Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 just always feel shortness of breath, and Im realizing that I cannot hold my breath at all anymore. It makes me dizzy and feel like I am going to faint. I am a 30 year old female. No known health issues, except for some neck and back problems from a car accident years ago. I do have chronic pain, and frequent headaches from this. Can that be tied in with the shortness of breath ? ### REPLY: Thanks for your question on . I can understand your concern. Holding breath can lead to legal nerve stimulation in some individuals. This stimulation causes vasovegal attack an . Better not to perform breath holding in the future. I don't think any connection between car accident related back and neck pain and these symptoms (Breathing difficulty and dizziness). 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 have been on dianette for 3 days and have bad headaches and nausea. It says on leaflet that you should stop immediately if you get this. But I don t want to stop it - just started it and I thought symptoms could get better after being on pill for a while. ### REPLY: Hi, Headache and nausea occurs due to the hormonal changes caused by the contraceptive pills. These side effects reduce in many patients as the days progress since the body adjusts to the hormone levels. In case the headache is very severe, or you have a history of migraine or hypertension, it is better to avoid using the .  You can switch over to other hormonal contraceptives for preventing the side effects. Use another contraceptive method for first 7 days after switching to a new  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father is 60 years old he lives with me,he woke up this morning with a large lump,the size of a orange cut in two on his right upper buttocks close to the belt line,it isnt painfull I can push on it put he says it doesnt hurt,in feels soft at the surface like it should but when pressed on I feel a semi hard lump,the only clue I have is that about a month ago he fell on that same buttock,bruised it X-ray came out fine and it healed now out of the blue this,Im stumped please help me decide what to do, sincerely Shannon ### REPLY: Hi ! Good morning. I am  answering your query. From the history of trauma, it seems that he developed a hematoma at that time, which did not resolve, and is in the way of getting organized. However, it can be firmly said only by a clinical examination. If I were your doctor, I would clinically examine him, stop all the blood thinning agents if he was on it after consulting his treating physician, go for a clotting profit and also advise a CT scan of the area if need be to be sure of the diagnosis before planning the management. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 4 weeks postpartum and I am having pain in my knees and hands still (the same pain I started getting in the third trimester of my pregnancy). My hands are still swollen and I cannot wear my rings. It feels like what I imagine arthritis to feel like. My knees hurt each time I sit or go to stand from sitting or walk up and down stairs. I would of thought this would be gone by now (all the water retention and swelling that is) Any idea why I am still having this and should I be concerned about the pain in my hands and knees? What could it be? ### REPLY: Hi Hope this message finds you in good health. I have gone through your query in detail and understand your concern. Its occurring due to low calcium and hormonal changes. Take calcium tablets and paracetamol if required. Hot fomentation will help Hope your query has been answeredNothing to worry about, You should eventually get back to normal. Get back to me for any FOLLOW-UP QUERIES anytime. Kind . .(MBBS, MS,MCH) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor I had this problem since lately in my penis n pain in my seed! Which I do handjob for about 2 years now about 2 -3 time a month,I want to knw if there is no side effect on my future an I am 18 years of age which I also discharge a little bit of sperm from my penis also pleas told me it will cum bk normal sir? Replied to text ### REPLY: Thanks for asking in  forum In short: Masturbating 2-3 times a month/whenever excited does not affect your sexual lifeExplanation: Don't be afraid of masturbation. Masturbating whenever excited is completely a normal phenomenon. Actually it is a preparation for your future action. It should not become a habit that's all.  So, your sexual life in future will not get affected because of this. For pain visit your local doctor for examination and treatment.  Enjoy 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: Unlike most people I turn pale after exercise, even in the heat. My All my blood counts are ok, I dont feel dizzy, though more recently I have been lagging in energy levels after about 40 minutes of exersize. Also finding myself more short of breath. Had childhood asthma but no major issues until now, though Shortness of breath doesn t feel like my asthma did, and no wheeze. Any ideas why? ### REPLY: Hi, if u had childhood asthma and at present shortness of breath on heavy exercises, then there is possibility of tracheobronchial hyper responsiveness, .due to exertion which leads to increased tissue oxygen demand and then increase of respiratory rate for a while. If it comes down to normal after taking rest for about 5- 10 minutes then there is no need of treatment, if not then u need to see pulmonologist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 muscular pain through my body. It started in right arm muscle when I bent my elbow. It is now in my butt, left arm, neck, shoulder. It is all muscular. It hurts with movement and now when walking. I was on Eliquis but asked to get off of it. Have been off of it for a week but it is still bad, especially in the morning. I have a hard time getting out of bed and combing my hair. ### REPLY: Hello, This pain and aches are due to muscle weakness and fatigue to set in. I will advise you to do regular stretching and strengthening exercises which will help improve the neck, arm, shoulder, back, hip, knee etc. Having doing 20-30 minutes of regular physical exercise helps to improve the overall well-being. Also, diet modification is advised to improve metabolism. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just had a CXR in which the radiologist identified 2 possible adhesions, but also stated that they are rounded on the frontal view and therefore cannnot rule out neoplasm.  They want a comparison CXR but I dont have one.  Any advice? How do you differentiate the 2?? ### REPLY: Thanks for your question on . I can understand your concern. Honestly speaking, one can not diagnose neoplasm (cancer) or adhesion only on the basis of chest x-ray. Chest x-ray is giving only Two dimensional (2D) picture of any lesion. It is only screening test for lung lesion. For confirmation, you need CT scan. CT will give you three dimensional (3D) picture. CT will also tell you about exact size, shape and margins of lesion, association with surrounding lung, necrotic center or not, mediastinal lymph node enlarged or not etc. All these things are important in differentiating between neoplasm (cancer) and adhesion (benign lesion). So better to consult pulmonologist and get done CT scan and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering with lower back pain for a number of months. I have seen my GP who has sent my case to my local hospital. Over the last week the pain is more constant and I am finding it hard to stand after sitting and getting up in the mornings. I get sudden very sharp pains into my buttock and into my right hip. I am taking co codamol which are not doing anything for the pain. The pain is now always there and I am not sure if I should go to the hospital via A&E as my appointment is not for 2 more weeks and living with the constant pain is now getting harder to bare. Can you please advise ### REPLY: Hi, I have read your problem. Usually back pain is managed with painkillers till 1-month period. If it persists beyond 1 month, then further investigations are done. Since you have a bad pain I will suggest the following: - Back pain can be due to many reasons. You should get x-ray lumbosacral spine done in AP and Lateral done send us report or discuss it with your doctor. Only then further management can be advised. - Avoid heavy weight lifting pushing and pulling heavy objects, because it will further increase back pain. - You can take medicine like painkillers + muscle relaxants by discussing it with your doctor. You may need stronger painkillers which are available on prescription only. You can try ibuprofen or naproxen till you see your doctor. - Apply hot packs for 30 min in morning and evening. I hope it helps. You are welcome to ask further health related queries. If you have any further query, I would be glad to help you. Let me know if you have any concerns. In future if you wish to contact me directly, you can use the below-mentioned link: http://doctor.ChatDoctor .com/doctors/ .   