Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, recently ive been having horible heaviness in my chest, like there is something literaly sitting on my chest making it harder to breathe. Im curious as to why i have this because its starting to affect my every day lifestyle. Ive also recently been very sleepy and my other medications dont seem to ever be working for me. I am on medications for anxiety, depression, and ocd. im unsure if this could be the cause of why im having these pains. I would really appreciate it if anyone could answer my question with any sort of advice, thankyou. ### REPLY: Howell come to ChatDoctorFrom the history given here I could guess that you must be female patient, but for age I am not sure, and you did not mention it here, this was very important because lack of this information cause the restriction.  Overview This could be anxiety and depression some patients may experience physical symptoms, this is common psychiatric disorders, your involuntary thoughts matters here, some time fear to some situation may be the reason.  Workup this is pure psychiatric disorder then no need to go for any investigation.  TreatmentS elf confidence, positive attitude, high moral, broad mind thinking, control bizarre thought, take sufficient sleep.  Medication Newer anti-depressant tricyclic .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: ive been diagnosed with a couple of issues narrowing between c5 c6 disk in neck and myalgia also in between my shoulder blades the stabbing pain comes right around through rib cage to the front of ribs plus ive been having muscle spasms in upper back for years ### REPLY: Hello, As nothing is mentioned taking any medicine and physiotherapy I will advise undergoing both as a combination therapy works better. Firstly will advise you to use the cervical soft collar to stabilize the neck muscles and spinal column to improve the intervertebral joint space. Post this static neck exercises, shoulder stabilization exercises, gentle kneading massage of the Trapezius muscles and inter-scapular muscle strengthening exercises will help to regain the muscle property, improve joint spaces and reduce the joint inflammation, muscle inflammation and pain levels. In my clinical practice of over 12 years, most patients with cervical spine pathology have responded well to a combination of .  Hope I have answered your query. Let me know if I can assist you further. Jay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: iv been suffering frm heart palpitation which my doctors cannot diagnose d cause..my angiogram result was very fine, no heart problems at all..am now taking isoptin 40mg 3X a day but palpitation still occur..my laboratories were ok but only slight electrolite diffrences..i have a mild thyroid parenchymal disease and a very tiny cyst on my thyroid..does this thyroid problem causes my palpitation? ### REPLY: Brief Answer:Yes, heart palpitations may be due to thyroid dysfunction (hyperthyroidism), even though your heart arteriogram (chromatography), is normal. Detailed Answer:Hello, Thank you for using . Yes, you may be right. Heart palpitations may occur in specific medical conditions such as hyperthyroidism, or anemia, low blood pressure, deny . In rare cases, palpitations can be a sign of a more serious heart condition. Thyroid parenchymal disorders, may be suggestive of hyperthyroidism, as the most probable cause of the symptoms such as in your case. A laboratory assessment of the thyroid hormones levels (TSH, fT3, fT4) is essential to make a right diagnosis. If hyperthyroidism is proven, you should see an endocrinologist for further treatment strategy and follow-up. Electrolyte levels assessment (Na, K, Cl, Ca) is essential, too and their correction (if deviations are noted) is necessary. Meanwhile, referring the fact that you are symptomatic (you still experience heart palpitations under Verapamil), I would suggest you to increase the dosage of Verapamil in 80 mg x 3, monitoring your blood pressure.Meanwhile, you should take plenty of water (2 - 3 liters per day). You should take an equilibrated diet. Try to avoid getting stressed or anxious. Hope this is helpful. Let me know if you need more clarifications. Otherwise, please close and rate the answer. Kind  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir, I am having problems maintaining erection. Ejaculation is also becoming difficult/painful. I am having high blood pressure and taking prolomet XL 100 in the morning and stamlo 10 in the night. Please let me know if my problems are caused by this medication. ### REPLY: Hi, Promolet-XL seems to be the cause for erection problems. Proposed XL 100 is a beta blocker commonly prescribed to treat high blood pressure, angina and irregular heart rhythms. Its most common causes include low blood pressure, fatigue, difficulty in breathing and erectile dysfunction. Stable on the other hand is unlikely to cause erectile dysfunction. Consult your treating doctor for an alternate effective but a safer medication instead of Prolomet-XL. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im married for the past 5 years, off recent me and my hubby had unprotected sex on the last day of my menstrual cycle, wherein thereafter i had slight spotting. but i think i have missed my periods by few days this month, shud i wait for few more days incase it is delayed or shud i do a pregnancy test. I dont want to concieve so soon as i have a 3yr old baby.. plz suggest ### REPLY: Hi, .  I welcome you to  VIRTUAL CLINIC. I have gone through your question, and I think I have understood your concern. Furthermore, I will suggest you the best possible treatment options. In a woman with regular cycles day 10 to 20 of the cycle is the most fertile period of cycle.  If you want to get pregnant, try to have sex at least on alternate days during this period.  As you had sex activity after this period, you are less likely to be pregnant. Still I'd you have doubts get mornings first sample of the urine tested for pregnancy. I hope this answer helps you. Thanks  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I was diagnosed with RA 6 years ago I was on Humira but I started experiencing muscle burning and very painful, my R-foot is numb. I experienced pain when breathing weakness when chewing, nightly fevers ans night sweats. I was in the hospital for a week done every test and still have no DX. Please help ### REPLY: Hi Hope this message finds you in good health. I have gone through your query in detail and understand your concern.It's due to muscle weakness and calcium and vitamin deficiency. Along with RA tablets, also take calcium and vitamin tablets Hope your query has been answeredNothing to worry about, You should eventually get back to normal. Get back to me for any FOLLOW-UP QUERIES anytime. Kind . .(MBBS, MS,MCH) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have mild cortical atrophy and cerrebellum  encephalomalasia on  mri. I get depressed some days. I had a test done and I have low average to borderline memory. I tend to forget. At times I have problems walking. Ther doctor said I have gait disturbance, atxia. My ? Is do I have dementia and is it normal with my medical status to b depressed and or have mood swings? Will my atrophy get worse over time? ### REPLY: Hello, Your symptoms could be related to a stroke. The gait disturbances and ataxia are related to the brain damage. I would like to know your age and your past medical history for a more professional opinion. Regarding your memory problems, they could be related to anxiety or depression. For this reason, it is necessary consulting with a neurologist and performing some cognitive tests to investigate for this issue. We cannot judge if your situation will get worse. It depends on the other comorbidities. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr, Daily early mornings i get itching in the nostril and starts runny nose after that. This happens when is sleep only. I wake up once i get the itchy feelfing. The day becomes a worst day of sneezing .There will be 10 sneezings per day and becoming tired. I am not happy with Alerid-D which was prescribed by my X doctor as it could not stop the runny nose but stops the Sneezing. I tried Avil as per a physicians advice it worked. I dont have any troubles for that 2 days with a tablet. Please let me know if there will be any side effects of that and also please advice will there a remedy for this problem by physical excercise or yoga . Thanks&Regards Siva ### REPLY: 1. Is it seasonal or perennial Allergy.2. Ayurveda believes AMA (Toxins) and Low Immunity level to be the prime cause of allergies.3. Elevate the head at nighttime to prevent nasal congestion.4. Avoid: dairy products, foods which are difficult to digest, cold stuff.5. In yoga, you can go for breathing Exercises like : Anulom-Vilom Panama, and after few weeks start practicing Kapalbhati.6. Practice nasal cleaning with water (JAL Net) whose effects are encouraging in relieving symptoms. