Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 18 year old daughter has tonic clonic seizures just before or after her period. In the past she had a problem with taking suppositories for constipation because of her vagus nerve (she would almost pass out). Could her menses stimulate her vegus nerve at this time and trigger a seizure? ### REPLY: Hi, Thank you for posting your query. It is common for certain types of seizures to get aggravated during the menstrual periods. This is referred to as Catalonia epilepsy. These phenomenon are related to hormonal influence rather than vagus nerve stimulation. Similar situation can occur in women with migraine, which can get worse during periods, referred to as Catalonia or menstrual migraine. In your daughters case, taking cloacae for a week during periods would help reduce the chances of seizure recurrence during that period. I hope my answer helps. Please get back 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: I have been diagnosed with BP 160/98. I have been advised by the doctor to take Stamlo 5, 1 tablet everday. I have started taking that from today. My question is that even if my BP comes to normal level, then is it necessary to continue medication throughout? ### REPLY: Hi, When your blood pressure comes to normal level, there will be a need to continue the medication anyway. It will regulate your blood pressure and will not allow it to increase. Anyway you should check your blood pressure from time to time after regulation, as sometimes there is a need to increase or decrease the dose. Hope I could help nourishing you good health In case of further questions don't hesitate to ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have hypothyroidism and recently went to the hospital because I felt weak and exhausted. When I got to the hospital my red blood cell count was 5.6  ...the doctors gave me a blood transfusion and the next day I developed paralysis and was diagnosed with Guillian Barre Syndrome. Does Low red blood cell count part of the GBS or is this something else? Can the thyroid be causing this ### REPLY: Hi! Thanks for posting your query on . I am sorry to know that you have been diagnosed to have Guillain Barre syn . It is a rare disorder that causes your immune system to attack your peripheral nerves which connect your brain and spinal cord with the rest of your body. The damaged nerves can not transmit the impulses to the muscles. As a result, your muscles have trouble responding to your brain resulting in weakness and muscle pains. The exact cause of Guillain-Barre syn ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 some difficulties with breathing and discomfort in my chest -- working with my primary dr. to find out the cause -- at this point they suspect paricarditis.  Had an echocardiogram done Friday and wore a haltor monitor for 24 hrs.  waiting on test results.  My question is 2 fold - 1) if I have paricarditis, how is it treated, and 2) if it isnt what could this be? (they have ruled out lung problems with xray and ct scan of lungs) ### REPLY: Hello and welcome, Pericarditis is treated mostly with non-steroidal anti-inflammatory .  But variety of factors (infections, autoimmune diseases) may cause pericarditis and your doctor may prescribe additional treatment according to the etiology of the disease. Other causes of dyspnea and chest discomfort are: -heart failure -cardiomyopathies-endocarditis-valvular problems (probably your doctors have ruled out these conditions with echocardiogram)-myocarditis-ischemic heart disesase-heart rhythm disturbances (holder monitor should detect it rare rhythm disturbances)-gastroesophageal reflux disease and other esophageal pathologies (you might need endoscopic evaluation) -obstructive and restrictive lung disease (spirometry)-pulmonary hypertension Ordering additional tests depends on your previous test results and physical exam findings. I hope the above information will be helpful for you. Please, feel free to ask me if there is anything else you need to know. Thank you, Malik Among MD ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hithanks for your reply. i have now got a orthodontist. i have braces which i need to wear for 18months. i will also need to get jaw surgery this time next year. i have mensioned my grinding to the dentist and he has said this problem isnt caused by this. i was wondering what else can cause this? i am 28 years old. look forward to hearing from you soonattia ### REPLY: Hi, Thanks for asking the query, According to your clinical symptoms I suspect that you have forwardly placed teeth, this can either be due to enlarged maxilla or mandible or both. You require an OPG radiograph, impressions of the upper and lower jaw to determine type of treatment. As you mentioned you are going to take a jaw surgery next year and permanent braces can be placed. The process of grinding the teeth is medically termed as BRUISE. This can be due to stress, bad . Treatment of bruise is required as it causes TMJ problems, attrition of teeth, sensitivity. Hope you find this is 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: Hello Doctor,I need a very urgent help for my mom, she is 48 year old.Her left half part of body got paralyzed 3 months back. She belongs to India in a small town so we were not aware about the 48 to 72 hours paralyzed cure treatment. now we are very late.Presently my mom legs, speech, mouth recovery is going fine but in left arm there is no recovery but left arm pain a lot. She is taking 2 times physiotherapy and she also use to walk with stick support.Any good suggestion to get my mom left arm working..Kindly helo and suggest, ### REPLY: If not taken proper treatment from beginning, there is possibility of developing "spasticity" on paralyzed limb. Also, can be chances to develop "frozen shoulder". You should consult a neurologist to see our mom clinically. For spasticity, few medicines are available like (baclofen, tolperisone, Botox injection)Also she needs full assessment regarding risk factors of stroke and preventive treatment to be taken life long. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hystepyrosismy mother is 55 yrs old she is suffering with back pain since 05yrs. now she is feeling so much pain in back during sleeping position also in stomach. after x ray and dxa reports doctors told that she is suffering with hystepyrosis. my question is that what treatment should be given or any more investigation is required? ### REPLY: Hi, Welcome to . After going through your query I think your mother is suffering from chronic backache with osteoporosis. Treatment of back pain is exercises and analgesics (diclofenac 100mgSR). For osteoporosis calcium supplementation is given. Sometimes vitamin D deficiency is the cause so get her vitamin D checked. If it is low then vitamin D supplementation (On DK 60K weekly with milk) can be taken. Avoid long continuous standing. Sit in a straight posture. Eat milk and milk product, fruits and green leafy vegetables daily. To further investigate MRI of the region is advised. I think your query answered. Welcome to any follow-up query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have ocd ,can i talk about it with u?i had a lways had odd.i know they r ridiculous thoughts but i can t control it.more logical i try to encounter them worse the result is.right now i have obsession with pronunciation of words mostly brands and name of super stars.something that seems so stupid to me but i can t help it.for example its in my mind for a week how the brand reebok is pronounced,is it reebahk or just reeb o k.i check it in net millions of times but i don t get certain by any of them.i listen to each pronunciation 10 times but i doubt if i heard it right or not.please tell me what should i do ### REPLY: Hi, I read your problem in detail and can understand the distress you might be having with your symptoms. You haven't mentioned if you are taking any form of treatment. Obsessive compulsive disorder (OCD) is amenable to treatment. You should consult a psychiatrist for the same. Treatment with selective serotonin reuptake inhibitors like fluoxetine, sertraline is safe and effective. In addition to medications, you can also opt for cognitive behavior therapy if someone trained in it is available in your area. It will consist of frequent sessions with your therapist and behavioral measures for obsessions and compulsions will be taught. Hope this information was helpful. