Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I was just worried, I m 16 and just recently I feel my tight and heavy and mild pain in my chest , it hurts a little more when I lie on my back and a lot worse when I swallow food but not when I drink, it only hurts when I seem to expand my chest. Do you think you can tell me the problem? Should I see a doctor? ### REPLY: Hi welcome to . I understand your query and concern. Your symptoms are related to to elevated blood pressure or cardiac dysfunction. This needs extensive monitoring of your heart and eyes through 2 dimensional echocardiography and baselines ECG. The blood pressure in your case needs an immediate resolution in the form of urgent institution of antihypertensive therapy in the form of beta blockers. Complete eye examination in the form of endoscopy will help to document simultaneous changes in the eye. Reduction of your body weight is advisable to weight around 60 kg. Antivertigo medications can be occasionally helpful. A complete 24 hr holder ECG can also be an efficient tool to detect the heart conduction blocks if any. Coronary angiogram with or without stenting is the procedure of choice in your case. Consult an expert cardiologist for further help. Post your further queries if any, 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: hello doctor am karthik am facing problem from hair loss and too much dandruff which was oily and my hair is losing in a pattern from front side can u suggest me to restore my hair lost and to reduce dandrufff.   my friends told that if we use helmet then hair loss will be increased how much is it true can any one give me ### REPLY: Hi, You seem to have seborrhea dermatitis on scalp. There may be flakes on scalp. It is an inflammatory skin disease. There may be some triggering factor. Stress, anxiety,sleeplessness, yeast like mellassazia on scalp.etc. might trigger. It may be responsible for hair loss. You consult dermatologist for firm diagnosis and treatment. I would like to suggest as follows...- apply mild steroid with salicylic acid lotion on scalp at night.- cleanse the scalp with ketoconazole with salicylic acid shampoo alternate days while bathing-tab ketoconazole daily for 2 to 3 weeks-tab biotin 10 mg daily for few months to control hair fall-avoid stress and worries hope this would help you. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 66 year old female with controlled diabetes in tablet form. My blood pressure is normal but today I have been told I have a very high iron count which is making too many red blood cells. I was told to expect it could be cancer and wasnt given any other explanation when iron count taken. I am so worried. Please can you help me in any way. They suggested I may have to have a lumbar puncture and said its not pleasant!!!!!! Thankyou Sandra ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. There are many reasons for the high hemoglobin value. This condition is known as polycythemia. Some people living on high altitude can have high hemoglobin value. So diagnosis of this condition is utmost important. Biopsy is the necessary step require confirming diagnosis. Once the diagnosis is available further management can be possible. I will be happy to answer your further concern, you can ask me on bit.ly/ .  Thank you. ChatDoctorInfectious diseases specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a history of upper back pain and have had lower back surgery.My family doctor wont refer me to a orthopedic surgeon.Now I am being treated for bladder cancer and I am concerned that the upper back pain is cancer.How can I convince my family doctor to refer? ### REPLY: Pain in back (spine) in presence of bladder cancer should be investigated. What is your serum Alkaline Phosphate levels (serum ALP levels). This test is part of liver function tests(Lots) which are routinely performed in patients undergoing treatment for cancer. Serum ALP is also released from bones in case of metastasis to bones. See if serum ALP is high as it may indicate bone metastasis. Was your bone scan done as part of your staging investigations. If not, bone scan should be done in presence of symptoms. Please discuss it with your doctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Alex from Malaysia here...I and my girlfriend having unprotected sex last night and I manage to withdraw in time but accidentally ejaculates a bit into her...she is now 3 week after her period last month...would she get pregnant? and I keep asking her to eat pineapples and papaya until the day she period, would it overcomes the chances of getting pregnant? thx. ### REPLY: Hello dear, I understand your concern. In my opinion the prevention of pregnancy by eating of papaya or pineapples is a misnomer. There is no such thing in modern medicine. The first sign of pregnancy is missed period. Other symptoms of pregnancy like nausea, vomitings, increased urination, sore breasts start 2 weeks after missed period. As per your information a bit of semen was ejaculated, so it cannot be definitely said that it will result in pregnancy. So I suggest you to wait and check for the period. If at all the period is delayed kindly do a urine pregnancy test a week after missed period for accurate results. So relax. Avoid stress. Nothing to worry. Kindly wait and check for the period. The papaya or pineapple increase the metabolism rate in body but there is no evidence that it will prevent pregnancy. Hope this helps. Best regards..., ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 16 mt old grandchild is exhibiting a fiery red rash on trunk and back of neck with some raised welt like lesions that are very transiet. He doesn t seem to be feeling very well - possibly a low grade fever. Question an allergy bur concerned because of West Nile season etc ### REPLY: Hello, I appreciate your concern. What you are describing seems to be a form of allergy, called urticaria lesions which are raised and welt-like. A viral infection (in view of the fever) is the most likely cause. Others could be an allergic reaction to a new food or piece of clothing/bedding (as it is confined only to the shirt area) The rash with West Nile virus will be smaller spots and bumps, which appear after the fever settles, so you need not be concerned.  I would suggest an anti-histamine to help with the rash and itching, it is important that you measure the temperature and give paracetamol if temp crosses 100 F. Hope he feels 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: Okay.  I am 68, Type 2 diabetes, overweight.  Have been having a lot of phlegm in my throat in the mornings for a couple of years.  Over the last couple of months, I have also developed a productive caugh with upper left chest pain that is noticeable, but not severe and usually is relieved whenever I cough up sufficient phlegm.  What gives? ### REPLY: Hi welcome to the  Your main problem is excess cough... I need to know following details... 1. Do you have fever? 2.are you having chest pain and dyspnea complaint?? 3.smoking history?? It might be allergic cough, chronic infection induce cough, bronchitis, bronchiectasis etc... As far as approach is considered work up done as follows... -Above history asked first -Auscultation -Chest x-ray -CBC -if needed spirometry and sputum cytology examination According to cause I can give further comment on treatment Take care Hope your concern solved Consult pulmonologist for examination and discuss all these with him ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 14 year old daughter has 3 quarter sized red lumps on her spine and another lump slightly larger on her shoulder.She says they itch.She has had the lumps on her spine for 2 weeks, the other appeared today. I thought it was a reaction to soap or clothing but now I am concerned. ### REPLY: Hi, Dear thanks for the query to  virtual clinic. I studied your query in full details updated from you. I understood your health concerns. Based on your query data, In my opinion, Dear Your daughter seem to suffer from bed bugs as all the red lumps are on spine and on the shoulder. Itching confirms the insect bite she had, which is causing these spine lumps. History of similar lump 2 weeks back on the spine, is suggestive of bedbug or insect bites and need to be treated accordingly. Hope this reply would help you to evaluate your case and treat it with your doctors in time to come. Hope this would resolve your query and worry and Anxiety accompanied by it. Welcome for any further query in this regard to ME. I would love to help you out.Awaiting