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. My boyfriend and I were dry humping. He had underwear and jeans on and so did I. It was only about a minute. I saw a little wet spot on his pants and it was pre ejaculation (he did not ejaculate for a day before this incident). I kind of touched the spot with my finger. And an hour and half later i was home and washed my hands and touched myself. Also, this was 21 days after my period. I know this is a silly question, but is there any chance of pregnancy? ### REPLY: Hi, I have gone through your question, and I think I have understood your concern. As you have rightly said pre ejaculation secretion does contain sperms. But chances of getting pregnant are almost nil in your case. As you did not have any penetrative sex or spillage of semen was not there in and around the vagina. Secondly in a woman with regular cycles day 10 to 20 of the cycle is the most fertile period of the cycle.  As your episode happened on day 21 of the cycle, you almost have no chance of getting pregnant. So please do not worry.  I will suggest you to get proper sex counselling done. I hope this answer helps you. Thanks .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a large lump on my left axilla(armpit area) and went to the doctor and he scheduled me an ultrasound and to drain the abscess. What is the abscess ?  Is it bacteria attatched to my muscle? It hurts like no other when i move my arm causing  severe pain.  I am on sulfmethoxazole for it right now. It doesnt seem to alleviate the pain. the large lump on my armpit is about the size of a gold ball and hurts real bad when i push on it or try to grip it. Is the abscess the disease itself or did it manifest itself into my muscl e and that is what i felt? ### REPLY: Welcome to . 1. If you are already taking Sulfamethoxazole . 2. Abscess means well-defined infective collection with pain and tenderness and fever like symptoms.3. The lump in the underarm / axillary region most probably a hair follicle infection.4.However, as you are posted for ultrasound - it will assess the nature of the lesion and its source and extensions, after that a small incision and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir, my father-in-law ageing 62 is a diabetic patient, recently suffered from first myocardial infaction, after few days of treatment, he has undergone angiography, which shows 3 areas of blockage including 95% in major left coronary artery & other 2 in right sub coronary artery (75 & 80%). please advise ### REPLY: As left main is 90% blocked so PTC is to be done urgently, to prevent a major hearty attack as left anterior descending area and left circumflex artery arises from left main artery any blockage more than 75% is to be taken care of and should not be managed only by conservative therapy keep your father on esprit av 150/20 mg once tab allowing 2.5 mg twice tab molar XR 25 mg twice tab Eliza 0.25 mg 1 stab Imgur 30 mg once daily and plan an early PTC(stenting) to avoid any emergency life threatening solution 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 brother is 52 yeaars old. ex alcoholic with scelorcis of the liver.he has not had a drink for 10 years. he suffers severe dhiorea snd stomach pain,vomiting, lack of appetite. he keeps pigeons dogs and a parrot. enquiring about yersenia psuedo tuberculocis. as our father died from pulmonary disease. tuberculocis being the uderlyig cause ### REPLY: Hi, Welcome to  forum.  Now your brother has diarrhea, stomach pain, vomiting, and lack of appetite. These are the symptoms of G.I. infection, usually called the food poisoning, due to some bacterial or viral infection of the food consumed.  I advise you to consult a physician for diagnosis and treatment.  I usually prescribe to my patient with such symptoms ofloxacin, ornidazole, omeprazole, risperidone, dicyclomine HY .  These symptoms may not have any relation with the tuberculosis, due to the animals.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was wondering, I have just noticed a lump on my temple starting. It s a not big maybe the size of a finger tip. It hurts to touch but doesn t give me a headache. When I bite down it hurts aswell. I do a lot of strenuous work but I m not sure if that would have anything to do with it or if I should see a doctor? ### REPLY: Hello! Thank you for the query. This lump is most likely a local skin infection. It may be caused by hair follicle inflammation, sebaceous cyst or any other skin problem. It has nothing to do with your work. As it is painful, pus is most likely inside. That is why I suggest you to consult general surgeon with this issue. The lump should be incised, .  Please do not ignore the infection in this area as from temple to the brain is very close, and such infection can spread to the brain. Hope this will help. 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 doc, my 11 months old daughter is having fever since7 days, her chest X-ray confirms infection,thus  she was prescribed with 3 antibiotic injection named monocef  of which 2 have been given, but her temperature have aroused by from 101 to 102 and she has also started wommitting, so what do u suggest ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query your daughter have fever since last 7 days which could be due to viral/ bacterial infection of body. I would suggest you nothing to worry about it. You should take NSAID medication along with antibiotic such as Levofloxacin. You should take plenty of fluids. Furthermore, you should take soft and bland food. Furthermore, you should take fresh juices in diet. Visit pediatrician once and general physician once and get it examined. Go for blood tests as well. Start treatment after prescription. 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: I had gastric bypass done on nov 5th I was told I had a ulcer a few months out and have been getting treatment for it I just woke up and had what I call a attack cant move only cry becasue it feels like someone is going to rip out you belly I did get sick and there was what look like a small amount of blood in it I feel ok now but not sure if I should call my doc when I get up or go to a ER ### REPLY: Hi. Thanks for your query. You should go to ER immediately as you need an immediate investigation called :X-ray of the standing position to see gas under the diaphragm; this is to diagnose or rule out the gastric perforation, needs urgent care. This is possible in spite of your previous surgery. Also get an ultrasound of abdomen / CT scan and an ECG to see there is no heart attack. The treatment will depend upon the diagnosis. Keep yourself will orally. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 daughter is 4 months old and shes had diarrhea for almost a week now and her doctor told me theres nothing i can do to stop it but to just give her Pedialyte and i have been doing that but its not working. is there something else i could do to stop the diarrhea? ### REPLY: Hi, It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better.  Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting. You need not worry.  There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic-associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,My close friend got conceived after trying for a long time.. They even went to the infertility center and found that her husband had low motility/mobility of sperms.. but still the doc advised them to try the natural way and luckily she got conceived naturally. Now, when they went to the doctor, the doctor has prescribed her heavy doses of medicines.They have asked her to take Folic acid with 11mg, gestone tablet.They have not even tested her for progestrone hormone and prescribed it. Is it safe to take these high doses during normal/natural pregnancy? ### REPLY: HI, I understand your concern. Progesterone is a hormone that is essential for maintenance of pregnancy in early months. In its deficiency, abortion can take place. Your friend had conceived a long waiting, efforts. It is supposed to be precious pregnancy, when doctor provides extra protection to pregnancy in form of Progesterone.  