Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had a deep cleaning last Friday for the whole mouth. Now the left side is OK to eat, but the right side is still not comfortable, not very hurt though. Part of my gums are still swollen and white ( at the front teeth and at the inner side of the lower right gum). I think I had it before the cleaning already. I did see  a little bit blood when I brush when floss, but just slightly. However when I lay down in bed, I have a lot of saliva, sometime mix with milk and a little of blood. But during the day time, my mouth is very dry. The doctor gave me chlorhexidine mouth rinse, and I still brush and floss every day.  Is this something normal with deep cleaning? Or I have other troubles. ### REPLY: Cellophane you for using . As you got advised deep cleaning you must have more accumulation of plaque and calculus.  Bleeding from gums can be due to incomplete healing of gingival. Meanwhile, u can apply Gumex 3, 4 times a day to enhance health of gingival. Your gingival(gums) will be taking few days to heal. Do not worry continue with mouth wash rinses. You can take metronidazole containing tablets by your dentists advise. I would advise following up to your dentist again regarding your discomfort. I hope I answered your query. Feel free to write back, if still has any doubt. 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 an area on my back that has been aching slightly and occasionally there is a sharp shooting pain and it seems to be stemming from the surface of my skin.  i have had an extreme amount of sun exposure in my life.  i am looking for a resource to use to locate a dermatologist in the austin tx area because i do not have insurance ### REPLY: Hi, welcome to our site. I am , MD. Read your query. That is a very significant question and I appreciate your problem. I will try my best to answer your Quertle pain you described seems more appropriately localized to the back, not the skin. The backache with sharp shooting pain radiating to the skin is a typical feature of nerve damage to the back. In this relation, I will therefore suggest testing an MRI of the spine. Reason being it's a more detailed study than a normal x-ray, and unlike the x-ray, does not tell us about the nerves. Also, a nerve conduction velocity (NCV) may be done if the skin affected is over the upper/lower limb. This further tells us about the location of the pain. If found affected, we may add a medicine like Gabapentin/pregabalin, and you may need to undergo physiotherapy. In case you are concerned about your skin, please let us know if there are changes in skin, like the texture and the color of the skin. We may be able to consider the information with pictures and let you know more about it. I hope this helps you. Inform the reports mentioned above/if any other, so I can be of help further. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. Please do understand that some details could be extracted from a detailed history and examination. Please feel free to ask another query. I would be glad to help you. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)Best of luck. . MBBS, MD (Internal Medicine), CC (Diabetes Mellitus), DNB (Neurology)Consultant Physician and DiabetologistJS Hospital Apollo Hospital, Delhi Baileys Hospital, Noida ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 about a 2 inch, straight, very narrow lump, on the back left side of my scalp. Sore to touch, but no head or appearance of a sore. Does not itch. No hair loss. No red areas around the site.  Sore to touch, but I have been touching it alot. Almost vein like in feel, and scaley feel. ### REPLY: Hi, Good Morning, Thanks for your query to My-ChatDoctor Clinic. I studied your query in depth. I understood your concerns. My opinion on the painless lump appears to be-soft supple-Sebaceous cyst of the Scalp-Its due to the old clogged sebaceous gland which gradually grows to -this size of 2 inches.-Scaly feel is due to the sebum bursts on it.-Treatment -would be-a-Consult a Surgeon and confirm its diagnosis.b-Excision Biopsy would reduce your worry totally.-Hope this would help you to recover from worry-some query. Wish you a Fast Recover. Wellcome to  again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 26 year old male. 2 months back I found out I have L3L4 slip disc, through MRI, after I noticed numbness below the waistline upto the knees throughout. I am under physiotherapy and slowly recovering from the numbness but the pain is still there. one more problem is that my groin is still numb and I can hardly feel my penis, perineum, anal area, buttocks and scrotum or I should say the sensation has gone down to 50% from normal. Also the erections have become weak. Kindly suggest a line of treatment as I am very much worried about this because I have read L3L4 slip disc causes impotence or ED due to nerve compression. Please help such that I can have a normal sex life. ### REPLY: Hello, I have gone through your question and understand your concern. This is very serious. I think your slipped disc causes compression on the rural sac and the nerves in it causing a caudal syn .  You should repeat the MRI (remember: a herniated disc may appear smaller on MRI because the exam is done in a allostatic position) and should have a decompression procedure, at least a micro craniectomy. Wishing you good health, please feel free to ask further 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: what may be health teachings for discharge planning for a patient diagnose with seizure? ### REPLY: Hi, Thank you for posting your query. For a patient with seizure, these are the dos and don'ts: 1. Take medications regularly, without fail. This is because the commonest cause of recurrence of seizures is missing taking anti-epileptic .  2. Sleep adequately (7-8 hours) at night, as lack of sleep can increase the risk of seizures. 3. Eat food on time and avoid fasting. 4. Avoid stress. 5. Avoid swimming and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son began vomiting over last night and has now presented with a fever, spotty tongue and achy side. What could it be? His father has him currently, as I am out of town. I would like to get him some course of treatment until he can see a doctor. Thank you. ### REPLY: Thank you for posting your question. The symptom list that you have suggested could be the initial presentation of a variety of diseases. Hence, at present, the illness just being 1 day old, can only be treated symptomatically. Thus, an antiemetic like risperidone for vomiting and paracetamol for fever should suffice at this stage along with plenty of fluids to maintain HY .  Apart from this, keep a watch for new symptoms, decreased urine output or alternation in sensorial and report immediately if present. If you need any more advise regarding the case, do write back. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 fell a few days ago at home, and fell on my left hip bone. It was very sore that night but the next day was not so bad. The next couple of days were bad also but tolerable. Friday I did some walking outside the hone and the next day I got up with real bad pain coming down my left leg, so bad that I can not stand on that leg. ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you should definitely consult orthopedic doctor and get done clinical examination and x-ray of the affected hip joint to rule out fracture or hairline Crack. Your symptoms like worsening pain after few days and with walking are seen with hip fracture. So get done x-ray as soon as possible. Avoid weight-bearing on that leg. Take proper bed rest and immobilization of that hip is required. If it is fracture then you will need surgical repair otherwise bed rest and immobilization will heal the muscle injury. So consult orthopedic doctor and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A small lump appeared on my inner thigh today . I checked it out in a mirror to find it had a small white head on it so I went ahead and squeezed once . The pain was unbearable. Now its like twice the size and purple. Nothing came out of it . I have put some TCP on it now and left it ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some benign cyst or soft tissue tumor like lipoma or neurofibroma.  