Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 having serious problems with neck and back pain due to degenerative disk disease in my C6 and C7.  I am trying to manage the pain and spasm with medications including anti inflammatory, muscle relaxants and some sort of nerve calming drug.  The cocktail makes it impossible for me to function at home or at work.  I have been waiting almost 2 years for an MRI.  I have no private insurance.  my income is low due to my inability to work many hours.  My question is , do I qualify for disability and is there a surgical procedure I could have that could relive some of my symptoms and reduce the pain to a more tolerable level.  How can I make this happen, I have no family doctor.  I am 42 and feel like life is passing by and I do not want to be disabled but it there is no medical solution, I need financial help.  Thank you for your time, Sincerely Suzanne Charlebois ### REPLY: Hi Suzanne. My name is Vinay. I am sorry to here about your disc degeneration. There are many types of surgeries that can be done to help control the pain that you are suffering from but none of them can be attempted before you get that MRI. The Surgeon needs to know what kind of nerve compression is causing the pain and the stiffness and needs to be able to plan out the surgery using the pictures that are given with the MRI. Now when it comes to insurance. I am no expert on health insurance and I wish I had some easy quick fix place that you could go to. My best advice is to check in with your local Public clinic (which I'm betting you have already done). The only other thing I could possibly suggest is that you look to getting treated in another country. There are companies that can arrange for travel and surgery to other countries to get treatment at a fraction of the cost of the same treatment in the United States. The whole concept is called medical tourism. You could look into it if you want. See if that works out better for you. I hope this helps. Thanks for coming to  .com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 diagnosed with RA in Jan 2014. My CRP level is high, 28mg/l. I have changed my diet to gluten free, and have been incorporating lifestyle and environmental changes to reduce inflammation and pain. I take a multi-vitamin as well as fish oil. I would like to continue this path, alternative ways to dealing with this disease. Frankly, the medications for RA have alarming side-effects, so I would like to try everything else first. My pain/joint-swelling is mostly in my ring and pinkie finger on one hand, and my other pinkie on my left hand, as well as severe pain on the top of my feet. My question is, I have seen some improvement with the changes I have made, and I would like to continue but at what point do you believe medication is a must? - ### REPLY: Hi I have read your letter and came to conclusion that you do not want to start medication for Rheumatoid Arthritis at this stage. Though this is the normal reaction in patients diagnosed with chronic diseases, I would strongly advocate starting medicines at this stage prevent progression of the disease rather than starting late when the damage has already been done. This other methods may continue by the side to improve the quality of life. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 m 23 yrs old and i m pregnant of 4 months i ve done all tests of thyroid my ts level is 6.37 and and no antibody of thyroid and even free t3 and free t4 is also normal. but still doctor suggested me to take thyromorm 25mg daily for 3 months. is their would be any side effects or would baby would get effected because of this tablet .... please suggest ... ### REPLY: Hi, No, Thermoform is safe in pregnancy, and can be taken without any worries.it would be advisable for you to take Thermoform and get your TSH levels checked. Ideally you should aim to get your TSH levels under 3 mid/L in pregnancy. As levels more than 3, are associated with a slightly higher chance of miscarriage, preterm labor and pre-eclampsia and slower developmental milestones in the babies born. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Rash on right inner arm for 4 weeks since trimming agapanthus.  Got a small scratch and lots of sticky sap.  Eyes and right breast were involved but antibiotics from my doctor cleared it all for a few days.  Steroid creams and antihistamines did not seem to help.  Now it has spread again around inner elbow - red welts, itching, burning, slight stinging and sometimes crawling of the skin.  Difficulty sleeping. I always get allergic reactions on inner forearms when I garden and suffer from continual sinus allergies.  Need some anti-itching remedies use or suggest to my doctor.  It may not be agapanthus and our cat now coincidentally has stomach discomfort every evening. Thanks ### REPLY: Allergies when not controlled properly can spread to other systems after long duration your allergies of sinuses has extended to skin. You have to treat galleries, and you will be fine few tips-------Stop all milk and diary production use mustard coconut walnut groundnut and soda oil apply olive oil use olive for cooking Take Montage FX(Montelukast and fexofenadine combination)twice a apply newsprint H eye ointment In side nose for sinuses can Apply Dip ovate ointment in affected area and calamine can be applied once a target blood serum tested for specific antibodies for food and environmental allergens and go for elimination diet ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 friend is suffering from blood cancer for the past 1 year. doctors have told that he can live for only 4 years because the condition is in advanced stage. what will be the remedy for this? please help him. i want him to live for more years. he is just 23 years old. ### REPLY: Hi, Thanks for writing in. There are many types of blood cancers and each of them have a different treatment protocol depending on the staging and type of cells. Chemotherapy is used in the treatment of most blood cancers. Some of them might show partial response to one type of . It is unfortunate to know that your friend has been diagnosed with advanced stage blood cancer. I hope he is getting treated in a cancer research institute where new medicine might be available on trial basis to know if a particular disease in late stage might be controlled by giving new medicine. Please have a discussion with a hematologist in a cancer research institute for such treatment options. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mother is suffering from sciatic pain since 5 years and she had surgery lase 2 years back and her pain was doubled and un explainable pain her 2 legs were swollen and anable to walk sit and sleep easily, please give suggestion to be followed to releive the pain. iam in contact from india. hyderabad. ### REPLY: Hello, Sorry to hear about the condition of you mother. It would have been good if you had mentioned the type of surgery done.However, here are some exercise that will help her in reducing the swelling and pain.1)lie down on the back with knees bend and press the back on the bed with the help of stomach muscles and hold for 10 seconds and release.2)While on you back lift the leg up without bending at knee slightly above the bed(30 degrees)and take it down3)while in above position (leg up)rotate the foot outwards, bend the knee and turn the whole leg inward (toward the other leg) and straighten the leg4)while standing place one foot on a stool(2 feet height, suppose it's the right foot)extend backwards and bend toward the left side and come back to starting position.5)while sitting do ankle toe movements (1000 times throughout the day I.e40 times every hour in 12 hours approximately)6)In sitting extend the knee and take it back to normal7)Apart from this activities like walking, jogging,yoga (avoid back bending positions) will help in recovery. These are only some exercise, each needs to be done 2 times daily with 10 repetitions each time. All need to be done alternatively on both legs. For further help or suggestions you can contact you can also refer to a physiotherapist in your locality for further treatment. Hope this helps you and your mother gets well soon thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son who is 44 years old has recently been diagnosed with RA.  He has been to a dermatologist also for a hive-like rash all over his body along with "knots" on his legs, thighs, and back of his head.  