any further query. Wish you fast recovery from this intriguing health problem. Have a Good Day. . N.M.S. Genl-CVTS -Senior Surgical Consultant ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 31 year old female married for last 1 year. I am HLAB27 positive and my disease diagnosed is Undifferentiated Spondyloarthropathy since 6 years. I got inflammation attack in 1 knee everytime and was injected local steroid. I also underwent arthroscopy for detecting any other possibility. I was taking Indomethacin-75 mg (ONCE A DAY), Indocap SR-25 mg (ONCE A DAY) and Sulfasalzine 1gm (ONCE A DAY) at that time. Then Methotrexate 17.5 mg/week was started for me. It was started 2years before and then i was perfectly fine. I took it for 1 year and 8 months. I wanted to start my family so i stopped Methotrexate and had plans to conceive after 6 months, so that i am out of its effects. Then i went for all checkups including ESR, CRP, Serum creatinine, TLC, DLC, ALT, AST so as to be assured about my health. But to my misery i discovered that i had raised ALT (198) & AST (168). I showed to a gastro Doctor and i got done Hepatitis B&C. I was positive for Hepatitis B surface ag as well as hepatitis B "e" antigen. I also got done ultrasound which reflected slightly coarsened echotexture & suggested Hemangioma. No antibodies was found against Hepatitis B "e" antigen.  I also got done my Viral load which showed HBV DNA titre to be 7.98x107 IU/ml. Right now i am taking Indocap-75mg and Indocap SR - 25mg, as i do feel some pain in few joints. I wanted to ask you what course of treatment should i undergo for Hepatitis B as I have higher proliferation a Th1 in my body because of Autoimmune response. ### REPLY: Hi.thanks for posting query at .Bag can not be completely eradicated in a patient suffering from Herb.however, complications maybe prevented if proper medication is taken and proper diet plan is followed. Treatment is advised if AST and ALT are > URN and HBV DNA count on PCR is very high. Liver enzymes and Bag status and HBV DNA PCR maybe done regularly every 6 to 12 months, As per your current presentation, treatment maybe initiated. Consult hepatologist or gastroenterologist. Even if HBV DNA count in PCR are not high, Liver enzymes should be monitored regularly while Herb markers maybe checked every 6 to 12 months. Hope to answer your concern. Wish you good n sound 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: The sensation to pee is strong, but cant--saw a urologists today and she says ttha my bladder is empty.  She had a cathether placed and removed because there was no need to keep it in--when does the sensation ends?  I am also stage 5 renal patient expecting to stop, so no surprises, but the sensation/urge--how long til I feel normal? ### REPLY: Hias you are stage 5 CKD patient, the urine output is going to be low and will cease as the disease progresses. The sensation of urge to pass urine when you have no urine in the bladder could be due to bladder spasms. The bladder spasms could be due to cystitis or due to neurological problem with the bladder. First to rule out bladder infection (cystitis) by doing urine routine test and treat with antibiotics. If no infection contact your Doc, to prescribe some anti spasmodic for bladder spasms. 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 am in my 39th week of pregnancy.my edd is 16th nov 2012.since last night am feeling a slight pain in my lower abdomen ,had excessive white thick discharge and pain in my lower pain.there is also change in my walking style..i had a c -section earlier,my elder son is 4yrs old .so are these symptons of normal delivery..have no idea abt it as my elder son was a breach baby..kindly advice. ### REPLY: Hello there. Since you have a history of previous cesarean, and you have completed term (37 weeks), you should not ignore any kind of pain you perceive. Regular Pain of gradually increasing intensity in the abdomen associated with backache and hardening of the abdomen, mucoid discharge from the vagina are indications that you are starting your labor. The outcome of labor whether a cesarean or a normal delivery depends on the progress of your labor in terms of dilatation of cervix and contractions (pain) with descent of the baby. If everything goes normal, you can deliver vaginally even after a previous cesarean birth. You should visit your gynecologist for an internal examination to check if you are in labor. Also taking pains at home in previous cesarean is not good as at times the previous cesarean scar on uterus disrupts with pain. So monitoring by a doctor is a must. Wishing you all the best. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a mole since I was young. But recently I noticed that it has grown a little bigger. It is not round, and it is multi-colored . I am nervous that it may be skin cancer. I think I remember it being like this when i was younger as well, but I am really nervous about it being cancer. ### REPLY: Hi, Thanks for writing in. A mole is an area in the skin surface where there is an excess of pigment deposition. Our skin gets its color from melanin pigment present in the skin. In a dark skin person, there is a higher quantity of melanin produced by the cells on the skin surface. In a light colored person, the melanin produced by skin cells is less. When the melanin is secreted in higher quantity in a particular spot on the skin surface, this gives rise to a mole and there can also be associated increased cell growth. The multicolor nature in a mole is due to the variable concentration of pigments in it. A mole is benign in most cases. However, if it develops sudden increase in size, appearance of hair on surface or pain sensation and ulcer formation then you should consult your doctor immediately. They will scrape the cells from mole surface if required and then confirm if it is a concern. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently delivered a week ago with ceaserian section,indication was hypertension,which has now came down to normal,and high uric acid,it was an emergrncy op.I have noticed that I get peripheral oedema whenever I m on my feet,should I be worried?I m also on TB treatment its the second month. ### REPLY: Hi, thank you for providing the brief history. As you had hypertension and high uric acid levels during the time of pregnancy this could be a post effect of pregnancy and the peripheral edema is possible. Since due to pregnancy there will be change in the normal physiology of the body and the hemodynamics changes due to the fetus. Now post delivery there will be again a change in the physiological process and the peripheral edema is possible. I will advise you to do regular exercises for improving the muscle strength and also some simple yoga will help improve the hemodynamics and improve the circulation. There is nothing to worry as this is a common complaint most females complain post delivery. With simple physical therapy guidance for exercises and yoga your peripheral edema will be reduced. Regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi ,I am 25 years old.I have suffered night fall nearly 1000 days .and have masturbate only 5-6 times till date.My skins are not moisturized as it should be given my age and my skin is not so thick now .Is it the reason for all those night falls.Please answer ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Body produces semen whenever it is sexually aroused. Such semen will be kept inside the scrotum. That is a waste product and should be eliminated. Body has its own mechanism to eliminate the waste product. One way is through night fall. Night fall takes place if you do not masturbate or indulge in sexual activities. You can safely indulge in masturbation twice or thrice in a week to prevent night fall. For your information both masturbation and night fall are normal, and you have nothing to worry. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor I have my result from my blood test yesterday. Then I know from the old doctor that I have hepa since 1999 which I am not aware of it.when I make a test long time ago. And the result from my SGPT Is 18.62 and my SGOT is 21.65. What does it means? Do I have my hepatitis B worst? And what is HBSAG - reactive? And what about my Anti-HBS (quanti) result is 2.00 - cut off value 10.00 mlU/ml - nonreactive. Is my health getting bad? Pls help me it effects me a lot:( I thougth it s for free sorry I can t pay and I don t have credit card or anything.. YYYY@YYYY ### REPLY: Hi, Thanks for posting your query. You have presently normal GOT and SGPT. These two enzymes indicates liver status. These two enzymes originate from liver. Out of these two, SGPT is very liver specific. You have positive Bag, and it indicates that you are suffering from hepatitis B. Though you have hepatitis B but normal GOT/ SGPT indicates dormant stage of hepatitis B and you don't need any medication right now. Anti-HBs shows immunity level after vaccination by hepatitis B vaccines. Anti-HBs must be above 10 mid/ ml. You should also get for hepatitis B vaccination, if not done previously. You should go for regular check up with regular GOT/ SGPT analysis every 6 months. 