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 4 year old daughter went to her babysitter this morning feeling perfectly fine and after breakfast started vomiting and has been non stop vomiting all day and still vomiting up liquids this evening. We have given her pedialyte, about 1/2 cup over the last hour and has not had food since 12pm. Is this type of vomiting normal for a toddler? She has had viruses before but nothing ever to this extent. At what point is too much? ### REPLY: Hi...by what you quote I feel that the kid is having pro .  If there is vomiting you can use Syrup Ondansetron as prescribed by your pediatrician. If diarrhea starts - it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. I suggest you use zinc supplements (Z&D  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi im 23 year old male just recently came back from the  Oregon coast an on my way home my right armpit felt like it was broosed but it wasnt. a few hours later red  bumps about the size of a nickles were formed in my armpit and very tender. A few hours after that one formed under my right nipple. Then the next morning the exact same thing has happened under my left armpit and left nipple. I dont think i got bit by anything and never saw a tick or insect of any kind. Its almost like lymph nodes but im not sure . Any help is appreciated. Thank you ### REPLY: Hi, Good Evening. Thanks for the query to . I studied it in depth and I understood your health concerns.-Treatment-for-tender lumps in the armpits and nipples-1- Mostly it appears to be -infected boil below the nipple with lymphadenitis of the armpit. This boil could be due to the insect bite or the chemical reactive bruise.2-As you are worried I would advise you to check with your ER Surgeon, who would fix its diagnosis and would treat it accordingly. Hope this would help you a lot to relieve from your wrist lump. Wish you fast recovery-and healthy life. Wellcome to  with more queries till you are satisfied. Have a Good Day...!! . N.M.S.GENL-CVTS, Super specialist and Senior Consultant-and Expert in Non-Curable-Disease therapy for Cancer, Asthma,etc., Rejuvenation therapy and Tissue failure -reversal therapies. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 seizure disorder patient presently on oxycabazepine.i am pregnant but the growth is slow. my LMP was on 19/12/2009 (have irregular periods).according to that my baby shud be 9 weeks 06 d.but the recent usg shows 6 weeks 6 days.last week also had a usg which showed 6 weeks 2 days.fetal pole has appearedthis week but no heart beat.moreover i culd have conceived only after 6 of jan since had intercourse only after that.my doctor says to go in for D&C.please advice. ### REPLY: Hi there,Since you have irregular periods its possible that you must have ovulated late and that's why the pregnancy is 6-7 weeks at present. So do not worry about the dating of the pregnancy. More importantly since the fetal pole has appeared when compared to the previous report it would mean that there is some progress in the pregnancy. I would advise you to wait and get another scan done to check for fetal heart after 10 days of this one. This will tell for sure if the pregnancy is viable or not. Also since you have a seizure disorder and taking medications for the same, you need to consult your neurologist and see if the seizure disorder is under control. It is very important that your medical condition is under control, do not stop taking the medication as seizures during pregnancy can have an adverse effect on the baby. You are also more likely to have a child with birth defect a slightly more chances about 35 more. So it is very important that you get regular scans and tests done to check for neural tube defects, heart defects. This risk can be decreased to a certain extent by taking high dose 5 mg folic acid. I would advise you to visit a neurologist and repeat the scan after 10 days before deciding on discontinuing the pregnancy. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father aged 69 years and 6 months underwent lapcholecystectomy, cbd exploration and stent is placed in may 2009. he was reluctant and delayed ERCP. ten days ago he had vomitings and elevated bilirubin levels and he is admitted in the hosp. ERCP is done, a new plastic cbd stent is placed, two stones of 0.5mm came out during procedure on 08-02-2011 and advised balloon spinchterotomy afler 5 weeks. please explain possible outcome of balloon sphinterotomy and details of hospitals at tirupati in india ### REPLY: Hi, I had gone through your question and understand your concerns. It is obvious that your father had multiple stones in common bile duct which caused complicated clinical scenario and after these procedures there is always a possibility that there is retained stone or again or that stenosis of bile duct occur. This is why balloon sphinterotomy should be done to dilate bile duct. This is much less risky procedure compared to ERCP and surgery, so you should not be worried about complications. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am a freshmen in high school and i have some concerns. For about a year maybe even two i have had some discharge and its normal nothing cottage cheese looking but i am very worried. I am not sexually active!! Recently i have found some bumps around my area and a pimple with solid puss looking stuff. Please I am really scared. ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have multiple sebaceous cysts over penis and scrotum. The scrotal and penile skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Please consult qualified General Surgeon for clinical evaluation and further treatment. You need to take broad spectrum antibiotic like Čeferin along with anti-inflammatory . If needed some of them which are bigger may need to get excised in Toto (Completely along with the sac) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a fatty liver but when a biopsy was done they found the liver to be okay. That was about a year ago. The last three days my bowels have been a white color but have now turned to a pale brown/yellow color. Today I started with these nasty tasting burps and a very very bloated feeling. I have had a few fevers on and off this week but I am not sure if that is really related. ### REPLY: Hi thanks for asking question. Noted you have fatty liver detection one year ago... With lifestyle modification it can be resolved in few months. So in biopsy right now you have no fatty liver... Anyway you might have just now gastric indigestion with inflammation of gastrointestinal tract... For few days take soft and bland diet... Fruits more. With . . Take more water. Avoid non veg and fatty food for few days. Apple, whole grain, wheat bran like fiber food taken more... Perform your tidal test to rule out typhoid. If needed definite like antibiotic used. If still problem remain USG, endoscopy like further investigation done... Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have random outbreaks of hives; usually on my wrist, forearm, inner leg, and foot. I have kept a food log and reliazed its not a food. Its not from tight clothing. There is absolutely no logical explanation. I dont know what step to take. Doctor blew it off like it was nothing ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. There are many causes for hives. So more detailed history and description is required to give more specific suggestions.2. Parasitic infections, viral infections, bacterial infections can cause hives.3. Some conditions/normal activities like sunlight exposure, cold/warm water exposure, exercise, sweating, etc. can also cause hives.4. Food allergies and food intolerance can cause hives.5. Hives can also occur due to adverse reactions to preservatives/coloring agents/flavoring agents etc. in packed foods/outside foods, some . 