This doctor did a culture and was determined that is not an allergic reaction, but a part of the RA he has been diagnosed with.  I am concerned about the knots and rash.  It is currently under control with steroids.  What else could this be and is this serious? ### REPLY: Hello, Thanks for the query. These knot like lesions are rheumatoid nodules. The lesions keep coming and going. In fact These are characteristic feature of RA. You don't need to worry much. These are not dangerous. Treatment is symptomatic. Dose of steroids is increased or decreased according to severity of disease. Please meet a dermatologist for exact diagnosis. Let me know if you have any other doubt. You can ask a direct question to me on this forum, following the below link.https://urldefense.com/v3/__http://www.ChatDoctor .com/doctors/ . 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: Hey I spent a couple hours in emergency room. For a burning chest pain every time I swallow and I have numerous canker sores that just appeared in my mouth. I am really dehydrated from the lack of fluid since it hurts so bad to drink an I stay weak with a fever on and off. I need to know something I can do for the canker sores and chest pain. The ER DR prescribed me with Zantac no help so far ### REPLY: Thanks for your question on . I can understand your concern. You probably are suffering a bad viral infection. You will require a detailed evaluation and blood tests for the same. I would recommend lots of liquids and byte gel for local application on oral ulcers. Also, a multivitamin which are prescription medications. Kindly consult your doc for the same.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: along with lung cancer I also have cirrhosis of the liver. My spec said the other day that after looking at my hands [palm side up] he mentioned that it mentioned my cirrhosis was starting to move . Just what did that mean? I am a 71yr, female never mind I did not know I had to pay. Should have been told at the beginning GREAT HELP ### REPLY: Hi thanks for asking question. Let me know you in cirrhosis hyperestrogen is there because of defective metabolism. So because of estrogen Palmer erythema present. So doctor just seeing that sign. Now you have to take care regarding healthy lifestyle because if you don't care it will progress and encephalopathy can occur. So take good dietary habits like.... Fruits more. Green leafy veg taken more. Avoid trans fat like pastry, cookies, meat etc. Avoid junk foodAvoid smoke and alcohol. Regular exercise. Oily food avoided. Cumin seed powder mix in butter milk and taken daily ... I hope your concern solved. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 12 year old son who has GAD and ADHD  but has not responded well to MEDS. Was seen by GP yesterday for fatigue and general not feeling well.  She did normal exam. Found enlarged thyroid. To piont when chin up can see thyroid.  Drew blood then and results just came back normal.  Sending for ultrasound .  What else should I do. Im very concerned ### REPLY: Thanks for asking question gone through your query. Your 12-year-old son is suffering from GAD and ADHD, and taking medicine. You consulted GP for his fatigue and not feeling well. GP noticed enlarged thyroid, and some blood test was done which reported normal. There is nothing to worry about enlarged thyroid. The thyroid gland size enlarges in this age group, the increase in size of thyroid is normal in this age, there is nothing to concern for present and future .size of third will decrease itself over about 6 months .this is normal part of development in adolescent. There are many cause for fatigue in this age group. So time medicine for GAD can cause easy fatigue. So talk with doctor who is treating GAD. In this growing age requirement of all nutrients, esp iron and protein is increased. I generally tell my patient for proper diet or I supplement by food supplements hope i able to answer your query wishes you healthy family life ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 m a 51 year old female who has been extremely dizzy, nauseated, having chest pains, and edema . My BP has been elevated even though I m on medicaiton for it, and my heart rate has elevated 20 points per minute. I went to the doctor for this and my EKG is abnormal , showing a block and an extra beat, and my liver function tests are elevated. My glucose is normal, as is my CBT . My bad cholesterol is high, my good cholesteral not as bad, and my liver function tests are elevated . I have an appointment with a Gastro to look into that, a nuclear stress test and ultrasound of my heart scheduled, and they have a Neuro scheduled (I also have PTC) to see if that s the cause of the dizziness and edema. I m concerned about all these tests and what could it mean? should I be scared? ### REPLY: HI....liver pathology alone can cause elevated liver enzymes, nausea,edema(advance stage), dizziness and upper abdominal pain.....so screening to rule out liver diseases is important....alternatively cardiac illness can cause edema, elevated liver enzymes and hence nausea.......so cardiac status should be properly evaluated.....another thing is medication side effects.....some antihypertensive . ...wish you good health... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter has been having several episodes of pain in her left kidney.  Does not ever have symptoms of UTI;s but has had 6 incidental findings of UTI because we have gone to doc for pain in her kidney.  she is having this pain daily.  it has been so severe we have gone to ER only to be sent home because they give her a antibiotic for a UTI that they think is coming on.  Could she have something serious in her kidney? ### REPLY: Hello Tracy, Usually when there is recurrent kidney infection/pyelonephritis/UTI then other underlying diseases conditions should be investigated notably kidney stones or urinary system abnormally or malformations especially in child .  If an adolescent or adult, then underlying conditions like diabetes, vaginal infections etc. should be checked further. Antibiotics might not get rid of the pain if there are kidney stones. It might get rid of the bacteria infection but not the pain as it will be caused by the stones. At this point it will be advisable to run an image scan (ultrasound or CT scan) to find out if there are stones. In addition to your antibiotics you should encourage your daughter to  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a breast infection, some pus coming from beside the nipple. I have had breast abscesses twice, close together, 30 months ago. At that time I had extensive checks for underlying cause, scans, mammograms and biopsies, all showed nothing abnormal apart from the infection which cleared up. I had been having tingling nipples and produced a small amount of breast milk, which also stopped. I am 52 yrs old, no real menopausal symptoms, but have had some bad frontal headaches lately that do respond to pain killers. I do not appear to be producing milk at present. ### REPLY: HI Thanks for posting your query.  For your breast infection you need to take Antibiotic course. Before being started on Antibiotics I advise you to get a test called Pus culture sensitivity. This test will help in deciding which is the right Antibiotic for your breast Infection.  I also advise you to get Ultrasound of your breast, it will give the information on whether only antibiotics is enough or you need a .  Kindly get the above-mentioned tests done and revert to me. Hope this information was useful to 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 dr,I am 66years old. I ve always had a very clear skin with no pimples . Recently underwent a colon surgery in2012 May. recently I ve developed pigmentation on my face. My cheeks upper lip and chin has turned black. I met a dermatologist . He gave a sunban cream to be applied thrice a day and a night cream melalite. after applying for a month pigmentation has reduced. He changed the night cream and suggested that i should use melrio , which is not available. right track? please help.what should I do? a Am I on the ### REPLY: Hello, Welcome to  Usually these lightening creams are prescribed in a condition called plasma. Melrio is a combination of steroid, HY .  