Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 11 year old son wets the bed, we have taken him to the doctors and he was prescribed medication that dod not agree with him, we are very concerned as it is affecting his self esteem, the doctors just keeps telling us that he will grow out of it, this is not helping him. ### REPLY: Bed-wetting is common problem in age group 5-12 years, needs to wait till 12 years of age before starting a problem.i advice you to follow these instructions:1. don't give any beverage after 5 PM, like tea, coffee which cause increased urination2. don't give any liquid diet after 8-9 PM or 2 hrs before sleeping3. Ask to urinate before going to bed, monitor it personally4. Set an alarm for midnight when he usually does bed-wetting, wake him up, take him to bathroom5. Maiatin a diary of same, follow for 1 month, tell me results ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has swelling or lump that starts from his anus to his scrotum, about 3/4 inches to 1 inch in length.It is very painful.  He is also feeling pain in the muscle of his left buttocks due to this.  He is very healthy and works out everyday.  Can you provide some feedback; is it muscular or prostate related?  He has not had any difficult urinating.  What types of doctor should be consulted. ### REPLY: Hello! Thank you for the query. Such lump is most likely a rectal abscess. It may appear due to fistula between the rectum and the skin. This causes tissues inflammation and pus accumulation. Such abscess can be related to inflammatory bowels' disease like Ulcerative Colitis. He should consult a surgeon in a first row. Abscess should be incised and pus .  He should also have colonoscopy and pelvis MRI to determine if there is a fistula. 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: Good morning, I have a numbing sensation near my left knee. If I kneel on it it hurts? It doesn t hurt when I walk or run on it? Just this morning on the way to work I felt some discomfort, it shot right up to my knee cap. Just curious as to what this my be? Thanks. ### REPLY: Hi... Your knee numbness is due to bursae of the knee joint it could have inflamed while you kneel for a long time and out pressure over the bursae... Since it may not be that much worse you may not have much of issues from it currently... The same us responsible for your pain around patella. Nothing to worry. I suggest you to... Do lot if icing to receive pain and season ...do it frequently... Gentle massage around patella and over front thigh muscles, inner thigh muscles and calf muscles... Gentle stretching to front thigh muscle...and calf muscles... Lot of icing over painful area of the knee (in the lower area of knee cap)Hope this is helpful for you... Kindly revert in case you need any further help in this 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: Hi. I started zoloft 2 days ago. The first night I took 50 mg as directed and had EXTREME insomnia, panic attacks, and felt like I would vomit. Last night, I cut the pill and took 12.5 mg instead. Still had some insomnia, mild nausea, but still a ton of anxiety to the point where I had to leave work. (Heart rate was 100-115 and was having PVCs). Should I continue or stop taking zoloft? ### REPLY: Hello and welcome to . Thanks for your query. I understand that you are going through a difficult time due to your recent problems. Zoloft (Sertraline) is an SSRI antidepressant medication used in the treatment of depression and anxiety disorders. During the first 1 to 2 weeks of starting Zoloft, many people can experience a worsening or increase in their anxiety symptoms. This is a common side effect of all SSRIs. It will subside on its own within 1 to 2 weeks and the medicine will then start giving you beneficial effects. So, don't worry about the increase in anxiety. I would advise you to continue Zoloft and wait for 1 to 2 weeks for it to start helping you. Wish you all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: RESPECTED DR NAMASTE.I AM A PARKINSON PATIENT SUFFERING FROM DISEASE SINCE 15 YEAR (SINCE1995) I AM TAKING FOLLOWING MEDICINE AS PRESCRIBED BY AIIMS SINCE YEAR 2005. MY ID IS MD NO.584/05.AGE 55 YEAR. MY MEDICINE:- (1) SYNDOPA PLUS 125 MG-1X7 TIMES ( 6 TO 8 TABLETS AS PER MOVEMENT REQUIRED i.e. 750 TO 1000 MG,)THIS DOSE IS CONSTANT FROM LAST 6 YEARS-WHEN I STARTED AIIMS TREATMENT IN YEAR 2005. (2) AMANTREL-1X3 TIMES (3) PACITANE-1/2 X3 TIMES (4) LONAZEP 0.5MG-DAILY NIGHT (5) SERTA-100MG-1 DAILY FOR B P:-------- (a) ATEN50-1 DAILY (b) AMLONG 10MG-1 DAILY (c) TOZAAR-1 DAILY ABOUT ALL MEDICINES HAVE BEEN TRIED.ABOVE IS THE BEST COMBINATION OF MEDICINE,FOR WHICH, I AM VERY GRATEFUL TO AIIMS. I HAVE CHECKED MY BLOOD SUGAR WHICH IS NORMAL(139 MG %) WITH ABOVE MEDICINES , I WALK ABOUT 200 M NORMAL BUT FUTHER ABNORMAL IS THERE ANY ANY HOPE TO AVOID FALLING TEDENCY? IMPROVEMENT IN WALKING AND WRITING AND TALKING?? . MEDICINE REACTED:--- 1--ECRIPT 2.5MG 4--PROCTINAL 2--TRIVASTAL L.A 3--ADCAPONE/ SYNCAPRONE 5--SINAMET ROPARK---NO EFFECT ### REPLY: Hi, It is good to note that you are doing fairly well even after having Parkinson's disease (PD) for so many years. However, it is well known that medicines for PD become less effective over time and may lead to side effects such as sleep disturbance, hallucinations, nausea, etc. In late stages of PD, you should explore the option of DBS-deep brain stimulation surgery. DBS is very useful for patients with tremors and .  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 Im 20 yrs old and Im an indian guy my penis is abt 3cm when not hard and 13cm when hard.. I will like to know will it grow... And another aspect how will I be able to detect that its mature and reached its final stage.. Pls do reply with some suggestions thanks.. ### REPLY: Thanks for contacting  I am sorry to hear that are displeased with the size of your penis. Since you are now 20 years old you have reached full maturity. The size of your penis will not change at this time. There are no known treatments medication or supplements that help improve the size of your penis. Hope this answers your medical question. Please contact us again with your health care concerns and questions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I feel that Im inadequate at everything in life. Im a 19 year old trying to sort out my life. My only goal in life is to make my parents proud. But I am awkward, highly introverted, shy and under-confident. My self-esteem is non-existent and I feel sad all the times. I dont know what to do. I have no friends or anybody out there who I can share anything with. Whats wrong with me? ### REPLY: Hello thanks for asking from  for your health related queries can understand your concern. You are just 19, and it is not good to take excessive worries at your age. The symptoms like persistent sadness, lack of self-esteem, less or no friends, feeling of introversion, shyness, lack of confidence etc. should be evaluated properly. These symptoms could occur due to depression more specifically mild depression. Please talk to your parents and tell them about the persistent sadness and lack of confidence you are having. Visit a psychiatrist for evaluation. Even good counselling by a counselor would help to reduce these symptoms. If symptoms persist then medicines will be needed. SSRIs like Fluoxetine, Paroxetine, Escitalopram etc. are used commonly in such symptoms. Talk to a psychiatrist for evaluation. Thanks, I hope this helps you. Take care.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 5.  For the past few months he has had a reacurring cough and it sometimes turns into a cold.   The cough just doesnt seem to go away.  He says he feels fine and doesnt feel sick when I ask but he is always coughing.  He is also congested. Sneezing and a runny nose. I am very worried but have no insurence at the momment and cant afford to go see a doctor ### REPLY: HI, thanks for using  He likely has rhinosinusitis due to allergies (most common cause) with possible intermittent episodes of worsening due to becoming sick with the cold. Rhinosinusitis is inflammation of the nasal passages and sinuses. It would be associated with the symptoms that you are describing. The treatment would be: (1) avoidance of the source of the allergies if known. Different possible sources such as dust, food, pollen, animals(2)using topical steroid nasal sprays such as alone, escort, Flonase(3)use of oral antihistamines hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello! I have beautiful teeth! never had a cavity in my life! but I do suffer from bleeding gums and my fron two bottem teeth have a darker line betwteen the teeth and gum line. im aware is could be Gingivitis and Periodontal Disease but before I go to the dentist (no insurance) what are some things I can do to help my situation and prevent tooth lose! thanks so much ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have bleeding gums because of inflammation and ulceration of gingival mucosa. Maintain proper oral hygiene. Do brushing and flossing regularly. You should avoid excessive use of tea, coffee as it will cause stains on teeth. Visit dentist once and get it examined. Go for qua .  