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I am 18 years old and recently I have had difficulty with sleeping. I have this problem for over a year now...It usually happens when I am about to fall asleep I get a feeling that there is something in my room that I can only describe as evil and wants to hurt me. Sometimes I am unable to move (this is not always the case) and have an intense feeling of fear. I have also heard this thing in my room whisper my name and sometimes whispering. I have also felt a pressure on my mattress and something touching me. This has also happened to me when i woke up from sleep. This has happenes to me before when I was around the age of twelve...I can t talk to it about anyone not even my own GP incase they tell me I think I m crazy or imagining things. I am now afraid to go to sleep and am also extremely tired during the day even when i do manage to get some sleep. Please help me. S. ### REPLY: Hi chemicalcheez, I am NOT starting out telling you that you are crazy.  Although I am not familiar with parapsychology, unexplained phenomenon occur daily.  So, I am not going to attempt to puzzle this out. I will state, there are certain medications (prescription and illegal) that can induce these symptoms.  Also, if our brains' chemistry is not balanced, you may experience these types of symptoms.  You are giving me descriptions of paranoia along with auditory and tactile hallucinations.  Have you attempted to change your sleep routine?  Have you attempted to sleep in a different location (both within your home and outside your home)? Are you a very spiritual-based person?  Have you attempted to enlist help from your local clergy? No family physician should make you so uncomfortable that you cannot confide in him/her.  If you do not trust your own physician, see another.  I believe you could benefit from seeing a therapist in addition to a clergyman. I'm trying to ad .  If this is a medical problem, the sooner you find out and begin the correct medications, the quicker the symptoms will abate.  If this is a spiritual situation, I hope you have a clergyman that is willing to help you.  Attempt to speak to a catholic priest. Be well, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a slightly enlarged lump on the left side of my neck, which has been there for about a week. I am a very healthy person, I hardly ever get sick. My roommates were just sick with colds so Im thinking this could be from my body fighting of a cold before it starts. I am experiencing no other symptoms. My friend is also a student nurse and she felt my neck and said it feels normal. Should I be worried? Can a lymph node be naturally larger than the other? ### REPLY: Welcome to  .1. The history given by you suggest the lymph nodal enlargement.2. Lymph nodal enlargement is seen after any infection / inflammation - it can be localized or systemic. 3. Lymph nodes can be of any size as they grow.4. Confirmatory is an ultrasound neck which will help to assess the nature of the lumps and its source and where all they are extending.5. In this case treat the cause if you are aware of anything, if not then lymph nodal pathology itself can be possible, also scan results can be followed. Good luck. Hope it helps you. Wish you a good health. Anything to ask ? Do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: In 08 and 09 I had knee replacement surgery. I have top of foot and above my ankle numbness since 08 rehab on my right side. The left side surgery 09 not as bad, but still, numbness above my ankle and top of my foot. It drives me crazy 24 - 7. I can walk, but I have a hard time finding shoes. I am 73 yrs old and I am not diabetic. I am ver uncomfortable. ### REPLY: Hi, thank you for providing the brief history of you. A thorough neuromuscular assessment is advised. As there is numbness over the top of foot and ankle as well, a thorough assessment by an orthopedic will help understand the issue better. If the or tho feels there is a need of the MRI of the lumbar spine, you will be guided one. Also, as you had TKR may be on both sides, as mentioned by you, before the TKR the gait pattern was different in your case due to pain and post TKR it changed further, which may have lead to the soft tissue injury in the spinal column. After a thorough assessment, you may be advised to undergo physical therapy, as they will help to improve the strength in the core muscles, pelvic floor muscles, spinal muscles and the lower limb as a whole. I am sure you will have 99% recovery at the earliest. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i was bit by my pet and i have taken 4 dosage of rabipur injection 0,3,7,14 and the 5th dosage of anti rabies is pending and again i was bit yesterday by my pet and the bite area is just like a small scratch which we get from metal trash or so my query is that should i undergo a full dosage of 0,3,7,14,28 or only the pending 5th dosage ### REPLY: Hello, Thank you for your contact to . I understand your concern. If I am your doctor I suggest you that you have taken the 4 doses of Raipur regularly, so you have developed immunity against it. There is no need to take the complete rabies schedule again. You can take the fifth dose of Raipur, and you will be protected with Rabies infection. I will be happy to answer your further concerned can contact me. . Infectious disease specialist. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Dr. How are you?I hope every thing is well, i wish to inform you that i have received my job visa ,  there is a condition to bring a medical examination , but i am a carrier of Hipatitis b with out symptoms .i am afraid that my job contracted is cancled , how could i hide the virus please?Ali KhanYemen ### REPLY: There is no way to hide the virus. You can be treated for hepatitis B, which might remove the virus from your body, so you are no longer a carrier. Talk to a doctor who specializes in treating liver disease and chronic hepatitis. This could be an infectious disease specialist or a gastroenterologist or hepatologist. They should be able to help you see about treatment so you no longer have the virus and can then get a job visa. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my child 5 yrs old is suffering from omitting,stomach pain ,fever,loose motion since yesterday.The doctor has advised for ofloxacin & metronidazole sus. & mefenamic acid tab. ,the chid still has loose motion and stomach pain. However fever is in control.Pl. advice ### REPLY: Hello, Thank you for your contact to . I understand your health concern, if I am your doctor I suggest you that do culture and sensitivity of stool. Take treatment according to sensitivity report. Till the report comes you can continue the treatment prescribed by the doctors. I will be happy to answer all your future concern. Thank you, ChatDoctorInfectious disease specialist. Wish you the best health at . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my baby boy is 15 mon old..he has been teething early...his two front teeth are yellowish to brwonish coloured...i asked his pediatrician he said this is nothing..but m worried.. also the edges of his teeth are not smooth..partially loss of the edges near this yellowish colour...please help i need your opinion...what can i do ### REPLY: Hello, thank you for consulting with . There can be two possibilities for this yellowish colored teeth, First it can appear in places where there is excessive fluoride in water, so the teeth are discolored, Second there can be a disease known as gametogenesis imperfect that is fault in structure of teeth. In both the cases you have to visit a child dentist (periodontist) and get proper examination of teeth done. