Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 noticed my 4yr old boy has a hard lump in his front groin area. I pushed a little on it and asked him if it hurts he said no, but when I did he realized that it was there from the look on his face. He does have another knot above his belly button that a doctor once told me was a hernia he had since birth. This is the first time Ive seen the lump in the groin area. When he moves his pelvis forward and outward the lump protrudes. And it looks kinda bluish. ### REPLY: Hi, thanks for writing to  sharing your boys' health problem with us! Well, If I were his family physician for this case of a slightly tender bluish lump on the groin, I would come up with three possibilities, these include: 1. Inguinal or femoral hernia2. Benign cyst3. HemangiomaI suggest you to go for an ultrasound of the lumps for confirmation and to relieve your concerns, and then please see a surgeon for prevention and other measures and the surgical treatment if necessary at this stage! Hope this answers your question. If you have additional questions or need for more clarification please do not hesitate in writing to us. I will be happy to answer your questions. Wishing your son good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I am 35,female, 5 ft 4 inches -75 kg. and am having frequent tremors in my limbs.I also feel rigidity and mid, sweet pain in wrists, finger joints and stiffness (not painful) in knees while walking DOWN the stairs but not when walking up. I am a homemaker from past two years but am not sedentary .Is neurobin forte good fro me ? ### REPLY: Hello dear, The symptoms as mentioned in your post can be attributed to:1. Entrapment of nerve fibers at the Lumbosacral region.2. Inadequate HY .  Dietary deficiencies of certain nutrients like Iron, Calcium, vitamin D, Vitamin B12, Folic acid, etc. which help in blood formation & nerve conduction.4. Peripheral neuropathy caused due to any fluctuation in blood pressure or blood sugar level. Symptomatic relief can be obtained by intake of cervicogenic agents (like Vitamin B6, Vitamin B12, Folic acid) as well as multivitamin & multimineral supplements including iron, calcium & vitamin D needs to be added in your diet. Physiotherapy & postural exercise will also be helpful. If symptoms still persist, kindly consult a Neurologist & get a complete Neurological examination done. Certain investigations like complete blood count, serum electrolyte estimation, fresh estimation of blood pressure & blood sugar levels & nerve conduction studies will be helpful to rule out any pathological cause for the symptoms.X-ray & MRI of Lumbosacral spine can also be carried out to detect any nerve entrapment. Wishing you a 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: My husband has been experiencing allergy type symptoms, constant cough and lack of energy a lot for the past few years. We have assumed it was the allergies but has not found a lump in his glands. Any suggestions where we should go next. He manages to go to work but often comes home and falls asleep right away. Any suggestions where we should start? ### REPLY: Hello dear, thanks for your question on . I can understand your problem and situation. In my opinion you should consult pulmonologist and get done1. Chest x ray2. PUT (pulmonary function test). In your husbands' case we need to rule out bronchitis and infection. Because cough with lack of energy is seen commonly in both of these. So chest x-ray is needed to rule out lung infection.PFT is needed to rule out bronchitis. So consult pulmonologist and first diagnose your husbands condition and then start appropriate treatment. Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi im 24 yearrs female.im having chest pain sine a week.i went doctor and doctor took xray and did soem blood investigation.all the reports are normal.but now when i bend also my chest pains and i start cough.and i feel my legs are heavy when i walk.i feel my hand and foot numb. ### REPLY: Hi. I can understand your concern. Chronic cough is commonly seen in bronchitis and lung infection. Since your chest x-ray is normal, no need to worry about lung infection. Possibility of bronchitis is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid (ICS)Possibility of musculoskeletal pain is also there. Ibuprofen is anti-inflammatory. You will definitely improve witChatDoctorbination of painkiller and muscle relaxant .  Also apply warm water pad on affected areas. Avoid movements causing pain. Don't worry, you will be alright in 1-2 weeks. 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: Can a toothache cause night sweats?  Had one 3 nights in a row with a bad toothache, then had a root canal 3 days ago.  The tooth is still sensitive, but pain is calming down finally, but had a night sweat just last night.  Can this happen, or is there another concern? ### REPLY: Thanks for using . Read your query. Good that you have started the treatment and there is relief in pain. As relating to the night sweat, this should not be related to the tooth pain as such. Your query doesn't mention any medications you are on, or any other issues related to health. Just relax and if still the night sweats are persistent, kindly refer yourself to a GP.hope this was useful. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello..I am mildly asthmatic and take symbicort twice a day. I am male 59 and 11 stone in weight. For the last two weeks I have developed a tight chest sensation with occasional dry cough. Ventolin and/or symbicort do not make any difference. My peak flow reading consistently registers 610+ (as normal) when chest feels tight and this doesnt change after medication. My chest feels restricted, but I can exercise hard without any problem. The doctor has completed an ecg, blood pressure test and listened to my heart/chest - all is clear. I have a feeling that this could be anxiety, possibly a virus or an allergy to pollen. Please advice. N ### REPLY: Thanks for your question on . I can understand your concern. I don't think, your symptoms are due to worsening of asthma because your peak flow reading is consistently high. So no need to worry about viral infection or pollen allergy. So possibility of stress and anxiety related chest tightness is more. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Avoid stress and tension, be relaxed and calm. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: our prematured baby when born was 2 kg and now she is 65 days old and 4 kg and we are feeding her pre nan since mothers milk is not sufficient as per the advice of doctor, now can we shift to nan 1, what is the better option pre nana or nan 1 or nan pro 1. please suggest ### REPLY: Hello, In case of premature babies it is recommended to continue with Pre Nan (or other types of artificial baby milk) until the baby is 4 months, in order for the baby to gain weight faster. Then, you can start Nan1 until 6 months old, and then you can change to Nan 2. Your baby girl is about two months old and about 4 kg, which is lower than babies born on term. If you consult with World Health Organization growth charts with the data of your baby (2 months old and 4 kilograms) then she is under weight (she should weight about 5 kilograms at this age). Therefore, you should continue Pre Nan for at least 2 other months in order to help your baby and give her best opportunities to catch up the growth pace of non-premature babies. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am using copper t from one year but nowadays I am having too much white discharge which leaves odour in my clothes and due to it itching occurs and also head ache dizziness so suggest me should I remove copper t and due to all this reason I am suffering from ringworm at vagina , thighs, some back place also ### REPLY: Hello dear. Understand your concern. Yes this is due to side effects of copper t.if you are more uncomfortable with copper t then you can remove it, try to other contraception methods like hormonal injection & patch, diaphragm,OC pills.side effects of copper t is like menstrual problems (spotting, heavy & irregular bleeding), backpain & abdominal cramps, nausea, leucorrhea(white discharge), pelvic infection, displacement or automatic ejection of copper t, ectopic pregnancy, allergy,cuts & injury to uterus, fainting & dizziness rarely, etc...for white discharge you take 6 tablet candid, placed it in vagina every night up to 6 days or take a single dose of tab, azee 1gm,tab.mini 1 gm, tab.zocon150mg. . Take tab. Dan -P for pain. For ringworm apply ring guard over site. Hope this will help you. Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 48 year old female with allergies to seafood, shellfish, and certain pollens. I have never before had allergic symptoms to a dog however after adopting one last week I have been suffering with several symptoms including red itchy painful eyes that clump together when sleeping, a sore throat , tightness in my chest , and constant nausea that is making it almost impossible for me to eat. Is it possible to have not known that I am allergic to dog dander? Or could it be the specific breed of dog that is the issue (she is a lab). Thanks. ### REPLY: Hi, you do seem to have allergy due to dog dander. Allergy is usually not related to breed of dog. You must be allergic to all dogs dander. I think it is best for you to avoid contacts with dog. If you cannot then I suggest you go to and immunologist and get your self tested for animal dander allergy, that way you will be sure your allergic to dog dander, and also you can start treatment for it. You will have to take immunotherapy which will surly reduce your symptom .but it's a long treatment (4yr) and expensive also. I suggest you avoid dog keeping dog it is more practical. 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: My father age 60 was hit by a massive brain haemorrhage on 31-12-2012. Since then he has been in paralyzed state.he is unable to move his right side.we have tried many medicines but nothing worked.which amway product or any other medicine should be given to him? ### REPLY: Hello! I read your question carefully and understand your concern. I am sorry for your father. Unfortunately there is no effective medication in this situation. The best treatment would be physiotherapy which helps move his paralyzed limbs and relieve the stiffness. Another treatment I would recommend is a good anti hypertension therapy, in order to obtain a normal blood pressure. This would prevent a second hemorrhage which would be devastating. A low salt diet is necessary to maintain a normal blood pressure. For the speech problems looped is very helpful. Thank you for using ! 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: My husband has has sever lower back pain ever since we have been together. He has had a lower spinal fusion and numerous tests done and every doctor has a different answer. He is only 30 and feels like 80 year old man. He is now having pain in his wrists, which sweel up, sholders and sometimes his legs and arms get the tingly sensation. Lately he has been getting extremly bad migraines. We have been to the hospital for chest pains and there are still no answers. Before the doctors were just giving him scripts for pain killers and depression. He has stopped taking it all because it wasnt doing anything. We need help.. ### REPLY: Hello, I have studied your case with diligence. As per your symptoms there is possibility of pain due to bad posture as your back is involved, If not relieved then possibility of polyarthritis needs to be considered .  There is reduced chest function in this disease. Stiffness in spine is increased do you have such stiffness in spine? When such patients come to our hospital I advise them blood test like RA factor, CCP, ESR, complete blood count, HLA B27Hope 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: This is embarrassing...but the end of my spine to the top of my butt crack is really red and hurting I can t stand, sit, or lay down it hurts so bad...also like a knot there also..I m used to lot of pain cause I have RA and fibromyalgia ..any answers would be appreciated....it s not on spine more the top 3 or 4 inches of my butt ### REPLY: Rheumatoid arthritis and fibromyalgias are two different entities the present complaint pain in the lower spine from top of the buttock to the lower end of spine with redness over that area probably suggests some infectious/ inflammatory lesions. Do you have any ?  Do you history of weight loss fever and increase in the pain during the nights which probably suggests tuberculous involvement? Any history of trauma? Kindly take an x-ray lumbosacral AP and lateral views to check for any lumbar spondylosis and consult a neurologist for opinion, and he may ask you if needed an MRI. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 blood pressure yesterday was 88/60 today is 105/63 i went for a stress test yesterday and during the stress test the number still didnt come up event after the shot they gave. I have been experiencing headaches in the last week. Why is my bottom number so low? ### REPLY: Hello, the readings you mentioned are not abnormal. Actually they happen quite often. Your diastolic blood pressure (60mmHg) should not cause you any troubles. The systolic blood pressure (88mmHg) could potentially cause symptoms of faintness but please note that there are many individuals who have that kind of readings without any problem at all. This is a rather common reading in young women. Symptoms of low blood pressure are usually vision disturbances (like if the lights went out), cold sweating and the feeling you're going to pass out. Headaches usually have nothing to do with it. You haven't mentioned your medical history, so I can't tell whether these readings seem normal or could be due to .  If you're taking antihypertensive medications then you should discuss with your doctor about possible dosage changes. If you'd like to provide more information like - your usual blood pressure readings.- your medical history-the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 patch of red on the head of my penis, i believe it was from being irritated by my girlfriends teeth. Also there is a path of skin on the side of my penis that is a little bit irritated, no other issues. I am going to see a doctor tomorrow, but need a little assurance. ### REPLY: Dear Patient, Thank you very much for your question. As you mentioned, during oral sex glans penis due to its high sensitivity can be easily irritated by friction. However, it is hard to diagnose without examine a patient.  Some infections can cause inflammation of the head of the penis or Atlantis that may cause pain and a foul discharge.  My advice is to see a doctor soon. Also try to be responsible for your sexual health. Abstain from unprotected sex and limit your sexual activities to one partner who has tested free for sexually transmitted diseases. Do not think that oral sex is disease free. Oral sex can transmit infections like Chlamydia, gonorrhea and even HIV with a negligible risk.  Therefore, an unprotected oral sex is not 100% disease free, and it still poses a risk of contracting an STD.  If you have any other questions, please let me know. I hope that I answered your question. 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: So I have been having really severe stomach pains that starts around my right side of my ribs and goes down to above where my leg starts...sometime it feels like someone is ripping my stomach apart. It seems to also be pain around my belly button and my middle to lower back. I also have been really nauseous. ### REPLY: Hi, From history it seems that you might be having abdominal colic giving rise this widespread site. There might be having some GI infection or acid reflux producing this spasmodic pain with nausea. Take antispasmodic medicine like metal spas or cyclogram as needed.If you require gopher one course of ofloxacilin, tinidazole combination medicine course for 3 days. Take plenty of water. Avoid taking spicy and junk food. 