It's a safe preparation, you can take it without any doubt. .  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 there my name is sarah giddins, i had a baby 4 months ago and ever since i have suffered with dizziness. I havd been to the doctors quite a few times and have given me loads of types of pills but nothing is working. The current pill they have prescribed me at the moment has given me an ear ache and made me feel very sick. As a result of the dizziness i cant do anything as i always feel light headed and feel i could pass out. I would appreciate some help as its becoming very annoying and feel like i cant do anything. Thank you ### REPLY: Hi, I am .  I have read your question with care and understand your concerns. Let me try to help you One of the common cause of Dizziness is Low Blood Pressure. You have not told me what is your current Blood Pressure and what was your blood pressure during Pregnancy Please get back to us with this detail Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. Let me know if I can assist you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive been experiencing lots of blackouts, maybe 1-2 a week. I eat regularly and properly. Ive been to the hospital about it and they can find anything. So today I went really hot and my vision went blurry and all I wanted to do was sleep. Any ideas what could be causing this? ### REPLY: Without more information on your age, medication regimen, and workups it is hard to say but in general the differential you describe can be anything from heart arrhythmias to seizures or Ties though the latter is less likely if the frequency is as high as you state.  You need to see your primary doctor who will likely run some blood work, check to make sure you are not running too low of a blood pressure due to medications or suffering from .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 abscess removed which was outside but adjacent to one of my front upper teeth. The gum has now healed after 2 weeks. There is still a sense of pressure when I touch the area, and today I have had nosebleeds immediately above the area of the former abscess. I will be seeing my orthodontist in 2 weeks. I have had nosebleeds before above this area of my gum. Is there likely to be a link between the two ? If so, what is the best treatment ? Many thanks! Richard Granshaw, WA ### REPLY: Hi Richard, your history is incomplete, you had written that you got an abscess removed, what was the etiology of that abscess and how it is removed. Does that involve the adjoining tooth. Normally if there is a pressure sensation and pus discharge from the area above the gum margin, it is because of the abscess from the tooth and the infection from the root tip is . Upper front teeth are very close to the nasal floor, it may be the possibility that the infection has perforated the nasal floor and discharge mixed with blood is coming out of nasal cavity. Meet a good dentist and get it resolved soon. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am interested to know what solution there is for someone who suffers from an insulin allergy everytime they inject themselves.  There symptoms appear within 15 minutes of  taking protophane insulin   as well as novorapid. There Blood sugars are unstable.They include diminished sensation within all fingers on both hands consistently . Last allergic reaction for this person was hospitalisation with symptoms of sore throat including swelling and ringing in ears. Are they connected?This person  is no longer on Lantus.They currently take  Novorapid three times aday but feels the diminished sensation within hands immediately within taking dosage as recommended by Doctors. A nerve conduction test was done recently and there was a strong possibility that it was carpal tunnel syndrome. The client disagrees with this diagnosis and firmly believes the insulin is causing an ongoing negative affect. They are currently on novorapid TDS 34unis/36units/34 units and protophane. There is insulin changes which tend to be ongoing as we speak. Any input would be much appreciated. ### REPLY: Many DOCTORSDONT BELIEVE BUT IT IS THE FACT THAT INSULIN CAN CAUSE ALLERGY OR IF INSULIN IS NOT CAUSING ALLERGY THE NEEDLE MAY CAUSE ALLERGY AS THE NEEDLE IS INJECTED SUBCUTANEOUSLY IT COME IN CONTACT WITH SKIN AND CAUSES METAL CONTACT ALLERGY IF IT METAL ALLERGY YOU CAN O FOR PATCH TOT AKE THE EFFECT OR IF IT IS INSULIN YOU HAVE TO CHANGE SALTS TO ORAL OR OTHER NEW SALTS NEED CONSULTATION WITH HIGHLY Specialized ALLERGY SPECIALIST DOCTOR TO COME OUT OF YOUR PROBLEMS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 shiva age 25 one day 15 days back i got severe pain on my back to stomak i tested for screening ultrasound test with that test dr said there r small stones on  my kidneys so he suggesed me to take ZURIG40mg 2-tab per day Aactually i want to know how ZURIG tab help me to melt stones how many daya it will take to mkelt and is it possible to come stones again in my life plesse give me suggessiong ### REPLY: HelloThanks for query. Your Ultrasound scanning has reveled you to have a small stone in your kidney and your family physician has prescribed tab During 4o mg. Zurig is class of . However, it is prescribed only when the stone that patient has passed out through urine or removed by intervention is analyzed in laboratory and confirmed to be Uric Acid stone and not otherwise. A small stone in the kidney will pass out spontaneously with general measures like  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i have been having severe pain in my back on right side, i have also had loose bowel motions every day sometimes more than once a day for the last 3 months. i am type 2 diabetic insulin depedant and have 2 gall stones, am a worrier and am getting really concerned, i am not sure if the back pain is kidneys, or something else, it seems to be from my hips up to my ribs, ### REPLY: Hello, Thanks for your query. The pain at the bottom center of the rib cage could be due to a renal infection or a stone if the pain does not seem to be muscular in nature. This can be ruled out after getting an ultrasound scan done. If the pain is aggravated with deep breathing or coughing then a rib injury or a muscular sprain is likely. The other causes that need to be ruled out include lung infections like pleuritic. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: will microgestin can help with lower abdominal /pressure pain  which occours mostly 3-4 days during my monthly cycle either due to 6cm fibroid or nova sure ablation sucrssfully done  about 2 years ago,no bleeding,shooting pain go to my hips to knees and all around back for those 4days.what is NATURAL cure,otherwise iam healthy 46 years old . ### REPLY: Hello, 1. Switching to organic foods By doing so you will avoid ingesting pesticides which are known to cause fibroid 2. Fresh fruits and vegetables Eating a wide range of fruits and vegetables (at least 5-7 servings a day) can help to fight fibroid, as can 3. Water As a general health rule . This will help flush toxins out of the body. 4. Fibroid friendly food Vegetables which have high fibroid-fighting properties are kale and cabbage. Include these as much as possible in your daily intake 5. Red and processed meat Avoid animal fats and processed meat as far as possible. Red meat is particularly bad for fibroid and must be avoided at all cost. 