Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sex with my boyfriend yesterday and used a condom. After we finished, we noticed that the condom was missing. Then I found it, inside me with just the end hanging out. I am on birth control, but I just started it and am just now finishing my first pack. I also just realized that my birth control is the kind that needs to be taken at the same time everyday, which I have not been doing. Do I need to consider emergency contraception? ### REPLY: Hello misunderstand your concerned are on the birth control pill, but you took it irregular, so chance of failure is high to prevent the pregnancy. And chance of failure is also high as you just finished the first pack of pills. So I advised you to take the emergency contraceptive pill like I pill or Unwanted 72 to prevent the unwanted pregnancy for safer side. In future use birth control pill regular on the same time without missing any tablet. Hope this may help noncontact the  for additional health problem Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my 20 mth old son has been diagnosed with a large left arachnoid cyst. The doctor just recommended that we keep an eye on its growth and go from there. Is there anything I can do such as a natural or alternative method to try to help shrink this cyst? I can t just sit back and wait...... ### REPLY: Hello, Arachnoid cysts are for the most part believed to be present at birth and typically, we do not believe they "continue to grow" nor do we believe they cause any specific pathology or problems in patients.  They are often found coincidentally because something else was being looked for, so I agree with your doctor that a little "benign neglect" is worth much more (and your daughter will appreciate this approach) than any type of further workup since this cyst is not being contemplated for surgery or any other intervention. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i m 23 years old. about a.month ago I started having occasional upper back/base of the neck stinging pain mostly when I sitted for long periods of time while trying to maintain a good posture. Recently, this pain has become more often and not related to the activity mentioned before. Also, now it associates to fifth right finger numbness (and only this finger) with stinging and almost constant elbow pain as well ( on its medial aspect). There is no history of trauma. ### REPLY: Hi, Your neck pains associated with numbness of the finger and pain of the limb points to a prolapsed disc in the cervical spine of the neck. These nerves run from the c spine down to the hand. This needs an MRI of the c spine which will reveal the status of the discs and evidence of pressure on the nerves. Meanwhile, you may take an analgesic (Tramadol / paracetamol), along with skeletal muscle relaxant like medical. You may also need medications like gabapentin and pregabalin which your doctor will prescribe along with these steps take rest and warm packs. The MRI will help your doctor to decide if surgery is necessary or these methods will suffice. 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, my age is 32yrs, from April 2011 to July 2011, I was suffering from a severe vertigo attack and was in hospital for 4 days. Now I don t have any problem regarding vertigo but i went into depression after the vertigo attack...Now I m taking Duzela 20 for last 2 months for depression but since them I m having the problems like constipation, headache, acidity, and pimples. If i do not take Dezula, then i feel depressed and i take dezula then suffer from the above mention problems...please advice....thank u!! ### REPLY: Hello, Most side effects are related to constipation. You should take sips of water every 10-15minutes (please donor take full glass at a time) all day long. Include lots of salad and fruits - 5 to 6 servings a day. Take sprouts at least on bowl a day. Go for walk for 30-45min.This measure are usually sufficient for most people having problems after taking.duel. For acidity, you may take antacid -omeprazole empty stomach 14 days, along with above measures. 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: hello i am concerned about my husband he has been having gout attacks alot lately to a point where he can t walk. and i took him to the summit in flagstaff and Dr. thomas told him his kidneys might be failing. i am trying to find a Doctor that will help him. ### REPLY: HELLO SIR, HERE I AM SUGGESTING YOU FOR GOUT PROBLEM, BETTER YOU USE HOMEOPATHIC TREATMENT. IN HOMEOPATHY IT IS CURABLE AND RELIEF OF SYMPTOMS Without ANY SIDE EFFECTS. Gout is a disease in which defective metabolism of uric acid causes arthritis, especially in the smaller bones of the feet, deposition of chalk-stones, and episodes of acute pain. Risk possibility by these conditions:Being leaving a family history of outlawing been born with a rare condition that causes high blood uric acid levels. Regular use of aspirin (more than 1 or 2 aspirin a day) or niacinDiuretic medicinesChemotherapy medicines (usually used to treat cancer)Medicines that suppress the immune system, such as cyclosporine, that are used to prevent your body from rejecting an organ transplant. Obesity. Moderate, regular, or heavy use of alcohol, especially beer. A diet rich in meat and seafood, which can be high in purines. Frequent episodes of deny . Very low-calorie diets. Diabetes. Kidney (renal) disease. High blood pressure. Lead poisoning. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good morning doctor. I shaved my penis recently and started developing spots all over. I used an anti-bacteria cream: Funbact-A and every morning before having my bath, I washed my penis with a little disinfectant. Now the skin of my scrotal sac is folding, it is also inflamed and itchy, please what do I do? ### REPLY: Hi and thank you for your question. It seems as if you have an inflammatory reaction to the skin of your penis and scrotum. This happens commonly after shaving the pubic area for the first time. I would suggest you stop using the antibacterial products seeing that this isn't an infection, and you could possibly cause bacterial resistance to these products as well. I also suggest you use HY . 5% over the affected area daily for the next 7-10 days until the inflammation has subsided. I hope this helps and good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a healthy, fit 20 yea old girl. I exercise regularily and eat properly.. Yesterday i felt sick to my stomach , have been tired for about 2 weeks now, was very light headed- almost felt like a light head ache. I passed it off and continued to work. When i went home, i ate some lunch and felt a bit better. Right after that i noticed i had a medium sized bruise on my right lower back- right where that dimple is. It was in a lot of pain. This morning i wake up, i do not feel tired, light headed or sick and that bruise is gone!.. Was it all a coincidence? ### REPLY: Hi welcome to . Forum.  Thanks for choosing  forum.  It appears that you had a viral fever, and the symptoms. Hence, you had weak less, light-headed less etc. The bruising on the right lower back could be an urticaria due to the fever. As the time passes it has gone.  If at all you get any of the symptoms recurred you consult a physician for diagnosis and treatment.  At present there is nothing to worry about.  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: Dear Doctor My daughter is suffering from RA +ve she had diagonised lumps in chest and montos +Ve she is now getting treatment for both TB and RA Now i would like to go fo second openion can you suggest CMC has got a team of doctors to diagnose the cause of RA and TB as opinion from other doctor that, RA could have developed (No heriditary) 1.due to injury that caused 4 to 5 years back while she is playing badminton 2. THIS MAY BE CURABLE IF parent disease is find out. 3 If lumps are developed due to injury treatment from lumps can be the nullifying the root cause. However I am looking for the best treatment that can be made......please suggest me ### REPLY: Hello, No, this is not true. RA (rheumatoid arthritis) is autoimmune (connective tissue) disease. It is not caused by injury. It is because of bodies immunity.  And just only on the basis of the positive Manitou test, you should not start antitubercular .  