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 there, I was just released from the hospital after suffering a grand mal seizure and then consequently being diagnosed with alcohol is hepatitis . I have stopped drinking (the wake up call was dramatic, I split my head open and needed 18 stitches), but in the last few days have been experiencing terrible ankle pain. Luckily, one side seems to be getting better, but the other is so bad I am using a wheelchair around my apartment. I have several friends who think this is gout , but I think it relates to the liver . WHat do you think? ### REPLY: Dear Trevor, liver has very important role in many biological processes. Your symptom could be related to your hepatitis problem, but it can also be a problem for itself. I don't know the degree of your liver failure, but there are at least 2 factors which can effect on your ankles. The first one is a higher possibility of infection and second one is a Hypoproteinemia. Those two disorders cause swelling and infection of any part of the body including ankles. Also, I'll mention some condition which are not related to the live: tendinitis, arthritis, stress fracture, rheumatoid arthritis and gout of course. You should check your rates blood level to rule out gout.  Check your liver function frequently and forget the alcohol...it can also worsen your epilepsy.  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: now I am 20 years old and I am in the habit of handshaking of penis for 6 yrs. I am very thin [height : 168cm but weight : 48 kg]  also I hand shake my penis once in every 15 days. Is it dangerous for my health. please advise me what should I do to avoid this habit. ### REPLY: Degree understand your concerns went through your details. I am surprised you masturbate only once in 15 days, and you call it a habit. Masturbation is normal and is natural and not all all unhealthy if you practice it moderately. Adolescent people at your age masturbate every day, and they do not have any healtChatDoctorplaints. You should stop worrying about this. Your underweight could be due to nutrition deficiency. You could consult a physician to rule out any physical problems, and then you should take proper nutritious diet for improving your health. If you still need my assistance in this regard, please use this link. http://goo.gl/aYW2pR. Please remember to describe the whole problem with full detail. Hope this answers your query. Available for further clarifications. 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: Thanks. Just got blood tests back with elevated AST and ALT scores. ALT 102 and AST 126. My doctor is confused. Suggested I have an alcohol problem and I do not drink but maybe once a month. Just beer and usually only one at a time. These levels are elevated from my last physical 3 years ago, when they were in the normal range. I have had some strange knee pain and tight neck pain in the past 2 months that I have never had before. Persistent for the past 2 months or so. I am a male 52 year old, former pro soccer player. Thoughts? ### REPLY: Hi thanks for asking question. Here you have elevated ALT and AST, suggestive of liver disease like hepatitis. Here possibility of chronic hepatitis or carrier of Bag has to be ruled out. For that viral markers are useful. If Bag positive more than 06 months than chances of carrier is present. If hepatitis is present viral markers will be elevated. If still cause for hepatitis unknown then liver biopsy can be taken according to patients examination. Second here neck pain and knee pain may be because of some bone condition like osteoporosis or arthritis related changes. You should check your vitamin D and calcium level, if they are low calcium and vitamin D supplement needed. Take regular milk. If you are obese weight has to be reduced. Regular light exercise helpful in arthritis related change. Knee x-ray can be taken to search for pathology. I hope you will understand my concern. 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: On the side of my right foot I have a bump /lump that I ve had for the past few years. I recently had a kidney transplant in April . The lump does not hurt to stand on it . It is sensitive when i roll my foot on a baseball ( for example ) . My pedicure lady has recently started questioning me about it. I m wondering if I should go to my foot doc. I am a type 1 diabetic also ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You may have some soft tissue tumor like lipoma or neurofibroma or may have some cystic lesion. You should go for fine needle aspiration cytology or excision biopsy of that lump. Go for that and then take treatment according to your diagnosis. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I am only 19 years old but my blood pressure tends to run really high. It generally runs around 150/100. I also have been having a lot of headaches lately and dizzy spells. I won t be doing anything and I will out of nowhere feel intense dizziness and vertigo for a few seconds, and then it goes away. This happens at least once a half hour. I m not overweight. What do you think? I m trying to get into the navy, so I don t really want to go see a doctor about it until after i get in, but I don t know how serious of a problem this is or if it can wait that long. I do have a history of high blood pressure in my family. ### REPLY: Sellotaping into account your family history of high blood pressure and your current symptoms, I think you really need to see a cardiologist as soon as possible. We should rule out cardiac issues first. Perhaps you might have inherited heart defects since birth which are giving symptoms at this point of life. I am really sorry you need to see the cardiologist as soon as possible. Should correct the high blood pressure. Even if you go in navy, they will check your blood pressure. If they find it high, then they will ask for cardiologist appointment. Hope you'll do the right thing. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 dentist which suffers from halitosis. As far as I know I have no dental/oral problems and I guess This bad smell comes from my stomach. I have this bad smell generally during a day, it decreases after meals and increases after stress and empty stomach. What to do? What is cremadiet powder and can it help me effectively? Thanks a lot ### REPLY: Hi;Welcome to ;Oral Balfour in your case might be is due to gastrointestinal problems or acid reflux. As you have mentioned your symptoms oral MAL odor in empty stomach or stress is mainly because of acid reflux or hyperacidity that gives acidic mouth odor. Creamadiet powder is nothing but Isabel fibers which is used in management and treatment of constipation. So treating constipation it may help to reduce the mouth odor. But creameries has side effects like flatulence; bloating; intestinal obstruction so I would suggest you to consult a physician before using creameries. I hope this helps;Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have swollen glands under my jaw. I have had them for over a year. Sometimes they hurt more than others. Urgent care doctor did mono culture and showed negative. Wanted me to go to primary for blood work. I had an ENT check last year and said thought the little node on the right side infer jaw was because of stones and told me to drink more water. What do u think? Could the nicotine from my vap cause this. ### REPLY: Welcome to  .1. Sub mandibular swelling, occasional pain - suggestive of sailoadenitis (salivary gland obstructions due to stones / stricture.2. In this case if you are my patient - I would have examined first, and ask for an ultrasound neck and submandibular region - helps to find out the nature of the lesion, origin and extensions. 