Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Are there any dentist here who are doing smile makeovers? Or will do dental work for free? Or I could find a way to pay you back. My fiance is completely embarrassed with her smile. She has periodontal disease. We do not have the income to fix it and doubt that we ever will. I am very worried about her because her mouth bleeds constantly and it is very painful for her to brush her teeth and I don t want it to cause more issues with her. Can somebody please help us out? I feel helpless. ### REPLY: Thanks for using . Read your query. Smile makeovers do require a visit to a cosmetic dentist which will involve a fair amount of budget and dental work cannot be usually done for free. If I were a treating dentist and keeping in account the issues mentioned, would advise to undergo full mouth cleaning from a periodontist followed by use of mouth wash gargling. Post cleaning instructions should be followed properly, and the teeth has to be maintained well. A natural clean mouth will indeed increase the smile of the person. Hope this was useful. 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: Hello doctor ! I m Priya from chennai age 26 married i m stone problem for the past 2 years at first i have 5 stones so i under went doctor advice and they treated with kmac syrup and cystone table for 2 months then later i get cured . Before 3 months i scanned in that they told me now in that 5 stones 3 were gone away and now 2 were still present in right side of the kidney .But from yesterday onwards i feel severe stomach pain in the left side of my stomach.i dnt know wat to do . pls give me some suggestion .& i have no child . whether i can undergo for the sexual life or not ### REPLY: Thanks for your query have 5 small renal stones detected 2 years back for which you have taken tab Cyst one and syrup. But I would like to state that there is no medicine on earth that can dissolve the stones Small stone normally pass down through urethra with urine. Now you have two more stones in the kidney. And you are getting pain in abdomen this is an indication that the stone has been impacted in a passage of urine mostly in Ureter. So pl get your Ultra sound scanning done to locate the position of the stone and the degree of obstruction it has caused on the kidney. Depending on the finding you can opt for modality of treatment which will be decided by Urologist. After this gets cured you can think of pregnancy. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yes. My mother is 65 and has been experiencing symptoms for 4 months. She has pain that starts in the right side of her neck and travels up to her head and down to her shoulder. Once that starts she also has pain in her left knee, thighs, legs, feet, toes, hands, fingers and even under her ribs. she describes that pain like that of a Charlie horse. She starts her morning feeling okay and then progressively has these symptoms I described. She is also tired and aches all over like you would with the flu. So my question is, she hasn t had luck locally, finding any kind of relief. Her primary doctor has prescribed her antibiotics several times, saying that her blood work shows an infection. Please help. Lena Herring ### REPLY: Hi I did review your concertgoer mother might be suffering from fibromyalgia where there is severe body ache. She could also be having any generalized inflammatory muscle problem. I would advise you to consult a rheumatologist or a neurologist and get her evaluated. Her regular investigations would be ESR, CRP and complete blood work up and also a clinical test to detect tenderness at various point to detect fibromyalgia score. There is treatment for fibromyalgia in form of pregabalin and other . I hope this helps. Let me know if you have any more questions or concerns. Wish you all the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a enlarged lymph node on the right side of my neck, I first noticed it about a year ago, I also had one that came up on the back of my head, behind my ear on the right side as well. I went to the doctor and they said it was because of an infection/virus and that it would go down. up until that point I had been perfectly fine with no infections/viruses. the one behind my ear did go down but the one in my neck has stayed and got slightly bigger. I went to the doctors again after having the lump for about 6 moths and was told again that it was nothing and it would go down. I then started to get migraines after going on the contraceptive pill, and feeling generally unwell/tired, so i stopped taking the pill and went back to the doctors, they did some blood tests as my doctor though it might be glandular fever, but these all came back fine. I still have to lump, it aches from time to time and I still get migraines, usually around my period, which can last for days. recently Ive also been getting pain/aching in the colar bone region of my neck upwards, especially on my left side, there doesnt seem to be any more lumps though. if that makes sense? should i be worried? ### REPLY: Good morning Madam, Thank you for sharing your concerns with us. I will try to help you as much as I can through my answer. As I understand, you have got two problems. The first one is a swelling (most probably an enlarged lymph node