RA itself can cause pulmonary nodules, fibrosis etc. So in my opinion, you should consult pulmonologist and get done a bronchoscopy and BAD (bronchoalveolar lavage) analysis. If BAD is negative for TB then no need for anti-tubercular  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Im 27 yrs old, M, .. Morning when i get up my calves near the leg gets caught very badly. i don t know how to explain .. whether its a cramp or something, but the pain is like a killing pain,.. I feel m gonna die in few mins.. I also sweat while that happens.. After few streches it ll be back to normal.. Please help me out.. ### REPLY: Hi, Thanks for your query. After going through your suffering, it seems you have developed muscle spasm (cramp). The cramps are caused by hyper excitability of the nerves that stimulate the muscles.  .  A simple way to prevent cramp is-1. Warm up and stretch your calf muscles before running stretch your calf muscle before going to field 3-4 times and each time holding for 10-15 seconds. 2. Talk to qualified trainer for proper running form and footwear.3. You may run in a heel-toe pattern and avoid letting the balls of your feet hit the ground first.4. Stay properly HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 bad URI in November and it lasted several weeks but over it now. For last month I have had continuous chest pressure over the heart with shoulder and shoulder blade discomfort. No shortness of breath, no anxiety, and there is no change whether I am resting Or performing daily activities -- I am a 60 year old women, with long history of smoking, and take blood pressure meds, cholesteral meds, 81 mg aspirin, and Prilosec for GERD. What can be causing this continuos pressure ### REPLY: Hello rearward welcome to .come have evaluated your query in details .* There are different conditions which can lead to such presentation as - cardiac issues as valvular or others - lungs related as emphysema or others - chest wall conditions as ligament or muscle sprain or strain with referred pain - neurovascular bundle related - stress induced psychological * Treatment depends upon finding out the cause of it with proper work uprising you fine recovery. Feel free to ask any further doubts. Regards . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello I am not dizzy but my doctor says I have sinus issues and gave me medication nazzel spray. My neck is sore and seems my heart beats faster than normal lately but I m taking lisinapril. I am confused but is it normal to feel this way? My sugars are normal but its an anxiety feeling then goes away. ### REPLY: Hello, Regarding your concern, I would explain that the nasal sprays could be related to such adverse effects.  For this reason, if these complaints started after starting the nasal spray, they could probably be related to this .  Otherwise, I would recommend checking thyroid hormone levels for 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 have been living in Bangalore for the last 1.5 yrs. Recently (6 months back) I have developed allergic reaction (runny nose, sneezing and sometime shortness of breath) whenever weather changes to cold or rains start. Have been advised to use inhaler by Pulmonologist but am also trying Homeo. Any advice on how to build immunity to prevent/mitigate allergic reaction? ### REPLY: Hello dear, The symptoms as mentioned in your post can be attributed to Allergic rhino-tracheo-bronchitis. Presented with similar complaints, I usually treat my patients with:1. Tablet Allegra 60 mg twice a day or Tablet Levocetrizine 10 mg in the evening.2. Tablet Montelukast 10 mg in the evening.3. Stalin inhaler.4. Voice rest-avoid talking in loud voice & for a long time.5. Stay protected from exposure to cold, dust & other allergens.6. Steam inhalation.7. Avoid smoking, cold food & .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 dear doctor My MRI has shown an oval calcification between my cervical C5 and C6. I fell numb in my left hand and sometimes my right one. I have to go to toilet every one hour. I think it is because of that calcification. I do some static exercises as my physiotherapist has recommended but I am really worreid when I dont do them for more than 5 or 6 hours again I feel pain. I am 42 and I think I am too young to do surgery. what should I do? ### REPLY: Hello, any chronic inflammation of spine heal into calcification, that could be evident in X-ray or MRI investigations. Rheumatic conditions like Rheumatoid spondylitis, ankylosing spondylitis, are the most common cause for such chronic inflammation of spine. There is no specific cause, as they are mostly due to an underlying autoimmune mechanisms. I would advise a regular exercise and keep the stress levels low by daily yoga and healthy lifestyle. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 hard lump on my left calf that I noticed in January 2014 after a run and don t know what it is. Went to my Dr and he was not familiar with it as he had never seen a lump on a calf before. Then I had sonogram and I was told they dint see anything malignant. Im a 34 yo male and take Bystolic and albuterol. ### REPLY: Hi. As per your history of finding the lump on the calf after a run indicates me for the most probable diagnosis of herniation of the muscles through a small tear through its covering (herniation). This can be nicely seen on sonography if examined with a high frequency probe. You may please consult an Orthopedic surgeon to get a proper diagnosis and management, may need to require a small surgery. Please keep me posted about the results f diagnosis and treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doc. My Son is 3+ Year and passing Broncaites ( Asthma ) and we Used Asthalin, Levolin, floracourt, except C, Derafiline and omnacortil forte syrep and inhaler repsols ect . but we not found relief in his cougf ( Khasi ) and Brithing problam .pls give any sug. doctor. ### REPLY: Hello, Thank you for asking at . I went through your sons history and would like to make suggestions for him as follows:1. I usually suggest my such patients regular montelukast and inhaled budesonide for at least 3 months. If your son has nose symptoms also, I would add levocetirizine to his treatment also. I also suggest them to use albuterol inhaler on as-and-when-needed basis.2. Please make sure your technique of using inhaler is correct. At this age, metered dose inhaler with spacer device with mask is a good option to use. However, the technique is equally important, so please review your technique of using the inhaler by your pediatrician/pulmonologist/allergist.3. I would also suggest your son allergy testing for common air-borne allergens like house dust mites, molds, pollen, insect proteins, pet dander (if you have pet). This will help you identify the substances causing allergies to your son as well as to know the measures to avoid them.4. In general, I would suggest him to avoid exposure to dusts, smokes and air pollution as much as possible.5. I would like to mention here that childhood asthma needs long term treatment (sometimes for months and sometimes for years also). So I would sincerely suggest you to not keep changing . Hope above suggestions will be helpful to you. Sould you have any further query, please feel free to ask at . Wish your son the best of the health ahead. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been taking Cipralex for anxiety for almost a year. I am currently taking 20mg/day and have recently noticed an elevation in glucose levels, and am having trouble controlling them. Blood pressure is elevated lately as well. Could this be due to the Cipralex? Is there another anti-anxiety medication that is more blood sugar-friendly? ### REPLY: Hello, Cipralex may indeed cause blood glucose disorders and blood pressure disorders, although both are rare. It may cause both hypo- and hyper- glycemic (the effect cannot be individually predicted) and both hypo- and hypertension. Such side effects occur in less than 1% of patients taking 20 mg of Circle. It has to be even less likely in patients who have been taking it for a year without any side effects. Perhaps your doctor should try to identify other potential causes for your problems. Weight gain and sedentary lifestyle are inciting factors for hyperglycemia, although genetics play a major role in it - some individuals will never develop diabetes no matter how fat they become, others will experience hyperglycemia even when they stay lean. The same factors are important for hypertension as well. Salt consumption is another important factor in this regard. Checking your glucosylated hemoglobin would be recommended. High glucosylated hemoglobin may indicate that treatment for diabetes might be necessary... Regarding your blood pressure. Measuring your blood pressure (at least twice each time) for at least one week will give your doctor a better idea about it. 24-hour blood pressure monitoring (Holder) may be even more accurate in detecting blood pressure issues. So in conclusion, I don't believe that these symptoms are caused by Circle - although I can't 100% exclude it. An investigation is required to determine the extent of these issues and whether treatment is required or not. I wouldn't recommend any change to your regimen without discussing the matter with your doctor first. Consequently, I wouldn't recommend any other antianxiety medication. A rate of less than 1% for side effects is perfect for any .