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: Fell on sidewalk face first about 8 hrs ago. Swollen, cut lip bruised and cut knee, and hurt pride initially. Now have muscle and shoulder pain, stiff jaw(think this is from the really swollen lip),pain in wrist, and headache. I assume this is all normal but are there specific things I should look for or will I just be in pain for a while given the hard fall? ### REPLY: Hello and welcome to , The injuries caused on various body parts have to be managed. The cut and swollen lip has to be managed by sterile . The body pains, pain on injured site and jaw pain should be managed by painkiller and muscle relaxant. I suggest you to consult your primary healthcare provider for clinical assessment. In case there is evidence of infection in any of the injured sites, a course of antibiotics may have to be started to control the 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 had all four wisdom teeth taken out Thursday. One side is very swollen and now has a hard lump inside the cheek that is very painful. Should I be concerned? The other side seems to be getting better but this side has this hard painful spot in the cheek. I have been on pencillin since surgery and on medrol to reduce swelling ### REPLY: Hi there A WISDOM tooth extraction wound does pains if there is abscess below. Which takes a little time to go off completely. Increase the frequency of warm saline rinses. Put cold fermentation from outside to subside the swelling. Moreover you got all the 4 wisdom teeth extracted on same day which is not advised. It's too much of exertion for anybody to take. Healing will take time.a complete extraction wound healing takes 3 months, but pain should go off completely in 3 - 5 days. There could also be chance of some broken root piece left inside the socket or a .  Thanx 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 doctori am a 22 year old girl.i was diagonised for pcod before 5 years,my doctor told me dat i hav pcod,for 6 months continously i did not have my perios..bt fdrom past 4 years i have my periods regulary because i was taking ayurveda medicenies in betwee.i am getting maaried and i am scared as top whethr i will b able 2 concieve or nt ### REPLY: Hello, Thank you for the query at . It is possible to get pregnant with PCs. Since you are having regular menstrual cycles currently, the chances of conceiving is very high. I recommend that you maintain healthy weight, eat healthy and exercise regularly. Even in women who find difficulty conceiving, there are effective treatments available for PCs and the rate of conceiving with treatment is very good. Please follow up with your doctor for further evaluation and see if you need any medications for PCs. Hope I was able to answer your questionPlease feel free to ad .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi im a cardiac patient, i have gum diease but cant afford treatment on my teeth. recently i have had a toothache in the corner of my left side and the back. now its turnt into a horriable pain spreading across my jaw, up the left side of my face and in to my head. i dont have a g.p as im moving home ### REPLY: Hello, Thanks for consulting ChatDoctorRead your query as you have toothache this toothache can be due to carious tooth, decayed tooth, periodontal problem or gingival problem like gingivitis, periodontitis. Don't be worried so much I will suggest you to do warm saline rinses two - three times a day.  You can take analgesic like Paracetamol or Diclofenac sodium by consulting with your local doctor. Consult dentist for oral examination and its treatment. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have been getting white residue on my penis, once or twice a day.I am uncut, and clean, always peel back head to pee and dab with toilet paper. The residue is like skin that i can rub off, but its not skin... ive had unprotected oral sex but thats it. Im 34 and this is a fairly new issue for me. Never had a smegma or other  issue.. ### REPLY: Hello, The Yellowish / whitish substance is called Sega. Sega is a combination of shed skin cells, skin oils, urine, sperm cells and moisture. It occurs in both male and female genital organs. In females, it collects around the clitoris and in males, Sega can collect under the foreskin. There is no evidence that Sega causes penile cancer, but its presence over a long period of time may irritate and inflame the penis, which may increase the risk of cancer. It may also make it harder to see very early cancers. Clean the area beneath your foreskin daily twice after pulling your foreskin back. 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: Went to dr today, I m on opana 15 mg er and Percocet 5 325 three time s a day for ten years now due to a very bad back injury, three ops later,failed surgery, my dr told me today that one of my enzyme levels was 89 n that I should refrain from foods like beef or fatty foods, I do not drink alcohol, dr said he will do more blood work in to months, and if this number of 89 doesn t go down I will have to go for a ultrasound of my liveris this number of 89 bad? And what does it mean? Dr also said I might have to change my pain meds ? ### REPLY: Hi welcome to , Thank you for posting your query. High or elevated liver enzymes indicate inflammation or damage to the liver cells. These damaged liver cells leak higher than normal amounts of enzymes into blood circulation, this causes elevated liver enzymes. It occurs in conditions like fatty liver, obesity, cirrhosis of liver, acute pancreatitis, Wilson s disease, hepatitis A, B, C. and prolonged use of certain .  As you are taking painkillers from a very long period, definitely it can be also one of the reason for high liver enzymes.  Hope I have answered your question. If you have further questions I will be to help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was suffering mild back back pain and associated 3 or 4 joints. She has been consulted with Dr.Vinod, orthoone in coimbatore and she has given sazo 500 for 3 months. After that medicine was stopped. After 8 months now she started pain on her back. She is aged 12 years. She has RA negative and ESR 29 per hr. Should I consult any other specialist for this or who is the best for this and I am very anixious whether this is a chronic or once she reaches puberty will go automatically? Is it a immune disorder ### REPLY: Hi, Last time, when she had the symptoms, what all joints were affected? Did it just pain or associated with swelling, redness and warmth over the affected joints also? Any history of associated fever? Recurrent attacks of back pain and joint pains, especially if associated with swelling, indicates recurrent arthritis. This can suggest VIA (juvenile idiopathic arthritis) or its variants, a counterpart of rheumatoid arthritis in adults. I would suggest you to consult a rheumatologist for evaluation. Initial basic workup can be done with a pediatrician also. You may be asked for few blood tests and an x-ray. Meanwhile, give simple analgesics like paracetamol for pain relief. Take care. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor I am very ashamed to even say my problem but have to do it anyway. I have a habit of chronic masturbation for the past 8-9yrs , now my age is 22 i still cant stop it even if i do it wouldn t last for a month or so. Is there any way to stop it ? And daily I did it more than 3-4tyms/more i think i don t even remember. I release the juices very quickly like in seconds , Would it be a problem in future , you know in sex ? Thank you in advance doctor. ### REPLY: Hi, Firstly you need not be ashamed as this is a very common problem. But you need to get over it. The good part is that you realize it as a problem and that is the first step of the treatment. Yes, frequent masturbation is a major problem, and you should stop doing that with all they will power you can muster. It leads to lethargy, premature ejaculation, limp penis and many other problems. I suggest you try and gather other hobbies like outdoor games or computers, etc. which can take your mind off the habit. You have to do it consciously, and it will happen. Believe in yourself, and it will happen, I promise you. Bring it down slowly, and you will feel the difference. Do contact me if you face any problems. You can get in touch directly by visiting my profile page or leave a Direct question for me. Take care, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering from a bit of lower back pain for the last 7-8 months. I had visited a bone specialist 7 months back. He gave me some medicine and asked me to do 3 yoga-asanas. I had relief but it has never been zero pain. some pain exists. What shall I do to reduce the pain to zero. ### REPLY: Hello, Thank you for contact us, As you described it might because of more . But Nowadays it's mostly the common problems in humans. Mainly its due to inactivity of muscles it. Today every one having totally sitting life as no work at all that could be count as a body exercise due to that problem occurs. For lower back Pain you should follow instructions described below -Best medicine for Lower back pain is Rest. Resting for some days will heal the muscles which could be damage because of jerk. Muscles need some time to heal so give them time for the same. Another way is to take message with hot or cold water, Some people take cold water and some takes hot for massage. If pain is because of any accident or something big issue than you have to concern good doctor for the same. Other exercise should be done as doctors suggest after checking you physically. Hope it will work for your back pain. Good luck, Take care. Thanks & 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 ve had diarrhea for two solid months; it started suddenly. all blood work and stool tests are normal (with exception of lipase.)Primary found a lump on my colon, ct. looked normal.