Or some malignant mass.  You should go for fine needle aspiration cytology of that lump. It will give you exact idea regarding cause. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My grandmother is a relatively healthy 86yr old with high BP(controlled w/medication) and hypothyroid controlled w/levothyroxine. She has a sister that 60yrs ago when diagnosed with hypothyroid was told she had cancer as well and they removed it. Her brother also passed having cancer of the esophagus. She lost 20lbs  about 5 months ago after a bout w/what she thought was a terrible flu. She then 3 wks ago found a enlarged lymph node on the left side. Large enough that if it wasnt in the lymph node it would be a mass. She is still fatigued and isnt able to lift her arms above her head. she can only put them straight out in front of her due to the pain it causes. Her PCP ordered labs and a chest X-ray. And referred her to a doctor(she did not know if it was an oncologist. Upon his return from vacation 2wks later a biopsy was done with a pathologist present. They drew 3 samples and then left the room. Upon their return, the pathologist asked if she smokes, she responded no, he then asked ever ? In which her response was no again. He then drew 2more samples. Its been 8 days (we were told it would be 3-5 days for results) and 3 days ago she got another bout of the flu- even to the point ofdry heaving, she still experienced naseau, and her stools is black. I asked her if it looks like coffee grounds and she said no just black as tar. She is also very weak. My mother in law had lung cancer and a very large mass from shoulder to bottom of ribs(diagonal across the chest along with cancer in the lymph nodes) and has since passed after fighting the good fight. Even my grandmother knows that she is bleeding somewhere if her stoole is black. She is very weak at this point and her symptoms are beginning to worry me as my fear is that this is what I think it may be. She of course had the sore throat along with her flu(s) I understand I do not have results to give you in this narrative, but that is because they havent given us any. Along with her brother, she has a sister pass before 50 due to cancer, but I was never told of what. Even an educated guess would help me immensely as I will be be the one she turns to if this is what I suspect. I do have experience in the medical field and I want to be prepared for the worst while of course hoping for the best. I appreciate your time and any advice you can give me. ### REPLY: Hi, I can not understand why the biopsy has been taken for several times. Anyway what was the report of that? Black tar like stool definitely signify upper gastrointestinal bleeding. But you have to be confirmed about that. Many a time patient can not assess the nature of stool. In case of upper GI symptoms upper GI endoscopy and/ or colonoscopy may be helpful. Consult an internal medicine specialist first. He/She can better guide 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 regularly suffer from irritation and pain in upper abdomen, which six months or so turns into infection. I feel its acidity problem. Recently I got food poisoning. And now can t eat normal food. Because acidity problem I have left milk, bakery products, tea, coffee. . What is the problem? And how can I start eating normal....I always eat homemade food. I can t eat at restaurants or enjoy a coffee with friends. ### REPLY: Howell come to ChatDoctorThese are the typical symptoms of hyperacidity, if I would be treating doctor of this case then I would treat this case with the following medicines, 1) Tab Omeprazole 40 mg once in day at evening time for five weeks 2) Tab Risperidone 30 mg once in day at evening time for five weeks you need to avoid the coffee, alcohol, smoking, prior to bed else you can have the coffee in the morning, hope this information helps, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have swollen feet, but not real severe; ditto for both hands. I was checked for diabetes (blood test) about 8 months ago and nothing found. I am on blood pressure medicine and I get it checked weekly (always OK). I am; however, overweight but I am stocky and carry weight well. I am 62 years old and I feel good (but overweight). This time of year, I have allergies that shorten my breath; however, by June, this goes away. I just noticed my feet. I have had this happen before, but not lately. I am to go to my regular doctor in June for a checkup (taking my blood first of June and appt. is June 26th...). Anything to really worry about until then? ### REPLY: Hi and welcome to . Thank you for your query. I am  and I will try to help you as much as I can. If both feet are swollen then it indicates more some kidney or heart disorders and I don't think this is related to musculoskeletal cause. You should do heart ultrasound and do Doppler ultrasound of legs. 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 parrtner has red round rashes on her body only the front torso and back.  These rashes are individual round blotches about 1 cm in diameter.she doesnt have an y known alergies.very strange as she suffered a flu type ilness for about 4 or 5 days but is now over this, however the round blotches are still on her torso and back.they havent moved to her legs or arms or face.  very strange   any ideas ### REPLY: HiT hanks for your querulous partner seems to have developed satyriasis rose. It is a self limiting condition. It usually follows viral illness mainly cough and cold. Itchy red round to oval lesions seen on upper body. Just apply a topical steroid. Can take antihistamines if there is itching. You need not worry as it is self limiting. Takes about two to four weeks for complete cure. Hope it 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: Hi, my little girl is 1 year old, we made her blood test , some results are not good. she has heat for about 3 days come and go, mostly at night. during the day she is seems ok, response good and she is fun. the bad results are: wbc 19.3 k/ul (5-13) neutrophils 7.9 k/ul (1.2-6.4) lymphocytes % 39.7% (41-68) monocytes 3.1 k/ul (0.25-1.43) monocytes % 12.8% (5-11) eosinophils 1.2 k/ul (0-0.78) hematocrit 31.8 % (32-41) please give an opinion. sory for the english. ### REPLY: Hi, Thanks for writing to . Your kid seems to be harboring some infection from the investigation reports. What are the associated complaints other than fever? Was the temperature monitored at any time? Does she have any cough? Does she have any burning urination or frequency of urination? Is there any history of sore throat? Does she have any chills or rigors? Please reply in detail. You may contact me with further details on the following URL...........http://www.ChatDoctor .com/Funnel?page=askDoctorDirectly&docId=65124 In such scenario the questions are directly forwarded to me .............. and I can answer your queries regarding your kid online regularly. Hope this helps. Take care . D.(Pediatrics)Associate Professor of Pediatrics ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter has raised pimples on the inside of her leg near groin area. There is no puss like a regular pimple. Is it child acne from the heat. It has been hot and humid. My daughter is not heavy but it is where the legs and groin area meet. I have been using 1 percent hydrocortosoin cream. Do I need to take her to a dermatologist? ### REPLY: Hi... Thank you for consulting in . Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, the last few weeks I have had pain in the top of my abdomen that radiates around to my back, to start with it was on and off and would settle but the last week it has been constant and has been intensifying to the point where I feel sick and have trouble breathing. It gets worse after eating and trying to lie down increases the pain in my back. Not sure what I can take to help the pain or what it is causing it ### REPLY: Hi. Thanks for your query. Noted the history and understood your concerns. Pain in abdomen n the top for the last few weeks along with pain radiating to the back can be due to the following reasons:Gastric ulcer on the posterior wall. Pancreatitis. Or rarely the lymph node mass or some problem in any of the retro-peritoneal structures of abdomen. I would advise you the following in such a situation:Get the clinical evaluation by a Gastroenterologist. Upper GI Endoscopy to rule out gastric and acidity related problems. CT can of the abdomen to see for the pancreas and other structures. Relevant tests of blood, urine and stool. Get started on appropriate medications as advised. PPI like Pantoprazole, antispasmodics and painkillers as needed. Liquid diet. Further management as per the reports. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have had a problem with my forskin crackin a lot lately it heals then I after I have intercorse it seems to crack again the skin has now become really swollen making my penis to appear wider I was able to forse it rite back the other day and noticed a bean sized hard cyst type lump on one side which makes the skin awfully hard to pull back it doesn t feel painful. But it noticeable ? ### REPLY: Thanks for asking in  forum In short:If your foreskin is tight then it may crackExplanation: Usually whenever foreskin is tight and difficult to retract then it may rack causing pain. Also, if it is .  I would like to suggest you to retract and protract your skin daily once and can apply point clobetasol locally for 3-4 days can relive you of your problem.  For cyst like thing, I would like to suggest you to visit a doctor so that he can examine you and suggest remedy. Good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello i would say for the past couple weeks i have had this pain un the right side of my chest right above my breast it hurts if i bend over towards my right side and occasionally when i breath and ocassionally on my right arm does anyone know what this could be? And it comes and goes ### REPLY: Thanks for your question on . I can understand your concern. Possibility of musculoskeletal pain is more because it is associated with movements of chest wall (bending and breathing). So avoid movements causing pain. Avoid bad postures in sleep. Avoid heavyweight lifting and strenuous exercise. Take painkiller and muscle relaxant .  Apply warm water pad on affected areas. You will mostly improve with these in 1-2 weeks. If not improving then get done chest x-ray to rule out internal pathology. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 37 year old fiance is currently in hospital, has been for 5 weeks and was in Intensive care for a week. He suddenly developed septicemia in the new year which highlighted a faulty valve from birth.  He had surgery to replace valve 3 weeks ago and then had to have it perfomed again last week because the infection attacked the new valve.  As well as all this the abscess broke off and scattered over his brain causing multiple mini strokes.  He is improving slowly but is suffering from a chronic back ache, would this be due to the infection attacking his back?  They are delaying an MRI because of the wires in chest bone.  Also we were due to fly to the Maldives in July to stay on a remote island, if he lucky enough to recover by then do you think this is a good idea?  Many thanks ### REPLY: Dear caring fiancé Your fiancé is under treatment for septicemia which leads to immunosuppressive status of body. Due to which he is susceptible to multiple site infections.  Was his back pain previous to this illness or started after valve replacement? If it started after valve replacement and abscess there is possibility of vertebral infection and MRI would be ideal investment to rule out it. If he recovers then u can definitely go to any part of the world by July month. 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: Dear Doctor.This is Nikunj from India .My Father is having Oral Cancer since 2003 He got operated Thrice had been given the radiations Thearapy also .But this this as per the Pet scan the symptoms has developed in Nasopharyngeal area.Doctors told that this cannot be treated further and he has gone in last stage with 2 month of life maximum.I dont wnt to loose hopes and want to fight till the end .Do we have any solution so that we can try .please help awaiting for your positive response at the earliest !!! Regards.Nikunj ### REPLY: Hi, dear I have gone through your question. I can understand your concern. He has oral cancer and spread to the hypopharynx. So it is last stage of cancer.  Surgery will not helpful at this stage.  Treatment of choice remains chemotherapy and radiotherapy.  Despite treatment prognosis remains poor.  Life expectancy is not good.  Sorry to say but it is bitter fact.  A man should not expect much from this. 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: My friends father got an injection of tpa and now has bleeding into his brain and is on life support, he also has a fever and high blood pressure. What does this mean? Will he ever recover? Does it take time for the effects to go away? Is it too late for him from having blood in his brain and from maintaining a high temp of 105 which has decreased to 102? Is there anything at all that can counteract tpa or generally be done to help bring him back? He has been on life support for 5 days. ### REPLY: Hi, Thank you for posting your query. Tissue pepsinogen activator (TPA) is used for treating acute brain stroke (lack of blood flow to brain) and is generally safe and effective. However, in about 5% of cases, bleeding does occur. If the bleeding in the brain is large, a surgery can be done to remove it. Fever is most likely due to unrelated causes such as lung infection. This can be treated with antibiotics. The ultimate recovery depends on the damage caused to brain due to his initial brain stroke as well as bleeding in the brain. Please get back if you require any additional information. Best wishes, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor, i want to ask regarding my 4 months and 3 weeks old baby..his pediatriacian change his milk from nan1 to nan H.A because he has rashes on face , he is drinking well the NAN H.A but the problem he is passing greenish watery stool 3x per day.Is this normal??thanks a lot. bunny ### REPLY: Hi... Thank you for consulting in . What your kid is having is not a diarrhea and is only a gastronomic reflux. It is quite common for babies of this age group t pass small amount of diarrhea or loose stools soon after feeds. This need not be treated as diarrhea and especially antibiotics are not indicated. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have taken 5mg of Lisinopril for the last 18 yrs when I started with asthma and I underwent a discectomy after 4 years of bad pain.Blood Pressure is usually reasonable but lately Ive been suffering from a thudding and faster than usual heartbeat more especially in the evening or when I  go to bed.Its uncomfortable and worrying. ### REPLY: Hi, It can be either arrhythmia or just elevated heart rate from stress or anxiety. I would advise you to have an ECG done. If it comes back normal, but you continue experience same problems, the next step is holder monitoring. It is an examination, when your 24-hour ECG is registered, so your doctor can find out what's going on with your heart when you have complaints. Hope I could help nourishing you good health In case of further questions don't hesitate 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: Thanks. Actually feeling heaviness on my chest left side, drowsiness, short breathing some times and when i answering someone , during talk, i forget the words. Kindly reply me. Always feeling sleepy. When i eat something meals i am feeling these things, and some times some food came out(vomit) then i feel well.So many time Thanks ### REPLY: Hello dear, thanks for your question on . In my opinion you are having mostly HERD (gastroesophageal reflux disease). Your symptoms like chest pain, vomiting after meals are more suggestive of HERD. But better to rule out cardiac cause first for your chest pain. So get done ECG. If ECG is normal then HERD is the probable cause in your case. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of chest pain and vomiting. So follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid stress and tension. 