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my son just turned 4 yrs old and has down syndrome.  After some routine blood work, his doc called saying that his levels have changed and she suspects hypothyroidism.  This was almost 2 months ago and he has an appointment to see an endrocronologist next month.  About a month ago my son began sleeping A LOT15-17 hours a day.  The other day he saw his doctor again and I explained how tired he has been.  He has also dropped some weight.  She told me not to worry he may be going through a growth spurt.  She checked his hemoglobin while we were there and said it was low.  Shortly after we returned home the doctor called and wanted more blood test done.  I recieved a call today saying that he is not anemic, it was the doctors secretary that called and could not answer the questions i had.  I am wondering if that means there is no problem of if that means there is another cause.  I know that children with ds have a 10-15% higher chance of suffering from lukemia.  Should I worry, get a second opinion, or just wait to see the endrocronologist next month. Thank you for any help you coould provide. ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Further blood reports details necessary to make any possible leukemia diagnosis. Risk is definitely present.2. Hypothyroidism is also common in Downs syn .  A thyroid hormone profile will confirm the diagnosis.3. Anemia if present, will require multiple tests to identify the type of anemia. Do not worry about leukemia as there is no bleeding episodes either in gums or elsewhere. Not to worry. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have pain in lower left back that radiates to front groin then down my left leg via front (no pain in the behind and back leg). It s so severe and no position relieves it. Not a shooting pain but constant very severe burning pain. Can t walk on it and hurts just as bad or worse if I keep weight off it. Nothing helps. Does this sound like Sciatica? Pain in the back has gotten better but leg has only gotten worse. It s been 4 days now. Did nothing to bring this on. Was just standing. ### REPLY: Hi, thank-you for providing the brief history of you. A thorough neuromuscular assessment is advised. As mentioned by you the pain was on the left side of the lower back and left side leg (frontal and medical aspect) and not the back side. You doubt it is sciatica? Well sciatica is a symptom where the pain. Travels the course of the sciatic nerve. And sciatica is not an obvious condition but rather it is a symptom. Also, as your pain is having radiating in nature with burning sensation it could be lumbar radiculopathy. In this condition, there will be compression of the nerve in the lumbar spine due to lumbar disc degenerative pathology. Also, an MRI will be performed to confirm the diagnosis by correlating the MRI reports with the clinical symptoms. Usually the upper level of the lumbar spine like - L1, L2, L3 gives pain in the inner aspect of the thigh - this is just an example to understand that which nerve will be pinched to give symptoms. The treatment will be guided based on the diagnosis. With medication and physical therapy the symptoms subside and the overall health improves.in my clinical practice we call this kind of condition as lumbar radiculopathy and with the combination of medication and physical therapy cases respond well. You may be advised by a physical therapist to undergo - Therapeutic ultrasound therapy, TENS therapy and exercises on a later stage. All together this will help you spine become stronger and the active lifestyle is achieved. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear sir, I am 42 years old and have been suffering from left shoulder and simultaneously upper back side pain for last 2 months and went for x-ray report is showing that there is loss of cervical lordosis and paraspinal muscles spasm.dear sir can you please suggest me  how can I get rid of this problem.thanking you . regards, DHARMENDRA SINGH ### REPLY: Hello, Thanks for writing to us. It seems you are suffering from cervical disc disease. Loss of cervical lordosis is due to para spinal muscle spasm. Treatment includes 1. Use of cervical collar helps in immobilization and brings relief. 2. Medical . 3. Cervical isometric exercises are beneficial to maintain the strength of the neck muscles. Neck and upper back stretching exercises, as well as light aerobic activities, also are recommended under the guidance of a physical therapist. 4. Hot fomentation helps in relieving acute symptoms.5. You can avoid using a pillow. Hope this helps you. Wishing you good health... Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About 2 weeks ago I sprained my knee, while skiing. X Ray at the doctors office was negative for a fracture but now I have feeling that I have damaged soft tissues. How long does the pain and clicking last? Should I go back to see the orthopedic doctor? They suggested MRI as a next step. ### REPLY: Hello understand you had a skiing injury and the X-ray did not show bony fractures.  The possibility remains of a tendon or cartilage injury.  Do you have a lot of pain and swelling? Do you have any bruising and are you able to bear weight on your ankle joint?  If you have any of these symptoms you should go ahead and get the MRI to rule out other injuries.  The pain from a simple sprain can last 3 to 4 weeks, but a tendon or cartilage injury could last longer or even require surgery. I hope you feel better soon ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: While doing a leg split, left foot forward in the sand,I went too far and heard a pop. Had pain in left butt, and all the way down back of leg to toes. It hurt to walk.I went for a gentle swim which was ok.Now 2 weeks later, it hurts some in left butt,hip and back of thigh to knee.I previously hurt left sciata which was okay til now.I can use left with small amount pain. It hurts to sit awhile on it. ### REPLY: While doing leg split, flexion occurs at hip and extension at knee joint. It causes stretching of hamstring muscles which are situated at posterior part of thigh. Sudden stretching can cause severe spasm in these muscle group and sometimes it may lead to tear of muscle at its origin (these muscle originates from social tuberosity, the bone on which we sit). Rest, ice , muscle relaxants and analgesics such as ibuprofen may help you. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had unprotected oral sex. I am a male. I notice three weeks ago, when I get hard and my penis stretches, it has a cracked look that will dry up to be scabby looking. Also, I notice that the head of my penis also becomes rough and start to look rinkly ### REPLY: Hello,The cuts or cracks are usually due to tight foreskin. The tight foreskin causes Sega to form a . This may irritate the glans and lead to inflammation of the glans (Atlantis). You need a course of antibiotic and coracoid cream to treat this inflammation. It is important to prevent the recurrences and the best way is to keep a good hygiene of your genital area. To prevent this inflammation you should wash the end of the penis (the glans) each day. Pull the foreskin back gently then gently clean the glans using just water, or water and a bland soap. Apply some liquid para fine (Vaseline) in the foreskin to prevent cracks. If the inflammation doesn't improve with antibiotic cream and steroid cream, then it might be a fungal infection, and you need to use an antifungal cream (Clotrimazole twice a day). 