This has to be applied under supervision of dermatologist and is not for long term use. Alternatives are lumbago cream, or Trig low cream follow doctors advice, and you are on right track if you are having plasma. Continue sunscreen. Hope this helped 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: After water was removed from my right lung the lung it could not open up because a wall had formed in the lung. My doctor says that only surgery can remove the obstruction. He also suggested doing nothing because I am not having problems breathing, I am 81 years old. ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of thickened pleura and non-expanding lung is more. It is common square after pleural effusion. No .  It is mechanical obstruction. And hence surgical removal of pleura is needed. But this surgery is quite risky and life-threatening. So it is not recommended in asymptomatic patient like you. So since you are asymptomatic, no treatment is required for this. You can do chest physiotherapy and deep breathing exercises for lung expansion. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father aged 82 yrs had angioplasty 1 yr back due to triple vessel disease. since last 6 months, he is feeling dizziness and 2 or 3 occasions he even felt down due to this and for 2-3 seconds he was unconscious also. Has this got anything with the heart vessel blockage or this is only vestibular problem? Please recommend any specific department we should visit. Pranab Sarkar, Bokaro, Jharkhand, INDIA ### REPLY: Hi Mr. Planar Parker, After going through your fathers case, I want to know about 1) Presence of diabetes, high blood pressure problem, cholesterol problem if any along with heart problem.2) Current medication going on. 3) Habits like smoking, alcohol. 4) Any recent illness like loose motions, vomiting, excessive sweating, high grade fever.5) Any ear problem (pain, decreased hearing, tinnitus-abnormal sound in ear), throat problem.6) Are symptoms increases after sudden neck movements. I would like to suggest following test for your father-1) ECG electrocardiogram preferably during episode. 2) Holders monitoring, electrophysiologist study of heart. 3) 2DEcho (echocardiography) 4) Blood sugar level during episode, Complete blood count, hemoglobin, kidney function test, thyroid function test. 5) Blood pressure check in supine position and In standing position to know postural hypotension. 6) If all these tests are normal then there may be need of MRI brain with angiography and carotid artery Doppler. In your Fathers' case there may be possibility of1) Cardiac arrhythmia (abnormal electrical activity of heart) - it may be a caused by decreased blood supply to heart (vessel blockage) or metabolic abnormalities (abnormalities of kidney or liver function)2) Postural hypotension.3) Problems related to blood supply of brain. 4) Hypoglycemic episodes (low blood sugar level) more common in patients with diabetes on treatment. If symptoms increases with neck movement or sudden change position (posture) and there is no postural .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had upper abdominal pain for almost 2 years. It is constant sharp pains which makes him curled up in a ball for a good part of the day. They have done alot of tests and is now being sent to a UCSF GI dr. thinking it may be his pancreas or bile ducts. I received his records to take to this dr. and noticed that he had a 2 x 2 0.1 cm cyst with intrinsic debris. This report was taken 5/11 and their recommendations were to do a renal ultrasound which was never done as we didn t know he even had a cyst until we received these records the other day. Spoke to a dr a Kaiser and they say it is nothing because its small and hasn t grown and many people have them. If he didn t have this sharp constant pain since then I wouldn t worry but I think further testing on this cyst is required. He has no other symptoms besides the sever abdominal pain. What do you think ### REPLY: Hi and thank you for using . Cysts in the kidneys are commonly found in people as we age.  The finding of a few simple cysts on an ultrasound in and of itself would not warrant further evaluation. The findings of a cyst that would warrant further evaluation would be large size (right around where his are or greater), complexity of the cyst by imaging which would indicate that it is not just fluid-filled or any masslike characteristics. If the original imaging was done in May 2011 and there has been no change in the size, it would seem unlikely to be of any significance. To reassure yourself, I would suggest that you request an MRI to further characterize the cyst as well as urine cytology. Benign findings on an MRI and negative urine cytology would be highly reassuring without the need for further extensive workup. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a man ...old man of 65 years age...an educatged man...m.a.ph.d., i am suffering from acute and severe mental disroder... OCD ..obsessive compulsive disorder. If i go to a temple or if i see a pic of a god or goddess, bad thoughts abd abusive words come to my mind...i have to make obeissance again and again till such a time..that i get a good thought...bad thgoughts come to instantly and instinctively. I am much depressed...please help me. ### REPLY: Hello .  It is unusual to start getting these symptoms at 60 plus age so first - were such symptoms present since a very long time but now have become worse? And does any of your first degree relatives have similar symptoms? (OCD is highly genetic) if really these have emerged recently, possibility of Degenerative disorders, seizure disorder or Space Occupying lesion should be kept. You should undergo EEG and CT Scan Brain alsoWhatever, you should consult a good psychiatrist and start appropriate treatment as delay can reduce the level of recovery best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I ve been having weird symptoms about 10 days after taking plan b? Dirreaha, stomach aches & this constant urge to pee. I had unprotected sex on the last day of my period but he did not ejaculate. & took plan b 24 hours later. Are these pregnancy symptoms or side affects of plan be? I also had some bleeding 6 days after taking it but it only lasted a day. ### REPLY: HelloThanks for writing to us with your health concern. The symptoms that you describe are not specific for pregnancy. Also, they are not typical side effects of plan B either. The bleeding 6 days after taking it was the with . Cramps and stomach aches also would persist for a few days. The plan B can delay or advance your normal periods by a week, or maybe, up to 10 days. There was no ejaculation so you are mostly safe. However, take a pregnancy test 3 weeks after the encounter happened, in case you do not have your normal period by then. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I recently got treated for a very bad yeast infection I got prescribed a three day cream treatment and that didn t work so I got prescribed a one day pill. I finished both and it cleared up. This was all last week...today it seems like my symptoms are coming back because my discharge is think and discolored again...also my clitoris is painful to the touch but that could be because I had intercourse a few days ago and was rubbed without lubrication ### REPLY: Hi, Thank you for your contact to . I understand your concern. If I am your doctor I advise you that recurring yeast infection is because of some underlying cause. I advise you to think about pretreatment with antifungal cream and fluconazole oral tablet. But it is necessary to get diagnosed the primary cause because of which you are having recurrent yeast infection. I will be happy to answer more of your concerned can ask me anytime. We wish you the best health to you at . ChatDoctorInfectious disease specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 knot came up on the arch of my right foot. I m not experiencing any pain, but the knot feels tight and kind of hard. It s approx 2 long X 1.5 wide. I ve never had anything like this before. My arch is almost non-existent, maybe about 1/2 to 3/4 left. I haven t stepped on anything that would have caused this. What could this be? ### REPLY: Hi. Thanks for your query. Noted the history of a knot that has come up on the arch of foot which has reduced, 1/2 to 3/4 left behind, the knot is approximately 2 long X 1.5 wide, no pain, knot feels tight, and is kind of hard, not stepped on anything that would have caused this. Since the knot is big by asymptomatic, the most probable cause can be certification for some foreign body that might have passed innocuously in past and the certification occurred now without any pain or so. Another possibility can be an insect bite, this is possible as some insect bites are painless and yet cause severe local reaction without any pain. I would advise you to consult your Doctor, preferably a General Surgeon so that a proper diagnosis can be made and further medical or surgical management done as per the cause confirmed. Til then, so not apply anything to the lesion nor do any massage, do not try to cut through at home. