Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 really bad stomach ache last night with a lot of cramping. I went to the bathroom and just sat there but couldn t go. I started to sweat profusely and when I got up from the toilet I started to feel very dizzy. This has happened before and I usually try to get to a low position incase I faint. Anyway, I was leaning on my ironing board, feeling sweaty, dizzy and started the chills. The next thing I knew I was lying flat on the floor, on my back. My floor is some type of a hard granite so I think I might have given myself a concussion. The back of my head has a huge lump, I have a very bad headache and just feeling very tired. Never mind!! I didn t see that you guys charge for this. I should have realized that. ### REPLY: Hi. You have two major issues.1. Related to the abdominal pain and sweating, fainting and so.2. Head injury The cause for severe cramps that lead you to the bathroom, profuse sweating, dizziness and falling down must have been died to severe intestinal infection causing the third space loss of body fluids into the intestine with electrolyte imbalances and severe toxemia due to intestinal infection. The head injury due to fall on a granite floor can cause concussion, internal bleeding and so on. The hematoma at the back of the head will resolve soon. I would advise you to report to the ER urgently to get yourself examined for vital of pulse, blood pressure and other signs, and get a CT / MRI scan to prove or disprove the internal brain injury. You will also get intravenous fluids and antibiotics and supportive medicines. Also gets observation for head-injury. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a young guy to the ER tonight that was diagonosed with staph infection..The ER Nurse Practioner opened the places and cleaned them...Can anyone riding in my car catch this from riding in my car even tho the places were covered up with his clothing? ### REPLY: HelloWelcome to  It is not true that it will also infect other. Wound was covered, so you need not worry about that. For treatment, do regular . Do not bandage so hard, will affect blood circulation. If small, make it open so heal well and early. For pain advised him to take simple paracetamol or Ibuprofen. For infection to be resolved, consult for the physician for antibiotic powder and cream and medicines. Have nice time ahead... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Very good aftnoon dr. My baby is 1 year and 2 months old past 2 week she is suffering fromcold, cough, and 2 weeks before she has fell down form bike , we went to dr and he gave syp amrodil and moxcid and she had fever last week, dr please tell me the reason and also the diet ### REPLY: Hi... Thank you for consulting in . Cough and cold are viral 95% of the times in child .  For cold, you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15 mg/kg/dose (max ceiling dose 500 mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. For cold, you can use Cetirizine at 0.25 mg/kg/dose every 12 hourly for 3 days. For nasal block, plain saline nasal  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 having angioplasty with medicated sten done last april and taking ecosprin and clopitab for blood thining, 2 days back he suffered through minor brain bleeding, now what i understodd if blood thining tablets are started then bleeding risk increases , but have to resume blood thining tablets asap . what to do ### REPLY: HelloWelcome to . After an angioplasty, the patient must be on blood thinners, or it will cause blockage of the stent. The first 6 more NHS to one year after an angioplasty are most important. During this period patient should be on two blood thinners to prevent blockage of the stent. After one year, patient can be put on one blood thinner only. However, stopping of blood thinner is strongly not advice. In your case they have stopped since he had a minor bleed in the brain. But they must be started as soon as possible. Remember, the bleed happened probably due to high blood pressure or some artery malformation. So once the bleed has settled, blood pressure should be kept under strict control and one blood thinner can be started. 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: what effect does liquid morphine have on a terminally ill lung cancer patient. My husband has a pleural effusion and multiple lesions on his metastatic lung. He is 62, 190lbs and started with colon cancer 8 years ago. 3 years ago the cancer he had an operation to remove a tumor from the right lobe and 30% of his lung. After 1 year after chemo, the cancer returned to the same area. He was given 6 months to live 10 mths ago. Now, discontinued chemo after 9 wks and no improvement. He s under Hospice care, has a cough and no energy. Just lays in bed most of the time and is on oxygen most of the day. The morphine and lorazepam doesnt seem to help much but does allow him to sleep some at night. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. He has terminal stage colon and lung cancer. So no any curative treatment is there. Only symptomatic treatment is given to relieve pain. Morphine is best painkiller for terminal stage cancer pain. There is no harm in giving morphine in terminal stage cancer. Consult your doctor and take treatment 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: I had cervical spine surgery 1 year ago C4 C5 disk replacement and C4 C5 C6 fusion from an injury 11 years ago, I also have rsd/crps II in the right upper extremity. S/P surgery in have had problems with my voice, it is slowly getting better. I have burning in my neck, the back pain is the same and now I have intermittant blurred vision and I have noticed some hearing problems increasing over the past year, I cannot hear someone speak to me when there is a lot of back ground noise ### REPLY: Hello, I would explain that the hearing loss is not related to the surgery but probably related to an inner ear disorder or the head trauma.  For this reason, I recommend consulting with an ENT specialist and performing a physical exam and an audio gram. Regarding the burning in your neck, I would recommend taking pregabalin or Gabapentin.  You should discuss with your doctor on the above tests and treatment options.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having flu like symptoms for over 9 days. I dont have diarrhea nor have I actually vomited. I have a loss of appetite and after I eat I get really bad abdominal pains. I have also noticed that I am peeing a lot more and my stools seem to be getting very dark. ### REPLY: Hi, Thank you for your query. I can understand your concerns. Myositis is occasional complications of influenza infection, and it can involve abdominal muscles too. Influenza caused by avian A/H5N1 virus are reportedly associated extra-pulmonary manifestations such as diarrhea.Otherwise, flu is not associated with bad abdominal pain. Howsoever severe pain abdomen may occur due to acute pancreatitis caused by infections (coxsackievirus, cytomegalovirus, echo virus). 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 grandson chewed on a thermometer case that unfortunately contained a mercury thermometer. When I removed the case from his mouth I realized that it contained a thermometer that had been broken. I don t know if he swallowed any mercury. How dangerous is it? ### REPLY: Hello! Thank you for writing! I think that the best thing is to rule it out. You aren't sure if your grandson has swollen some, so better go to the ER. Swelling mercury its dangerous Mercury poisoning is a type of metal poisoning, due to mercury exposure. Symptoms depend upon the type, dose, method, and duration of exposure. They may include muscle weakness, poor coordination, numbness in the hands and feet, skin rashes, anxiety, memory problems, trouble speaking, trouble hearing, or trouble seeing. High level exposure to methyl mercury is known as McNamara disease. Methyl mercury exposure in child .  Long term complications may include kidney problems and decreased intelligence. The effects of long term low-dose exposure to methyl mercury. Tests of the blood, urine, and hair for mercury are available but do not relate well to the amount in the body. Wish your grandson good health. