Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had pancreatitis last Sept. was in hospital for nine days. Lipase was 0000. They waited a month to take over abundance of stones gallbladder out. Surgeon said I could eat anything. GI/ Internest says low fat diet. Ive had loads of trouble after the temporary stents were taken out of Pancreatic and Common Bile duct.  Ive had sludge in common bile duct six months ago, enlarged pancreas, fatty liver, cysts on pancreas, kidney and breast. Everything I eat makes me bloat and look nine months pregnant. I take xifaxan, pancreatic enzymes, something to dissolve sludge and stones, Gas X, Levsin XL. Fruit of any type makes me bloat, I can eat very cooked veggies, shrimp, small piece OD chicken, baked potato and still swell terrible. In the mornings I can fit in my cloths, by 5:00 I look pregnant and cloths are so tight they hurt. Do you have any diet suggestions. Im 58 and dont want to go through another year of this. ### REPLY: Hello! Thank you for the query. As an acute pancreatitis patient, you should have abdominal CT scheduled and for sure done in case of symptoms described by you. This disease makes you prone to create abdominal cysts which can get huge. Such large cyst can get infected and lead to serious blood infection. It may also be large enough to compress stomach or intestines and cause gastrointestinal symptoms. Bile ducts should be checked if there is no obstruction and in case of it, ERCP should be done. Please visit your doctor and ask about abdominal CT first. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I have a sharp pain under my ribs on my left side and breathing is shallow I m in bed when I get up I have to roll to my right it eases pain some or a lot when trying to lift up to get out of bed I can hear my heart beat and bubbling and gurgling, it all started last night when I sneezed and I was already uncomfortable cause I ate so much watermelon felt I would pop and I have hiatal hernia just saying Thank you ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of acute gastritis and related pain is more. But better to get done ECG and 2d echo to rule out heart diseases because left sided chest pain is commonly seen in heart diseases. If both these are normal then no need to worry about heart diseases. You have hiatus hernia. And due to over eating you have acute gastritis. So better to avoid large meals, instead take frequent small meals. Avoid stress and tension. Avoid hot and spicy food. Start proton pump inhibitors and prokinetic .  Go for walk after meals. Don't worry, you will be alright but better to first rule out cardiac diseases. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I started taking the birth control pill on Sunday March 16th, but it was after my period had already ended. I had unprotected sex on Monday March 24th. He pulled out, but I was wondering how long it takes for the pill to become effective? And if I will be ok? Some say 1 week some say otherwise. Thank you! ### REPLY: Hello misunderstand your concerned not worry. There is no chance of pregnancy as you did sex in the safe period of cycle (just after period). It is safe period because ovulation does not occur during this time. Contraceptive pill started to work from the first pill only, but you have to take the remaining pill regularly at the specific time for effective contraception. Just be relaxed and take you remaining tablet normally. Avoid stress and take healthy diet. Hope this may help noncontact  for further health query Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor i am 20 years old and my height is 5"7 .i am having irregular periods from before the marriage and after marriage also it continued the same . i have gone to daoctor and they took scanning and told that i am having pco problem and they told its not a big problem .and they suggested me to reduce weight by doing regular exercise i have reduced 5 kgs but still pco problem exsits and at present they r giving menogon injection from day 3 to day 6. i am very worried about that i will get pregnancy or not. recently only we have completed 1st year of our married life.pls can u help with ur suggestion ### REPLY: Hi, actually in PRO patients, there is problem in ovulation. So, you can take medicines for ovulation. Mention is given for that only. You can track your follicles' growth by repeated ultrasound and when your follicles is more than 17 mm, take injection for rupturing the follicles.  Be in contact with your husband for next 2 to 3 days.  Take progesterone for next 2 weeks to support the pregnancy.  Do a urine pregnancy test at home after that. You can try like that for 3 to 6 months. Hope I have answered your question. If you have any other query I will be happy to help. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my name is XXXX. I am 28 years of age,smoker, weight 50kgs, 5ft..something? I have had a number of seizures in the last few years. Im a heavy user of both GHB and iv methylamphetamine. I suffer chronic anxiety. I don t have epilepsy but have had a number of seizures just this past week. i stopped going to hospital for them and have told my friends im fine and not to take me there. I am prescribed 600mg seroquel nightly and 50mg XR seroquel daily (which i haven t ) ### REPLY: Hello, I will suggest you to slowly reduce the use of GHB and methamphetamine. This will help you relive your chronic anxiety. You should start taking the prescribed .  Epilepsy or a seizure is a condition which needs further elaboration. Do you suffer jerks movements over the body? Does anyone else witnessed your fits? What about tongue bite, urinary incontinence, or a fecal incontinence during fits? Do you sleep after fits? If you have a video of this event, its also required. You need to go to your local doctor along with a witness friend or a video recording of these events, so that doctor is confident to prescribe you a regular anti-epileptic, if he is convinced about these events as fits. 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: hello sir....  Am rahul & am 24 years old ....well i have 20 years old girl friend ...well v had sexual intercourse 2 times with a time gap of 45 minutes same day on 09-08-2010  using condom.... nothing went wrong like condom failure ....& my girl friend menses date was on 12-08-2010 but still she didnt got her periods...... we are very much worried...... is she got pregnant??? ....please help..... Thank you... ### REPLY: Hallow Rahul, The condom has got good success rate in preventing pregnancy if used correctly. Since you have not noticed any accidents like condom burst or slipping, the chances of pregnancy would be minimal. To confirm, please get her urine tested for pregnancy. If the test result is negative, she is not pregnant. You may give her Tab. Devilry for 5 days and then discontinue it. She should get her period 4-7 days after that. 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: Hi. My son ( 10 yrs old) had a baby tooth extracted a few weeks ago- as the dentist said he needed a baby root canal, so rather extract the tooth, Unfortunately his adjacent permanent tooth got loose and fell out now. I am not too happy ( to say the least!!). What are my options- we still have the tooth that fell out- can it be put back in like dentures? Can i assume its the dentist negligenc? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint if the permanent tooth has been fallen due to removal of the adjacent baby tooth then it is due to abnormal forces implicated on the permanent tooth while extracting the baby tooth and is not a correct practice. You can put it back in socket only till a period or an hour or so after it is removed but not longer than that. So in case if you are early enough consult a Periodontist immediately and get evaluated. Better to keep the tooth in milk or saliva to give it a favorable medium. In case if the tooth has been extracted long back then it cannot be re-implanted in the socket and in that case you need to as of now get a space maintainer placed and once the permanent teeth erupt adjacent to the extraction socket then a bridge can be placed. Hope this information helps. Thanks and 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 had unprotected sex with a man who has htlv-1, I asked my gynecologist about this she has never heard of it, I have asked to be tested she couldnt find a test for this disease. Can you tell me how to find out about testing? And how long after intercourse should one get tested ### REPLY: Thanks for posting you query to  .HTL 1 is basically HIV, and it causes STD.there are several tests available for its diagnosis .you can select among them which is available at your area .1. Blood serology test or HIV antibody this test come positive 7-10 day after contracting infection .2.ELISA for HIV 1 antigen it comes positive earliest after infection .3.PCR for HIV antigen having high sensitivity and specificity come the earliest positive .hope you are satisfied with my answer.  