Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,, I have some problem regardin health .. most of the time i feel reflection in my body like i wake up in the morning or some1 touch my body i feell suddenly reflection in my body,, or most of the time i fell  without ant touch.if the enviorment is even little bit cold i fell same reflections .I dont know whats happening with me ..i am very disappointed thanks ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. This could simply mean 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. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. 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 m a 39 year old, 3 time cancer survivor. I m not sure which surgery I had that left over 20 staples in my body. Some day s I get severe abdominal pains, also blood in urine and rectum . I have searched Hi and Low to find a doctor to help me get these things out, but no doctor will touch me. How do I find a doctor that will help? ### REPLY: Hi, I do not know your past medical history. Severe abdominal pain can be caused by many reasons but bleeding per rectum and urethra is very alarming signs. If the previous cancer history and type of treatment were available to me, it will be easier to ad .  Any tumor in bladder if invade rectum may give similar symptoms but to make sure at least an abdominal ultrasound to be done. Please try to contact your treating oncologist. 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 wife that is 31yrs old had a major operation 6mos ago. She had thymic cancer with 3 large malignant thymomas pressed against her right lung her heart and her liver ..they removed her right lung and removed then reconstructed part of her pericardium (lining of her heart) and the tumor on her liver was completely encapsulated so they didn t take a slice of her liver like he though he would have to . Dr. Calhoun of uc davis who is a straight up stud removed 100% of the tumors it looks like so far. Her first 3mos checkup was fine last week for her second checkup they said it was still OK. They called us today and said she needs to come back for another ct scan because they just noticed dark spots on her liver..what would you think this could be?...they think her tumors were very slow growing so it wouldn t make sense that already it would be showing up..but this is a very very rare case. So they don t have a lot of other cases they can refer to. She spent a month in ICU because of every complication in the book..a lot of infections (cdif etc..) I am hoping it s just something like that. what do you think the odds are for all the different possibilities it could be ? ### REPLY: Thanks for the query from the history it is quite evident your wife had shad a very tough time but from the diagnosis of malignant Thomas I have to tell you that it means the liver has got metastasis from the Thomas that is what they mean by the dark spots in the liver, and mostly they want to resect it now I would suggest you talk to the oncologist who's in charge of the case for a clear-cut explanation take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having an aching pain inbetween my shoulder blades. The pain has recently started to travel up my neck and is getting very uncomfortable. Just a constant soreness. I have found relief in taking deep breaths. These deep breaths tend to make a popping/grinding sound inbetween my shoulder blades which feel good to me and help with the pain. I know I shouldn t be doing this but it seems to be the only thing that works. ### REPLY: Hello, I read carefully your query and understand your concern. Shoulder blade pain can be related to muscle pain. I suggest:-Rest your shoulder blade from activity. If your pain worsens when you do certain movements or physical activities, such as household chores or exercise, rest for a day or two. -Apply ice and/or heat. Take over-the-counter medication such as Ibuprofen to relieve the pain. -Massage the area for relieve Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards!  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello.. I am a 23yr old female from hyderabad suffering from scalp psoriasis since 7 months.. it gradually started spreading to other body parts since 3 months. I tried topical steroids and tar shampoos but it just gave a temporary relief to some extent.. I also tried ayurvedic treatment for mare than a month but it also brought no relief.. I wanted to know whether there is a complete cure of psoriasis in allopathy or homeopathy.. which treatment should I prefer?? ### REPLY: Hi, As you said you suffer from psoriasis... I would like to say few things about psoriasis.... Psoriasis is a chronic relapsing and autoimmune disease. You may be having scaly plaques on various parts of the body, scaly lesions on the scalp. Exact cause is not known. Genetic tendency, autoimmunity, stress, . .etc. may be responsible for precipitation and exacerbation of psoriasis. You consult dermatologist for firm diagnosis and treatment. I usually recommend cap accretion 10 mg twice a day along with methotrexate 15 mg weekly in three decided doses 12 hourly...for psoriasis. This may be taken for long time till good response. Blood tests may be done to monitor the treatment. For itching, you may take antihistamines like levocetirizin... Avoid steroid, as there may be severe flare up after stopping it. You may apply mild steroid cream or calcitriol point on the lesions on the psoriasis lesions. You may apply moisturizer to improve the skin texture. Furthermore, you should avoid soap bath for few weeks. And you should be free of stress and worries as that might worsen psoriasis. You might get good result. There is no complete cure of psoriasis in any path. It is a controllable disease like DM. So, be calm and have treatment till you feel better, when it recurs, repeat the 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: iam 32 years and marriage life is 8 years and have 7 years baby girl and now iam trying for 2nd child but no result from past 1 year my pelvic, ChatDoctor, and one follicular study is also over  but it was not sucess  and today is my period 2nd day what should do ### REPLY: Hallow Dear, From your brief description, I gather that your uterus and the tubes are normal and patent, and you are releasing the eggs regularly. Please get the semen examination of the husband performed. If that also is normal, please observe the following instructions. Follow the ovulation monitoring. This can be done either by a home kit or by ultrasonography. Plan your sexual relations on and around the day of egg release. The advantages of ultrasonography monitoring are:1. Size of the follicle can be assessed at the time of ovulation. Eggs released from the follicles of size between 18 mm and 21 mm have best chances of fertilization and successful implantation. 2. The thickness of the uterine lining (endometrium) can be assessed. Endometrium of 9 to 14 mm thick is most conducive for successful implantation of the fertilized ovum. If in spite of all the investigation reports within normal range and planned intercourse you fail to conceive, you fall in the category of unexplained infertility. Then you might have to report to Infertility Consultant for some Artificial Reproduction Technique. However, I feel, since you have proved your potency to have a successful pregnancy, with little assistance depending upon the results of the remaining investigations, you should be able to conceive. I hope this helps you.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir,I am 33 years unmarried male. Problem I am facing is rarest one. I am suffering from OCD (Obsessive Compulsive Disorder) and anxiety since last 15 years. I am under treatment for this problem since May, 2008. I am taking tab. Pari 10 (2 tabs in morning only.) and equilibrium (1 tab each morning and evening). For OCD and anxiety problem I visited nearest Patanjali Clinic I am taking their treatment.( Makar Dhwaj, Praval Pishti, Moti Pishti,mahavast vidhvansan vati, medhavati)I always have constipation and digetion related problems. Also, I was mastrubating from 10 years (from the age of 15 to 25).  