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 a dry spot on my buttocks and a big lump and I mean big lump that hurts like crazy there is no eye so it cant be a boyl I can actually put my whole palm and grab it and it hurts really bad I cant sit down comfortably at work I need to know what this is is my life in danger ### REPLY: Hi ! Good evening. I am  answering your query. From your history and symptoms, it seems that you have got a cellulitis/forming abscess on your buttock. However, it needs to be examined physically and some investigations if need be to arrive at a diagnosis and a proper management. Therefore, I would suggest you to take appointment with a general surgeon in your area, and get it assessed by him. Till then, you can go for some anti-inflammatory . I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 2-3mm right disc herniation at L3-L4 level related to proximal desending right sided nerve root what is done for this. also multilevel lumbar spondylitic changes lateral disc herniation. Lateral herniation at L2 L3 YYYY@YYYY mullti level spondylitic changes an disc bulging at other levels Female 54 years old ### REPLY: Thank you for contacting . The report describes multi-level disc prolapse with nerve root compression and spondylitic changes. Treatment depends on symptoms and examination findings. In the initial phase, physiotherapy is very useful. This includes back extension exercises, traction and use of treatments like IT, ultrasound to relieve pain. You can get more details after contacting your physiotherapist. If the patient has pain, neuropathic pain medications are useful. This includes pregabalin, gabapentin, amitriptyline, etc. These are prescription medications and your GP/neurologist can prescribe them. In about 10% of cases, surgery may be required. Surgery is required in patients where medical treatment has failed or if there is severe leg pain, or as decided on the basis of clinical examination. 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: my baby is 6 months old and I just discovered a lump on his back just on the tip of his right rib cage.  i am frantic and plan on taking him to the doctor tomorrow.  have you heard talk of this before.  also when he lies on his stomach you can see the lump protruding out . ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You may have some benign lesion or may have some protruding lesion. You should go for ultrasound of that lump and if needed to go for fine needle aspiration cytology. 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: I have facial swelling... Mainly around both cheeks and under the chin ... CT scan of my sinuses came back negative, x-rays of my teeth showed no problems, blood tests showed no abnormalities related to my thyroid. As of now my doctors have no explanation and no treatment plan. Please help, this has been going on for 10 weeks. ### REPLY: Thanks for your question on . I can understand your concern. Not only thyroid diseases, many other diseases can cause facial puffiness (swelling). Diseases related to kidney, liver, heart, hypoproteinemia etc. can also cause facial puffiness. So better to consult doctor and get done 1. Liver function test including serum protein levels 2. Kidney function test 3. ECG and 2d echo to rule out heart diseases. Treatment should be started on the basis of these reports. Don't worry, you will be alright. First diagnose yourself and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my name is summer, and i have been sick lately with a mess of things, right now my main concern is i might have cancer in my breast, it is not on the breast , but it is below where the neck chest is, it is a hard lump and it is painful to touch, im pannicing and im worried i might have it... help me please.. i dont know how to tell ### REPLY: Hello and welcome to , A lump in the breast needs to be investigated. A breast lump can be benign or malignant. However, the have mentioned that the lump is at the junction of neck and chest. This lump could be arising from breast tissue or arising from the soft tissue of the chest. A clinical assessment needs to be done. Whatever be the location of the lump an aspiration cytology of the lesion needs to be done. In aspiration cytology, the cells are aspirated from the swelling, spread on glass slide and stained with appropriate stains. This investigation will determine the origin and nature of the lesion. Management can be done after getting the results of the investigations. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have m any of the symptom of appendicitis.Bloatng pain on th right lower abdomen pressure on yhe left side brings about the pain ,to mention a few.It is 130 am where I am. should I try to reach my doctor or go to th er. I am 77 and otherwise in goodhealth  WWW.WWWW.WW ### REPLY: Hello, Thanks for the query to . Forum. Pain is on the right side in lower abdominal region, so may be due to .1 Right renal colic, diagnosis can be confirmed by ultrasound of abdomen .2 Amoebic colitis, most possible reason in this age group. Diagnosis can be confirmed by physical examination .3 Appendicitis, the least possible cause in this age group, so need not worry. In my opinion consult your physician and get his opinion. At least, if pain is bearable need not visit E R. Good luck.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i am a girl my age is 21 i have severe hairfall problems for nearly more than 6 years.i have undergone a treatment in vcare center for three to five months but the results were good initially but later i again had severe hair fall. after that i tried kotakal arya vaithiya saalai for more than 6 months it was also initially good but later again i had a bunch of hair fall everytime i comb my hair. then finally i tried NUZEN gold herbal hair oil. i am using it for past 8 months and my hairfall is under little control.my hair is growing longer but not getting the volume.the roots of my hair are very week.even if i slightly massage my hair my hair will fall.i used to take care of it very gently but even then the results are very slow.i have done perming twice first time before five years and second time before three years.my hair is not at all healthy.i want a healthy hair.i am afraid of trying new things as it may not suit my hair.i use meera shampoo thrice a week.at times i do have little dandruf and ill use head and shoulders.coconut oil will not suit my scalp because it will results in more hairloss when i use it.my roots are really very week. i have heat body.my weight is 72 and my height is 166cm.i do sweat a lot.i dont have thyroid problem.please suggest me a good remedy.next year is my marriage and i want my hair to look healthy. ### REPLY: Hi, You seem to have halogen effluvium. There may be some cause. Your dermatologist might investigate to find out the cause of hair fall. Anemia, thyroid dysfunction, vitamin deficiencies, internal diseases, stress, malnutrition or internal diseases.etc. may be considered. I would suggest...- biotin 10 mg daily for long time-vitamin E 400 mg daily-vitamin B complex and minerals like Zinc, iron,copper...etc .- treatment of the cause-herbal shampoo alternate days-you may continue to apply minoxidil 2% twice a day OR- you may apply mild steroid lotion daily at night instead minoxidil. Along with herbal hair oilhole patience, as the good result take long time. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been having really bad sharp pains in my stomach and keep having headaches to the point where I m about to cry it s so uncomfortable. About a month ago they diagnosed me with a UTI but I got medication for that and should be cleared, could I have something else wrong with me? ### REPLY: Dear Patient, It sounds like you may have stomach infection. Is there any history of eating out or eating possible bad food in recent past? If yes, then I can say little more surely that you may have stomach infection. You have taken antibiotics for UTI about a month ago, so they might not be able to cover you for the recent infection. Do you have fever? Headache may be associated with fever. Also, stomach infections are very notorious for being associated with headaches. So I would not advise you to take headache as a different malady. When the stomach infection will resolve, headache will disappear automatically. I do not know what medicines you took for UTI, but I would suggest taking Norfolk 400 mg 2 times a day for 5 days. If the symptoms are not resolved, you might need to go for a complete blood test (CBC). Avoid this medicine if you are allergic to fluoroquinolones group of medicines. Furthermore, avoid eating out for a while and take diet that is easy for you to digest. I hope this helps. Wishing you good health. Take care. Thank you for choosing us to help you. Best regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Since two reoccuring bladder problems and meds, I am trying to help myself.  I was recently diagnosed with fibroids.  Will this present condition, although doctor explained it to be common, cause bladder problems.  