Use Listerine and Betadine mouth wash. Do gargles after every meal to prevent bacterial accumulation. Go for curettage. Rinse mouth after every meal to prevent bacterial accumulation. You should Use 0.2%chlorhex mouthwash once daily half an hour after brushing 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: Hi Doctor, my fiance has been advised to take Krimson 35 as a contraceptive pill . We are getting married in 2 days and we wanted to use a contraceptive, hence this was advised. She is a virgin and has never used any contraceptive pills before. What are the major side effects of this pill? Is it safe to use? WWW.WWWW.WW ### REPLY: Yes it is safe to use crimson 35. The use of oral contraceptives increases the risk of- thrombophlebitis, arterial thromboembolism, pulmonary embolism, myocardial infarction, cerebral hemorrhage, cerebral thrombosis, hypertension,hepatic adenoid, retinal thrombosis.Anyone with a family history of cerebral hemorrhage should consult her doctor prior to starting oral contraceptives. Other side effects include nausea, vomiting,git symptoms, breakthrough bleeding, spotting,change in menstrual flow, temporary infertility after discontinuation of treatment, oedema, breast tenderness, breast enlargement, breast secretion, change in weight, mood changes, skin troubles etc. These are .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My name is deepak and just gone through the liver path test. and the reading of the test are as follows- SGOT-58; SGPT-149 Alkaline Phospate-149, rest test reports are OK. Please tell how to reduce SGOT & SGPT level. Am i suffering from any liver disease? ### REPLY: HelloYour findings may suggest raised SGPT, SGOT and alkaline phosphatase. Elevated SGPT and GOT may indicate liver injury. It may be due to many reasons like hepatitis, alcohol intake, altered lipid profile, medicines,autoimmune causes etc. You may need few more investigations like routine hologram, random blood sugar, lipid profile, viral markers, urine RE/ME, ultrasound of abdomen. I suggest tablet ursodeoxycholic acid 300 mg tablet twice daily for three months. It helps in regeneration of liver cells. You may need to take few more medicines after complete investigations. Alkaline phosphatase is mildly raised and it is acceptable. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Overall I m usually in very good health. Three days ago I suddenly felt very weak, no energy, and all my body aches. All joints, legs etc. Ache. Feel listless. Had very slight feeling of high temperature, but thermometer today says normal 98.6. Appetite is diminished, but have no upset stomach. Sinuses are not draining. No sneezing or running nose, or fever. I m trying to take in a lot of liquids; my urine is very cloudy and darker than usual. My age is 81, but I am very fit relatively. I had the customary flu shot last Sept. It s summertime here and we have unseasonable temps of near or above 100 deg. But I have avoided going outside. I live near Portland OR. Do I have simple flu or something more serious? GW ### REPLY: Hello, It seems you have contacted an infection. Could be flu or urine infection considering your age.  Anyway you have not mentioned urinary symptoms like burning sensation while urination or increased frequency. Since you have mentioned cloudy dark urine, it is better to get a urine full report, full blood count and CRP done. Sometimes when you are at advanced age you don't show fever, you just get constitutional symptoms.  If the count show a viral one you have a flu. Any way these joint pains and body pains are more of viral plus symptoms.  If investigations results are of urine infection you may have to take antibiotics. Hope this helps. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have severe tail bone pain and over the last few days, I have had copious amounts of bright red blood in my ejackulate... I had the blood issue several years ago (12) and it was determined to be prostatitis (sorry spelling) worried this could be more... the pain in my tail bone and lower back and hips over the past several months... ### REPLY: Hi and welcome to . Thank you for your query. I am  and I will try to help you as much as I can. This may be arthritis of tail bone, however, I suggest doing colonoscopy and abdominal CT scan to rule out some more serious diagnoses such as tumors of colon or sacral teratoma. I hope I have answered you query. If you have any further questions you can contact us. Kindly regards. Wish you a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 3years old not having food nor he intake any liquid from 26/06/2012 after 3.00pm till date,. whatever he intakes he immediately vomit. he has heavy fever,slight cough plus cold. We had given medicine Nurofen & panadol as per Doctors prescription but no improvement in him ### REPLY: Hi... Thank you for consulting in . Cough and cold are viral 95% of the times in child .  For cold, you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15 mg/kg/dose (max ceiling dose 500 mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. For cold, you can use Cetirizine at 0.25 mg/kg/dose every 12 hourly for 3 days. For nasal block, plain saline nasal  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: History since age 17: ibs by age 60 mild inflammatory colitis to cholecystitis, culminating in the removal of a diseased gallbladder in september 2013. Since that time, two months of poor recovery, digestion problems, and 4 months continuing inability to eat normally, and suture not healing, with mild infection. Repeated blood tests show elevated lipase and now alt([pt), Tbil low abn liver function tests, and cbc MO% just above normal H. Doctor has assigned a hepatitis and hepatic function panel, ana, & asma.to be taken friday. Years previous have had + & _ allergy test results and brittle asthma and cardiac svt with long rp yielding angina like symptoms. Turning 70 years in January 2014. Dr. has recommended allergist testing. should i be going to Mayo Clinic? ### REPLY: HelloThanks for the query to . Forum. Allergy test will find out sensitivity to certain allergen and usually helpful for asthma and allergy. As you mentioned that raised level of lipase and A L T. As gallbladder already removed, so you may get infection of liver also. In my opinion also get in M R I of liver as well as pancreas. In this type of cases usually patient develop pancreatitis, diagnosis can be confirmed by estimation of lipase and amylase. As you mentioned that suture is not healing, so get in HBA 1 C and also blood sugar examination. In my opinion at present you require.1 Allergy test as desired by your doctor .2 MRI of liver 3 Pancreatic enzymatic tests 4 Diabetes rule out. Consult a physician and get his opinion and all tests as mentioned above. 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 recently had a total shoulder arthroplasty two weeks ago. When is it possible to resume my weight training with my personal trainer. Also, is it possible to resume some speed bag boxing as I love hitting it. I hit the gloves of my trainer also. I am a female over 50. Thank you. ### REPLY: Hithank you for providing the brief history of you, As you have undergone shoulder arthroplasty, you need a thorough musculoskeletal assessment. As to understand that now you have a new joint, which is artificial in nature. So the chances for it to have dislocation will be very high. Also, undergoing the weight training needs to be waited till the shoulder girdle becomes stronger than now you do not have any ligaments to support or hold the shoulder joint. Also, first you need to consult the surgeon who operated you, post which he will send you to a physical therapist, as physical therapist will assess the muscles and direct the rehabilitation plan according to the requirement of the shoulder joint. Post which you may have to go slow with strength training and also boxing. Because each time the shoulder dislocates it will give you recurrent to the dislocation. Undergoing the complete 100% rehabilitation under a physical therapist will be even the choice of your surgeon. Post which you can undergo weight training and boxing. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a mole under my stomach. Near my vaginal area. I accidently scattched it and it started to bleed. I noticed that only the edge of the mole is open. I haven t really looked at it to see if it s really bad. I m really conserned that may it could cause cancer. I researched. Some answers say it s fine nothing to worry about, some say I could get skin cancer. Should I be worried? ### REPLY: Thanks for your question on . Moles are pre malignant lesion for skin cancer. But it is not 100% true. Not all moles are going to develop in cancer. Moles on face are more prone for malignant transformation due to constant exposure to UV rays of sun. Same thing is true for moles on high fraction area like in inner thigh, under arm, belly button etc. So no need to worry at present. But if you don't want to take chance than it is better to remove it surgically. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 an auto immune thyroid disorder that in the beginning was a level over 150, I also have anxiety and panic attacks and possible OCD. I am also overweight. My doctor put me on cytomel 50mg twice a day and also phentermine for the weight. I am also taking lopressor for irregular heart problems and have a butterfly feeling in my chest at times that takes my breath away. I take prozac as well and a low dose zanax at night. I feel fine now that I am taking these medications but wonder if it is too much different medications for one person to take? In the past I was very anxious and irritable on top of the thyroid making me forgetful and in a scary daze. Now I feel leveled out and fine but have had friends say that they think that the phentermine and the lopressor is not good to be taking on the same day? I put many hours inbetween the two but would like the professional opinion on what is safe and what is not because I feel fine but do not want to be hurting my body at the same time. ? thanks *deb* ### REPLY: His understand your concern. Prozac and Xanax are the best medicine to treat anxiety and panic attack. You can take it as per requirement and improvement. You will take Xanax as when required when you feel panic. And if you have improvement with this medicines then please continue to take it for maintenance. You can take Lopressor along with these medicines on same day. You can take it both together there is no problem with it. Still have query then feel free to ask. Thank you. Get well soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A vein popped in my leg two weeks ago.  Yesterday I was feeling short of breath and my foot/ankle was swollen all day.  I dont want to ignore it but I also dont want to overreact.  Do I have symptoms that warrant an ER visit or would these symptoms have not waited almost two weeks since the vein popped.  Also, I already had varicose veins from my 4 pregnancies.  Thanks, Stephanie ### REPLY: Hi welcome to the  Don't ignore this condition... I appreciate your concern and hope nothing danger is present Let me know you when leg swelling occurs calf should be examined for redness and tenderness. Check whether dorsiflexion great toe produce calf pain... If this presentation positiver than deep vein thrombosis induced pulmonary embolism might be there leading dyspnea For that work up done as follows -Auscultation -EKG-Echo -d dimer only if needed Is pulmonary embolism not present than anxiety induce dyspnea, anemia and respiratory problems looked for Hope your concern solved Consult physician or pulmonologist for examination and subsequent work up accordingly 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 involved in a car accident 6 days ago. I have severe neck, back, shoulder, knee, chest and jaw pain. I dont think I hit my head because I was wearing a seatbelt. I came back to work yesterday and besides the pain, there werent any additional symptoms. Today Ive had a pain in my left arm, near the shoulder area and my vision is blurred. ### REPLY: Hi! Good evening. I am  answering your query. If I were your doctor, I would refer you to the ER of your nearest hospital for a complete neurological and ophthalmological assessment and a possible CT scan of the head even if there was no history of any head injury. Till then an anti-inflammatory along with a proton pump inhibitor . I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I just recently got my second steroid epidural in my lower spine and for at least the past four hours any slight movement I make hurts like hell I am already on fentanyl patches Percocet Ibuprofen Tylenol gabbipentin Valium and cymbalta, and even with all of those it is barley taking the edge off of the pain and I don t know what I should do... ### REPLY: As per your explanation I realize you have a Severe back pain. I suggest not to treat the symptoms of pain but do proper evaluation for the reason of back pain. You already have taken enough of painkillers and steroid injections even after this if there is no relief you must go for MRI of spine and consult again your or tho as well as physio doctor for further treatment and planning here or tho will give options of surgical and medical based on your MRI report. Suppose if there is no severe problem then you can consult a physio and take the physiotherapy treatment like ultrasound and IT which will help you further for pain relief also take proper spinal exercise program to continue doing exercise at home this will help you to improve strength and stamina of your spinal muscles. You can also use hot and cold pack at home frequently and regularly on a daily basis to have some more pain relief by anti-inflammatory as well as relaxing effect of this. For now if you have developed sudden pain then it can be a catch at your back, and you need to take muscle relaxants. For this you can contact your doctor again. I am sure this will help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: As I and My husband are trying from last six months to have a second baby. but iam not conceiving why?I consalted a doctor she gave me a folic acid tablet for the first month and the second month shee gave me aclofert and susten for three months.This is my third month but still i did not get pregnant , this month she gave me folvit tablet with this two tablet.So what should i do . ### REPLY: Hi,First, you should get evaluated for secondary infertility. There are various possible reasons like tubal block, ovulatory cycles secondary to post delivery weight gain and subsequent hormonal imbalance, pelvic inflammation, male factor and so on. If everything is fine, then you have to wait for a few months with continuation of treatment. Polite contains folic acid and if you are naturally ovulating, Camphene is not needed, and it could lead to hyper-stimulation of the ovary. Please consult your doctor for further advice. 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 took omnicef 300 mg twicw a day x10 days for a sinus infection but it didnt help. every morning i cough up alot of secertions, cough through out the day. cant seem to get a good deep breath. I take clairinex every night before bed.  do i need another antibiotic or just deal with it and hope it goes away. i also have been feeling really bloated ever since this has been going on. ### REPLY: HiT hank you for asking ChatDoctorI have gone through your query. You shouldn't take antibiotics without any prescription from a doctor. It can do more harm than good. Bloating you have is most likely due to dysbacteriosis after antibiotic therapy. For sinusitis not always antibiotics is needed. Nasal decongestants like phenylephrine or local decongestants like oxymetazoline, NSAID like nimusulide and antihistamine like cetirizine will be helpful. But in case of moderate to severe infection antibiotics can be used judiciously according to need. UNICEF is ceding which is quite strong antibiotic. If there is no improvement even after decongestants and antibiotics then x-ray of paranasal sinus should be done and puncture and .  Hope this may help you. Let me know if anything is not clear. 