My problem is, when I look at any woman, many times,  I look at womans breast. This is very embarrasing. This has create many problems and misunderstading in my life. Please help me. ### REPLY: hello are trying to ride on two boats simultaneously. I should not comment on what ever Ayurvedic pills you are taking, but certainly these are not helping you. This symptom is an obsessive symptom, and you should raise dose of Part CR to 75 mg slowly, under supervision of a good psychiatrist. Masturbation is harmless and other problems will be taken care of when you meet psychiatrist. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 8 year old son had a pain above his belly button this evening - got him a hot water bottle. just been in to check, he is fast asleep but felt cold to touch on forehead...temperature of 35.3. he did respond when I tried to wake him to check he was ok but now asleep again. should I be concerned? ### REPLY: Hi... by what you quote I feel that your kid might be having a worm infestation, or it could be a mesenteric amenities which means, but he might be having some small lymph node enlargement in the tummy. This could be the reason for pain. I suggest you not to do anything as of now. But if he develops green color vomiting or blood in motion or continuous Diarrhea and decreased urine output or rash and joint pain then approach the nearest Emergency Room or your children pediatrician. 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: Good day Sir ,I was infected with HBV in 2007 and that time my virus load was 9.4*10^4 by pcr qnt,HBeAg -ve and ALT was 71.My hepatalogist started my treatment. I took adefovir for 1 year and enteavir for 2 year.HBV DNA by pcr become nagative and HBe Ab +ve and normal LFTs right after 2 year of infection.I stopped my treatment and after 8 month of stoppageHBV DNA was still -ve but HBsAg is reactive by eliza 3700 cutoff 1.Please ellaborate my disease status.Am I suitable to immigration to other countries and marriage? THANKS A BUNDLE ### REPLY: Thanks for your query at ChatDoctorI suggest it is good that your Head is negative and in that case there is the least chances of infectivity to others. But the matter of concern is Bag reactivity I suggest you get the test repeated. In some cases it takes time for HBS Antibodies to appear late. So don't worry just be in touch with follow up with your physicians. Avoid marriage/immigration for some more time if you can as if your Bag is positive for more than 6 months then you might be a carrier and have risk of chronic infection. Get your liver enzymes checked to confirm the same. Ready to take more queries if any. Take care! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have am recovering from an assault and an abduction. I ve had anxiety problems since I can remember. Sometimes I could function and work through my spells sometimes I would have to go on an anxiety med. This has been a rough year and my doctor has me on Xanax xr 3mg 1x a day and ambien 10 mg. to sleep. After the assault he added one to two 1 mg Xanax as needed. I really think these benzodiazapines have done all they can. I m not receiving any level of relief and I feel like PTSD is setting in. My therapist is not an MD and she is very helpful but clueless about how quickly tolerance can develop. I m 39. I ve been off and on them for twenty years. I read online where several people all receiving symptom improvement from phenobarbital. I know my mom gave me these in a drop form as a child (panic attacks started at 6) but I also know from my research that the withdrawal can kill you. Is it worth it to try and see if they can provide some relief? I startle awake all night, no appetite, and although my blood pressure is low my heart rate is usually 110+. Frightened has become my natural state. My doctor put me on a beta blocker but it hasn t started helping yet. ### REPLY: Benzodiazepines are not treatment of choice for PTSD. They just help for short term symptom relief. There long term use is associated with a variety of problems like dependence, with .  In cases where PTSD is quite troublesome like yours, first line medications are SSRI, SARI, TCA etc. (ex Escitalopram, sertraline, fluoxetine, venlafaxine, amitriptyline etc.). SSRIs are preferred among them because of the safety profile. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Why does ER doctor tell me that I have a kidney stone in each kidney - one is 9mm and the other 6.5 and said I shouldn t be in pain from them as they are in the kidney not obstructing. They said I pulled a muscle. I want them out and I see my urologist tomorrow. Will they take them out if they are located in the kidney. ### REPLY: Hi, Welcome to  forum.  As your doctor describes, you have big stones in the kidney, and not obstructing. So they are pain less.  At this position, doctors may not prefer to touch them.  I advise you take plenty of fluids to have plenty of urine. It may make them resolve, and may bring in the way of the flow of the urine. Then it may cause pain, but make a way for treatment.  I advise you to consult a urologist for diagnosis and treatment.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Dr, I am suffering from jaundice and value of  bilirubin (total) reduced from 4.9  to 4.2 and for bilirubin(direct) reduced from 3.7 to 3.1,  present SGOT value is 822 SGPT value is 900 (U/L). I am now consuming Silymarin , Enzomac, Stafcure -500(Cefuroxime Axetil) tablets and Sorbiline.I want to know how long should I continue taking tablets and is it good to eat lots of rasgula and sugarcane juice. Thanking you. ### REPLY: Hi, Welcome to , Thanks for asking us, You are having most likely viral hepatitis, you have not mentioned type. I don't know if is tested or not hepatitis A & E are infective and are self limiting diseases, but Hepatitis B & C can be chronic also, so it is better to test and know which type of hepatitis. If your bilirubin and liver enzymes are reducing which indicate recovery is taking place. Diet in hepatitis if there are no vomiting than normal nutritious diet should be taken, few suggestion are taken care of water it should be safe boiled and cooled is simple, Whole grain cereals, Brown rice, Vegetables, (potatoes in moderation Homemade Vegetable Soup)Beans, all kinds, Fresh fruit in moderation Lemonade made with fresh lemons, Homemade Vegetable Soup. This is a great healthy .  I add a banana and 1/2 cup unsweetened apple juice. There is no need to take a lot of sugarcane juice or Anguilla it is simple sugar puts a lot of load on liver. Please continue treatment as per your doctor and hope you will recover soon. Take care. Good Luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi... I have a pain in my vagina when I pee like cystitus... also there is blood in it... I often have abdominal pain.. I have been to the doctors over 10 times in the past 3 month... I feel they thob me off... also I have been to the gu and my result were ok... can you help me please ?? ### REPLY: Hi. Thanks for your query and an elucidated history. If you have visited Doctors for more than 10 times, this indicates that you have problems. The possible causes of the pain in the vagina which passing urine and having blood too can be :Cystitis Stone in the urinary system or some obstructive myopathy.  I would advise you the following:::Ultrasonography of the whole abdomen including trans-vaginal route. CystoscopyIntravenous pyelographyFull Urological evaluation by the Urologist in assistance with a Gynecologist so that the root-cause can be found and treated accordingly. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 acute hemoptysis 2 weeks back. I didn t have cough and chest pain. I did do x ray and resulted right lung infection in upper part. I took some antibiotics and tranxenemic for hemoptysis. So I resides after few days. But now two weeks after I have little pain in my right upper thorax while taking deep breath. So I again did x ray and reveals that the infection is now on upper and middle region of right lungs. I am also having petechial hemorrhage on both of my lower limbs. And a ulcer on floor of mouth. I m losing weight. No other symptoms. ### REPLY: Thanks for your question on . In my opinion you should immediately consult pulmonologist and get done1. CT thorax2. Sputum culture and sensitivity3. Sputum for AFB4. Bronchoscopy and BAD (Bronchoalveolar lavage) analysis. Since your chest x-ray is worsened even after treatment, we need to find out the causative organism and antibiotics effective against it. Tuberculosis should be ruled out as hemoptysis is common in TB.CT will be more useful in determining infectious involvement in lung. And sputum AFB is needed in rule out tuberculosis. Culture and sensitivity helps in guiding antibiotics. Haphazard use of antibiotics are very harmful. It will increase the recovery time and increase chance of resistance. So better to consult pulmonologist and start treatment according to the sensitivity report. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had a sex with my girl friend one month ago and I had some red spot in my penis I was scared so when to the doctor after one month .did the test for vdrl and made my girl test for hiv and vdrl both result was negative I took a course of 30 days medican and now its ok .doctor told its some type of fungnal infection now as its ok is it possible I might suffer again should I use condom everytime  while having sex please advice me ### REPLY: HiT hank you for asking ChatDoctorI have gone through your query. The problem you had could be most likely fungal infection. Local antifungal ointments like clotrimazole or terminating and oral fluconazole will clear that. As you have taken 30 days there is no need to worry. If your partner have infections/STD or you want to prevent pregnancy then better use condom. But for STDs condom is not 100 percent protection. For preventing pregnancy if you use abstinence along with condom it is a very effective contraception. Hope this may help you. Let me know if anything is not clear. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 40 yrs old female wt=65 kg ht= 5ft 2in. i have two daughters. my husband is also a teacher. i teach in high school. my problem is knee pain and some times pain in middle fingers quite often and pain in my leg below the knees. i feel that i am lossing my memory power or forgetfulness. ### REPLY: Hello, As most teachers are having similar complains about the back pain, knee pain, legs pain and radiating pain in the upper limb. These symptoms are related to the job profile. As teachers have to stand longer, teachers have no proper physical health care, always tensions and troubles etc. The reason for the pain in knees are due to early OA changes in the knee joint, and the leg pain is added to the standing for the long run. Pain in the middle finger is the reason due to cervical spine disc nerve root entrapment due to postural changes. I will advise for doing regular exercise which includes the strengthening of the neck muscles, upper limb muscles, inter-scapular muscle, knee muscles, leg muscles, hip muscles, core muscles etc. As these muscles are used in a wrong posture and repetitive stress injury is occurred to the tissues, joints and ligaments. Taking utmost care is important from now as most people ignore these symptoms and when the symptoms boom up it may lead to pain and aches to the maximum. None of the students is having a sense of respecting the teachers. But it's sad that most of our teachers s are suffering from the same issues and there is not much help from any student. I will request you to take care of your health and get selfish for it because we need teachers like you who have shaped the world of today. I salute you for being a great mentor to the community through its unheard and ignored by others. Hope I have answered your query. Let me know if I can assist you further. Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have a lump that has been on the left side of my throat for almost 20 years and I believe it is due to my thyroid no matter the diet I cant lose weight I get confused easy Im always tired I have dry skin my hair is a mess its dry and brittle and falls out sometimes I was messing with the lump like all day and now my neck feels tight and irritated I am come a lot and seem to have a slow pulse please enlighten me on what this could be ### REPLY: Thanks for your question on . I can understand your situation and problem. You're all symptoms like weight gain, weakness, tiredness, hair trouble, skin issues, slow heart rate etc. are suggestive of hypothyroidism. And lump can be due to either small colloid goiter or thyroid nodule. So better to consult doctor and get done 1. Ultrasound examination of neck 2. Thyroid function test (TSH, Free T3 and Free T4). You will mostly have hypothyroidism and treatment is daily thyroxine tablet according to thyroid function test report. So consult doctor and discuss all these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 horrible stomach pains have been to ER twice in the past month. My Dr cannot find why Here s my symptoms CT scan shows one gallstone on my left side I was told it s to big to pass. It have been there for over 7mths. Now. The next is my stomach I get the pain right above my belly button, I am Nassau I throw up, I feel faint ### REPLY: Thank you for posting your query. Needs evaluation. What is your age? Male?female?are you anemic? How often do you pass stool? Color of stool?if your anemic or black colored stool, visit a gastroenterologist asap and undergo endoscopy? If NOT anemic and normal bowel habits, then;undergo any test for H.pylori.?  Do it either by stool antigen test OR by urea breath test. If it turns out to be positive then you need eradication therapy and visit your treating physician with all the results. Until H.pylori test results are awaited, you may take "Medium 40 mg", once daily before breakfast. Avoid spicy food, oil rich food, smoking and alcohol. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good 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: I have had Bell s palsy twice now and I am only twenty years old. .. shoulld i be concerned. her doctor mention something about shingles but she has never had a rash or anything that i looked up even look like the shingles never mind this is not free ### REPLY: Hi! How are you? Bells palsy (facial weakness) is caused by a number of conditions. Most of the time the underlying cause is not known. For the recurrent attack it is due to the viral infection-shingles (herpes simplex) affecting the nerves supplying the facial muscles. The virus resides in the nerves quietly, whenever there is compromised immunity or change of weather, stress it causes the nerve damage resulting in facial weakness. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my wife has ankle pain she has injured it severely when she was 16 playing softball she is now 25 the pain came on acutely and seems to be getting worse she is able to walk no problem but pain is releved temporarily with icy hot but comes back after about 10min ### REPLY: We need more details of the prior injury to determine if it's related. If the injury when she was younger involved just the bone and not the articular cartilage of the joint, and the bone was in good alignment then the bone would have healed 100% with no residual problems. If the cartilage was involved in the original injury then she may have arthritis causing her pain at this time, or if the bones didn't set correctly she may have a new problem brought on by the old one. If the old injury was a purely soft tissue injury, such as tendon or ligament, and surgery was not done, the healing was done by fibrosis and scar tissue which is not as strong as prior to injury, thus more likely to re injure something. you're best bet at this point is rest, ice, compression, elevation, anti inflammatory, and take a X-ray. If the X-ray fails to reveal anything, an MRI would be warranted. If this is an arthritic inflammatory problem, a steroid injection may be attempted by a foot and ankle specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello! this is sharmin. ive been suffering from severe hair loss since the last 2 years... and i am a patient of hypothyroidism. i am extremely tensed about my hair loss... its getting thinner day by day... what can i do to regrow hair? and to stop hair fall? and what vitamins do i need to take to regrow hair? ### REPLY: Hello and welcome to , You seem to be suffering from excessive hair fall commonly seen with hypothyroidism. Though your levels maybe normal, the overall hair growth and rate of growth may be affected more in your case, even on treatment. I hope your thyroid levels are in check. In your case, the hair fall, maybe prolonged due to other factors as well, such as poor nutrition, stress, lack of rest, low iron and hemoglobin levels, hormonal changes etc. Dan . For your hair to grow well, it needs sufficient nutrition. Fever, typhoid, recent