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 13 mo old daughter was diagnosed with RSV about 4 weeks ago. After 2 weeks she was not getting better (coughing, mucus, fever, vomit) so they took a chest xray and said she had walking pneumonia. They put her on an antibiotic, and an abutural inhaler. After another week she was sounding better, and her cold was gone, but she continues to vomit, at least once a day, always immediately following a meal, or after her evening bottle. She is also uncomfortable and irritable. The dr now says she has post infectious gastritis, and put her on Prilosec. She has been on for 3 days, but now the vomit looks like big (some 2 ) chunks of cottage cheese. I m assuming this is from her stomach acid and her milk from her bottles. Are we doing eveything, or the right thing? ### REPLY: RSV is a virus that frequently affects child .  The treatment is with nebulization which basically breaks the water and medicines into fine particles and delivers it deep inside the lungs. Steam inhalation at home could give her some relief if nebulization cannot be given at home. Also give some antiallergic like cetirizine syrup. It should reduce the irritation in her throat which is the likely cause of her vomiting. You may also give some antiemetic like ondansetron half an hour before feeds. You may continue Prilosec. Otherwise, you are doing the right thing. Our stomach contains acids that are meant for digestive purpose. The milk is supposed to get curdled when it comes in contact with this acid and this is normal. So, the chunks looking like cottage cheese, are not abnormal if she is vomiting out. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 28 year old girl, weigthing 55 kgs. I was diagnosed with SLE four years back and suffering fom hairloss some 10 years back. I have lost 70% of my hairs. and the loss s diffused . I there a treatment for SLE hairloss.?? wil transplant work in my case. ### REPLY: Hi.have been through your query carefully.dear in she skin and hair changes are very common, unfortunately. And that is no specific treatment for she hair loss.however using minoxidil hair spray twice daily for 3 months help in solving your problem up to some extent. Also take multivitamin with zinc supplements for at least 2 months. Regarding hair transplant, there is no specific contraindication for hair transplant in she. However if you are on steroids are immunomodulator . U can take a second opinion from rheumatologist too. I hope you are satisfied with my answer in case of any problem feel free to ask.thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Respected Sir,My wife,Mrs. Madhumita Banerjee,aged approximately 26 years,is bedded,feeling severe pain in lower parts of the body.Details of the case is furnished below:History:1.Went through severe jaundice on March092.During cesarean delivery of child,was applied spinal anaesthesia on January113.Had a fall from a running bike on October11,which didnt result in any immediate after effect.CASE HISTORY:Symptoms started showing up one and a half month earlier,when she felt unbearable pain in right side of waist.Mainly she was having problems while trying to move after rest.General physician suggested COMBIFLAME,what she continued for almost 3 weeks,but it was not any good except for some temporary reliefs.Having some medical suggestions,with a Lumbo Fractal Digital X ray report(which was absolutely fine),we moved on to an Orthopaedic.He advised her Lenox Plus,which reduced the pain of the right waist,but the pain shifted to the thigh area(from groin to upper thigh).On intimating the doctor,she was prescribed Zerodol MR.It reduced the pain to some extent,but the left ankle showed signs of swelling and black patches.Then she started taking Altraday(1 tablet per day) as per medical experts advice.As now,the left feet and right knee are showing clear signs of swelling,she is feeling unbearable pain in those areas along with in hip joint.The pain has got no burning feelings and grows unbearable as she tries to move from rest.Meanwhile,as per medical advice,a blood culture is done,which is showing only haemoglobin(10%) and ESR(38),fluctuating out of normal limits.Complete USG of lower abdomen is also perfect as per latest reports received.Your diagnosis and advice in this critical situation will be of great help.Please mention if any more tests need to be done for better scope of diagnosis in future.Regards,Preetam BanerjeeWest Bengal ### REPLY: Hi the problems of generalized pain and the waist pain and now thigh pain after the jaundice, while 1. First is related to nutritional deficiency. Has to be treated with vitamin and folic acid supplementation. The vitamins particularly it B complex. No investigation are required, and you may start vitamin supplement like Recharge plus or Erosion forte, once daily.2. Second is related to disc herniation in the lower back. This may not at all be related to jaundice, but poor muscle tone in back may lead to this. You must get an MRI of the lower back and consult a pain specialist in your city. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 2 years old son has heavy breathing. Or that s how it seems to me. His belly bounces very noticeable when he is sleeping. Not all the time but sometimes. But there is no usual heavy breathing noises or moving in the neck or ribs coming visible as in asthma. I ve been in doctor couple times for this matter but has not gotten any wiser. I shall take a video and book appointment. What tests i should demand? ### REPLY: Hi... Thank you for consulting in . Greetings from Chennai. By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. Both these diagnoses are clinical and no test however extensive will prove them at this age. Spirometry is useful only above 6 years of age. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever? If your answer is yes for any of the above questions, your kid might be having viral associated wheezing or multi triggered wheezing, and I suggest you meet a pediatric pulmonologist who is near your place. No point in using antibiotics every time. It will do more harm than good by increasing bacterial resistance. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Had a gaulbladder operation on the 11th May 2011 came out on the 12th stiches on the 20th May 2011.  The same night i was addmitted back to hospital i was there for 4 days i was told i have a built up of blood where the drain came out.  Before i came out they took a scan they said it was all right but i was still in alot of pain and feel quite ill they told me to see my doctor so  after a week  i did so he put me on  two courses of antibiotics one was 400 mg the other 375 mg for two  weekes.  After two  i had a rest to see if it was any better but it is still the same, i went back to see the doctor today and he send through to get me a scan  as soon aspossible can you give me any advice be very grateful thank you . ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can. This is common complications of gallbladder surgery and may happen if blood vessel is damaged, or it bleeds for the liver bed. You need to do ct scan and check our red blood count in most cases it can be treated without surgery but sometime sit is required do evacuate hematoma and cingulum if antibiotics won't work. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i was having gastric lately but i take food it disappears n hungry back ,i went to see doc, he gave me nexium medicine , and now my mouth drys n the saliva in white n sticky, mouth is tasteless, like want to vomit,n my tongue is white patches n hurt burning sensation,pls advice ### REPLY: Hi, It is suggestive of oral thrush (fungal infection of oral cavity). Medium is a proton pump inhibitor that acts by suppressing production of stomach acid and is commonly prescribed to treat symptoms of gastroesophageal reflux disease, stomach ulcer and other conditions. Its common side effects include diarrhea, headache, and on prolonged use it may cause thinning of the bones and increased risk of gut infections. Having oral thrush and symptoms of increased hunger I advise you to check your fasting blood sugar to rule out diabetes. I also advise you to use antifungal creams like clotrimazole or fluconazole for oral thrush, maintain good oral hygiene, brush your teeth twice daily, and rinse your mouth after eating. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had upper right side pain that comes and goes but has been getting a little worse. It radiates to my back at times. It is tolerable with advil when its bad. I have had a ct scan with contrast and ultrasound and blood tests done and all have come back ok. Do I need to worry about my liver or gallbladder since these have come back ok. The next test they are going to do is a HIDA scan. I am a 44m not very active with a desk job 6 3 215lbs ### REPLY: Hi thanks for asking question. Your USG and CT scan is normal. Here liver problems and gall bladder problems seems to be less. You can have simple colitis or ulcer. If colitis seems bacterial then antibiotic needed. Omeprazole also can be taken. If symptoms increasing endoscopy useful. It may show suspicious area and for which biopsy can be taken to rule our microscopic colitis. Here you can have simple abdominal muscular strain by heavy weight lifting or excess exercise. Simple analgesic and hot compress can be useful. The ribs can be affected by Costco . The ribs are painful to touch. Analgesic and rest will be useful. I hope you will recover soon. Wish you good healthRegards; ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 couple of weeks ago I woke up with a hard itchy lump on my back left side. A short time later another one appeared in the the same place on the right side. They went away in a couple days they were very itchy. Last night I had some irritation in my left knee. This morning there was a hard itchy lump on my left knee and a hard itchy lump appeared on my right knee shortly after. What is this? ### REPLY: Hi, Good Morning, Thanks for your query to  online Clinic. I have read your query in details.-Dear In My opinion, this simultaneous lump on knee is mostly -Erythema Nodes.-This indicates an Auto-immune reaction activity in your body over sometime. And indicates-? Sarcodosis, crohns, ulcerative colitis?or . -Remedy -would be to Consult a physician-who would-do CBC/ESR/CRP and would fix the cause of it in your case.-Tb NSAID / Tb Aspirin to reduce anti-inflammatory reaction -Steroids to reduce the autoimmune reaction causing these lumps-Colchicine in aspirin induced cases would reduce this lumps.-Usually these lumps go in 3-6 was time on their own. They could be treated if it does not go or causes more worry and pain. Hope this would resolve your query. Wellcome for many more queries to  from your friends and you in time to come. Have a Good Day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my child is four years old his CRP was 8.0 positive TLC 10800 HB 11.3 in April dated.his fever was 106 degree.his fever was controlled by antibiotic leriago accutaz 1000mg ampicilin etc.after 14 days he recovered.now he is again suffer by fever 102 degree.what i do now ### REPLY: Hi... Thank you for consulting in . Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Meftal-P contains Metonymic acid which is a NSAID. It carries the risk of gastritis and renal problems in the long run. Please do not use Metal. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had surgery about 8 months ago I had my galbladder removed on sunday I started having like lil sharp pains on my right side where I had the surgery that sameday I woke up and felt my right aide swollen it bothered me to sit down and no I been feeling like hotness on my right side I feel like is hot water is runninv my side I could feel it inside I dont know if thats bad or why im feeling like this I feel like if I have some on my side that bothers me wen I lay on that side and I had abdomen sharp pain today ### REPLY: Hello, bettyqee16,You state that your surgery was 8 months ago. I am not sure if you had a laparoscopic surgery or open surgery. If there was a lot of inflammation at the time of surgery, it is possible to have some scar tissue develop after the healing. You may have pinched nerve in that area under the rib cage on the right side. It is very unlikely to have an infection after all these months. If you have post-operative complications, usually that occurs within the first two weeks. Delayed complications such as retained stone in the bile duct can show up much later. Thesis associated with fever, chills, abdominal pain and yellow jaundice. It does not look like you have any of these symptoms. Just keep an eye on that area, and you can apply some plan relieving cream that you can find at a .  If the pain gets worse, have your doctor check you for any additional tests. I wish you well. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 constant sound in my head except for when I m using my brain for some current activity. I saw something that said it may be due to inadequate serotonin in my system. I take Effexor and bupropion which are described as seratonin uptake inhibitors. What is medically correct. My Dr. is unaware of my problem. W ould you please advise me or at least tell me if the medication I am taking inhibits Serotonin production in my body .is that what uptake prohibitors do? ### REPLY: Hello! Effector and Bupropion are both antidepressants, but they use different mechanism of actions. Both inhibit the reuptake of neurotransmitters. Effector(venlafaxine) inhibits the reuptake of serotonin and norepinephrine, bupropion inhibits the reuptake of dopamine. The production of serotonin is not affected, but the reuptake inhibition increases the level of serotonin to be used by the receptors, so in easy words effector increases serotonin action. Anyway, i don't think the sound in your head be explained by high levels of serotonin. In my opinion you're on the right . I hope I have been of help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am having jaundice since 25 days. my bilrubin level was 6.5 then 12.5 thereafter decresed to 5.3 then 2.1 and now SGPT and Alkaline Phospate is normal. HBSag test was negative. How long I hav to avoid oily foods. plz suggest me a diet an plz tell am i affected by any virus that caused jaundice? how long i would be suffering from jaundice? ### REPLY: Hello, According to history, you have jaundice, but you have not mentioned which is a causative factor for it. Rule out hepatitis A, hepatitis B, hepatitis C and hepatitis E by the biological marker. If it is hepatitis A or hepatitis E, then no need for further testing, and it will recover in two to three months. If hepatitis B or C then repeat the test again after three months and six months to check for carrier stage. Until two to three months, avoid high fatty foods, trans fat foods, and pizza etcetera. Fruit juice, sugar cane juice, Apple juice, Indian gooseberry, grapes, coconut water etcetera beneficial. Adílio should prescribe. 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 my self ravi from india, my mom hostpitalised and found cepticemia in day 1, i want to know that which is the best test which can tell that which antibiotics will be suited for her as she is diabatic petient. on 24th her leucocytic is 22600 and on 25th total leucocyte count is 7200 with platelate count 2,88,000 and on 28th again her total leucocyte count is 22700and platelate count is adequate. need your help ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your mom is suffering from diabetes and infection is more frequent in diabetes. It is difficult to treat.  She should go for culture and sensitivity test. She should take antibiotics treatment accordingly. Furthermore, she also needs to control diabetes. 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: My daughter has been dealing with nodule in her neck and she just visited a dr bout ten weeks ago and they did an ultra sound and found that one of the nodules is now 12 cm big. They did a referal to a endo dr and after waiting for two months foe the appt they told her they didnt take her ins. so then they had to start the process over now she is scheduled to go to another one on May 1st. I m really concerned that this is taking so long and wonder what the odds are of i being cancer. She has also been having pain in her side and wont go to the dr for it but I talk to her earlier and its gotten worse and if she doesnt feel better in morn she is suppose to call her dr. sorry just a worried mom. ### REPLY: A nodule in the neck could mean a number of things including an infection, tuberculosis or cancer. However, a nodule that is increasing in size should definitely raise suspicion of cancer. The best way out would be to get a needle test (FNAC) from the nodule. That will indicate whether there is any chance of there being cancer or if it is definitely cancerous or if it is entirely something else. It is a simple test done on outpatient basis at any lab. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I had a cyst on my neck for 2 years and recently it turned white like a pimple does and it squeezed it and now it is huge and swollen and painful and hard it gets multiple white spots and I squeez it gently and get a tan liquid and blood come out.any suggestions ### REPLY: Welcome at  I have gone through your query and being your physician I completely understand your health concerns.  