(small cyst on liver) Constant bloating, gas and pain along with distended stomach. Any ideas? ### REPLY: Hello! Thank you for the query. Lump in the large intestine should be verified with colonoscopy. It can be a polyp however colon cancer is also possible. Especially if you are older than 50. Bloating, diarrhea, distended stomach clearly indicate partial bowels' obstruction. It can be caused by colon cancer. So please do not ignore it. Visit your doctor and have colonoscopy done at first. If it shows nothing, stool tests should be done next. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi ....my son is 3.9yrs at 14.3 kg...he is having fever since last 7 days....he had fever that wud hit 103.7 or 101 or 102.... high grade fever.... the doctor put him on Moxikind -cv forte (amoxycilin and potassium clavulanate oral suspension) and suggested calpol to reduce the fever..initially for the first few days inspite of giving calpol 250(5ml) ,the fever wud nt subside that much..it stayed on .. so meftal-p(3.5ml) was also given....meanwhile got his urine and blood test done...urine test was fine and the blood test showed lower platelets count... he also had tummy pain.. so now he s having oflox 100 rediuse syrup since 3 days twice daily..still he has fever that comes back every 7 hours of giving calpol... why is his fever still persisting? and is it safe to give calpol for so many days to reduce fever? urination is little lesser (3 times a day) .. stool was little constipated(passed... 2 days back)... m worried cos its been 7 days n he still gets fever! please help! ### REPLY: Hello, Diagnosis of disease does not confirm yet, seven-day fever can occur in typhoid fever, urine infection, etcetera so needs to repeat some blood test as complete blood count (CBC), Tidal, blood culture, urine culture. After the test report, we will find the diagnosis, treat accordingly. Cal pol is a safe medication, can be used for weeks in dosage prescribed by your doctor. Hope I have answered your query. Let me know if I can assist you further. Regard,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 29 yeah old female, 53 and 128 lbs.  Ive had some sort of stomach bug for the last 24 hours (vomitting, diahreah, severe cramping), and havent been able to eat much besides a few saltines.  I went to bed feeling better and knowing that by period would be starting any time now.  I think I have started my period (as expected)  owever, the menstrual discharge doesnt look like the normal blood, it looks more like bile - a yellowish color.  Kind of freaking me out!  Any explaination for that? ### REPLY: Hi. This is a very typical problem you have developed - of bile like menstrual flow. It is just possible that you have got a fistula between the upper intestines and the uterus. This can happen in cases of Endometriosis / Tuberculosis/ Gallstone getting eroded into the uterus and all such possibilities. Most important is :Get admitted as you need an observation and intravenous fluids and antibiotics. Examination by a Gynecologist and to collect the sample for showing bile into the vaginal discharge. Ultrasonography, barium studies to show of a possible fistula and to plan accordingly. The vomiting, diarrhea and cramping needs a regular treatment with antibiotics and supportive medicines, probiotics and all. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 is it that no matter how much I follow an asthma preventive plan, I still have severe attacks? ### REPLY: Hi, It is worth mentioning here that Asthma cant be cured but don't get scared. Its symptoms can be well controlled. You should be avoiding particular asthma triggers using long term control medications to prevent flare-ups and using a quick relief inhaler to control symptoms once they appear. Since how long are you Asthmatic? Since asthma changes over time, you will be working with your doctor to track your signs and symptoms and adjust the dosage of treatment as and when needed. Kindly don't lose hope. Learn more about this condition, this will help you stick to your Treatment plan and will help you understand your condition better. Exercise regularly and eat healthy nutritious balanced diet like fresh fruits and green leafy vegetables. Maintain a healthy weight and avoid stress. Use an AC at home which will reduce the amount of airborne pollen from trees, grasses and weeds that finds its way indoors and keep your indoors clean. Use a face mask for cleaning off the dust and if possible remove the Pet animals with fur and dander. Wish 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: I was diagnosed with ankylosing spondilitis in 1999 and am under the care of a rheumatologist at the University of Michigan Hospital. About two years ago, I began experiencing pain under my armpits, in my breasts, in my groin. My breasts leak drops of a clear fluid and the pain increases significantly under my arm pits, groin and breasts increases when I receive a drug for Ankylosing Spondiltis that lowers my immune system. General anethesia and local anethesia also cause significant pain under my arm pits, in my groin, and in my breasts...and it takes about one month for the pain to subside after receiving anesthesia. But these areas of pain (Under arm pits, in groin, and the breasts) are not swollen, they are only painful. What can you say about this? ### REPLY: Hello, In ankylosing, there is presence of scar tissue at various joints, your pain at arm pit and groin reason is due to that. All general anesthetic medicines alters the pain pathways with some temporary chemical alternations this may lead to pain at various joints after surgery in your case. The indomethacin is best proven medicine in AS, You may have this from your doctor on prescription for relief of such pains. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi~ I am a school nurse and looking at MRI results for a studentThe results state that there are a few scattered punctate white matter hyperintensities in both cerebral hemispheres. Significance uncertain but consideration include gliosis, punctate foci of demyelination or punctate old ischemic change.Can this affect his learning? ### REPLY: Hi, Thank you for posting your query. I have noted the MRI abnormalities of your student. I would like to reassure you that these abnormalities are minor and would not adversely affect the students learning. These findings are common in people with migraine and are not significant. The decision to use any medications would depend upon the patients symptoms. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son aged 22 yrs finished his eng.and even though got admission for p.g. course and also job opportunities is now doesnt show interest in these.  He spendsentire day with friends and demands nowadayshuge sum of money, doesnt inform us anything .we consulted a psychiatrist who initially prescribed oleanze 2.5 and noe since the problem exists has prescribed dicorate 500(at night) or dicorate 250 in the morning. I haven,t started giving the medicine (he refused to come for counselling nad he is unaware the he is given oleanze) I mix with juice and giove the medicine.  Now after reading about dicorate tabs side effects I am confused whether to start or just wait for sometime giving only oleanze 5mg or consult another psychiatrist for secnd opinion. My son wouldnt come to a doctor. ### REPLY: HiT hanks for using  Either he has behavioral issues or manic episode. If he has manic episode, only then there is benefit for giving clean and decorate. If it is his behavioral issues, in that case, you should consult a psychiatrist and get him proper evaluated. If he is not welling to go for consultation, you can get a psychiatrist for home visit. That would help to get a proper line of treatment. In case, you need further help, you can ask. 