illness, water change, work stress, pollution etc. is a factor. Low hemoglobin/iron levels need to be checked as well. These causes need to be considered and treated as they affect hair growth. You can consult a dermatologist regarding any tests that may be required to diagnose the causes. They can assess your hair in person and advise accordingly. They may advise hemoglobin, iron, hormone levels if needed. For now, you may start a Recite solution or Tress go serum to scalp at night, along with hair supplements daily like Seraglio or Bootee capsule. This needs to be continued at least for 2-3 months to see results. Use mild shampoo and conditioner like Anaphase or Renoir for hair growth start with the treatment as advised and see a doctor. And remember to check your thyroid levels regularly as advised and follow treatment. Due to the thyroid condition, hair growth will be a little slower than normal. If your hair is very thin and scanty on the scalp, and medical methods do not work well for you, after a few months of observation, certain new surgical procedures can be considered such as PRP, as will be advised by your consulting doctor after observation, if they feel that it will be a good option for you. This is a later option. Also get a good nutritious diet, avoid stress, pollution, get good rest. Hope this guides 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 Doctor, My father is 63 years old. 2 days back he suffered a chest pain for a long time when he was walking for quite sometimes. He did some chest examinations and after he was shown a cardiologist he told that apart from a blockage in heart there is a small miocadial infarction. I dont stay with him and i really dont know what is the his health condition and what is the immediate doable for him. He is fine now. Some medicines are given. I dont understand was it a heart attack because the doctor havent told like that. I stay in Bangalore and he is in Kolkata. Could you please suggest me the immediate doable and places in Kolkata/Bangalore where treatments would be good. Regards, Rita ### REPLY: Hi There After going through your query I understand your concern. I would like to tell you that your father’s symptoms are suggesting that he has a heart attack (Myocardial Infarction) , means he must have blocked coronary arteries that caused a myocardial infarction and an evaluation and management is required to support heart functions and to avoid complications of a heart attack. Kindly get his ECG, echocardiography done and consult with a Cardiologist for diagnostic evaluation by Angiography. Further treatment will depend on angiography result. Hope to have been Helpful. Kind Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yesterday i inhaled the fumes of harpic in my toilet ,after an hour i felt heavy breath,n the next day i woke up with pain in my right side of the chest ,now i inhaled my mums inhalor for asthama thinking that it would help relieve my chest pain .plz respond ### REPLY: Thanks for your question on . I can understand your concern. You are having inhalation lung injury. And most commonly, this will cause bronchitis (inflammation of airways). Normally, no treatment is required. Avoid further exposure. Breath fresh air and take antihistamine and anti-inflammatory .  You will mostly improve in 1 day. But if you still feel heaviness in chest, breathlessness, constant cough etc. than consult pulmonologist and get done PFT (Pulmonary Function Test). This will tell you about severity of bronchitis and treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and inhaled corticosteroid. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Have had a bad sore throat over a week with lots of spider type veins around the top of my throat area. Also yellowing of same area. I m a male non smoker 50 years with history of cancer 3 years in remission. I ve had a chronic sore throat all winter. Very frustrated with Dr. who always say gargle and drink clear liquids. I don t know what else to do. I m also very fatiigued. ### REPLY: Hi, thanks for using  Infectious sore throat is usually caused be a virus and resolves with pain medication along with the other modalities that were suggested. If, however, you are seeing a yellow discoloration, it may indicate a bacterial source for the pain which may require treatment with antibiotics. You may want to revisit your doctor for a reassessment. There are non-infectious causes of sore throat such as post nasal . IF the doctor reviews your throat and thinks that a course of antibiotics is necessary then the symptoms, if due to bacterial infection should resolve provided adequate antibiotics are given and there is no resistance. If you still have pain despite adequate treatment, then it would be necessary to look for other possible causes. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: for years I have constantly have a pain in my right wrist (top) that keeps going and coming back and sometimes in my left wrist, its hard to bend it and it feels like a hole in both wrist like a dent or something I can stick my finger down in it. I ve had it for about 7 years and have never gotten it treated. But it does not have a bump. sometimes when I accidently hit it while the pain is there its hurts even worse its like a tightness when I try to bend it and makes it hard to bend. what is this?? ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have swollen and painful forearm. Well there can be many reasons for symptoms you mention in query like perform repetitive tasks with your hands such as typing, diabetes, gout, rheumatoid arthritis, osteoarthritis or psoriasis arthritis. I would suggest you to consult orthopedic surgeon for proper examination. Doctor may order CT scan, x-ray, or physical examination by checking movements. Doctor may prescribe muscle relaxant along with anti-inflammatory and vitamin supplement for quick recovery. For now restrict movements of wrist, apply warm compresses 10 minutes twice a day, do gentle message with almond oil and take ibuprofen or acetaminophen for pain. Hope your concern has been resolved. Get Well Soon. 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: I have numbness and burning with intermittent sharp pain from my left hip area down to my knee. I have a history of scoliosis and Baastrup s syndrome but have never had sciatica or the intense pain in my left thigh to knee. I can only lift my leg (straight up) about 8 -10 inches from the floor. Does this sound as though I many have a ruptured or bulging disc in my spine? The pain is more intense when I have to stand, especially standing in one place. ### REPLY: HiT hank you for asking . I have gone through your query. Your problem can be due to intervertebral disc herniation in lumbosacral area. A positive SLR (straight leg rise) test gives a strong suspicion towards this. An MRI of lumbosacral spine will be helpful to rule out this. Muscle relaxants like cyclobenzaprine, NSAIDs like diclofenac, neurotrophic like pregabalin and methylcobalamin will be helpful for this. Physiotherapy and back muscle strengthening exercises also should be done along with this. Hope this may help you. Let me know if anything is not clear. 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 just noticed that my 6 years old son has a lot of blueish red flat small spots on his chin and juste below it.  It almost looks like he hate blueberries or raspberries.  He was not feeling well today, he had a sore tummy so I kept him home.  