My two are small and not worth taking out.  Doctor says "we will watch".  Only sometime I feel something and then I know I MUST drink more more water.  Pls Answer and thanks. ### REPLY: Hi, Thanks for using , I have gone through available details, you have fibroid in uterus and having recurrent bladder infection. If there is any obstruction to passage of urine then only fibroid may cause recurrent UTI. If there is no obstruction and your infection is cured after proper . Otherwise, also females are prone to urinary infection so discuss with your Gynecologist and if necessary prophylactic antibiotics may be given to you, specially in association with sexual activity. You should take proper prescription before taking any  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Why do I have a little white bump on my raphe line? Its not a painful feeling its more of a discomfort every time I pull the skin back, I m not sure if its because my girlfriend is pregnant and her change in ph level may have messed me up. Answer back ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern and I would like to say here form the history given here that you are under the wrong impression as long as the condition of your girlfriend is concern whatever the issue your girlfriend has this is nothing to take anything with yours, do not try to pull the skin frequently, in my opinion this could be developing of fibrosis and this need to be ruled out, take care and have nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my sister is suffering from hepatitis c last 7yrs treatment given which has worked on her and she has developed cirrhosis of liver throwing up blood white cells 32000 and blood count 8 every six months admitted to hospital has enlarged spleen and liver what can be done at this stage ### REPLY: Hello! Thanks for putting your query in . I am a Gastroenterologist (DM). I can understand your concerns regarding your sister. At present She requires admission and evaluation. Since She has been throwing blood she requires urgent endoscopy and therapy such as varietal banding or fungal glue. Also, She needs to be investigated for hepatitis C like HAVANA and Genotype and treatment accordingly. Moreover, She should also be evaluated for liver transplant. I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr. Grief,  I have yellow urine with an odor even though I drink alot of water a day. I also have lower back pain which maybe kidneys, but I also have deg, disc  in my lower back (difficult to issolate the two). Ive also had chills and sweats... but not very often.  No pain during urination. ### REPLY: Hello and welcome to , Lower backache along with chills can be due to urinary tract infection. Yellow colored urine is not suggestive of urinary tract infection. In case of urinary tract infection, the urine is usually turbid or contains pus. In case there are other urinary symptoms like burning sensation, increased frequency of urination, urinary tract infection is likely. However, you need to get examination of the urine to assess the presence or absence of urinary tract infection. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am high grade 3, stage 1, triple negative, node negative cancer. Second time , first cancer 5 years ago was er positive stage 1 , treated with mastectomy and aromatase inhibitors. What chemo is used for the triple negative? I am apprehensive. ### REPLY: GOOD EVENING. You have developed a 2nd breast cancer which is triple negative. The usual chemotherapy is same for any other cancer subtype (we don't use hormone and trastuzumab in it). However, triple negative tumors have high chances of recurring in first 3 years of life. It has been seen that platinum group of .  We regularly add platinum to our patients of triple negative breast cancer and results are good. YOU can tell your doctor to use platinum in your case.(reference: geparsixto and Caleb 40603 trials) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 donated a left liver lobe 5 years ago (plus gallbladder removal to better visualize and remove the liver). Initially LFTs were elevated but returned to normal. Now my LFTs are normal but my bilirubin level is mildly elevated...what is the significance of this? ### REPLY: Welcome to . Thank you for posting your query. I can understand your concern. Elevated bilirubin level without raised Liver enzymes could be due to pancreatitis obstructing the bile duct, or it could be stones in the bile duct which have originated on their own or fatty liver. It is difficult to make a pinpoint diagnosis without actually examining you. I would suggest you to - Take a soft, bland diet for a week.- Get an ultrasound of the abdomen done-Get your amylase and lipase levels revisit a gastroenterologist. He/she can examine you and correlate clinically. Hope this helps. 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: Hi, may I answer your health queries right now ?  Please type your query here...my sister has stage 4 cervical cancer it is in all her lymp nodes and has a tumor on her uterus and masses in her lungs they are not offering treatmenthow much time do you think she has left? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. She has cervical cancer with lung metastasis. It is stage 4 cancer. Surgery is not useful in this stage. So treatment options are chemotherapy and radiotherapy. But it will not cure the disease. It just works as palliative therapy. Despite all treatment prognosis remains poor. So no treatment is good option. Life expectancy is not good. Sorry to say but it is fact. Consult your oncologist and plan accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I ve been diagnosed with adrenal insufficiency due to a pituitary adenoma. I had the tumor removed in July and started on prednisone (4mg) every morning. Just how serious is this condition? Is it the same as Addison s disease? I see my endocrinologist on the 16th. What are some important questions I should be asking? I m a 65 year old woman ### REPLY: Hello. I have been through you question and understand your concern. Addisons disease is not the same to pituitary adenoids in their management though they have the same hormonal disbalance features. In these cases you should be concerned to1. Tumor recurrence - seen with an annual MRI2. Visual field impairments - tested annualy3. Hormonal screening and their eventual replacements - decided by the endocronologistHope this helps. Please feel free using MHC again ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a culture done and I have a UTI - but I am actually feeling better. My doctor prescribed Nirofurantoin Mono and I am concerned of the side affects. Do I have to take this medicine or will the UTI clear up with drinking plenty of water and cranberry juice? ### REPLY: Hello, A urinary tract infection (UTI) is a very common condition and should be treated with antibiotics if the diagnosis confirms or even empirically. Nitrofurantoin is not routinely prescribing, it's indicated in two situations: the first for pregnant and the second if sensitive in the culture. The other medications commonly prescribed: Co-trimoxazole for lower UTI and Ciprofloxacin for upper Otis. Also, you have to know that nitrofurantoin causes gastric upset most commonly, and the other serious complications like lung fibrosis occur only if you use it for the long term. Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi Dr. I am 43 years old. I just did my yearly blood work up and found that my ALT and AST is mildly elevated 35,40 respectively. everything else in my blood panel is normal escept myn lipids are 219.I was just wondering if I should be concern. I will be repeating the liver panel in 1 month. I am slightly over weight 5ft 1 in about 138 lbs most weight in my belly. I am working out and working on my eating also taking vitamins. thanks for your help ### REPLY: Hello and welcome to , AST and ALT are liver enzymes, and they are elevated in damage to hepatocytes or liver cells. The normal range for AST and ALT is 0-40 IU/L. The values of AST and ALT are within normal range in your case thus there is nothing to worry. The value of lipid is also elevated, however, you need to specify which lipid value is this. The general measures to reduce lipids in blood are to reduce the consumption of lipids and exercise regularly. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am currently taking 10 mg Percocet after being on Lortab and Norco 10 mg for over 32 years. My Doctor wanted to see if the oxycodone would give me better pain relief. I seems to be helping somewhat more, but not a whole lot. I was taking 6 Norco per day and now am taking 5 Percocet. I want to know if Percocet comes in a stronger dosage than 10mg; and if not, what we be the next step from 5 Percocet per day. Thanks ### REPLY: The narcotic in percent does come in higher doses BUT with higher doses than this there is a very real risk that 1) if you stop you will feel quite bad for 1-2 weeks (with . But then, it depends a bit on the type and etiology of the pain. If something goes in the pathway of a nerve, then that is the nerve involved. Nerves are long and the pain is in a belt-like long pathway. Smaller areas are smaller nerves. This also tends to say what might be going on. Obviously if there was an injury to the area and then there was pain outward from it "hit a nerve" would be a possibility. Sick nerves are MULTIPLE areas and tends to be the TIPS of the nerve not the whole nerve. And the point is that nerve pain can also be treated by nerve pills like anti-epileptics. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 WAS JUST RELEASED FROM THE HOSPITAL AND WAS ON BLOOD THINNERS TO HELP WHAT WAS FIRST DIAGNOSED AS A STROKE BUT MRI SHOWED NOT STROKE.HE IS 49 YRS OLD, IN GOOD HEALTH,BLOOD WORK WAS GOOD.HE HAS DEVELOPED A KNOT ON THE INSIDE OF HIS RIGHT KNEE ABOUT THE SIZE OF A MARBLE.CAME UP SUDDENLY ### REPLY: Hi, Greetings from . Since you were initially diagnosed as having stroke doctors will put you on blood thinning medicines as a first line of treatment. Problem with anticoagulants like aspirin clopidogrel will produce bleeding complications if the dosage is not titrated. This has resulted in hemorrhage or heamarthrosis. Since MRI is not suggestive of stroke you can stop or withhold blood thinners for time being and wait to subside ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Couple of days ago, I had a bar or chrunchy chocolate and since then I have a swollen gum at the back of my mouth only on the left hand side....It is just swollen and i cant eat properly....It does not hurt me alot nor is it red....Could you please help me on this? Thanks ### REPLY: Thanks for your query, I have gone through your query. The swollen gums could be because of the gum infection secondary to the deposits. The infection could have aggravated by the trauma caused by the chocolate while eating or from some other food items or while brushing. Nothing to worry, consult an oral physician and get your teeth cleaned and maintain the oral hygiene after that. Do saline gargling morning and night. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have low back pain on left side. Also am experiencing urgency to use the restroom, my urine is brown in color, with maybe a pink tint... I have had some sweats and chills, but not all the time.. Now I have dry mouth, this has been going on for a few days, but the dry mouth is new. ### REPLY: Hello! This is .  Thank you for posting your concern to . From the symptoms you are describing looks like you have a urinary tract infection, and you may need antibiotics to prevent it from getting worse. If I was your caring doctor I would suggest the following:1) Sweats and chills are sign of probable fever. Check it and if its higher than 98,6 F (37oC), you may take Paracetamol 500 mg or Ibuprofen 400 mg as needed, max 4 times/day, with food.2)  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: last Thursday I passed out in my driveway from the terrible back pain. my doc gave me oxicodone and an antiflamatory. I am supposed to see a pain management doc but I have to wait until Thursday. What can I do until then. Someone recommended B-complex. any suggestions? I am in really bad pain ### REPLY: If it's a muscular back pain then use hot pack and apply pain relieving ointment immediately after using it.  Do it multiple times a day and if possible do take painkiller for temporary use.  And I must suggest visiting physical therapist once to get some more pain relief and do take spinal exercise program also to prevent further similar episodes. By performing it regularly. Hope this was useful.  Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,my siter hit me in the face with her purse which had a bottle of water in it. My tooth cut my cheek where there is a hard lump almost like a gulf ball.  All other swelling has seem to go since this happened 5 days ago.  I am concerned that this lump wont go away!  Can you help me! ### REPLY: Hi Dear, Understanding your concern. As per your query lump on my inner cheek after an injury is due to formation of hematoma in that region. Lump formation is an inflammatory response of body or secondary inflammation. Take anti-inflammatory and analgesic like ibuprofen (if not allergic) or acetaminophen for 3-5 days. Give cold compresses 3-4 times a day. Keep cleaning it with Betadine. Hematoma may harden and will resolve with time. If condition doesn't get better in 4-5 days then consult dermatologist or your surgeon for proper examination and to find out if there is infection. Doctor may clean area with HY .  Hope your concern has been resolved. Get Well Soon. 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: Is it possible to get insulin with no preservatives?  I am allergic to preservatives and I am taking Lantus at night and I have started getting symptoms of allergies, coughing and wheezing.  Have been on the Lantus for about 5 weeks.  I stopped injecting Lantus 48 hours ago and my symptoms have subsided. ### REPLY: Hi. It's not possible to get insulin without preservatives. Insulin is degraded and it becomes impure without them. Since you have found such a strong correlation between your symptoms and insulin use my advice would be for you to undergo desensitization under the care of a dermatologist. Prior to that please undergo a patch test. If you can be managed with other injectable preparations for diabetes you should consider that. Take care.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I developed c-diff after hospitalization.  Now I have it again after taking amoxicillin for a sinus and bronchitis infection.  Will I ever be able to get shed of this stuff or is it something I will deal with every time I take antibiotics?  Is there a vaccine for it? ### REPLY: Hello understand your concerns need to ask you certain questions first. What treatment you took previously for c.difficile infection? What exactly are the symptoms you are experiencing now? C.difficile infection are generally treated by . If it is just diarrhea, it may be a mild infection, it will resolve by discontinuing antibiotics which you are already taking for other health ailment. Probiotics can be used to aid regrowth of normal intestinal flora. If symptoms persists beyond 2 days after stopping antibiotics, then a course of metro is given as mentioned above. If you have already done with this course and here is recurrence with diarrhea, fever,abdominal pain, a second line treatment with vancomycin  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Im 18 and I have suffered from chest pain fr a whole year...I sit there counting my heart beat it worry me so much...I am use to having a very strong beat then sometimes its very soft like its going to stop...but the main thing is my chest pain is on my left hand aide and when it occurs I try to pin point the location ...it ruins my life so much I suffer from aniexty and my aniexty happens more thinking about the pain...I have bin hospital doctors and nothing..my doctor saids Im fine...I just want for someone to say I will be ok :( ### REPLY: His understand your concern. Stressful life events and social life can bring psychological anxiety. Biological changes like change in neurotransmitter can also lead to anxiety and depression. It can be treated with . SSRI like Escitalopram/sertraline/paroxetine along with benzodiazepine can useful.Besides this, Lifestyle changes will helpful like exercise meditation deep breathing and hyperventilation proper sleep stress free activity do pleasurable activity music and hobbies discuss with friends see all thing with different angle positive outlook confidence all this will help you to counter daily stress. Hope for the best. 