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 stomach will increase it size sometimes, after which I find difficulty in breathing. Is this related to gastric problem ? ### REPLY: Hi, your complaint may be related to gastric problem indigestion and stasis can sometimes cause fermentation and flatulence giving rise to distension of abdomen.recurrent g i infection may also be the reason of distension of abdomen .get a check-up with physician and get investigations done if required.chronic constipation also prevents normal passing of flatus and distension of abdomen. Avoid constipation, take healthy balanced diet that better be non-spicy and easily digestible .get a check-up and discuss. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had laprascopic cholecystectomy on august 23. the surgeon stated their were complications. i had five incision site; the imbilical one contained 8 sutures alone and a jp drain. since that time i have constant pain, fever, nausea, vomiting, appearance of jaundice on my face. i have been to see the surgeon four times and to the e.r. the surgeon stated that i had fluid in the abdomen and cholangitis and gave me a prescription for antibiotics that i am not responding too. i am thinking there is a bile duct injury. i have had two ct scans with contrast and it is not showing anything out of the norm they say and blood work just shows elevated wbc. i thought that it was the norm to either do a choliangagram (not spelled correctly) or ultrasound. i am looking for another doctor before it worsens. because everything i read sounds like a bile duct injury. ### REPLY: Hi, Thank you for your query on . Elevated WBC count, appearance of jaundice, fever are suggestive of infection most probably intro abdominal like cholangitis or sometimes peritonitis. You need consultation with the surgeon and physician opinion may be required to evaluate for these symptoms. Course of intravenous antibiotics may be required to fight against the infection. In mean time you need investigations like blood cultures, liver function tests, and cholangiogram to know the exact problemTherefore consult the surgeon. 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: Hi, Yesterday I started having the most unusual sudden back pain in my middle back on the right side. Later the pain seemed to travel to the right side and in my abdomen. It almost felt like something was moving on my right side, and my husband believed it to be a kidney stone. When we got home I decided to just sleep it off, although every so often I would feel a pinch and it would make me gasp. Today I am having the same pinching pain on my right side, and some dull pain in back on my right side. I am not sure what it is, but can add that a month ago I had an abnormal pap, and then three days ago had a colposcopy and some biposies taken. I have abnormal bleeding and have post coital bleeding. In addition for the last three months I have become extremely fatigued, and sometimes have pain when I urinate. I had blood taken for a vitiman A count and a urine sample, not sure about the result yet as it was Friday and my Dr. has not called me yet. She said the biopsy should take two weeks! My pap a year ago came back normal. I am 28, in good shape, and have three children. Although my abnormal pap a month ago came back showing HPV 16, and 18. Please help. Why am I having this severe sharp pain in my side right now? ### REPLY: Dear patient Considering your case it seems to be renal calculus.  Sharp pinching or grasping pain in abdomen is better known as colicky pain caused due to movement of stone within urinary tract and muscular spasm. You need to do ultrasound of abdomen asap to assess size shape and location of calculus. Need to consult expert urologist with report. Meanwhile, take Injection Tuscan which is muscle relaxant and relieves colicky pain. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there, I have a marble sized lump that is firm and movesHi there, I have a marble sized lump that is firm and moves up and down only when I swallow. It seems like it is attached to the cartilage in my throat on my right side. It is approximately 1-2 inches north of my adams apple and to the right a little bit. My doctor recommened a sonagram. I am just worried. Does it sound like something serious. Thanks ### REPLY: Hi, Dear,Thanks for the query to . I studied your problem in depth and I understood your concerns. Cause of the hard movable lump on top of throat-You seem to have-Lipoma / or a lymph node or / Thyroid Cyst. Your USG would resolve few issues .and Hence for further treatment I would advise you to Consult ER Surgeon who would treat it accordingly. This advice is based on the facts from the history you give and needs further clinical check.Hence, I would advise you to check with ER Surgeon. So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you. Hope this would relieve your problem. Welcome for any more query in this regard to . Write good resume and Click thanks if you feel satisfied with my advice. Have a Good Day. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello.I have recently been ill and sick, the last time i threw up my mouth didnt hurt but now evreytime i speak eat or drink it clicks just when i move my jaw backwards and fawards. How will i get back too normal again or is it like this forever, please help me! ### REPLY: Hi, read your query and can understand your predicament. Temporomandibular Joint disorders is the usually associated with the difficulty in eating and . I would suggest you to visit an oral surgeon at the earliest and get it treated at the earliest to avoid more complications. I would suggest a few possibilities to reduce the pain like:*Painkiller like ibuprofen and muscle relaxant can help relieve the pain.*Eat soft food and avoiding sticky food.*Avoiding excess jaw movements during yawning, eating.*Applying warm, moist heat or ice to the side of your face may help alleviate pain.*Gentle jaw exercises will also help. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. 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: So.... After I gave birth to my beautiful little girl, I decided to get on the birth control Implanon. Well it had been a year to the month since I had it put it my arm. I stopped having a period this entire year. Well... now I had a period last week that lasted 3 days (which has always been my normal menstration time.. 3-4days a month) & all of the sudden it decided to come back yesterday... I am just wondering if this is going to continue the entire time I am on the implanon. Cause lord I can deal with a monthly period... but not a weekly period. LOL any advice I would greatly appreciate! I am thinking of contacting my ob/gyn tomorrow b/c he will probably have better information for me considering I am his patient & he knows more about my history.. ### REPLY: Thank you for your question and I will try to help. Breakthrough bleeding with the implantable progesterone birth control devices is extremely common.  This commonly occurs early on after their insertion.  It also occurs over time because the progesterone in the implant leads to thinning of the uterine lining (which is normal).  This thinning is associated with breakthrough bleeding.  I do not think that this is your period because you cannot physiologically get a period every two weeks.  Finally, make sure that you check a pregnancy test.  I agree that contacting your OB/GUN is a great idea. I hope that this helps and good luck! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a rash all over my body I am a 59 year old women they are spreading more a dr called in a steroid pack and I am taking Benadryl but it is spreading more and does itch I have not taken anything different. I now have a flush face and temp of 99.3 what might this be ### REPLY: Hello, Perhaps you have Hives/ Acute Urticaria. Hives are itchy welts with a surrounding flare. Hives may happen as an allergic reaction to a food or food preservative, .  Alcohol is also a common cause of hives. I suggest you to use a soothing lotion e.g. calamine lotion, 2-3 times a day to calm down the rashes. In addition I suggest you to take an oral antihistamine e.g. Tab cetirizine 10 mg once a day for symptomatic relief from itching.  Hope I have answered your query. Let me know if you need any more assistance. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 husbands BP has been running in the 140/90.s range but tonight it was the highest at 159/104. I am concerned. Do we need to seek help now? He is 5/7" and 210# otherwise in good health. He had back surgery on May 27th and is doing well. Has been walking over 2 miles a day. ### REPLY: HelloYour husbands blood pressure is elevated, normal is less than 130/85.  To start with, he should consume no more than 2 grams of sodium/salt per day.  It sounds like he is already physically active, which is great. There are many medications that can be used to bring the blood pressure down to normal range. They should be given under physician supervision. I recommend you seek medical care soon. The effects of elevated blood pressure includes heart attack and stroke, in addition to enlarged heart. Best of 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 !   my name is Marlin and I am 51 years old.  I have condition that I have developed for the last 4 years that I believe is bronquios or Ashma. for the last 4 years I have this condition 1 or twice a year. star with wheezing or coughing really hard, I am using an inhaler Ventolin.  for two months I have this medicine plus a syrup Cheratussin AC100/10mg/5ml. The situation is that 4 days ago I started to have the coughing and several chest congestion, terrible wheezing and still like a thunderstorm. I went to a homeophatic store and bought to syrup 1 for day time, and 1 for nighttime. I didnt work, so I stop because I realize that contain suppressant. I cant  afford a doctor now, I dont have health Insurance, I have this problem that start the las week of November. I pay a clinic that was a Practitioner no a Doctor. and just got some prescription for Ventolin and cheratussin. treating myself with home remedies but right now I feel like only this terrible thunderston is in my chest .and supposed that the ventolin is for the wheezing . in the past I have taking PRO AIR AND SINGULAR. But I am taking the allergy medicine in the morning. I dont know why is this phlegm in my chest is spam there. ### REPLY: Hi and thank you so much for this query. I am so sorry to hear about what you have been experiencing. Wheezing in most cases suggest an obstruction of the airways of which the most common cause is asthma. Allergy medications and Ventolin are meant to control the symptoms and not cure asthma. The main stem of treatment is identifying the provoking factors and preventing exposure to. Some include oil, pollen, dust, cold, exercise. Etc.depending on the severity of your symptoms, you may be required to take medications daily or only take .  Ask you doctor about educational material on this to help improve your understanding and participation in the management of this condition. I hope this ad ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 died suddenly after playing handball. He was 50 years old. The doctor who did the autopsy said the cause was an enlarged heart. Hypertrophic cardiomyapthy. The night it happened would he have experienced pain like a heart attack befor he became unconscious? ### REPLY: Hello! Thank you for asking on ! I understand your concern and I would like to explain to you that facing his clinical diagnosis, it is possible he may have suffered chest pain and ischemic heart symptoms before the fatal event. Nevertheless, hypertrophic cardiomyopathy predisposes also to life-threatening arrhythmia, and when this happens it may lead to death if not promptly treated. So, there are some possibilities of the clinical scenario before the last fatal event. Hope to have been helpful. Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Rynne, I have a 42 year old daughter who has an upper eyelid that has recently dropped & is obvious in pictures. She has seen her optometrist who is referring her to an oculoplastic surgeon in Atlanta (where she lives). My concern is whether her brain should be scanned before just treating for cosmetic appearance. What do you think? Thank you, concerned mom Janice Forrest ### REPLY: Hello! Welcome on  ! You are right to think that other disorders should be excluded before discussing surgery. It is true that a lot of neurological disorders may lead to such clinical situation. For this reason, I would recommend consulting with a neurologist and performing a repetitive nerve stimulation (ENG) to exclude myasthenia. A brain MRI may be needed too. Hope you will find this answer helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have has a dull ache in the lower right side of my stomach near my hip bone which has been on and off for nearin 3 weeks now along with constant lower back ache bloating gas headache and the other night I woke in the middle of the night to vomit but do not feel ill, my cycle was delayed by 10 days but the bove was occurring a week before my cycle was due,I have taken a pregnancy test after 5 day of no cycle and was negative I don t normally have the above symptoms with my normal cycle. I have been to the doctors who have referred my for scan but this was over a week ago and I have still not had my refferal , I am worried that if it is something urgent this delay may be preventing a early resolution please help ### REPLY: Hi welcome to  forum.  You have got right lower pain, back pain, and nausea.  Your period is late by 10 days. It appears that you have urinary tract infection, or stone in the urinary tract, or pelvic inflammatory disease, or poly cystic ovarian disease. Delay in the period could be due to anemia etc. I advise you to consult a urologist, for diagnosis and treatment. You may have to go for M.R.I.besides other routine tests for confirmation.  Wishing for a quick and complete recovery, and thanks for choosing . F.  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: Doc im 17 year old nd from past two years i have been mastrubating once in a week or some time couple of time but it has increased now a days nd i really want to stop it nd i think i have even weaken up my memory is it really true that mastrubating causes memory loss if yes so how can i gain it back please help me ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. No masturbation won't cause any memory loss. People have many misconceptions in their mind regarding masturbation. In fact masturbation never cause any harm until you do it with clean hand. Masturbation has many advantages. It will relieve your sexual desire, it is safe, gives mental relaxation. It is very common practice in today's life to do masturbation. Furthermore, it will also decrease the incidence of rape in the community. You can do it safely with good hand, and it will never cause any weakness by mind or by body. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 what looks like skin tags right at the opening of my penis. Sometimes when I masterbate I see blood befor I orgasm, not in semem. I have an extremely slight pain every once and a while around my testicals and just below my waist. I was thinking it might be HVP but I am not sure. I have been tested for HIV and Syphilis so im sure its not that. ### REPLY: Hello, It may be due to urethritis or urethral carbuncle or wart or edematous mucosal rash etc. Until examination is done it is difficult to say what it is. Please post a photograph or use machine gel locally twice a day for five days. If no improvement please consult with your physician he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I think i masturbate two Saturday ago and when i did...i injured my penis now i have 2 red spots..look like bumps.i went to the emergency room and they think said it was syphilis ...they gave me shot and pills to take for 14 days...a day later...2 small bumps with a clear raise and the next day i was working and it pop with clear fluid ...i didn t hurt or anything..and after several day its still their..i need help ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have developed two fluid filled bumps on your penis after masturbation and have been diagnosed to have acquired syphilis. Please note that one can acquire syphilis only if one has sexual intercourse with a woman known to be positive for STD. The bumps that you have on penis may be due to . You need to take broad spectrum antibiotic like Čeferin along with anti-inflammatory  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HIMy mother aged 60 years, has been diagonised overian cancer 3C stage  she had undergone surjery 8 months, uterus has been removed and 6 cycles of chemotherapy has been given , At the end of 6th cycle , The CA 125 count was showing 16rescently got checked and CA 125 count has increased to 1300Kindly suggest next treatement ?? ### REPLY: Hi, dear. I have gone through your question. I can understand your concern.  