Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I got hit with a large desk about 2 months ago right above my ankle bone. It swelled a bit and bruised, now there is nothing but a fairly large bump. Still quite tender when pushed on, but not when walking or running. Wonder if that is usual that it can still be so tender after that long or if I should go in to have it x-rayed ### REPLY: Hi, thank you for providing the brief history of you. A thorough musculoskeletal assessment is advised. As the lump is not painful you do not need to worry much. If it is restricting your functional ability you shouldn't be worried much as it is just a skin tissue.Also, if you wish to get assessed than an x-ray will be of guidance but not so sure if it can show anything. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 29 years old. 2 days backI kept detol soaked cotton over night on pimple. My cheek burnt with a big dark cicircular burn mark. The burn is dry and smooth. In morning I treated it immediately with aloe vera and massage almond oil at night. Will this mark disappear? Do I need to consult doc? Pls suggest some medicine to be applied for getting rid of  burn mark. ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern if the burn mark is superficial then chances of vanishing of this mark is very likely without any medicine if the burn is little deep then this would take little more time to vanish, but no medicine is there that could immediately vanish this mark, neither try any this for this, otherwise this could worsen the condition, take care and have nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here..I have pains,& like lumps below my navel.I suffer wid pressure at times,feel weak&dizzy,feet pains,headaches.I also had a ceasure when I gave birth,this is really begining to worry me.please can I get help ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have either hernia or some soft tissue tumor like dermatofibroma or other mass.  You should go for ultrasound study.  If it is hernia then it needs meshplasty. If it is soft tissue tumor then you should go for fine needle aspiration cytology or biopsy of that lump. Then go for surgical excision. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has had open heart surgery about 6 yrs ago and the doctor was only able to do 2 bypasses even though he wanted to do 4. He used the artery from his arm for the bypass instead of the leg where the vein is usually taken and used for a bypass surgery. The bypass colapsed in the back of the heart where one of the bypasses was done, the other bypass was an artery connected at  the front from his lung. He has now had 5 stents in the back part of the heart where the bypass colasped and was told he was not a candidate for open heart again. What will happen when they cant reopen the stent in the back of his heart. Is there anything that  can be done? ### REPLY: If the stent becomes occluded then he will have a heart attack. Heart attacks are caused by ischemia to the heart muscle. The goal is to prevent the ischemia to the heart muscle. You need to optimize your medical treatment now before the ischemia becomes worse. He should take aspirin daily and all the medications that have been prescribed by the cardiologist and or cardiovascular surgeon.  He should also exercise daily and eat a diet that is high and fruits, vegetables, whole grains, and omega fatty acids. He should avoid red meats and foods that are high in cholesterol. You should also try to avoid fatty foods. He should not eat any fast food at all. He should also avoid alcohol and tobacco. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 33 yr old female, noticed a lump at base of skull, back of neck one year ago. At that time it was about the size of a grape and kind of lumpy. Now, it is hard as a rock and the size of a golf ball. I notice it more when head is tilted up. I get severe headaches, 2weeks straight now. Feels like my head and neck is FULL , pressure. I am concerned because I was told it could be a lipoma about a year ago and to keep an eye on it. But, I am worried because it is getting larger and tender. My neck also feels stiff. Is this something I should be concerned about? ### REPLY: Hi! Good morning. I am  answering your query. Even though it seems to be a benign condition due to its slow growth, if I were your doctor, I would go for a CT scan/MRI of the head and neck area to rule out any possibility of the lesion communicating with the inside of skull however remote might be the chances. Further management would depend on the report of the radiological investigation and a physical examination of the lesion. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Back at the end of may this yeaar I was involved in a wreck and suffered a concussuion. I was in the hospoital for a month when released I experience unstability, some memory loss loss of balanace, stumbling and uncomfortableness walking. Worrying that I wouldnt improve. I hav also had a difficult tie typing. I guess it is confussion. I was told that I will recover. DO you have any advice or thought ought of how long it could be before i recover even to close to my former self. Particularly my balance I love to walk and ride bicycles and and am concerned about that. Thank you. Sorry about the long email ### REPLY: Hi there the symptoms you are experience are very normal after a concussion, Being a Neurosurgery resident I have a number of cases like these, but they resolve completely in 4-12 weeks depending on the size of your concussion.Don't stress out by trying to overcome these symptoms. They will resolve over time. But just in case I would advise an MRI brain just to be sure. Take a good diet and take some multivitamins they will help reduce the recovery time hope that answers IOUs question 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 hav gallstone /polyp 15*12mm since 7 months without pain or any other symptoms & 4mm sized kidney stone in the midpole of kidney. It s not mobile stone.Both can t dissolved by ayurvedic or homeopatChatDoctoredicine .stone.I have like gout problem also. I am so depressed . Please suggest me about the proper treatment .Please please . ### REPLY: Hi, In most cases, treatment of gallstones is considered necessary only if you are having symptoms.  Of the various conventional treatments that are available, surgical removal of the gallbladder is the most widely used.  Some alternative treatments have also been found to be effective in alleviating the symptoms of troublesome gallstones. When deciding what course of action to take for symptomatic gallstones, doctors usually choose from among three main treatment options: Watchful waiting, nonsurgical therapy, and surgical removal of the gallbladder. Though a gallstone episode can be extremely painful or frightening, almost a third to half of all people who experience an attack never have a recurrence.  In some cases, the stone dissolves or becomes dislodged and thereby resumes its "silence." Because the problem may solve itself without intervention, many doctors take a wait-and-see approach following the initial episode. Hope I have answered your query. Let me know if I can assist you further. Take care .  Rammstein, General Surgeon ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: SIR IM 42YRS OLD,I HV STONE PROBLEM & acidity problem. already i remove the stone from my stomach,yesterday i feel a large pain in my stomach & consult doctor but after ultrasound doctor said  now there is no problem of stone.and there is small like 3mm to 4mm stones are there.so my pain is causes due to stone or acidity & please tell me the precatuion also.. ### REPLY: Hi & Welcome. You seem to have small stones of varying sizes 3-4 mm. Usually such stones do not cause any problem unless there is urinary obstruction or infection in the urinary tract. Precautions to prevent the stone formation: . As far as your acidity is concerned you may take proton pump inhibitor like Pantoprazole once daily, one hour before breakfast for at least 4 weeks from your doctor. Precautions to prevent the stomach acidity issues like:1. Avoid smoking, alcohol, stress, fatty vegan and non-vegan meals.2. Take small portion meals preferably home cooked food, increase the intake of fruits and vegetables.3. Do regular exercise and try to reduce your body weight (if overweight).4. Don't sleep immediately after having meals, sleep 2-3 hrs after the meals. Hope the suggestions given above would be useful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 diagnosed with Anti Musk Antibody Myasthenia Gravis in September and twice (the last being Saturday) I woke with severe pain in the middle of my chest and back. It was hard to breathe because it hurt so much. It did ease off and I now have a dull pain. ### REPLY: Hello! Welcome and thank you for asking on ! Regarding your concern, I would explain that it is important performing a comprehensive differential diagnosis between different possible causes that may lead to such symptoms: - a lung disorder- musculoskeletal pain- a Tacoma (considering your positive antibodies)- a heart disorder-esophageal spasms, etc.  