3. Avoid large meals, instead take frequent small meals. 4. Start Proton pump inhibitors. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in bed to prevent reflux. 7. Lose weight if you are obese. 8. Avoid smoking and alcohol if you have these habits. Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI, please advice on this report VOLUME 1.5 mL PH 7.5 7.0 - 8.0 FRUCTOSE DETECTED DETECTED COLOR GRAY-WHITE LIQUIFACTION 30 MOTILITY 60 MOTILITY-GRADE 0 - NON-MOTILE 40 % MOTILITY-GRADE 1&2 - SLUGGISHLY MOTILE 20 % MOTILITY-GRADE 3&4 - ACTIVELY MOTILE 40 % VIABILITY L 62 % SPERM COUNT 50.4 ABNORMAL FORMS 03 PIN HEAD 01 % SHORT TAIL 01 % CURLED 01 % AGGULTINATES NOT DETECTED RED CELLS OCCASIONAL NOT DETECTED /hpf PUS CELLS 2-3 /hpf EPITHELIAL CELLS 1-2 /hpf CRYSTALS NOT DETECTED NOT DETECTED AMORPHOUS DEPOSIT NOT DETECTED NOT DETECTED BACTERIA NOT DETECTED NOT DETECTED Test Method ### REPLY: Hi welcome to  .... I can understand your concern.... In your semen report you have abnormal motility report..... See non-motile sperm usually not exceed more than 10 %.... Here it is 40%.... So rule out cause. First smoking and alcohol avoided if habit of it. Excess heat exposure less that is less hot shower ... Avoid tight under cloth .....Don't take stress. Too much sex not done as frequent sex can lead less motility.... Regularise sex habit. Vitamin and minerals deficiency ruled out.... Take broccoli, citrus fruits, spinach and red peppers that provide antioxidant, vitamin C and vitamin A. Coenzymes Q, selenium and vitamin B 12 supplementation useful. L carnitine tablet increase sperm motility. With keeping this in mind consult psychiatrist. If you can't conceive even with every treatment then final option is assisted reproductive technology. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello so I have wisdom teeth that have been coming in for over a year and I m not sure if I need to get them removed. However I always have sharp pains comig from where my wisdom teeth are and recently my ears have been feeling pressure and when I touch under my jaw and by my lymph nodes on the outside it feels tender could this be due to my wisdom teeth being impacted? ### REPLY: Hi, Thank you for the query. Presence of radiating pain in the ear and under the jaw is because of infection in the teeth or surrounding gingival flap infection i.e. development of peritonitis, and tender lymph nodes. An x-ray should be taken to know whether the teeth are impacted or can erupt into occlusion normally. If impacted it has to be removed surgically or operculectomy should be performed if only the gingival flap is infected this should be followed by a course of antibiotics and analgesics. Hope this information helps you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am in a bowling league, which is a new thing for me.   I usually bowl twice a week now and were about 7 weeks into the season.  All of a sudden my lower abdominal area on my left side hurts a lot when i try to bowl.  In fact, I cant bowl right now.  Everyday activity and other activities (such as golf) do not bother it.  Any ideas? ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  You had pain abdomen on left lower abdomen after bowling. It is again paining while bowling only, and not during other games.  It appears to be a muscle catch, due to stretch on the left side, while bowling, that is why it is paining while there is stretch on that side.  Other causes could be urinary tract infection, stones in the urinary tract, or infection of the descending colon.  I advise you to consult a surgeon for diagnosis and treatment. You may need to have M.R.I. besides other routine tests for confirmation.  Wishing for a quick and complete recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am 27 years old 6 ft tall and 12.9 stone. I have a soft lump half way between the bottom of my calf and ankle I have had it a year now, my bottom part of my ankle seems to swell if its a hot day, I have a strange dull ache in that area, and now I seem to get pains up the inside of my leg up to my knee. Any ideas? ### REPLY: Thank you for asking . My name is .  Lump in this region of the leg can be due to localized skin lesion or bony deformity such as hands deformity also known as pump bump which is due to irritation of soft tissue when bony enlargements rub against shoes. There can be other causes including inflammation, infection or trauma etc. you need to consult doctor and may undergo radiography of this region and some Labs. 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: I have been having problems at work and i was ill with anxiety/panic attacks. Last few days ive been so sleepy and my legs feel weak and shakey really infact all my body and i just cant sleep and if i do its for a few hours tops. Could this be anything serious like cancer or other related problems im really scared ive been to the doctors loads and they told me to do breathing techniques please help ### REPLY: Hi dear, according to your symptoms and signs you might have depression and anxiety. Whether you have severe chest pain or palpitation which leads to feeling of dying?any symptoms like low mood, loss of interest, irritability, fatigue, appetite disturbance etc....consult psychiatrist for detail history and mental status examination. Not to worry much there are many medications which helps you. 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 know someone who had cervical cancer. She abuses prescription meds. In and out of rehab. Lately she has had nausea, inability to hold food down, lost her hair and lost a lot of weight. She wont tell anyone what is happening.  Then she said she has kidney failure.  Can she do dialysis? How long do people like her last? We are trying to gather info to scare her into taking care of herself. ### REPLY: Hello and welcome to . As a Urologist, i advise you, that a person with kidney failure can do dialysis.There are indications for dialysis. Surviving kidney failure on dialysis, in a patient with cervical cancer, is difficult to predict, without knowing its stage. Dialysis can be done, but the long term prognosis isn't very good. If you send details like abdominal CT/ MRI scan, all blood reports, to me as a direct question, i can give you an expert opinion. .  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: Hi, may I answer your health queries right now ?  Please type your query here...Last week while at work, my left breast started fluttering, like in the top.  Didnt think anything about it.  That night after lying down, my heart started racing. Took me a while to go to sleep. Next morning still pretty fast, but quieted down during the day and nothing erratic since.  I did have an ekg that morning since I was fixing to get on a cruise ship.  Other than my known right bundle branch block, nothing else.  Should I contact my cardiologist since nothing else has occurred.  Im a little anxious. ### REPLY: Hello, This can just be an anxiety or can be a cardiac arrhythmia like PSV or atrial fibrillation, in which heart rate suddenly goes up and also suddenly decreases. Blood pressure falls during these episodes and one has dizziness, fainting, blackouts, sometimes syncope. Usually ECG is normal as it is usually done in between the episodes. ECG done during episodes will show abnormality. You will need 24 hour holder monitoring if episodes are occurring on daily basis so that it can pick it. So visit nearby cardiologist for this investigation. Also, hemoglobin and thyroid test should be done. Ln order to abort such episodes you should try to cough hard.  Is there any stress or anxiety associated, if yes it can also cause it.  Till the time your evaluation is complete, you can ask your local doctor for tab collar LA 20 mg once a day which will take care of such episodes and also anxiety. If none of the above is successful then last option is of electrophysiologist studies which is invasive test which can diagnose and treat the arrhythmia permanently in most of the cases. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 curiousity sake is it usually the case that a person with hydrocephalus have a seizure disorder as well due to imbalance of electromagnet current in the brain?  