3. Other possible causes can be lymph nodal engagement.4. Take an appointment and get the needful test (ultrasound) done.5. Nicotine do cause intro oral causes of obstruction - strictures and so on. Hope it helps you. Wish you a good health. Anything to ask ? Do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 38 weeks pregnant and had my bottom left wisdom tooth removed 2 weeks ago. I was prescribed antibiotics but never took them. This week my bottom right side (gums) were throbbing so I took the antibiotics thinking it would help. The pain is gone but now my gums on the lower right side are itchy terribly. Could it be the antibiotics? ### REPLY: Hello, It looks like there is infection in the gums that has caused itching due to inflammation. Many a time there is inflammation of the gums in pregnancy that is due to hormonal changes and the condition becomes worse if there is infection and deposits in the gums. You should consult an oral physician and get evaluated. For now, you should do:- Warm saline gargles-Do ice packs over the gums-Avoid spicy and acidic foods-Massage the gums with Chlorohexidine gel but do not swallow and keep spitting 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: I have been having lower abdominal cramping only throughout the night its not very painful but uncomfortable enough that it keeps me up at night. This cramping is associated with lower back pain and i have been staining throughout this time. What can this be? ### REPLY: Hi. Thanks for your query and an elucidated history. Cramping in the lower abdomen only during the night, enough to keep you awake with backache and staining through-out this time can be due to mild for of hemorrhagic, which you may not be noticing due to being busy throughout the day. I would advise you to have a direct examination by a Gynecologist and have abdominal and per-vaginal ultrasonography to get a proper diagnosis. Proper treatment would help you. IF required the curettage and biopsy may be needed to rule out cancer of the uterus. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 42 year old healthy female and  have experienced a  severe sustained increasing pain in my upper right side abdomen in the past few days, I shift positions and that helps but the pain does not seem to go away. I was hoping it was gas or diet related so I kicked up fiber intake to flush my system and notice black pellets in my stool today with  no blood present and I am in less pain at the moment, what does that mean ? ### REPLY: Hello! Welcome to . Right upper abdominal pain suggests gall bladder related pain. As you said black pellets, there can be occult blood positive if you do stool exam for it. This can be due to bleeding somewhere in upper gastrointestinal tract. This can also be due a stone in ureter causing obstruction to urine outflow. In my clinic, many such patients do come to whom I advise ultrasound abdomen & pelvis, urine & stool routine, CBC. Treatment is done accordingly. Hope this information is useful to you. Wish you speedy recovery. Thanks. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 42 year old male. I am a healthy adult. My blood work came back recently and it was normal, but I am experiencing some odd symptoms. For some days now I have been noticing my body twitch infrequently. It mostly happens when I am falling asleep, or relaxing, but sometimes it happens when I am wide awake. I have also noticed some sharp pains on the surface of my head. It only lasts a couple seconds. I cannot figure it out. It doesn t seem to be a serious problem, and it doesn t interfere with my daily activities, but I thought I would ask you anyways in case you have some insight and to stop it early. ### REPLY: Hi, Oddly enough, twitches and pain on the head matter tremendously on where on the head they occur. At the back of the head is most common, and it is due to nerves in the top of the neck being affected. x-rays of the neck usually show the problem and a neck brace alone often helps, but surgery might be indicated. Twitches in the front of the head which people would say "face" are somewhat psychological and various nerve pills work. On top of the head is quite uncommon. Local nerve or skin problems might be the cause but frankly, I have never seen anyone with that problem. There are of course local nerve endings. They go in a short path into the brain. A brain scan might actually be indicated. 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: My daughter was bitten by a dog that has been vaccinated for rabies. The wound was cleaned and it skin was bruised and it healed and she has only mark where the tooth cut the flesh. She is healthy last 5 months since bite, but it ithces some times. What must I do, or is it nothing ? ### REPLY: Hi, I understand your concern.  Your daughter has occasional itching over the scar of a dog bite, It can be due to possible scar condition called scar-where it overgrows to form a thick scar. If there is no such thickening till now - - Avoid itching at the site, for itching stimulates keloid formation.  - Apply steroid ointment, If it does not stop itching, & starts thickening, injecting steroid at the scar site/ excision of keloid (by external beam radio therapy/ Cryotherapy) is the last resort for it. Consult a surgeon for that.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have concerns regarding my hair.. hair fall has increased a lot and at some of parts even the scalp is visible and the hair is not growing there..scared that i may get bald head soon.. what do u suggest to get for hair growth in the area where it is not growing now ### REPLY: Hi!! I understand your concern regarding hair loss, but we first need to find out the cause and then treatment can be started accordingly. Common causes I have encountered in my patients are male or female pattern baldness, hair loss due to thyroid disorders, anemia, any long ailment or intake of certain medicines. You will have to undergo certain tests like serum iron, TSH and serum ferritin levels. The treatment can be started once we are sure of the cause of hair loss. Hope this has 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: Hi, for many month I have been telling my pcp that I do not feel well: specifically extreme tiredness, extreme constipation despite ever effort to correct, very dry skin, extreme sensitivity to cold and being cold all the time, severe leg cramps especially at night, the wrist clinical depression I have ever experienced in my life. Yes I have been under EXTREME stress since since 07-13-2013 when my beloved husband cast me out of our home that we build together over a 20 year period because I was too sick & sad & not getting better we were married fore 27 beautiful loving years, he demanded a divorce, sellin our house and sending me away on 07-13-2013 to from VT to Ny to be near my father but my father got sick that slept in 2013 & and later died of cancer on 0314-2024; I cared for him with hospice help as he died. I moved into a small house a few mikes a way from my father because him he would not allow me to live with him, which really hurt. Then my little kitty died 08-15-2014, she was only 3.5. I trigger with my health in general but the last year+ has been extreme stress and emotional agony over loss of spouse. I have chronic pain, from a spinal cord fusion back in July 2005 that went very bad, have had 14 kidney stones from 2008-20011 & a botched lithotripsy where they accident lot spot pulses through my body, verses target kidney stone in July 2011 cause many damages to layers & tissues & organs in body, along with an MRI a few weeks later with contrast dye that my body could not get rid off so I end up with severe galladium radiation poisoning at a level measured to be 100000 times max level ( I was so sick) then a few weeks later I provisioned with isovue ( radioactive iodine) during some kind of X-ray, this caused me to get bad neuropathy in fingers nd especially toes. I have a long standing thyroid condition, hypothyroid hosimoto thyroditis ( sp?), but it be well controlled, even thru fall of 2013. I write to you because I beg pcp to check me because I feel so bad, he say no until 11-04-2014, then agree to check a few labs. By now I am feeling so bad it is horrid. My tsh is 140, my t4 is 0.48, my GFR is 36, with very high cholesterol& triglycerides ( in upper 300 s both ) my BP is high 160/120, pulse 60, temp around 97.4, I have ever increasing esophagus spasms with worsening acid coming into mouth all the time since last fall. Dr said to increase my synthroid from 1/2 tab to whole tab which is 0.075 mg daily, which I did on 11-07-2014. I do not feel any better, I actually feel worse & start to have micro burst of very intense heat just lasting 10-20 seconds but very vey severe, immediate followed by bone chilly cold. I have moderate continual flank pain. My liver fund Cation values were not good either. I feel I am in trouble but pcp wants to wait 4-6 weeks to recheck va,use, I am not ok with this as I feel worse not better, ,I ve alone and do not know how much more I can handle. 