Feel free to communicate if any query.regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I started out being treated for TMJ mainly just wearing a splint to keep from grinding teeth ., over a year. Now I find I have jaw deterioation on the right side caused by arthritis . I am constantly aware of this because the teeth collide on that side almost like my jaw has dropped causing speech problems & stress. I have seen 3 oral surgeons & other doctors but they seem to think I don t have a problem & won t treat me. The last Doc was an orthodontist & really showed what was wrong but could not help. What kind of doctor do I need? I m so disgusted w the drs. I have seen & please don t suggest I see another TMJ Dr. Thank you & please help. ### REPLY: Hello Robinson, Thanks for posting your query. As per the details provided, you were wearing splint to prevent grinding of teeth. This has lead into jaw deterioration due to imbalanced occlusion or biting. I would suggest you to use either side of the jaws equally/simultaneously, without applying pressure on a single side. If required, the splint has to be removed. You can also try jaw movement exercises. Avoid too much of wide mouth opening. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have really bad back pain!! My low back and hips hurts bad. I do not know what to do!! I took 800mg of invprotin!! I am still hurts!! I cannot sleep because it hurts so bad!! Should go to ER or I just wait to see my chiropractor tomorrow afternoon!! ### REPLY: Hi, Thanks for your query. After going through your query I came to know that you have backache and hip pain. It has not improved by ibuprofen, so you can take strong analgesic such as Tramadol. Rest, analgesics and Mecobalamin will be of benefit. You can get x-ray pelvis with both hip and X-ray lumbar spine for further investigate it. You can discuss with your treating Doctor about it. I do hope that you have found something helpful. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: doctor please i need ur help.im 26 years old female suffering from hairfall for about 5 years..my hair is falling and nothing seems to work on me ive tried herbal homoepathy aloepathy but still my hair is falling..i have no apparent skin problem with my scalp..my hair is thinning and not growing back as they should what should i use..please please help me ### REPLY: Hello, I have gone through your query and would recommend you to get your hemoglobin, serum ferritin levels, serum vitamin B12 and serum vitamin D levels and thyroid function tests done to rule out any internal cause of hair loss. Start applying minoxidil 2 per cent lotion on the scalp twice daily and take hair supplements containing biotin once daily. You need to continue this for 4-5 months to see significant results. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am to have an endoscopy on Monday, I have at present got a cough and a sore throat, this is handleable using common of the shelf remedies. I am sure i can go without any medication ( I am not coughing up infected phlegm but some clear phlegm ) for the six hours required but may start to cough a little during the process. Do you think I would be aright to go ahead with the proceeder. I really want to have it done as I am going on holiday the next day and don t want to delay my exam any longer than possible. thanks Doug. ### REPLY: Thanks for your question on . I can understand your concern. Possibility of viral upper respiratory tract infection (URI) is more. And it will mostly heal by itself in 5-7 days. So if you can manage your cough without medicines then no need to take .  But if you want to take cough medicines, you can take. No harm in it. This won't interferes in your endoscopy. So if you don't have much cough then no need to take anything. Also do following things for better and quick relief in URI.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a small lump on my balls when I applied pressure it moved so I slid my fingers together and it moved up eventually releasing thin puss from a hole near the base of my penis . What is that and why is it doing that? It was a good bit the first time I did it but it seem to be just a small amount every couple day . ### REPLY: Hello appreciate your concern This could be infected sebaceous cyst of the scrotum or sign of Stiff you can upload me a photograph I will be able to guide you better I would like further information to help you better Your age and relevant medical history like diabetes or Past incidence of Stand recent exposure to unprotected sex? I would advise you to wash and clean it with antiseptic soap or solution and apply antibacterial ointmentMaintain good hygiene it doesn't heal than consult your doctor for examination and battery of tests if need be, to confirm the diagnosis and accordingly treatment. Thanks and 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: For back pain which is best to use - flector patch or lido dream patch?  Are these similar or different?  I have had a s-elective nerve block that has really helped the sciatic pain.  But when I do work which requires bending,  pulling, lifting or pushing and sometimes just walking, I have very uncomfortable pain.  Therefore, Id like to know which pain patch is best or is there another that you recommend? ### REPLY: Hello I have studied your castles two patches are somewhat different. The Elector patch contains a diclofenac, a NSAID or inflammatory, and is usually used to treat sprains, bruises and muscle pain.  Laborers contains a local anesthetic, lidocaine, that blocks nerve signals to brain. So elector patch is good for sciatica. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor, in my street there are 5 puppy newly born less than one month.her mother and puppies both have some problem of khujali ke .i was feeding food to him then one of them puppy may bit me.there is very very minner cut just like pen niddle.help me ### REPLY: Hi, I appreciate your concern as Dog bites could lead to severe disease. Most probably there would have been no transmission or the dog may have not been infected, but to be 100% sure as there is no care for Rabies, I suggest that you take a full course of Anti-rabies Vaccine (ARV) and Tetanus shots which is free in any government facility if you are from India following the bite 72 hours or otherwise also. Also, I suggest you to keep an eye on the dogs if they show any warning signs.  Besides, take care while feeding street dogs because you can't be sure about their histories, and you can't track them down to keep an eye on them. So better be careful i future. I hope I helped you with your question, Feel free to ask any further questions. Reagrds, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pricked my finger on a rusty nail. A tiny spec of blood the color of the rust appeared and i then wiped it off and no more blood appeared.  I washed my hands shortly after.  This was 90 minutes ago and aside from anxiety, i am seeing no symptoms of anything.   I do not recall when i last had a tenus shot but i get a physical yearly. Is there any symptom that i should look for before going to an ER? ### REPLY: You have a clean or minor wound on your finger. After basic first-aid such as washing with water, which you have done, it is important to think of Tetanus. In a minor wound such as yours the chances of tetanus are minimal. However, since you do not know when your last tetanus shot was, and I presume it was more than 5 years back, you must receive the tetanus vaccine. If your injury was more serious (deep, penetrating wound with rusted iron) you would require both tetanus vaccine and immunoglobulin, to be taken at different sites. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I Had bypass surgery 6 years ago .Now following a TMT test doctor has prescribed Isosorbid nitrate but have an unpleasent headache all through out the day.The doctor has told me that i should continue to take this medicine inspite of the headache.Is there any alternate to this medicine? ### REPLY: Hi There As you have gone through bypass surgery and now TMT might be showing some doubtful changes that's why your doctor have prescribed you with nitrates. Headache is a very common side effect of nitrate during initial part of starting treatment, but it will get relieved very soon if you continue taking them and this is usually advised as Isosorbide nitrate is a very effective and beneficial .  There are alternatives like TRIMETAZIDINE but as a Vasodilator and antianginal its efficiency is less. 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: .hi my penni is getting small in size or i should say its getting in and the nervs r not that much powerful they use to be plz help i am not able to any thing i am just thinking that i wont be able to have sex in my life. ### REPLY: Hi, Much Research says the average length of a flaccid penis is 3.61 inches, while the average length of an erect penis is 5.16 inches. Few studies recommended flaccid penis length of less than 1.6 inches or an erect penis of less than 3 inches should be considered for treatment. Surgical (liposuction around their pubic bone, skin graft), inflatable penile prosthetics are helpful if size less than 3 inches. Share your penis size when flaccid and erect. 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 am 38  and having hypertension problem for the last three years approximately. Can I use one boiled egg per day? Is it helpful to reduce the high blood pressure. Please advise how and in which form the egg is most suitable for hypertension problem.Thanks Imran ### REPLY: Hello Imran, There is no direct Co relation would off egg with hypertension, it doesn't decrease your blood pressure nor taking it will increase the pressure.  So you may take eggs, boiled are always better because its healthy and egg white is one which is Rich in protein, while the yellow is rich in cholesterol.  So if you are overweight and your lipids are bad, you should try avoiding egg yellow, and if you are otherwise fit, 2 parts egg white and 1 part egg yellow is a balanced combination.  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 keep getting sudden stomach cramps, worse after eating and drinking even water feeling nauseous and my poos are like liquid (Sorry) i had the same thing and felt the same a couple of weeks ago on holiday im not sure whether its a bug or something more :s ### REPLY: Hi. It would be wonderful to know that you have not yet met a Doctor or taken no medicines. Please give details if you have taken any medicines. This looks to be gastroenteritis, and you need to start the proper antibiotic treatment under the guidance of a Doctor for 5 days. You will be fine. If there is no positive effect, GP for blood, urine and stool tests; ultrasonography and other tests as suggested by your treating Doctor as there may be a pathology which may need further investigations and treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: will javex on a tooth kill the nerve, I was on Lythium for 3 years and I had perfect teeth not even a small cavity when I started this drug and continued seeing my dentist until my insurance ran out from work.  Now I have sever enamel loss on my upper teeth, pits in my lower teeth and one bad nerve exposed tooth in the upper right molar and cant afford a dentist. ### REPLY: Hello, Absolutely no use of household bleach designed for use on fabric is recommended in the mouth. Yes, Jagex will kill the nerve. Sometimes a bleacChatDoctorpound is carefully used by a dentist to disinfect the canal system of a tooth when having a root canal. Exposure to bleach will cause your tissue to suffer from burns and possibly require a trip to the emergency room. Different formulations of HY .  Your medication is known to affect the saliva flow in your mouth. This can have a detrimental effect on your enamel. Keep up with good daily oral hygiene. Use toothpaste with fluoride and make sure to rinse with fluoride. There are prescription fluoride gels and rinses available. Your plaque can have a very thick consistency and be difficult to remove if you experience a  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 visited my doctor today and said my blood test says i have 119 creatinine level . i suffer from repeated toslitis and muscle pain , he was talking about kidney failure but he asked me to do ct scan and blood test i used to suffer from high uric acid . I am 42 y male and a sportsman and healthy i do not suffer from any other diseases ### REPLY: Hi, welcome to . High creatinine level indicates kidney dysfunction, not always kidney failure. It may be acute or temporary dysfunction due to some reason, or it may be chronic pr permanent kidney dysfunction. Do basic urine report, Check BP and do CT scan or sonography. First determine the nature of kidney dysfunction and then evaluate for cause of it and then treat it. By this approach, it is possible to revert it to normal. So, don't get worried. Consult your nearby nephrologist, or you can get back to me with above reports. I think this would be helpful to you. Best wishes. TC. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell down a set of stairs in high heels, as I fell my leg went under me at the knee as I hit my shin off the step, I can limp on it but it s a bit painful but most of all from my knee down my leg and foot is swollen and my leg is bruised and every now and again my toes are tingly and numb ### REPLY: Hi, Thanks for your query. From description, it seems to be soft tissue injury over leg. Swelling might be due to hematoma formation(collection of blood). You need an x-ray to rule out any bony injury. I suggest you to consult an orthopaedician nearby for a detailed examination. You may get the X-ray of the area affected under his/her guidance. Beside icing and elevating it, you can take anti-inflammatory . I do hope that you have found something helpful, and I will be glad to answer any further query. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have recently been told that a lesion removed from my leg is cellular and deep penetrating fibrous histiocytoma.My doctor wants to do a wider excision of the area again. He said he is confident about the outcome but local recurrence can happen. Is this cancer?  It said in the report it was CD43 positive in blood vessels. ### REPLY: Fibrous histiocytoma is a type of tumor that does not spread to other parts of the body. However, it is a locally aggressive tumor and recurs locally even after adequate surgery. So, recurrence at the same site after inadequate surgery is almost sure shot. Thus, a wide excision of the area is mandatory. As, I said, local recurrence can still happen, but the chances are much less. CD 43 positivity in this setting means nothing and doesn't change either the outcome or the treatment plan. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 checked my BP and it says 133/96 with a heartbeat of 82.I am 60yr olkd and weigh 212 I am currently taking 10mg of Prednisone Daily & 300mg daily for maintenece agains both gout and ulcertive colitus. Would my BP decrease if I wean myself off the prednisone? ### REPLY: HelloWelcome to ChatDoctorIt seems your systolic blood pressure is normal for your age and diastolic blood pressure is little higher for your age. Prednisolone does have effects on blood pressure by retention of water and salt plus it increases your weight. So weaning off from prednisolone will reduce the blood pressure but up to certain limit only. And at present your blood pressure is within acceptable range for your age. So don't worryStay happy .