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: any links ... my husband has a confirmed case of the skin.blood disorder porphyria .. and was rearranging furniture in our living room.... [1] ended up with a black eye...looked like he was the loser in a bar fight ; whites of one eye were bloodshot [2] next day he had nose bleeds for over one hour [3] went to hospital where they packed the nose & installed a cage over it like a goalies mask,,, [4] approx 3-4 days later while waiting for our orders to be delivered to our table. my husband thinks maybe he should visit the restroom before the food arrives. he stands up turns to walk towards the restroom in the restaurant he takes about 2 or 3 steps and immediately drops face first to the floor like a stone; hitting his head on the concrete floor ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern if this is the case of porphyria the neurological manifestation is likely and not the bleeding crisis if your husband had bleeding episode then this would be unlikely and very rare condition in porphyria, still form the history given here I could say that intensive must be taken in this case hope this information helps you, take good care of your husband and have nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a friend whose mother hoards but is also displaying some different types of behaviors. I am just trying to find out if some of these behaviors are also common amongst people who hoard. One of the recent complaints that my friend has expressed is that once his mother gets an idea in her head about something there is no convincng her otherwise. He expressed that she told his sister that she had hid some money in her basement and is now unable to find it. She is convinced that he has gone into her home and taken the money since he has a set of keys to her home. The hoardind she does would make it impossible for anyone to enter the home and go into the basement to find the money without literally removing item by item just to get in and move around. A second incident has occurred where again she gets an idea in her head and no one or nothing can convince her otherwise. Almost like a paranoia ### REPLY: Hello gemini671 thanks for your questionHoarding is one of important symptoms of Obsessive compulsive disorder in a significant stratum of population, compulsive hoarding is very anxiety provoking to patient as well as to caregivers. It is characterized by inability to discard items and individuals suffering from hoarding tend to store the items and they even some times do not let others know this, due to fear of embarrassment. It is a part of OBSESSIVE COMPULSIVE SPECTRUM disorder. Mostly the patients of hoarding also show other features of OC disorder like orderliness, cleanness, magical thinking, compulsive handwashing, obsession of doubt etc. In more than 50% of cases depression is also associated. And in a few cases paranoid ideation may be seen as your friend is observing in his mother. It may be persecutors delusion against anyone or sometimes other delusional ideas like she is having. Her fixed firm belief about money is part of associated psychotic symptoms. In rare cases of Psychosis hoarding or obsessions or compulsions may be presenting symptoms thank frank delusions alone. Best thing to resolve it is first try to reassure her, once she is ready to talk then try to give her evidence to contrary and see whether her belief is still fixed? If she is a little sharable and ready to accept that she might be wrong then further strengthen the evidence. If that's not possible then take advise of some good psychiatrist for further management of her psychotic symptoms thanks, all the best hope I solved your query kindly rate ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my 7month old was ust diagnosed with breath holding spells. He is a very happy baby with o temper tantrums. He was not breathing, lips blue and non responsive at daycare (he was not crying when this happen) Also, at the hospital he passed out when they took his blood. ### REPLY: First you should go for echocardiography to rule out chaotic heart disease. If this is normal, then baby is suffering from chaotic type breath holding spell. The most important approach is to reassure the family, because witnessing a breath-holding spell is a frightening experience for observers. There is no definitive treatment available. We can use iron therapy in a dose of 3-5 mg /kg/day. This is resolved as baby grown up. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 myself suffering from oilgospermia prsntly my sperm count is 35 milion,my wife sufffering from pcod ,she undergone follicular study ,she ovulate but delayed on 17 th day, and her menses was irregular erlier,her gyanc perscribe diane 35 to regular, metformin daily, n clomiphene citrate for 3 cycle ,her ovulation is now good n proper ,menses r also regular,but recently i knew abt my oilgospermia ,last year i chcked the count was 60 perc,i m non alchloic,no smoking , we have 3 yrs of marriage,i m on paternia tab,is there any chance tht sperm increase,or should we undergo ivf ### REPLY: Hi, Thanks for your query. I read your query and understand your concerns. Following is my reply: 1) You have been given wrong report. If your count is 35 million it is normal. Oligospermia is count less than 20 million/ml 2) GUI would be a better option before going for IVF. 3) The tablets you are taking won't make much difference in count. Please get retested in a standard laboratory. 4) Please see an IVF specialist to discuss necessity of IVF after showing all you reports in detail I hope I answered your query. I will be available for any followup queries you have.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had pain for a few months on the left side of my pelvis just under my underwear line.  I thought it may be a hernia and i also cut my dairy as when i was gassy it made it worse.  a few times the pain went into my left testicle only.  i also take lithium 1200mg and lisiniprol 20 mg. ### REPLY: Good Day, and thank you for being with  ! Pain in the left testis could be varicocele. This is located on the area that you have described. This is be confirmed by a Doppler ultrasound of the scrotum or if it is severe then by physical examination. This is felt like a bag of worms in the spermatic cord or the cord that connects the testis to the body. Other conditions could still be an inguinal hernia, a kidney stone (radiated pain) or a testicular tumor.  Manuel C. See IV, M.D. DBU FPGA ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For the last 4 days I ve had light head, dizziness, nausea, loss of appetite, and when I do eat I feel sick.... The best way i can describe it is it feels like a really bad hangover and if i move quickly I feel like I m going to fall over, and if i shut my eyes the room spins.... Can you help? ### REPLY: Hi, The possibilities of problems are variable and can range from a GI disturbance to an inner ear problem or even reduction of blood flow to the brain due to low circulating blood volume or blockages.  All of these possibilities need to be considered since you've not provided other important details such as your age, previous medical history, lifestyle habits, etc. 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: Sir have a nice evening. Does cure for pigmentation exist in medical science. I am 31 year old man having pigmentation round the eyes consulted dermatologist they recomends laser treatment shud I go for that????? Meanwhile they prescribed topcort cream I m using it since 5 months no visible effect pl help ### REPLY: Hello, Welcome to . Pigmentation around the eyes could be due to various factors including familial, thin skin around the eyes, diabetes mellitus, deep eye sockets, stress and lack of sleep. You will not benefit from using topcoat cream around the eyes. Is a mid potent steroid and should not be used for prolonged duration. You could benefit from using cream containing 2% comic acid and vitamin C twice a day. You could also get glycolic acid peels done by a dermatologist once weekly for 6-8 times. If your eye sockets are very deep, they can cause a "shadow effect" which can be treated using dermal fillers. Lifestyle factors play an important role in reducing dark circles. Have a good diet with lots of fresh fruits and vegetables. Try to reduce stress by yoga/ meditation. Avoid prolonged computer/ TV usage. Try to get sound sleep for at least 6 -7 hours a day. These measures may help to lighten the pigmentation. Hope they help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a pea sized lump on my vulva. It is between the opening of