this decline. Any ideas of why this is happening and what I can do. ### REPLY: Hello, There are several kinds of diabetes medicines in addition to insulin. These medicines can lower blood sugar levels but they're not the same as insulin."b" Insulin can't be taken as a pill because acids in the stomach destroy it before it can enter the bloodstream. "B" A diabetic who need five injections of insulin/24 h to control his Diabetes. Cannot switch the therapy to oral medications because the oral therapy very probably won't be effective. About the insulin pump, these are possible alternatives for treatment because the patient uses multiple daily injections of insulin. Pumps use only rapid-acting insulin to provide basal (background) bolus (meal or snack/carboy .  So, Do not attempt to use an insulin pump without professional training. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi...doc..I am suffering with fractured tibia and fibula and undergone surgery and they put plate on 12 may 2014 but the fractured bones are not at all growing or joining each other.. and i have swelling on my ankles ..can i take calcium supplement and vit D for quick healing and tab chymoral forte 2 thrice a day for this. Plz help ### REPLY: I do not know your age, neither do I know if you have any Diabetes history. Cal. Supplement and It D are good as well as Choral may be given but Chorals dose is on the higher side. To my own such patients I would have advised to get pure herbal Ayurvedic Medicine in such conditions of non-union of bones. Aha GGUL and Lanai GGUL are classical Ayurvedic medicines to use in such cases. No side effects. No interaction with other . It's commonly available in India. In other countries one has to try to find it get through Net. Hope you will be benefited. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI , Im a female of 44 yrs 157 lbs 5.2 ,I have a abs eosinophils of 1782cell/ul and immunoglobulin E 850 I have a history of sarcoid too, Im takeing prednison atarax and plaquenil is there any other treatment ? could be sarcoid causing the problem? ### REPLY: Hellothank you for posting hierarchic doesn't cause raised absolute eosinophils or high IGE. These two parameters maybe raised in allergic conditions or parasitic infections. They are usually high in patients with allergic asthma. Since you are on Atari I guess you have some allergies. Other causes of high eosinophils are parasitic infections in the stomach or lungs. You can do a stool routine test to rule out parasitic stomach infections. A sputum eosinophilic count can also be of help. If allergies are an issue then a skin prick allergy test can be done which involves checking your sensitivity to 20 or 40 common allergens. Another possibility depending on if you are from an endemic area is filariasis. In the meantime continue taking above medications. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 trying to conceive but not able to get pregnant. I have history of MTP before 4 years but afterwards I had not tried. Now I want to concieve and m trying since 3 times but not successful. Last attempt was USG guided ovulation but then also not successful. Please le me know the treatment. My gynec has suggested me tablet ovaflo or tab. susten ### REPLY: Hi, First you go for some basic tests like thyroid profile and Prolactin, and a semen analysis of your partner. You can take tablets for growth of your eggs and then an injection for rupture when egg size is more than 17 mm. You should be in contact with your husband for 2 to 3 days after injection. Oval is for increasing the number of eggs. So if you have less no of eggs, you can take it. Austen is a progesterone which you can take after the rupture injection for 2 weeks. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a swallen throat. Its not sore. It is painfull it hurts to swallow and yawn and even just turning or touching my neck. It is towards the bottem part of my throat and feels like a lump or something might be stuck but there isnt anything stuck. Please help ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have granular pharyngitis. You should take c course of antibiotics like azithromycin.  Furthermore, you should also take antihistamines and saline water gargles. Furthermore, you will get benefit. Consult your doctor and start treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been taking ortho tri cycles for over 10 years, recently on my third week, I missed 2 pills, which was the Thursday and Friday, on sat morning, when I noticed,  I took the 2 missed pills right away, so I did not take any more pill on sat at my regular time, on Sunday I took sat. Pill and Sunday pill, I should get my period yesterday, ( wed) but till now it still did not happen, am I ok? ### REPLY: Hi. Thanks for asking in . Ortho TRI cycle contains same amount of estrogen in all 21 pills but varying doses of progesterone for every 7 tab (so called TRI cycle). For effective action, OCP should be taken at the same time every day. If you miss one pill, you should take two pills the next day at