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 report details: sperm count 180ml / sperm concent 90 / morphology NIL / Morphology per 100 sperms: head defects - 100%,midpiece defects-40%, tail defects-80% / vitality 15% / motility within 1hour: classses a-NIL and classes a & b - 10%. Pus cells: 8-10/hpf Rbc: 4-6 /hpf Epithelial cells: 1-2 /hpf Comments: Gross teratoasthenozoospermia. Note: Small agglutinates and aggregates(+). Will appreciate if anyone could help me with my above report and solutions to my problem. Many thanks ### REPLY: Hello, Thanks for the query, Teratospermia is a condition characterized by the presence of sperm with abnormal morphology that affects fertility in males. Asthenozoospermia is the medical term for reduced sperm motility. Teratoasthenospermia is the combination of both. Treatment includes use of antiestrogens, Intracytoplasmic sperm injection (CSI), injecting sperm directly into the egg. Even with severe teratozoospermia, microscopy can still detect the few sperm cells that have a "normal" morphology, allowing for optimal success rate. So good luck to you, regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband age 73 5 8 209# Symptoms: Chills Fatigue Night Sweat Fevers around 103 Shortness of breath. He has had Pneumonia a three times over the last three years. History: Asthma COPD- Never Smoked, Sleep Apnea , Restles legs, Fevers Unknown, Diabetic, Neuropath, Pain in Muscles, Defiant in Iron. Doctors know there is something more wrong with him but do not know what. He has gone through lots of test but still know answers. Thank you ### REPLY: Dear Sue, Having history of Pneumonia for several times, history of COPD and having diabetes with the current symptoms of night fever with chills suggest he should undergo test to rule out pulmonary tuberculosis. I do not know which country you are from but the weak lungs and lower immunity due to less hemoglobin and long-standing diabetes makes one prone to get infections which general healthy public can resist. So I hope the test to rule out tuberculosis has been carried out on him. Secondly, having low iron can make his legs very restless, so please get prescription for appropriate iron supplement to ease the symptoms. Neuropathic and muscle pain can be treated appropriately by a planetologist and with optimum it D supplement. I hope he gets relief from his disturbing symptoms with appropriate evaluation and treatment. Do get back for further queries. 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: Hi, my weight is 74 kilos I am 170  tall. I am aged 57 woman. I was diagnosed with a couple of gallstones 5 years ago. I had full bloods and medical in early march in Australia and my bloods, liver showed not signs of a problem. However from 16 March till July 01 I have been living in hanoi, Vietnam, my place of temporary residence for the past 5 years.I went for a routine medical check for insurance and on ultra sound they discover my liver is fatty. Also in the blood. I have pain after the doctor pushed my abdomen to examine. I am wondering how medical exam in march shows no liver issue and now in hanoi less than three months later, I have a fatty liver. I am now thinking about the dental treatment I had here, the manicure and pedicures ...could this be some acute infection ...from maybe drinking ice, summer heat...or eating street food. The exam in Australia was very thorough yet did not detect such a change. Thank you ### REPLY: Hi.fatty liver is mainly caused by your diet. High fat and high cholesterol food intake through the years may have contributed to your current condition. If you are not experiencing any signs or symptoms other than the findings in your ultrasound, observation may be done. But if there are, a repeat abdominal ultrasound focusing on your gallbladder, liver and pancreas may be suggested. You probably have a gallbladder pathology (possibly gallstones or biliary colic). It is best if you consult with a doctor, preferably a general surgeon, for physical examination and clinical evaluation. Other diagnostics and management will be directed accordingly. Hope this helps. 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 daughter is 6 she will b 7 in a week.. She has been running a fever for the last 2 days.. she is drinking and trying to eat but isnt doing good with it.. she hasnt been throwing up but has nausea and she hasnt had diarrhea.. her temp has been 100 to 103, i have given her sprite and Tylenol but it goes down then right back up.. she has a dr appointment tomorrow at 11 should i wait and take her then or take her to er? ### REPLY: Hi Dear welcome to the , High grade fever with nausea to be tackled initially as a viral fever. Needs to be gone for the tap water sponging vigorously when is required. Paracetamol @ 15 mg/KD 4 to 6 hourly is sufficient to reduce the fever. Contnue to give her plenty of liquids. Post rainy season is season of insect borne disease like dengue. Should be taken care of accordingly. Hope the query is answered. 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: Hello I have been having sharp pains in my lungs (both) especially on my right (about 5 years now, but it s getting worse), when this happens I can t breathe properly because it feels as if it will be teared apart along with this pain my upper arm also hurts and lately whatever direction I turn my head - my lungs hurts immensely mainly my left - seems pretty close to my heart. It hurts so much but I haven t seen a doctor have been busy do you know what it could possibly be? 19 Female Non-Smoker Do Not Drink ### REPLY: Thanks for your question on . I can understand your situation and problem. You are having all these symptoms for five years. So in my opinion, you should definitely consult doctor and get done 1. Clinical examination of respiratory system 2. Chest x-ray. 3. PUT (Pulmonary Function Test). Lung infection and bronchitis are common cause for chronic chest pain and breathlessness. So chest x-ray is needed to rule out lung infection. PFT is needed to rule out bronchitis. You may need antibiotics, inhaled bronchodilators and inhaled corticosteroid (ICS). So better to first diagnose yourself and then start appropriate treatment. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: The neurologist says that having looked at my husband s MRI it is possible that he has a build up of fluid in the ventricle. He has had chemotherapy for lymphoma in the central nervous system and these new symptoms which replicate a TIA are worrying to say the least. He is now losing speech and ability to process for up to an hour roughly every 10 days. The neouologist seems laid back but I am at my wits end as I can see my husband s personality changing and we are both losing confidence. He doesn t have another hospital appointment until May 15th which is for an EEG. We still await a cognitive assessment and then the neurologist will view the results and we should see her in 3 months! Help please. What do you suggest we do? ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. In my opinion your husband is having mostly HY .  It is narrowing of ventricles in brain. Ventricles are CSF (cerebrospinal fluid) transmitting system. So any narrowing in it can cause fluid accumulation. This fluid accumulation cause raised ICT (intracranial tension) and this can further cause compression on vital brain areas. This is the reason for personality changes and other neurological symptoms. Honestly speaking, lymphoma with neurological complications carry worse prognosis. You can ask for VP (ventricle peritoneal) shunt to divert the excess fluid and thus reducing ICT. So discuss all these in depth with your neurologist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 facing severe pain in my joints...i.e. Knee, Ankle, Hip Joint, Neck stifness, lower back is stiff and shouler joints are also locked...some of my body parts has shown swelling sign also..i.e. my finger, left leg ankle, palm joints...can u pl help.. ### REPLY: Hello Your Polyarthralgia symptoms (Pain, Swelling & Stiffness in Small & large joints) resemble the onset of Rheumatoid Arthritis (RA) which is multiple Joint Inflammatory diseases. Kindly go through Arthritis Panel Tests (S.RA factor, CRP, ANA, ANTI-CCP, AS Title, ESR, S. Uric Acid & vitamin D). This would get a confirmatory diagnosis, to get a precise treatment. 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 sever back pain, not all the time usually at night or when i rest. it goes down left side of my buttocks and hurts when i put pressure on that side of my body. for example when i put weight on left leg when i walk. is there anything i can take for the pain ? have been using a heat pack. but nothing really helps. ### REPLY: Hello and welcome, Thanks for your query.  When you say your pain is usually at night, is it because you sleep on your back and thus apply pressure on your lower back and/or left leg (mainly till your mid-thigh) ? Does the pain start from her lower back and go down till mid-thigh?  If yes, this could most probably be her Sciatic nerve being irritated and is also called Sciatica.  