I have had hydrocephalus since I was 3 months old.  I am 55.  I had my seizures start when I was 17.  I take a lot of medication and also have a vagus nerve stimulator.  I hope this is enough information for you. i can add to it if need be. ### REPLY: Hi, Thank you for posting your query. Generally, a person with HY .  So, we need to look for other causes for your seizures. MRI of the brain (epilepsy protocol) can help us find out the reason for your seizures. Sometimes, no cause can be identified, when it is referred to as idiopathic or cryogenic seizures. I hope it helps. Please get back if you require any additional information. 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: Earlier i was taking Glycomet2 twice daily.Last week i consulted doctor and he advised me to go for insulin since my sugar level was 250 random and fasting was 157 and three months average was 8.1.He had advised me to take 20 units in morning and 12 units in evening of Eqlucent Mix-25 .I took this for 03 days but now i am taking only 20 units in morning ,Evening i am taking insulin and my Random sugar is coming at 90- 100.Along with Insulin i am also taking tablet Zomelis met 50mg/1000mg twice a day. Also can you suggest some other cheaper insulin which is compatible with Eqlucent since this one is very expensive As suggested by my elders i should also take some multivitamins.So kindly whether i can go for Revital H or recommend me some other Multivitamin. Thanks n Regards, Kishore ### REPLY: Hi sir, you should control your HbA1c to 6-6.5%.taking insulin is better than medicines. If you feel hypoglycemic reduce the dose according to your sugar levels. You should take all these medicines till your HbA1c comes under control. Avoid taking some fruits like mango, banana, dates, jack fruit and tender coconut and coconut. You can take other fruits since sugar levels is less in other fruits compared to those I mentioned. Multivitamin is also necessary. 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 doctor my name is Preethi..my mom is 50 years old.2 years ago my mom had a liver scan...as per the scan report the doctor said..she had a fatty liver grade 1...but they dint give any medical suggestions or pills...they say its not that dangerous...is it so?.can this fatty liver can be reduced..what treatment could be taken...she is also a BP patient...she takes Prolomet tablet for that...her BP is always normal..her ESR high..it is 40 for half an hour and 60 for an hour...why is this always high..we asked many doctors..they dint give proper answers at all please help... ### REPLY: Hi, welcome to , Firstly, fatty liver is the most common incidental finding during Ultrasound scan. It is not a dangerous condition rather it indicates you to avoid rich diet and alcohol.  It will not reduce by any .  Only lifestyle modification is the measure which can stop it disease progression.  Now, ESR - it is a not so much reliable indicator of any specific disease. Because many condition gives falsely elevated result. So it is not a problem when clinically there is no disease condition.  Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have recently had allergic reactions that cause hives and swelling in random places. For example, bottom of feet, face, lips, cheeks and on legs and arms. I use chewing tobacco daily. Could this cause these symptoms? I have never been allergic to anything in the past.  Symptoms started about 6 mo. ago ### REPLY: Hi, thanks for using  If the allergic response started soon after you began to use the chewing tobacco, then it is likely related. You may want to consider discontinuing its use to see if the symptoms resolve. If they continue then the allergies are related to another source, and it may be best to consider allergy testing to determine what it is exactly so that it can be eliminated. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has severe Charlie horses/leg cramps at night especially after sweating a lot or working the clutch on the tractor, I suggested he use the magnesium gel I purchased from Dr. Becker - Bio-nutrients!. A pharmacist suggested he take potassium supplement and eat bananas. What is your suggestion? ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have severe charlie horses/leg cramps. Well there can be many reasons for symptoms you mention in query like inadequate blood supply, nerve compression, mineral depletion or vitamin E deficiency. I would suggest you to do gentle massage of your leg with sesame oil, apply warm compresses on leg, eat healthy diet including banana for potassium and do light walking for 15-20 minutes daily. If condition doesn't get well then consult orthopedic surgeon for proper examination. Doctor may recommend physical therapy and vitamin supplement. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have an 8yr old that has been having headaches and dizzy spells for 2 weeks now, the headaches are in her temples and hurt like a stabbing pain. We have been to numerous drs and her sinus are clear ears are clear bad am MRI done this week and it all looked good. Tonight she has yellow bloody snot. They thought it was vision or migraines?? ### REPLY: Yellow blood stained snot is not unusual in case of a respiratory tract infection and not a cause for concern. But it could be related to sinusitis which in turn could be the cause of the headache that she is suffering. Sinusitis is often hard to treat as they have poor blood supply and hence the medicines cannot properly reach there. Taking steam inhalation should provide relief. Water in form of vapor can reach deep into the sinuses and help in diluting the cough. There is indeed a possibility that the headache is due to migraine or visual problems. These would not be evident on tests like MRI. Clinical correlation and vision testing is needed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, my sgpt/alt-91 & sgot/alt-60 and nearly same range was one year ago. Recent Lipid profile test is showing total cholesterol-223 & TG-190 . My Gall bladder has been removed in Feb2012 . Now i am feeling light burning sensation or mild pain from Gall bladder area. USG is showing my lever is mild fatty . I am non alcoholic & non smoker . Pls advise how to reduce my sgpt & sgot level . ### REPLY: Hi, Thanks for posting your query. Are you an alcoholic? With the available described symptoms, there could be possibility of non-alcoholic fatty liver disease (NAFLD) and untreated case may lead to non-alcoholic steatohepatitis and cirrhosis. You should consult with internal medicine specialist/ gastroenterologist and should go for thorough check up. You should go for complete blood count, liver biopsy, Bag, Antioch. Meanwhile, you should take low fat diet along with brisk exercises. You should take Ursodeoxycholic acid, vitamin E and statins. Statins also helps you in controlling deranged lipid profile. 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 three and a half year old has thrown up two nights in a row.  She seems fine during the day but has woken up around 4:30 am 2 morning in a row to throw up.  The first night her vomit was thick and clear.  Last night was thick and mixed with her dinner.  She seems to be back to normal as soon as she throws up.  What should I do to help my baby?  Thanks. ### REPLY: Hi, Thankyou for your question. Throwing up at nighttime can be because of either reflux disease or coughing episode at nighttime. If she has not got other associated symptoms of flu or allergy with cough then most probably it is because of reflux disease. To diagnose reflux you may get 24 hours PH test done and discuss with doctor. And to prevent from vomiting you can give spy.ondansetron before sleeping. Hopefully my answer will be helpful. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 25 years old and was recently diagnosed with allergic esophagitis. I have been taking the inhaler fluticane medication as prescribed. It seems that everytime I eat I have trouble breathing. I only drink water and have cut out any foods that contain, milk, wheat, soy, egg, or peanuts. I feel like forced burping is the only relief. When I cant get the burp out I cant breathe. What is causing this? Is there anything I can do to help it out? ### REPLY: Since your Doctors have diagnosed you with allergic esophagitis and forced burping the only way to get relief, you are not taking any food. It can't be the scene for long. You can't survive on water alone. If you were my own patient, I would have advised you to take the following which I have tried on some of my patients with success:Please boil water approx 200 ml with the few leaves of Holy Basil (Opium sanctum) and small 1-2 ginger pieces. Allow to cool (Lukewarm). Mix honey 1 tsp to it. Add little turmeric, say 1/4 tsp.  .  Rather sip it. May do it twice or thrice too. In few days you will start feeling better. Its safe and no interaction with inhaling medicines. If you can report through , we will be able to guide further. Hope it will help you to improve day by 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: Hello, for the last few months I have had occasional and persistent numbness/slight swelling on the inside of my bottom cheek usually on my left side (sometimes on my right also). It normally lasts for about an hour or two. Its usually after I eat something or brush my teeth . However I do use toothpaste for sensitive teeth. This morning all I had was oatmeal and coffee and its pretty numb. Is this something to be concerned about? ### REPLY: Hello, Thanks for posting your query. Numbness/slight swelling inside of cheek may be due to- Deep dental carries associated with teeth cervical abrasiongingival recession impacted wisdom teeth resulting in inflamed periodontal flap chronic cheek biting. Toothbrush injury. I would suggest you to get a thorough check-up and radiological examination done. Any anesthetic gel can be applied on the affected site.Meanwhile, maintain good oral hygiene. Treatment can be planned based on the investigations. 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: what is my lump? Hi my names Melissa im 15 years old around 54 and i weigh about 124 pounds. A year ago i was at the waterpark with my friend and felt my stomach and there was this lump under my skin. Its not 3D but you can definitely feel it. Its still there. Its in between my belly button and boobs. I tried looking it up and i think it might be a hernia or something. I can push it in and it feels weird. What could it be? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have umbilical or para umbilical hernia. Or you have some soft tissue tumor.  You should go for examination first and if needed go for ultrasound. It will give you exact diagnosis.  If you have hernia then you should go for surgery.  Hernia repair by meshplasty is the treatment of choice. Consult your doctor and take treatment according to diagnosis. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello well im a 23 year old female and weighs 98lbs,,, don t worrie im totally normal, but i do have a question, lately ive been having these symptoms like my bones hurt me really bad mainly my joints and i no funfeel really weak and i have no appetite,, what should i do to feel better again ### REPLY: Hi, As you are perfectly fine and not having good appetite than you should consider one by having good fruits and fruit juices. As this plays important role in improving the appetite. Also, the joint pains can be due to other factors and needs a clinical examination for the same. Do regular exercise which will help improve the metabolism and allow the body to provide intake more. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I recently went to a clinic to have an ultrasound done on a lump I recently discovered in my armpit area. When I looked at the image on the screen, I had to take a picture of it with my cellphone. After having several people look at the picture, they all confirmed what I confirmed when I saw it. There are four distinctive images of mens faces plus an army soldier. We could nt believe it. Any thoughts? I can forward the image! Very strange! ### REPLY: Hi, Dear,Thanks for the query to . I studied your problem in depth and I understood your concerns. Cause of strange USG image of lump in armpit-This could be due to the Teratoma tumour-with congenital anomalies / or hematomas. This advice is based on the facts from the history you give and needs further clinical check. So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to  and be comfortable to resolve your health issues. Welcome for any more query in this regard to . Write good resume and Click thanks if you feel satisfied with my advice. Have a Good Day. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My partner had an angiogram yesterday  and this eving she has been shivering and her face is white and she feels cold and has a temperature of 37.6 even though shes taken paracetamol. The angiogram was normal. Is it normal to have shivering and slight fever start 24 hours afterwards? ### REPLY: Ya you may have some feverish feeling with shivering post angiogram, not always but frequent as for an angiography a dye is used, your partner had delayed reaction to the dye.  Take plenty of liquids and the dye will be flushed out of the system through urine in 24 hours.  You need not worry about the same and its just mild reaction to the dominated dye. . Wishing you best of health.  Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi..I am 34 yr old male..have been married for the last 5 yrs..but dont have any kids.....I have been masturbating since the age of 14..am not able to stop this habbit...still do it for 3-4 times a week...I am in a very stressful job and have a high BP problem as well...m taking a medicine daily as well for my BP....me and my wife do sex once/twice a month...but m not able to ejaculate while doing sex...but when I masturbate I am able to...I dont drink/smoke...do exercise twice or thrice a week but not regularly....Because of this problem we are not having regular sex life as other couples..I am a non-vegetarian and eat non-veg 2-3 times a week....I feel that I face a problem of retarded ejaculation....pls advice how to overcome this and how to lead a healthy sexual life ### REPLY: HelloThanks for query. You are unable to ejaculate while having sexual intercourse with your wife whereas you do ejaculate when you masturbate. This is mainly due to what is called as Psychological Inhibition and due to stress and anxiety. You need to consult qualified Psychiatrist for counselling, Following measure will help you to boost up your confidence and getting good erection and delay ejaculation. 1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning. 2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc 3)Take anti oxidants like Almonds 5-6 every day 4) Avoid alcohol and smoking. Taking Sildenafil (Viagra)as on demand will help to get good hard sustainable erection and to have enjoyable sex and ejaculate .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doc, I have been told by my urologist that the cortex of both my kidneys are thinning at an alarming rate . This conclusion was arrived at after viewing the ultra sound images of kidneys. This is the first time I ve heard of such disease. I d like to know how and what causes the cortex to reduce in thickness? Can the thinning process be arrested and cured? Would I need surgery? Tq. Hamdan ### REPLY: HelloThanks for query. Thinning out of Renal cortex strongly suggest chronic Parenchymal Kidney disease.(Chronic Pyelonephritis)Please consult qualified Nephrologist for clinical examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) DMS scan to assess the kidney function 3) Renal Function Tests 4) Renal Biopsy (if required)Further treatment will depend upon result of these tests and final diagnosis. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 diagnosis for tingling..itchy head in a little child. He is active in sports and has allergy concerns and wax in ear that was cleaned several times by an ENT. Several years ago he miraculously recovered from bleeding in brain after many angiograms and cat scans cleared him. We thank the Creator. ### REPLY: Hello and welcome to BIX/. The issue here is not related to his past bleed inside the skull. I think it is a skin issue, and it may be useful to get him checked by a skin doctor to rule out any allergic or infective causes of his itching. About the tingling ... I did not understand. Is the skin tingly or does he hear tingling sounds from his ear. If it is the ear sounds, yes, wax and ear problems can cause tingling sounds. Else, I am not sure. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 iam latha. iam 23 years old just i 11 months back i married after 4 months on that time iam conceiving 2nd month but unfortunately abortion to me on that 2nd month. on that time this time iam not conceivig after my docor check thyroid test it is is normal .so my doctor suggest letroze 2.5mg ,2nd day to 6th day of period now 25th day to me i check pregnency test today early morning it is negitive. so what happen to me? ### REPLY: Hi, it is very early to test for pregnancy.  If your periods get delayed, then do a pregnancy test. If positive, consult a doctor.  If negative wait for your periods.  You can try naturally for 6 months to 1 year.  Don't rush. The chance to conceive in a normal couple in one cycle is only 5 percent.  So, it may take 1 year for you to conceive again. Hope I have answered your question. 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: sir, My father had a fall and has subdural hematoma. As he is 80, due to brain shrinkage whatever gap is produced, the hematoma is adjusted within. No midline shift was there. He was hospitalized for 8 days. Now he is at home with Eptoin 100 three times a day. He does not have any complain but is drowsy  and when he takes eptoin has delayed speach. Should he continue Eptoin 100 tid or BID? ### REPLY: Hi, Thank you for posting your query. Your question is very important, and I congratulate you for that. In fact, there is no need to give option (phenytoin) in an old person with subdural hematoma. Phenytoin is an anti-epileptic . So, if your father has not had any seizures, then, option can be discontinued. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i am from chennai. i have few black spots in my face which makes me look dark. This is my only problem pls help me with a good solution ### REPLY: Hi prithiWelcome to  Black spots on face or hyperpigmented spots which have developed later on in life could suggest hormonal imbalance or due to excessive sun exposure best results it is advisable to consult a dermatologist cum cosmetologist who can study your skin type and provide appropriate remedial then try to have a balanced diet, plenty of water and exercise for at least half an hour. Use only mild glycerine soap and sunscreen daily.avoid the afternoon sun 10am to 4pm if possible. You can try fresh lemon juice or natural lover application to decrease the black spotsThanks W ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive been sick for months with viruses streap and vaginitis ive never been sexually active i still feel sick frequent urination headaches nausea swollen lymph nodes and severe back pain now chest pain im 16 what is wrong with me because my doctors arnt diagnosing this and im so weak and tired. Help please ### REPLY: Hello Dear. You might be having Urinary tract infection. Since you mentioned that You were never sexually active, the possibility of Sexually transmitted infections are ruled Otto identify a UTI, keep an eye out for the following symptoms:A burning feeling when you urinate frequent or intense urge to urinate, even though little comes out when you domain or pressure in your back or lower abdomenCloudy, dark, bloody, or strange-smelling unfeeling tired or shakyFever or chills (a sign the infection may have reached your kidneys)Some key preventive factors are maintained perineal hygiene, .  Feel free to contact me if you have any more questions. I'll be glad to help you. All the besting warm 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 doctor. I just had unprotected intercourse. and right after the intercourse I 4 take abets of althea contraceptive and plan to take another 4 tomorrow. Im fertile and Im scared. What are the chances of geting pregnant? Will i still need to take emergency contraceptive? ### REPLY: Hi, If you are not using any other hormone contraception and have regular cycles, chances of conception are high after an unprotected intercourse during the fertile period. The efficacy of Althea as an emergency contraceptive is not well documented. Since you have taken heavy doses of the medication, taking another dose of an emergency pill, which in itself contains high dose of hormone, may totally derange your hormone milieu. Please wait for your next natural period and get help if you miss it by more than a week. 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: Hi, My name is Dianna! My husband was in a car accident many years ago and has 3 surgeries to try and fix him! I dont know the exact medical terms for all that he has going on but I do know the medications he is on that are causing him to act very strange! I am worried about him, and cant pin point what medications are responsible for the way he is acting, or if it is a mixture of two or more!? So as of today here is a list of all meds he is taking: Hydrocodone, Atorvastatin, Cymbalta, Cyclobenzaprine, Lisinopril. He has had memory loss, trouble getting his point across, at times slurred speech, he always looks lost but very chatty and eager, when I confront him and try to explain to him how he is acting, he gets depressed and discouraged! This is not at all him!!! I watch him hurt with severe pain daily but he never lets it get him down! Im really concerned that if he continues on with these medications that he will loose his job! please help!!! ### REPLY: HiT hanks for using  Sometime due to any physical illness or injury, patients get underline depression which is characterized by mood swings, crying spells, decrease concentration, somatic complaints etc. In that case, they need proper treatment with antidepressant. He is already on cymbal ta and just carry with same antidepressant. According to symptoms, his dose could be increased, and it would help to overcome from depressive symptoms. According to law, a patient can not be fired from job due to his disability, so nothing to worry about that. He would stay on job. 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: One year ago, I accidently went to hospital to have check up and found out that my blood glucose is high up to 170 with some urine glucose. The doctor asked me to do only serious exercise for month month and be on diet. The exercise and diet gave good result esp. for the first two weeks and the blood glucose downs to normal range. Until now my fasting blood glucose is still in normal range without any medication. However, the new sumptom has happened for three months is that the "slow down of heart beat sometime in a day esp. at noon and in the everning. To prevent this irregularity I went to the local doctor and he treated me for Flecain for 10 days, but it seems temporarily relief but generally is not effective. Then I stopped using medicine and try to exercise instead (morning and everning) and the heart beating becoming better. The questions are: Whether the slow heart beating relates to history of high blood glucose?; how can I deal with slow heart beating. Please recommend me whatever the best way to solve my heart problem. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. Your slow heart rate is not related to your high sugar level. It may be due to exercise. It increases your legal tone. So heart rate decreased in athletic person.  If you have slightly low heart rate then no need to worry. If you have significantly low heart rate then consult your physician and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello my name is brittany monroe, just a few moments ago i started getting this twitch in my upper pectoral area which lasted about 10-15sec and then i started getting this light mild tingling in my left hand that has stopped and the twitching came back and lasted about 3-5 sec. im only 22years old and is this something i should be concerned about? ### REPLY: Thanks for your question on . In my opinion it is only muscular twitching.  