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, i just had my x-ray both chest and apico last week and it says that i have presence of few fibrohazed infiltrates in right upper lung, what does it mean? i have the same diagnosed last year and undergo the 6 mos. treatment for ptb, does it mean that i still have an active ptb or just a scar?need answers desperately please thanks ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, your current chest x-ray is suggestive of scarred lesion from previous tb infection. Any lung insult whether TB or pneumonia heal with treatment. Healing occurs in following ways. 1.  Fibrosis (most common). 2. Calcification 3. Rarely Complete resolution. So your current chest x-ray is showing, fibrotic lesions and these are nothing but old, healed, inactive, scar lesions. So no need to take anti-tubercular .  Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 3 year old son is having a fever for last 3 days yesterday the doc gave a vaccination for fever to reduce also for cough to come down ... also suffering from sever chest conjestion and cough now he has started passing frothy motion is it because of the mucus or something more serious ### REPLY: Hi Dear, Understanding your concern. As per your query your child have fever and cough which is due to chest infection due to poor immunity of child. I would suggest you to consult pediatrician once for proper examination as infection has already spread. You should get throat swab test and complete blood profile to find out extent of infection. You should start with antibiotic such as augmenting along with decongestants and anti-inflammatory such as Levocetirizine. Take diet rich in multivitamins. Mantra and leveling syrup is a safe combination for child. For now do warm saline gargles. Take steam inhalation. Take proper rest and keep yourself HY .  Maintain hygiene. Hope your concern has been resolved. Get Well Soon. 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: My son is 21years old. At age 13we noticed changes in his self confidence etc... we took him to the Dr had him evaluated after many Dr visits and the put him on anxiety medicine and anti depressants. Sad to say he continues to go downhill more and more. We have tried treatment at mayo clinic, many psychiatrists and no help to make a short story out of the past 8 years. Now he rarely gets out of bed because he says he has so much physical pain. Can you please give me a direction to try. My son is very smart and always feels like he knows the questions the dr s are going to ask before they ask them and I feel like all of the drs WE have had contact with doesn t want anything to do with him. I know that there has to be a place where these type of people go to get help and be around others that ate intelligent to a scary leg I would appreciate any suggestions. Thank you ### REPLY: Hello and welcome to . Thanks for your query. I'm sorry to hear that your son has been doing badly despite treatment. In such cases, where multiple trials of medication fail, it is a wise thing to re-evaluate the case completely and re-examine the initial diagnosis. With the very little information you have provided about your symptoms, it is not possible to get any definitive direction about the diagnosis. I would suggest that you try to get an independent, unbiased second opinion from another psychiatrist. You can also try psychological and behavioral therapies, in addition to the medication. Wish you all the best.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had a tooth removed in hospital, 11 days ago, it was a moulder very deep and was also drilled out.  My mouth is know very difficult to open and my neck seems to be swollen more, do you think it could be a dry socket.  I am taking metrogyl 400 can not open my mouth more than 1/2 inch ### REPLY: Thanks for your query, I have gone through your query. The limited mouth opening following extraction of the tooth can be secondary to trauma to the muscle fibers while injecting local anesthesia or because of the repeated injections. The other possible cause can be a disc displacement in the temporomandibular joint due to keeping the mouth opening for long time. Nothing to be panic, it takes another 5 days to return. Meanwhile you can take ibuprofen and chlorzoxazone combination .  You can also give hot and cold fomentation over the joint. If the mouth opening does not increase in 5 days, consult an oral physician immediately. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i had a pimple like bump on my arm closest to my elbow..i squeezed it and alittle bit of blood came out. It is healed over now but still puffy. I also have a bunch more smaller ones that have developed all around my elbow now as well as some dry skin spots and occasional itching, what do i have? ### REPLY: Hello, Welcome, and thanks for sharing your concern I went through your query, and I feel, these could be allergic spots, keep your elbows clean, do not let it be wet, also watch for what you touch on that spot in the day, You should see a dermatologist, and share your concern with him/her hope my advice would have been useful, in decision-making regarding your treatment, still if you have any clarifications or doubts feel free to contact back. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an ultrasound yesterday says im 9 weeks but there is a black dot next to baby the ultrasound lady said that its old blood from conception an that it should disolve an nothing to worry about but I am, I have to take progesterone daily even when not pregnant and the dr yesterday said i didnt need it ### REPLY: Hi, Thanks for asking.  If a normal pregnancy of 9 weeks is evident in USG... also showing black dot next to pregnancy. Indicating old bleed...normally progesterone is advised till 12-14 weeks of pregnancy (to avoid recurrence of bleeding due to progesterone deficiency) Any way if your doctor had estimated progesterone in blood its normal she would advise no need of such replacement.  You should follow your treating gynecologist in such incidence.  Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a problem of retracting my foreskin while having sex due to which I found it very uncomfortable to insert in the vagina. Urologist told me I have a tight frenulum and I will have to undergo Frenuloplasty . Which eventually I underwent on June 28th 2014. I took all medicines and its been almost 2 months. Now when I try to retract my foreskin its tight and eventually it does. I tried this but due to slight pain and discomfort I haven t tried again. I feel twitching feeling and slight friction feeling when I masturbate. Is this normal? How much times does it take to heal? I am confused will I be able to pull my foreskin back with no discomfort? Well its better than before the operation for sure. But the doctor said my foreskin retracts I don t need circumscison. Please guide me. ### REPLY: Good Day, and thank you for being with  ! It has been a while after your frenuloplasty. For it to succeed you need to retract your prepuce to fully expose the glans penis, so it will dilate. If you're not dilating there is a chance that it will return to the pre-surgery tightness. For best results get a circumcision to fully expose your penile head.  I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.ChatDoctor .com/doctors/ .  Best wishes.  Manuel C. See IV, M.D. DBU FPGA ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doc,my baby was born very fair,kind of whitish.am an African woman,am light in complexion and the dad is also fair in complexion.later on the first month she developed rashes that caused a dark brown dot dot colouration permanently in between her neck and chest,and that region has been rough up till now,as if something blended or covered her skin complexing.now her colour has become brownish fair,but her finger is still very fair.I don t know if it s because of the cream am using on her which after applying on her body,I don t apply on her fingers because of sucking of the fingers..the cream is chicco,and I heard it do have fake and Original...but pls Doc,what can I eat or do to make my baby s skin shiny and glowing permanently.will be grateful to get a good result.thanks Doc..... ### REPLY: Hi...skin complexion is 100% controlled only by genes and there is no food or cream or beauty tip which can make it permanently fair or glowing or shiny. By what you quote I feel that it could be an eczema which has started all this. The trick of the management is keeping the skin moist and never allowing it to be .  