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 believe I had gastroenteritis yesterday.  I threw up about forty times and could not keep anything down.  For the past 24 hours I have been fine, but I am having pains when breathing deeply.  My right lung/chest area is hurting, and it currently just made me wake up.  Is this a serious issue or what could this be from? ### REPLY: Hi thanks for contacting ... Noted you are giving history of sudden chest pain while breathing and also about gastroenteritis like pain... If you have eaten outside food then there might be gastroenteritis or ulcer like condition.it can lead referred chest pain also. For that antibiotic and omeprazole given... Low fatty and spicy food taken.... Second if you have lifted heavyweight then also chest pain can occur as muscular strain. Rest and hot compress useful.If you need analgesic can give... If your ribs tender to touch Costco . ... If you develop cough and fever then to rule out respiratory cause auscultation and chest x-ray needed. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctors. please help me im desperate for medical attention for my beloved sisterher symptoms includes:-CONTINUOUS pain in the region of diaphragm (according to local diagnosis, its muscular narrowing and its untreatable) also, the pain increases significantly when she breathes or try to swallow some food... her breath is very shallow ### REPLY: Hi. Thanks for your query. This is an emergency if your sister has shallow breathing, and you should take her to the ER or the hospital immediately. If the pain is increasing on breathing, there is either a problem of the lungs or pleura or just below the diaphragm. Continuous pain in the region of the diaphragm according to local diagnosis has to be investigated immediately as this may need immediate intervention. I would suggest the following in such a patient:Admit in Emergency / Measure the SPO2, vitals. CT scan of the chest and the abdomen to find the most probable cause of this which may be :Liver abscessSubdiaphragmatic collectionPlural infection and may be Pneumonia. The treatment will obviously be - general : Supply oxygen, antibiotics, painkillers, intravenous fluid, and Surgical : like .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 7 year old daughter has a small fleshy bump on her upper left gum above a tooth for over a week now. it looks like there are a number of white little bubbles contained within it also. It is about 5mm in diameter but it hasn t popped. It is soft to feel and is sore every now and again for her. Should I take her to dentist? ### REPLY: Hello, The bump in the gums is because of the infected tooth or the infection in the gum.Sometimes as it is difficult to clean the tooth the gum around the tooth becomes infected with pain and swelling. For this you have to visit the dentist and get the diagnosis made. The dentist will do the clinical examination and take the radiograph to see whether the tooth is infected or it is the gum. Till then, you can do the warm saline rinses 2 to 3 times a 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: good day,sir i receive my  ultra sound today,january 14, 2012 ,and it was saying in my certification the prostate glance measures 3.3x3.6x3.5cm with volume of 22gms.no focal nodule seen,high level echoes are seen in the central zone,urinary bladder is distended withanechoic lumen. as the evaluation of the doctors grade 1 prostate gland enlargement with concreations.Sir pls tell me what is the meaning of this.tnx ### REPLY: Good day, and thank you for being with  ! Grade 1 prostate enlargement means that you have very slight prostate enlargement. The smallest is grade 1 and the biggest is grade IV. As long as you are urinating okay then I don't see any problems with your prostate. It is natural for the prostate to grow once you reach the age of 40. Concretions in the prostate is of no clinical significance and is not associated with anything.  I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.ChatDoctor .com/doctors/ .  Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr, My father follows a healthy lifestyle and he is 60. Few days ago he had a slight chest pain and had a very light sweat...so immediately he got chest pain medication from his brother and had 1 tablet and he was okay after that . He went to the doctor the very next day and took ECG and the result was normal. Still the doctor recommended isordil and also a stress-ECG(treadmill test). The test showed some abnormalities. IS it possible to have a normal ECG and an abnormal Stress test ? ### REPLY: Hi! Yes, it is possible that a normal ECG is followed by an abnormal stress test. The ECG done when the person is at rest, does not always show the problem of coronary heart disease. This is because while resting, the heart gets the amount of blood and oxygen that it needs to work. That is why, when there has been a typical chest pain and the ECG at rest was normal, the doctor recommends a stress test-ECG. During this stress, the heart job increases and the amount of blood and oxygen that it needs are doubled. In a healthy person, the heart work and the amount of blood and oxygen that it needs are in balance, while in coronary heart disease they are disbalance (stress test shows abnormalities). I tried to explain why it can happen to have a normal ECG and an abnormal stress test-ECG. I hope to have been clear enough for you. I wish your father gets better soon! Thanks for sharing your concern with us! 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: I had protected sex with a latex condom with someone I have known for 12 years. It seems that everytime we have sex and I always use a condom, I get a stinging burning sensation at the tip of my penis and have to urinate more frequently! I never show signs of STDs and this happens all the time after protected sex. Could I be allergic to condoms or the lubrication? ### REPLY: Thanks for asking in  forum In short: Usually urinary tract infection causes frequent urination and burning sensation, but allergy to latex can cause this. Explanation: As I told you it may be due to Urinary tract infection or allergy to latex. So, ask your doctor for urine test and if it is normal then may be because of allergy.  If you are allergic to latex you can go for other types of condom materials available in the market(but are costly). ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Raymond and I have been having this lower back pain that shoots down from my right side of my lower back to the right side of my knee for going on four years now I can especially feel it when I bend over to touch my toes. I started experiencing the pain May of 2011 gradually after doing a workout routine. ### REPLY: Hello, I have studied your case. Due to compression of this nerve root there can be pain in your back and leg. I will advise you to do MRI spinor these symptoms analgesic and neurotrophic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear doctor, my son is 7 1/2 yr old. since Jan 13 he has hoarse cough . during this period the peaditrican gave him antibiotics twice within a gap of 3 weeks and all cough syrups and available medication . recently got an chest xray and blood tests done. there were 10% Esnophils. now the doc advices us to use Montair LC for 3 months. if not to start using inhaler (Asthalin 2 puffs) + prednosolone 5mg + neoventil 5ml. Kindly advice if this is serious and my son is getting Asthmatic. My father was Asthamatic since a the age of 17 yrs and lived upto 72 yrs. Also my mother in law is Asthmatic. will these heriditory asthma effect my son. Many thanks in advance. ### REPLY: Hi, yes your son has very high chances of getting asthma, the medication given by the doctor is also correct i advice you to follow the doctors advice and give the medication properly, there are chances that he may not develop asthma. Also you improve his general health, which will again reduce the chances of getting asthma.I also suggest you get a skin prick test done for him by an immunologist, then you will come to know if he is allergic to something which is causing asthma. If he is strongly allergic to something then immunotherapy can be started which actually has potential to cure asthma to some extent. Also with correct medication asthma can be controlled very well. 