But since you are having left sided chest problem with arm radiation, we need to rule out cardiac cause first. So get done ECG to rule out this. If ECG is normal than mostly you are having muscular twitching. Try to follow these steps for better symptomatic relief. 1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Avoid stress and anxiety. 4. Take good painkiller and muscle relaxant. 5. Apply warm water pad on affected site. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 56 years old and am not on any medications.  Ten days ago I had some flu like symptoms such as fever, chills, shakes, headache no vomiting but felt shaky inside which made me feel like I wanted to throw up.  I went to my doctor who put me on a drug called azithromycin which before I started taking these I told her my heart had been speeding up. She gave them to me anyway. I have taken four but have now quit because I feel awful. What should I do?  Please dont tell me to go back to that doctor that prescribed this medicine because this is not the first time she has misdiagnosed my health. I trusted her and now I feel worse. ### REPLY: First it is necessary to find the cause of fever Usually such symptoms are indicative of viral self limiting illness. Where you need Tab. Paracetamol 500 mg stat and up to 4 tablets for high fever over 101 degree f. Second possibility is that of some bacterial infection and if it I'd respiratory then you may be given author but if you are not tolerating then you may be given definite 200 mg twice a day for 7 days.Instead, I request you to get your blood tested for complete blood count, smear for malaria if common in your region and urine for routine and microscopy. After getting your reports you may go to your doctor for further guidance. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 on Glipizide 5mg 3 times a day. sugar levels were running at 58 before meals and 88 after meals. Had a lot of sweating. Finally stopped Glipizide and now level is 153 before eating and 144 after meal. Next dr apt is not until March. How to best control numbers? ### REPLY: Hello and thank you for asking! I have gone carefully through your concern and understood your query! Glipizide is a class of antidiabetic medications that causes hypoglycemia or low blood sugar. Your doctor will prescribe another medication in the next visit that does not have hypoglycemia as side effect (metformin for e.g.), depending on the HbA1c level, BMI, liver and renal function etc. Meanwhile, if you are overweight I would suggest seeing a dietitian and do physical activity. If the fasting glucose levels, persist high, take 2.5 mg glipizide once daily. Hope the information will help. Kind regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had Right Upper Quadrant pain for the last week.. I have a sudden change in my stools becoming black and mucous consistency. went to the ED yesterday and after an ultrasound was told I did not have gallstones but did have some noted hemangiomas in my gall bladder and common bile duct. Do feel better today after much pain last 10 days. What does this all mean? ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can. I am not sure if you meant on hematomas in gallbladder or liver, but these are probably hematomas in liver and this is benign condition and this should not cause your difficulties unless there are huge hematomas. Gallbladder issues may lead to such pain even if there are no stones, so cholecystectomy should be considered as well. I hope I have answered you query. If you have any further questions you can contact us in every time. 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: I think my husband has carpal tunnel, he complains of weakness and trouble writing . He describes a vice like constant pain of his right hand and wrist radiating towards fingers. I have suggested icing 2x an hour when possible , bought a moderate wrist brace for night (and when possible at work) and feel he should use ibuprofen, but we are wondering what dose would be best for relieving his pain which has been debilitating to him this week. Any suggestions? ### REPLY: Hi, thank-you for providing the brief history of your husband. As he is having pain in the wrist and below towards the finger, a thorough clinical examination is advised. As the neuropathic pain is articular in symptoms this can be either related to the pinched nerve in the cervical spine or may be the carpal tunnel syn .  Now for coming closer to Diagnosis a thorough examination is advised post which may be an MRI of cervical spine or the NCV study for the upper limb will perform and then treatment will be advised.Also, Physical therapy is a non-invasive treatment which helps reduce the pain and also helps regain the hand function. 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 had flu about 4 weeks ago .and I got over it ok and nouw I have rely bad chest pain.it feels like I have broke my chest bone.and when I try and move or lift somthing it hurts.also when I cough it hrt and not much mucus cmes of. Can you tell whats up with me its herd to breath as well. ### REPLY: Thanks for your question on . I can understand your situation and problem. By your history and description, possibility of pleuritic chest pain is more. And it is seen commonly with lung infection and bronchitis. You are also having cough and difficulty on breathing so possibility of bronchitis and lung infection is high. You also had flu infection. And this can also cause bronchitis and lung infection. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x-ray and PFT (Pulmonary Function Test). Chest x-ray is needed to rule out lung infection. PFT is needed for the diagnosis of bronchitis. You may need inhaled bronchodilators, inhaled corticosteroid (ICS) and antibiotics. So better to first diagnose yourself and then start appropriate treatment. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have chronic back pain. aherniated disc(c3-l4 & l5) and facent joint lumbar pain tha facet pain is going to be burnt off on 8-29 9 A TRIAL OF 10HRS WAS DONE A MONTH AGO ) BUT NO ONE IS DOING ANYTHING ABOUT THE DISC PAIN. i know IT IS A HERNIATED DISC FROM READ THE RESULTS ON MY PORTAL & i HAD L4 REMOVED 20 YRS AGO. THE SYMPTOMS ARE THE THE SAME AS 20 YRS AGO.i HAVE A PRIMARY DOCTOR APPOINTMENT TODAY AND NEED TO KNOW WHAT TO SAY/DO TO GET THIS DISC ISSUE SOLVED. THEY ARE DOPING ME UP FOR THE PAIN BUT IT JUST MAKES ME TIRED,PAIN IS STILL THERE. PLEASE HELP! ### REPLY: Hi, I had gone through your question and understand your concernsWith such presentations in my clinic, I would first reassure my patient telling him that the first line in treating disc herniation problems is conservative treatment then to wait for improvement of back pain and radiculopathy if present. If there's no improvement of the back pain and progressive increase of articular symptoms in spite of treatment, so we proceed to surgery. Conservative treatment for your problem include the following:1- Physical rest :Avoid heavy activities, prolonged standing, bending 2-Wear lumbosacral belt 3-Receive Muscle relaxant once daily, NSAID when needed and pregabalin 150 mg once daily before sleep. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: It seems if I do much of anything with my right arm, my shoulder, elbow and wrist start to ache. It keeps me up at night. I feel I need to put pressure on them for them to stop aching, but that doesn t always help. It also usually creates a knotted muscle between my neck and shoulder. Is this old injuries popping up, and does the weather affecting these areas? I am 51 years old. ### REPLY: Dear Patient, it seems you are suffering from disc prolapse in the cervical(neck) region, this neural pain feels like it will improve if pressed, but on pressing it exaggerates.I feel you need to check the neck movements, and if they are painfuller than the chances are even more. The investigation of choice in your case would be an MRI of the cervical spine, this will give details of the inner pathology of neural compression. I want you to realize that taking this lightly will increase it much, so please consult your doctor, and get investigated. Thanks. ### END