in the neck). If a lymph node stays enlarged for a long time without any signs of infection (warmth, redness, pain), it is safe to have it removed so that it can be seen under a microscope to make sure that there is nothing dangerous. I would recommend you to discuss this option with your doctor. The second problem is a headache. Oral contraceptive pills are known to cause a migraine. It can also occur around the time of menstruation. If a migraine is too frequent and is disruptive, then I would recommend discussing the option of prophylactic medicine for this condition with your doctor. I hope this answers your question. Please feel free to contact me if you have any other query. Sincerely,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mom has multiple myeloma . She received chemo for about 3 months. It was discontinued because they found an orange sized rapid growing tumor in the stomach which is also cancerous. She is home, under the care of hospice. She is 65 years old. Just got over phnemonia about a month ago. What would you guess the prognosis is for her. ### REPLY: Hi, Thanks for writing to us. Given the history, it is likely that the tumor in the stomach is a lymphoma/Malta. Since there are 2 coexisting tumors, the prognosis definitely is poor. As far as the Myeloma is concerned, the prognosis can be ascertained by several lab parameters like chromosomal abnormalities, beta 2 microglobulin levels, increased calcium levels etc. but also by other issues like age, her medical condition and the grade of her myeloma. On an average, survival for myeloma patients will vary from 11 months to 3 years. Given that your mom has 2 tumors, at this stage, it would be best if we take an endoscopic guided biopsy to know the nature of the 2nd tumor and decide which . Hope that helps regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son has had MS for twenty years now. He ws treated with Tysabri and contracted PML He is still alive and trying his best to keep strong. His Doctor has not given him any medication since h left the hospital Is there a treatment for him? The PML caused a stroke and took most of his eyesight. He is also dependent on his wife and health care person to get around in a wheelchair. I feel there has tobe something that can helphim improve. Can you give him some direction as what to do. PLEASE ### REPLY: Hello! Welcome on  ! I am really sorry for your sons medical condition, but you should know that there is not too much to be done in his clinical situation. I would recommend taking a vitamin supplement and continue performing physiotherapy. Unfortunately there is no cure to his damaged nervous system. Physiotherapy and a balanced diet, can help improve his situation. Hope you will find this answer helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I m 20yrsold.. i think i have ezcema, i have bumps on my ua and its so itchy.. i cured it with hydrocortisone. the itchy was gone but the bumps were still there and looks so dark:( what cream shud i use? ### REPLY: Hi...dear user., Thanks for choosing ., Bumps under arm, itchy.....not ECZEMA., It could be Fungal. Tinea corporal....it produces bumps., So follow this treatment...1) Qua . . Betamethsone, gentamicin and Fluconazole., apply twice daily, until disappearing of lesions., (Milford)2) Tab Limit 250 mg daily for 7 days.,3) Tab Decline daily nighttimes for 15 days., Dont scratch and pinch......ok4) One can dust powder ...dust on affected part(Wallace)., ok...bye good luck., ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I got into a fight last week, I was hit in the right side of my jaw and throat. It was complicated to close my jaw on the right side and when i did clamp down i could feel tension/popping close to my ear, after the pain was gone from that i started feeling it painful in my upper right esophagus area, the pain gets better throughout the day and no trouble eating, its sensitive in the one spot. I am worried it may be a swollen lympth node. Any advice? ### REPLY: Hi, thank-you for providing the brief description of your injury A thorough neuromuscular assessment is advised. As mentioned by you the mechanism of injury I will advise to first get it clinically assessed. As we need to see any muscular or bony injury is present. Also, as you mentioned you were not able to close the jaw, there may be an inflammation of the joint as well as the muscles of the post. May be to come closer to the diagnosis the CT or MRI may be advised to see the bone and the soft tissue status. As head and neck are really an important part of the body, negligence is not advised. Usually due to injury there may be three possibilities - no injury at all, injury to the bone or injury to the muscle & nerves. For coming closer to the issue, a proper assessment is advised. Also, in the front of the neck there is a presence of cartilages which needs an attention. Post that clinical assessment & if needed an MRI or CT the next treatment plan will be initiated based on the symptoms and signs. I wish you a good health and advise avoiding such fights in the future. Life is very important and precious.regards Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI, i am 22 yrs old married girl, i am trying  for pregnency,but i have a background of PCOD,I AM Taking Metformin 1500 daily , mensuration witll be every two months once but this time now it is 2 and half month and i am not getting pregnent , feeling hungry,saliva is coming from mouth and sour voimiting from 2 days. ### REPLY: Hi, I think you should do a urine pregnancy test at home.  