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently found out that I was pregnant, I told my boyfriend about it.  He always jokes about me getting pregnant so was not expecting his answer.  He wants me to have an abortion.  I went through the consultation for the abortion and just strongly disagree with it.  I told him about this feeling and continually have nightmares about it.  He does not want to hear this and is gong ho about this abortion.  I feel even if it was an accident why are we killing this baby, it was not its fault it was conceived and now i feel its my job to protect it but I am scared about just up and leaving, he has threatened that if i leave he will find me and take my baby that he does not want and raise it with his ex.  what should I do ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  The cause of your fear is due to conflict of opinion. That is normal. Also, you have a good human view point towards this issue. But you must also understand your husbands view. He could be compelling you to abort because of some compelling issues. Talk to him about this. Understand his feelings and points. Do not argue. Arguments always provides no result. Discuss. Discussions always produce results, decisions. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had what looks like a leg ulcer for almost 4 months. My doctor took swabs and told me i had peptostreptococcus. Which is an unusual bug in someone who has not had surgery. Therefore they think i must have contracted this from a insect bite. I have had a course of penicillin and a course of metronidonzle which didnt help. I now have a combination of both together which again does not seem to be helping. can you tell me a bit more about peptostreptococcus? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Peptostreptococcus is an anaerobic and aerobic bacteria. It can grow in absence and presence of oxygen. It is usually resistant to all the routinely used antibiotics, so it has not responded to metronidazole and penicillin. I advise you to take clindamycin now. This .  It is potent enough to kill the peptostreptococcus. Maintaining good hygiene by frequent cleaning 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: severe pain left leg knee to ankle. Lasts about five minutes and goes away. seems to hurt through the bone and all around the lower leg. Can t stand or walk during this time, too painful. This doesn t happen very often. could be weeks or months before it happens again. ### REPLY: Hello, High uric acid levels cause knee or ankle pain. Intense pain is experienced & repeat attacks may occur if uric acid levels are not under control. Get investigated, get Urinalysis, Synovial fluid analysis, Uric acid test (urea & creatinine), Imaging tests (CT, MRI, USG) to rule out gout, septic gout or pseudo arthritis. Your treatment will depend upon the severity of your illness diagnosed. You can take acetaminophen (Tylenol), NSAIDs (Naproxen). Do not stress unnecessarily. Keep your knee elevated on a pillow while on bed to reduce discomfort.  Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 2 year old may have a necrotic lymph node in the jaw area caused by trauma. He has been on a coures of Antibiotics for the last week after having the infected area drained via a small cut uner the chine. What would the next step in the treatment be? ### REPLY: Hi dear, I understand your concern. At the first you should consult ENT and treat throat problems with antibiotics-Ceftriaxon 100 mg/kg divided for 2,times during 7 days, decide question about tonsillectomy, If it is necessary. Secondly, take vitamin E, A and cod oil capsule, it will decrease cholesterol, also use olive oil 1 tablespoon 2 times a day. Eat pomegranate or Apple every day. Treat completely your nephritis, then cholesterol will normalize. Wishing you a 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: Over the past two weeks, I have felt a lump under the skin between my scrotum and anus, slightly towards the right side.  Painless, and not visible, I only know its there when I exert slight pressure.  Bean-shaped I guess.  49 Year old male.  I also find I am constantly tired, listless, completely without energy, total contrast to my normal self. ### REPLY: Hi, Dear,Thanks for the query to . I studied your problem in depth and I understood your concerns. Treatment-In my opinion your perineal lump for 2 was has caused systemic effects of infection with in and has lead to listless life for you. I would Suggest you to consult ER surgeon- and to take antibiotics / anti-inflammatory with hot fomentation locally or/ infra-red locally for the early recovery of the bean sized perineal lump. Cause of it is mostly a folliculitis with boil formation with cellulitis and induration in it. Leave it to ER Surgeon who would treat it accordingly for that lump. If it grows in size consult ER Surgeon. So consult your doctor and don't worry. So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to  and be comfortable to resolve your health issues. Welcome for any more query in this regard to . Write good resume and Click thanks if you feel satisfied with my advice. Have a Good Day. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello..I am seeking help for my son who is experiencing serious health problems,  He is very much overweight  and experiencing edema and kidney problems.  He is 48 and can hardly get through and 8 hour days work.  Last evening he experienced intense pain in both legs and groin area that then went into his chest.  Could  this pain be from the kidneys or heart? ### REPLY: Hello, I have gone through your query and understand your concern. I suspect he may have deep vein thrombosis. That is he have the pain in the lower limb due to the thrombosis and clot. That blood clot may break down and moved to lungs or heart and caused the chest pain. Thank god, he did not develop an acute pulmonary embolism or heart attack, a life-threatening conditions. He needs to do the further investigations like duplex Doppler ultrasound for his both legs. He needs proper treatment with blood thinners like heparin or warfarin. As he had chest pain, he may have to be investigated for any heart attack and to rule out pulmonary embolism with Electrocardiogram, Echo cardiogram, and Treadmill test. Please consult the cardiologist and get properly investigated and treated. Hope this helps. Please reply for further queries. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hai i am 15 year girl.. i have slight fever and i have whole body ache and from this morning i have pain in my throat and i could see some acne like in my throat inside .... pls pls doctor i am suffering a lot i am writing my exams now and i am suffering ### REPLY: Hello, Welcome to , The history and symptoms suggests me that you may be having upper respiratory infection, which has led to sore throat, body pain and fever. The symptoms are due to release of mediators of inflammation which is causing all these symptoms. For your symptoms I would suggest you to follow1. . Gargling with chlorhexidene mouth wash3. Oral Autoclave, 625 mg, twice daily for at least 5 days.4. Oral NSAIDs to relieve pain and fever.This medication will reduce the symptoms and improve the condition. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 50 year old man. I was diagnosed witChatDoctormon variable immunodeficiency in 2008 as you can guess I am on Igg 30g every 3 weeks, even with the medication I have a new infection every 2 to 3 weeks in hospital on IV antibiotics or at home on them.  A condition of my disease I develop DVT.s in my legs and twice I developed an embolism in my right lung 6 months later I developed one in each lung at the same time I almost died with this one.  I was started on Coumadin after the second DVT as you can see I continue to develop the clots on the meds and my doctor says I am in therapeutic range I feel every day I wake up is a crap shoot. I  have tried to find a hospital that will do a stem cell trans plant any information you can give me would be greatly appreciated.Thankn You,Lee Dudley ### REPLY: Hi, Welcome to .  