Neck swelling should also always be investigated properly by the surgeon. You should meet surgeon. It may appear to be bronchial cyst, hypoglossal cyst, sebaceous cyst etc. meet your surgeon as early as possible Meanwhile stay calm and use acetaminophen to relieve pain Get well soon Hope your query is adequately ad .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been experiencing shortness of breath, like I can t breathe as deeply as I should able to. Sometimes I ll burp a few times and I can breath but it comes back. I also have a red rash on my chest. It s splotchy, not raised at all. I used to notice it when I was warm or just got out of the shower but it been present for a few days straight now. ### REPLY: Thanks for your question on . In my opinion you are having allergic bronchitis, as rash on your chest may be due to allergy. Another possibility is bronchitis.  So better to consult pulmonologist and get done chest x-ray and PFT (Pulmonary Function Test) to rule out these. If both are normal than no need to worry. Your symptoms may be due to anxiety only. So avoid stress and tension. Be relax and calm. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, right before I put my 8 month old baby to bed, I noticed she had a dark reddish-purple mark on the fron left side of her tongue. She is teething (one breaking through and another on the way). She sucks on her lower lip a lot as well. Could she have bruised it, or bit it? Could this be something else? She s never had this before. ### REPLY: Thanks for your query, I have gone through your query. The dark purple mark on the tongue can be because of the ecchymosis or hematoma secondary to trauma by biting caused by the erupting teeth. Nothing to be panic, consult an oral physician and get it evaluated. Nothing to worry, it is a self limiting condition. If there is any change in the size of the lesion them, immediately consult the oral physician. I hope I have answered your query, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi folks: my wife has this bad cough, that makes her cough every three to five minutes, she feels low and tired, its been about 4 weeks, she has gone thru one course of medicine doesnt seem to help. this started with a cold adn the never stopped. she keeps blowing her nose a lot too.  some years ago i had the whooping cought.. and that is something that no adult should have to go thru.  my wife is woken up nights by this cough also.. help ### REPLY: Thanks for your question on . I can understand your concern. Your wife is having chronic cough (cough for more than 2 weeks). She had cold initially. So possibility of lung infection and bronchitis are more as both of them are common after cold. So better to take her to pulmonologist and get done clinical examination of respiratory system, chest x-ray and PFT (Pulmonary Function Test). She mayor nerd higher antibiotics, inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone) on the basis of diagnosis.Don't worry, she will be alright. Hope I have solved your query. I will be happy to help you further. Wishing good health to your wife. 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 husband s penis burns during and after intercourse. He claims he can feel my ID on the tip of his penis and it s sharp. We use KY jelly and other lubricants sometimes, but it seems to happen 9 out of 10 times wether we use anything or not. I also seem to have a bad oder when I get aroused and become wet. He also claims that I have a bad taste sometimes when he s performing oral sex on me. After intercourse, he has to take a shower to wash off my fluids because they continue to burn him. This has been happening on and off for the past several years. He is 47 and I m 43. ### REPLY: HelloThanks for query. Burning of penis during sex and after intercourse that your husband is getting is mostly due to infection transmitted from you during intercourse . It is most likely that you have vaginal infection (Vaginitis). Please consult qualified Gynecologist for clinical and vaginal examination and get following basic tests done to confirm the diagnosis 1) Swab test and culture of vaginal discharge or fluid from vagina. Both of you need to take appropriate antibiotic as per culture report for a week or two . Ensure you clean up your vagina with Betadine vaginal solution twice daily. Ensure to avoid sexual encounters till it heals up completely. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 excess mucus draining down into my throat.  It is very thick while sticky stuff that I have to wipe out of my mouth.   I have had sinus surgery; been check for allergies; use netty pot; use nasal sprays; had my house checked for mold and nothing seems to help.   It is really bad and I have fought this for three years and have had no help.  I have taken several sinus medicines. ### REPLY: Sinusies are always affected by allergy even if you get operated they flare again because you have not treated allergies if you want to cure you consult with allergeologist who will be able to fine allergy and that by desensitization therapy till you get treatment you can use Allegra 120 mg morning and spy portion 1/2 SF night with warm water apply Aureomycin h eye ointment in nose band seawater .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 33 years old female my height is 45 and weight is 58.....my problem is irregular periods and sever hair fall....for which i have been suggested usg lower abdomen...........and it shows my overy is bulky ..right overy measures 16cc and left overy 17cc.......i am not under any medication till now....this problem has started long back12 years ago................i am married for 4 years ...now i want to become pregnant...i want to know what r my chances and what medications should i take to get pregnant soon....my last period was 12days back...but it was scanty. ### REPLY: Hi, Thank you for choosing . Your irregular periods need to be evaluated, you need some basic investigations like thyroid function, Follicular Stimulating Hormone and Routinizing hormone FSH: LH ratio, prolactin level and random blood sugar levels. Husband semen analysis is very important. As your married life is 4 years, you need urgent evaluation. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well. Please do not forget to accept it. Thank you, Wish you good health. .  .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: hello dear doc. its 14 years i feel im gay but i cant tell any one , now im 26 realy every night im cry coz i cant tell any one about that im afred they not accept me like gay person coz my family are muslims and im afred of them .now i thinking too much its 3 week ihave burn in my stomach and ihave somuch heartburn ,i have somuch pain in my stoamch i cant sleep in night day by day i feel im worse , i feel i have Node psychological some time im shoking wheni tolk with may family im afred , pless help me i dont know what to do , ### REPLY: Hello. I can tell you that your physical symptoms are secondary to your stress about your orientation and inability to disclose it. You need to consult a psychiatrist regarding your feeling for two reasonsFirstly, it will relieve your tension by disclosing about it in a confidential and accepting environment. Secondly he can tell you the mean of calming ourselves by therapy and if required medication. Along with that he can assess your level of conviction about your orientation. Once its become clear and you are calm you can deal it more confidently and can divulge it to others. Before disclosing about it, you should be prepared to deal with the expected consequences and to continue in the direction you feel appropriate for 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: When I injected I didn t think I missed the vein. It didn t really burn. It swelled up instantly its been maybe over 24 hours and it is pretty swollen , red and pretty painful.. But it s also stiff but very sore all around. It s hard to stretch my arm all the way out. I ve been tryin to google my symptoms but I ve seen so many different things.. I m not a frequent user it was just recreational stuff. So I have know idea what to expect. What do I do ### REPLY: Hi, I had gone through your question and understand your concerns. Pain, redness,swelling in the arm vein after injection are mostly due to thrombophlebitis. With such case in my clinic, I will reassure the patient telling him that this swelling will fade with treatment. I suggest doing duplex Ultrasound for his arm, Using cold fomentation, also I suggest receiving systemic and topical anti-inflammatory medication, suitable antibiotic, NSAID. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have chronic strong halitosis and my doctor wants to test me for h pylori. ive been to many doctors over the years and nobody ever mentioned this. i saw several specialists, ent, had tonsils out. tested for food allergies. is this something new. i need help ### REPLY: Hello, Read your query, understand your concern see as you have halitosis there is nothing to be worried so much this halitosis can he is due some reasons which include not having proper oral hygiene, .  You can do is maintain proper oral hygiene, properly brush your teeth twice daily, do chlorhexidine mouthwash twice daily, Do Luke warm saline gargle two - three times a day, clean your tongue properly using tongue cleaner. Consult dentist and go for oral examination and oral prophylaxis for healthy gums. Hope it will help you.  If you have further queried I will be happy to help.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I dont know what to do. I was recently bed ridden in the hospital for several days where I did do much with my penis at all. The day I got back I realized the smegma had built up which was the first time that I had ever seen it and several days after, the skin on my leg right next to my scrotum rubbed off as well as the skin on my scrotum. Everything pretty much dried and it still looks rashy though around my leg. I also noticed that the skin on my foreskin( around the part where the phimosis affects it) grew dry. Ive come to realize that it is balanitis. ### REPLY: Thanks for query on . There might be beginning of infection due to Sega collection. It also occurs due to bad local hygiene due to bedridden condition in hospital. Take proper local care. Clean that area with antiseptic liquid, make it . Antibacterial cream on it. It will subside within 3 to 5 days.Otherwise, oral treatment is also required. Also get examined by your treating doctor for proper guidance and medications. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a ct scan that showed white spots in my lungs, I have had a lung biopsy that shows it is not cancerous, they sent me to a exotic infection specialist. they ordered all types of test one was even for aids. I have been with my GF for 4 years and am very healthy and young. are white spots a symptom of aids? also I have a huge anxiety about AIDs i take an anti anxiety medication due to my fear of aids. is this just non sence? ### REPLY: Thanks for your question on . I can understand your situation and problem. White spots on CT scan of lungs suggest possibility of following conditions. 1. Tuberculosis 2.  Fungal infection 3. Bronchopneumonia 4. Cancer etc. Since your biopsy report is negative for cancer, possibility of infection is more likely. And HIV testing is part of screening for infectious disease. So no need to worry about HIV testing. Better to consult pulmonologist and get done broncos copy and BAD (bronchoalveolar lavage) analysis for the diagnosis of infection. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 using skinlite since 2 month s i m not getting a satisfying result. I want to get fair could u please help me and suggests me something more to get fair as soon as possible..make sure the treatment is not much expensive.. Waiting for ur favourable reply... Thank u. ### REPLY: Hi, Basic color of the skin is due to genetic factors. The increase in color may be due to different factors like sun exposure, poor hygiene, internal diseases, nutritional deficiencies and poor nutrition. Complete body check up should be done to confirm that you do not have any disease or nutritional deficiency. Skin lite cream should be avoided as it contains harmful chemical.HY .  To improve color of the face you avoid sun exposure, it causes tanning effect which ultimately darkens the skin. You apply sunscreen gel like sun mask aqua gel. You may apply comic acid, vitamin C and albumin containing cream on the face at night. And cleanse the face with glycolic acid and comic acid containing face wash. You may take glutathione, viramin C and nicotininic acid tab orally for long time. You might feel better after few months. I hope you got my answer. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am an asthma sufferer but it was very miled and hardly i have to take medicine once or twice in a year. but recently a disease named as GERD has develop in me and since then the condition of asthma worsen and i have to take ashthalin inhaler regularly. I s any advive for me? ### REPLY: Hello. Thank you for asking at . I would like to know your age. At present, I assume that you are a young adult or a middle-aged adult. GERD is Gastroesophageal reflux disease, in simple language, contents from your stomach enter esophagus in an abnormal way that causes any of the symptoms like regurgitation, nausea, vomiting, burning in chest or epigastric, etc. Normally a valve (sphincter) is present at lower end of esophagus which prevents this. Due to various factors, this preventing mechanism is disturbed and causes HERD. As you are having asthma, it is important for you to know that: 1. HERD can worsen asthma. 2. Some asthma medications like Stalin, theophylline may contribute to worsening of HERD. So at this stage, I would not suggest taking frequent Stalin inhaler by yourself. Of course, you will have to take when there is an acute exacerbation. From my view, managing HERD is your first priority and it's quite simple. I would suggest you daily proton pump inhibitors (omeprazole or pantoprazole or omeprazole or like) before meals for 6-8 weeks. Also, I would suggest you to avoid spicy & hot foods, all caffeinated .  Please do not eat till full stomach. Also, I would suggest you to have light meals in evening, it will be best for you if you could manage a short relaxing evening-walk after evening meals. Please stop smoking if you smoke. Also, weight reduction will help you if you are obese. Regarding asthma, as your asthma has worsened, I would suggest starting a regular preventer medication (such as inhaled corticosteroids or montelukast) which will decrease your need for Stalin inhalers. Hopefully, if you can control HERD, you will see an improvement in asthma control also. I would suggest you to consult a physician/pulmonologist for managing asthma who will suggest appropriate preventer medicine after detailed history & examination and explain how to use it. Both HERD and asthma take some time to improve, so please take your medications regularly. Wish you a fast recovery and best of the health. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: had a mosaic plantars wart on bottom of foot and surgically removed, hole about the size of a quarter and at least a quarter inch deep still, doesnt seem to be healing after 2 weeks of soaking and covering and antibiotic ointment.  what should I do to help it heal? ### REPLY: Hi thanks for asking question. To heal well wound must be clean with doing regular proper . Take vitamin C containing food more which will fasten healing. Antioxidents are helpful for healing. If you are taking steroid for any condition then stop it. Overall healthy nutritional diet help healing fast. Check about your diabetes condition .as in diabetes wound healing delayed. I hope I have solved your query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 55 and have been under great stress of caregiving for 3 years.  My own health is deterioating.  BP goes from 89/50  to 145/125.  I feel awful when my bp is out of whack  Last night I had the 145/125 spike after an arguement..My chest was very heavy, Pain in my L shoulder area and today woke with a dull fog and lingering headachel  The heaviness in my chest waxes and wanes.  At what point does it get called an emergency ### REPLY: Hello! Welcome and thank you for asking on ! Regarding your concern, I would explain that the heaviness in your chest may be related to high blood pressure. But, I would recommend consulting with your attending physician for a physical exam and some tests to exclude other possible causes of chest pain and uncontrolled blood pressure: - a chest X-ray study- a resting ECG-complete blood count for anemia-kidney and liver function tests-thyroid hormone levels for possible dysfunction- blood electrolytes for possible imbalance-fasting glucose-blood lipid profile for dyslipidemia.  