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i feeling mutch pain in my right abdomen according to ultrasound report evry thing is clear like kidnee liver stomec  appendux andblader etc.but a mass is seaing in right illalic fosa region.size of mass is 85mm by 55mm.hear no any further detail of mass.my family docter is treeting me with ofloxacine and pain killer. starting of pain is from 10 day ago ### REPLY: Hi. Thanks for your query. The pain in the right abdomen will be obviously related to the right Iliad fossa mass. Such a big mass of the size of more than 8.5 cm by 5.5 cm can be due to a few things. -Twisted ovarian cyst, the stalk becomes elongated. And can be palpated / seen in the ultrasonography. - Mesenteric cyst is another possibility. I would suggest you the following. Confirmation by CT scan The best way is to put a Laparoscope, see what it is and to excise this mass in toto and to send for histopathology report. Consult a Laparoscopic Surgeon and a Gynecologist for second opinion and get operated after Physicians fitness for anesthesia and surgery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Dr. Rynne, I recently had a CBC and was told my platelet count which had been at 100 for eight years had dropped to 64. I have very pale skin and over the last couple of months have acquired tiny red dots on my lower legs. My primary care doctor wants me to see a hematologist, and I am waiting for an appointment. In the meantime, I have been trying to find information on these symptoms and am hoping you can help. Thank you very much. ### REPLY: Hello and welcome to , Pale skin is a sign of anemia or low hemoglobin. Anemia can be caused due to decreased production of red blood cells, increased blood loss or increased red blood cell destruction. The cause for the anemia has to be found out, and relevant investigations include hemoglobin level estimation, red blood cell counts, red cell indices and peripheral blood smear examination. Development of red dots over lower legs can be due to low platelet counts. Low platelets can lead to petechial hemorrhages which appear as small red spots over the skin and mucus membranes. Thus, you need to consult a hematologist for both anemia and low platelet counts. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mom has had her second surgury on her leg to remove infection. the wound is 6 inches deep and about 3 inches wide to prevent any infection from setting in to her leg what is the best thing to clean it with and is cloropacktin the best thing to pack the wound with ### REPLY: Hello, Welcome to , As your mom underwent a surgery on her leg for the wound which was measuring around 6 inches long and 3 inches wide. You don't want to infect the wound. To prevent the wound infection I would suggest you to follow1. Keep the wound clean and . 2. Injectable antibiotics like In Cipro, twice daily and In Metro, three times a day for at least three days to prevent infection of the wound and this is followed by shifting into oral antibiotics.3. Inj TT, if not taken in last five years.4. Tab Acetaminophen will help to reduce the pain and fever associated with the wound.5.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: SIR ,I HAVE BEEN SUFFERING FROM BIPOLAR DISORDER AS PER my DOCTOR SAY WHEREAS I M SUFFERING FROM INSOMNIA RATHER THAN BIPOLAR. I HAVE BEEN TAKING 2MG CLONAZEPAM SINCE 1998 WITH TRICA THAN PROTHEDIN THAN MIRTAZE THAN NITROZEPAM THAN REMITAX THAN DIAZEPAM THAN VALLIUM UP TO 2010. WITH CLONAZEPAM 2MG I HAD BEEN GIVEN LITHIUM, IT SET ME BUT LITHIUM BADLY AFFECTED MY THYROID PROFILE SO AS IT SET ME MY DOCTOR STOPPED IT. THAN I WAS GIVEN 2MG CLONAZEPAM WITH 400MG QUTIAPIN PLAIN +600MG GABANEURON SR WITH 10MG ZOLFRESH SINCE LAST 4YEARS.NOW SIR THOUGH I HAVE BEEN TAKING THIS DOSE WITH SLEEP HIGINE LIKE WARM MILK WITH COWS GHEE AT NIGHT MY SLEEP DISTURBED AND I HAVE TO TAKE 0.5MG OF CLONAZEPAM AT MIDNIGHT. I THINK 2.5MG CLONAZEPAM IS HIGH DOSE. I WANT TO BE OUT OF THIS NEXUSES. WHAT SHOULD I DO? HOW CAN I ADJUST MY DOSE? MY MAIN ISSUE IS SLEEP EITHER DISTURBED OR INSUFFICIENT. I HAVE GONE THROUGH VARIOUS MEDICAL JOURNALS REGARDING THE ISSUE AND CONTENTS OF DRUGS WITH THEIR GOOD AND BAD EFFECTS.PERHAPS I MAY BE MY OWN PSYCHIATRIST OR NEUROLOGIST. SORRY SIR PLEASE GUIDE ME. ### REPLY: Hello, You did not describe your symptoms, but according to your .  Main thing is insomnia for you; I will suggest you to first follow proper sleep hygiene along with medication like Mirtazapine along with benzodiazepine. In sleep hygiene:1) Do not use of your bed for any other work expect sleep2) Stop all activity half hour prior to sleep3) Take warm water bath before sleep4) Not to use of clock with sound in your be ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had about 20 extractions and dentures put in about 6 months ago and never really got comfortable with them and the adhesive. Could the fact that I was grinding and fidgeting with them made it possible for the inner skin inside to peel off inside of my body as I have had feelings of string or rubber wrapping around my head and body sometimes it feels like my ear is actually pinned backwards but when I look I m the mirror it is fine. I went to the doctor and he said it was neurological so I went to the emergency room and get MRI and am awaitiny appointment with him. Have you ever heard of anything like this? ### REPLY: Hi. Thanks for the query. Well, if you have a habit of grinding teeth then the denture will unfortunately not set well causing difficulty in adaptation of the dentures. It can continuously dislodge he denture and making it difficult for you to wear them and use efficiently.However, the denture will not cause any peeling of skin inside body or the other symptoms of string wrapped around the head. Yes, you are advised correctly that the symptoms can be neurological and even the grinding of teeth can be related to it. So my suggestion is to get your MRI evaluated.Also, for teeth grinding habit you can do meditation and reduce stress. Also consult a Prosthodontist for manipulation of your denture. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have sever nasal draining and sneezing (5-20 times) after I eat sugar. It happens any time I eat too much sugar. I think of it as a sugar allergy as it happens every time, sometimes right after, sometimes the next day, depending on the rate of consumption. I love sweets and have tried for the last 5-10 years to find another answer, but it ALWAYS comes back to - sugar makes me sneeze. I have no other medical conditions.  I sometimes sneeze once at sun,strong mints, but only rarely, not really pepper/peppers or any other food(I am a chef). I have tried antihistamines and they do not help. I dont want to stop eating sugar. Is there any cure, antidote, food balance? ### REPLY: Cellophane You for contacting . As you have chronic allergy problem so I would suggest you following two things:> First, take montelukast once daily for one month. Research has shown that it decreases the incidence of allergy.> Second, I would also suggest you to undergo allergy testing at allergy clinic as you have chronic allergy problem. It will tell that you are allergic to what specific thing. The results will help an allergist to prescribe you immunotherapy to that specific allergen, and it will improve the problem. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. 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: Suddenly was unable to come with right  words thats vital s were completely familiar. She is 89 years old and had three TIAs in the past 10 weeks. A visiting nurse came and tested her vital signs. Everything normal. Doctor say these TIAs are random occurrences. Besides monitoring there is nothing once can to prevent them. Do you agree? ### REPLY: Hi, This is common at this age as there is insufficient blood circulation in the brain leading to temporary forgetfulness and even unconsciousness. After circulation becomes alright, she will be fine with normal memory.at this age there are some atrophy changes in the brain might cause this problem as well. If her physician finds it proper he can be given Low does of aspirin for thinning of blood. Avoid keeping pillow below neck while sleeping. Ok and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor... my child is suffering with abdominal pain and vomiting..he had outside food yesterday . i took him to a pediatrician today morning. he has prescribed syp.indowell,syp,cyclopam,and syp.taxim. i have given the doses as prescribed. but he has vomitting and abdominal pain still. what to do? ### REPLY: It seems that your child is suffering from acute gastroenteritis. Medication is proper. Treatment is not supposed to bring down the frequency of passage of loose stools. Give ORS (Oral Rely .  