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: About a month ago the tip of my tongue started tingling at random intervals, maybe once or twice a day.  This past week it has been tingling 8 or 10 times per day, lasting about 30 seconds each time.  Today my tongue started tingling, and now my left fingertip is tingling.  Should I be concerned about this?  I have diabetes and I take metformin and insulin. ### REPLY: Thanks for your query, I have gone through your query. The tingling sensation in the fingertip and tongue can be because of the diabetic neuropathy or secondary to any nerve injury. Nothing to be panic, consult an oral physician and get it evaluated. Meanwhile you can take nerve regenerating .  You have to keep the blood sugar level under control. Once the blood sugar level comes to normal, the tingling sensation gradually reduces. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father is 81 year old and on his ct scan a black spot was seen on his hip, I do not know if the right or the left, what could it be? He is havng a procedure done right now to removed a mass from one of his kidney and when they did the ctscan for this, is when they notice the black spot. I do not much because  am in California and he is in Texas. I got this information from my sister that is there with him right now. ### REPLY: HI, thanks for using  I am sorry that your father is unwell. It is possible that the black spot that was seen represents a mass or defect in the bone. If the mass on the kidneys is malignant, it is possible that the black area on the bones represents spread to that area. The mass on the kidney would be sent to the lab for analysis to determine if it is benign or malignant. You and your father should speak to his doctor. 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: i felt strong stomach ache on right side of my belly last night. what medicine should i take? I called fortis hospital that time and one doctor said dolo-650, but the medical store guy said that it is used for fever etc. Then i called my doctor and she suggested pan-d. ### REPLY: Hi ! Good evening. I am  answering your query. You could take Pan D which would reduce the acid secretion in your stomach. You might have to add an anti-spasmodic to it if the pain increases. However, to know what caused the pain, I would advise you for an ultrasound of the abdomen, and also a physical examination your abdomen by the concerned doctor at the earliest possible. Further management would depend on the physical examination and the investigation reports. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Due anxiety symptoms like numbness, feeling of loosing control ,restlessness doctor prescribed me Clonafit Plus o.5 mg, and told me take whenever i feel nervousness i can take this medicine and it really help me to overcome the symptoms. But as its have many side effects as well which will be a huge problem for me like dependency on this medicine. I would really appreciate if you could let me know what should i do to skip out of this medicine.Thanks & Regards,Arvind ### REPLY: Hello and welcome to . Thanks for your query. Clonafit Plus is a combination medication that contains two medicines - Escitalopram (an SSRI anti-depressant) and Clonazepam (a benzodiazepine sedative / antianxiety medicine). However, you have mentioned that you have developed many side effects as well as a dependency on this medication. In case you want to stop the medication, it is better to taper the dosage gradually and then stop, in order to prevent any with .  I would suggest that it is best to do this under the advice and supervision of a doctor. You can also consult a psychiatrist for a detailed evaluation so that you can discuss further treatment options for your anxiety problem. If you don't want to take medicines, then there are good psychological therapies which can be effective in controlling your symptoms. So, please consult a psychiatrist in person for a detailed evaluation and further management. Wish you all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is 51 and has been diagnosed several times in the past with Anemia,he has had excesive bleeding from the rectum for years,he has had iron and blood infusions and last year had a hemroidectomy. That almost stopped the bleeding for 3 months,now he is bleeding bad again,has rapid heart beat, occasional chest pain,if he s not moving around he s sleeping,restless legs and shoulder twitching and muscle cramps and headaches. Can you help me, I need to know where to take him and what I can do to help him. Thank You, Donna Crews ### REPLY: Dear DonnaHaemorrhoids are notoriously known to recur (come back) after treatment. It sounds like it is likely his hemorrhoids are back, and his other symptoms are likely due to significant anemia. This is what I suggest you do :1. If he is significantly bleeding and uncomfortable right now please take him to your closest hospitals emergency department and there he will be seen by an emergency physician who will examine him and decide on the course of next action(stabilization of the patient and referral to a colorectal surgeon)2. If he isn't bleeding at the moment, and he is comfortable please schedule an urgent appointment with a colorectal surgeon. This should happen tomorrow or as soon as possible ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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,Its regarding my friend health problem. Recently we noticed a cardiac problem i.e., MULTIPLE BLOCKS in his heart. (through angiogram)Till now we did not even noticed any sympom and even he is not having any healtChatDoctorplaints like BP or Sugar.But unfortunately we noticed that by birth he is having only one KIDNEY.The doctors told that we could not do anything as he is suffering with severe LV dysfunction and the pumping rate is only 24percent.so they cant go for either ANGIOPLASTY OF BYPASS.They just preferred to go with MEDICAL MANAGEMENT and there is no life gaurentee.could you please suggest us how to face this abnormal situation. Is there any possiblity for his life gaurentee?. ### REPLY: Hello, Since his heart function is low, and also he is having only single, both bypass and angioplasty are risky options. But in order to prevent further fall in heart function, he should have either of two. Bypass is a better option but has more risk. So you need to take the risk and go ahead with either procedure.  He must be on multiple medicines like Aspirin clopidogrel statin like atorvastatin beta blocker like Metoprolol and ace inhibitors like April. All these should be continued. Get his repeat echo done to see if any improvement in function. Hope this helps you and get back if you have any doubts. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 researching side effects of the medication I take cause I am having coughing episodes very often. It starts with a tickling sensation in my throat and then I sneeze. The coughing can last up to 10 minutes. I am taking enalapril, dializiam, and montekaulast ( generic for singular) ### REPLY: Hello dear, The symptoms as mentioned in your post can be due to:1. Enalapril induced cough. Under such condition, kindly consult your treating Doctor and discuss regarding change of the medication. Your symptoms will be relieved with that.2. Allergic tracheo-bronchitis. Examination of the throat using a laryngoscope and X-ray of the chest will be helpful in clinching the diagnosis. Management includes:1. Antihistamine preparations like Allegra & Cough expectorant syrup for symptomatic relief.2. Montelukast preparations- used as a maintenance therapy to relieve symptoms of seasonal allergies.3. A course of antibiotics may be taken to prevent secondary bacterial attack.4. Maintain adequate HY . 