For this reason, I recommend consulting as soon as possible with your attending physician and performing some tests: - a chest X-ray study and pulmonary function tests- a resting ECG and a cardiac ultrasound-complete blood count, PCR, ESR for inflammation- D dimmer levels for possible pulmonary embolism. A chest X-ray study would help investigate for the presence of Tacoma. Hope you will find this answer 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: my daughter is guilt - She is 13 years oldridden and can t stop her thoughts and fanticies.She tells me everything,even when she remembers something she did months or years before. she is in tears 10 times a day, she feels so sad and bad . I have reassured her and tried to lift her up, but have so far been unable to break through. Help! She is 13 years old, plays basketball, and is on the honor roll at her Catholic school. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. From the given symptoms, it is difficult to diagnose. It may feel like depression. But the age of your daughter is also factor. She has attained the puberty age period and depression related to that age group and developmental pattern is normal. Recalling all those past events and crying is pointing towards that possibility. Thoughts and fantasies are also part of adolescent age group. In all it seems to be a developmental problem coupled with age of adolescent. Don't worry. You may talk to her in details and if need be, consult a psychologist. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i m 39 years of age from Asian subcontinent.my doctor subscribe symbicort turbuhaler 160/4.5 1 dose twice a day on the bases of my Chest X-ray which says a) Hyperinflated chest with bilateral increased bronchovascular markings b) No hilar or mediastinal adenopathy c) cardiac shadow is within normal limit of size and configuration while PFT test shows FVC 3.26 (%Pred=87) , FEV1 2.92 (%93) , FEV1/FVC 89.9 (%107).so am eager to know whether i have abstractive or restrictive lung disease and do i need to use symbicort turbuhaler (Budesonide/formoterol) or just physical exercise will b enough.My background history is that i have high blood presure, fast heart beats (heart specialist said i have no cardiac problem just minor cholesterol in my blood. some time i head pain in my left side under arm and also once or twice in a week i feel hard in breathing im 39 years of age 168cm tale and 55kg weight.i will really appreciate for your advice guys thanks ### REPLY: Respected user, HiT hanks for using .come have evaluated your query thoroughly.* After studying your reports and case, there seems decreased lung compliance to marginal extent.* Suggestions for better outcomes - No need to use inhaler at present.- Maintain graph of your symptoms on daily basis after doing following * Daily deep breathing exercises, YOGA for 45 minutes.  * Regular walking in fresh air for 30 minutes.  * Balanced nutritious diet with plenty of liquids.  * Avoid smoking, alcohol.  * Regular sound sleep of 8 hrs.  * Avoid stress, anxiety.  * Spirometry exercises will make your lungs more strong along with giving chart of progress on daily basis. Hope this helps you. Advisable to follow up after 2 weeks. Wishing you fine recovery. Regards dear. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 suffered from Potts disease at D12 and L1 level 4 years back. Howvere it got cured after a period of 2 years. Now a month back i started doing cardio and picked up weights upto 10kgs. Now my back is again paining and i feel less sensation in distal part of right leg. Nolw i have left the Gym .. i went for an X-ray but it was O.K. Now should i just take rest ? ### REPLY: Hello, Thanks for your query. After going through your query I came to know that you are suffering from chronic backache. It may be due to weakness of muscles and bone and vitamin and trace element deficiencies specially vitamin D and vitamin B 12. Your old pottdisease made your back slightly weak. Back exercises, Cartilage D once daily, NURSING GOLD ONCE DAILY and analgesics (DICLOFENAC 100 MG SLOW RELEASE TABLETS) give relief. Sometimes vitamin D deficiency can aggravate this so serum vitamin D test is advised if it is lower than vitamin D supplementation will be required. Avoid long continuous standing. Sit in a straight posture. Eat milk, fruits and green leafy vegetables daily. You need to do MRI TO RULE OUT other causes. You can discuss with your treating Doctor about it. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i wana ask for my fertility issue. i took clomid last month n results are multiple tiny follicles were in right ovary and 1.0x0.7 size of a single follicle in left ovary. am i normal or do i have fertility problem? n what u would suggest me to do if i have. thanks ### REPLY: Hi, Thanks for writing to . Your scan report suggests you have polycystic ovary disease (PCs). It can cause infertility by affecting ovulation. If you are ovulating with closed then I suggest you to go for GUI after getting tubal patency done.  GUI is intrauterine ingestion of sperms.  Here sperms are washed and processed and placed in uterus.  This will increase chances of conception.  If you are not ovulating with closed then you should discuss with your doctor regarding addition of FSH injection along with closed.  FSH help in ovulation.  After rupture, you can get GUI done.  Hope I have been helpful. 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 19 weeks pregnant and had a colposcopy last Wednesday. I now have swelling and what feels like pressure around the outside of my vagina. I spoke with a nurse earlier who thought it was irritation from medicine used to stop bleeding during the colposcopy. I ve noticed an odor now, and am wondering if I should go to the ER or if I would be OK to wait and see my doctor tomorrow morning. ### REPLY: Hi. You can wait and see your doctor tomorrow morning, this is not an emergency, and we should also be considerate to the medical staff working at the ER, by not troubling them with cases that are not urgent. The odor could be related to the healing process, but could also be related to infection if the procedure was not conducted well enough. Speak to your doctor about it when you meet him/her tomorrow. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have been vomiting for 1 week and my blood pressure is 143/93 when it usually runs 110/60. I have been short of breath at times and feeling a stinging feeling in my heart. This just came on suddenly. What does all those symptoms mean? ### REPLY: Hello, I would explain that your symptoms could be related to a viral infection (gastroenteritis).  The high blood pressure could be related to stress.  Anyway, I recommend going to the ER for a physical exam and some tests: - a resting ECG - blood electrolytes- complete blood count, PCR, ESR for inflammation- kidney and liver function tests.  In the meantime, I would recommend taking a PPI (omeprazole, pantoprazole) and an antiemetic .  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 am 5 foot 9 1/2 in. and weigh 190.  i have been taking limictol for several years and vyvance for the last year.  im feeling great and concentrating well.  i recently signed up for a scuba class.  