6. In some patients, hives can be difficult to treat, like those with chronic conditions, autoimmune urticaria, etc.7. Stress can aggravate some hives.8. For treatment viewpoint, I would suggest you to take antihistamine like levocetirizine or cetirizine or fexofenadine for symptom relief.9. I usually suggest complete blood counts, ESR, CRP, thyroid functions, serum total IGE, urine and stool examination to investigate patients with repeated hives as first line investigations. If these investigations do not reveal any abnormality, more detailed investigations might have to be done.10. I usually also suggest my such patients a good multivitamin-multivitamin containing vitamin A, D, E, zinc, selenium, essential fatty acids, for 2-3 months which improves skin and immunity.11. I would also suggest you to apply moisturizing lotion/cream regularly, especially if you have  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 some twinge like pains in my upper back. Like a pinched nerve but they are shorter pains that come and go. It almost feels like pins and needles but worse. Of course working with my shoulders and arms aggravates it, but I have Type 1 diabetes and am wondering if it may be a symptom of nerve damage. ### REPLY: Welcome to ChatDoctorAfter going through your query I concluded that you there are having probably diabetic neuropathy. Neurotrophic agents such as Mecobalamine are of help. You should control your diabetes well. For pain relief you can take analgesic such as ibuprofen. Vitamin D3 level should be tested as it is important cause of back pain. If found low it can be supplemented. Vitamin B and C with be helpful in recovery. You can discuss with your Doctor about it. Hope your query get answered. If you have any further questions then don't hesitate to writing to us. I will be happy to help you. You can also write to me directly on below link:https://www.bit.ly/ask . 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 know someone is has just recently started getting a bad headache with a quick onset and when he gets them, his legs go numb and just give out. He has fallen once or twice because of this. He has seen his IM doctor and now is going for an MRI - they are looking at his pituitary gland. Can a sudden onset of a headache cause his leg numbness and weakness? His headaches do not last more that 10 - 15 minutes. ### REPLY: Hi, First, a headache is a symptom and the causes of the headache can cause leg numbness. For example atherosclerosis, smoking, .  Second, he should measure his blood pressure and if it were high, he should receive a medical treatment and stop eating too much fat and salt. Third, the women who take oral contraceptive pills or a hormonal replacement therapy can suffer from vascular problems, so they should ask a gynecologist to adjust the dose. Finally, the deficiency of vitamin B complex due to unhealthy lifestyle can cause headache and numbness. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,m 20 years old girl,,,my skin is dry and m getting white and rough pattches on my face,how can i remove this ? and i want my skin to be fair,,could u pls suggest me any good cream...which can be available in medical shop,so dat i can buy....pls help me out ### REPLY: Hello. Thanks for writing to us at  The white patches are most likely due to satyriasis Alba. The patches are common on .  They can be somewhat scaly as well, thus giving a rough appearance to the skin. Pityriasis Alba patches are light colored (lighter than the surrounding skin); the light color being actually due to post-inflammatory hypopigmentation. I usually recommend a good moisturizer, twice daily. You may use an OTC moisturizing lotion like Vaseline, once or twice daily depending on the severity of  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sir,my dad age is 60,if in spine d10,d11,d12 are damaged it causes tb or not neurologists telling that it may be tb but symptoms are not yet seen out side only back pain is thre last 3 months now leg problem is seen pls tel me sir all are awaiting for ur reply ### REPLY: Hi, Than for Firstly to start with the symptoms of Tb spine are malaise, loss of weight, loss of appetite, night sweats and evening rise of temperature. The spine is stiff and painful on movement. Unusually, the first presenting symptom may be neurological deficit and kyphotic deformitytreatmentNON OPERATIVEisoniazid, vitamin, and pyrazanamide therapy for 9 to 18 monthsethambutol and streptomycin added for part of treatment. Spinal orthosis OPERATIVE TREATMENT anterior debridement with instrumented strut grafting +/- stabilization may be done for pain control and prevention of deformityADVANTAGES OF SURGICAL TREATMENTless progressive kyphosisearlier healing decreased sinus formation in patients with neurologic deficits, early debridement and decompression led to improved neurologic 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: Thanks for responding, I had a craniotomy 6 weeks ago, meningioma in the falcine area.  Chronic pain behind right eye, was just seen by gp and have acute sinusitis.  On penicillin as well as Keppra, I feel a lot of pressure on the top of my head and left ear area as the sinus infection is breaking up, is this a dangerous situation, given the recent craniotomy? ### REPLY: HIT hank for asking to ChatDoctorYou have recent history of craniectomy and right now have symptom which quite related with your surgery If I would be your doctor then I would certainly ask for ct imaging to rule out the possibility of this if your GP is suspecting it as sinusitis and put you on antibiotic then you finish this course if it does not go away then will be required investigation take care of your self and be in touch with  have 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: hi my grandmother has cancer in the stomach the dr say they cant do anything no more that is better to not to do anything. she eats a lil she throws up almost everything she cant move on her own and she doesnt know who any one is. i will like to know it this means ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your grandmother has stomach cancer. Treatment depends on type and stage of cancer as well as spread of cancer. In early stage surgical removal is possible. In late stage chemotherapy and radiotherapy is the treatment of choice. However, it is just palliative treatment. It can not cure the cancer. Consult your doctor and plan accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . 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 haemoglobin is 18 & hemotocrit is 53.8 does it create any problem. I have gone through the spine surgery before 3 years & nowadays i m suffering from right side chest pain radiating with back. I have gone through the blood tests, x rays, vitamin d3 , vitamin b12, sonography which appears normal but the pain exists. Kindly help ### REPLY: Hello, Thanks for posting your query. Normal value of hemoglobin in men range 14.0-17.5g/dL, as you are having slightly high hemoglobin levels which may be due to smoking, living at high attitudes, deny . Chest pain radiating to back may be caused by pancreatitis, liver or gallbladder disease, peptic ulcer or cardiac ischemia. You are advised to visit doctor and get your LFT, serum amylase and endoscopy to reach causative factor. Hope it helps. 