For this oil massage and lotions like Hiatus will help. Regarding cure options - eczema is a sort of allergy...allergies can only be controlled and can never be cured. But usually kids grow out of it...that is as the age progresses. 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 cyst under my penis. It showed up when I was 14. Long before sexual activity. I m 35 now, it was always small, and never hurt or annoyed me, just this last week it became larger, swollen and red. It kinda hurts. Been applying warm water frequently, it seems to help. But looks like it wants to pop. I don t have health insurance. So is it an expensive procedure to have removed? Or is there something I should do? ### REPLY: Hi. It seems to be a sebaceous cyst. That is the commonest swelling in that area. You should see your GP or a Surgeon and get it removed if it is causing problems. If not then you can leave it alone. It's a minor surgery and can be done on OLD basis. No hospital admissions required. Do let us know if we can help you with any other query. You can contact me directly by leaving a Specialist question. Take care.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My symptoms started about a year ago, i was woken up suddenly in the middle of the night, it all happened so quick i jumped straight up and fell to the ground as my left leg and arm were numb and in pain, then feeling slowly came back. After this mild neck pain and stiffness started and which over the last year has progressed to severe and seems to be traveling down into the top of my back. I have constant headaches and eyeball pain as well as muscular pain in arms and legs and general fatigue . Recently my numbness sensations have started to happen more frequently again awakening suddenly during the night with one side numb and in pain and causing me to fall, sometimes i just awaken with just my arms numb. I had MRI of BRAIN AND CERVICAL SPINE in March 2012 both were clear. At time of scans i had very MILD neck pain/stiffness and only 1 episode of numbness. Since then they are becoming more and more frequent and my doctor has now diagnosed me with anxiety. Can you still have ms with an all clear mri scan? I do believe i have some anxiety but can this not also be a symptom of MS? Everything i have read, forum after forum its quite clear that doctors miss-diagnose ms all the time and that it is a very hard disease to diagnose. I am also getting physical therapy for the neck with no real affect, and when my pyhsio performed a reflex reactions exam there was no reaction to my left arm, when i told the doctor he completely ignored it. I am 25 year old male non smoker who has went from attending the gym twice a week, playing for an amateur football team and golfing regularly to basically sitting in front of the TV and not wanting to do anything. ### REPLY: Hi, welcome to .  Fortunately you are not suffering from multiple sclerosis.  It affects functions very severely.  There nothing like a numbness in only one arm or leg. So please forget about MS. Also, for diagnosis there should be combined features of clinical and radiological features.  I think your doctor is correct.  You are having anxiety related disorder. Just take a second opinion of cervical spine imaging.  Otherwise, you need to consult for anxiety.  Hope I have answered your query.  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 just inhaled one or two sunflower seeds and began coughing for about 15 min. Coughing now subsided and lot of phlem finally came up. Produced by lungs? I did not sense seed coming up in my throat and the sensation of it there is still prevalent. Now what? Drinking water and having yogurt has soothed throat. Thanks. ### REPLY: Hi, the best way to cure allergy is avoidance of it but if u had already feeling coughing type allergic response to flowers then u can take antihistamines or mast cell stabilizers or steroids as we are not suppose to prescribe medicines here, so I have mentioned only groups of that particular . There is nothing serious as most of this kind of allergy subsides by itself after 1 or 2 hours. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Wbc count done sept. 2013 and it was high. I wasn t sick. Had it tested again, a few weeks ago and Dr. Called and said it was high (20,000). Again, I m not sick. Dr. Did CBC a week later. Everything was normal, except WBC--it was stii high at 12,000. Had wbc checked again 3 weeks later and it s still high at 13,000. Dr. Said I don t have leukemia because my WBC are mature. He said he thinks Its demargination. Should I be pressing my Dr. For more testing? ### REPLY: Hello and welcome to , High leukocyte count does not occur only in leukemia. There are several other causes of increased leukocyte counts. Infections and inflammations anywhere in body can lead to elevated leukocyte counts. Since, the leukocytes are all mature thus, chances of leukemia are low. Moreover, leukemia are usually characterized by very high blood counts. Demargination is one of the causes of elevated blood counts. Thus, do not worry, repeat the total leukocyte count after about a year. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: MY HUSBAND IS EXPERIENCE SHARP STABBING PAINS ON LEFT SIDE OF UPPER ABDOMEN. HE IS VERY WEAK AND HAS NO NORMAL STRENGTH. HE IS URINATING FREQUENTLY WITH NO WARNING. HIS BREATHING IS SHALLOW. HE IS OUT OF TOWN WORKING AND IS EXPECTED HOME THURSDAY. DO YOU HAVE ANY SUGGESTIONS? DO YOU HAVE ANY THOUGHTS ,ADVISE AS TO HIS SYMPTOMS? SHOULD HE SEE HIS DOCTOR OR GO TO EMERGENCY ROOM ONCE BACK HOME? ### REPLY: Hi ! Good afternoon. I am  answering your query. If I were his doctor, after a proper general examination and a clinical examination of his abdomen, I would advise him for a routine/microscopic and culture sensitivity of his urine, a routine stool test for ova and cyst, routine blood tests like a CBC, Blood sugar, blood urea, serum creatinine, serum lipid profile, serum amylase and lipase, serum PSA and an ultrasound abdomen to rule out any intro abdominal pathology and a possible enlargement of prostate. Doing a routine ECG would be worthwhile. Further course of action would depend on the result of the clinical findings and related investigation reports. Yes, with the kind of history you have narrated about your husbands problems, he would need an immediate medical care possibly an inpatient care, and so I would advise you to take him to the ER of the nearest hospital in the town. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ll always had panic attacks since I was a child. Recently they have gotten so bad to the point I can t leave my house farther than a few miles away. I get to a certain point and I panic. Is there anyway to overcome the fear of having the panic attack, that prevents me from even trying? Nothing the doctor has given me is helping. I get so nervous going anywhere by myself. I often can t go without a loved one. I want to be independent. Any tips on how to overcome this illness? Thank you ### REPLY: Hi, thank you for using . I can understand your concern. Panic disorder is treatable condition. Most important thing is to remember that panic symptoms are mental symptoms and not a physical one. You need to master few of the relaxation methods like deep breathing, muscle relaxation etc. Keeping this in mind you can try exposure for panic provoking situation and try to get relax with the help of relaxation methods you mastered. Gradually you will be able to tolerate panic provoking situation. There are medicines available called SSRI (sertraline, peroxiding, etc), which can help you. Symptomatic treatment like Benzodiazepine can also help you to overcome the panic situation. Psychotherapy with or without medicine, like cognitive and behavioral therapy also worked well in panic disorder. Hope this will help you. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My girlfriend has been nauseated with keytones in her urine x 3 days, she was seen at her primary care physician and was told to drink more water, she has also had a tremendous amount of fatigue, she has had chronic uti s for 2years and recently had a kidney stone removed about 3 months ago, she is also having lower back pain. ### REPLY: HAI, As kidney stone may cause vomiting. Fatigue caused because of vomiting, not by kidney stone. As your kidney stone size should be ruled out with the help of ultrasound. If it is more than 2to 3 cm kindly take an opinion to treat it through lithography. If it is less than 1 cm kindly take more water as advised by your primary physician. Kindly take cyst one tablet (Himalaya Ayurveda company)- 2 twice a day. This will help in dissolving stone. Regards . Senthilnathan ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 drinking several red bulls. Was recently told I had a heart murmor. Somtimes my eyes burn.also I have had very frequent uti since drinking them. Basicly I have realized I need to stop. Also having high blooid pressure. Will every thing return to normal if I do and the murmor I never had go away? I am 47 ### REPLY: Hi There After going through your query I Understand stand your concern. I would like to tell you that Red Bull contains Caffeine and excessive use of caffeine leads to high blood pressure and high Blood pressure can cause LV dilation or LV failure which results as a murmur.It's advisable to limit use of Caffeine n Caffeine containing products and personally consult a Cardiologist to evaluate the reason or Murmur. Get one ECG and an echocardiography done and see a cardiologist with reports for proper treatment of High BP and murmur. Hopefully this will answer your query. Kind Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am female, 80 years old. I have PKD. Cysts were found on my kidneys when I was 40. I was diagnosed 10 years ago.I was anemic and Procrit was prescribed. I am still on Procrit. I am stage 3. Over time my iron level has become lower and I started taking iron supplement. Recently the iron and ferritin levels were below the level that Procrit shots can be given. I had iron infusios and my iron level went down once more and I had another infusion.My concern is that the hematoligist Dr. where I receive the Procrit suspects bleeding. I have had 2 stool sample tests with no signs of blood and I am VERY observant and have seen no blood.My question is --Even though my kidney function is good, can the iron anemia be a result of the PKD? And is there a test to confirm that?Thank you for any help you might give. ### REPLY: I would analyze the cause of anemia based on your MCV, RAW, peripheral blood smear pattern etc. In addition, tests such as reticulocyte count, serum ferritin and transferring are also required to find out the cause of your anemia. Usually polycystic kidney produces raised Hemoglobin due to increased erythropoietin, however sometimes PKD may cause anemia. This anemia is usually due to declining renal function. However, as you have described your renal function as normal I presume that renal function tests such as blood Urea nitrogen and creatinine have been done. Some other causes for anemia are anemia due to chronic blood loss. Chronic bleeding into the cysts may cause hematuria or blood in the urine which may be microscopic. To detect this we have to look at the urine report. Should you require more information you may post your complete blood count and hematological profile here for further assistance in finding out the cause of your anemia? Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am a 29 year old white male. I recently noticed a lump in my leg that seems to only appear when I put pressure on my leg. It feels soft and I can push in on it. But when I m sitting or not standing on it you can t really see it. It only seems to bulge out when I am standing or applying pressure to my foot. It almost looks like part of my vein bulging out, but it really does appear to be a bump bulging out. I couldn t figure it out, but I also noticed one in my opposite leg, that one is much smaller but does the same thing. My question is could this be cancer? Everyone I ask seems to think I m just being paranoid and that it s probably something from me running. I m not sure though because I never noticed this before and it is really worrying me. I have no insurance and I don t have a job right now as I am in college. What should I do? ### REPLY: Hi, Dear,Welcome with your query to . Studied your query in full depth of its details. Reviewed it in context of your health concerns. Based On the facts, You should go to your doctor as You mostly seem to suffer from-Varicose Vein Lump in both the legs. This lump is not due to Cancer Lump. So Don't be obsessive and Paranoid about these leg lump being -Cancerous Lumps. What You should do? Get Second Opinion from your Surgeon / or Family Doctor. If need be get the Doppler Study of the leg veins-which would fix DVT or no DVT with Short / or Long or Both System Varicose Veins in your case. Get the Veno-Stocks to get the non-surgical care of these Varicose lumps. Avoid long-standing jobs or work. Rest /Elevation with calf exercises to tone up the Venus systems. Decompressing the Chronic Exertional Stress Syn . This reply would reduce your scare hope so. This reply would help you to plan further treatment soon with your treating doctors. Best of Luck and early recovery. Welcome any further query in this regard, which would be replied in next session. Good Day!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,Me and my wife are sufferring from sneezing and slight wheezing during night. We are perfectly alright in the morning. And our child who is 2 year old is having no issue. We start sneezing when we move to bed. Is there any chance that bed may be poluted with dust? And in washroom is having a leakage issue and the wall is slightly turned to black color. Also we use mosquito repellent liquids through out the night.Please help me to get rid of sleepless nights.Thanks & RegardsArun ### REPLY: Hello. Thank you for asking at . I went through your history and would like to make following suggestions to both of you:1. In my opinion, you are spot on! All the three factors that you have mentioned can cause sneezing and wheezing.2. Most common are - house dust mites, the most important source is bedsheets.3. Indoor molds are another important causes - they origin from leakage and moist areas.4. Mosquito repellent liquids may cause sneezing but not very commonly wheezing.5. I would suggest both of you allergy testing for house dust mites and common indoor molds. Depending upon results, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which specifically works on your allergies.6. I would also suggest you regular montelukast & levocetirizine before going to bed and to use albuterol inhaler for wheezing on as-and0when-needed basis.7. Please correct the leakage area and reduce humidity in be .  I would also suggest you to wash in hot water 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: My daughter (26) is just shy of being 6 months pregnant....she is experiencing kidney stone issues. Within the last 72 hours she ended up having a stent put in and they plan to leave it there until after the baby is born. She is on the antibiotic Macrobid and I was helping her look up information on this medication. She experienced an unusual discharge (vaginal) this morning - no pain, no blood...no cramps etc. Just a discharge she hasn t seen before and she called me to ask if I thought that was normal. (She is at work) so I looked it up and see that it is possible to have a vaginal discharge while taking macrobid. Question is - without pain, blood, cramps or anything - should she call her OB about the discharge or since she is taking the medication Macrobid and it says vaginal discharge is possible.....should she just see if she continues with this discharge. I also noticed it said not to take this medication while nursing and not to take it during the last 2-4 weeks of pregnancy. THAT bothers me - why is it safe for the baby NOW but not in the last few weeks of pregnancy?? Thanks ### REPLY: Hi there,Macro bid or nitrofurantoin is the recommended antibiotic for Urinary tract infections in pregnancy except after 38 weeks as it can cause a rare type of blood disorder called hemolytic anemia in the baby. It is safe in the remainder of pregnancy and is Category B (that is proven to be not harmful). It is recreated in breast milk which is why it's not prescribed to breastfeeding mothers. If she has discharge she should get examined by an obstetrician as vaginal infection can occur in pregnancy and these need to be treated promptly to avoid preterm delivery. Hope this helps. Regards. ### END