Could it be a child illness or just a contact allergy? ### REPLY: Hi, Welcome to , In dermatology, skin conditions are difficult to evaluate without actual examination. As per your description, it could be acne or some allergic bumps which needs to get examined. Also, provide more information regarding these spots, Whether they are painful or spreading? Is there any fever? However, you can give antihistamines syrup (cetirizine) to your child twice daily. If this red spots remain persistent then you need to see some local doctor or allergic specialist for complete evaluation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im under going treatment for what my doctor believes is an MSRA infection. I have been a relatively healthy, albeit overweight 31 year old. (53 -270). The infection began as an abscess in my armpit that rapidly grew and had to be opened and drained. While they took a culture at that time the results have not come back yet and that was Sunday. Since then redness spread from my armpit down to just past my breast on my left side. After days of daily packing of the wound, receforin shots and 2 oral antibiotics the redness has begun to dissipate leaving behind healing blisters and hard lumps under my skin. The packing has been removed and the doctor feels we are over the biggest hurtles and on the mend. I have however noticed in the past 25 hours that me calf muscles are really sore, my jaw and front teeth ache like Ive been clenching my teeth and I often get nauseas an hour or so before its time to take another dose of pain medicine. I also seem to have indigestion along with the nausea and have not had a bowel movement in 4 days. Im just not sure if these new symptoms are apart of the spreading infection or a result of the medication Im on. Advice would be appreciated. Im taking reprexain 10-200mg tablets every 6 hours for pain along with clindamycin hcl 300mg (2 twice daily) and sulfamethoxazole-tmp ds (bactrim generic 1 tablet twice daily). Thank you for your time and consideration. -jessica ### REPLY: Hi Dear, Welcome to , Understanding your concern. As per your query you are wondering if represent cause sore calf and pain in jaw. Jr pain occur due to many reasons like bruise, dental infection, nerve pain or TMJ problem. Calf muscle pain can occur due to May reason like sciatica, DVT or muscle cramps. But in your case the symptoms are probably due to side effects of represent, so consult doctor who prescribed it. Doctor may alter the dose or prescribe substitute. If condition doesn't get well then consult orthopedic surgeon for calf pain and oral surgeon for jaw pain. Hope your concern has been resolved. Get Well Soon. 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: my husband has just been diagnosed with a hiatal hernia. After eating holiday foods yesterday he has had abdominal pain and nausea all day today. He takes omeprazole. Will Pepto bismol give him any relief. Is there anything wrong with doing that. ### REPLY: Hi, Thanks for writing to . He seems to be having gastritis along with the hernia. Holiday foods are rich in spices and fat, which increases gastric acid production, leading to pain. Ask him to switch to a combination of prokinetics like levosulpride along with omeprazole, in consultation with his doctor, that will provide better relief. And next time when he is having holiday food, ask him to take those medicines twice a day, or better to avoid them. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am having generalized anxiety disorder for last two years. When I write with my right hand, it shakes (trembling) and writing is not legible. Earlier, I was having falling tendency but it has come down substantially of late. whom should i see, please advise. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. If you are sure that the trembling of your hands are due to Generalized Anxiety Disorder, Then the right treatment method should be awareness and psychotherapy. I hope you did properly diagnose. If not, consult a psychologist who should diagnose your problem. The best method to overcome any anxiety and apprehension is to treat this anxiety as they just do not exist. Ignore them. Concentrate on today and enjoy. Because anxieties are always based on tomorrow. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. 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 am having trouble with my anus. inside it is really sore just at the bottom. When i wipe there is no blood but if i poke up it a bit there is blood on the tissue. This is really sore and really uncomfortable. I looked in the mirror and i think i can see like a lump, but i havent really looked before so i dont know if this is normal. Please can you help me. i would go to the doctors but feel very embarrassed. ### REPLY: Hi ! Good evening. I am  answering your query. Although a physical/clinical examination is required to diagnose your problem, the history you have narrated points more towards a perianal abscess, either a primary one, or due to the closure of the external opening of a fistula in ANO. Apart from this, the hemorrhoids could get prolapsed and strangulated resulting in a painful swelling in the perianal region. If I were your doctor, I would advise you for a routine blood check up including a blood sugar, and refer you to a general surgeon for a clinical evaluation and further management. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. So I ve been told I have bilateral acetibular hip impingement (surgery is scheduled) my hips flare up hurting so bad it s hard to walk. Today is one of those days, but now I ve actually noticed a bruise right on my hip in the exact spot where it hurts....however I didn t do anything to cause this bruise?!? Is this something to be alarmed by? Thank you. ### REPLY: Dear Sir/Madam have gone through your query and read your symptoms. In my opinion, not to be alarmed of but to be careful of, as the bruise is sign of you hurting yourself and causing some minor bleeding, one thing you should take care of is to get your coagulation profile, although this investigation will be done prior to surgery. I hope that answers your query. If your want any more clarification, contact me back. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 40 year old female living in Chennai. I had a severe attack of chicken pox 3 weeks back and have recovered now. I now have more than 50 dark spots on my face alone, and have about 200 dark spots all over my body. These dark spots are are not deep. As suggested by a doctor on this site I am using Kojivit cream and Sun Cross UVA cream for the past one week. I am indeed worried whether these dark sports would go off and wonder whether I should go in for any laser treatment for removing these spots on my face, at this stage. Kindly advise me on this, and if you would suggest laser treatment, please also suggest a good clinic providing this treatment in Chennai, how long will it take for a complete cure and the approximate cost for the same. ### REPLY: Hi!Vida v, Welcome to  forum, Since its only 3wks that you had chicken pox, you should let all the lesions completely heal. At this moment you should only use a sunscreen daily esp for face. You can continue Bolivia if you want.Don't peel off the skin from the lesions, let them heal on its own. As far as laser are concerned, you should wait for at least a month or two more. If you see any depressed lesions on face then you can go in for lasers. Till then, you should take all precautions from direct sunlight. If you land up with depressed lesions on face then you can go for fractional laser either co2 or erbium laser. You might require 3-4 sessions of the same. Cost depends upon the number of lesions you have. 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: For 2 days i have been suffering from a ache from my breast bone and under my right breast only when i laugh. When i breathe and when a cough a little i do not experience this ache. I have been suffering from heartburn for the past few days, could i have strained myself? ### REPLY: Respected user, HiT hanks for using .come have evaluated your query thoroughly.* This seems in relation with inflammation of typhoid process of the sternum and not in relation with heart burn.* Reason for the same may be undue pressure over the area or muscular or ligament sprain or strain while working. Hope to clarify your query. Thanks for using  .com Wishing fine recovery. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I am a 63 year old female with Atrial Tach and only one kidney, asthma and COPD.  I now have several masses on my right lung and am having a VAT biopsy tomorrow.  I was told I have to be in intensive care for two days with a hospital stay of 5 - 7 days....is that normal procedure.  