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: Ive lost flexabity and have pain in my right wrist. when I dont move it for even a short while it becomes so difficult to bend it normally and painful, I end up using my other hand to move it back and forth until it can sort of move more normally but for more than a week Ive not been able to turn or pull it back by itself without a good deal of pain. its a little swollen just at the bend of the wrist but thats kinda gone down and today it hurts when I m not trying to move it.????? thank you for your time but at this time I m unable to pay the cost so have a good day and thanks again. God Bless But I dont have to money even if you do satisfiy my questions thank you anyway, ### REPLY: Hi, thank-you for providing the brief history of you. A thorough clinical neuromuscular assessment is advised. As you have stiffness and pain in the right wrist joint, you need a thorough neuromuscular assessment as the flexibility cannot be disturbed by smaller issues. Understanding the complete mechanism of the wrist joint will help assist in helping you further. Trying out physical therapy will be of good choice, as it will help improve the ROM and flexibility. Also, strength can be achieved and the pain and restriction can be Avoided. In my clinical practice such cases care related to CTS, and they respond well to physical therapy. 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 was playing soccer one day when another player hit me with his metal cleats right above my ankle at first it was really painful and lost strength on my foot, but then regained. Afterwards, it started swallowing and hurt for a couple of weeks. Now sometimes it feels funny and in some minimal way painful, but what worries me is the hard bump it left sort of like as hard as a bone. ### REPLY: Hi, thank-you for providing the brief history of you. As this hard bumps are sometime muscle knots, and they restrict the muscle activity of contraction and relaxation. Therapeutic ultrasound therapy will help loosen the muscle knot and post which mild stretching and then Strengthening of the lower limbs should correct the weight transferring. Also, taking up an x-ray on a safer side will not be a bad idea. In my clinical practice when such sports injury comes we deal very technically to sort out the matter as the sports shouldn't be affected. Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my teenage daughter got a rash that started in her inner thigh area, it spread to the rest of her body, the doctor said it was probably scabies and prescribed her the medicine that you put on all over your body and then wash off the next morning. that didnt help, 3 other people in the house are now having the same symptoms.  Is this scabies?  what can we do?  The itch is so unbearable, especially at night! ### REPLY: Hi there.1. Your daughter concern is scabies most probably2. it's a highly contagious infection due to mites.3. Here all family members need to be treated at a time, to prevent cross infection.4. You can try permethrin 5% cream of any brand, apply all over the body from neck to toe single application, leave it for 12 hours and wash off in the next day after 12 hours.5. Every family member of the house need to use the cream at a time.6. Usually infection subsides within a day, but itching takes around 10 days to subside. For relieving itching you can try any levocetrizine 5 mg tab daily bedtime. This will help you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My dad is 66 and diagnosed with labyrinthitis 10 days ago. He has been resting in bed as advised by GP and dizziness has improved a little. He is still sometimes sick after a drink but not too bad. The thing is he s lost his appetite totally and hasn t had any proper food for over a week. He has tried a little bit but has struggled to eat. Should I be worried and is it a matter of time? ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  Your father aged 66 yrs, had laberinthitis 10 days ago, With bed rest he has improved, but he lost appetite.  Laberinthitis is an inflammation of the internal ear, causing dizziness and vomiting sensation, which may be felt as loss of appetite.  I advise you to consult an E.N.T.surgeon for diagnosis and treatment. You may need to have an M.R.I. besides other routine tests for confirmation.  There are medicines for dizziness, like interline, and betahistine to overcome the dizzy less and vomiting sensation, and hence loss of appetite temporarily, till the infection of labyrinth is cured.  Wishing for a quick and complete recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello drI am 24 years old, unmarried girl. i have always silent pain in my stomach, twice in a day it becomes more severe, chronic pain , i cudnt bear it anymore, more pain in abdomen while passing stool, eating.i have hypotherodism, PCOD, Piles(bleeding),mensis irregularity, low flow, persistent mouth ulcers, ### REPLY: Hi. Noted your medical History and pains you have. The pain in abdomen is more of an irritable bowel syn . Piles are secondary to your intestinal problems, will get OK with improved bowel conditions with the help of medicines, meditation and diet adjustments according to your needs. Mouth ulcers are due to again the intestinal condition and can get OK.POD, Hypothyroidism are medically treatable and consult proper specialists to get a treatment. Menstrual problems may get solved with hormonal treatment of POD. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir i had been bited by adog on 17 of march and i got verorab injection on 20,27 and 04th of april and my family doctor advised me this is not a correct course so start from the first so i started from 04th of this month so please suggest me on what dates i should take this vaccine ### REPLY: HiT hanks for your query. I appreciate your concern for the schedule of anti rabies vaccine. As per the current recommendation of prevention of rabies following dog bite, a total of five doses should be taken on 0, 3, 7, 14 and 28 days. Since you have started taking the vaccine on 4th of this month, the remaining doses should be taken on 7th, 11th, 18th and the final dose after 14 days of the last dose taken on 18th day. Hope this answers your query. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! Im an allergy sufferer of beef. Whenever I take beef or products with contains beef, soup, seasoning or anything, I will have rashes on my skin. And also sometimes, allergy to crab, tiger prawns & stingray...Is there any suggestion to prevent or cure it? ### REPLY: Prevention is better than cure. In my opinion you should avoid those food items to whom you are allergic. This is the only and the best prevention. Regarding cure there is nothing to cure about as your body is functioning normally without these food items. Allergy is as per se not due to problem in human body, but it is due to reaction of our immune system with foreign substances and this reactivity varies among all of us. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had a hysterectomy at the age of 30 for endometriosis and had a complete with my appendix also removed. developed a horrible staph infection, then 6 months later has my gallbladder removed....i am going thru tx for depression and anxiety, irregular bowel habits and just found out i have NASH....could the endometriosis be on my colon? i just want to feel normal again... ### REPLY: Hi and welcome to . Thank you for your query. It can be on your colon, but it would have been seen on surgery. It is more likely due to your depression and stress. If you take some medicines it can only worsen bowel function. ALso, there can be postcholecystectomy syn .  You should do some of imaging tests to see is there any pathology such as adhesions and obstruction.Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Recently completed a CT due to severe abdominal pain - the test results provided There is some soft tissue density in the left adnexa, which could be multiple adjacent loops of bowel - Very small ventral hernia just to the right of midline, approximately 12.5 cm above the umbilicus. The fascial defect measures 1.9 cm in maximum diameter - rather large mass appearing to arise from the anterior fundal portion of the uterus, measuring approximately 6 cm in size, likely uterine fibroid. Uterine contour otherwise somewhat lobulated, likely fibroids - Enlarged, measuring 19.3 cm in AP dimension and 14.2 cm in superior to inferior length ### REPLY: The report of the CT scan is simple and straight forward. It shows ::It looks you have problem with the left ovary and / or Tube- inflammatory reaction leading to intestinal adhesion. Secondly you have-Hernia in the central part of upper abdomen-needs surgical correction. Thirdly you have big masses coming from the uterus called Fibroid, which to need removal of the uterus - Hysterectomy. All this can be done now-a-days with Laparoscopy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a reddish brown, scaley, extremely itchy rash on my shin for almost 4 months. It is located just below a scar from a previous car accident. The skin tends to swell and stretch in that area from edema making the itching worse. I ve tried lotramin for 4 months and it s still not gone. ### REPLY: Hi, You seem to have developed an allergic skin disease. You should avoid applying any kind of skin irritants like detail, spirit over it. You might need to apply a topical steroid cream over the affected area twice a day for few days. Take some oral antihistamines along. See a nearby dermatologist if the condition tends to persist despite this therapy. You might need a course of oral steroids. Hope it helps, . MD(Dermatology) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About two weeks before I had my wisdom teeth removed, I went in and had a large cavity filled. The dentist said it wasn t bad enough to do a root canal , but he wanted to cap the tooth since he had to drill away a lot of it and he didn t want me to lose the filling. All was fine, no pain in that tooth, not even sensitivity. Then, a week ago I had my wisdom teeth removed. I had no pain from that at all and almost no swelling. Dry socket has also not been an issue. However, the capped tooth is now causing me extreme pain to the point I m watching the clock so I know when I can take another pill to kill the pain before it even starts up again. I guess this tooth would be my first molar, and the one behind it (the one that would be next to my wisdom tooth) is also sore . Could this possibly just be due to fluid buildup or some other complication or is it possible that I need a root canal after all and it s just showing up now ? I am 19 and I have good teeth and a very high tolerance to pain, so the fact that this tooth is bothering me so much is a concern. Please help! ### REPLY: Hi, you are giving a history of sharp, shooting, continuous pain, and also it is localized (as you said first molar), with a past dental history of large filling, these are the particular sign of necrotized tooth. You have to go for immediate root canal treatment of that tooth.  That is the only treatment. painkillers can only subside pain for a short while but the cause of pain will not subside without root canal. 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 DR,I M A DENTIST, MY MARRIED TIME S LAST 2YEAR  8MONTHS,I M USED CONDOM,BT  LEAVE ITN THIS YEAR ON 21 FEB,IT BECOME8 MONTHS TO LEAVE CONTRACEPTION,WE WANT A BABY BT THERE R NO RESULT THEN I GOT MY SEMEN ANALYSIS,REPORT SHOKED ME,I M VERY FRUSTRATED,PLZ GUID ME,CAN WE ACHIVE A BABY OR NOT,MY REPORT S-NO SPERM SEMEN FULLFIELD FROM PUS,AZOOSPERMIA,PH-ALKALINE. ### REPLY: HelloAzzospermia means no sperm in semen and this is a big factor of infertility in your case. Let me explain you, although the sperm is produced in the seminiferous tubules of the TESTES, other organs of the male reproductive system contribute to the composition of the semen. As, Testes 5 % seminal vesicles 46-80, prostate 13-33% & bulbourethral gland 2-5 %. One thing note down, Sperm output could vary considerably from time to time and has to be kept in mind when semen is evaluated in lab. In you case pus cells and alkaline pH are normal so don't worry. For azoospermia, I want to tell you consult a surgeon and get his opinion as at which place there is defect. Please don't trust over quacks. 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 daughter is 14 months old weighing 18lbs her birth weight was 6.1lbs. She s breastfed on demand and the issue is she just doesn t like to eat any food, be it fruit or vegetables or cheerios or smoothies.she doesn t chew her food either.She simply spit the food out or smash it and throw it on the floor. She only drinks water from a straw cup.And in case she chews then also she won t swallow it. She s also constipated..she ll pass hard stool after 4-5 days. PLEASE HELP. ### REPLY: Hi... This is food cads and habitual constipation. I have certain questions and suggestions for you. Questions:1. Did your kid pass motion or meconium on day one of life?2. Since how long is the kid constipated?3. Does the kid have any bleeding along with hard stools?4. How much milk does the kid consume per day?5. Does the kid eat fruits and vegetables (fiber diet) appropriately? Suggestions:1. Natural methods are the best to relieve constipation.2. Constipation is a risk factor for UTI3. Maximum milk consumption per day should not exceed 300-400ml4. Minimum 3-4 cups of fruits and vegetables to be consumed per displease get back with answers to above questions. You can approach me at the following link. Please find the link below.www.ChatDoctor .com/doctors/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was a little intoxicated on alcohol about 3 night ago and injected household cleaning solution into my arm where i previously had an abscess drained. now it has a huge hard lump that is red and yellow on the surface of the skin and the red has spread down to my forearm. its hot to the touch and very painful. i know its definitely infected having an abscess before i know the sings. Ive been watching it and its not getting any better if not worse. im just wondering if it could be possibly be gangrene? and what should i do about it? thankyou ### REPLY: HI, Dear, Thanks for the query from you for your painful red-arm lump, which grew in to abscess with redness of the arm.1-I feel concerned that you are serious to know how to treat this painful hard arm lump, with cellulitis of the arm, after injection of the cleaning agent in to your arm.?2-In my opinion this painful lump of the arm needs immediate . 3-I would advise Surgeons opinion -who would treat it by urgent incision and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive never been able to drink sodas very fast becaue i get a tight feeling in my chest near my throat, it happens a lot more often when i drink alchoholic drinks.  I have a feeling its trapped air of sorts because i hiccup a lot and feel like a good burp would make me feel better (which ive never been able to do on command) ### REPLY: Thanks for your question on . I can understand your situation and problem. In my opinion you are having HERD (gastroesophageal reflux disease). It is due to laxity of gastroesophageal sphincter. Because of this, the acid of the stomach tends to come up in the esophagus and cause the burping sensation in the esophagus (throat). And alcohol actually deteriorate HERD. So better to avoid alcohol and start proton pump inhibitor. Avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Avoid stress and anxiety.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: Hi I have 4 years daughter and she has seizure when she was 8 months without fever and again on 9 month it came twice... Then doctor suggested tegrital and later velparin.Now she is taking velparin 7.5 ml twice a day and its been 3years she has no seizure.But she is not able to run or jump properly and hyperactive..Her blood and sgpt levels are ok.. I want to know is there any serious side effect of velparin on behavioural as well as childs growth? ### REPLY: Hi, Thank you for posting your query. I have noted the symptoms of your daughter. I am glad to note that she is seizure free for three years on Valarie syrup. Valarie (valproate) is a safe and effective medication for controlling seizures. Behavioural changes and growth delay are not the side effects of Valarie. Weight gain, tremors and hair loos may occur in some child .  Please discuss these issues with her neurologist. 