the usual time. If you miss more than 2 pills as in your case, you should discontinue the pack, go in for some other alternative method and start the next pack after you get regular period. The last 7 pills contain more amount of progesterone. So, the reason for your delayed period may either be due to increased level of progesterone or may be failure of contraceptive protection, and it is too early to come to any conclusion now. So, wait for a week and still if you don't get with . I hope this is useful to you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a fever and diarrhea few days ago. WBC level was 12.12 and NEU 9.63 on last 17th. dengue virus NSI Antigen- Negative. Doctor said it is a bacteria infection. on 19th my stomach pain was still there. WBC level was 7.93. and NEU 4.42. did a ultra sound scan of abdomen and the result was liver is enlarged & extends 3cm below the costal margin. comment was diffuse fatty infiltration of the liver( grade 2). doctor asked me to do more exercises and asked me to stop having oily foods. am non alcoholic person and always try to have healthy foods . more like vegetarian .I am female and 31 years old. height 5 6 . weight 59 kg. I don t know what to do and really confused.please help me.Thank you ### REPLY: Hello ma'am I appreciate your concern grade 2 fatty liver can be reverted to normal, so you should be worried but not too much in my opinion you should get your blood test for liver enzymes and bilirubin for assessment of liver function would advise you to follow these guidelines1. Avoid fatty fried and junk food 2. Have plenty of diary fibers and fresh fruits 3. Regular physical exercises like jogging and aerobics4. Avoid all kind of medicines5 you can ask your doctor for certain ayurvedic preparation like Liv 52 or other liver tonics hope this answers your question best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 30 years old i had miscarriage one year back i m trying to concieve from last 10 months still no sucess .my present endometrium line is measured at 6mm on day 13th and ultrasound shows dominat follicle in left ovary one of 2.2mm size and another of 1.5mm size is this normal to concieve ? ### REPLY: Hi for conception to occur the dominant follicle should reach a size of 18 to 20 mm. Just see our ultrasound report carefully is the size of your follicles mentioned in mm or cm. Your ET is 6 mm which is normal. If your follicular measurements are in cm then it is the right follicular size and conception is very much possible. If it is 18 to 20 mm you can take an in of  5000 units to make the follicle rupture and have daily intercourse for 5 days. All the best 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: Good day,sirMy wife is suffering  with typhoid fever at 99-99.5 degree for the last 1 month.he is taking medicines, but no recovery. temprature does not go to 98.4 from 99-99.5. doctor has not given any tablet for temprature like crocin.he said fever is due to infection.pl advice. ### REPLY: Hello, Welcome o , As your wife is having fever for last one month it may be a fever of unknown origin (DUO) which should be thoroughly evaluated to find out the causes for the fever. As she is having for last one month all the relevant investigations should be done to rule out the cause of fever. As your doctor has prescribed paracetamol to reduce the fever, this .  The source of infection should be found out by the investigations. To confirm it has typhoid after having fever for last one month your wife should undergo stool and urine culture to confirm it. There are many conditions which can lead to fever of more than one month which should be evaluated thoroughly. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I am 24 year old male. I have a problem of frequent urination. Everyday I go to restroom 12-15 times. I drink 5-6 glasses of water everyday. Most of time Im afraid to drink more water thinking that might lead to even more frequent trip to the restroom.   Is it normal to urinate that frequently? Thanks so much in advance. ### REPLY: Hey. Welcome to . Well, urinating 12-15 times a day is definitely not normal. In my opinion you should get few tests done like RANDOM BLOOD SUGAR levels, COMPLETE URINE EXAMINATION. If your Random blood sugar levels are elevated, then confirm it by getting FASTING BLOOD SUGAR and PPBS tests done to rule out Diabetes. And . Hope I have answered your question. If you have any questions, then I will be happy to answer it. Take care. 