It comes in ready-made form or may be prepared by mixing a full sachet in the designated amount of water. Replenishment of the lost water and salts as the mainstay of treatment. The adequacy of the HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a sexual encounter for the first time two years ago with a gay person and they was no penetration involved,we rubbed our genitals together and two day later i woke up with a tingling and itchy sensation on my penis shaft and scrotum i have been going for hiv tests they have been negative took antibiotics for other stis but the itch still persists,i have no rash discharge,pain or sores what could it be ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. You are not infected with any STDs including HIV. Please allay fear for the same. As you have not penetrated there is no question of HIV infection. Secondly rubbing genitals can cause STDs but only itching and tingling cant be STDs. STDs usually present with some other sign and symptoms apart from tingling and numbness. Usually it is present with discharge, swelling, redness etc. As you have taken the antibiotics there is no question left for any STDs. Your problem may be wanes of in some times. Please maintain good hygiene by cleanliness over the penile area. Avoid sexual intercourse during this period, or you can use condom instead. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?      Please type your query here...from past three days i have severe abdominal pain that too  at  midnight 1.30 it starts from abdominal and i talke ocid20mg and gelusil but it is transfered from lower abdominal to the back  and later the hip  and the back when i consulted the doctors they say it is more of bile juice secreation what should i do  to get releif from the pain ### REPLY: Hi. Thanks for your query. You have got a classical pain pattern of developing it at 1:30 am and the pain is transferred to the back and hip and back again. The occurrence at this time is indicating that the stomach get emptied of the dinner you had and so the timing as this is the time to get the pains . I would recommend you the following:First thing to do is to get an upper GI Endoscopy done so that you get a perfect diagnosis and the treatment can be modulated as per the findings. Take Acid Twice daily. Antacid every 3 hourly to cover the stomach when it is empty Take small frequent meals. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 underwent my 3rd vp shunt revision on 07-31-14.,I came home the next day with extreme headaches, confusion, memory loss, felt feverish, etc....notified neuro surgeon and he had me return to the ER the next day. Stayed in the ER for over 24 hours waiting on a hospital bed. Was finally readmitted and taken back to surgery and my entire shunt system was replaced. I was discharged home at approximately 8pm now yesterday. Upon arriving home began to experience fever, chilling, etc..... Had a low grade temp at discharge now fever over 100.3. Unable to reach my neurosurgeon and trauma center is 2 hours away. Unsure if I should try getting there now or wait until morning to call surgeon. ### REPLY: Hi, Thanks for writing in. There is a small possibility that you might have got an infection following revision of VP shunting surgery. Such infections are not common but should it happen then it needs to be treated at the earliest. Please take over the counter medication for fever like Tylenol and then wait for about 4 to 6 hours to see for any improvements. If your doctors have given a course of antibiotics then please take it. You also need to eat well and take rest. If it is late evening and fever is 100.3 then you can still wait till morning but the first thing you should do is talk to your neurosurgeon if possible, any time before that. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 low blood pressure ususally 80 systolic and 40s and 50s dyastolic. I also have heart flutters especially when I lay down too fast and lay on my left side. I have had panic attacks for 14 years. I have had an echo and two holter monitor tests and felt the flutters with the holter on but nothing was ever picked up. I recently switched from atenolol to metropolol and it made the flutters worse. Is it likely that I am just experiencing pvcs or something and that nothing is wrong. I have seen two cardiologists who have put me in the clear ### REPLY: Hi Thereafter reading the medical details provided by you, I am surprised why you are taking BETA BLOCKERS in first when your BP is staying low. I would like to advise you to stop taking Metoprolol for a week and monitor your BP daily at same time for a week and if it stays below 140/90 MMH then you need not start the medicine back just need to maintain healthy lifestyle habits, and you will be fine. THINGS TO DO for healthy lifestyle habits.1. Daily brisk morning walk for 45 mins a day for 5 days a week.2. No smoking 3. Low salt diet4. Avoid junk and canned food5. Include good amount of fruits and vegetables in diet.6. Keep calm and happy 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: ok, so ive been feeling a little sore and tired the last two or three days and the this afternoo i notcied a red rash on my hip. it is not ichy or painful and it is not raised or bumpy, its just a red splotch on my side. do you think this is cause for concern? ### REPLY: Hi, Most probably the lesion you described may be ecchymosis. It is a purpuric patch. It may be idiopatChatDoctoreans without cause or there may be some cause like friction or blunt injury. You consult dermatologist for firm diagnosis. Blood tests may be done to rule out internal diseases. You may take vitamin C and vitamin K along with thrombophob ointment application on the patch. It might fade within few weeks. If it relapses, you go for investigations and have perfect treatment. I hope you got my answer. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve had implanon for 2 yrs now. When I first got it I bleed for about 6 months .. I have had may 3 periods since then .. maybe! I just recently started being more sexually active and started bleeding again I thought it was related to that but now I have been bleeding for about 3 months now and I m starting to think something is wrong ### REPLY: Hello, Thanks for posting your query. I have gone through it and understood your concern. Persistent bleeding after settling down with the contraception should call for further evaluation by an expert. You need a proper clinical examination, a sonogram of the pelvis preferably in the trans-vaginal route, blood counts, coagulation and liver profile and urinalysis. Pregnancy should be excluded. Local causes like erosion, polyps and infections should also be excluded. Weight disturbances, stress, infections and use of certain medications create hormone disturbances and can cause such bleeding. Hope you find this information useful. 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 sir, i am raj 24years old male .i had take 3 months treatment (jaundice) ,i had take fist Folk remedies treatment that time  serum billirubin(total) 3.5 % then i had consider doctor take medicine 1 month  serum billirubin(total) 3.0 % now s.b 3.1% why will increase? what type of medicine i will take & what type food i will take ? which method is best  reduce s.b   how long will take that treatment . ### REPLY: Hi.noted history of elevated bilirubin. It is possible that you have an obstruction (a stone or a lesion) somewhere along your hepaticopancreaticobiliary tree. It is best if you consult with a doctor, preferably a gastroenterologist or a general surgeon, for physical examination and clinical evaluation. Other diagnostics (such as ERCP/MRCP, liver function tests, complete blood count, etc.) and management (medical and/or surgical if indications are found) will be directed accordingly. Low fat low salt diet is also recommended. 