Is there any problems with taking these meds while diving? ### REPLY: Hi, thanks for the query. Brief answer NO. Both these medications Aborigine & lisdexamfetamine combination prescribed for you for whatever set of medications are not known to cause any significant side effect of such an extent to prevent you from doing scuba diving. But to be on safer side; get a general health check up done to evaluate whether you do not suffer from any middle ear condition or breathing problem which may act as potential contraindication for this adventure sport! Wish you well & All the best! Good Luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been prescribed Lyrica 75mg caps for Spondlytis at the age of 83 years 1 twice a day.  I have had Heart By-passes, but am experiencing considerable stomach, bladder and bowel problems which have existed for some time. It has been recommended I have an operation to correct the daily nerve pain.  My husband has Dementia and I feel an operation of this kind would only cause considerable problems for both of us at home.  I need to be on my feet to handle daily needs for him, without occasionally bringing in a carer?  Any great side affects with Lyrica? ### REPLY: Lyrics is rightly suggested by your doctor as it helps in neuropathic pains and also helps in dementia, anxiety states. It can be taken long term and relieve the symptoms. Usually physicians will start the patient on a low dose of pregabalin(lyrics) and increase it gradually, depending on the patients' evaluation. Its therapeutic effect appears after 1 week of use It is rapidly absorbed when administered on an empty stomachLyrica 75 mg daily is low dosage to begin with and may be gradually increased side effects, if there is some fresh symptom developing after taking it for 7 days, report to your doctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lump under skin upper inner thigh. Not red color. size marble. 48 yrs old female. granulomatous chest disease. had substernal thyroidoctomy 5 yrs ago goiter large. Have pain in right leg like nerve or circulation problems. fatique and smoker and depressed. not a boil. lymph node more likely. was small and in 1 month its larger. ### REPLY: I welcome you to  I am , General Surgeon and I will be ad .  I appear to be lipoma, which is a collection of fat under the skin. Simple tests like it is mobile, skin can be pinched over it, helps in diagnosis. However, you need to go to general surgeon, who after examination will establish his diagnosis. Treatment of this simple condition is excision under local anesthesia. Other differential diagnosis can be sebaceous cyst, some muscular growth or hematoma etc. In difficult cases Ultrasonography of the lump can lead us to diagnoses. Wishing you all the best and rapid recovery. I hope my answer will help you. Do rate my answer if you like it. 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: Hello. I have mild scoliosis in 2 parts of my back that was just diagnosed and I am age 49 (done bearing children and have had a hysterectomy). My dr. has me on 4 tabs of (300/30) Tylenol 3 1 time a day. I also have back spasms. The tylenol 3 does not seem to work and I have to take more and more and I am concerned b/c of the high dose of tylenol. I used to take Vicodin and I would take 1-2 a day and I was fine. Am I stepping backward by asking my dr. to prescribe me less of a higher dose vs. more of a lesser dose of pain med. I have tried tramadol, meloxicam, you name it. The codeine is really what seems to make the difference so that I can get through the day without being in terrible pain and having to stop and put on heating pad for an hour. Any recommendations of a pain reliever that has codeine but you don t have to take in super high doses and doesn t contain dangerous amounts of tylenol? ### REPLY: Hi. For back spasms I suggest a muscle relaxant for example Flexion MRT answer your specific question u can take Canada.However, I should warn you u should not take it for more than 3 days continuously as it can cause addictionsAlso since Flexion MR does have PCM don't take the 2 together. If Flexion is unavailable try LoraineSuggested dosage:1 tab of Flexion MR in the morning1 tab of Canada at night ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 slipped on a wet floor today and twisted my right ankle, at first I felt dizzy, then when i was able, i walked inside the house and rested, but as I felt better i continued to walk on it. Later the ankle, top lateral part started to swell and ache as I walked on it. Now I think its worse than before. i am wondering if i hurt it more by not icing sooner. ### REPLY: Hello, I think you had a bad ankle sprain. Since you are able to walk and bear weight this will decrease the chance for fracture, but only x-ray will rule out. I think you should rest for the next 48 hours, ice it every 15 minutes, keep the leg elevated above the heart level and wrap it with elastic bandage. After 2 days you can start to walk and bear weight as pain allows. If x-ray shows no fracture then is an ankle sprain and will need physical therapy after the second week when the swelling goes away. 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: Had some irregular hearbeats and dull ache in middle of chest. Had ekg done and blood pressure check and all was good. Few day later get the dull ache again. Seems like thats all I can think about. Should I go to er or wait and check with family doctor? ### REPLY: Hello! Welcome and thank you for asking on ! Regarding your concern, I would recommend performing further tests to investigate for the possible cause of your symptoms: - an ambulatory 24-48 hours ECG monitoring is necessary to examine your heart rhythm trends during the day.- a cardiac stress tests is needed to exclude possible coronary artery disease which could lead to chest pain - a chest X-ray study to exclude possible lung disease- a fibrogastroscopy to exclude possible gastroesophageal reflux or gastritis, which could also be the cause of chest pain. Hope to have been helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have severe pain in my wisdom teeth top and bottom left side,i havent had any sleep for 2 days and im 6 months pregnant, everything i try doesnt seem to work, parecetomol, salty water, cold compress. i saw my dentist last week and she said it was my wisdom teetChatDoctoring through but this feels like more, the pain is going into my ear and head. im going back tomorrow but my dentist said she wouldnt be able to numb my gums as i am pregnant is this correct? ### REPLY: Thanks for using . Read your query. Tooth pain during the pregnancy condition is to be managed as and when the symptoms arise as most of the medications are not to prescribed during this time. I would advise you to continue with paracetamol and salt water gargling. Visit your dentist and get an appropriate antibiotic prescribed based on the condition if required. Dental procedures are using postponed during the pregnancy, and then later on you can have the tooth extracted if needed. Hope this was helpful. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have cramping/pain off and on on my left side -- halfway up my chest, under rib.   Ive had a bad cough for some time and when I cough hard it hurts, but sometimes I feel it when I dont cough.  Just wondering if it is something to be concerned with -- ### REPLY: Thanks for your question on . I can understand your situation and problem. Chest pain on coughing is classical sign of pleurisy (inflammation of pleura). And common causes for pleurisy are pneumonia, pleural effusion, tuberculosis etc. You are also having chronic bad cough. So better to first rule out all these conditions. So get done chest x-ray first. If this is normal than no need to worry about all these causes. You are mostly having musculoskeletal pain. So avoid strenuous exercise and heavyweight lifting. Avoid bad postures in sleep. Avoid movements causing pain. Start painkiller and muscle relaxant .  Apply warm water pad on affected areas. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: a 49yr.oldnman with no personal or family history of chd, and who is not hypertensive does not smoke. results: TCHOL=260mg/dL TAG=505mg/dL HDL=25mg/dL FBS=134mg/dL what is the LDL value using the friedwald and de long calculations? does the patient have a risk factor for CHD? enumerate them and explain why is it safe to report the derived value? why ### REPLY: Hayes the patient is at risk factor for CHD, his TG and total cholesterol levels are elevated, dyslipidemia is a very important factor for coronary artery diseaseCalculating LDL value using equations is an obsolete process and there are many chances of error hence it's not used these days, but as per your question val;UE of LDL is 140 mg/DL according to equation. Get a LDL cholesterol level done the patient should start taking statins for 3 months along with lifestyle modifications. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had my breakfast this morning, lunch at lunch time then a snack...about 20mins ago I got bad tummy cramps , sicky feeling, shakes and blurred vision . I get this feeling often, it usually feels like I m about to pass out but if I dive for the chocolate/lucozade quick enough it usually passes off within 10minutes. It s clearly not hunger as I m eating plenty. I have noticed that recently I m not sleeping as well I should be; I struggle to sleep but once I m asleep I can t get up..I have to set 5 alarms in the morning for work and am late regularly. It s all just stressing me out. What s up with me? ### REPLY: Hi there ~ symptoms such as yours i.e. eating something and subsequently having cramps, having a sickly feel, shakiness and blurred vision seem to me like they are related to a gastrointestinal condition.  Feeling of passing out or passing out after food also needs medical attention.  I suggest that you see a gastrointestinal (GI) physician.  However, if it is stress, and you need to elaborate on the kind of stress please feel free to do so here, I may have answers for you.  Alternatively, speak with a psychiatrist or psychologist about your stressors.  I hope this helps.  Take care and have a good day ! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is having this in his blood report and also detected as high pP(255) and fasting(189). Please tell is there any liver disease ALKALINE PHOSPHATASE PHOTOMETRY 162.3 U/l BILIRUBIN - TOTAL PHOTOMETRY 0.45 mg/dl BILIRUBIN -DIRECT PHOTOMETRY 0.14 mg/dl 0 - 0.3 BILIRUBIN (INDIRECT) CALCULATED 0.31 mg/dl 0 - 0.9 GAMMA GLUTAMYL TRANSFERASE (GGT) PHOTOMETRY 211.5 U/l M: 0 to 50 - F :0 to 30 PROTEIN - TOTAL PHOTOMETRY 7.99 gm/dl 6.0 - 8.3 ALBUMIN - SERUM PHOTOMETRY 4.39 gm/dl 3.2 - 5.0 SERUM ALBUMIN/GLOBULIN RATIO CALCULATED 1.22 Ratio 0.9 - 2.0 ASPARTATE AMINOTRANSFERASE (SGOT ) PHOTOMETRY 70.7 U/l M: 0 to 37 - F: 0 to 31 ALANINE TRANSAMINASE (SGPT) PHOTOMETRY 161.5 U/l M: 0 to 37 - F: 0 to 31 ### REPLY: His blood tests show elevation of liver enzymes, which requires further evaluation if he has no know history of liver problems. He should get at least an abdominal ultrasound and a few more specialized blood tests to look for causes of abnormal liver enzymes. Alcohol is the number one cause of liver problems, but there are other problems that can be diagnosed by blood tests (such as hepatitis b, hepatitis C, autoimmune liver disease, medications, etc.). He needs follow up with a liver specialist or gastroenterologist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 25 year old male who has had a stich like aching pain one inch below my breast bone and two and half inches over about an inch below my rib cage on the right side for about six weeks. This pain started above my belly button and has since left and came back again and seemed to move all about a general are. What is so confusing about all of this is the different pains I am having. My ribs themselves hurt if I press on them they feel like they are bruised all over. My right side pain under my rib cage feels like its radiating around to my back. If I press on the area around my belly button it is sore. My right shoulder also has seemed to be sore the last week. I take medication that regularly makes me constipated during the day but the constipation has since gotten worse in the past two or three weeks. I had a spasm like episode in the exact localized spot im having pain about six weeks ago. It lasted for about 90 seconds. I had gotten into an argument and was very stressed but also had just eaten a VERY GREASY cheeseburger and drank 2 beers about 30 mins earlier ( I stopped drinking besides a beer or two every couple months in 2011) Any ideas what is happening to me?! Please help! ### REPLY: Hi, Thanks for your query. The pain at the bottom center of the rib cage could be due to a renal infection or a stone if the pain does not seem to be muscular in nature. This can be ruled out after getting an ultrasound scan done. If the pain is aggravated with deep breathing or coughing then a rib injury or a muscular sprain is likely. The other causes that need to be ruled out include lung infections like pleuritic. Stopping smoking might help in reducing the symptoms do hope that you have found something helpful, and I will be glad to answer any further 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: Doctors found 1.5 cm enhancing isointense T1 hyperintense T2 focus in the left temporal calvarium immediately cephalad to the left mastoid. This said it may reflect incidental left temporal calvarial hemangioma. Could this cause me to over heat very easily? ### REPLY: HiT hanks for askingBased on your query and findings my opinion is1. You're presenting complaint of getting heated up is not related to the hematoma.2. Hematoma is proliferation of capillaries/ veins and are known to cause hemorrhage if ruptured.3. They do not produce any cytokines (chemical substances).4. A sensation of heat or warmness is generally caused by cytokines and or vascular dilatation but not by hematomas. Hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...I have a skin infection, kind of rashes around my anus,groin & under the penis..the skin texture & colour has changed..it burns at times..has white erosions as well at times..??Please help ### REPLY: Hello, A penile rash is the presence of spots or sores on the penis and possibly on other areas of the groin or genitals. It can be accompanied by itching that may be intense, and pain or tenderness.  Related symptoms may include blisters; burning or pain with urination; redness, warmth or swelling; scabbing; and scar tissue. Therefore, I suggest consulting a skin specialist for physical examination, diagnosis and treatment. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell on some ice, smashed my left shin juuuuust below my knee. It doesn t hurt to walk, but if I crouch, I feel a burning pins and needles sensation down the outside of my bone. I also have a numb area to the side of where I hit, and an excruciatingly painful spot/huge dent where I fell. Could I have chipped my bone or done nerve damage? ### REPLY: Hi going by your description, it looks that you have damaged soft tissues just below the knee. In my opinion such smashing of the soft tissues also causes damage to nerves and subsequent sensation of pins and needles along the compressed nerves. Chipped bone will give you lot of pain on walking. The painful spot / dent is there because of collection of blood in the region. Do cold compression, take anti-inflammatory painkillers for few days. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Background: I m male, 56, 5 10 , 255 lbs, type 2 diabetic. I m on 50mg Atenolol at night and 10mg Lisinopril in AM, 1000mg Metformin & 50mg Januvia in AM & again in PM, and normally around 50 units of Lantus around midnight. Yesterday (01-31-2012 Tuesday) I only consumed 140 carbs throughout the day, tested my BSL at 0130 hrs today (Wed.) and found it was 128. Afraid to take my 50 units of Lantus and not knowing if I should adjust my dosage, I injected only 20 units at 0230 hrs. My problem: I could feel my heartbeat pulsing as I tried to get to sleep, so I checked it, twice. It is 162 over 94, pulse 59. I don t feel dizzy or anything like that. My questions are, should I be concerned over my readings? And, is it safe to adjust my Lantus dosage like that? Should I have just skipped my Lantus? And, should I take an extra dose of Atenolol to lower my BP? Mike in NH ### REPLY: Hello, 1) the blood pressure reading are not a panic issue as acutely it would not have caused symptoms. Rather the anxiety that you have not taken the prescribed Bantus and would it hard would have just triggered the symptoms and in itself this may have given a higher blood pressure reading. So an effect rather than a cause2) However with diabetes your blood pressure should be controlled under 140 / 90. So titrate your antihypertensive accordingly 3) Never miss a dose of Bantus insulin, if you have made changes in your diet and discussion about decreasing dose should be done in detail with your doctor. He would plan up a regime based on your cars and calorie intake. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 46year old and am on a Depo shot that started in Feburay of this year 2014. I am about to have m 4th one. I was told I could have light periods until it takes hold anyways on september 19th I did indeed start a period but it was a light one and it ended a week later or it should have it is now October 5th amd I am still expericing a bloody ( brownish) dischatge when I wipe after a pee. any ideas ### REPLY: Hello, Thanks for sharing your health concern with us. Abnormal menstrual pattern is usually observed with hormone contraception until the body adjusts to the altered hormone milieu. Also, weight gain while on the hormones increases the need for higher doses thus creating hormone imbalances and hence, menstrual disturbances. If you do not fit into either pattern, you need further evaluation. Styptics help to control the spotting. Please maintain proper nourishment and good genital hygiene. Please take the help of your health care provider for further management. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is getting terrible leg cramps at night, quads, from the top of the knees to top of the legs....worst than I have seen ever. I bought pure magnesium so he could rub on his body when he has a cramp. also calcium magnesium citrate to take orally. He still gets them...they just come up with a vengeance. ### REPLY: Hellhole Muscle cramps are very common my advice for YouTube plenty of water, fluid intake will dilute toxins. Physiotherapy with ultrasound and Tens will help you, you can do exercises like swimming, riding stationary bicycle, but do not overexert yourself. Take potassium rich diet. Hot and cold fomentation to leg. You need to continue you medication for a couple of month to see effects. Add tab methylcobal 1500 once day. Wishing you good health. Take carhop I have answered your query. I will be available to answer followup queries. If you are satisfied with the answer, please give your review at the end of the discussion. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 am 30 yrs old, married for last 2.4 yrs, trying to conceive since two yrs by now, but not able to do so. Yesterday I went for a HSG test and the report says that there is irrgularity and beading , more marked distally near fimbrial end, suggestive of bilateral tubal block.All my previous reports are quite normal. Like my uterus is normal, ovaries are normal, cervical canal is normal, hormone levels are normal but still infertile. Please suggest. ### REPLY: Hallow Dear, Unless the tubes are patent, there is no chance of natural conception. However, your tubes are not just blocked, there is irregularity and beading in the tubes noted in Hysterosalpingography. This finding is highly suggestive of genital tuberculosis wherein the tubes are affected. Please get yourself investigated from a Gynecologist for genital tuberculosis. Also look for presence of tuberculosis elsewhere in the body, particularly the lungs, by X-ray. Hysteroscopy will help to have a look at the endometrium for similar lesions. Laparoscopy will throw more light on complete pelvic health. If tuberculosis is confirmed, you will have to undergo antitubercular line of treatment. Tuberculosis can definitely be treated completely by treatment under observation; however treatment of tuberculosis is a prolonged treatment and for genital tuberculosis, you may have to take the medicines for at least 9 months. Along with the treatment, healthy high protein and high calcium diet with adequate Vitamins is necessary. Fresh fruits, fresh green leafy vegetables and fresh air to breath help speedy recovery. If tubes are affected by tuberculosis, the chances of natural conception are rather poor since though by surgery the tubal patency is regained, the tubal function is damaged. So after completion of the antitubercular treatment, you may consider Artificial Reproduction Technique for conception and pregnancy. One more suggestion, as per the WHO suggestions and our experience, every case of tuberculosis should be tested for HIV since tuberculosis increases the possibility of HIV infection six-fold; so also HIV increases the possibility of tuberculosis six times. I feel you should concentrate first and more on getting healthy. Then later, attempts for pregnancy may be considered.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 5 year old girl has had a bit of a cold for the past week Yesterday she came down with a fever which is controlled with advil and tylenol, she vomited when she gets the onset of the fever again but that is normal for her. Now she is complaining of a sore tummy even to touch she says it hurts.. What should I do? ### REPLY: Hi.... Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Sore tummy could be due to viral illness as such due to mild gastritis. This is quite common. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has been diagonised with Paranoid Personality Disorder.Please advise the donts  and also a daily regime which will ensure him a healthy life. I would also like to know if this disorder can be fetal in any possible way ?await your reply ..thanks ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Paranoid personality disorder (PPD) is a mental disorder characterized by paranoia and a pervasive, long-standing auspiciousness and generalized mistrust of others. Individuals with this personality disorder may be hypersensitive, easily feel slighted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions that may validate their fears or biases. Paranoid individuals are eager observers. They think they are in danger and look for signs and threats of that danger, potentially not appreciating other evidence. The following can be of use:1. Recognize and accept their own feelings of vulnerability2. Increase their feelings of self-worth3. Develop a more trusting view of others4. Verbalize their distress, rather than use counterproductive strategies such as shunning or intimidating them. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 17 years old. I have major depressive disorder. I get headaches almost everyday (not my eyesight). I am ALWAYS tired. I do have a history of anemia but whenever I get blood tests now my iron level is fine. I also used to have low blood pressure but that is also fine now too. I am taking pristiq (for my depression). Ive been on it for almost a year now. i used to take iron pills and I currently also take birth control to regulate my periods. Recently (for the past month) every time i stand up and start walking I cannot see for a second or so and then i can only see through the centre of my eye for another next few seconds (the perimeter of my vision is black). my eyesight is very unfocused and i get very dizzy everytime i stand up. it focuses and im fine after about 5-7 seconds. Another problem I have (and have been having for years now) is trouble breathing. Every second of the day I feel like something is in my chest and throat blocking my breathing. I take a deep breath every minute or so and that lasts me till the next deep breath. i dont know if that makes sense or is even possible since im still alive but my mum doesnt really take me seriously. however, im constantly having breathing problems, heart aches and my doctor says its because of depression. i literally feel like my throat is blocking air from going in and coming out but i know its obviously not. I am tired all 24 hours of the day and i have no motivation to study for university, no energy and no concentration. whenever i try to concentrate my head hurts (I learnt that after trying a concentration meditation exercise. it just made my head hurt and didnt help my breathing). thanks. sorry for the long message.. ### REPLY: ! I have read your question carefully, and must say that it is very well written. From what you wrote and from my clinical experience, I can say that you have symptoms of lethargy, depression, breathing problems (most probably due to anxiety), visual problems. You used to be anemic but now fine. Now, according to me - you have two sets of problems ---1. Psychological and 2. Organic. The psychological or psychiatric illness looks like combination of anxiety and depression. You have been on desvenalafaxine (prestige) but looking at your symptom profile, I must say that it is not working at all. Had I been treating you, I would have gone for some other . ...there are many better and effective choices available, which also donor carry any major side effect. Second problem is organic / physical problem. It looks like that you have postural hypotension, as you feel almost black out, dizziness occasionally, and weak. Every time you get up, you take few minutes to gain some balance. You need to get some test done like-blood pressure reading both sitting and lying down position, thyroid, hemoglobin.  