5. Also make sure that you are well protected from cold, dust & other allergens. Wishing you a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a 12 y/o with Dx of Aspergers ( mild) & a very bad anger problem. She is on Zoloft 100mg, in AM along with Risperidone 0.5 mg. Seroquel 100 mg @ HS. She falls asleep in school. My question is are these the medications used to treat this? 2 Antidepressants & a antipsychotic starting when she was 6 y/oShe has had other wicked medication & one not recommend for people under 18 y/o. She is not allow to talk to the Doctor without Mother present & she does all the talking. As her Grandmother, I fear for her & the long term effects of these medications. She recieves no theraphy just medications. There is also a Family Hx on her Mothers side of Drug & Alcholol addiction. ### REPLY: Hi, Thanks for asking. In my opinion she requires more of counselling sessions for anger management. In such sessions the counselor tackles with the anger issues and provides her with the alternative ways to vent her anger which does not harm her or anyone else. In my opinion she does not require any anti depressants but the dose of risperidone can be increased up to 2 mg. But she will do best with an anger management program. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: While taking scan report - Abdomen: Stomach bubble visualizes. Right kidney measuring 2.8 x 1.7 cm with mildly prominent pelvicalyceal system with AP diameter of renal pelvis being 4 mm. Multiple cystic lesions of varying sizes noted in right kidney, largest measuring 6 x 6 mm. Left kidney measuring 1.9 x 1.0 cm shows mildly prominent pelvicalyceal system with AP diameter of renal pelvis being 3.7 mm. Urinary bladder is visualized and normal Is it problem for a baby M (19 Weeks 4 Days) ### REPLY: Hi and welcome to . I understand your concerns. This report is showing polycystic kidneys disorder on the right side and this kidney may have reduced function or even be functional completely but left kidney is better condition, and it may overtake whole necessary function. In the future, your baby should be closely followed, and it can't be predicted how long will his kidney work but in most cases there is no need for transplantation or dialysis in childhood hope I have answered your query. 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 can t afford plan b or the morning after pill and it s going on 48 hours since having sex and I just feel awful. I know it wasn t smart considering I m on no birth control but what s done is done! What are some things I should do At home to prevent a maybe pregnancy! ### REPLY: Hello dairy understand your concernSorry to say, but there is no any home remedies that prevent the pregnancy after sex. I would suggest taking morning after pill early as possible within 72 hours of sex. It is 80-85% effective in preventing the pregnancy as 48 hours has been already crossed. Plan B pill itself cause delay in period by 8-10 days. But of period will delay by the 12 days then go for urine pregnancy test and or blood  to confirm the pregnancy. If you will be pregnant then still you can terminate the intrauterine pregnancy by abortion pill under the supervision of the gynecologist.Meanwhile, avoid stress, take plan B pill, eat healthy diet, . Hope this may help noncontact  for further health query 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: My wife and I are trying to concieve, however I am having problems ejaculating. It seems the only way i can ejaculate is through masterbation. Is there anything that can help stimulate and make me ejaculate faster without resorting to masterbationin order to properly concieve? ### REPLY: Hi, Thanks for posting in . I understand your concern. It appears from your description that you are having delay in ejaculation rather than premature ejaculation. Premature ejaculation means getting ejaculation soon after inserting penis into vagina, most often within a minute of sexual activity. Since you are able to ejaculate during masturbation, things are fine and normal with you. Delay in ejaculation could be due to lack of proper sexual stimulation or Aurora and due to apprehension or anxiety. Spend more time during foreplay to get enough stimulation. Penetrate slowly and relax in between while having intercourse. Use proper lubricant to achieve good lubrication. You must remember that every sexual activity doesn't always end up with ejaculation. Gradually, you should be able to overcome it and perform normally. Hope the information provided would be helpful. All the best.  . S., MBBS., MD. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: When I lift my arm to get something high up off a shelf and then twist my head up, I get a burning feeling on the left side of my head which is quite uncomfortable. I describe it to friends as fireworks going off in my head as it feels like an explosion going off. I have quite a lot of tension in my left shoulder and base of neck due to a computer job. Is this serious? ### REPLY: Hello, Thank you for using . I understood your question as I have had such experience before myself. This is nerve impingement in their origin from the neck due to possible spondyloarthrosis or fiscal hernia of the neck. This can be from your work position, age and or genetics.i advice you to do a neck X-ray and of you have spondyloarthrosis of the cervical spine you can start with some physical therapy procedures to relieve pain. Wish you quick recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I was told my bad cholesterol was high and needed to lower it.  So far Ive tried simvastin, crestor, and these give me severe pain in the area of my liver and gallbladder.  Then I tried fish oil and niacin and both give me headaches.   The docs and pas are free at the employee health clinic but seem to not believe me.  I dont think they have much experience.  I cant afford to go to a specialist. Wendy ### REPLY: Hello! Welcome and thank you for asking on ! I understand you concern and would like to know your actual LDL and HDL levels. You should know that LDL is not a confident indicator of dyslipidemia or your cardiovascular risk. Total cholesterol/HDL or LDL/HDL ratios are better indicator of your cardio-vascular risk. For this reason, I would like to know more on your blood lipid profile. Some natural ways to lower LDL cholesterol would be : - perform Yoga and aerobics-avoid sweets-take food rich in omega 3 fatty acids (fish oil, fish, olive oil, walnuts, etc.). - try to lose some weight if you are overweight. If these tips don't help, I would recommend trying low doses of atorvastatin and increase the dose very slowly, in order to avoid possible adverse effects. Hope you will find this answer helpful! 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: Dear Doctor,My cousin,37 years has undergone buccal operation on 20th june 2014 followed by 33no of radiation and 5 no of chemo therapy start from 25th july and completed on 16 th sept,2014. Now he find one small tumor with pain on operated area inside the lip and biopsy found positive.He is financially not sound. Please suggest some idea about what to do now.Thanking You,Regards,D.M.Nath ### REPLY: Hi, dear I have gone through your question. I can understand your concern. He has history of buccal cancer. He took radiotherapy and chemotherapy. But there is recurrence of tumor. If it limited to that area then he should go for surgery. Then chemotherapy and radiotherapy depending on need.  If some part of tumor is left then there is chance of recurrence.  So complete removal is very important. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 been having stabbing pain on the right side of my stomach which radiates to the back. Also loose stools. Pain comes only in the late evening and lasts till past midnight. Unable to sleep. Did blood, urine tests and x-ray. All readings normal except White Blood cell count shows 11.6. Ruled out kidney stones by doctor. Prescibed with spasmoliv and damotril but not effective. Also took charcoal tablets. What should I do Doctor? ### REPLY: Hi ! You have not mentioned if an ultrasound of abdomen was done as an investigation for you or not. If negative, then I would suggest you to go for it after consulting your family physician, as a gall stone colic can also give rise to such pain upper abdomen radiating to the back. The raised white blood cell count may also point to some kind of infection in the body, and in your case, we can think of cholecystitis or a pancreatitis. Your family physician may also take help of some blood tests like serum amylase, and serum lipase to exclude this. If he symptoms are increasing, I would advise you to go immediately to your doctor, and get yourself treated at the outset. Wishing you an early recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My baby got sever urine infection in a year she got 4 times doctor had suggested taximo 10ml twice a day along with oflomac mforte - 4ml twice. she is 3 years old her weight is 15kg . In urine culture report she got Organism isolotaed as Klebsiella pneumoniae.please suggest frequent urine infection will lead to any problem ### REPLY: Hi, Many a time resistant type of organisms cause this type of chronic and recurrent urinary tract infection. In such case culture and sensitivity test will give specific antibiotic medicine effective against that particular organisms. Now your doctor might have prescribed antibiotic medicine accordingly. Go for long antibiotic medicine course. Give her plenty of water. Important is to keep local hygiene clean and healthy. Wash local part with running plane water after passing urine or bowel. Ok and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,My sister has brain cancer GBM Stage 4 and I want a second opinion about her conditions. I have the films and records translate into English. Do you have a brain cancer neurologist to analize and read the records and answer some questions that I have???Thanks for your help.Luz Hiratsuka YYYY@YYYY ### REPLY: Hi, Thanks for consulting  ! I am sorry for your sisters condition. GBM (Nuroblastoma multiform) is kind of neoplastic brain tumor, in which the treatment options vary from surgical intervention to radiotherapy etc. Yes, we do have Neurologists to give a second opinion. You are welcome to ask. If you like my answers and wish me to answer in the future, bring it to my attention: .  URL link is as follows:http://doctor.ChatDoctor .com/doctors/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doc....I am 28years old married... I was recently diagnosed for PCOD... Only my sonography says that ... all other hormonal tests are normal...before I could start on nay treatment, I started with my periods which were delayed by 8 days. Today is the 6th day and I have heavy bleeding... My gynae has given me etosys. Is it safe to take? I am also planning to go for a baby. Please suggest. ### REPLY: Hi, I think toys is a safe to take while planning for pregnancy.  It will decrease the flow of your periods.  I think you should take some medicines like camphene for the growth of your follicles and track your follicles' growth by repeated ultrasound and when your follicles is more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband for 2 to 3 days after your injection.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  You can try like that for 3 to 6 months. Discuss with your doctor regarding this.  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: my boyfriend and i been having unprotected sex were trying to have a baby together we been trying over 1 year now and we have been tested for any STD s we had chlamydia but was treated for it back in march. I still get my period every month would could be wrong ? ### REPLY: Hallow Dear, Chlamydia is an infection which may cause tubal block. So please get your Hysterosalpingography done to evaluate the tubes. If the tubes are blocked, you may have to get them reopened by surgery. If the tubes are patent, find out the status of your ovulation by ultrasonography. If you have any ovulation problem, you may require ovulation induction medicines. If you are ovulating naturally, then plan your sexual intercourse on and around the day of ovulation. Please get his semen examination done after 4 days abstinence for evaluating his semen quality and quantity. Please report to your Gynecologist or Infertility consultant.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,i am a man of 35 years old,i discovered i am having a burnin sensation at right part of my upper abdomen that goes through my right thigh..the pain normally goes off and on....i have been experiencing this since last 4years and it makes me to loose weight sometimes,we can i do? ### REPLY: HI. You have a very atypical problem. It says 35-year-old man has occasional burning pain in the right part of the upper abdomen that goes through right thigh (same side)This can be explained only by the nervous system involvement, may be at the spinal level. I would advise you to have an opinion of a Neurologist and a second opinion of a General surgeon just to rule out any problem in the abdomen, may be with added tests of ultrasonography of the abdomen .MRI of the whole spine will help us to confirm or rule out any specific problem. The weight loss is sometimes and again this is an atypical presentation and does not really fir into any of the symptoms-complex. Yet this too has to be investigated by doing X-ray chest and blood and urine and stool tests just to rule put any specific diseases. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 malignant melanoma 10 years ago with multiple mole biopsies, breast cancer with treatment three years ago, uterine cancer witChatDoctorplete hysterectomy two years ago. Since my cancer, I now have high blood pressure treated with medication, hypothyroidism treated with medication and B12 injections. Most recently, I noticed a lump on my lower back/spine area. My doctor said to watch it; she thought it felt spongy and may need to be biopsied if it continues to grow. Should I wait or have it done immediately? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have history of malignant melanoma, breast cancer and uterine cancer. Now you have lump. It can be soft tissue tumor, or it can be metastatic tumor from any of your malignancy. You should not wait. Go for biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been operated ACL tear right Knee before 2 year. After operation there is a Pus Formation on knee due this I had operated again to remove the screw after one year again the pus formation on my knee started. Is there is any drugs or remedy to stop pus in my knee. . Please suggest me to heal my wound on knee. Thanking you ### REPLY: Hi and thank you so much for this query. I am so sorry to hear about this pus formation. This is suggestive of a chronic infection and am afraid this may be chronic osteomyelitis. If there is still any foreign material in there, it would need to be taken out. A culture of deep tissue taken from the .  Treatment would be a long process and may go up to as many as 6 months. Talk to your doctor for review, removal of any foreign materials and culture of tissue from the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi 2 days ago my father in law underwent ultrasound scanning and the results are as follows:1. Urinary Bladder-- Mildly thickening urinary bladder wall measuring upto 6mm.  Prevoid- 220cc, Postvoid-170cc, significant postvoid residue2. Prostate- Measuring 3.8 x 2.9 x 3.0 ( volume 18cc)  Mild cyst measuring 1.3 x 0.8 cms noted   parenchymal calcification notedWe are really worried about this. As i have surfed about this it was written it might be stone or cancer...This is worriyng us a lot. The appoint with our family doctor is on 30th dec. So, could you please let us know about this soon so that we can get some relief.Thanks ### REPLY: HelloParenchymal calcification in kidney is different from renal calculus. It is not calculus or cancerous. Parenchymal calcification may be due to many causes like vascular etc. It is not a serious finding, and it is generally an age related finding. Main findings are thickened urinary bladder wall and significant post void residual urine. Thickened urinary bladder wall may be due to changes of cystitis(chronic infection in urinary bladder). As size of prostate is normal, significant post void residual urine may be related to neural component. Findings also suggest a small cyst in kidney, it is generally age related developmental finding. In short, findings doesn't indicate cancer or calculus. You need proper evaluation by a urologist. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering from hormonal imbalanced problem since 10-15 yrs. I get pimples after period becoz i have high progesterone . I have been on Diane-35 for the past 10 months but still im not cured completely. Should i take some other medicine along with DIane-35 or just continue with the same. if i need to continue with same medicine then for how long?? ### REPLY: Hi! Welcome to  forum, If you have a hormonal imbalance then Diane 35 usually works if you have taken it for more than 6 months or so. If Diane alone doesn't work then you need to get all your hormonal profile done along with serum insulin level. . If your acne is sever then even retinoids can be added. All these needs a consultation with both an endocrinologist and dermatologist together. Along with this topical medicines too should be added. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 can feel my blood pressure rising and it feels like all the blood is rushing to my head. I can t even hear because the pounding is so loud. I feel sick about 25% of the day because of this. I m also having some bloody discharge and cramping. Is that related? Should I get BP medicine? ### REPLY: Hello, I understand your concern and would explain that your symptoms could be related to anxiety.  Anyway, I recommend you to closely monitor blood pressure values in the next days (in sitting position after 10 minutes of total relax) and take note of those values.  If your blood pressure values are above the normal ranges (125/85mmHg) most of the time, I would recommend starting antihypertensive therapy.  I would also recommend checking thyroid hormone levels in order to exclude possible thyroid gland dysfunction.  Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i m 36 years old female. i have a 9 years old girl ,i gave birth to herwith a C-section . and have been using IUD from August 2003 till June 2007. i ve been ttc since then but in vain. i ve tried clomid , menogon injections and got pregnant in 2009 but had a misscarrige at 7 weeks, i had a D&C afterwards. i had 3 IVF cycles in 2011 and they all failed. i haven t been taking any medications for a whole year now. I would like to know if it is possible for me to try Clomid with Glucophage? and if so, how can i take them?what is the right dosage? and if there are any other medications or multivitamins that can help? ### REPLY: Hello, Just to answer your question, I would say yes, you can take closed along with gluconate. But, I would suggest you to avoid self-medication. Please consult a fertility specialist for the need of these medications and the correct dosage. As you were not on any treatment for 1 year, I would suggest you to get yourself and husband evaluated again and treatment planned accordingly. You have conceived twice previously, so there is a fair chance for you to conceive again. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a fractured molar filled almost 2 weeks ago.  There is no pain from the tooth but there is sharp shooting pain through my gum right before the molar(by the way, there is no tooth before the fractured molar, it was pulled many years ago).  So the gum in front of the filled molar is sore and a little swolen.  Is this just inflammation from the procedure or possibly an infection? ### REPLY: Hello there, Thanks for writing your query, Pain and swelling in gums adjacent to the filled tooth indicated the spread of infection from the infected tooth to the surrounding area.  Pain in gums adjacent to an already filled tooth indicates the presence of infection below the filling.  It indicates bacterial decay or infection in the tooth that involves the exposed tooth nerve tissues. You need to get an x-ray done the affected area to confirm the presence of infection, approach a dentist for the treatment. Such infected tooth needs to be treated by a root canal procedure, so please consider getting the treatment done by consulting a dentist. I hope this helps, take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: am experiencing involuntary body jerking movements-am finding it almost impossible to sleep due to this-plus it occurs all day and night- both sides of body afftected-lower legs more often-what causes this and what can I do? Should I go to ER? thank you ### REPLY: Dear Patient, Thank you for asking. Tremors can have wide spectrum of reasons. I do advice you to refer to a neurologist since a proper physical examination is very important. It can be due being generally tired and stressed can also be thyroid related or neural in origin indicating a more serious problem like Parkinson, but proper physical examination is needed. You would expect your doctor to order a blood test, and do MRI(brain scan), EEG (monitor brain electrical activity) and can prescribe tremor medications. I hope this helped guide you to what to do next and what to expect. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 (20 yrs, 170 lbs) has developmental delays, seizure disorder (uses a VNS to control with nearly 100% control) and was on Risperdal for 7 years for tics, behaviors and OCD/Stuck behaviors. After having to move up and up on Risperdal with little benefit we weaned him off 3 weeks ago. We had started Clonidine 2 months ago and he is on .1 tid. He is also on Celexa for depression but on ly 10 mg. The tics are still relentless -at what does of Catapres should we expect to see some benefit? Will Celexa help with Tics and stuck behaviors too? ### REPLY: Dairy am sorry for the symptoms your son is suffering. It is rather difficult to find the right medication due to symptoms Anyway I see that the right protocol is being used to treat your sonic my opinion it is still hope that Elena will be effective in dominating the Tucson should wait till three months if no benefit is seen discuss with your doctor about changing therapy Hope my answer helps you Best regard .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: how many pills do it take 2 go 2 sleep an never wake up i carnt cope with no sleepin nomor its like ther 2 ov me i put up this front 4 other people so they think every thin is ok an reley i hate life im not happy i hate myself im on a drug called quetiapine how many wud it take ### REPLY: Hi, Thanks for writing to us, Suicidal idea is a very serious symptom usually seen in depressive disorders. When you get this thought kindly get in touch with a mental health professional as soon as possible and not take any step to harm yourself. You need to remember that this feeling is a symptom of a disease which has altered your perception at this point of time. Once your symptoms resolve, this feeling will go away. Continue taking your medication as prescribed by your psychiatrist and do not alter it. You need a consultation right away to adjust the dose of your medicines. Hope you follow my instructions, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yes, my left side was 149 over 92, the other side was 151 over 101 my arm..there has been tingling over my left arm since last week thats why i think it may just be a pinch nerve but early this morning i got scared bec there is a tightness but it feels more like near my underarm..i have no med insurance right now..what should i do.. ### REPLY: Hello! Welcome on ! Regarding your concern, I would explain that such differences in blood pressure are normal and are related to the anatomical changes in blood vessels between the arms. Anyway, your blood pressure values are above the normal ranges, and you should consult with your attending physician and perform some tests (chest X-ray study, resting ECG, complete blood count, kidney and liver function tests, fasting glucose, etc.) to exclude possible causes of high blood pressure.  You may need to start antihypertensive .  But, high blood pressure does not explain your tingling sensation in the left arm. Are your symptoms (tingling over the left arm) modulated by arm position changes? This would be indicative of a nerve pain. In such case there is nothing to worry about. A nerve conduction study would help determine possible nerve compression. Meanwhile, regarding your high blood pressure, I would recommend some tips to help you have a better control on your blood pressure: - reduce salt and caffeine intake-perform a lot of physical activity (aerobics, walking, etc.)- try to lose some pounds if you are overweight. Hope to have been helpful! 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: Hi! I was diagnosed with both kidney distinct corticomedullary differentiation. Pelviectasia is evident bilaterally, mo lithiasis seen , per my upper abdomen ultrasound. What does this mean? It also said both kidneys have normal size. Thank you, Yolanda r. Salvador ### REPLY: Hello Your findings indicate bilateral dilatation of renal pelvis. It is generally a benign finding. It may be due to over distended urinary bladder. However, it is important to rule out bilateral reflux. You may need repeat ultrasound with both filled and empty urinary bladder. Other findings are normal. Cortico-medullary differentiation is maintained. It is good that there is no calculus in either kidneys. Take Care .  ### END