1) What do you think might have caused tsh to get to be so, given I taken my synthroid faithfully same way for 15+ years? (Stress). 2). How do I recover ASAP from this as I live alone and can not endure much more, waiting weeks to see I I am headed in right direction seems wrong given I feel so bad. What is protocol for cases like mine that are a bit complicated. I take a large menu of meds to control ago keying spinal cord pain. Current pcp yanked me totally off all supplements last week, each one which had been carefully selected to help me for a specific reason, ie mg glycinate for leg cramps, iodine to help thyroid. Also my vit was very low but I was taking 5000 iu daily in a special blend with A. & K in it to help absorption., but I am not aborning much of anything well. Also because of spinal cord injury intestines do not peristalsis correctly, big issue. Any recommendation would be appreciated, as I am failing on all fronts. Respectfully, Brenda ### REPLY: Dear brands, from the history of your events in life it appears that you are having defense stress in your life. The cause being multiple health related and stressed life events. As I figure our aim at this stage is to minimize the stress and develop coping abilities to deal with it. At present you are suffering from clinical depression secondary to various medical conditions. The cure of this depression is the cure of underlying disorders. However, a course of anti depressants will definitely help you along with sessions of stress reduction techniques. My advice is start a course of anti-depressant like SSRI for adequate duration of 6 months. And regular sessions of stress reduction activities. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have just discovered a small lump on a dimple on the small of my back. It moves around easily and causes me a little pain but not too much. Im just beginning to get over a bout with severe constipation and have been having digestive problems lately along with back pain. Could I have cancer? ### REPLY: Hi, Dear,thanks for the query to my - virtual Clinic. I studied your query in depth.IN My opinion -it is mostly-a nevus or wart with a peduncle. I would advise You not to worry as an indication of Cancer by any means. Still if you have obsession for cancer-excision biopsy from a Surgeon would resolve your issue. Hope this would resolve your query. I would love to help you for more queries. 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 right arm has a rash and is warm to touch it is also a little swelling I don t know if I have insect bites I thought it was mosquitoes bites because it really itches a lot what can I can I put on nothing seems to help I have tried benadyrl and nepsporin ### REPLY: Hello dear, The rash in your right arm can be either due to insect bite, dermatitis or fungal infection (Tina) in that region. Management includes:1. Keeping the area . 2. Antihistamine preparations like cetirizine to reduce the itching sensation & provide symptomatic relief.3. Application of topical antifungal cream like Clotrimazole or Fluconazole to tackle the causative organism.4. Topical antibiotics to prevent secondary bacterial infections. If symptoms still persist or aggravate further, then it will be better to consult a Dermatologist & get a proper examination done to find out the actual cause. So that appropriate management steps could be taken. Also avoid wearing tight clothes, as it will cause sweating & predispose to fungal infections. Wishing you a Good Health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi......iam priyanka 24 years .......from my young age i was not doing any kind of physical work i was just hooked to reading........and now from past 1 year am slowly working a bit....am doing tread mill walking ....i do it just for 30 mins......for 1 month i did only upto 5.8 speed.....after 1 month i walked at 6 speed for just 10 mins and then slowed down.......now my problem is am getting abdominal pain .....like when i walk my abdomen is aching like its gripping effect and when am sleeping and jus twist my abdomen its like my abdomen muscle is aching and also my thighs are aching........also my hips and back are aching......even when i jus cough my stomach ie abdomen aches.. i have done all test stomach scanning ,x ray,blood tests and all...my ESR range is 75 and every other tests are normal...........please tell me whether shud i continue walking r stop it........thank you all... ### REPLY: Hello, Priyanka Dayanandan, I am reallybglad that you have gotten into work-outs! In the long run, this will be very beneficial to you and makes you healthy and strong and leads to long life. The symptoms that you are experiencing are very typical for someone who has been inactive for a long time. What I suggest is that you do your workouts three times week resting in between.The some nice warm tub baths if you can after your workout. Elevation of ESR is from activity. I would not worry about that. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a friend that was in a car crash about 11 years ago and he is disabled and has mental health problems plus health problems where he can now walk again but where he sometimes need a can or his powerchair. he has bladder problems with momery problems sometimes he has forgotten to change himself where i had to change him or he remember later. when he does end up in the mental health hospital i dont know if they help change him when he forgets because i dont thinking he tells them he forgets he has that problems. and i think its because of his car crash. and there other problems where he blacks out and wants to jump out of his clothes i got him some clothes like jumpsuits with zippers on the back where he cant reach. to help keep his clothes on. but i dont know what the hospital does when hes in the hospital i know he has bipolar and alot of depression and i think he hears things. but i dont know much but help him from time to time because im a close friend what can we do i know he need a mental hospital more then being on his own or being in a nursing home or group home. he will not like it there but he needs it. ### REPLY: HAI agent001ck, In this case salient findings are accident 11 years ago with residual disability memory disturbancesprescence of mood disorder Kindly understand if your friend had brain damage and dysfunction following that too remaining for about 11 years then he needs to go for Euro Psychological Assessment.following which he will be given some excessive which will gradually make him better than now. Also in this case memory disturbance may be due to Psedodementia because of underlying depression. If so by treating Depression his memory disturbance will vanish.  So I suggest you to Meet the nearest psychiatrist to evaluate your Memory disturbance. Also ask for NeuroPsychological segment to diagnose also for prognosis. I wish him to get better Physically and mentally ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Having difficulty taking a deep breath or yawning but have frequent urge to take deep breaths, chest feels tight for past two days. Toda having light headed ness, tingly in extremities, dizziness. What could the problem be? I am 26 year old female no Health hx on no medications. ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. In my opinion you are having anxiety related symptoms. But better to rule out pulmonary causes for your symptoms. So get done chest x-ray and PFT (pulmonary function test). If both are normal then no need to worry much. You are having mostly anxiety. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. Avoid stress and tension. Be relax and calm. You may need anxiolytic .  Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I significantly bruised my lower left abdomen the other night. I tripped over a folding chair, causing it to fold into my stomach. It is causing me pain two days later and I was wondering if I should be concerned of any possible internal damage I may have caused. Thank you! ### REPLY: Hi, I value your concern regarding the symptoms. I have gone through your symptoms, and in my opinion if you have no problem breathing eating and passing flatus, rest in piece, and let the injured abdominal wall heal, if you want to be sure I would recommend you to get a USG abdomen done. 