They would check the cause behind this symptom. Your breathing difficulty and heart aches is actually due to psychiatric problems, as your doctor says. I can understand that you really problem in breathing and you feel choked, but it has a psychological basis rather than physical one. Such breathing problems are frequently seen in such patients in our clinic. With proper medicine this will certainly go away. ### You could not proceed with medication as it needs a silent state of mind, and it is not concentrating on something.....meditation is relaxing....when you have so many issues, you have breathing difficulty, etc., how can you relax? This result in strained meditation and there is headache....ok, so first get better with  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a 2 month old baby and he seems to be really bad colic, he is really gassy and cries all the time, ive tried everything from drops to bottles and suckies to massage to burping more frequently i am wondering if it might be a good idea to change his formula, he is currently on enfamil a+ i want to change him to isomil is this a good idea? ### REPLY: Hello, American Academy of pediatrics (AAP) prohibits the use of soy based formula in infants. Studies have found that 3 compounds found in soy based formulas may be harmful to baby, these are trypsin inhibitors, physic acid, and phytoestrogens. Only some pedestrians in Asian countries prescribe soy based formula in medical conditions like severe lactose intolerance, galactosemia, etc. For gas problems in baby you may use other milk based formulas, . Consult your doctor and ask for stool tests for lactose intolerance or clinical evaluation for cows milk allergy. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my wife has a history of 1 miscarriage and one abortion she is just 22 years. now she has diagnosed with abdominal tuberculosis, and now she is getting fail to conceive , she is taking forcox tab. for last one month is it right. what should  we do for a baby , ### REPLY: Hi Treatment for Tuberculosis is long term and does come with some residual effects but with today's advancement in medicine getting pregnant Post Tuberculosis is very much possible. Your wife will have to take Tab. For cox for about 9 months. After the entire course is complete she can visit a gynecologist who can help her get some scans and blood work up to make sure everything is alright. Planning for a baby after the treatment has been completed will be the best thing to do for both mother and baby. In the meantime It's important to take care of your wives nutrition. She can take some vitamin supplements. I wish your wife a speedy recovery 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: My name is Bonnie. I had my kidney removed 8 months ago because it stopped working. I had problems with the ureter not staying open and had to have stents put in and replaced over and over.  Now I am having pain in the other side in the area of my ureter and having test done. Two days ago I had a double contrast abd. CT and now I feel even worse then before. I feel like I want to puck all the time and Im so tired doing anything is very hard.  I feel like I have the flu and also have some pain in my right kidney. Should I just wait and see what comes of the tests show or should I go back to the ER. But I really think that would be a waste of time. Please help. By the way I also have cardiomyopathy. ### REPLY: Dear Bonnie,First you must get the detail investigations done to know the present status of your remaining kidney. If it is found to be normal to get the treatment for the ureteric problem at the earliest, mostly to overcome the infection or the obstruction and take the best care of your only kidney as advised by your doctor. Unfortunately, if it is nonfunctioning then the best temporary option is to go for dialysis and start mentally preparing yourself for the "Kidney Transplant" as the permanent solution for your problem. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 24 yrs old and its almost 2 yrs for my marraige..and I had ectopic pregnancy in my first year of marraige..where laparoscoy was done successfully..after dat I cudnt conceive until nw...I had d pregnancy course last month but dnt succeed....so my doc suggested me to do hsg test...lookng for right fallopian tube blockage... Wil I conceive through d left tube???should I continue d course for conceivng.????plz guide me..I m very much worried and moreover my husbands job is on shore..he is on vacation for one mnth only.... ### REPLY: HelloThanks for your query. Firstly, you should go for a laparoscopy.HSG is not reliable in diagnosing tubal blockage and type of blockage. Laparoscopy would be diagnostic and therapeutic also, as it can correct some blockages. Moreover, for achieving a pregnancy, you need to cohabit with your husband on a regular basis. After laparoscopy, if tubes are patent, and your husbands' semen analysis is normal, you can go for one more course of ovulation induction. 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: I have been experiencing severe chest pain for the past month. It first started out that it hit me suddenly and lasted about an hour. A week went by and it happened again. This past week it started happening every few days. The pain is right under my boobs on both sides and in the middle of my back. No position makes it feel better. Its a feeling of being squished. And in my back its almost as if I have been hit with something hard. The pain lasts now up to about two hours. What could this be? ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. For your chest pain, we need to rule out cardiac cause pulmonary causes first. So get done1. Ecg2. 2d echo3. Chest x-ray. . If all of the above tests are normal then no need to worry much for major cardiac and pulmonary causes. You are mostly having musculoskeletal pain.  So better to start painkiller and muscle relaxant. Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: have been suffering for the last 4 months from erratic pain traveling from my left jaw down to throat into my chest. It does not have to do with the activity I am in. Means both while at rest and some times while working. Some times the pain is also very deep in my left ear. Got done a Cardiac Angio ,Brain neck CT chest,C-Contrast,Brain Angio done in addition to various blood tests, under the supervision of a Cardiologist,Internal Medicine Physician,ENT specialist and a Neurologist.They so far could not point out my problem and am still suffering from the same. Can any one help me out. Thanks and Regards. ### REPLY: Thanks for your question on . I can understand your concern. Since your all extensive reports are normal, no need to worry about major heart and lung related diseases. In my opinion, you should get done vitamin B12 level, vitamin D3 level and calcium levels to rule out deficiency because deficiency of these can cause similar kind of pain. Another possibility is trigeminal neuralgia. It is clinical diagnosis. You can start pregabalin or Gabapentin and if you are improving then chances of trigeminal neuralgia is more. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi , I have swollen gum and I am not a good teeth caretaker and I have realised  in a big way .now the issue is that I have swollen gum or you can say a lump ( medium).I am maintaing the cleanness and taking a medicine and applying some ointment on swollen gum .please help and suggest what can be done or what type of antibiotics can taken to reduce swelling or lumpness on gum .thanks shashank ### REPLY: Hi Welcome to  . I have gone through your query and can understand your concern. Swollen gums can be due to many reasons. 1. If you have a localized swelling on gum, the most common reason might be a dental abscess as a result of dental decay. 