Based on the information it seems that you are having a common variable immunodeficiency and has various issues like thrombosis in lungs as well as in the leg, and now you are looking for the hospital that may help you in stem cell transplantation. University of Chicago medicine (UC hospitals) will be able to help you here is the ad .  Maryland Avenue Chicago, IL 60637 | 773-702-1000AND FOR APPOINTMENT CALL 1-855-702-8222.------------------------------------------------------------------------------------------ RUMP Mario Remain Center for Blood CancersHillman Cancer Center Fourth Floor5115 Center Avenue Pittsburgh, PA 15232-1305FOR APPOINTMENT : 412-864-6600------------------------------------------------------------------------------------------hope things work out fine for you. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 20 mth old. He is presently in kerala, India. there is slight emergence if H1N1 cases, plus recently he has been visiting hospital to meet his grandmother who is admitted. does he need to get vaccinated (prophylactically). If so , which one and the dosage n frequency ### REPLY: Hi, welcome to . Since you are visiting a hospital and winter is coming, i sincerely advice you to give flu vaccine to the child. For first time vaccination of flu, the vaccine is given twice at an interval of 2 months. Thereafter a single dose of vaccine is required every year. Vaccines of flu come by the name of influence or handgrip. I hope this has helped you. Take care. Regards - .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 2 months ago, my arch started having some pain off and on.  Im teaching in China this year and do a lot of walking.  Recently, it started having more pain with the walking.  This week the pain moved up into my ankle and even aching in my leg.  I see swelling in my ankle.  What can I do to help it stop swelling and relieve the pain.  I am on my feet quite a bit and wont return to the US until July. ### REPLY: you much show an orthopedic doctor. Pain in arches can be due to flat fleet or muscle imbalances, or excessive fatigue of feet muscles and ligaments on prolonged pressure of walking, standing on hard surfaces without adequate shock absorbing cushions in insole or on faulty footwear, high heels etc. Treatment is contrast bath (alternate dipping in hot and cold water for 10 minutes, massage,elevation of feet on sitting, use of ankle support in daytime, use of silicone in-sole in footwear, Take anti-inflammatory medicines and acetaminophen. Take short breaks from walking and standing. Do toe and ankle exercises 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 small bump in my armpit. Just above the crease. It is hard and hurts when I touch it, but only a bit. There is no redness. It can move around a little bit. Area a bit warm. I have gotten the same thing in the area between my legs (area leading up to vag) ### REPLY: Hi. Thanks for your query and an elucidated history. A small lump in the armpit, which is small and just tender and can be moved a bit, without redness and the area is warm can be due to:A Sebaceous cyst just infected. Or a Lymph node. This can be confirmed by a physical examination by a General Surgeon and ultrasonography and guided FNAC. If this is a sebaceous cyst, get it removed. If a lymph node, then a course of 3 weeks of antibiotics and anti-inflammatory medicines will solve this. Since you are a female patient, Excision biopsy is a must for the following reasons - You get rid of the swelling-you get a diagnosis by histopathological examination. Also needed is a physical examination of the breasts to see whether there is a cancer ion the breast. Besides go for FNAC, mammography ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Today, while my 4 yr. old son was at school he started complaining of chest pains and holding his chest. He was screaming in pain according to his teachers. This went on for about 3-4 min. and then went away. He was born at 26 weeks premature and weighed 2lb. 2oz. He did have a slight heart murmur when he was a baby, but he is perfectly healthy now. What could it be? ### REPLY: Thanks for your question on . I can understand your concern. It is very difficult to assume diagnosis in child .  He is premature and had heart murmur, so we should definitely rule out heart and lung related diseases for his chest pain. So consult pediatrician and get done 1. ECG and 2d echo to rule out heart related causes. 2. Clinical examination of respiratory system and chest x-ray to rule out lung related causes. If all these are normal then no need to worry about major heart or lung related diseases. Simple musculoskeletal pain can be the cause for his symptoms. So give him painkiller syrup and apply warm water pad on affected areas. Don't worry, he will be alright but first rule out heart and lung diseases. Hope I have solved your query. I will be happy to help you further. Wishing good health to your son. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My biyfriend has been experiencing around 39.8 fever every night for the past week. He also seems to have a swallen tonsil although he is not experiencing any throat pain. He continues to have headaches, and fever that goes away during the day.Those are the only symptoms - no mucus- no runny nose- only headaches and high fever at night- what can this be? ### REPLY: Hello, If symptoms do not indicate a respiratory infection or develop into a cold with all the expected side effects, look into some systemic disorders. A fever for a long period of time is a concern and indicates the body is fighting an infection. Blood tests will provide a great deal of information about overall health. Mononucleosis and blood disorders are a couple of possibilities. Consider having a dental exam to rule out any oral infections. This includes an abscessed tooth or periodontal disease. An oral infection, untreated, can spread and cause a systemic reaction including sepsis. Try to control the fever with Anti-inflammatory medication, keep well HY . Thank you for your inquiry. I hope that my suggestions are helpful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband has cholesterol total cholesterol is 200 other things(ldl , triglycerides etc) he has brought under control by dieting. his 3 months average sugar is 57, can he take liv 52? will it help him? what is the dosage you recommend? will it have side effects? the allopathy doctor said since his 3 months average sugar is within limit and treadmill tests are normal he need not take cholesterol medicines. please guide. ### REPLY: HelloYour husbands findings suggests borderline high cholesterol level. He may need regular follow-up test. It is good that he has controlled other lipids like LDL and triglycerides by dieting. He should continue these measures.Ha, may need statins like atorvastatin if cholesterol level crosses 200 mg %. He should take the lot of fibers in his diet and go for brisk walk regularly. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am traveling and got a small half second electric shock on my left hand. The shock was felt mainly in my fingers though my forearm did tighten.Where I am traveling there is very limited ( potentially none ) medical services. It was about 2 hours ago, I was a bit shaken but feel fine. My question is about the shock disrupting my hearts rhythm. It feels fine but I am not sure what symptoms I should be looking for.My pulse feels strong and even at around 58bpm. How long after the shock is there any risk.Appreciate you answerLuke ### REPLY: Hi, If shock was mild no damage is done. What I guess from your description, there is a very low probability of any problem occurring after this. So it doesn't looks like a matter of worry. Shock does disrupt heart rhythm but only during the period when shock was passing through body, once it has already passed and no damage done, I think you are safe. 