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, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: How should I proceed in finding out if I have problems with 18 year old saline breast implants? About 3 weeks ago I had a cough that, I thought, caused pain in my chest. It is better with pain meds but still hurts and is more localized to the side of my right breast. ### REPLY: Hi thanks for asking question. Here are few possibilities.1. First if area over implant or skin over chest found red and inflamed then myositis or Costco . Ribs are painful on touch if infection of it. For infection antibiotic needed.2. Second it could be simple muscular pain. Take analgesic for its relief. Take rest over bed in supine position. Avoid heavy exertion.3. Third if you have associated cough, cold, headache, sore throat like symptoms it could be viral infection. Symptomatic management done for it. If inflammation is severe over skin anti-inflammatory  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i hit my hip on a railing nearly two weeks ago.. it was the middle of the night so i went back to sleep. the next day i felt sore, saw a bruise but no lump/knot within 2-3 days later i started to get a lump.. now it s nearly 2 weeks later... i don t have the bruise any more.. just the knot... i even tried to massage out the lump.. it s only gotten bigger should i go to the ER... ### REPLY: Hi, Dear,Good Morning, and Thanks for your query to my virtual Clinic At . I studied your query in depth and understood your concerns. Causes for painful lump on hip as follows-Mostly they are - could be Abscess in post-trauma Hematoma on the hip with infection in it, due to which it has increased in size. Treatment-Tab-NSAIDs -like VoltarenTab-Amoxycycline 250 mg x three times a days . Check with ER Surgeon and check your FBS and PPS, and plan for-Scraping of the Chronic abscess wall and adequate  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor! I am 16 years old and I have had unprotected sex about a week ago it was a stupid decision and I regret it a lot. I m so afraid that I am pregnant. Is there anything that I can do to reduce my risk of me falling pregnant? Are there any sighs I should look out for which would indicate wether I m pregnant or not? If it turns out that I am, is there anything I can do to naturally increase my chances of miscarriage ? And if I needed an abortion, there is no chance I could ever ever tell my parents , I can get an abortion without their consent ? And could the doctor be forced to keep it confidential? Please if you could advise me I would be so grateful! ### REPLY: Hello dear. I understand your concerns. The absolute sign of the pregnancy is the missed period. Other variable symptoms will not tell about the pregnancy. No natural way to induce the miscarriage. I would suggest to wait for period. If period will delay by the 8-10 days then you should go for urine pregnancy test and or blood  to confirm the pregnancy. You and your bf together should consult the gynecologist to terminate the pregnancy after confirming the intrauterine pregnancy by USG scan. You should use abortion pill containing MIFEPRISTONE AND BISOPROLOL under the supervision of the gynecologist. Do not worry, Gynecology consultancy is confidential process. Do not use abortion pill at home as self-medication as it cause severe complication. Avoid stress, take healthy diet and do regular exercise. Hope this may help noncontact  for further health query Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I took clomid 50 mg on 3-7 CD.got an US done on CD13,there were 3-4 small follicles in both ovaries,endometrium was 4.9mm thick.HSG report was normal.Hv irregular periods.taking oosure since last mth...dr has advised Evadiol and Meprate BD for 10 days now.what does this mean?Is there no chance of conceiving this month? ### REPLY: Hello. Thanks for writing to us. Since you had an HSG in this cycle and there are no dominant follicles seen, the chances of conception are very less. If your periods are overdue then you can test your urine for pregnancy before starting with me prate. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 44 years old, and have a long history of asthma and chronic bronchitis. Lately I am developing a very sensitive throat and have tons of tiny bubbles when I cough up mucus. Lately hot flashes/head rushes are accompanying the cough. I used to smoke a variety of substances, but gave it up for the most part for dipping tobacco. I went through a horrible lung fungus but God healed me miraculously a few years ago. There are no signs of the fungus, but the bubbly phlegm seems to keep my throat coated and irritated/sensitive. I have lost all but 6 teeth due to severe periodontitis over the last 25 years. Guafenisin doesn t seem to loosen it, and dextromethorphan helps very little. I use albuterol, but it doesn t help the cough, just the asthma. ### REPLY: Thanks for your question on . I can understand your concern. Cough indicates that your asthma is not under control. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS). 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: i have a 10 cm posterior subserosal fiberiod and am 5-6 weeks pregant. the ultrasound shows that the baby sac is pressed against the fiberooid and sac is elongated... i am worried about potential of miscarridge or abnormal growth please advise thanks ### REPLY: Hello, I have gone through your query. While the submucous fibroid carry the maximum risk of causing an abortion, secondary to the submucous variety, subaerial fibroid are rare to cause complications in pregnancy unless they are large enough. If you have a introverted uterus and hence the posterior fibroid is pressing on the growing uterus, postural treatment can be somewhat helpful. If the sac is getting distorted as has been shown in your case, mastectomy may have to be contemplated to save the pregnancy. This should be managed in expert hands so as not to disturb the existing pregnancy. Uterine artery embolization may not be suggested in view of an active pregnancy. Hope you find this information helpful. 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: Ok hello i have a question, my lower front tooth is fine no cavities, so why wud i have swelling behind it,and in the front of the lower tooth on the gum its a hard white knot so wat could this be please?? Oh and now instead of throbbing pain its went numb cant feel that tooth.Thank u ### REPLY: Hello, You may have a periodontal problem causing an infection. Front teeth are subject to trauma and can abscess without decay present. Have you had a recent dental exam to know that there is not any decay present? Do you have tartar buildup and need a dental cleaning? A growth or tumor is a possibility. I suggest you have a clinical exam with an X-ray to find out an accurate diagnosis. Do your best to Keep up with daily dental care and rinse the area. Any abrupt change especially with numbness raises a greater concern. I am glad to answer more questions with additional details. Thank you for your inquiry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 esophogeal cancer in January of this year.  I underwent 28 days of radiation and 15 Chemo treatments.  In april I had surgery to remove the esophagus and by may I felt fine.  The cancer had spread to some nearby lymph nodes which were removed.  I had a scan in June and the cance was found in my adrenal gland and soft tissue in my thigh.  My oncologist has informed me that this is incurrable but in order to extend my life has starteds me on another series of Chemo.  What life expectancy am I looking at?  I am a 53 year old female in good health aside from this cancer ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have esophageal cancer with metastasis in to a .  So it is stage 4 tumor.  Surgery is not possible in this case.  Prognosis is very poor despite treatment.  Life expectancy is very short.  To increase life expectancy chemotherapy and radiotherapy is helpful but despite this treatment life expectancy is not very good. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my name is sreekanth...and i am employed.. recently i got a chest infection which started 1 month before with light coughing... i had to travel a lot and due to that it got worsened. i consulted doctor and did a x-ray and blood test and ol seeme dto be fine.. and  i took antibiotics prescribed by the doctor too. but still i am having some problem and mucus is still devoloping and i am having slight chest pain... pls suggest a medication ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of post infectious bronchitis is more likely. Bronchitis (inflammation of airways) is common after respiratory infections and is known to cause prolonged coughing, chest pain, tightness etc. So you will need inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone) for bronchitis. Consult pulmonologist and start above treatment. 