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 father s age is 69. He is a diabetic patient for the past 30 years and has been only using oral medications. Recently he has been diagnosed with AML and undergoing chemotherapy treatment. His counts are fluctuating and his sugar levels are unpredictable and has to take insulin. Please help. ### REPLY: Hello, If a diabetic patient is on chemotherapy, those .  Controlling blood glucose becomes much difficult. Proper titration of insulin dosage and repeated checking of glucose levels at home is absolutely essential. Also, one may have to use more than one type of insulin like a long acting newer insulin (glaring or deluded) and a rapid acting one to control post meal surge of glucose. If corticosteroids are used in the treatment they also do affect, so you have to manage with extra care. 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: Well i am on the phone with my cousin right now. she just drove herself to the doctors this morning because she said her heart was pounding very fast, and she had a tingling feeling down her arm and saw pulsating vein in her left palm. dr. said her pressure was 180 over 104 ### REPLY: DEAR USER, THANKS FOR CONSULTING WITH ChatDoctorI UNDERSTAND YOUR CONCERTGOER COUSIN BP IS VERY HIGH AND SUCH HIGH BP CAN CAUSE SYMPTOMS OF PALPITATION AND POUNDING VESSELS ADVISE YOU TO URGENTLY CONSULT THE ER AND GET HER BLOOD PRESSURE CONTROLLED AFTER WHICH THE CONSULTING PHYSICIAN CAN EVALUATE HER TO FIND THE CAUSE OF HER DISEASEHOPE I ANSWERED YOUR QUERY. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Got a very minor dog bite which was cleaned with soap and water and then covered, scanned over in just a few minutes and over the next four days has developed a bumpy itchy rash with no discoloration. What is the cause and can it be treated with out visiting a doctor ### REPLY: Hello, Welcome to , As you were bitten by a dog four days ago, and you have washed the wound thoroughly with soap and water. Washing the animal bite wound with soap and water will clear off 95% of the virus if it presents at the wound site. The rabies virus is very sensitive to detergents and water, it is first and important step in the management of animal bite. As you a developed a bump around the bit site it may be due to internal bleeding following the animal bite, nothing to worry it will come down by reabsorption. But you need to take both active immunization and passive immunization with antirabies vaccine and antirabies serum respectively. You may require a course of antibiotic, Tab Augmenting is an excellent . Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My one year old has two vertical nickel size lumps In the top of is abdomen right below almost inbetween the rib cage he had one when he was born i was told it would go away it has grown since and now he has another one right above it. Pediatrican says it is to high for a hernia and she has never seen anything like it she would have to call and ask other docters about it and im suppose to call her mondayhelp me please im worried sick ### REPLY: Hi... Thank you for consulting in . Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had once last november, my sgpt was nearly 3000 and total billirubin 7. And by february after diet it came normal. After that i had some alcohol. After few days a slight uneasiness i felt on my right side of my body that is near to liver. When i went for lft test my sgpt showed 50 rest were normal. Is it a warning!! Or is a problm?? ### REPLY: Hello, I read your question carefully and appreciate your concern very well.  I would like to tell you that SGPT of 3000 and bilirubin of 7 strongly suggested of acute hepatitis mostly. So I would suggest you to go for ultrasound of abdomen to rule out the extent of liver involved.  If you are chronic alcoholic, then there are every chance of cirrhosis of liver, which is a very serious condition. So I will strongly advise you to stop .  Hope this will help you and feel free to ask any of your further follow-up questions directly to me, I will be happy to answer 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 query is about a swollen ankle. I have degenerative arthritis of the spine affecting all my lumbar discs and so far treatment is 7 steroid injections twice a year which do help, however, my right ankle is always swollen compared to the left and I am wondering if there is a connection. One doctor suggested that it was normal thickening of the skin. I am a 64 year old female and weigh 10st 7lbs and my height is 5ft 5 . I am very self conscious of the swollen ankle. I do get leg pain in that leg and sometimes my foot goes numb when the pain is very bad. I would appreciate your thoughts. Thank you. Mrs Doreen Johnson ### REPLY: Hello, At this age if you are having continuous swelling at your ankle with associated swelling then this can be due to associated arthritic changes at your ankle. As you are already having arthritis of spine, so there is maximum probability of having this at your ankle. You should do following to have relief in this- -Take a good analgesic like Advil or Tylenol for relief.-Apply warm fomentation over affected ankle at least 3 times a day.-Take some joint supplements like collagen preparations, glucosamine or Chen .  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 ve been feeling lots of pain in my knees, and after doing an MRI exam it showed i have dry cartilage the doctor prescribed brexin as a medication for me i m 19 years old i want to ask what are the causes of this? and is the medication enough to remove the dryness thank you. ### REPLY: Hello, I have studied your case and most probably you are having either Chen .  In this condition there is pain during squatting and sitting cross leg. Brexin is just a painkiller and there is no role of curing this. I would recommend you to send your MRI report to me so that I can offer you better advise. Till then, I would suggest you to take tablet Etoricoxib one daily and do not do any ground level activity. I hope this answer will be useful for you. Let me know if there is any other followup questions. 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 am nursing mother my daughter is 3 months old and she is on EBF. since her birth I am feeling pain and burning sensation in my left breast. from last 3 weeks I have pus filled bump on my nipple. I am in great pain. doctor recommended me antibiotics which I took but no relive. now she has suggested me to go for ultrasound for cancer. please guide me what is it and how I get rid of pain and bump. ### REPLY: Dear Ma'am, Sorry to hear about your problem. You are probably suffering from a lactational breast abscess, which needs to be treated with antibiotics and .  Sometimes a breast abscess can mimic a breast carcinoma as well and there is no harm in getting it evaluated by an ultrasound and a biopsy of the lump. You should visit a surgeon and have it evaluated immediately. Hoping for the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I was very nauseated the past two days, and off and on the past month. I also notice that I am increasingly tired, and do not feel any better after I have slept. Today I noticed my sweat smelled very sweet, and my nausea was very prevalent. Any ideas on what could be happening? Is it just stress? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  In psychology, we broadly call it obsession. You had that disturbing sensation once. You expected it to happen again and tried. Then you started experiencing it as you were expecting it. Then your body brought the familiar symptom because you are expecting it. Then you started worrying that the symptom is coming again and again and expect it. Body brings it again as you are expecting it. You become worried and so on. That is obsession in simple terms. Ignore it and the problem vanishes. Be active. Concentrate on your studies and career. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had an abdomen surgery (a 8*12 inch dermoit cyst) 8 months ago. but now my weight has gained. As I want to do rope skipping & walking in the treadmill. Is it harmful for me. I am married & 27 Years old, have no baby. Is it harmful for my conceiving. ### REPLY: Hi, Thanks for using .I understand your concern. There is no problem with rope skipping and walking in the treadmill. There is no harm as long as you are not pregnant. From the month you are trying to conceive, it is better to avoid heavy exercises. But walking and upper body exercises can be continued. There is no proven clinical evidence to support early trimester abortion due to heavy exercises. Hope I have answered your queries. Good day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 5 year old daughter was bouncing on her bed and fell and hit her forehead on the corner of the radiator 2 weeks ago. a large lump came up straight away and bruising. the lump went down a lot 2 days later. she was not sick or showed any signed of drowsiness. in fact she was fine. the lump is still there and very hard now 2 weeks later. should i be concerned? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. She has history of trauma.  So she may have some hematoma formation due to extravasation of blood.  It will heal gradually.  Nothing to worry about that.  If she has pain then analgesic plus anti-inflammatory .  Otherwise, no treatment is required.  Apply ice massage on it.  Nothing to worry about that. Just be relaxed. 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: Hi.. I fell off of the bike and I got just surface injury.. Nothing to worry about. But after 2nd day my leg swells and I feel pain when I walk. My hole leg from the knee down is swelled.. And I was working every day.. So it s something serious? Thank you... ### REPLY: Hi, Thanks for your query. An initial X-ray of the injured part is mandatory to rule out any bony injury (fracture). If the X-ray is negative for a fracture, then the other possibility is soft tissue injury either to the ligaments, tendons etc. The initial management for your condition is as follows -- Give adequate rest to the injured part and avoid any movements that produce pain-Apply ice wrapped in a damp towel to the injured area for 15 to 20 minutes every two to three hours during the day-Compress or bandage the injured area to limit any swelling and movement that could damage it further. You can use a crêpe bandage or a simple elastic bandage - Keep the injured area raised and supported on a pillow to help reduce swelling. If your leg is injured, avoid having long periods of time when your leg is not raised.- Gentle massage with a painkiller cream over the injured area might be helpful If your symptoms are still persisting after the above measures, consult an orthopedic surgeon for further evaluation and management. 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: Hi there, I am 33 overweight female with high blood pressure, have suddenly developed tingling feet and hands while lying in bed and having weird head spins. Am on blood pressure medication and currently on weightwatchers losing an average of 1 kilo a week. Should I be concerned about tingling in hands and feet ### REPLY: Hello, 2 things I would like to recommend.  1) Keep a tab on blood pressure if you have a machine at home. Make sure that the blood pressure is well under control with medication. A slight variation in comparison to normal self may result in all symptoms you describe.  2) see which medication you are taking for reducing weight. Most of they have a lot of side effects which include an increase in blood pressure which may cause headache and tingling. Exact information on the medication will help me be more objective. However, if your blood pressure is normal and yet you are having symptoms, Stop the weight watcher medication. Hoping I could 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: Thank you....I often get lightheaded after bending over. I am quite tall (6 3 ) and while I am 66 years old this has been a lifelong issue since I was a young adult. It generally goes away in a minute or so. I am in good health and am not overweight nor do I have any chronic health issues. The only medication I take is 10mg of Lipitor at night. Thank you, Bourke Corcoran YYYY@YYYY ### REPLY: Hi, Thanks for writing in. The feeling of lightheaded after bending down is explainable. The brain gets its blood supply from the heart through the carotid and vertebral arteries. The carotid arteries transmit the blood along the front and sides of the neck region and the vertebral arteries run through the spine. When bending, it is possible that there is decreased blood flow to the brain momentarily and since you are experiencing it from when you were a young adult, it looks likely due to positional changes of the cervical spine and mild pressure on the vertebral arteries when you bend down. Lipitor (atorvastatin) is used to treat high cholesterol and will help in clogging your arteries should there be any blocks due to aging. This will enable good flow of blood to your brain. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i am 40 years old i have two sons now after 4 years of my second berth i went through two cases of missed abortions. Ive done the following blood tests: salmonella paratyphi ah was 1/160 and salmonella paratyphi bo was 1/240, CMV IGG was 116.6 , RUBELLA IGG WAS 146 , AND TOXO IGG WAS 139.4 . My question is is it possible and safe for me to get pregnant again? thank you sarah ### REPLY: Hi, I think it is safe for you to get pregnant. You have got typhoid fever according to your tests, So first take antibiotics for treatment. Your other tests are fine. You should go for an APA profile and a thyroid profile and sugar tests to find out the cause of abortions. You might need some medicines for supporting your pregnancy. Consult your doctor regarding this. 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 used Melacare for 3 years for fair skin which showed good results. Whenever, I stopped it for a while always the skin turned darker. Recently developed hyperpigmentation aroung neck and so stopped using melacare. Visted a Dermotologist who suggested me peels. She has done 20% glycolic peel and had adviced 6 peels. The peeling took a long process nearly 20 days, my skin is rough and dry and looks dull. my doctor says the peeling is incomplete and need to keep doing more. I had gone through peeling reviews but have seen very few cases where peeling had taken 20 days. Is this due to usage of melacare fo prolonged period? Is peeling the right option for me? Should i continue with more peels? Please suggest. ### REPLY: Hi, Thanks for writing in. The problem can be acanthuses Nigerians, tanning etc. Without actual visualization of the skin it is not possible to comment on nature of pigmentation.  Sun protection is most important for any cosmetic treatment. Use good quality sunscreen. Avoid sun exposure. Use brevity face wash. Apply Bolivia cream at night over dark spots. Take a lot of vitamin C in diet.  Glycol peels are ideal treatment for this you can continue the sessions.5-6 sessions would be required for good results.  Hope this helps. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have swelling from cold sores on my forehead.  The ones on my forehead have joined together with swelling and it looks like I have a goose egg, right between my eyes.  My right eyelid is starting to swell and I am not sure what to do, it is stinging like mad.  Also my lymph node on right side was really swelled when  went to the Dr. on the 8th.  They gave me Valtrex, Cefdinir, and sulfameth/trimethoprim, but this swelling is getting huge.  Should I go see a dermatologist tomorrow, I am scared this will continue further into my eyes. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern.  You may have angular Desmond in between your eyes.  Or may have some other lesion.  You should go for fine needle aspiration cytology to check the lesion then you should go for surgery accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter 9 yrs old went to community swimming pool for 3 days there .she developed some skin infection around her right eye and on her chin and lip. both areas have got inflamed and she is complaining of pain and itching. now my question is whether her condition can be treated by only topical application or she needs oral medication too. ### REPLY: Hello, thanks a lot for your query on , dont be worried.it all depends on the severity and size of the infection...if it is mild and superficial, topical application will suffice.if it is deep in, then oral therapy is also needed...there is no harm in taking oral medicines also.it will speed up the recovery process...better do visit a physician and give topical with oral therapy.things will go on fine in due course... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sir. I am trying to conceive from last one year with no success. Last month we went to doctor. I have pcod and tsh 5. Using tablets ovacare, folic acid, and some diabetes tablet for pcos. Semen analysis done for my husband and found plenty of pus cells. He used antibiotics. Used fertyl from 3rd to 7th day of period. Went to follicular study on 11th day. Df was 15mm. Till 30th day also it is 15mm only. This is my 40th day. And still waiting for period. Can u please help me my situation ### REPLY: Hello are taking medicine for ovulation stimulation (clonidine). The dominant follicle size was 15 mm (till 30th day it is also 15th mm). The size of follicle should be around 19 mm to 20 mm on day 14-15th at least to rupture and endometrium thickness must be around 11 mm to conceive. In your case 15 mm on 40th day is useless. You are also having pod, so this may be the cause of irregular menstruation, so need not worry .PCs is the main cause of your problem. Cysts are often caused by hormone changes. Using birth control pills can sometimes help regulate hormone levels so that the cysts can be taken care of. Your gone will likely want (if you visit for 2nd opinion to another gynecologist) you to come back after you have been on the birth control pills as well metformin (according to you medicine for diabetes) to if cyst is gone. At that time doctor may suggest you to stop using medication of if indicated, you may need to continue it for a bit longer. Once you stop the birth control pills, as long as there are no medical concerns, you SHOULDN'T have any problems in FUTURE CONCEPTION. Sometimes birth control pills and anti-diabetic . In my opinion don't be in so hurry, rather first take treatment for pod. So consult a gynecologist and get his opinion (2nd one). ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a lump just above my testicle it is connected to the testicle by something like a bit of string!then from the other side of the lump is a vein leading into my scrotum!the lump is not directly on the testicle but connected!i dont think its the epydermis because i can feel that on my testicle and the lump i feel is further alon the top of the testicle!what can it be? ### REPLY: Hi, Welcome. Based on the facts of your query, the lump above testicle you have, seems to be INDIRECT Inguinal Hernia/or Epididymis Cyst /or Spermatocyte/Varicocele/Lipoma of the Cord. The possibility of it being Spermatocyte or Epididymis Cyst is less and seems to be INDIRECT INGUINAL HERNIA, as you have clearly submitted that -a-there is a bit of string connecting the limp to the testicle b-and that lump is not directly on the testicle but connected to testicle- and that you feel the lump on the testicle further on the top of the testicle. Investigation-USG study of the lump would show, air bubbles and fluid levels of the intestines, and would differentiate Indirect Inguinal Hernia from the other lumps quoted above. Hope this would help you to plan further treatment with your doctor. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Welcome with any other further query in this regard. Good Day!! . S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 the last 2 weeks, I have been feeling some tightness around my heart area. Its not painful but uncomfortable. I am in very good shape. I work out on p90x 4 to 5 times a week. The tightness is now coming several times a day and I am just concerned about it now. What could be causing this? ### REPLY: Thanks for your question on . I can understand your concern. Most common cause for chest tightness is stress and anxiety. But better to rule out heart diseases because you are having severe chest tightness in heart area. So get done ECG, 2d echo and stress test (trade mill test). If all these are normal then no need to worry about heart diseases. Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hellow doctors, My baby girl is about 9 months old and she is having a frequent diearria and we had a stool test and result came like every thing is ok but pus cell is like 2-3/HPK i am in need of suggestion please help and how can it be stopped. Regards,Abhishek Mathema ### REPLY: Hi...the above-mentioned stool test is normal. Do not worry. It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 2 years i fell off a 8 ft ladder ans broke the little in the bone in The ankle on Thursday! On Tuesday ended up in hospital with my gall bladder rupturing and stayed for 10 days came out and went to the orthopedic for him to look atthe leg and he Discovered a massive blood clot!, stayed another 7 days . Finally went back to orthodox and he exrayed the knee and ankle and said that everything g was good and released me I finally found Dr gary .davis in gain esville and I do not like him. He says that s I have acl damage! Manicuc damage in the knee! Nerve damage in the a:nkle and that there is nothing that can be done!,,,,,,,, I do not believe that but don t know where to turn. I have spent about $50.000 on this and I hurt EVEry Day ,,,,,,,,,, xrays, MRI, cat scan, shots (no surgery) nerve damage test. . I am looking for someone that can help !,,,, I hurt !,, ### REPLY: Hi Hope this message finds you in good health. I have gone through your complaints and understand your concern. ACL damage definitely can be cured. All you need to do is get a good quality MRI done to see exact amount of tear. If tear is incomplete it will heal with rest spontaneously. If It's complete, it can be surgically repaired. Nothing to worry about. I hope your question has been answered. If you have any follow-up queries, feel free to consult me anytime. Thanks, Take care, God bless. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A recent CBC shows that I am anemic. RBC of 4.17, Hemoglobin of 10.9, Hematocrit of 34.0. My doctor says these values are fine and does not plan on treating. I am exhausted, cold, etc. I am taking oral Iron and eating more iron rich foods. What more can I do? ### REPLY: Hello and welcome to , Iron deficiency can lead to iron deficiency anemia. Anemia can cause fatigue, weakness, tiredness and exhaustion. Replacement of iron is the treatment of iron deficiency anemia. You have been prescribed iron by your doctor. The iron replacement has to be continued for at least 3 months. Take iron for 3 months and thereafter get hemoglobin levels and iron levels done. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 51, 53, 240 lbs. I have lost 75 lbs so far (was 315). Had a heart attack Nov. 20, 2009. Also, Ischemia to the intestines due to lost of blood flow. My question is in the past week I had a little itching in navel area. Notice a clear liquid that has an odor. Now the area is red and actually looks bruised and cracked. What is this? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. It is likely to be infection. But there is need for the confirmation. You can do Grams staining from nearby laboratory. If the report states some bacteria than there is need to take the antibiotics accordingly.Sometimes there may be reactionary excretion. In that case local hygiene maintenance will suffice for cure. You can apply Betadine ointment after proper cleaning. Application of the polypoid ointment can also help. Maintenance of the good hygiene, and . I will be happy to answer your further concern on bit.