Let me list few of the most common causes of sciatica: -Degenerative disc disease: The discs in every human being undergo a degenerative process with age, and is considered to be normal. When these discs undergo degeneration they tend to irritate the nerve root present in the lower back, which can result in sciatica.  -Sacroiliac join dysfunction: the lowest end of your spine consists of fused bones called the Sacrum. This bone articulates with the Iliad bone (one of the three bones forming your pelvis), thus this joint is called the sacroiliac joint. Any irritation of this joint can also cause the same pain that would be typical for sciatica.  -Performs syn .  The sciatic nerve passes under this muscle, and any irritation of this muscle can also lead the sciatica.  -Herniated disc: The Lumbar part of your disc can develop a hernia which is when the inner core of the disc leaks out or herniates. This protrusion can irritate the nerve roots, also resulting in sciatica.  --Islamic spondylolisthesis: In this condition a small fracture allows one vertebral body to slip forward on another. Due to this the sciatic nerve can get pinched and cause the pain.  -Lumbar spinal stenosis: Stenosis (narrowing) of the spinal canal can cause the sciatic nerve to get pinched and cause this pain Other causes can be: muscle strain, spinal tumors, pregnancy, scar tissue, infection, direct injury, etc. Please consult your doctor on the same and try to find the cause in order to properly manage the sciatica as different cause require different management techniques. I hope I have succeeded in answering your questions, you could write back to us anytime for further clarifications.  Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi . My leg pain began in my left thigh with numbness and shooting pains . Now both legs hurt so bad I want to scream. They are so heavy I can hardly walk. Diagnosis:lymes ,fibromyalgia possible neuropathy . Ruled out M S from MRI . Yes I have bulging disks L 4 and L5 years ago and thought shooting pains and numbness in left leg was from that . Gabapenton helps . Without it my legs shut down . ### REPLY: Hi, The lumbar spinal nerves are affected the compression of the inflammation of your neurovascular bundles at levels L4 and L5. These nerve compressions irritate your nerves and sends pain sensation to areas supplied by these nerves . 73% of people showed reasonable to major improvement without surgery. Treatment usually consists of non-steroidal anti-inflammatory pain medication (NSAIDs), but the long-term use of NSAIDs for people with persistent back pain is complicated by their possible cardiovascular and gastrointestinal toxicity. Epidural corticosteroid injections provide a slight and questionable short-term improvement in those with sciatica but are of no long term benefit Please click THANK YOU and consider a 5-star rating with some positive feedback if the information was helpful. Hope the above information helps you. Any further clarifications feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am dare by name, from nigeria, i am 28 years now... i have been masturbating since over 10 years ago...  if i go to the toilet, when i pee, i do see sperm rushing out of my penis instead of urine coming out, and also when urinate i do have urine leakage i.e urine dons stop after urination, i do have wet dreams and 1-2 minutes of ejaculations when having sex, am having back pains also and if i hear anything emotional i will start releasing sperm.. sir is there drugs u can prescribe to these symptoms, am a student and i cant come abroad for treatment...  YYYY@YYYY  my mail ### REPLY: Halloween in urine is a common finding, and it may be due to overexcited state, straining,inadequate emptying etc. You should try relaxation technique and avoid provocative literature and videos. You should try to be calm and can go for yoga, mediation. You should try to engage yourself in your job. You will be fine with above-mentioned measures. If findings persists then you may need psychological counselling. It is also important to evaluate for constipation. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, i m feeling giddy when i turn my head.This scares me a lot as i loose balance...it usually lasts for a week....all my MRI are fine...i have gone to many neurologist but not able to get rid of this problem.Every 3 months i m facing this problem...i had vertin and stugeron...but still no good results. ### REPLY: Hi, The symptoms you describe is typically caused by positional vertigo - a condition which is related to vestibular system in your ear. I would suggest you to consult an ENT specialist if you haven't seen one yet. You would need careful examination of you ear, test like audio gram / Dix Hall pikes test to confirm the cause. Vestibular exercises will help you in the long term. Wish you good luck and speedy recovery. 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 doctor, i am a 23 yrs old girl. i have neck pain from the past 1 yr and lower back pain from the recent 2 months .my doctor suggessted me to take mri scan and blood test, my lumbor spine mri says i ve multiple adenopthies and disc bulge and mantoux says positive with 20mm.what it means?please suggest. ### REPLY: Hello I have studied your case. There is possibility of tuberculosis considering your reports may need to investigate in form of complete blood count, ESR, CRP, DNA-PCR. You may need clinical examination also to confirm diagnosis. Till time, you can start medication and antibiotic consulting your treating doctor after confirming diagnosis. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am Ritobroto from Kolkata. my baby is 4 years old girl. From last few weeks she started complaining about pain inside her ear. Almost everyday she complains it. But within a few hour she forgtes about it starts playing around. Initially we thought she might be fooling us but since she had serious ear-pains 2 times in last year(due to cold, as doctors said) we are a bit worried about this complain. Can you suggest advice something Thanks Ritobroto ### REPLY: Hello Rigoberto. I just have gone through your query. First never take your children problem for granted. By doing this you unintentionally are losing her faith in you. Always listen to your child and try to help her as much as you can. Try to believe in your child in her every single concern.Anyhow, as you said that she suffered 2 times from severe earache due to cold. I would suggest you to please get her ears checked from a good ENT specialist in your area. Only after that we would be able to judge what is wrong with her. There might be infection leading to pain, or any blockage or only earwax might be troubling her. 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: Last week I was started on a combination birth control pill to stop bleeding that has been ongoing since my IUD was placed in December. So the 1st day I was told to take 4 pills then 2 them 2 then 1. The first day I took the four the next day I took 3 and then I developed gallstones which I never had. I m healthy but just had my 3 rd child he is 5 months. So yes I m a bit overweight but otherwise healthy so I went to a surgeon today for consult on gallbladder removal upon assessment the doc asked if I had thyroid issues and recommended I get an ultrasound in the near future. My question do you think the possible thyroid issue and the extra estrogen could have contributed to the stone formation and that I should correct those things riser before totally removing my gallbladder?? ### REPLY: Hi, Your doctor is right. Thyroid issue and contraceptive pill both are predisposing factors for gall stone.  Thyroid problem can cause high cholesterol level and so the stone can develop.  Moreover, you are obese as well. Obesity is also one of the risk factors for gall stone.  So you need to correct all these factors by reducing weight and stop taking pills. If thyroid issue present than treatment needed for that according to reports.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my fathers age is 55 years. he is have hyper tension since 10 years. but it is raising from 1 year. previous one year he used to take nebivolol 2.5 mg once a day. now he is taking nebivolol 5 + s amlodipine 2.5 mg twice a day. he is also taking medicine for raised uric acid contents and thyroxin sodium 25 mcg. he is always thinking of raised hypertension. please guide for reducing medicines. ### REPLY: HIT hanks for posting your query.  