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 74 years old, in reasonably good health. Beginning last night I began to experience minor discomfort in the left chest area. The discomfort has not increased, nor has it gone away. I had a stent put in several years ago and am being medicated for high blood pressure. Should I do anything or await further developments? ### REPLY: Hello thanks for posting at . Since you have a history of heart disease with stent in place I think you must not wait for further developments and get evaluated. I hope you are taking your medications regularly. I suggest an ECG, 2d echo to be done for further evaluation. If both show no changes then a treadmill test should be done where you are made to walk on a treadmill while your ECG is continuously being monitored. If all the above tests are normal, then u can stop worrying about it. In the meantime please take a course of antacids. Wishing you good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a multitude of symptoms and cant find anyone to look at all of them. My lab work doesnt seem to be leading doctors anywhere yet. I have petechiae on my earlobes intermittently, especially when Im going to be sick or am extremely stressed. Sometimes it shows up elsewhere too. I have extremely heavy menstrual cycles, which are every 3 weeks, not four. I was diagnosed with severe food allergies ten years ago, but cant afford new testing (and I know your allergies can shift). I have the symptoms of hypothyroid, but my initial test shows that Im in the normal range. I am fatigued, even when I am regularly exercising. I have a hard time not being overweight, though I eat well and am active. Could this be an autoimmune issue, a thyroid one, a blood disorder, a bunch of things. Who should I go and see? My resources are limited, so I want to use them as wisely as possible. ### REPLY: Hi I would suggest you to see a gynecologist. An ultrasound scan and a couple hormone tests which will give an idea about the heavy menstrual bleed. Having periods once every 3 weeks is normal. I don't understand what you mean by allergies shifting. When you are found allergic to certain food unfortunately it lasts life long and the only thing you can do is to avoid foods that you know you are allergic to. A couple of explanations for your symptoms are Anemia and PCs. These are only possibilities, you need a test or two to confirm whether you have this or not(CBC and Ultrasound Abdomen). Donor allow the internet to mislead you and donor take undue stress by what you see online. Many patients with hypothyroidism donor have half the symptoms mentioned online. So see a gynecologist who will be able to help you figure out what is wrong (if anything is wrong at all :)) . You can be active and eat well but being stressed out can also cause you to gain weight. Practice relaxation exercises. Skin in the ear lobes are very thin, and a capillary can burst with little pressure it is not an indication of anything serious. Do not worry. I hope this helps. Take care :) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good day doc.. I have a sister whose bone near the jaw are growing, at first it was only a small growth but it is growing now like a marble... She was checked up by a doctor at cebu and the doctor say it might be an ossifying fibroma..My sister now is already 26 years old, female and single... ### REPLY: Hello, I suggest a consultation with an oral surgeon. You report an increase in growth, and it is important that you seek professional care. An increase in size can affect function of the jaw and cause loss of multiple teeth with damage to the roots. Your sister should be up-to-date on her routine exam and cleaning at the dentist. There is a possibility that an infection has formed from a tooth abscess. This would need treatment with an antibiotic such as amoxicillin and further dental treatment such as a root canal or extraction. Anti-inflammatory medication such as acetaminophen and ibuprofen may limit inflammation, but make a dental appointment to diagnosis this advancing condition. Thank you for your inquiry. I hope your sister will feel better soon. I am available for additional questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother s wbc is high, bilirubin is high, hgb is 6.8 and falling despite 2 units of blood. Bun was fine but now elevated, Bun/creatinine ratio is now elevated. The hospital Dr dx her with hemoletic anemia. Said it is an autoimmune problem. They Don t know what is causing it. Can you tell me reasons why this could be happening. They have ruled our rx medications, travel, food, and environmental triggers. ### REPLY: Hello, The body needs red blood cells to survive. They carry hemoglobin, a complex protein that contains iron molecules. These molecules carry oxygen from the lungs to the rest of the body. Some diseases and conditions can result in a low level of red blood cells.  There are many types of anemia, and there is no single cause. It can sometimes be difficult to pinpoint the exact cause. 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: just had a echo and needed to quit early because blood pressure went to 237/58.  EKG look good.  I had a heart MRI which showed a normal heart.  Still having some chest pressure so dr. wanted this ECO.  waitng for the results. The MRI showed this borderline/mildlvh present.  Would that be the reason for the high blood pressure.  I have never had high blood pressure at all. ### REPLY: Hello I appreciate your concerning blood pressure can be caused by stress and anxiety, age related, genetic based or heart disease or atherosclerosis (narrowing of blood vessels If you can provide me more information I will be able to help you better libelous age and complete medical historySince how long you are taking triple medicines?Meanwhile, please follow these guidelinesAvoid smoking and alcohol Low salt dietAerobic exercise regularlyAvoid fatty and fried footage lots of fresh fruits and vegetables should do yoga and meditation with relaxation exercises to allay stress and anxiety Hope this answers your questionThanks and regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I checked my sperm last week and result came that all other are ok but semen is slow I want to know is this danger to make a baby? What they can effect on birth? I can pragnet my wife or no? I have one 2 years baby now we are trying to get an other but result nothing plz help me my email is  YYYY@YYYY ### REPLY: Hellos you mentioned that your semen is slow, so assuming that you are talking about sperm. While all other parameters are normal (according to you). Please write down in detail about the motility of sperm as well sperm count and normal morphology, so that proper treatment could be advised. While you are already having a baby of two years and that is normal so this time, if your wife get pregnancy then she delivers a normal baby, this is not a cause of concern. So upload the report of semen analysis. 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 am a 22 year old Asian woman and I have noticed that I am becoming increasingly short of breath after doing small tasks such as walking around the house, showering, going up and down the stairs. I am also pretty sure that I have a murmur in my pulmonary area (it sounds systolic but I m not 100% sure. I am still just a medical student). I also get palpitations infrequently, but when I do it is usually when I am at rest not stressed or doing anything in particular. The most bothersome thing is the shortness of breath. it does get relieved when I sit and rest for a bit though. I have noticed it for a while and it is not very severe but it is definitely more noticeable now. I am just not sure what to make of all this. any help would be appreciated ### REPLY: Thanks for your question on . In my opinion you should investigate yourself to rule out pulmonary and cardiac cause. In your case possibility of cardiac causes like valvular heart disease are more as you are having murmur too. Pulmonary diseases like asthma and bronchitis can also cause such symptoms. So I give you plan of action.1. First consult cardiologist and get done ECG and 2D Echo to rule out valvular heart disease.2. If this is normal than consult pulmonologist and get done chest x-ray and PFT (Pulmonary Function Test) to rule out asthma and bronchitis. 