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 husband had a thorascopic wash out 8 weeks ago after He suffered an oesophagul tear and aspirated.. he had two lung drains . One was removed 1 week after surgery the othe removed 5 weeks after surgery.He also caught cdif whilst in hospital. He has now been at home for 3 weeks. He has a lot of discomfort in his abdomen especially when he eats or drinks his abdomen becomes very bloated . is this normal How long will it take to fully recover. he has no temperature. ### REPLY: HI. Thanks for your query and an elucidated history. Esophageal ear with the complications and sequel your husband had will have a varies course, meaning what will happen next is not possible to judge. In addition, he got cliff, this is again very difficult to control as due to the previous problems the body-resistance of a patient is reduced a lot. Proper HY . I am sure he is on the correct antibiotics, metronidazole and probiotics. Avoid all the foods which can cause bloating. The stress and anxiety can cause bloating. He should move around in house a lot as mild exercise helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. About a week ago, my husband started complaining about loss of strength in his fingers. There is no pain, no numbness or tingling . It has gradually gotten better then his right hand was almost back to normal but the left one got worse. Yesterday he felt mild pain for the first time in his hand and arm . He managed to drive himself to emergencies where he was kept over night and monitored. He had various blood tests done today whicChatDoctore back clean then was referred to a neurologist who did a thourough physical examination on his arms, muscles etc and suggested the possibility of a herniated disc or pressure coming from a rib located between the shoulder and hand. He was then seen by another consultant who suggested an inflammation. Both seemed to rule out a neurological cause as his reflexes all seem to be responding well but they decided to keep him overnight and tomorrow give him a whole body scan to eleminate all possibilities before referring him to treatment. I am quite worried that they re now going to give him a brain scan and I keep thinking of the worst. My husband is 50 and is generally in good health, he doesn t smoke or drink. Also a couple of weeks ago we moved to a new house and during the move he has been moving lots of big and heavy boxes over his shoulders etc so could this be the reason? Thanks in advance ### REPLY: Hello, Lifting heavy weight could result in bulging of the disc and cause compression of the nerves in the neck which can cause symptoms like your husband has. Additionally, his age is also a factor which can predispose to disc bulges. Neurologist might also get nerve conduction tests, which can give information about the function of nerves. Since it has improved, so possibility of minor stroke should also be considered. 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: yesterday night all of a sudden I had a gush of blood. I am 8 months pregnant. I went to the hospital and was hooked up to a monitor and the baby s heart beat was fine. I was hooked up to the monitor for 4 hours. Was only seen by the nurses, no doctor ever came. I was sent home then. I didn t have any pain or contractions. I was told it probably was a blood vessel that burst. There is still a very small amount of blood like spoting. It looks like it is drying up. Is this common. I never heard of this before and can t find anything on line about this. Only about placental aburption. I am very afraid since the doctor didn t actually see me. I will call my doctor tomorrow morning. What do you think? ### REPLY: Hi, Bleeding after 28 weeks of pregnancy is due to Abruption of placenta (early separation of the after birth) or Placenta prefix (where the afterbirth is attached to the lower part of the womb). Pain, abdominal cramps and changes in fetal heart beat are seen in abruption. Placenta prefix generally presents as painless vaginal bleeding. You need to be thoroughly evaluated by an ultrasound examination, to see position of placenta and see if there is any collection behind the placenta. Also, blood should be cross-match and kept available for you, in case excess bleeding occurs again and blood test to see for hemoglobin and clotting studies also are needed. Please contact your gynecologist soon. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I had a colecystectomy in November 2010, and I have been feeling well.However the pain at the incision areas are not completely gone aspecially when it is cold. I alo suffer from stomach aches at times which my GP has sugested and reffered me to the surgeon who perfomed the op for further observation which I havent done due to the fact that my husbsnd hd been diagnosed with stageiii pancreatic cancer and Im  scared to face another drastic diagnosies. I am scared and confused, please help. ### REPLY: Thank you for posting query. Post cholecystectomy pain maybe due to stones in common bile duct OR increased fat intake OR functional pain. Need further evaluation.advice:- get an ultrasound (abdomen) to rule out any stone remnants in common bile duct-also get a complete blood cell count(CBC) test-avoid OILY food altogether- or few weeks, you may need to take medium/antacid 40 mg once daily before breakfast-avoid eating stomach full and mouth full-avoid spicy food wish you good health. Further queries are welcomed. Wish you good health. Regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My general practicianer just informed me that my blood test shows a GFR level of 40 and it should be 60 and my Creatinine is high at 1.3. I have high blood pressure and am on Losartan. 135/75. I see by the web that I need a special diet, but that wasnt discussed. I feel I should get a doctor that deals with kidney disease but I dont know what type doctor I should get. Any advise? ### REPLY: Hello, GFR is a number based on your blood test for creatinine. It tells how your kidneys are working. A GFR of 40 suggests moderate kidney disease. There should be more tests performed on you to see the extent of damage to kidneys. These tests include various kidney function tests and 24 hour urine estimation of protein. You must keep your BP below 120/80 and avoid taking nephrotoxic medicines. Keep your sugar levels normal if you are diabetic. Eat healthy food which is less in fats and salt. Exercises to be done to keep a healthy weight. You must consult a nephrologist and get yourself thoroughly investigated and treated. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a bump on the inside of my lower lip, it just appeared this past Sat. no changes in diet or food. It looks similar to a small wart its solid, not a blister. I have, of course been running my tongue over it. it is not irritated just there. i just lost two of my pts to what started to oral cancer. At the end they did not even look human. So of course my mind has gone astray. any suggestions?? trying to see a dentist as i have had all my teeth break of in the last year due to a 27 year battle of dry mouth due to anti anxiety med and antidepressants. ### REPLY: Hi, happy to help you on your health concern on part of ! In the present case of LOWER LIP swelling or lump, if I were your consulting physician, I would just say you, nothing to worry! Just avoid rubbing or hitting over it; and avoid hot/spicy foods; it might go itself! As per your description, it is a benign harmless lesion like mucus retention cyst or common papilloma like some fibroepithelial polyp. In any case this could not be cancer... Take caution not to get injured there as this might invite infection. If you are still worried, please get examined by a surgeon or get some FNAC like cytological examination or revert to us. Hope you got your answer. Please feel free to write to us if any more queries. Wishing you the best health! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I dove head first into a pool and hit my face at the bottom and chipped my tooth. About a month later I began feeling pressure when I bite down on my molars, like the upper front teeth are being pushed together. Are the teeth going to have to be removed. Email me at YYYY@YYYY ### REPLY: Hello and welcome. Thanks for sharing your concern. It appears to be abscessed developed post trauma. It is best to get it examined clinically by taking suitable x-rays. This will show the periapical infection. Based upon the x-ray finding root canal treatment can be done. This does not require extraction of tooth mere devitalizing the pulp tissue helps. Therfore please see your dentist soon in this regard.Meanwhile, if required you can take painkillers until you see your dentist. Hope it helps. Thanks. Take care. ### END