A cardiac stress test is needed to exclude possible coronary artery disease. Meanwhile, I would recommend some tips to help maintain a normal blood pressure: - avoid salt and caffeine intake-perform a lot of physical activity (aerobics, walking). - try to lose some pounds if you are overweight. Stress seems to play an important role in your symptoms. Yoga and meditation may help in this regard. 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: I have MRSA with anti-biotic resistant staff infection.  I go this week for surgery to remove a carbuncle in my armpit.  I have been vomiting for 12 hrs and the first time tasted like pure salt.  I have never experienced anything like that and it was a little scary.  Is this part of MRSA? ### REPLY: Thanks for your query at ChatDoctorMethicillin sensitive Staphylococcus aureus infection is the cause of your carbuncle in your armpit. I suggest if you are getting it removed post surgery send the tissue for bacterial aerobic culture sensitivity tests. You will be started on .  Also get your nasal swab tested for carriage of MRSA which could cause problem in the future. As far as your vomiting is concerned it does not seem to be the part of MRSA infection. Are you taking medicines??? It could be  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 4 year old just came home from the hospital with pneumonia 2 days ago and now I have a horrible cough. My little one says I sound like a sick duck. When I cough my chest gets tight, I can barely get a breath in, and I feel like I m going to pass out from being dizzy afterwards. I do have asthma and was in the hospital with my daughter the whole time. Could I have caught what my little one has? ### REPLY: Thanks for your question on . I can understand your situation and problem. Yes, possibility of spread of infection is high in your case. Asthma patients have higher chance of lung Infection. Since you are asthmatic and your symptoms like cough, breathlessness etc. favors possibility of lung Infection more. Your child recently had pneumonia, and you are taking care of him. Lung infection spreads through .  So you might be infected through your children pneumonia. So better to consult doctor and get done clinical examination of respiratory system and chest x-ray to rule out pneumonia. You may need antibiotics, bucolic and expectorant  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 I was at work today I touched some blood that I didn t know was there after I realized I touched something wet I rubbed my fingers together only to look at my hand and see blood on my fingers. I didn t have an open cut on the hand that touched the blood but I have a scratch on my other hand. I washed the hand first and then washed my hands together. Am I at risk of catching anything? And after washing my hands do I still have to worry about further germs still being on my hand? ### REPLY: Hi, It is very dangerous to touch or get exposed to blood and body secretions. Please take care of this and observe universal precautions in the future. An infection can not pass through and intact skin. As you had no cuts on that hand, so there are no chances of you getting the infection. Cuts on the other hand does not mean anything. The best we can do during such accidental exposures is to wash our hands well with soap and water which you did. 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! My name is Clairissa Silva from Portland Oregon. I have a very important question that seems to have a very elusive answer. I have spent hours online searching, but have not had any luck finding anything close. Before I drop this bomb on your fancy brain, let me paint the whole picture for you......I m a very physically active 36 year old with a high pain tolerance, lots of piercings, and is particularly stubborn about going to the doctor for ANYTHING....Oh... and I like to climb just about anything, but that temporarily got put on hold when I broke my ankle pretty bad in July 2012. I dismounted from a tree about 12 - 15 feet up and landed all my body weight on my right ankle which dislocated it. The talus bone was the force that snapped the ends of my tibia and fibula off during the dislocation process. (I didn t even know that it could do that!) When anyone shows up to the ER with a dislocation, the doctor on board is required to relocate the body part before the onset of inflammation occurs which makes task more difficult with every passing moment. When the time came for that nasty event to unfold, he preformed it without knocking my ass out first due to his observation that I appeared to be in little, or no pain. Because I was currently training my body, and mind to convert any consensual pain into pleasure, you could say that I was having an abnormally good time, and the doctor took that as a green light to make a mistake that later on would eventually bring me to where I am today. Long story longer... The unnecessary trauma, created a fracture blister, so when the foot specialist went to open me up and fix me, he couldn t until it had cleared up. My bones had already started to regenerate by the time he could cut me open to screw in the 2 initial plates, which threw off his placement. Instead of both of the bones reaching out to grow back together, the fibula was bolted down, and secured just a tiny bit too far away from the broken off bit to reach it sufficiently. He had to slice through the same incision, unscrew/remove the plate, create another incision to remove bone from my own heal, mix that with bone from a cadaver to make a putty to fill the gap, drill all new holes, and place a new plate. On top of hitting the reset button on healing time, I had to use a bone simulator machine daily, but the job was done right. I got to keep the old plate and screws, so I have a $1,300 piece of titanium jewelry in my collection which I wear around my neck. Everything healed perfect, except for the skin that covered the outer plate. It always seemed to be irritated to some degree. I could feel the screw heads pretty clearly, and trace the outline of both plates through my skin. Then in April 2013, while working full force as Farmboy landscaper, one of my employees accidentally hit me directly in the ankle with a shovel. The only thing between steel, and titanium, was that fragile skin. A few days later I looked down to see something shiny. Thank God that my actual bones have been long healed, and sealed up or else I could have been in trouble I m sure. I called the foot specialist to get his advice before making any appointments but he was on vacation, so I waited a bit. Metal attracts bacteria like crazy, so being extra cautious has been the norm. I have had a daily routine from the start which includes cleaning, sanitizing, and bandaging. The current amount of plate that you can actually see is significantly smaller than what was initially there. I was even instructed by my doctor to squeeze the skin around it together, then secure it with tape to encourage it to form together. There is virtualy no recorded cases, blogs, entries, pictures, medical forums, or info of any kind at the library/internet, so I m now starting to ask around to the web doc s to see what they can make of it. The 1 year anniversary of being visably bionic is coming up, and without any real issue.Trust me when I tell you that I have more than enough experience with how to deal with metal objects in, and through my body. I ve gotten close to getting critically infected from a handful of the various, and abundant amount of adornments that I ve acquired throughout the years, and had to do some major home remedies that saved the day. I was curious what my risk factors are for getting into some real trouble in the future if I just continue to treat my ankle bling like....well....ankle bling. Thanks for hearing me out! I have tons of pics as well if you are interested in checking them out. Thanks! Clairissa Silva in Portland Oregon ### REPLY: Here is what I understood your problem is at present-You have an open skin wound at the site of your implant which is not healing. The risks are many in case of a gaping skin wound. From cellulitis to gangrene. Have you sought opinion of a cosmetic surgeon for a skin graft? It is not advisable to keep an open wound that wouldn't heal. If possible please upload pictures here to get a clear idea of the extent of your injury. Thank you. ### END