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. Special note-Any medication prescribed needs to be taken after consultation with your personal doctor only. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering with throbbing in my head for 3+ years,also my head is tender to the touch but not always in the same place also I become red and flushed in my face and neck and also hot to the touch,I have been told I am suffering with chronic daily migraine,but medication I am on is doing nothing and it has steadily got worse but my own doctor still insists that it is migraine. ### REPLY: Ur doctor is correct. Most likely u have headache of migraine. Sometimes it may cause redness of face or watering of eyes. Try tab Topiramate as prophylaxis. It has very good efficacy and few toxic effects. Another possibility is Trigeminal autonomic cephalic. It responds to tab indomethacin. Consult your neurologist and discuss in detail about headache character, frequency and associated features. It will help to formulate diagnosis and treatment.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 am kindney patient and having a HB 11.40, Cholesterol 118, Calcium, Serum 9.50,phosphorus, serum 3.50, Urea 72, creatinine 3.49. Please advice me the diet and if possible the medicine may please be intiated to me. I am under treatment of Dr. Mahaptra, Nephrolgist, Dr R.M.L. Hospital, New Delhi. Please send me the reply on my email nandapradeep2010@hotmail.com I am very thankful to you in this regard, nandapradeep2010@hotmail.com ### REPLY: Your reports are quite acceptable. With a creatinine of 3.49 your kidney function is about 25% to 30%.  You have to come to terms that CKD cannot be reversed. However, you can prevent additional stress on your kidneys by avoiding unnecessary medications, except those being taken in consultation with your nephrologist. Especially avoid painkillers easily available. A balanced diet - low fat/ low salt/ avoid red meats/ fluid as per your output (The best guide is your doctor). Remember Don't try any magic remedies. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, Ive noticed recently that my corona on my penis has a ring around it that is lighter than the rest of the head. The skin looks more wrinkly than the rest of my penis and the discoloration extends about 2-3mm towards the tip of my penis. Any ideas what this could be? ### REPLY: Degree understand your concerns went through your details. Please don't worry about the discoloration if it did not have other symptoms like itching, burning etc. The shrinking of the penis head skin, could cause such a discoloration. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. 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: Im currently on the birth control IMPLONON and have been for a year. I havnt had a period in about two months. My last one was very heavy. I think im starting my period but its tinged pink very lite. I had unprotected sex a week and four days ago. So im not sure if what im having is implantation bleeding. ### REPLY: Hello, Thanks for letting us know your health concern. It is often usual to experience irregular menstrual pattern while on hormone contraception. This is due to the altered hormone balance. However, this occurs during the initial couple of months until the body adjusts to the new hormone milieu. In the current scenario, you have to exclude/confirm pregnancy, though the chances are remote. Please get the blood test done and follow it up with a pelvic/trans-vaginal sonogram to clarify the situation and plan further management. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Just finish my period on the 13th it came on th 9th. And I was 5days late. And after my period am having lower back pain with cramp like period. Very annoying pain. And my my flow wasnt very heavy like it use to seem like it mixed with water light period. Pls help me doc. ### REPLY: Simply anemic and exhausted you are. Iron rich diet and some hot water fomentation over back will help. Occasionally may take analgesic tab but pl don't make it a habit. In Ayurveda Rohitakaishta + Dashmularishta + Lhasa in equal proportions will bring happy hrs back within two weeks to four weeks. It is safe and no side effects. May see Ayurveda doctor to get more guidance. Hope you get the hint to decide better. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 trying to get pregnant and I have just received my Pregnyl injection last March 24 which was the day before yesterday. I took Progynova last night as prescribed by my doctor. However, I am a bit worried about it because I read in the leaflet that came with the medicine that Progynova should not be taken by pregnant women. The doctor said I m fertile on the 25, 26, 27th and 28th of this month so I should try to get pregnant by then. I m also going to be taking Progynova on those days. What if I get pregnant? What will be the effect of Progynova to the baby? Thanks so much! ### REPLY: Hi there, I have understood your concern. I will suggest you the best possible treatment options. 1. First do not panic. Please fully trust in your treating doctor .2. You might be aware that organ formation of the baby starts 28 days after the conception.  Your doctor must have given the progynova tablets for 15 days from ovulation. Progynova tablet is an estrogen hormone tablet.  This is to provide good endometrial lining for the implantation of the embryo.  It's well before organ formation.  So please do not worry. I hope this answer helps you. Thanks. May God bless you with a bundle of joy.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 18 and have recently found in my groin that I have a swollen glan, its not a massive lump but I can definetlty feel it, its a little sensitive to touch but not massivley painful at all, i think i am suffering from hayfever or possibly a cold, could this cause my glans to swell? Thanks! ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have enlarged inguinal lymph node.  Mostly it is due to some infection and reactive hyperplasia. You should go for a course of antibiotics. If it doesn't respond to treatment then biopsy diagnosis is advisable. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 2 days back my mother suffered a 220/136 level of BP.She has been taking BP medicine(amlopres 5 mg) for the past one year but had not had such a high BP level ever(last high was 180/100 4 months back).Plz suggest what could be the possible reason behind this ? ### REPLY: HiT hanks for your query. Based on your query, my opinion is 1. Uncontrolled hypertension can be due to undetected high lipid/ cholesterol levels/ being irregular on medications/ sedentary lifestyle/ unhealthy dietary habits.2. In your mothers case, it needs to be controlled immediately with additional medications as high blood pressures can cause serious cardiovascular and cerebral complications.3. Once it is controlled, the cause for not responding be evaluated and necessary measures taken.4. She needs to make lifestyle modifications along with taking regular medications.5. If you have not checked her sugars, get it done to rule out diabetes mellitus as diabetes can complicate pressures due to vascular complications. Hope this helps. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My Sister-in-law was diagnosed 4 months ago with squamous cell carcinoma of the lung with metastasis to the humerous and pelvis.  She presented today with a bilirubin of 15, but her liver enzymes are normal and there is no biliary obstruction.  Over the past year, she was having a problem with anemia for which no one could find a cause.  Could her elevated bilirubin level be related to some sort of hemolytic anemia leaving an increased amount of bilirubin in the bloodsream? ### REPLY: Hi & Welcome. It is unfortunate to know that your sister-in-law is diagnosed to have squamous cell cancer of the lung with bone metastasis. Based on the history given, she seems to be suffering from hemolytic anemia. It is a form of anemia due to hemolysis, the abnormal breakdown of red blood cells (RBC's), either in the blood vessels (intravascular hemolysis) or elsewhere in the human body (extravascular) resulting in increased formation of bilirubin. She needs to be evaluated by a hematologist or physician for the proper assessment and treatment of anemia which may involve blood transfusion and certain immunosuppressive . Hope this will help her. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, here i started masterbuting from the age of 16 now am 29 yr stl am maserbuting daily once r twice i came to knw dt my dick got shrinked & usualy i use to rub it on bed while sleeping till i get to satisfy. now my parents forcing me to get marry, but my girlfrnd  weight is 94 & my weight is 70.can i satisfy my wife?is dr any problm to make her pregnant?please ans me ### REPLY: Thanks for contacting  with your medical questions. I would like to congratulate you on your upcoming wedding. Your penis size change is not directly caused by masturbation. The size of your penis is genetics and can't be changed. You should have no problems performing sex with your new wife, and you still have a very good chance of getting her pregnant. I would recommend that you reduce your masturbation because excessive masturbation will reduce your overall sperm counts. Hope I answered your question. Please feel free to contact us again for you medical concerns and questions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor, sorry for this lame question but i had the filling of my molars when i was 10 years old. The filling was a black colored filling. I m quite uneasy with that and so i want to know that is there any kind of strong white filling( i also had my incisors filled with a white filling after they broke in an accident but the filling break off). ### REPLY: Dear friend. Thanks for sharing your concern. Black filling that you are taking about could be traditional silver amalgam filling. Today in advance dentistry there are many more newer materials added, which can fulfill all requirements of a good filling, both in strength and aesthetics. I would suggest you to visit your dentist and get an appropriate filling done for your tooth. I am sure both aesthetics, and strength will be well taken into consideration. Hope it helps.thanks.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: Around the age of 10, my daughter started experiencing nausea, dizziness, back pains, stomach pains, and headaches.  She is always freezing.  Since then, the doctors have told her it was all in her head.  She spent a year on antidepressants, but all symptoms stayed the same or were worse.  She had her gallbladder out at 15.  She is allergic to most trees, grasses, animals, etc.  She is now 20, and her symptoms have not lessened.  We also went to a homeopathic doctor.  He put her on 20 vitamins, but that is hard to swallow.  Her hair sample showed zinc levels off the chart.  She is currently on thyroid medicine.  We are seeking a doctor that believes she has an actual issue, such as autoimmune... Any ideas of what could be wrong? ### REPLY: I feel for your daughter. On the other hand you have done best in allopathic and homeopathic. I would suggest to my own patients to get Ayurveda treatment support by visiting an Ayurveda doctor who could find body type of the patient (which probably is vat Pitt type) and select medicine accordingly. It would be a long term herbal therapy but no side effects. Totally safe. The worst would be that it would not affect much. Then you always have the choice to leave it. Initially no need to stop anti depressants and thyroid med she is taking currently. Ayurveda doesn't counteract. If she could learn Yoga and Meditation for 35 minutes, it would change her life and would be visible soon. Hope it helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I am 43yr Caucasian female and 84kg, badly anemic and generally feeling tired - otherwise health is ok.My dad died of stomach cancer at 52 (other organs were effected and he died within 3months of diagnosis) and now my mum has colon cancer (stage-3), - am i a high risk? Thankyou for your time ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Colon cancer has proved genetic cause, and it is hereditary.  In stomach cancer few are hereditary.  So overall you have chance of GI cancer.  You should go for regular colonoscopy and CEA level to rule out possibility of cancer. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m waiting to hear back from my PCP at this time. I have a horrible constant pain in my back - left side, under shoulder blade towards my side. It s gotten worse over the past few weeks. It s much worse in the morning. I also cough up frothy, white phlegm in the morning but at any time throughout the day! If I laugh hard or overexert myself I have a coughing fit as well. Any suggestions just to calm my nerves? I came upon this site on accident, but glad that I found you. Thank you much. ### REPLY: Thanks for your question on . By your description of pain and cough, I think you are having pleurisy (inflammation of pleura). Pain on coughing with expectoration are symptoms of pleurisy. The causes of pleurisy are1. Pneumonia2. Pleural effusion. 3. Tuberculosis etc. So get done chest x-ray to rule out all these. If x-ray is normal than mostly you are having muscular pain. Try to follow these steps for better symptomatic relief. 1. Avoid heavy weight lifting and strenuous exercise. 2. Avoid bad postures in sleep. 3. Take good painkiller and muscle relaxant. 4. Apply warm water pad on affected site. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have not had my wisdom teeth taken out yet and I just noticed a hole in the back on my gum and it has turned black. What is this? I am also pregnant and I noticed another doctor said to another person it could be caused by hormonal changes. Is it because I am pregnant? ### REPLY: Hello, Thanks for consulting , Read your query, as you have hole in gum it can be due to the eruption of wisdom tooth or due to your wisdom tooth is carious that why it turned black causing gingival inflammation secondary to personal abscess or this can be pregnancy induced gingivitis also. For this I will suggest you to consult dentist and go for oral examination, and as you are pregnant dental treatment is possible in second trimester of pregnancy. In meantime you can do warm saline rinses, maintain proper oral hygiene by brushing and do regular mouthwash. Hope it will help 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: im 28 yrs and my doctor advised to take fertyl-M 25 mg from day 5 of my period till the day 9.for how many days need to be in physical relationship.will it works.am i able to become pregnant?in how many days after using this tablets i may conceive.plz reply me soon. ### REPLY: Hallow Dear, Fertyl-M is a Camphene citrate product. It is given to induce ovulation in women who fail to ovulate normally, but have sufficient ovarian reserve of the follicles. You are very rightly taking these tablets for day 5 to day 9 of the cycle. After day 9, you should ideally submit yourself for ovulation monitoring by ultrasonography. It has got two advantages:1. You can locate the day of egg release (ovulation). Thus, you can plan your sexual intercourse accordingly. The egg has a life of 24 hours while the sperms are active for 72 hours. Hence, from just before the day of ovulation daily or alternate days' intercourse is advised. 2. Ultrasonography will reveal at what size did the follicle ruptured to release the egg. Eggs released for the follicles between 18 mm to 21 mm size are the most healthy eggs, and they have high chance of successful pregnancy. 3. Also, ultrasonography measures the thickness of the endometrium (uterine lining) at the time of ovulation. Endometrium of 9 mm to 14 mm thickness is most conducive for implantation of the fertilized ovum. Alternatively you can locate the day of ovulation by home kit. However, it has limited advantages. Considering these facts, you can plan the days of intercourse. In short, utilize the day of ovulation and then have sex at least on alternate days for next 3 days. If you do not want to go for ovulation monitoring at all (which is not advisable), you may start the intercourse 4 days after the last tablet of Ferry and continue to have at least alternate days' intercourse for next week. I hope this helps you.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was on Zocor.  Had a blood test after a couple of years and found that my ALT ans AST were 125 and 150. Had an ultrasound of the liver and was diagnosed with Grade 2 fatty liver. Stopped Zocor. ALT and AST went to 24 and 31.  