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: Had copper coil fitted 3 months ago. Between periods I have a pink/brown creamy discharge , particularly when I m ovulating. It has a slightly unpleasant odour. I took prophylactic antibiotics when it was inserted and had not had sex since. This discharge is a contraceptive in itself. Will it stop? Or shall I have it removed? ### REPLY: NamastheWelcome to ChatDoctorGreetings of the day either the discharge is contraceptive related, or it could also occur at time of ovulation. If the discharge is very minimal and not associated with pain in abdomen or fever, it should subside over period of time. There is no cause for concern. In case you need any further assistance, will be glad to assist you. Wishing you happy and healthy lifetime Care Best Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I hit the front of my shin on a brick wall a little over a month ago, after I had hit it there was a little reddening and swelling. Now the red is gone and it is back to normal. The small area that was hit is still swollen. It is about the aize of a quarter and probably is swollen up about 3mm. it feels hard to the touch, but can still be pressed (but the pressing hurts a lot). Is this normal? Will it heal on it s own, even though it has been so long? ### REPLY: I there, thanks for your question at . The swelling and the pain will reduce gradually over 5 to 7 days. Rest, Ice and bandage application with limb elevation on two pillows accelerates the process of healing over fort 2 to 3 days. I would ask you to follow these four things. However, by third day you should experience considerable pain relief and should be able to walk with mild pain. If you are still not able to stand or walk after at all, I think it's appropriate for you to meet your physician and let him or her see it in person. Hope this helps. All the best. Regards. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: someone I know has just noticed blood in her urine, her symptoms are also diarrhoea, occasional vomiting, and pains in lower abdomen, she has a medical history of abnormal cells being removed twice in her cervix and she hasn t gone for a smear in 3 years. She s just recently had a urine test done and nothing has shown, she won t go back for more tests and I m worried. Is this serious? ### REPLY: Hi. Noted the history you have posted for someone else. The history of blood in urine, diarrhea, vomiting with pain in lower abdomen with past problem of abnormal cells from cervix noted. 3 years is a long time and this may be one of the reasons which may be a cancer of the cervix causing all the problems. I would advise her in such a situation the following:Check up by a Gynecologist CT scan of the whole abdomenPlan for the treatment as per the findings. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 vertigo three times within the last 10 days. The last episode two days ago. I have a bad cold that has been ongoing for a week now. I have coughing spells. No fever, no chills but I lost my voice. It is very raspy. My chest is tight but does not hurt with no noises that I can hear. My cough is kind of dry. I am 51 yr old female. In good health other than this cold. ### REPLY: Hello! Thank you for asking on ! In my opinion your symptoms are related to an upper respiratory tract infection with impairment of the inner ear. This could explain the dizzy spells. For this reason, I recommend consulting with your GP for a careful physical exam and some tests: - a chest X-Ray study- a sinus X-Ray study for sinus infection-complete blood count, PCR, ESR for inflammation. Meanwhile, I recommend taking some rest and take plenty of water. If your symptoms do not improve, it will be necessary to consult with an ENT specialist to exclude an inner ear disorder (as a complication of the upper respiratory tract infection). Hope to have been helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For the past six months Ive had three trans-vaginal ultrasounds for an ovarian cysts. It started put at six cms, then went down to 2 cms and now it is 3.5 cms. The first ultrasound was suspicious for ovarian cancer, but now they say is a simple cyst. What should I do? ### REPLY: Hi, Thanks for writing in. If an ovarian cyst is continuously decreasing in size then malignancy is unlikely. A cyst measuring more than 3 cm requires regular monitoring. I guess that in the first ultrasound, the cyst was measuring 6 cm and had no features other than its size to suspect malignancy. It is a regular protocol to repeat ultrasound in 2 to 3 months before doing cancer specific tests. I agree that in the second ultrasound, the cyst reduced to 2 cm which is a good response. You have not mentioned any treatment you were taking at that time and I guess you were taking treatment and therefore there was a response. This sort of treatment response occurs when there might be any hormonal imbalances causing the cyst and correcting it leads to decrease in the cyst size. In the third ultrasound, it is possible that the hormonal balance again got altered and therefore the cyst increased. However, to put at rest any suspicion of malignancy I recommend you to get a CA 125 level test done to confirm that your cyst is not at risk or a malignancy. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...My dad has gone to a surgery for prostate cance.and his both the testicles was removed.checked psa after 1 month it is showing 29.96 and border range is 4.10 and the doctor has suggested urodynamic test.can u answer will it can be treated. ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  It may be due to recurrence or residual prostate cancer or some other cause.  