3. If all of the above are normal than it must be anxiety related. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 for the past couple of years I have problems with the arch in my foot on and off and a about a year ago my right keen stated having pains and later on it when to my left keen .it s rare for them to both hurt at the same time but it Wil happened every now and then. Also when I wake up in the mornings my arch in my foot will hurt so much to the point that I have to set down and wait for the pain to go down. And the pains in my keens and feet aren t on and off any more .they have stated happening very day. For example right now I can t stretch out my right keen at all when I try to I get this awful feeling in my keen, it s like a bubble that s being crushed and explodes a sense of altering pain that that travels through my keen and other parts of my leg. ### REPLY: Hi, thank you for providing the brief history of you. A thorough neuromuscular and musculoskeletal assessment is advised. As you have pain in the knees which keeps altering and also in the feet then a thorough clinical examination of the knee and feet is advised. Now something to understand here is when one side of the knee is having injury the brain itself acts as a protection and diverts 70% of weight to the other side of body and that is how the pain gets shifted from one side to the other. Also, the pain is having change of nature which may be due to neuropathic issues which needs a proper assessment. If the SLR Test is positive clinically than it might be related to the pinched nerve, if this test is negative then the issue is muscular. Also, if you have a bubbling sensation than understand of the vascular system is needed. If any skin color changes are present in the lower limbs a vascular hemodynamics is compromised which is leading to pain factor. If this is not present then have to come back to knee. Usually when knee is Injured the clinical assessment is focussed to the knee only and may be an MRI to understand the soft tissue Injury as well. Performing a patella grinding test will help understand the muscle strength status. Any injury in the knee will lead to patella grinding test positive and the muscles will be weak as well. After a thorough clinical assessment, physical therapist will be able to assist you in strengthening the muscle groups and regain the mobility. Iny clinical experience after a thorough clinical assessment patient is advised to undergo physical therapy and majority of them respond well to physical therapy. 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: Hello Doctor, In a recent diagnostics it has been observed that I am a fatty liver patient. One doctor told me that right condition will leads to cihrrosis in 6 months. What are the precautions i should take care. I am 32 year male working as an IT professional. I am non Alcoholic. Please let me know a perfect diet for me to reduce my wait as well as fat. My waste size is 40. weight in 95Kg height is 175cm ### REPLY: Hello Fatty liver is a reversible stage. It is important to know your grading of fatty liver. Elastography of liver can be done to assess its propensity to convert into fatty liver. Most commonly it is due to obesity and sedentary life. You need few investigations like routine hologram, Random blood sugar(RBS), Liver function test(LFT), Lipid profile, Renal function test(RFT). Fatty liver can be reversed by diet and lifestyle changes. You may need some medicines after full investigations. It may take 3-4 months to reverse the findings. You should be active in your daily life. You should avoid red meat and high fat milk products. Cook food in olive or canola oil. You should take limited salt in your diet. You should also avoid fried and junk food. Take a lot of fruits and vegetables. You should also increase your physical activity in the form of walking and exercise. Get well soon. Hope I have answered your question. 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 father has been diagnosed with mediastinal lymphadenopathy. He has a history of prostate cancer - but the specialists are treating him for multiple myeloma.  Is this routine? I am getting mixed literature.  If mediastinal lymphadenopathy something serious, or are we looking at something sinister? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. First he should investigate properly.  Whether he has multiple myeloma or not.  He should go for protein electrophoresis and bone marrow examination. It will give you exact diagnosis. Mediastinal lymphadenopathy may be due to metastatic lesion or some other cause.  You should go for excision biopsy and take treatment according to cause. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: So my doctor said i have something that can affect people up the age of 25. It had youth in the name and its where the bits in between bones dont grow as fast as the bones and causes a lot of pain. I get it in my chest - when i breathe in sometimes feels like something stabbing my lungs almost and sometimes likes some one is grabbing the bones in my chest and ripping them apart.. i need the name ### REPLY: Thanks for your question on . I can understand your situation and problem. In my opinion you are having anxiety mostly. But better to rule out cardiac and pulmonary cause for your symptoms. So get done ECG to rule out cardiac cause. If ECG is normal than no need to worry much for cardiac cause. Get done chest x-ray and PFT (pulmonary function test), to rule out pulmonary cause. If all are normal than anxiety is the cause for your symptoms. So avoid stress and anxiety. Be relax and calm. Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution.Don't worry much, 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: I had an MRi of my knees and it was diagnosed that I have meniscal tear in both knees. I have some pain and take anti-inflammatory pill each day & tylenol several times a day.. Surgery was recommended. It is supposed to be minor surgery to repair it, but nonetheless, it is surgery. Is there another alternative to surgery...like therapy? Thank you ### REPLY: For less severe meniscal injury some simple exercises can help maintain muscle strength in the front of the thigh (qua .  All of these areas are important for your overall leg function while your knee heals after an injury or after surgery. Exercises should only be done on the advice of your doctor and only if you feel very minimal or no pain while you do them at home, or you can use knee hinge braces to support the knee, which can help in healing. Knee hinge brace will transfer your weight from thigh to leg.  I hope you will get help with this. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 my dad has undergone surgery for HCC a 10 months ago, now the tumor has has been diagonised in ct scan ,he already undergone for chemo once,now the doctors are planning for another round of chemo,will the chemo works for him or should i look for other alternate treament? please help me ### REPLY: Hi, Thanks for writing in. I understand your concern on your father being suggested another round of chemotherapy following surgery for HCC. Cancer is a difficult disease to treat and is based on individual patients following response to initial treatment. It will not be wrong to go for another round of chemotherapy. Chemotherapy is not one single treatment, it is a combination of medications that are infused in to the system to cause the cancer process to slow down and control the proliferation of malignant cells. There might be other treatments available for your father, but every method is not suitable for all patients and a review of his past and present medical records is necessary. There are treatments like transcatheter arterial chemo embolization, radiofrequency ablation, focused radiation among others. Please have a discussion with his doctor and accept the one recommended. ### END