Im terrified. ### REPLY: Brief Answer:VAT biopsy is the best and less invasive approach to take a biopsy of the lung masses and discover their nature. Detailed Answer:Hello, Thank you for using . At this point, after being detected the lung masses, the best approach to them is to undergo the biopsy through VAT(Video assisted thoracoscopy). The scope can be inserted into the chest through small 2-4 cm incisions made between the ribs. It allows the surgeon to view, under high magnification, the lung masses and manipulate the instruments to effectively transect and remove the tissue from the body. Compared to thoracotomy (traditional, opened procedure), VATS is minimally invasive, with less pain, smaller incision, fewer days of hospitalization (generally at about 3-4 days). As you suffer from atrial tachycardia and having only one kidney, asthma and COPD you need a more accurate medical care. The lung function, in your case, needs a longer time to recover comparing to a healthy lung. This means you may need a more long hospital stay, but you should understand this is the best choice in your conditions. Hope this is helpful. Let me know if you need more clarifications. Otherwise, please close and rate the answer. Kind  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 dad has chf. He went into the hospital and is now experiencing renal failure. he initially went into the hospital because his gall bladder needs to be removed. They will not remove his gallbladder now because he is nnow septic due to the gallbladder and they state he has too many medical conditions. I know that this gallbladder needs to come out or he will eventually be die because of sepsis. The hospital was talking about placing a tube in his kidney for the infection, but I know this is only a temporary fix. Any other options because they say if the put him under with anesthesia, it may kill him? ### REPLY: Hi and welcome to .  As a Urologist, i can understand your anxiety. You should've written your fathers age. Your father has multi-organ failure, including the heart and kidneys. The gall bladder infection can be controlled, with antibiotics.They're right in advising stent placement to improve kidney failure. Once his general condition improves, he can be reviewed and decision taken.It's in the interest of your fathers' health, that a high risk surgery is avoided. If you've any doubts, you may send a direct question to me. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mother who is 63 years old, Recentlt she is having lower back pain , as per MRI report it says Its grade 1 lysthesis seen at L5-s1 and also disk protrusin seen at L5-s1 compressing anterior thecal sse, bilateral traversing nerve roots and encroching into bilatteral nueral recess . And she was given epidural steriod given along with some medications which didn t help. Later on we have seen some other physician and the medication prescribed by this phycisian also of not help. And the side effects of these medicines are swelling on the body , I wanted to know the reasons if it might be because of the medications or because of the dick pprolapse or it might be becaiuse of vitamin deficiency? ### REPLY: Welcome to . Sometimes the medicines can cause such side effects. It's not due to disc prolapse or vitamin deficiency.  I would suggest considering definitive treatment for this problem depending upon patient symptoms. Medicine and epidural block are more of symptomatic treatment and does not change the pathology. If she has significant pain and restricting her mobility then need to consider surgical option. Timely intervention always gives the maximum benefit. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am taking Telma 40mg for controlling bp levels in the range of 120-130/80-90 since last 3 years but recently I started feeling heavy head, irritation, swollen face and on checking bp, found the levels are in range 145-150/90-95 at different timings. I take low salt food, no sugar, 3-4 days walking 3-4km/day, water -2 to 2.5 lit/day. Please advice the best way forward to control bp. Thanks Tej ### REPLY: Dear Ten, If you have swollen face I would advise you to have urinalyses done and also check serum creatinine to exclude kidney problem. If they come back normal, and you continue to have the same complaints, then you should talk with your doctor to make some corrections in your treatment. In your case low dose diuretics may be added. It will help to avoid edemas and will regulate your blood pressure. Take fearsome back if you have any further questions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have symtons of shortness of breath, increased fatigue,and chest pains.  I have had an echo cardiogram and a bubble test preformed.  my doctor says i either have an ASD of a PFO but being as he is an army doctor its hard to get a straight answer from him.  I am going soon to have TEE preformed to get a better look.  I was just wondering if i could possibly get another opinion as to which defect I might have, the PFO or the ASD.  thank you ### REPLY: Hello dear, Warm welcome to .come have evaluated your query thoroughly.* This is in relation with cardiac compensatory state giving rise to variety of symptoms , differential diagnosis requires TEE and management depends upon the conclusive evaluation of the same.* Symptomatic relief with medicines but at times one requires corrective surgery as well. Hope this will help you for sure. Wishing you fine health ahead. Regards dear 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 having pain on my right side from below the ribs till the umbilicus. I had undergone gall bladder removal surgery and suffered from ulcer few years ago. Yesterday my friend hit on my stomach ans since then it hurts badly. I did not have any vomiting or other problem just pain the abdominal area. Please help me. ### REPLY: Hi, it might be nothing but get it checked by a Doctor if you have severe pain. Do you have any giddiness or fainting feeling? Any swelling or fullness of the abdomen? If yes, then you should definitely get an Ultrasound done to rule out any injury. It would be safer to get it evaluated. If you think the pain is subsiding, and you do not have any of the above problems then you might want to watch for another day before seeing the Doctor. Take care and do let us know if we can be of any more help, Take care, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor, I am 63 years old and a male someone overweight at 5-7-1/2 and just less the 250lb. I don t have a regular doctor and haven t seen one in quite awhile because I usually feel good. The only doctor I see is my dentist twice a year to be honest with you. Anyway just yesterday I was in my home office and felt something weird going on in my left hand that I could not control before you know it my hand was bent over and it was taking over my arm and pushing towards me finally talking over my body that I could not talk and I believe I passed out. Here I am thinking I might of had a seizure of some sort. This was maybe 11am in the morning being I am retired and was at home. I took a Aspirin just in case after that as I was ok then which seemed like maybe 15 minutes later. I am not sure. Same thing happened when I was out in my barn later yesterday afternoon but I sat back in a chair and was fine like possibly 15 minutes later. During these 2 attacks which I never had before I barely could talk and was having a hard time breathing during it. Since late yesterday afternoon I haven t had any problems and have been taking 1 Aspirin maybe every 4-5 hours. I feel fine today as I do any other day. My wife when she got home from work wanted to take me to emergency but I didn t feel the need to go. Spent a lot of time laying on the couch today resting as not wanting to push anything and I feel find as of this letter. Do you have any idea of what may of gone wrong? ### REPLY: Hi, I am .  I have read your question with care and understand your concerns. Let me try to help you Question : Do you have any idea of what may have gone wrong? Answer : Both the episodes you resemble fits. Hence, I request you to kindly consult a Neurosurgeon / Neurologist at the earliest Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. 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: Doctor, I have an obstruction in the edge of the penis while urinating. Though urine flows fully, it is flowing like a shower. Almost 2 months now. Though I have not felt it alarming, still I thought you will be able to help me through this columns, with suitable instructions and medicines. Thanks. ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. An obstruction in the edge of the penis suggests that there could be a wart or growth. This can cause shower of urine instead one flow. It's very difficult to comment on the exact cause of the lesion without having a look at it. It would be advisable to either upload some pictures of it in  or show it to a urologist/surgeon/sexologist. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link: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: i recently went to the doctor, did blood work and he called me in that one of the  blood results showed i have a problem with my liver....i have thyroid and he said it maybe because of that too but he not sure thats why im going for a songram today.....what do u think? ### REPLY: Hi thanks for contacting . Hyperthyroidism can affect multiple organs of our body. Liver can also be affected. So abnormal liver profile might present. So treat hyperthyroidism with . Doctor wants to do USG just to rule out fatty liver or hepatitis like changes. If fatty liver, hepatitis or cirrhosis present then also abnormal liver profile can present. So perform USG as advised by doctor.Meanwhile, take care of liver by taking low fat diet, fruits more and green leaf veg. Regular exercise done. Wish you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son 15 years of age a very bright student, studying in 10th std has difficulty in writing fast, complains of mild tremor and not able to hold pen and write normally,tells he has more difficulty in writing tamil and writes keeping the pad over lap,Eventhough he completes exam, he is afraid whether he would be able to get 1st mark.Diagnosed as writers cramp and is on Tab,Pacitane 2mg, Tab. Inderal 10mg and Tab. Clonazepam 0.25mg once in morning. What is the treatment for his problem?He wants to get school first, as he always gets in 10th std also.Kindly give your advice. ### REPLY: Hello, I have gone through your query. This might happen due to too much writing without break, wrong posture and stress. You need to concentrate on his physical strength too. First you need to correct his posture. He needs to work on his endurance of gripping strength. Keeping pad overlap and writing itself is bad practice, so avoid it. Consult a physiotherapist nearby for strengthening exercises for grip and posture. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: We had protected intercourse last night but while removing the penis from the vagina the condom got stuck in the vagina So I wanna ask that is it a contraceptive failure And if yes then will I have to take ECP I took ECP 15days back as well Is it ok to take ecp twice in a month ### REPLY: Hello, I have gone through your query and understood the concern. Since the condom got stuck in the vagina after the intercourse, it is possible for some spillage of semen to happen and if you happen to be in the fertile phase of the cycle, conception chances are high. Yet, use of emergency contraceptive pills should be restricted to only once or twice a year. This is because the high hormone content in the pill creates hormone disturbances and fertility problems in the future. Another way of emergency contraception is the insertion of an IUD soon after the intercourse to prevent implantation. 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: hello sir, it have been six year for marriage i have been diagnosed with azoospermia and under went biopsy test with following result right testicular biopsy - partial atrophy with associated maturation arrest please help me with further line of treatment ### REPLY: Hi dear. I had gone through your query. Maturation arrest with atrophy means there no sperm maturation, so it will lead to azoospermia. There is no line of treatment to increase sperm. You have gone with artificial method of insemination. There are various methods like IVF or artificial insemination from donor etc. You need infertility counselling. So consult gynecologist or infertility specialist for better assistance. Still if you have a query then feel free to ask. Happy to help you further. 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.I hadnt walked long distance in awhile.I took a 7 mile fast paced walk to feel better.later in the day my left knee became very swollen and the pain is excruciating I used ice packs,hot heated wet towels and asperin and bengay as relief.this is day 3 and the swelling is still at the same level.I have no insurance and Im getting worried about the situation.I also keep my leg elevated as I am sleeping on my back.can you give me some tips to reduce the swelling and heal this knee as quickly as possible. Thank you kindly. ### REPLY: Hi Hope this message finds you in good health. I have gone through your complaints and understand your concern. The pain you are having right now may be due to straining of some sort of soft tissues, nerves or ligaments around knee. Avoid strenuous work, take adequate rest. Avoid walking for 2-3 weeks then start gradually. Physiotherapy, analgesics,anti-inflammatory . Get a X-ray to find out what's wrong. 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: i am a 46 yr old female with right breast discharge. I have had a mammogram and 2 ultrasounds and have been referred to a breast cancer surgeon who has recommended that i have a ductal removal and biopsy. My question is what is entailed in this procedure and what is the doctor looking for since both mammogram and ultrasound has been declareds normal? ### REPLY: Hi, Thanks for writing in. It is important to know what symptoms you are facing which prompted 2 ultrasound and a mammogram. There might be a clinical suspicion from the cancer surgeon after clinical examination and the ultrasound of breast also might show doubtful findings and this might suggest the need for a biopsy even if the study is normal. Biopsy of duct is important to recognize ductal cancer in early stages. There might be some altered clinical findings which have led to the doctor refer you for a second ultrasound and because of persisting doubt there is a requirement of confirmation through biopsy. 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: hello sir, I am a 26 year old married man. we have got married in 2007. first 3 years our bed life was really awesom but now a days for last 6-8 months my wife is not comfirtable with me on bed. she don t like all these things. she even don t want to to talk about this matter. because of all these things i became very frustrate , I can t concentrate in my professional life. I am not able to understand why she is behaving like this. Please help me. Actaually after 3 years of marriage i want a baby desperetly, but she even don t want to ta;k about this. after Marriage she got pregnent 2 times, but at that time we have not continue those issues. I feel very sorry for that step. Please help me. I am in Delhi. ### REPLY: Hi! Welcome to  .com. What about a child is your wife worrying??? Extra responsibility? Additional loss of freedom. Talk to her openly and nicely what exactly she is feeling? Is she depressed? Does she work outside or homemaker? Do take a second honeymoon away from your place if possible for a week or so, the change of place may do some good and encourage her to talk freely as to what is troubling her. If nothing works maybe she requires some counselling. Do the needful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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. Over the last couple years I have been getting really dizzy when standing up from kneeling. Lately I have been standing and I just about black out, my tongue goes numb and my body goes into small spasms for a couple seconds then it passes. Is this serious? I m worried this could lead to something serious. ### REPLY: Hi, Welcome to  .com I am . Mariano Into Bruno Mascaras. I have gone through your query with diligence and would like you to know that I am here to help you. This can be posterior circulation Displease consult your Neurologist or Neurosurgeon immediately Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in  at http://bit.ly/ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mother is suffering from typhoid fever .she is having fever from last 12 days.everyday sometimes it goes up or sometime come to normal.she is having liver related problem too.doctors hav given ciplofloxin medicine .is the fever last for so many days? ### REPLY: Hi & Welcome to . I appreciate your concern for your beloved mother, I can understand her problem. Usually 10-14 days are required for Ciprofloxacin to be effective in the treatment of typhoid fever. However, the duration of treatment depends upon the severity of infection, for severe and complicated infections more prolonged therapy may be required. Yes, the fever in patients with typhoid can last for days together. Since she is having associated liver problem, the dosage of . Hope this answers your query. Wishing your mother a quick and smooth recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hisir i am 30 year old and suffering with herniated and degenerated  disc L4-5, and mild bulging in L3-4 DISC. due to bulging of L3-4 DISC  left leg nerves get compressed & feeling mild pain in the leg . from past few days, i observed that few patches of blood is coming in morning toilet . i want to know that is it due to mentioned problem ?  