CA 125 is the marker of ovarian cancer.  If it is raised up to 1300 it means you have recurrent ovarian cancer or some metastatic lesion from ovarian cancer.  You should go for ct scan abdomen to know the spread of cancer then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello sir I am 23 years old. I had a habit of masterbation after 2-3 days, but one day I felt nurvis and I thought I got weakness in my penis..so it increase my blood pressure due to is problem so tell me how I increse my penis size and stronge sex.... ### REPLY: HelloThanks for query. You had been indulged in masturbation since many years and now facing problems related to sexual activities and general weakness.First there is myth in a mind of common man that excessive masturbation is the reason of all sexual problems But I would like to state that it has been discussed in scientific forums all over the world and proved scientifically that masturbation does not have any negative effect on any organ or system in the body. All the problems that you are facing now are mind related and due to anxiety. Following measure will help you to boost up your confidence and improve your health and sexual potency. 1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc3)Take anti oxidants like Almonds 5-6 every day.4) Avoid alcohol and smoking. Though it is harmless, excessive and frequent habitual masturbation does affect quality of erection and delays ejaculation. Please try to reduce the frequency of masturbation by keeping yourself busy in activities like sports, reading , social work etc. so that you will not get free time to masturbate. There are no medicines that can increase size of the penis. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir/Ma am, Iam an anxious first-time mother based in Chennai. My daughter is 10 months 28 days old. Her birth weight was 3.5 kg, current weight 11.8 kg. She s on breast feeding & solids. She had been suffering from cold & cough for the past 4 days. At first we tried giving T-minic drops alongwith the Nasoclear nasal drops(prescribed by one doctor). When her symptoms got bad, there were coughing fits & audible wheezing, we consulted another paediatrician who s also a professor of paediatrics. After check-up(by stethoscope), he also used a device(that i later understood was a pulse oximeter), the readings were 95 & 70,(the sensor was put on her finger & toe respectively). The doctor appeared to be busy not allowing us time to ask questions or doubts. While he never explained anything regarding the findings, except that it should be 99 instead of 95,and that there was heavy phlegm in her chest built up due to cough syrups. He later proceeded to give the following list of medicines to take: 1. Montair LC kid 5ml @ N for 30 days 2. Liquid Advent Forte Syrup 2.5ml @M & N for 6 days 3. Liquid AB Phylline 10mg/ml 2.5ml @M & N for 7 days 4. Ivepread tablet4 @M-A-E-N for 3 days 5. Liquid Ceroplox 100 2.5ml @M & E There s no immediate family history of obesity, sugar or asthma(but my husband s grandmother had asthma, i don t know if that counts!). I would first of all, like to know, if it s safe for her to take so many medicines. It s extremely difficult to administer any of the above medicines(esp. the tablet which dissolved in water, is too bitter for my liking!) In just half a day s dosage administering, she s begun to show disinterest in eating & feeding breast milk. During the night, she also threw up twice(part of her solid intake & the other time, her breast feed!!) Does this mean, we should stop(any or all)the medicines?? Won t she have side effects? How to continue if her appetite s affected & her vomiting increases? Please find the time to explain & clarify, as i have to keep giving her the meds the next 3 days & I don t want my baby becoming sicker than she is, because of the drugs. An immediate response is highly appreciated. ### REPLY: Your child seems to be having wheeze associated with acute respiratory infection. This is a viral infection does not need antibiotics (perplex, advent forte). An oximeter reading of 95% is absolutely normal. You have not mentioned the respiratory rate of the child, if the respiratory rate is less than 60 then there is no need to hospitalize.Moreover, too many medications have been started without proper investigation. Please take a repeat opinion as the prescribed medications are not rational ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello! My mother aged 78 years who is being suffering from bronchitis allergy for past one decade... two days back she suddenly had short breath with noise while breathing and her foot and ankle are swollen. She has varicose veins.. Doctor have put her on CHESTON DT, DERIPHULLIE SYRUP and ZIFI 200 all twice a day... Her chest x-ray shows as all normal... is she on write medicines? please help me out.. ### REPLY: Hi, thank you for providing the brief history of your mother. As by history I can understand that your mom is 78 years old, so the Cardiorespiratory endurance will be less. Also, on addition she has asthma, so the respiratory system is weak. She has varicose vein and not the foot and ankle are swollen. To assist further a thorough neuromuscular assessment is advised. To understand the situation a little knowledge about the conditions is needed. Bronchial Asthma - as you know when people having difficulty in breathing they will consume more energy and feel weaker with fatigue. When there is bronchial Asthma the patient feels weaker to perform any activity due to early fatigue and less oxygen supply. They will have shortness of breath, difficulty in doing deep breathing. Varicose veins - this is like the clots obstructing the normal venous return and led to high blood pressure. As sometimes this leads to swelling as well. Age - as she is 78, she will have slow metabolism and the vascular system will also be slow which may lead to insufficient flow of blood to various organs of the body including the brain. In my clinical practice I deal with geriatrics range between 79-107 years of age. I have a strong recommendation for them to perform exercises. The exercises are divided into various forms. For your mothers initial complain of swelling in ankle and feet I will advise to elevate the feet and perform ankle toe movements. As it will improve the venous return and reduce the swelling & pain. Also, for asthma I will advise doing regular breathing exercises. These include the following -* deep breathing exercises* pursed lip breathing exercises* diaphragmatic breathing exercises* costal breathing exercises* abdominal breathing exercise. For the aging factor - general body exercises to improve the metabolism and immune system. By doing regular general exercises the vascular system Improves and also the blood supply to different organs which helps the other organs nourish. Also, aging demands a physical exercise, but each case has different way to deal and get helped. In aging the pain levels are not bearable and also due to lack of exercise the muscles and joints become painful. Exercise will also improve the blood supply, breathing ability, functional Mobility etc. My geriatrics patients recover in 4-8 weeks of time and prolong the therapy as long as they can perform. As by doing regular physical therapy exercise they live healthy and mobile.regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 8. He has aortic stenosis and our cardiologist said I need to be cautious of any skin infections or anything to cause valve infection He just got stung by a bee or wasp, not sure which. I have put ice on it and saw baking soda paste helps neutralize the acid. Should I be concerned and follow up in regards to the cardiac condition. Our cardiologists office is closed. Thanks ### REPLY: Hi...bee sting as such will not cause any infection. But I will tell you the danger signs of the sting getting infected - if surrounding skin is becoming red or hot or tender to touch along with high grade fever ranging more than 101 you need to be careful regarding the condition which you have mentioned. Otherwise, no need to worry about the sting. If he develops itching you can use any over the counter anti-allergic medications licensed in your country. Regards -  ### END