First there is no question of reducing medicines if his blood pressure is raising. First he needs to keep his blood pressure under control with the ongoing medicines, diet and exercise.  With time (every 2 weeks) he needs to increase his exercise duration or intensity or both. Let him follow a strict low salt diet.  Get his Blood pressure rechecked after 2 weeks, if it is extremely normal then we can consider reducing the dose of medicine but if the blood pressure is high normal or high then no chance of medicine reduction.  Also get his TSH test done if it is not under control his thyroxine dose has to be changed. Hope this information was useful to you. Any clarification feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I broke a bone on the outer side of foot and sprained my ankle, after xray, the doctor has me wearing the socks to prevent blood clots and a boot to my knee. My question is can I walk on the heel of the boot and not do anymore damage to the break? I am a 78 year old female. Thanks for your reply ### REPLY: Hello, Thanks for writing to us, I have studied your case with diligence. As per your history pattern there can be persistent tear in ankle ligament leading crunching sound or capsular tightness. I will advise doing MRI ankle for soft tissue involvement. Till time, you can continue physiotherapy exercises and also use supportive splint or brace. Physiotherapy like ultrasound and TENS will help in early healing. Walk with support to avoid further damage. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What does it mean when my ultrasound says I have a questionable bilateral extrarenal pelvis sees verus mild hydronephrosis bilaterally? The impressions says slight prominence of the collecting systems bilaterally left greater than right. What does this mean? ### REPLY: Hello and welcome to . As a Urologist, I can fully understand your concern. Your scan report suggests there's urine collection, just outside the kidneys. Its minimal and the significance of this cant be made out. It could be a normal variation or a possibility of very, mild, block between kidneys and bladder.  Normally, urine . If you can send me your blood, urine and scan reports, as a direct question, I can give you advice expert management.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father has pancreas cancer( metastatic stage). He was taking all sorts of drugs starting from gemcitabine, gemzar, avastin and morphine for pain. He recently started a new treatment that combine 4 different drugs. He is feeling a lot better, he is not in pain anymore but his feet are swollen and now his hands are starting to do that. What does this mean? Should I be concerned ? Is this just an side effect or does it have a bigger meaning? And what can we do to stop them from swelling more? ### REPLY: Thanks for your question on . I can understand your fathers situation and problem. Chemotherapy .  So renal damage is one possibility for his feet and hand swellings. So get done renal function test to rule out renal toxicity. Another possibility is hypoproteinemia. Pancreatic cancer causes decrease functions of pancreas gland. So absorption of protein from gut is reduced. And hence hypoproteinemia is seen. This can also cause swelling in feet and hands. So also get done serum protein levels. If this is lower than he needs additional protein supplements in the form of albumin injections and high protein diet. Hope I have solved your query. Wishing good health to your father. 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: Hi, I had taken treatment for TB thrice i.e. in 1997 (6 months), 2000(8 months) and 2004 (6 months). In 2009, I once again became sick with the symptoms of fever and dry cough. At last, I went for Ayurvedic treatment and taken medicines for 1 year and became fully cured. Now, I am again suffering with fever since July and dry cough for last 15 days. I have again started Ayurvedic treatment. But fever comes everyday in the evening with dry cough. ESR is 65. What are the chances. Am I again infected with the TB? ### REPLY: Thanks for your question on . I can understand your situation and problem. Yes, possibility of recurrence of tuberculosis is more in your case. You are having past history of tuberculosis thrice, having high ESR (erythrocyte sedimentation rate) and fever with cough, all are suggestive of recurrence of tuberculosis. So you should consult pulmonologist and get done clinical examination of respiratory system and chest x-ray. If chest x-ray is suggestive of tuberculosis than you need sputum or BAD (bronchoalveolar lavage) culture and sensitivity to rule out M .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, what kind of topical steroid creams can i buy off the shelf in the UK to treat phimosis? I have tried stretching the foreskin for 2 months now and i have only got i half way back. I am too embarrassed to go to my GP about this situation.Thanks, Dale ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern as long as the fibrosis is concern the best way to rid out of this is surgical procedure otherwise using some medicine locally for this may cause more problem and later this would be difficult to manage it so in my opinion it is better to go for surgery and no need to use any medicine either locally or orally, hope this information helps you have nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my wife was admitted for chest pains monday, nuclear stress test was given no cath needed discharged  tues. my wife has become confused and friday got lost taking kids to  school i had to go and find her on side of road, she wasnt sure were kids were . took her to her doctor and was sent for ct scan result didnt get back before five. ct scan was given at 1145am , I took her to e.r. and sugar was checked and i thought we were not worth the docs time they gave her .5mg atrivan and lortab5 for headache shes had since test. we were sent home today headache confusion still here i dont know what to do e.r. sent us home and her docs answer service wont call  what can i do ### REPLY: Thanks for your question on . I can understand your concern. Sudden onset headache, mental confusion, disorientation etc. are more suggestive of brain pathology like meningitis (infection). So better to consult neurologist as well soon as possible and get done MRI brain and lumber puncture to rule out meningitis. If both these are normal then possibility of psychiatric illness is more likely. So consult psychiatrist and get done counselling sessions. She may need anxiolytic and anti-depressant .  Don't worry, she will be alright but first diagnose her and start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your wife. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had a tetanus vaccine on monday, of wednesday i noticed a bit of pain in the armpit on the same side as the vaccine was given, thought nothing of it, ingrown hair or something. today the pain is much more noticeable and now i can feel a lump at the source of the pain in my armpit, its about the size of a gumball. reaction from vaccine? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some enlarged axillary lymph node or some other infection.  It may be due to vaccine or accidental infection. You should take a course of antibiotics. If it doesn't respond to treatment then biopsy diagnosis is advisable. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: what might cause mild pain/discomfort in mid back just below rib and around rib to side? Discomfort began mid October. Was uncomfortable for about 3 or 4 days in mid December and since then has been mild - just doesn t feel right . No other symptoms. ### REPLY: Hi, thank you for providing a brief history of your illness. Since you have discomfort since last October I will recommend you to meet a physician and take an x-ray to see if the lungs and ribs are fine with their anatomical and physiological state. As even the muscle spasm will not stay for such a long time. If all fine with the x-ray then you need to perform some breathing exercises and costal breathing exercises while placing the hand at the painful area. A physical therapist will be of great help to ease your pain and get strength in the respiratory muscles. With the grace of God I wish you a speedy recovery ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my husband and I have gone through numerous IVF treatments, without any success.  