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: Hello, from last 2 days i am caughing (medium), but today i found some blood mix with spit(like air boobles),what could be the reason?. It only happens once, after that i drink lots of water i can feel remaining blood i drunk with water, but im feel ok now cough was reduced, almost gone ### REPLY: Thanks for your question on . I can understand your concern. Blood in sputum is known as hemoptysis. In your case possibility of friction bleeding due to coughing is more. Other causes for hemoptysis are pneumonia, tuberculosis, bronchiectasis, bronchitis and lung cancer. So better to get done chest x-ray to rule out all these lung related causes. If chest x-ray is normal than no need to worry much. You are mostly having friction bleeding due to coughing. 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: Hi, My jaw on the right side has been hurting for at least 1 week. My tongue on the right side also had a tingling sensation last week which is now gone. Now this week I noticed a pencil tip size blood blister on my gum directly behind my last tooth on gum. one day its there and the next day its gone .What could be the cause of this I a starting to worry. ### REPLY: It may either be erupting last molar which is compressing upon the nerve supplying the oral cavity. Kindly let me know your age. Or it may be Folic Acid deficiency. You may take Tab. B-FOLCIN (FOLIC ACID) 5 mg twice a day. Use a mouth wash like MEDICINE gargles four-five times a day. Cover the blister with painkiller gel like COCAINE before taking food. Do not worry about COCAINE going into stomach as it is medicine. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband just had some dental surgery.  He has hydrocodon-acetaminoph 7.5-325 for the pain.  He took an ambian to help with sleeping.  Should he be able to take one of his hydrocodon pills along with the ambian?Please send the response to  YYYY@YYYY ### REPLY: Hi. Thanks for the query. Well, it is not advisable to take narcotics with any sleep medicines as it can cause increase sleepiness, dizziness and other symptoms. So it is better to take painkillers other than narcotics for avoiding any complication. You should also consult his dentist or an Emergency room to get a prescription of painkiller other than narcotics. Narcotic along with sleep medicine can be taken only if other options are not helpful in pain relief. So better to be on safer side. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a vocal tic where i force air out of my chest putting extreme pressure in my head the veins bulge out on my left temple this has been going on for over 12months, it is worse when i am under stress which i am most of the time. I have had bouts whre I cannot even walk a straight line i feel really dizzy and my face on the left side and my left hand and forearm and left foot feel heavy and numb and tingle. I get sharp pains in the head and get confused easy and irritable lately it seems to be getting worse and i feel lighted all the time and always tired my face is slightly drooping on the left side it has been slowly drooping more an more over the months. ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. You are having tics due to stress and anxiety. Your other symptoms are also due to anxiety more. But better to rule out cardiac cause by ECG and 2d echo. If both are normal then anxiety is the cause for all your symptoms ABD tics. Better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. Avoid stress and tension. Be relax and calm. You may need anxiolytic .  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: Greetings sir ,I had a missed abortion at 8 weeks in April I just had a torch levels done last week which showed rubella IgG 93 and cmv IgG 169 which is positive rest all r negative for IgG and IgM I want to plan for pregnancy will dis affect my baby to hav any anomaly I m a nurse please feel free to inform all d pros and cons ### REPLY: HelloThanks for your query. Ig G indicates a past infection with rubella and CMV and positive IG G levels in fact indicate that you have developed immunity to the infections. You can definitely plan your pregnancy, as these results are NORMAL and you require NO TREATMENT for these reports. For the missed abortion, ideally karyotype of the products of conception should have been done. Also, screening for other infections, screening for autoimmune disorders, hypothyroidism, gestational diabetes, blood group mismatch, anomalies of the uterus, hormonal imbalance etc. should be done before planning your pregnancy. Consume folic acid for at least 3 months prior to planning your pregnancy. 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 left hand has been (just today, twice) cramped up and almost forced me to make a fist. Not sure if I need to get it looked at? or if just a overuse/cold weather issue? ( I was doing some manual labor today which involved my hands, although nothing I would think would have caused this. ### REPLY: Hi, as you mentioned cramps, it may be due to cold weather. Keeping the body warm will be advisable. Also, the sodium intake should be in adequate quantity and the neural transmission shouldn't be affected.Also, you can do regular exercises for regions lime, cervical, upper limb, Lower limbs, core, etc. by doing exercise you take into consideration the stretching and strengthening part of it which helps to keep the property of The muscle maintained and make you avoid cramps. 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: Last May I went to the Dr because I was feeling extremely weak and tired for a few weeks. Previously I had awoken one night with sweating, weakness, nausea and was very pale, I was so weak I just climbed back in bed and the next day I could not climb the stairs without resting. I wondered if I had the flu or something but the weakness persisted. When I had bloodwork done was diagnosed with severe iron deficiency (which I found unusual because I had sinus surgery in Nov and I was fine then). I am in menopause for 7 years. There was no occult blood in tests. The treatment I received was 7 iron injections. But I wanted to know the reason for the deficiency. The reason given at the time was that my pernicious anemia (PA for 15 years with monthly injections) was causing the iron to not be absorbed. However continued blood tests showed iron absorbtion from diet alone. I persevered with the Dr and he finally sent me to an internist who in turn ordered a Gastroscopy and a Colonoscopy. The results showed Negative on H. Pylori and tests for antiparietal cells postive. There are no ulcers or tumours or polyps present. Some metaplastic (sp?) cell changes probably due to a chemical bleed. (Chemical Bleed?!!) Dr said it was probably due to nsaid ingestion. I have randomly taken nsaids but never in excess or more than directed. Could a casual use of nsaid cause such a bleed and if that wasn t the cause what else could it be? Am I at risk of another bleed? Are the metaplastic cells pre-cancerous? I m confused and wanting to prevent further bleeds or catch anything possibly ominous sooner than later. ### REPLY: HI... sometimes NAS ID causes bleeding When its continuous use especially when taking before food ...but in gastrostomy I should find many small bleeding or not bleeding ulcers .and you should have complaints of Heartburn and Lower gastrointestinal bleeding which you do not have. H pylori has been implicated as a major cause of metaplastic (negative in your case) . Biopsy in gastrostomy should be from sites that show the typical appearance of whitish plaques, patches, or homogeneous discoloration(gastrostomy is normal in your case!!!!). There is something wrong . I advise you to do endoscopy again or take the biopsy to another lab.in the end :metaplastic in the stomach has a high cancer risk and is therefore defined as a precancerous condition. Be sure from diagnoses ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sudden pain in the back of my leg at the top of the right calf. I am not a runner, biker or was doing any exercise at the time. When I bend it, there is a sharp pain. I noticed it when I was walking down the steps. There is no swelling or redness. What could be the cause? ### REPLY: Your symptoms suggest that you have spasm of gastrocnemius muscle. It occurs due to unnoticed sudden jerk at knee while climbing stair or unsupported standing from sitting posture. But you need not worry at all. Rest, anti-inflammatory analgesics such as ibuprofen and muscle relaxant such as thiocolchiside will help you in reducing pain and spasm. It will take 5-10 days to heal completely. Hope this helps. 