Had another ultrasound 9 months later. Still have fatty liver grade 2. Any connection here between Zocor and fatty liver? any suggestions? ### REPLY: Brief Answer:NORMAL liver enzymes with fatty liver. Detailed Answer:Hi. Thank you for posting your query at . Zocor may have caused the deranged liver enzymes but NOT the fatty liver.advise:get following blood test:1. Viral serology - anti HAD, Bag (if not vaccinated against HBV), anti HCV2. "Lipid profile"You may visit hepatologist. Get the blood tests done asap. Further advice:- abstinence from "Alcohol" - LOW fat diet should be followed, AVOID junk food and beverages-decreased oil consumption (oily food)- NO red meat-green vegetables should be ingested daily-use lemon juice (lemonade) once in a day-reduce weight if overweight/obese-"recheck liver enzymes after 6 to 8 weeks" and/or ultrasound. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good and sound health. Any further questions are welcomed. Regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 1 yr old son has been vomiting off and on all day. I put him to bed like normal he then woke up 2 hours later screaming. I went to his room and he was standibg in his crib. I picked him up and craddled him to get him back to sleep and he pucked a little over a cup of vomit. i cleaned him up and seen there was about a cup of vomit in his crib. i took him to the couch to comfort him and he has puked two more times but only about 1/4 of a cup each time and dry heaved 3 more times. He also has a bad diaper rash that started this afternoon. should I take him to the ER? ### REPLY: Hi, I guess he had not fallen from height today, and no associated fever or loose stools. At this point, you need not rush to ER. This may be a pro .  Now just give him ondansetron suspension 2.5 ml and wait for 1 hour before trying a small feed- if no further vomiting continue same twice daily for 2 days, and give paracetamol in case fever comes. Most likely he will be fine in 2 days. If not getting better, or he refuses to feed, kindly take him to doctor. 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 an oroantral fistula resulting from surgical extraction of an abscessed tooth two-and-a-half weeks ago. Aside from the fact that it interferes with normal talking, eating and drinking, Im worried that the OAF will not heal and lead to chronic sinusitis. What is the most successful method for treatment of an OAF? ### REPLY: Thanks for your query, I have gone through your query. The most accepted treatment of choice for managing the oraoantral fistula is the buccal pedicle or palatal pedicle or advancement flap positioning after removing the fistulous tract lining. Consult an oral and maxillofacial surgeon and get it done. Yes, if you won't get it treated, it will result in chronic maxillary sinusitis and pus discharge from the fistula. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: During my sleep last night I started having gradual stabbing pain in my mid back. My mid back felt like it was burning and that pain enveloped the sides and then my sternum/chest area. I was dbled over this morning and found out when I inhaled/exhaled the pain got worse. Now I do take meds for arthritis that travels down my lumbar/leg area; it is not back pain, I really know how that feels. I will tell you that my meds and my back brace has helped me with my pain; any ideas?..... Thanx Alot, Pati PS I m 55 yrs old and take very good care of myself ### REPLY: Hello, It looks from your details that you are taking medicines for arthritis. Most probably you are also taking pain medicines. Such symptoms can be due to gastritis or pancreatitis. At present, you should take an antacid preparation like kinetic 150 mg and avoid oily and spicy preparations. You should also avoid preparations containing excess of fat. If it continues to be there then you should consult to your doctor. Take care. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 4 1/2 year old son is experiencing a burning sensation in his tongue that seems to get worse throughout the day. By the end of the day, it appears that his tongue has enlarged, white bumps at the tip, and it is unbearable for him. Any suggestions? Should I be taking him to see a doctor right away or wait until symptoms get worse? ### REPLY: Hi. Thanks for the query. White bumps and burning sensation of tongue can be due to Authors dermatitis while can also be due to viral infection causing herpetic cold sores. You should consult a Pediatrician and get him evaluated and a thorough clinical evaluation and investigations like oral swab culture has to be done. He will be advised treatment accordingly. In case if it is only authors dermatitis then numbing agent like Lidocaine mouthwash can help in relieving pain. Vitamin B complex supplement can be advised. You can also be advised to make him suck ice pops to reduce inflammation. In case if it is due to viral infection then anti-viral medicines like Acyclovir, Val acyclovir etc. can be advised orally as well as topical application. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello,im scared. my daughter has been having night paralysises the last month. last night she had one. when she got up this morning she was having cold sweats, quivering chin, she felt like she was burning up but she was cool to the touch. she is urinating normally light headed. what do I do? ### REPLY: Hi, Welcome to  .com I am . Mariano Into Bruno Mascaras. I have gone through your query with diligence and would like you to know that I am here to help you. This can be due to Hypoglycemia. Please have your HbA1C Checked Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in  at http://bit.ly/ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: SInce on Lipitor I have developed tight and painful calfs when I walk to far or to fast. I ve had 2 dopler tests on my legs and the test was fine. I m ready to off statins. I m 4 11 and weigh 128. I m 73 years old and have always been ac tive and worked outside in the carpentry business, mowing lawns splitting and chopping wood and also 10 years of weight lifting I m still active until the calf muscles act up I shovel snow and do all house work. Thanks Shag ### REPLY: Hi Shag, I have gone through the details. You have developed calf pain while on Lipitor, and now you are off statins. But the pain persists. In my opinion since you have stopped statins, there may be some other cause of pain. Due to your occupation I think you might be suffering from disc disease. So start painkillers, and muscle relaxants and if you feel no improvement in 10 days, get MRI of Lower back. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have an MTHFR antibody and am being tested for anticardiolipin panel ana anti-beta2 glycoprotein (G A M) (SP, COAG ONLY Factor V Mutation (Leiden) anti phosphatidylserine   Had tia May 1995 Are they looking for some type of cancer. Isnt there a blood test to tell if you have cancer? I am diabetic ### REPLY: Hi, It is very important to detect cancer early when it is still curable. However, none of the tests you have mentioned is for cancer. Unfortunately, the answer to your cancer is not that simple. Cancer is a disease that can be presented in various types and can arise in any body part. Depending upon the type of cancer, there are different tests available for early detection, however, there is no one test, that can detect all types of cancer with certainty. For example, for breast cancer - tests like mammography (special types of x-rays of breasts) can help in detection. For Lung cancer - tests like CT scan can help. For Prostate cancer - blood test like PSA can give clues. For head and neck cancer - a simple examination by a doctor can help in detection. Thus, for every cancer, we have a different test for its detection. 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: My gums have been bleeding since I started flossing again in March after not flossing for 8 years. My oral health was fine. I only flossed for a week in March and then stopped again. Recently I became very ill from an unknown viral infection, and my gums have been inflamed and bleeding. Its hard to eat and almost impossible to brush my teeth. Is there anything I can do to relieve the pain and/ or help my gums? ### REPLY: Hello, You should do your best to maintain proper dental hygiene. Be gentle and include rinsing. The stress on your system will affect the gums and take time to heal. You may have a fungal infection develop with a compromised condition. The antifungal medication Statin may be prescribed. Schedule a dental exam to evaluate your oral condition if it persists and evaluate if the need for a prescription is necessary. There are prescription mouth rinses that include pain medication available by prescription, too. Keep well HY .  Vitamin B12 helps to heal. Anti- onflmatotyeficstion such as Tylenol and Motrin may offer relief. Thank you for your inquiry. ### END