2. Other common reason of localized swelling on gum is periodontal abscess (collection of pus inside gum tissue).3. Next is localized gingivitis or infection of mistreatment depends upon the cause. In case of periodontal abscess/ gingivitis scaling & curettage is required. In case of dental decay root canal treatment/ extraction of tooth may be required. You should visit a dentist, he would make diagnosis and treat accordingly. In meanwhile, you could take metronidazole 400 mg thrice a day. Hope this information helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello my boyfriend is taking lipitor,plavix,and ramipril he is having an alergic reaction from one or more of them he is getting a rash on his back,buttocks, and inside the underarms aswell as the inside of his growing it is very uncomfortable and getting worse. What can he do to stop this itching? ### REPLY: Hello, Thank you for posting on . The condition you have referred to is called Urticaria or hives. It's an allergic manifestation of skin, where an allergen leads to release of certain substances from your blood, leading to itchy skin rash and swelling over soft tissues. Its proper management requires thorough history, clinical and laboratory work-up. You may have to go for specific tests like patch test, food prick test, IGE antibody levels etc. As for treatment part, best would be the avoidance of allergen as far as possible. Try to eliminate possible triggering foods from diet. I would also advise you various antihistamines for long duration(at least 3 months) with or without oral corticosteroids. For non-responding cases there are many other .  Hope this will help you in resolving your query. Thank you  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have recently been made aware of living with mold in my apartment building. I have had symptoms of chronic headaches, stuffy nose, stiff joints aches everywhere and tendonitis since moving here 1 year ago. I had been referred to a rheumatologist in December and he conceived that I have pallindromio arthritis with tendonitis and treating me with plaquenil (didn t work, made it worse for 2 months) followed by sulfasalazine ( allergy to for 1 week) and now dioxycycline for the last 3 weeks. i had a blood test on monday this week and they called telling me my white blood count was high (18.5) and to schedule a visit to my pcp. I would like to know if I should call him back with the finding of the mold (it s had to have been here for years, black, almost tarry in the basement). ### REPLY: AS YOU DESCRIBED THAT YOU HAVE LONG ALLERGIES AND Mold IS ONE OF THE CAUSES GO FOR TREATMENT AND GET CONSULTATION WITH ALLERGY DOCTOR WHO WILL FIND CAUSE AND TREAT THIS TIME IS TIME TO CLEAR THIS EPISODE YOU HAVE ALLERGIC FUNGAL SINUSITIS WHICH GIVE SAME SIGNS WBC IS HIGH DUE TO INFECTIONSTART METRONIDAZOLE 200 MG BD FOR 5-7 DAYS AS IT IS BEST TO TREAT SINUS INFECTIONTAKE FLUCONAZOLE 150 MG ONCE A WEEK FOR 4-6 WEEK ADD ANTI-ALLERGIC FEXOFENADINE 120 MG BAND TAB FLUNARAZINE 5 MG NIGHT ADD LIQUID ANTACID MISAPPLY AUREOMYCIN H EYE OINTMENT IN NOSE BD SEA WATER 2 .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 73 year old father had a direct laryngoscopy on 8-1-2014. Afterwards in recovery he complained of burning pain in his back and there was a red square on his skin where he said it hurt. on 8-10-2014 we took him to the ER with pain in his back and side and they said he had pneumonia. During the next few weeks after several more trips to the ER and two to his Family Physician and two stays in the hospital treating pneumonia, all with constant back and side pain on 9-6-2014 an xray of his chest to look for pneumonia (again) exposed a T6 and T7 compression fracture of the spine that was acute. Is there something in this procedure that caused this fracture? He walked into the procedure and lived independently at home before the procedure with no complaints of pain. he does have osteoporosis which this ENT knew of before the procedure. He had a clear chest xray and was released by his family doctor for the procedure on 7-18-2014. From 8-1-2014 to 9-6-2014 he progressively worsened with pain to the point of walking leaned over at a 90 degree angle and now he cannot walk and will be in long term care. Did this procedure cause his fractures? ### REPLY: Laryngoscopy is a procedure done by specialist till your neck level or upper respiratory level to view the larynx and surrounding area for problems like voice change, hoarseness of voice, dyspnea, irritation cough etc. It can not affect back spine practically. There is possibility that his spine was extremely weak due to osteoporosis and due to some improper posture while doing the procedure spine came under pressure, and he started having the problem. Burning sensation and pain in back shows damage to either soft tissue near the spine or damage to spinal nerve or disc at that level. However the conformation can be done by MRI of affected spinal level. Based in result here you have to take opinion from spinal surgeon or orthopedic doctor on further treatment planning. Boost the patient with calcium and vitamin D as directed by doctor. In severely damage spine here doctor may ask for surgical correction also. In that case you can also take secondary opinion and go ahead with needed treatment. After this consult a physiotherapist for rehabilitation part and also take suggestion in posture as well spinal exercises which will help the patient further to improve strength and stamina of spine. You can also use hot pack at home for some more relief and soothing effect on soft tissues. 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 was diagnosed of HBs(hepatitis) ,i did a test  fro liver function and the results was ok like thisSGOT 2.6UI and SGPT 17.6.I NEED TREATMET.THAT IS HERBAL AND I WISH TO GET DRUG AIDS COS ITS DIFFICULT FOR US HERE IN AFRICA.iam on green tea,coffee enema,i dont drink ### REPLY: Hi all diseases are curable except death. So do not panic. In yoga there are breathing exercises which will help you too much. You can see it on the internet. Second press on your right palm on the line which is under your three fingers under the small finger. There will be pain [press and leave for 10 second repeats for 2 minutes] two to three times daily .......... do inhale daily [crush one full garlic and one tablespoon of black seeds] twice a day. Morning and evening. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 slipped on the stairs and fell on my right leg and knee. I did not hear anything pop but the inside of my knee is sore. My knee and leg is very slight swollen. My foot also may swell very slightly. I am walking but with a limp. I feel the effects of the trauma when I get into the car or sit for long periods of time. I am not in a lot of pain but it is uncomfortable. It has been four days and when I wake my leg is kinda stiff. I have been wrapping my leg but the sypmtoms are still there. Does this sound like something major? ### REPLY: Hello, The symptoms seem to be related to sprained muscle due the injury. I suggest applying heat or ice to the sore area can help reduce inflammation, relieve pain, and improve movement. Over-the-counter anti-inflammatories or pain relievers such as Ibuprofen 400 mg three times a day might help if needed. I suggest resting and avoid activities that can trigger the symptoms. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my small brother age 18 has been paralysis attack about last moth ago....he is under the treatment of dr anupam sahni.......he is not able to right...get tired after 10 lines....not able to speech clearly...what short of tratment should do to make ghis voice clear....and sir how long it will take to recover ### REPLY: Hi, Recovery after paralytic attack depends on the severity of the stroke and the will power of the patient. There is no specified time limit in which recovery is guaranteed, sometimes it takes a few months only sometimes even a lifetime is not enough. Though full recovery is rare but more is they will better are the results. 