the vagina and the urethra and seems to be maybe in the tube - it is visible only when I lift the inner flap. It is extremely sensitive and hurts to touch or urinate. Can I fix this at home? I am using colloidal silver and oil of oregano internally at the moment, but it doesnt seem to be shrinking. ### REPLY: Hi, Welcome with your query to  virtual Clinic. I reviewed all the details of your query, in context of the painful lump on your vulva. Based on the facts of your query, You seem to have Bartholdi Cystitis, as its soar to touch, but is not reducing with colloidal silver and oregano oil.Hence, I would not suggest you to apply it, as it would complicate by its side effects. As it's a cystic swelling with mild infection, the painful lump is not reducing in your case. Consult your family GP or Gone doctor who would treat in the best possible way for you. Hope this reply would help you to plan treatment with your doctors and resolve your worries. Will appreciate writing excellent review comments to help the needy patient visitors like you at . Welcome any further query and information in this regard. Good Day!! . N.M.S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 46 year old female who exercises regularly. Lately I am finding it hard to catch my breath. I exhale deeply, then find it hard to breathe in. And sometimes I feel my heart pounding. I m not under any unusual stress or anxiety. Wondering what could be causing this? ### REPLY: Thanks for your question on . I can understand your concern. For your symptoms, we need to rule out cardiac and pulmonary causes first. So gets done ECG and 2d echo to rule out cardiac cause. Get done PFT (Pulmonary Function Test) to rule out pulmonary causes. If all these are normal then stress and anxiety are the likely cause for your symptoms. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solutions. You may require anxiolytic .  So avoid stress and tension. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife passed away in Turks and Caicos in March of 2011. She had Lupus was sedentary and came off a long flight. The Dr at the hospital diagnosed her with an infection in her lower leg. She died of a PE which resulted from a DVT.The Doctor and the hospital acknowledge that they erred but say because she died 22 hours after entering the hospital that she had no chance to survive even if the correct diagnosis had been made. What do you think? ### REPLY: Hii am sorry to hear of your loss but it is a known fact that pulmonary embolism is difficult to diagnose and is usually diagnosed late of course with other comorbidities, it might have been a difficult case to treat however without having seen the clinical status it is difficult to state the exact prognosis but overall I feel it would have been difficult again, I am sorry for your loss 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: I have a herniated disc with bone spur resting on spinal cord. (t10-t9) I had a fall two month ago and have steadly been having problems with pressure in the head and some back pain. Also, my b/p is going out of control. I have had very good control until after the fall. This makes me feel very anxious . I have been taking lorasapam for anxiety , that does nothing for the feeling of pressure and b/p problems. Thank You for any communication. ### REPLY: Hi, Thanks for writing in. The spine is made up of an alignment of small bones. These bones have sponge like discs between them and the spinal cord passes along the back of these bones through the spinal canal. Between the bones we also have nerve roots originating in the spinal cord and passing through foramen between bones. You seem to be having discs at a particular level that is protruding between the bones and this protrusion is backwards and causing symptoms. There is also extra bone growth at that level leading to additional pressure on the nerve roots. It might also cause obliteration of lateral recess and neural foraminal compromise. This is leading to pinching of nerves causing severe pain. There are patients who get relief by doing physiotherapy and taking neurogenic pain relievers for up to a year. Injections are also given for relief. However, this might not always happen. Lorazepam is a potent medication to help reduce your anxiety. If your pain is severe and not responding to medical treatment then the disc protrusion needs to be removed by doing a small surgery at the lower back region by a neurosurgeon. Presently, laser assisted surgical techniques and radio frequency ablation is also available. You can try to feel more comfortable at work by taking small breaks every 30 minutes and not straining your spine especially the painful areas. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 implanon contracepion implant expired 14 days ago and only gives 3 years protection.I had very irregular periods during the past 3 years. I have had unprotected sex with my partner a few times since it has expired and I cant stop urinating, have a tightening feeling in my abdomen , am very tired , have nauscea and a little diarrhea . Do you like I could be pregnant, these symptoms have only started this past week. It is too early to take a pregnancy test and i dont know when my period is due. How likely do you think I could be pregnant? ### REPLY: Hi, Thank you for posting your question here, I will try to answer it to the best of my abilities. If the contraception you are using had expired there is always a chance of getting pregnant, especially if you were ovulating when you had unprotected intercourse. I recommend waiting a couple of more days and then taking a home pregnancy test, another thing you can do is to go to a doctor and ask him to test your blood to check if you are pregnant. I hope this answered your question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 have been involved in masturbation from last 4 years, not daily but occasionally I used to masturbate, I have already stopped doing this 6 months back.but I was doing night fall, and also after doing urine sperm was getting discharged.i am healty I haven t faced any troubles yes but but eyes got dark circled.i am going to marry next year I don t want to face any complexity problems in my life, , please suggest me what I nees to do. And if I want to consult with a doctor which doctor should I cunsult please let me know. . ### REPLY: Hi, Thanks for writing in. Night fall is a normal occurrence and a method by which the body replenishes the semen. The night fall is because you stopped masturbation. In itself masturbation is not a bad habit, but you should not do it more than once daily and 2 -3 times a week. More than this can cause addiction and affect your daily study and work schedule. If you are worried about nocturnal emission then there is no need to consult any doctor as this is normal if you don't masturbate. The darkening of skin is due to pigmentation and is a frequently seen in adults. This will not cause any problems in marriage. After marriage when you start having sex regularly that time there is no need to masturbate. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: have a lump and tube like lump running from Right side abdomen toward belly button, took all tests ( ultrasound, xray, blood tests, psa, and even the scope!)...Local doctor says it is probably just fat, but I feel it is something more.took three falls in past 2 years, off a bike, while tobogganing, and running up the stairs ( into the corner of a low shelf)....also, was poked directly into the belly button ( finger) and now have a herniated belly button. Could any of these tramas have caused this type of lump and tube lump feeling, just under my skin? ### REPLY: Hi! Good morning. I am  answering your query. Yes the past traumas could be responsible for your swelling by the way of causing a hematoma(collection of blood) which might have got organized. Another possibility is your history of hernia, which might be coming up on increasing intra-abdominal pressure and subsiding again on the release of pressure. However, the swelling needs to be examined by a general surgeon clinically to arrive at a diagnosis along with your other investigation reports. Therefore, I would suggest you to take appointment with a general surgeon in your area, and seek his advice on the management. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr, Deepak,Am siva kumar from madurai...in trichy opposite to our house, there is a girl around appox age of 23-26, her mother says she seems like developmental delay patient, but hearing her..she has completed  WWW.WWWW.WW degree..how it would possible...she stays lonely during her college days and not much socially active with others..she got married and came back within a week to her home..now she behaves like childish and not mature to the stated age..they told they have saw some psy dr in trichy but not clear..what is the solution for this dr..if so give your address i will send them to you ### REPLY: Hi dear. I understand and appreciate your concern. But in this case I want to know detail. Regarding developmental history and growth oh her till date.2nd thing if sudden change in behavior will require to know psychopathology. For evaluation, you will bring her to psychiatrist. He will tell you after getting brief history and her mental status examination. Hope for the best. Thank you. Still have query then feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 17 yr old woke up yesterday morning with the left side of his face swollen. He cant hear very well from his left ear. Im not sure if it is a medical problem or a dental problem as a few weeks ago he said his wisdom tooth was coming out. What should I do? ### REPLY: Thanks for your query, I have gone through your query. The pain and swelling could be because of the gum infection from the wisdom tooth (periodontal infection leading to space infection). This can produce swelling over the face. Consult an oral physician and get a radiograph done to rule the amount of space present for the tooth to erupt if space is there for the tooth to erupt then the gum covering over the wisdom tooth can be removed. If the space is not available then you have to get the wisdom tooth removed. You can take a course of antibiotics like amoxicillin 500 mg and metronidazole 400 mg TID for 5 days (if you are not allergic). Do saline gargling. Regarding the hearing problem, you consult a ENT surgeon and get an opinion. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have Identical Twin boys both born with Hypospadias and both were opperated on at 13 Months of age. Tonight after bathing them I noticed black dots, I 1st thought it was fluff and tried to wipe it away. When I pushed on it it became more prominent in another area. Quite a few spots can be seen on both boys. They both say its sore there. Is this possible 5 years post op? The black spots are where the Foreskin has been cut so its quite likely to be stitches. Has anybody else experienced this? I will take them to see our Doctor, but I know from previous experience his knowledge is limited where the hypospadias is concerned. ### REPLY: Howell come to ChatDoctorI really appreciate your concern, if this was the hypomanias and operated, it may not give you exact normal appearance as it is looking in another male, and the hypomanias can be corrected in two steps, it is all depends upon the clinical examination that what type of appearance it has got, so it is advisable to see the surgeon who did the operation, it may be normal one as long as the condition are concern and repaired done hope this information helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 53 year old male and had a sigmoid colectomy with bladder fistula repair towards the end of nov 2013, since the operation the bowels and bladder are working fine but I have constant lower back pain around the loins. I have been taking paracetamol but it does not seem to help much, any help greatly appreciated. ### REPLY: Dear friend you can take aceclfenac witChatDoctorbination of paracetamol. If severe you can also take muscle relaxant combination such as diclofenac+paracetamol+chlorzoxazon if needed.in your case physiotherapy and exercise will help you a lot on long term basis.-exercise for low back pain-raise your leg straight from hip joint without bending from knee after sleeping on back and then put down slowly. Same exercise for another leg and then raise both leg simultaneously. Sleep on abdomen and raise your head and chest backward. Do all these exercise 40-50 times per day by increasing slowly every day. Hope this answer will be helpful to you. For more queries please don't hesitate to ask. Get well soon dear friend .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: small black spots inside my gums but is not pueter ??? i was diagnosed with something other than that other one. one that is not cancerous. i am 72rs old. i was then told that alot of people frome India also have this inside their mouths. my father also had this. i just cannot remember what it was called. ### REPLY: Hello and thank you for your question. Based on your question it could be a few things:-Physiological pigmentation-Amalgam tattooing from old fillings-smoking-associated melanosis-oral melanotic macules-melanoma-heavy-metal pigmentation (lead, bismuth, arsenic, mercury)-minocycline pigmentation These are the main ones I can think of.  Google photos of these lesions to see if they look similar.  To be honest, I can't give you a proper diagnosis which out evolution and possible biopsy. Hope this helped.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am from bangladesh. my mom is 43 years old. She had back pain for last three months. 20 days back we do her MRI in which pott s disease in D 8 & 9 was identified. then we do CT guided FNAC in whicChatDoctorment was Suspicious nonhodgkin s lymphoma. she has no fever, no weight loss. what should i do now. we have already strated the remester dose for tuberculosis. ### REPLY: The definitive diagnosis of lymphoma can only be made with a biopsy and not a FNAC. FNAC can only create suspicion as in your moms case. SO, the best way to go about it would be to undergo a biopsy from the offending lesion. This will confirm the diagnosis and also provide tissue for determining the type of lymphoma which is important for treatment. If it does come out as lymphoma then you will need to contact an oncologist at once to start treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 2 months old now ..he started to have like rashes like pimple on the face when he was 2 weeks old and now its all over his body .its tiny little reddish pimple when it dries the color becomes white/transparent. like heat rash .. it keeps on coming back .i dont know what to do ..pls advise me ..thanks ### REPLY: Hi, Your son may be having neonatal acne. It is a harmless and benign condition. The acne lesions at this age may be due to testosterone in blood. Not to worry at all. It may recover by itself without any treatment. Still, it remains.you may apply erythromycin gel on the lesions. No oral treatment is needed. Do not squeeze the lesions, otherwise he may develop secondary infection. In that case, he needs oral antibiotic like azithromycin in pediatric dose. You consult dermatologist for firm diagnosis. 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 mother had a kidney exam and we received following statement:IMPRESSION: Prominent bilateral renal pelves. Small postvoid residual. Left renal cyst.With the above, my mothers doctor says the above condition comes with aging and that the urinary residual needs no treatment. The kidney cyst also does not need treatment.Is my mothers doctors response true? Will everything just go away naturally with my mothers kidney condition? ### REPLY: Hello and welcome to . As a Urologist, i can understand your anxiety. Kidney cysts are seen after forty to fifty years age, if they're simple cysts. Prominent renal pelvis will need evaluation, if there's associated infection. The renal cyst doesn't need treatment, but till not go away naturally. Its harmless, as long as its uncomplicated and remains a simple cyst. Similarly, dont worry about the bilateral renal pelvic prominence. Wish you well. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a small hiatus hernia and abnormal esophagus which was diagnosed with a endoscopic exam 4yrs ago. I am on 40mg of omeprazole a day. I have noticed for the past 2 weeks everytime i eat it feels like its gone down the wrong hole so to speak and i end up coughing. I have also notice first thing in the morning im coughing alot with thick phlegm which when cleared coughing stops. I dont smoke ### REPLY: Hi a hiatus hernia phones a person to get reflux of the food back and which leads to aspiration of the gastric content into airway leading to choking and coughing. Only omeprazole will not help you in this situation. You will need a surgery for hiatal hernia repair. Till the time you prepare yourself for the surgery please follow the following instructions:1. Small and frequent meals. No heavy meals.2. Water half an hour before food. No water with the food.3. Keep yourself in either sitting or standing position after meals for at least half an hour.4. Avoid any product which causes constipation.5. No tea, coffee and chocolates. If, you follow these, the chances of aspiration will become less. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dr. am 32yrs,it took me over 7yrs to be pregnant and now am 22weeks pregnant i noticed fluid coming out of me,i then went to the hospital and was sent for a scan. dr the report shows that my baby is doing fine but that my amniotic fluid is moderately reduced. what am i expected to take to increase these fluid ### REPLY: His have gone through your complaints and sonogram report findings. Feel sorry for your condition. Its precious pregnancy for you. As you are saying fluid is coming out and scan shows reduced liquor, it means leaking liquor due to premature rupture of membranes.to avoid further decrease of liquor absolute bed rest is recommended. Cervical stitching is also advised. Complete bed rest and encourage fluid intake. Scan once in two weeks to assess liquor and fetal growth. Once you reach 36wks you can plan delivery. Thank youRegardsVasundhara ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a coronal browlift l5 years ago. I have had lingering pains since then. Nerves from eyes to vertex and a band around my head above ears. It is so discouraging as I ve been to many doctors. The band also feels that it goes up around the top l/2 of my head. Could I have intercranial hypertension? I ve had botox to try to destroy nerves, but it did not work. Thank you ### REPLY: Hi, Thank you for posting your query. The symptoms do not sound like intro cranial hypertension (ICH). In ICH, there would be headaches, especially on waking up in mornings, associated with vomiting. Blurred or double vision at the peak of headache is also common in ICH. An examination by ophthalmologist (funds examination) would show papilloma in cases of ICH. So, the absence of papilloma on eye examination would exclude ICH. Your symptoms seem to be due to involvement of local nerves on the scalp. Medications such as carbamazepine or pregabalin may be useful in relieving the symptoms. 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 been taking cerazette after having my first baby 4 months ago and have been bleeding almost non stop since.  I had a uterine infection 2 months ago which was treated with antibiotics and the bleeding stopped for about a week but has since continued. Gp recommended doubling dose of cerazette which after 10 days hasnt made any difference what could be wrong? ### REPLY: Hello, Thanks for posting on , At this stage, I do believe that the cause of this postpartum hemorrhage should be investigated further instead of taking cigarette (progesterone hormone). Most common causes of late postpartum hemorrhage could be uterine Tony, retained products and unlikely tear. If you are taking cigarette and any of the above causes are responsible then it is useless taking it. I think you should have been referred to a knobs a while ago as bleeding for 4 months could be very fatal. Having uterine infection could be as a result of retained products and will need to be evacuated with D&C. Hope this helps and wish you the best ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear sir i have only right kidney from birth and i am feeling pain around  right kidney from 4- 5 days.i go to the doctor my blood report is normal but urine report is sowing blood positive and rbc - 2.4 HPF ,wbc - 0.2 HPF .doctor is saying your kidney is well. he give pain killer like paracetamol .please suggest me. ### REPLY: Hi, I am sure that you are well aware to be cautious as you have single kidney. So far although tests may be normal but actually your kidney is doubling as 2 kidneys. In the process, exposing your kidney to wear & tear.Therefore, your intention should be to avoid all such insults. You should maintain BP, body weigh, blood sugar as normal. Do regular exercises, Avoid having extra salt, alcohol,tobacco, proteins,soft . Paracetamol & Tramadol are safe for kidneys. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 bad wisdom tooth ache. The pain has lasted since the beginning of the year. The wisdom tooth has been repaired several time.  I consulted with a doctor, he suggested me to remove the tooth. In the meantime, he prescribed Azithromycin for me. The antibiotics works a little bit but not very effective. What will you suggest me to do.Thank you ### REPLY: Hi. Thanks for the query. Pain in wisdom tooth can occur due to common causes like:1. Inflammation of gum flap over the wisdom tooth.2. Decay in wisdom tooth that has reached the nerves. Taking antibiotics will reduce Infection that will help in reducing pain, but it will take a long time and at times the pain will continuously recur till the tooth is treated. So in case if it is due to decay in tooth and treating the tooth is not relieving the condition then extraction is the best Treatment of choice for permanent resolution. In case if it is due to inflammation of gum flap then also extraction is the best option. As of now to relieve pain you should take anti-inflammatory painkillers like Ibuprofen, Diclofenac or Naproxen for pain relief. Hope your query is resolved. Regards. Hope your query is resolved. 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 infant son is 2 mos old, and he has a lump right above the breast. there are a few tiny red spots on the skin.. he otherwise looks perfectly healthy..does not seem to irritate him, but i will be getting it checked soon, as i am concerned... (i breastfed for about 5 days so not that long..) any thoughts? ### REPLY: Hi. Thanks for your query and an elucidated history. Noted your history of your 2 months old son getting a lump above the breast with tiny red spots. This obviously looks to be an inflammatory swelling and hence may need antibiotic and anti-inflammatory medicines. Consult your Pediatrician for clinical evaluation and to get the correct weight adjusted medicines. Breastfeeding may not be related to this incidence. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 15 years old and have never smoked before. I also never drank any form of alcohol. After having braces for about a year, I notices white patches growing along my mouth (where my teeth touch my gum). I often scrape my braces there and was wondering if this is anything I should be worried about. I have had one patch for around 3 months and another for a week. I did some research and suspect frictional keratosis. However, I am worried it might be something more serious, such as leukoplakia. Can you please help me out? The patches are around an inch long and have a "scale-like" texture. ### REPLY: Hi! Welcome to . I read your query. Since you are currently having Orthodontic treatment (braces), there are regions where your toothbrush might not reach for effective cleaning. Also, areas where your braces material impinges continuously onto your gums, leaves a white mark called as Frictional keratitis (as you read too). I would suggest you to visit your Orthodontist and ask him for braces adjustment in that particular area. Also, you can use Orthodontic brushes specially meant for braces cleaning. Use mouthwash regularly as it removes particles from difficult to reach areas of mouth too. Go for oral prophylaxis every 3-6 months. Maintain good oral hygiene and diet. Hope this answer helps. Thank you! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am sufffering from endometriotic cycst and adinomiocis in my uterus ,to reduce the uterus size Dr. had given me lupride depo 11mg injection and due to that 4 months i didnot had my charms and then again they gave a pills to regular my periods and from that cycle i plan for pregnancy ,Dr. gave injection to increase my follicles but my bad luck after taking 2 injection also my follicles are not increasing.so i need ur suggestion how to improve my follicles,in my case Dr. are advicing to go for IVF ,as IVF is costly so i kept that as last option so planning to go for IUI please suggest which will be good IVF or IUI and also suggest some good hospital in bangalore for IVF and IUI. can u suggest any medicine or home remidies to increase the follicles.looking forward to hear from you. ### REPLY: Hi, Thanks for your query.  