The doctors say everything is normal except for low motility in my husbands sperm and at times my FSH levels were somewhat high. ( I reached 12, but now it is lower).  We are planning to do yet another IVF treatment this summer.  Do you recommend for us to continue trying IVF treatments, considering they tell us we have unexplained infertility?  In other words, should we keep trying IVF treatments? Do you think they eventually work, even if they havent worked 5 or 6 times? ### REPLY: Hello, Welcome to . Thanks for writing. I am .  I have read you question completely, I understand your concern and will try to help you in the best way possible. There is no harm in trying again as you know those who try hard eventually succeed like there is nothing abnormal and wrong with you and your husbands and if its unexplained fertility i DNT see why there's any harm in trying again I mean you DNBK for sure that it won't work this time like it might work and then even if it doesn't you won't regret that you made the choice so my advice will be to try again also take healthy diet and regular exercise and also tel your husband to do the same ....you will have better luck this time hope this answered your question. If you have more queries I am happy to answer.Otherwise, rate and close the discussionRegards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Sir, I am Nikhil Gandhi, age 49 years, Male from mumbai. My HDL chol. is 30.3 and LDL chol. is 110.3. My 2d echo is normal and stress test of 7.15mts. is also okay. my cardiologist has suggested to do CTangio of heart. Is it necessary? He has prescribed  me Ecosprin AV 75mg. also. Pl. advise. Thank you. ### REPLY: Hello! Welcome and thank you for asking on ! I carefully passed through your question and would explain that it is important correlating your tests with your clinical symptomatology. If you have typical chest pain which raises high suspicions of coronary artery disease, or changes in your cardiac enzymes, or well-known coronary risk factors (smoking, hypertension, diabetes, obesity, etc.)  Further tests like coronary Anglo CT scan or coronary angiography may be needed. Otherwise, considering your normal cardiac tests, no further tests are needed. Hope you will find this answer helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had pain in neck region and shoulders for months now. I ccant turn my neck all the way to the right and I have a hard time sleeping at night. My shoulders are more painful at night and my arms go numb during sleep. Is this a shoulder issue or spinal issue? I want to make a dr appointment but not sure who to see. ### REPLY: Hello, As this sounds like a cervical spine nerve root entrapment so does the symptoms. I will advise taking an MRI. Post which we can plan the treatment. Treatment included - neck stabilization by using the cervical soft collar, hot water fermentation for the neck, upper back, and shoulder.  Post having this, doing simple neck stabilization exercise like static neck exercises and range of motion exercise will be helpful.  Also, shoulder stabilization exercises, inter-scapular muscle strengthening exercises, upper limb strengthening exercises will help to reduce the symptoms to a greater extent. Hope I have answered your query. Let me know if I can assist you further. Take care 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: Suddenly I felt sick to my stomach, got cold sweats and bad middle back pain. I alternated between sitting in the bathroom feeling like I might throw up and laying on the bed. After about an hour, all symptoms disappeared. I did have the flu shot - is this the flu? ### REPLY: It is quite possible. Depending on the area you live in it could be dengue as well. If you have severe back pain, pain behind the eyes and bone pain in other areas: it could be dengue for which you should get an NS1 serology done even so I suggest a complete blood count to give a fair idea of what you possibly have.in the meantime I suggest a healthy intake of fluids(coconut water would be perfect) and paracetamol 500 mg 6th hourly(unless you have a liver condition of any sort) when you get fever ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 feeling shaky almost nervous. I get dizzy very easy. I am tired all of the time. I am thirsty all the time. My head hurts a lot. I had heart surgery in 2008 for aortic regurgitation. Two months ago I was hospitalized with chest pain and they kept giving me potassium. I need help ### REPLY: Hello! Thank you for asking on ! Regarding your concern, I would like to explain that many disorders could cause this clinical scenario. I would recommend consulting with your GP for a careful physical examination, a resting ECG, a chest x-ray and some blood lab tests : - complete blood count for chronic anemia-kidney and liver function tests - blood electrolytes (including calcium and magnesium)- thyroid hormone levels and cortisol plasma levels (to exclude possible thyroid and a .  -inflammation tests (fibrinogen, PCR, sedimentation), because an autoimmune disorder could mimic such a clinical scenario. -blood and urine osmolarity (this test helps define the cause of your thirst)I also advise monitoring your blood pressure in both sitting and standing up position. A head up tilt test is necessary to exclude possible orthostatic hypotension. Hope to have been of help! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Enivian@ WWW.WWWW.WW Hi i just had my tooth remove on tuesday.. It was growin sideways and it shifted because My wisdom tooth was forcing its way in.. Its in da middle of my jab n noone can see it .. It had to b removed cuz da tooth was undermy tongue Practicaly didnt play a roll in crewing.. Anywaz i dont think i treated it right... No wash Scop or salt water... So know i wanna know wat To do to cleanse it so i dont have wierd Gum problems n stuff. Can u recommend Something and is it possible i hav dry socket how Can i treat it if i do...it doesnt look to bad but Still wanna be safe.. ### REPLY: Hello, Thanks for posting your query, The initial healing period typically takes from one to two weeks, gum tissue takes about 3-4 weeks to heal and complete healing of the bone can take about 6-8 months depending on your care of this creator several days after the extraction, it is important to keep the area as clean as possible to prevent infection and promote healing. Do not directly brush the extraction site for the first 3-4 days after surgery to prevent dislodging of the blood clot from the socket. You are required to make a post-op appointment in one week to check on the healing of this area.  If sutures were placed they will be removed at this time. I hope this information has been both informative and helpful Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having stomach bleeding 3 times in last three weeks. The first time this happened to me was October 2014 and endoscopy was done but could not find where the bleeding started. I have stopped all anti inflammatory meds. I.e. Lodine, aspirin but I am in a lot of hip pain causing difficulty walking. I didn t go to the hospital with the most recent bleeds since the place of. Bleeding can t be found, so I just suffer thru for a few days of discomfort. But the most recent bleed came with a feeling of tightness across my chest and left side neck pain that kept me up all night. Also I had more abdominal bloating with Hugh belches and gas. I am taking iron and eating food that build red blood cells. This is occurring once a week for past three weeks. What should my dr. Be recommending for tx of inflammation and locating bleeding area. Thanks Maria brock ### REPLY: Hi, Dear,Thanks for your query to . Dear I read your query and reviewed it with context to your query facts. I understood your health concerns and feel Concerned about them. Based on the facts of your query, you seem to suffer from-Upper GI -Unknown Bleed site-With NSAID chronic use for Severe Hip joint pain-Under Evaluation. As there doesn't appear to be blood vomiting, indicating the bleeding from Stomach is gradual and is from oozes mostly caused from Gastric Erosion from Chronic Use of Aspirin. As no site is found in Stomach, you need to find out sites of bleeding in intestines and in colon. Remedy For your case problem--Protective PPI to control Gastric erosions-Volez D -1 x 2 times a day.-Shifting to Gabapentin from Aspirin/NSAIDs-for severe Hip Joint.