You should go for aerodynamic tests and ultrasound abdomen.  Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr.Jain, How are you,i would wish to know the solution for the problems which am undergoing that its going to be 2 years since have got married am planning for a family but am unable to conceive because of irregular periods and polycyctic ovaries due to which follicles are not growing.i tried Homeopathy and other english medicines to make the follicles grow but in vain.And the doctor where am consulting says that i need to do laproscopy but am really scared of that.More over am working and 26 years old i feel not to undergo such treatment as am very scared for which it causes too much of pain.So i would like to kn by any chance will i get conceived soon without such treatments.Please advise.That will be a great help. ### REPLY: Hi, I have gone through your question and understand your concerns. Polycystic ovaries and irregular periods is suggestive of the fact that you are having polycystic ovarian disease. Conception is difficult in PCs as there is irregular or no ovulation, hence no conception. The line of management in PCs is stepwise, the next step to be done when the previous step fails:1. Ovulation induction with .  Intrauterine insemination3. In vitro fertilizationThere is no role of laparoscopy in the treatment if PCs is confirmed and bilateral fallopian tubes are patent. I would suggest you and your partner to consult an infertility specialist and get properly examined, investigated and treated accordingly. Hope you found the answer helpful. 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: I m 19 years old and my last period was on the 11th of April. I ve since not had a period yet. Whilst I have had sex twice in the past month, both times a condom was used and in the first, no ejaculation occurred. I ve done pregnancy tests on the 16th, 17th and 23rd of May which have all been negative. I also received the HPV vaccine last month. I ve been feeling bloated and my face has broken out. Firstly, is there any possibility I could be pregnant and if not, could Gardasil be the cause of this? Thank-you in advance. ### REPLY: Hallow Dear, Since on both the occasions your partner had worn condom and there was no ejaculation, you do not stand the risk of pregnancy. Moreover, your three tests for detecting pregnancy have confirmed that you are not pregnant. Yes, Ardabil (human papillomavirus (HPV) vaccine) is not free from the side effects. Facial swelling, bloating, etc. are reported side effects of the vaccine. The reaction may delay your menses.  If they are causing much discomfort, please report to your Gynecologist or Physician. Depending upon the severity, you may have to get some anti-allergic medicines, since these are the symptoms of allergic reaction to the vaccine. I hope this helps you.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently had a cervical fusion (C5-C7)  the surgery was 9 weeks ago  I am in more pain than before the surgery.  the pain radiates from the right side of my neck down the shoulder into my arm. The pain is throbbing and stabbing and almost constant. they discontinued my physical therapy after 1 day.  The doctor says its inflammation so he gave me a Medrol pack and it didnt do anything  I am taking 1 Norco every 4 hours.  Sometimes it helps but not always.  Please help me to understand why I still am in so much pain. ### REPLY: Hi, Thank you for posting your query. It is unfortunate that you still have nerve pain, about 9 weeks after the surgery. It is not usual to have pain for so long after surgery. Inflammation may be one of the causes, however, lack of adequate nerve decompression could be another cause for your symptoms. For pain relief, you may take pregabalin or gabapentin capsules. Physiotherapy may be re-started, especially IT/ultrasound and traction. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been getting like tooth aches off and on and cant pin point what tooth or what is happening.Had xrays taken and cant see any thing.IT GOES AWAY AFTER I TAKE MY HYDRACODONE.I  TAKE 0.125MG OF Digoxin and 25 Mg OF ATENOLOL ONCE A DAY FOR IRREGULAR HEARTBEAT Tachacardia BRADYCARDIA AND A FIB.ITS LIKE A TOOTH ACHE BUT ALL MY BOTTOM TEETH ARE SENSITIVE AND CANT SAY ITS A TOOTHACE BOTTOM LEFT ONLY BOTHER ME..iT STARTS IF IM GOING TO HAVE A PROBLEM A FEW MINUTES AFTER I TAKE PILLS.iT DOESN"T HAPPEN ALL THE TIME.bEEN TAKING THIS FOR ABOUT 6 MONTHSi goes away.other than that no problem ### REPLY: Hi. Thanks for the query. Well, the medicines that you are taking are not commonly seen to cause toothache, however pain in teeth that is not generalized can be either due to generalized gum infection or nerve related problem. So my suggestion is to consult an Oral Physician and get checked. A full mouth x-ray can be done for further confirmation. In case if there is gum infection then a deep scaling and a course of antibiotics like Metronidazole can be advised for relief. Hope this helps. ### END