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: my child is 2 months old now. when he was new born screen the result was positive in G6PD. he was required for another test. the G6PD confirmatory. the result was ** 0.40 U/g Hb. my childs pedia is out of town right now. so i dont have an idea right now what this result mean. thank you very much and i hope you could help me to lessen my worries. ### REPLY: G6PD enzyme deficiency is a hereditary condition seen mostly in boys, as it is passed from the mother to her sons. Normally, this condition is completely harmless. However, when a child with this problem ingests certain medicines or foods, the lack of the enzyme on his red blood cells causes the cells to burst open and cause anemia and jaundice. With such an episode, he may need to be hospitalized, and even given blood if too much of the red cells have got destroyed. The complete list of .  Just type " ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 have been having headaches, along with feeling light headed. I also and had trouble getting my breath when exercising. The PA had me take a blood test and she said I had an anemia caused by an iron deficiency. This was yesterday. I am scheduled to fly to Colorado tomorrow morning, and I wondered if I should postpone it. I was concerned about my oxygen levels. Does that make sense? Thank you. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You have iron deficiency anemia.  So your question is worth. But it's all depends on the degree of anemia you have.  If you have only mild anemia with he more than 10 gm or like that then no any problems are there. But if you're suffering from severe anemia then you should not go. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a question for neurologist, my brother is severing from diseases SSPE, his age is 15 year ,weight 25, that time his is on bed, he can not move and talk to any one and day by day his condition is going bad.if u have any solution plz reply me right now my email ID is  YYYY@YYYY  reply ### REPLY: Hi, Thank you for posting your query. I have noted your brothers' diagnosis of SSE- subacute sclerosis pan encephalitis. Unfortunately, there is no cure for SSE today. Despite medications, the disease continues to progress, however, the rate of progression differs in different people. Isoprenosine is a commonly used medication in SSE. For control of seizures and myoclonic jerks, sodium valproate can be used. 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 a lump on my left but cheek, that drains a clear fluid. Every week or two it drains blood. Sometimes its not alot sometimes its alot of blood. It s located just and inch or two below inside where the crack begins. The lump isn t hard, it feels sorta bubbly. It has periods of time it doesn t do anything and shrinks little. After those times it comes back the same size and starts again. ### REPLY: Greetings Sir/Madam. I am glad that I am able to help you to overcome your problem. What is your age? Are you a male or female?Anyhow my opinion after reading your query is that probably it might be any unnoticed trauma or the area is infected or any breakage of previously unnoticed birthmark. Whether it is associated with any fever? If so it might be infected. Since it shrinks and get refilled, it probably got infected. If it feels very discomfort for you, kindly get examined by a Family Physician/ General Surgeon & identify exactly what it & get treated accordingly. As i haven't seen personally, I could do this much only viz., guide you. Hope I helped. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 chest is congested. I have been taking robitussin dm for cough & chest congestion and Advil for a headache. The headache is gone but my head still felt a little swollen. The last Advil was taken this morning. I have been coughing up mucous. My right arm feels tight. Is that normal? ### REPLY: The chest congestion and the headache with your arm pain suggest a viral respiratory infection. The headache is better as u said, but the head cannot be swollen. If you are coughing up mucous, then take good steam inhalations three times daily with an expectorant cough syrup about 10ml three times and rest with lots of fluid supplements. If still not better than do a Chest X-ray and see a chest physician ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Age 19years, hight 6ft, weight 62kg.                                                 medical=using salbo inhellar.                                                                            Question= which quality of food should i eat to get control on asthma? ### REPLY: Thanks for your question on . I can understand your concern. Asthma is allergic in nature. So you might be allergic to some foods also. So better to first get done food allergy test and if you find allergic to any food than you should avoid that in your diet. Overall as an asthma patient you should follow this dietary advice.  1. Avoid Hot and spicy food. Oily and fatty food. This is because this kind of foods can cause HERD (gastroesophageal reflux disease) and this can worsen asthma. 2. Avoid stale food. Eat only freshly prepared food. 3. Take high protein diet like pulses, protein powder, milk etc. 4. Take anti oxidant rich food like fruits, green leafy vegetables etc. Along with good diet, you should also take your oral .  Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am in my early fourties , I am experiencing a persistent cough, I have had this problem for about 5 months. I initially thought I had a cold, my dr treated me with a cough syrup , then I was treated with a antibiotic the problem did not go away. I don t feel sick like a cold makes oh feel, but I sill have tne cough usually after eating something especially milk,ice cream ### REPLY: Hello are having cough for 5 months and took cough syrup as well some antibiotics. You got some relief, but cough still present, particularly when take milk, ice cream (milk products). Such type of cough may be due to these possibilities, these include:1 Allergy to dairy products, particularly, you mentioned that you develop cough after milk and ice cream. Diagnosis can be confirmed by allergy test for milk products. So consult an allergy specialist and get allergy test.2 The next possibility of such symptoms may be due to asthmatic allergic bronchitis (in this condition patient develop cough due to bronchoconstriction caused by allergy by mold, dust, pollen, fumes, smoking) So take care about these allergens.3 Smokers cough, if you are smoker then this cough may be due to smoking. Be careful about that also. However, there are so many other reasons of such cough but consult another physician and get his opinion as mentioned above. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with chronic cough a few years ago (saw a top respiratory specialist for 10 months and all the tests did not show I had asthma or any other problem). Also may years ago we lived through a stressful period and I starte having an irregular heartbeat - was on a beta--blocker for the next couple of years then went off it. Presently I am on no medication whatsoever; I just take a multi vitamin/mineral capsule each day and a magnesium supplement. This past year I have been having irregular heartbeats again - and (finally!) my question is - can a chronic cough in itself cause an irregular heartbeat - thank you.. ### REPLY: Thanks for your question on . I can understand your concern. If chronic cough is due to chronic bronchitis then this cannot cause irregular heart beats. Chronic bronchitis can cause arrhythmia (rhythm disturbances in heart). So better to consult cardiologist and get done ECG, 2d echo and Holder monitoring (24 hours continuous recording of ECG) to diagnose type of arrhythmia. You may need anti arrhythmia . Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having a lot of swelling in my lower legs and ankles...I have had my heart checked everything is great with my heart. I do have an urinary tract infection. But can t seem to find out why my legs and ankles swell so much. Can you give me some advice. ### REPLY: Hi, Thanks for your query. There are numerous causes and conditions that produce swelling in the ankles. A few important causes are chronic venous insufficiency, Heart related issues, kidney disorders, liver problems, water retention etc. A thorough and detailed evaluation along with a few investigations are needed to establish the correct diagnosis. I suggest you to consult a General physician for further evaluation and management. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END