-Statins-Atorvastatin- to control high cholesterolemia- and Teams 40 mg to control high BP -Anti-anginal . -Hemostatic sealants / like endoscopic hemostats or oral hemostatic agents-Gaviscon Liquid-2 SF x 3 times with food intake.-Tab It B12-2500 MCG x once a day.-Tab Folic Acid- 5o MMX once a day.-BRAT diet-Banana/rice/ smashed apple/ toasts-Bland light volume diets.-Besides NSAIDs accompanied other causes need to be ruled out. Get following tests done-Superior Mesenteric arteriogram / Colonoscopies to detect colonic bleeding sites like cancers / or erosive lower bowel bleeding from NSAIDs. / or from Colonic polyps / or accompanied Diverticulitis if any. Assessment and treatment accordingly from Surgeon or Gastroenterologist would be needed to investigate and treat your case accordingly. In Brief -Your long term use of NSAIDs need to be omitted and need to be changed to Gabapentin or Nor co/ HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What is wrong with me? I have been experiencing: Severe fatigue, some nausea, headaches, slight dizziness, temperature changes. Over the last 3 days. I don t know what is wrong with me. I have been very stressed. I have been paranoid of contracting a possible STD, its been 5 days since I have had sex. Also I think I could be lacking vitamins or something needed. What do you think may be causing me to feel this may? I really appreciate any help. Thank you. ### REPLY: Thanks for asking in  Forum In short: Urinary tract infection may cause these symptomsExplanation: You have not mentioned your age and sex and any discharge from your genitals. You have mentioned that you had sex 5 days back with the above symptoms. If you had sex with unknown person STD is a possibility.  Don't get panic, be calm and pay a visit to your local doctor and get yourself examined and tested for Urinary tract infection and STD for the relief of your anxiety.  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: Hi I have some white patches on my face.I am currently on omeaopathic treatment and it has been a year since I took the treatment.The patches have not reduced or become milder but it has spread a lilttle only on the left side of my face(i was told by the doctor that it may increase) Is there any cure for this.Should i stop homeopathy ? any solution that can be applied externally in addition to the treatment i am undertaking? ### REPLY: Hello and Welcome to , Thanks for writing to us. You must always keep your face clean by washing it with water several times a day. Do not use soap every time you wash your face, unless it is a very mild one, or rich in moisturizing oils. After washing your face, gently pat it . Twice a week, you should also exfoliate your skin in order to remove dead skin cells and dirt from the pores on your skin. Make a paste by mixing two tablespoons of honey, a teaspoon each of rice powder, sandalwood powder and turmeric powder, and apply this scrub on your face. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 having a hard time breathing at night when I lay down. Its been goin on for a month now I cant sleep because of it. I try sitting up on the couch to get some sleep but thats not working either I feel like I am gasping for air when I lay down. ### REPLY: Thanks for your question on . I can understand your concern. You are having orthopnea (breathing difficulty on lying down). Orthopnea is classical symptom of heart diseases like heart failure and coronary artery disease (CAD). So without wasting much time, you should immediately consult cardiologist and get done 1. Blood pressure monitoring 2. Ecg3. 2d echo 4. Stress test 5. Coronary angiography (if required). You may need diuretics and other cardiac supportive .  Don't worry, early diagnosis and treatment will definitely resolve your symptoms. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve been having swelling in mostly the right hand. Middle finger is the worst and seems to lock up in the morning. I also have pain in the joints right by my toes. I am having gripping problems and seem to have a hard time using my hand to open or unfasten things of late. ### REPLY: Hello Hand swelling can be due to carpal tunnel syn . You may need clinical examination and further investigation. Use of machine can reduce your pain and swelling, you can ask your physio for wax bath therapy Use ice packs to reduce swelling, inflammation and pain. Physiotherapy with ultrasound and Tens will help you, For early healing you can take Tab Colin [it C] and antioxidant with anti-inflammatory [Tab enzymic plus]. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: after several days of feeling off and dizziness, my husband became violently ill.  He was very weak, vomiting and couldnt walk.  his vision was blurred.  We took him to ER and they said he had the flu. It has been 4 days and his vision is still a little off and although he is not vomiting anymore, he still seems to have trouble walking.  In ER they did blood tests, xrays of he abdomen, and EKG and urine tests.  Where do we go from here? ### REPLY: Hi, Thank you for posting your query. Your husband needs detailed evaluation by an ENT doctor and neurologist. This is because he could be having a vestibular dysfunction or a mild brain stroke. After evaluation, a brain MRI scan may be needed to confirm the diagnosis. There are excellent medications available to treat your husband, and hence, there is no need to worry. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my cousin had a mild heart attack (he s 51 yrs old) a month back and one of his arteries is 100% blocked. Yesterday he climbed down around 25 steps had food and climbed up a steep ramp. Few minutes later he felt giddy and his hands went cold and the whole day we was very tired. We were wondering if it was another mild attack. Is it ok for a person to climb up/down the stairs for slant surface? can it cause another attack+ ### REPLY: Hello, Patients who had a heart attack is usually advised gradual progression of activity levels to avoid sudden precipitation of a cardiac event like chest pains. And considering that his arteries are documented to be blocked, even the slightest activity can cause symptoms. And he is advised no to do any physical activity that would precipitate symptoms.  Patients with blocked arteries are expected to have symptoms with several activities, and it is important to go for a regular follow-up with your doctor to check for new problems, as well as possible adjustment or addition of medications to help decrease or prevent symptom recurrence.  If his symptoms persist more than 20-30 minutes and are not relieved by rest, I would suggest a follow-up in the Emergency Room as it may portray another heart attack which needs prompt medical intervention and observation in the Intensive Care Unit. 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 aracnoid cysts on my spine and in my nervesi am a 26 yr old female and i have more then 15 cysts in my spine,not sure how many in my nerves. i suffer from pain,loss of feeling in right leg,seizures and extreme headaches. no doctor will offer treatment due to my age. i would like to know where and who will treat me ### REPLY: Sounds to me as if you may have a legitimate reason for surgical intervention, however, I would really need to read your radiograph reports to more fully understand the complexity of your situation.  Also, can you secure any of the consultation reports from any of the neurosurgeons you've seen thus far?  There is no way you can obligate any doctor to offer a specific type of treatment...even if it seems justified and reasonable to the patient or another doctor.  It is the responsibility and liability of the doctor undertaking the procedure therefore, it has to be their decision.  Arachnoid cysts are typically felt to be benign and present since childbirth.  For that reason most neurologists and neurosurgeons are very hands-off doing anything when they are found in the brain or spinal cord.  However, in this situation, if there are significant numbers of lesions, and if they are causing visible or measurable mass effect in the brain and can be shown to be actually compressing or squeezing important brain structures or obstructing the flow of CSF then, a very compelling circumstance can be argued to exist which would invoke surgical intervention.  Please upload what I've asked for to: www.bit.ly/ .  Cheers! ### END