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: I am from bangalore.My husband met with an accideny on 8th of sept.He had diffuse axanol injury of brain .He was unconcious for 22 day. now he is ok, but always asking for better treatment. does it has any best dreatment,regarding this we are giving hinm levipil 500,and how long it will take to get the memory back. ### REPLY: Hi, Thank you for posting your query. I am glad to note that your husband has made an excellent recovery after being involved in a severe accident (after remaining unconscious for more than 3 weeks). Memory impairment and other cognitive impairment is common after severe head injury. Level (levetiracetam) is not used for brain recovery, but it is given to prevent fits. At Bangalore, you could take him to SIMIANS, for evaluation by a neuropsychologist. Further treatment can be suggested by them to enhance the memory. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI, I HAVE A FIVE MONTH OLD BABY SHE STARTED REFUSING BOTH BREST MILK N FORMULA SINCE A MONTH.... I CONDULTED DOC BU NO HELP. SHE DOESN CRY FOR MILK BU KEEPS ON SUCKING HER THUMB.. SHE TAKES MILK WHEN SHE IZ ASLEEP N THEN ALSO IN DEEP SLEEP SHE STOPS.. I FEEL SHE DOESN GET PROPER NUTRITION PLEASE SUGGEST????? ### REPLY: Hi..... At this age according to WHO only exclusive breastfeeding is indicated. But as you say the baby is completely refusing milk of any sort, you can start giving Carla stage one rice or Nestum rice stage 1 etc. All are same in calories and energy. Only thing is palatability which is subjective for each kid. Other home-made food options will be - 1. Deal and rice well cooked and made into a oatmeal along with ghee2. Boiled apple or banana and mashed into a paste.3. Any made cereal oatmeal preparation with additional ghee added. Remember certain principles like -1. Add one food material / cereal or fruit per week. This will be useful because if he develops vomiting or diarrhea, we will know what to avoid.2. Add vegetables and fruits made into a paste surely to avoid constipation.3. Do not add too much sugar as it may cause diarrhea. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a sharp pain in my heel when I get out of bed in the morning, or when I stand up after sitting a while. It started 10 days ago, but got much worse today. Yesterday I walked the circumference of the mall 8 times, not wearing walking shoes (i.e. sneakers). I need a cane to walk. Is that the cause for the flare up. How can I relieve the pain? ### REPLY: Your symptoms sound typical of plantar fasciitis. it's a common condition related to footwear and aging. Basically the culprit is tight ankle flexors, i.e. the Achilles tendon. This leads to microtears in the plantar fascia especially where it attaches to the heel. The inflammation and further microtears from a tight Achilles tendon make the symptoms worse and worse.I would recommend:1. Anti-inflammatories to reduce the inflammation2. Regular Achilles tendon stretching. This can be either done by pulling with a towel (while sitting) or using your body weight to extend the ankle against the floor (standing, leaning forwards with straight hip and knees). Regular stretching exercises will relax the muscle and fascia, allowing it to heal properly.3. For very acute debilitating pain, an injection can be performed to numb the area and also reduce the inflammation. However it is the proper exercises are not performed after the injection, the symptoms will recur. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i got a high wbc it 22.0 hemoglobin110 hematocrit 0.333 rbc count 3.42mcv 97.4mch32.2mchc14.8 platelet count 17.6 absolute count 17.6 lymph 2.9 mono 0.2 eos 0.2 baso 0.0 band 1.1 do i got to be worried my doctor say no ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your total WBC count is high.  Your neutrophil count is also high.  It suggests that you have some bacterial infection. You should take a course of antibiotics according to your doctors' advice. Your MTV is also high to suggest you may have it b12 deficiency.  You should take treatment for that also. Hope I have answered your question, if you have any symptoms then you can 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: hello Dr. i have white patches both side on lips. so i want treatment immediatly. now i am in chennai. where i get treatment ### REPLY: Hi!vent, Welcome to  forum, vent, treatment of lip vitiligo is difficult, but not impossible. Treatment depends upon whether the patches are spreading(active) or are they stable(inactive). If they are spreading then you need to stop the spread by taking oral steroids and immunomodulators. Along with this you can take some photo sensitizers like melanocyte to give it color. Once the patches are stable say for more than 6 months, then you can go for surgery called BLISTER ROOF GRAFTING. This is a very specialized surgery where in a blister is created on the abdomen and this thin skin is grafted over the lips, after dermabrassion of lip skin. This gives good result. You can see details in my website www.skinhairclinic.com.(vitiligo section). I hope this answers your question, if you have any further question, you can write back to us. .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 a weeks worth or less of the sprintec birth control realize that i didnt want to take them any more for the simple fact i am trying to conceive and produce my bundle of joy. I am wanting to know the side affects i may have and also what will my body go through or will have to go through after not taking this medicine.? ### REPLY: Hi, Thanks for the query. As you took the contraceptive pills only for few weeks, there may not be any major change in the hormonal levels. But better to avoid the pregnancy in the month when you took the pills. Contraceptive pills can lead to irregularity in ovulation and menstrual cycles sometimes. Usually these will become regularize soon by their own. So better to wait one to two months for regularization of the cycles. Once your cycles become regularized, track your ovulation either with kit or with follicular study. And plan unprotected intercourse around that period. This will increase the possibility of pregnancy. Start taking folic acid supplementation from downwards. 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 Sperm Count = 26.50 million/ml; Motility (PR + NP) = 51%; (PR = 40%, NP = 11%) Immotility = 49%; MSC = 13.40 Million/ml; Progressive MSC = 10.60 Million/ml; Velocity = 11.00 mic/sec; Sperm Motility Index = 82.00 Ph = 8.0 Verdict Normospermia. Is there any problem to get baby? My age is 35 ### REPLY: Hello Your semen analysis findings may indicate low sperm motility. You may need investigations like routine hologram, random blood sugar, ultrasound of scrotum. Motility should be at least 55 %. Your findings suggest over all 51% overall motility, so it is low. Sperm count is normal. It should be at least 20 millions/ml. Sperm morphology is also normal. You should take anti-oxidants and do exercise. If findings persists then you may need additional fertilization techniques. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doc. This is quite a weird kind of question. I had been in depression for 2 months because of my sexual health. Although I don t have any issue with my sexual life. I am a married guy & my age is just 29. What actually happened was while I was anxious I felt a little hard tic on my penis just behind the gland while I once bent down to tie my shoe laces. It was absolutely not painful & I ve no issue getting erection. Infact I m very healthy sexually. What I am now believing is that maybe any vein would ve come under any nerve and it released when I bent. Quiet laughable. I know but please let me what that tic sensation would have been? ### REPLY: Hello, Your mentioned history doesn't suggestive of any pathology in the penis. The vein can be visible over penis skin like that of another skin area.  So you are taking anxiety unnecessarily, and might not have any pathology.  