I have read your query & I understand your concerns. Leupride will help you in down regulating hormones. Not to increase follicular size. You can still go for GUI if your age is young. We can try by changing powerful injections.  If you are in Bangalore you can come to my clinic after taking appointment calling 9886744700. I shall discuss in detail about possible options.  I hope I answered your query. Furthermore, I will be available for any followup queries you have.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr. Samuel, I m Ela from Philippines.My 2 year old baby was diagnosed with primary complex and now he is under treatment in a private clinic.But i am still worried because I think he is not as healthy as to his age.He only weighs 9kg.Every morning (5-7am), his lower extremities are warmer/hotter then became normal later on.He is on 2nd month of treatment as of the moment.Can you suggest some ways to prevent his having fever or hot body temperature in the morning?And what are the causes of this?Thanks. ### REPLY: Hi ELA.am happy to answer your problem. Presence of just warm periphery is not a diagnosis of fever. Fever you must document with a thermometer. If temperature more than 99 F, is called fever. So check for temperature, if it is less than 99 F, nothing much to worry. To increase the weight increase the calorie content of food by adding ghee, curd. If you are happy with my suggestion kindly rate me. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 25 years old male I suffer from muscle weakness and fatigue also have shortness of breath when climbing up stairs. i also have low testosterone levels. my muscles feel so sore and tired that i just quit my job i have in good faith tried to work all these years but my condition has deteriotated. i spent my money on doctors already. any body has a clue what my condition might be. ### REPLY: Hello, You told that you have spent money on doctors. Please tell us what are those blood work and other tests your doctors suggested and how many did and what are the results of those tests.  If you can provide us those test results, we will be able to help much better. You mentioned that your testosterone level is low. Why did you check it, and how much low it is? Do you smoke? Please answer. Hope I have answered your query. Let me know if I can assist you further. Take care .  V. Anand, Psychologist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What is the significance of a elevated seg (84%) normal 32 to 70 combined with low lymphocytes (ll%) normal 20-40. This lab test was done in Costa Rica but I think the values are the same. My friend has flu like symptoms: joint and muscle aches, lethargy and a dry cough. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. His reports suggest he has some infection.  Neutrophils are increased in bacterial infection.  He may have some bacterial infection.  He should consult doctors and need to take antibiotics accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am suspecting that I have anemia. I am always tired, I always crave ice and eat it, I have acne, I am very pale, my hands and feet are always cold and my head is always fuzzy when I get up/move rapidly after staying still, all of which I read could be caused by anemia. What do you think? ### REPLY: Tiredness and dizziness can be caused by low blood sugar/ low blood pressure/ or low Hemoglobin (anemia). Dizziness on waking up or sudden change in posture can be due to postural hypotension. Coming to your query, Nutritional deficiencies like iron/ VitaminB12/ folic acid. You can get a complete hologram to know if there is any problem with counts, also get your blood sugar and blood pressure checked to rule out the causes I have listed aboveRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there, i am a bit worried.  My symptoms are the following.  I started having pain in my chest and upper back, for more than 3 months, I went to our famliy doctor and he eventually diagnosed Tietzes Syndrome. After almost 4 months of pain ( now also my lower back, jaw, and headaches, he reffered me to a internist for further tests.  What could this be.  I am slo itching all over my body 24/7.  Thanks ### REPLY: Hi thanks for contacting ... Tietz syn . ... As your symptom of chest pain and upper back pain stable since 3 month cardiac cause less like.... Here you might have muscle inflammation or myositis like condition... Sometime muscle tendon might tear and producing pain ... So history of trauma ruled out. For detail grading of muscle tear or tendon rupture CT scan helpful... Your detail history and examination needed and accordingly investigated . If history suggestive connective tissue disorder then ruled out by molecular diagnosis. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Im not having chest pain or shortness of breath at all.  But Ive become paranoid about heart disease as it runs in our family history.  I have muscle fatigue especially around the shoulders and have not been sleeping well.  I see a massage therapist at least 1 -2 times a month.  I weight 260 lbs and am 38 yrs old.  I alos have IBS.  Since yesterday I have been having bouts of diarherra an am concerned its heart related.  Please tell me its not my heart.  I took my blood pres and it is 120/81 pulse is 85. ### REPLY: Hello, Thanks for writing to , I am . IBS is a condition in which patient have changing bowel habit like sometime have diarrhea n some time have constipation...fatigue n muscle cramps u having is mostly due to electrolytes problem as u having diarrhea which may lead to loss of electrolytes n result having such features,if u are my patient I would like to do electrolytes test n TX it accordingly.for severe cramps u take OTC analgesic like acetaminophen.family history of heart disease make patient pine to heart disease, but it is NT necessarily that u having or will have that disease in the future, thee symptoms are very much suggestive of electrolytes prob n u donor worry about the heart ... I hope this answered your question, if you have more feel free to ask. 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 went to the ER on Thursday with fever, vomiting , diarrhea and painful navel. My wbc was 19k. They did CT of the abdomen with and without contrast, which showed enlargement of my appendix, but no air-fluid levels or signs of rupture or abscess . Essentially they said my CT was normal. They prescribed Phenergan and sent me on my way. Now two days later my belly button has a small round protrusion on the inside of my belly button. It is in the very center. I normally have an inny . In addition, the area directly behind my belly button is very hard. I continue to run a mild fever, but have not been vomiting. My question is....could the changes to my belly button be related to appendicitis or is it completely separate? ### REPLY: Hello! Thank you for the query. Finding enlarged appendix with 19k WBC and fever and sending you home is more that risky for you and for the doctor who did this. You obviously may be suffering from appendicitis and the only way to diagnose it is to rule all other possible reasons of such conditions. The lump in your belly button can be an umbilical hernia (if it has gotten stuck, may be causing such symptoms as well, and should be treated right away) or persisted Uranus (this is a connection between urinary bladder and umbilical cord which should disappear). Persisted Uranus gives umbilicus discharge and urinary tract infections. It is advisable for you to go again to the doctor and have abdominal ultrasound with abdominal wall view, full blood work (CRP and WBC will tell either infection is rising or not), abdominal X-ray (stuck hernia can cause intestines obstruction), urinalysis. 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: an enlarged lymph node aabout 2 inches was removed from a 3yr old. tests showed mostly normal lymph node cells however there was a few unsual cells spread far out from each other. the oncoligist has not been able to determine what this is. They have now sent a sample out to a lab in utah to test it. Is there anything about the small number of unsual cells and that they are spread out that would make any differnce in a diagnosis better or worse? ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  Few atypical or unusual cells in otherwise normal lymph node is normal finding. You mostly have reactive lymph node. It can be due to some infection. Just take a course of antibiotics. If it doesn't respond to treatment then biopsy diagnosis is advisable. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END