if yes then how serious is it ? ### REPLY: Hellos you have said you have fresh blood in morning toilet, have a known case of disc herniation, following are your probable causes1. Due to having different painkillers for back pain, can cause intestinal ulceration, and hence causing bleeding2. Due to back pain + pain +stress+constipation can lead to hemorrhoids , and hemorrhoids do bleed Hope this helps, and you understand your cause of bleedingTake care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have elevated AST (i.e., 90) and ALT (i.e., 74), no hepatitis, exercise regularly, rarely consume alcohol and have a BMI of 20. I recently had mastitis was placed on clindamycin (300 mg/TID) for a week. Is it feasible the antibiotics are contributing to the elevated levels? Would breastfeeding have any impact? Kind regards. ### REPLY: Hello, I had gone through your question carefully and can understand your concern very well.  As you were being treated with accolades like clindamycin for a week and accolades most commonly acid stable erythromycin estate leads to hepatitis like features and that can raise AST and ALT levels. Also, incidence of hepatitis like features are high in pregnant women.  So in my opinion, because you were pregnant and treated with accolades (clindamycin), AST and ALT levels can be high due to antibiotics. No need to worry about it, as it will normalize by itself after discontinuation of .  I would suggest you to repeat the AST and ALT levels after a week, and it will be normal mostly. Don't get stressed and be relaxed. Also continue your breastfeeding, as it will not have any impact on your baby.  Hope this answers your question and let me know directly if you have any further queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mother age 71 years is suffering from heart burn, stomach pain and frequent vomiting for the last one year. she has try rabiment d and other antacids but as soon as the medicine stops her sysmtoms arises. should i give her himalaya yashtimadhu? i have heard about gasex also. please help.thanking you in advance.Vidya ### REPLY: Yashtimadhu in common language is called Multi. A commonly used herb for treatment of sore throat or cough etc. In the latest research it has been established that it is one of the finest antacid and has ulcer healing properties. Your mother appears to be patient of HERD. Use of only yashtimadhu or gases may not offer complete cure but will relieve her major complaints. Certain lifestyle changes are a must in such cases which hasten the recovery period e.g. eating small amount of food for more time a day, light and non-spicy food, stress-free life etc. . Co.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: I am positive for hep c.  Had severe hep in 1991.  Presently Riba and Rna testing show virus innactive.  Am I contagious to babies or other people through saliva or eating utensils.  Mainly, can my grandchildren be infected by me. I am extremely concerned.  My daughters pediatrician told her it WAS possible.  Please help me!!! ### REPLY: Hello, Thanks for posting in . The main mode of transmission of hep C virus is through blood. So blood Transfusion, sharing sharp objects like razors can transfer. Also, household things like sharing tooth brush or towels can have slight chances of sharing. Sharing same food or utensils won't transmit hep C. Your grandchild . I hope I have answered your query well. If you have any more query kindly write back to me. 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: Hi...I chew ice constantly (I know bad). I also have had issues with my sinus recently. I chewed a piece of ice this morning/a little bit ago, and I had bleeding from somewhere inside my mouth. I am guessing I cut the roof of my mouth. Should I do anything further about this? Can a cracked tooth bleed, or gums that are irritated bleed too I presume? Just curious..... ### REPLY: Hi, As per your complaint it seems that bleeding from inside of mouth seems to be most probably due to any traumatic injury inside the mouth while can also be due to infected and inflamed gums. Cracked tooth would cause more of pain than bleeding. I would suggest you to consult an oral physician and get evaluated, and a thorough clinical evaluation will be done. In case if there is injury to mucosa of any area inside mouth then doing warm saline gargles, applying antiseptic ointment and cold water rinses can help. Take a soft diet to avoid further irritation. In case if there is gum infection then deep scaling, curettage and antiseptic mouthwash gargles can help. Hope this information helps. Let me know if I can assist you further. Thanks and regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i m male 53 yrs age. having pain in right side of pelvic area & also lower back on right side since last 15 days. i took prescribed by doc cyclopam 10 tabs, then dolonex & flagyl. pl.guide me further . the pain is still der. i just did x ray of lumbosacral spine A P Platarol. thanks. ### REPLY: Hi, thank your for posting! I have gone through your query and I understand you concerns. According to your symptoms, I think that you suffer from lumbosacral arthritis. The diagnosis is determined by taking a lumbosacral CT-scanner, abdominal ultrasound, complete blood count, fibrinogen test and urine test. The treatment is made with non-steroidal anti-inflammatory medications and painkillers. You should also contact your neurologist. Take care, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed w/ a severe serraria marcescens lung infection.  This infection was in my intestines 4 years and almost killed me.  My doctors refuse to treat saying that it is normal for it to "colonize".  However I am severely symptomatic.  What to do? ### REPLY: Erratic marcescens is a gram-negative Enterobacter. It is not involved in respiratory tract infections except in critically ill patients or patients that have a chronic pulmonary condition that affects the lung anatomy, like bronchiectasis. Lungs of patients with bronchiectasis are chronically colonized by several bacteria that can't be found in a lung without disease. Most of the time these bacteria will coexist with host immune system in a balance. If by any means this balance is broken, there may be an exacerbation of symptoms. It is important to know that not every symptom that you feel has to be caused by the bacteria, and it really can be just colonizing your lungs. The use of antibiotics against a colonizing bacteria has the potential to induce resistance to the antibiotics, making it hard to treat a real infection when it occurs. It is important to discuss with your physicians why they consider these bacteria a colonizing agent and if all your symptoms really correlate with it or not. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am a bisexual male. When I have anal sex with my partner, I have a hard time receiving pleasure from my prostate. Additionally, I do not feel any pleasure nerves in my anus. Medical research says that the anal area is full of nerves that can give pleasure, however mines is lacking. I wanted to know if there could possibly be a medical condition since I can not feel or receive pleasure from my prostate during anal sex, nor feel any pleasure nerves in that area. What can I do to improve my pleasure down there? ### REPLY: Dear serve understand your concerns went through your details. Which medical study says that anal nerves are pleasurable ? Anal nerves give pleasure once it releases feces. Not when you have anal sex. All body nerves have its own purpose and those are not only pleasure. When you receive anal sex from your partner, you will not feel any pleasure just because anus is not a sexual organ. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. ### END