You should remove fear about intercourse. You can Consult a urologist for penis examination if you feel any difficulty in intercourse.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with a chronic partial acl tear. In the operative report it states that there was a bulge and obvious avulsion of the acl. It also said that there was an absence of the ligamentum mucosa. One Dr. said I should have acl reconstruction another said don t worry you are all good. I should preface this with the fact that I am a corrections officer and rely on stability in my legs to do my job. Any opinions? ### REPLY: Hello, I will go with the opinion of the first orthopedist. As leaving the ACL injury like this will land you in the OA knee earlier.  To avoid the early OA or in detail, if mentioned the degenerative changes will occur faster due to non-stability of the joint, and it will even damage the internal structures of the knee.  Hope I have answered your query. Let me know if I can assist you further. Take care 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 am 24 year old and have lower back pain in low temp., had meet with doctor and he suggested to take X-Ray i did the same and doctor also advised me to have a medicine called " Cyclobenzaprine " but still same problem and X-Ray Result was " everything was normal but only one thing was not good and that was "straightening of spine is seen with loss of normal curvature suggestive of muscle spasm" what that mean i dont know. please help me to resolve this problem.thank you ### REPLY: Hi, Showing loss of curvature and straightening of spine in elderly might be due to degenerative and osteoarthritis in spines. But as you are young this might be due to faulty posture of sitting. This can be due to long time sitting in front of computer or table work. Correct your posture. Sit straight and avoid bending from back while doing work. Go for back extension exercises daily. Ok and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was not feeling well and I went to the lab to be tested, I was diagnosed of malaria and typhoid, Doctor prescribed medicine for the treatment but the illness persists. subsequently, I have done eight test and treated eight times and each test result from various labs are the same - Malaria and typhoid, What is the cause and the permanent treatment/cure for it. ### REPLY: Hello tested 8 times both for malaria and typhoid fever, took treatment every time but still fever present due to malaria and typhoid. Typhoid :Depending on the specific species, salmonellosis results in typhoid fever or gastroenteritis. When tested in blood or stool, there is positive for typhoid fever as well as for non-typhoidal salmonellosis (NTS). Typhoid require treatment and the . NTS :Antibiotic treatment is not recommended in most of the cases as it does not shorten the duration of symptoms and is associated with increased rate of relapse, a prolonged carrier state, and adverse  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 aunt is to undergo valve replacement surgery, she has tooth cavity but the dental doctor checked it out and said that it would not be an issue as it is not giving any kind of problem to her at present! thought of having a second opinion but due to time constraint ended up in searching net... whats ur say on this... expecting ur valuable and a educative reply at once ### REPLY: Hello, Thanks for consulting , Read your query, as your aunt has to undergo valve replacement, and she has cavity don't worry if she doe snot have pain in cavity tooth you can go through surgery if she had pain in carious tooth then you should consult dentist and go for its treatment. I will advise you that after surgery when she is fine then consult dentist and go for treatment of tooth. Hope this will help you. Wishing you good health.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: BP 88/58 pulse 109 at rest.  I feel faint, dizzy, fatigued.  I had my gall bladder out 5 yrs ago and am going to see a urologist for some chronic problems, but other than that I am healthy. Recent cbc shows almost everything at the low end of normal. (cell counts, platelets, and metabolic stuff) 32 yrs old 59 135lbs ### REPLY: Hi, here the cause of your faint and dizzy may be your low blood pressure. Your blood pressure is really very low, and it needs treatment. You should consult the physician and should search the cause of your hypotension. Then take treatment accordingly. Your gall bladder removal has no relation with your faintness. Your CBC is almost normal as you said so just take treatment of your hypotension. Thanks for using . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI I AM 45 YRS OLD FEMALE, HAVING RECENTLY DIAGNOSED WITH GALL STONES I DO NOT HAVE ANY SYMPTOMS, EXCEPT INDIGESTION AFTER HAVING CONSUMING SOME TYPICAL ITEMS KINDLY SUGGEST ME SOME MEDICINES/TREATMENT METHODOLOGIES TO DISSOLVE THESE GALL STONES AND IMPROVE DIGESTION FURTHER AWAITING YOUR VALUABLE ENCOURAGEMENT AND GUIDANCE ### REPLY: Hi.noted history of gallstones, not associated with any sign or symptom. Clinical observation & monitoring or conservative management may be done if asymptomatic. Diet modification (low fat diet) is recommended as fatty and high cholesterol intake aggravates symptoms. Healthy lifestyle is also encouraged. A consultation with a doctor, preferably a general surgeon, for physical examination and clinical evaluation is best. Other diagnostics (such as liver function tests, bilirubin, alkaline phosphatase, blood counts, ERCP/MRCP, etc.) and management (medical and/surgical if indications are found) will be directed accordingly. Definitive management is cholecystectomy (removal of your gallbladder along with stones), which can be done laparoscopically (gold standard) or through open technique. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a pain that wont leave me at rest, doctors havent found the issue, other than there was two gallbladder polyps , and I have this stomach pain that is presistent, all they give me for pain is percocet , and I live with it until these doctors can find the issue with my stomach, hard to believe other folks must have the same thing , but they cant find it, and I hate living with pain killers. Is there any  hope that the medical organization ever will find it. ### REPLY: Hello. Polyps of the gallbladder typically do not cause symptoms. What are the size of the polyps? What type of abdominal pain is it? Does the pain worsen with food or more on empty stomach? Please get evaluation with upper GI endoscopy done if pain is persisting. If you are symptomatic with biliary pain and no other cause is found, then consultation with surgeon regarding cholecystectomy should be considered ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just moved into Youngtown, AZ, which is near Peoria. I don t have really reliable transportation so would like to stay close to home. I am looking for a pain managment doctor for an evaluation and possible treatment. My issues include lower back pain T-11-T12 deforming my spinal cord. Do you have any suggestions? ### REPLY: Hello, Thanks for your query. It seems you are suffering from degenerative disc disease & it occurs due to repetitive overload or stress to the disc & it increases the risk of disc herniation & spinal canal stenosis. The main treatment of such pain is bed rest along with painkillers and muscle relaxants. Muscle relaxants can help with your symptoms if used in appropriate dosage in combination with a potent analgesic. You can get the appropriate . Meanwhile, you can follow these measures:- If the pain is severe, you need bed rest till the pain resolves. - Get some analgesics prescribed and apply analgesic spray or ointments.- While resting, keep a pillow under your knees if it doesn't bother you.- Avoid lifting heavy objects.- Back strengthening exercises and stretching exercises daily as advised by a Physiotherapist.- Avoid exercises in times of pain. - Improvise your posture while sitting.- Using an LS contour belt of appropriate size might be helpful in providing support to back muscles. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have stenitious lower back been to theropy to try,and correct the problem. It didnt do any good as I expected it wouldnt  I went to a chirprator had a pinch nerve. i have scolious curve of the spine. I went one last time,and I havent been able to walk hardly at all. Ive had this for months now went to take a walk,and had to turn around come back. I see the doctor next month to find out what will need to be done. Ive been told all kinds of things massage lazer so on. I get curious as to how long the I would I be off my feet weeks days a couple hours Plus I was told I have a sist at these thats what I was told when the MRI results were back. Not able to lift to much weight if any or stand for a long period of time. I dont want to keep haveing surgrious in order to get it right. Im at a loss : ) ### REPLY: Hello, Welcome at . I have read your details. It looks from your details that you are having back pain with deformity at your back. The abnormal curve at your back may be due to presence of displaced disc or due to spondylosis or other spine pathology. You should have some investigations including MRI of spine to check the problem. If this is an early stage then you may have relief with conservative & physiotherapy methods. In late cases or if problem is severe then you may have relief by surgery. Hope this will help you. With best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI. I have had a LP Shunt put in from a major spinal fluid leak that could not be closed, I since then have vision problems , bad head aches, and tons of back pain. I was a officer injured in the line of duty. Had a Emerg. Spinal Fusion, the doc accidently nicked the dura. 8 surgeries all together, What kind of doc do I need to search for these latest problems? Neuro, and neuro surgeon, etc. SORRY, I DIDNT KNOW I HAD TO PAY FOR THIS, NO MONEY TO PUT ON DEBIT CARD. THANKS ### REPLY: Hello Based on your description, the symptoms I am concerned about your symptoms and I would refer you to a competent neurologist who can order for routine blood test that checks your electrolyte level, vitamin assays and other metabolites. If required, your doctor may advise doing MRI brain and spine. If neurologist feel there is need for surgery again then you may need to consult neurosurgeon. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. 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 to all...i just wanna ask something about my pus infection on my delts area...im a competitive bodybuilder..before it happen i remember my last injection of steroid on that site was 1 1/2 month ago..and now my delt are infected with pus,i tried to remove those pus on my delt by sticking syringe and suck the pus on it...i drawn 20cc + of pus on that same day..i tried to take cefalixin for two weeks but nothing happen....pls help me what kind of atibiotic do i need to take...cause in planning to get back in training again for a show... ### REPLY: You probably need more extensive incision and .  20 cc is a lot of pus, so it appears that you have a pretty big infection there. To really get rid of it, the infected area needs to be opened up and rinsed out well. This is NOT something you should be doing yourself. A doctor has to do this. Best to go to emergency or urgent care and have a doctor take care of it. They might also need to take a test of the pus to see what bacteria are causing the infection and what antibiotic would be best to take. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son has never been in trouble he turned 18 last Christmas and decided to try weed.  He now smokes and recently got in trouble.   Problem is he was depressed prior to all this. Had ups and downs in his mood.  During argument about using my car he said some very dark things against my husband and I he repeatedly kept saying he will kill himself.  Things he said were very graphic.  He is refusing help from a doctor, I feel lost like theres nothing we can do.    What are my options?  He is destroying himself and we cant do a thing.  He has bouts of anger.  He in hypersensitive to smell and sound. ### REPLY: I am sorry for all the trouble you are suffering. Your story is heartbreaking. The first priority is to determine if he poses a physical threat to himself or others. Physical safety is at risk. It is imperative that you discuss this with a mental health professional, even without your son. An experienced clinician will recognize these symptoms and know exactly what to do. I wouldn't waste any time as I am concerned for all of you. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr Samuel, my name is Ruth and I just came back from visiting a friend he has been having problems digesting the food he eats. first of all about a month ago he started having abdominal pain and not able to eat as he used to. then as the days went by he started loosing weight and it would take some time to digest the food..but about a week ago hes been throwing  up most of the food he eats..what can be the cause and what do you recomend for him to do? Thank you Dr. ### REPLY: Hello, Welcome to . From your query, I suspect he may have Gastric outlet obstruction or peptic ulcer. In gastric outlet obstruction, Food can not pass through intestine from stomach due to obstruction. This results in accumulation of food in stomach and lead to recurrent omitting and abdominal pain. Chronically it ends in loss of weight. There are many causes for gastric outlet obstruction. Some are Chronic peptic ulcer disease, gastric polyps and gastric cancer. It is essential to do an upper GI endoscopy to find the cause. Also do H. Pylori test. If it is a peptic ulcer disease with H. Pylori, antibiotics and proton pump inhibitors like pantoprazole are the treatment. If it is found to be a polyp or cancer, it either needs removal or chemo and radiotherapy. Depends upon the position and involvement and extent, treatment vary. Kindly consult a Gastroenterologist. 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: I have a small lump above my collar bone. It s been there for 6 years. When I went to the doctor she said if it doesn t hurt don t worry about it. Well off and on during this time it s moved a little bit and has gotten more sensitive. It s starting to make my left ear feel like it s harder to hear. Also my throat feels like it s going numb. Any ideas of what might be wrong? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have lump over collar bone.  It can be enlarged supraclavicular lymph node. It can be due to reactive hyperplasia, tuberculosis, lymphoma or metastatic carcinoma.  Or it can be some soft tissue tumor. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, My brother has been suffering from mental health disorder since long long time almost from birth. We consulted a doctor only since 2000 and his treatment was continued till 2004. He stopped having the then prescribed medicines(sizodon and feliz). However he was alright till 2009. Again from 2010 he started becoming violent and recently his violence increased. He is non adjustive, does not like change. With lot of difficulty we have initiated treatment again but I want him to take to bangalore with me, and he is not willing to come permanently, He stays with my parents in bhubaneswar and he treats my parents very aggresively and sometime violent. He does not expose much in front of others, even me, and remains polished most of the time, please advise  doctor,  I am desperate to find out a solution.. ### REPLY: Hi, Thanks for writingFrom what I understood, your brother has some mental health issues, which has been there since early childhood, and has been causing you a lot of trouble of late. As you have mentioned, he however responds well to medicines, and hence probably that is what is needed presently. Visit a psychiatrist, and get him on a regular medicine regimen. Subsequently, the treatment can be planned accordingly. Hope that helps, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im 19yrs old. for the last 3 days my testicles have been hurting on and off, there are no lumps and i have not been sexually active for the last 2 years. only thing i have done is masturbated. im not feeling sick or anything like that. just that they hurt. sometimes the pain goes down my leg. but thats about it. they are normal color and everything ### REPLY: Hi, You may have a condition called varicocele. This is the dilation of the veins in the scrotum and this causes pain during physical activity and ejaculation. There is also a chance that you may have the pain because of frequent ejaculation. If that is the case then I suggest you abstain from is relation until the pain goes away. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my friend is an asthamatic patient suffering from childhood. He takes continous doses of capsules of deriphyllin to get instant relief. e has become more irritability & frustrate & gets angry soon. Please recommend any good asthamatic institution or any relief inhaliers other than asthalin. ### REPLY: Hello. Thank you for asking at . I went through your friends history and would make suggestions for him as follows:1. I would suggest him regular montelukast and inhaled corticosteroids for at least 3 months. Furthermore, I would also suggest him to use albuterol (Stalin that he is already using) inhaler on as-and-when-needed basis.2. Furthermore, I would recommend him allergy testing and consult an Allergist-Immunologist. This will him identify the substances causing allergies and also to know the measures to avoid them. Based on the report, an Allergist-Immunologist may prescribe him allergen specific immunotherapy which works on immune system to gradually improve his allergy symptoms on a long term basis.3. In general, I would suggest him to avoid exposure to dusts, smokes and air pollution as much as possible.4. I would also suggest him regular breathing exercises and a healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc.) to improve his lung capacity and immunity gradually over a long term basis.5. Deriphyllin is a very commonly used . Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish your friend the best of the health. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi my age is 26 yrs.i have done my thyroid t3, t4 &tsh test the result are - 122 ng/dl,10.10 mg/dl, 5.10 mIU/ml. Commets: suggesting Thyronormalcy. I am having knee pain from past 2 months. So i would like to know about my report and further treatment for my joint pain ### REPLY: Hello, As there are changes in the thyroid levels there will be kind of fatigue to set in the muscles. So by having fatigue which is a physiological process, there will be the weakness in the knee muscles leading to knee pain. Doing strengthening exercises to improve the endurance of the muscles of the knee it will be helpful to avoid knee pains. Like doing walking, reverse walking, static Qua .  Use icing as help for reducing the pain. 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: sir i am a married man for 20 years now my age is 47 and my wife is 37.we are still awaiting our child.in the 2nd year of our marriage my wife conceived but due to hypertension as doctors stated she got abortion in the 8 month.after that she developed a gaanth and 1 fallopian tube was removed.since then means from 1997 we are trying hard for child we attempted many IUI and recently we went for IVF for 3 cycles but with negative results.do you think we still stand a chance to get our child.?she started getting irregular periods irregular ovulations her eggs were not hatching on time etc.my semen showed 20% 1 grade 40% II grade with count of 10 millions kindly suggest ### REPLY: Hellos far as known to me "giant" means tumor in fallopian tube and one removed. So make clear one thing in your brain that ovulation occur once in the time of two months because one tube is no more. Your semen analysis is not complete in this query, so I will write down about fertility. Normal fertility is associated with sperm counts of > 48 million /mL with a motility of >63 % with 12 % exhibiting normal morphology.FERTILITY is seen with sperm counts of You only mentioned that there is 10 million sperm (a total or in one mL???).First get in follicular study of your wife, ovulation time, size of dominant follicle, maturation date, burst date, endometrium thickness. Still you can have baby, but it depends upon many circumstances, so either upload all reports or consult one more infertility specialist and get his opinion. Hope this information will be helpful for you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently had sinus surgery to remove a glomangiopolycatoma tumor after a positive culture for conrybacterium. the tomor was on the right side and the positive culture was on the left side. my research indicates that the only antiobiotic therapy for all strains of this bacterium is vancomycin. have other sypmtoms of this infection, lesions problems swallowing, sore muscles and hip pain. any suggestions ### REPLY: Thanks for your query at ! Sinuses are air-filled cavities in the front of the skull that connect to the nasal passages and are lined with mucosal surfaces. You suffer from Corynebacterium infection. Can you name the species? As antibiotic susceptibility varies from species to species therefore susceptibility testing is recommended. Take treatment based on sensitivity results. All the problem will subside after infection control. 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 had two episodes of heart racing, first time my heart rate was 220 and the second 190. Both times I was given something through i.v to stop and restart my heart. Since the first time I have what feels like fluttering in my heart. I am on Beta Blockers - 5mg once in the morning and 5mg at night. I was on synthroid for my thyroid but the first time I had the racing I was told to stop taking the medicine. The Dr. has now out me on Teva-Gabapentin but it does not seem to be helping either. Help!! ### REPLY: Hi Welcome to . I understand your query and concern. Arrythmias in your case could be related to stress and anxiety. Irregular heartbeat is known to alter the blood supply to the brain leading to impaired function in a transient way. Few . I advise you to have a complete 24 hour holder ECG which can accurately determine the cardiac conduction abnormalities. Monitor your blood pressure and heart rate. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear sir, my both kidney sizes reduced, i think due to high blood pressure sizes of kidneys are 7.5 and 8.1. i contact to specialist he gave me some medicines and advice for proper walk. He also advice me for food. In this regard any good suggestion is appreciated. ### REPLY: Hello, yes due to high blood pressure kidneys can take some damage and as you have, they can shrink in size and their functioning also decreases. I suppose your doctor must have put you on antihypertensive medications. For your condition not to worsen, few things are very important. First is taking medications regularly. You should not skip any medication given for high BP or delay the timings. Second thing is taking proper diet, low salt diet, less oily food, low cholesterol food will keep your blood pressure and blood cholesterol in control which is essential. Third and important thing is exercise. With regular medications and proper diet, regular exercise is also equally important as it keeps your heart functioning well and keeps your blood pressure under check. All these things will help you in long run and also keep other vital organs like kidney, heart healthy. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have just done the sonography in second trimester of pregnancy of my wife. the report impression are 1).A single live intrauterine gestation of 21 weeks and 5 days. 2). Both the fetal foot appears rotated/deviated, suggests possibility of persisitent bilateral club foot(true clubfoot) And they suggest follow up scan after 7 days please tell me what s the meaning of this report ### REPLY: Hi, Welcome to  .com.  I had gone through your question I can understand your concern about your intrauterine fetus.  The said ULTRA SOUND report suggest that the fetus is normal except he has one abnormality which is club feet. (feet are backwardly rotated). It is not fully rotated but not placed normally forwards but deviated too inwards.  This problem can be treated after birth and is highly successful if treatment is started as soon as possible. Regards .  ### END