If positive consult a doctor.  If negative, you can take some medicines for inducing periods.  In pod, ovulation doesn't happen.  Thus, pregnancy doesn't occur and periods get delayed.  You have to take medicines for growth of your follicles and track your follicles' growth by repeated ultrasound.  When follicles reach a size more than 17 to 18 mm, take injection for rupturing the follicles.  Be in contact with your husband for 2 to 3 days after injection.  Take progesterone for next 2 weeks.  Do a urine pregnancy test at home after that.  You can try like that for 3 to 6 months.  Also do a thyroid profile and prolactin levels for yourself and a semen analysis of your husband.  If it doesn't work, then you have to go for tubal patency test and thereafter GUI. Metformin alone will not help you in conceiving.  Hope I have answered your question. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have a painful pea size lump inside my mouth on the right hand side of my lower lip . I can move it around with my tongue . It does hurt and is making the whole area ache. There are a few other lumps in the same area and on the other side but this one seems to be swollen and is the most prominent. You can see it clearly when i pull back my lip. Any ideas? Many thanks kerrie ### REPLY: Hi, Thanks for asking the query, Painful lump can be because of either due to gingival abscess due to accumulation of bacterial plague and calculus deep into gum pockets of front teeth , it can be due to periodontal abscess from the infected tooth, it can be authors ulceration , or block of salivary gland vesicle. I suggest you to get a complete clinical examination of the tooth by the Dentist. Take an OPG x-ray. .  At home maintain a good oral hygiene. Use chlorhexidine mouthwash gargles twice daily. Take vitamin supplements . Hope this helps out. 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 Doc, m Pooja from Bangalore. I have bilateral cysts in the ovaries. Also my AMH results are worst. I am 28 years old, wanna get pregnant asap. Doc has adviced me on Novelon and Ovares tablets. Is there no chance fa me to get pregnant naturally?? Without IVF or so?? Kindly advice if I have to go fa second opinion or... anything of that sort. thanku ### REPLY: Hello, I would be happy to help you with your question.1.  Track your periods - first day of your cycle = day#12.  Abstain from intercourse until day #103.  Have intercourse on 10/12/14/164.  Use over-the counter ovulation kits to determine your timing5.  Have your partner get a semen analysis6.  Make sure that you are tested for thyroid disease, prolactin levels and PCOS7.  Definitely get a second opinion before starting these medications hope that this helps and good luck! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor.will a person beat himself or harm himself without knowing. i am getting lot of slaps invisibly and i can see the marks on my body especially on my back. scratching and finger marks..  not believing in spirits etc.. but just want to understand why and how this could happen? ### REPLY: HI! Thanks for this query!! it's definitely an interesting question... I would like to have additional information like what is your age, sex, background, where & with whom do you live etc. In addition, since when all of these problems have begun? When do you notice these injury marks & precisely on what locations. Jumping to any conclusions ranging from harming self involuntarily to "spirits" is premature. So don't worry.if possible get in touch with a psychiatrist as soon as possible for a detailed evaluation or if you are comfortable, get back to me with answers to my aforementioned questions. 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 there,I have been getting mild chest pains for the last four days, yesterday I phoned NHS 24 and thay advised me to go to the hospital.I was seen by a pleasant doctor who checked me out quite thoroughly, did an ECG to make sure it wasnt my heart, she thinks it may be esophageal spasm and prescribed me peppermint oil tabs, so far Ive only had one and no change.My chest feels like there is pressure on it, just because the ECG and other checks were ok, can I be sure there isnt an underlying problem that hasnt been picked up, my uncle has a heart condition which wasnt picked up with an ECG.I have young children to look after and Im experiencing other health problems such as breathlessness when doing normal activities like chores, I saw my own GP about this months ago and a series of blood tests ruled out anemia, I just want to feel normal again.Thanks Christine. ### REPLY: Thanks for your question on . I can understand your concern. Yes, you are right. Normal ECG does not always rule out heart diseases. So if you want to be 100% sure that this pain is not heart related then you should get done 2d echo and stress test (trade mill test). If both these are normal then no need to worry about heart diseases. Sometimes stress and anxiety can also cause chest pain, pressure and breathing difficulty. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Don't worry, you will be alright with all these. Avoid stress and tension, be relaxed and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a question about birth control.  I would like to know how long it takes for birth control to leave the system and start ovulating again.  I get comments made to me that it takes at least a year for it to get out of the system and possibly get pregnant.  These people telling me this seem very adamant that it is a year for every female.  Now that I am in my early 40s I get these comments a lot. ### REPLY: HI, thanks for using  It can take 2 to 4 menstrual cycles before everything returns to normal. It does not take a yr for this to occur. In some women it may even take less than the 2 cycles stated earlier. Because you are in your early 40s, it may be more difficult to conceive. If you are unable to conceive after 6 months, you should consider visiting your doctor for an evaluation. 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: hi, i turned 40 in November. I have never had a problem with high blood pressure. The past week i have not felt well. I have a weird feeling in my head sometimes. Just a sense of overwhelming or pressure. my arms have been aching and hurting some; as well as my hims and legs at times. Diabetes and heart disease are in my family. I felt really bad one day and checked my sugar with my father s meter 2 hours aftet eating. My blood sugar reading was 140. But i have checked it before eating lunch the past days and it was 79 and 78. I have checked my bp at home also. It has been readings such as 134/99, 140/101, 123/90, 134/96..and elevated other times too. I ve been checking it several times the past few days. What should i think and do? I had already made an appointment with a new medical doctor for march 31 to get established. I called back but the receptionist said he had no openings before that date. And if i needed attention before to go to a local clinic. I am making it but i just don t feel well. Should i be more concerned or fine to keep waiting till my appointment? ### REPLY: Hello! I carefully passed through your question and would explain that your symptoms do not seem to be related to any cardiac disorders. The muscular pain could be related to a viral infection or electrolyte imbalance. This does not seem to be an emergent situation, and you can wait until your doctor consultation. I would recommend performing some tests: - complete blood count-muscular enzymes- PCR, sedimentation test for inflammation- liver and kidney function tests-blood electrolytesRegarding your blood pressure values, I would recommend to closely monitor your blood pressure different times during the day (in sitting position, after 10 minutes of total relax), write them down and show them to your new doctor. The values you refer are within the normal ranges, and some of them are borderline. This means that you do not need to start antihypertensive therapy. Some lifestyle modifications would be enough to help you maintain a normal blood pressure: - a healthy diet (low salt and caffeine intake)- a lot of physical activity (aerobics, walking, jogging, recreational sports, etc.)- reduce your weight if you are overweight. Considering your blood sugar levels, they are within the normal ranges and do not indicate diabetes. So do not worry about them! Hope you will find this answer helpful! Kind regards! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi...I am 22 years old male and I get wet dreams regularly (atleast twice in a week). I regret the next day morning because my conscious mind says its wrong spiritually. I want to avoid this immediately. Please suggest me some methods to avoid wet dreams. ### REPLY: Hi, I understand your turmoil as in many societies, sex is considered tabooed. Nature has given the system of sex for continuation and propagation of humanity.in that system, in males there is continuous production of semen. If the produced semen is not ejaculated via masturbation or sexual activity, it comes out in the form of wet .  In simple words, if tank is full of water, and you do not open the tap, water stats spilling. Rest assured that there is nothing wrong in it. As it's not in our hand, we are not responsible for it hope my answer was helpful ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a problem with my right hand and arm - the middle two fingers and thumb seem to be numb most of the time. This has been getting worse for the past two years and is now to the point that I do not rest well at night. In addition I have a torn rotator cuff on my left side from a fall on the ice a couple of years ago. What can I do about the numbness on the right side? ### REPLY: Hi... Your numbness in your right hand is due to neural compression of a nerve called median nerve or due to nerve root compression...in the neck. I would like to know if there is any associated muscle weakness like reduced grip strength.etc suggest you to kindly meet a neurologist to get investigation done to rule out the source of problem and plan for treatment... Your left shoulder tear is not connected to this issue...while I would do suggest you to get a good rehab program and do it at least for six weeks to improve overall strength and function... Hope this is helpful for you. Kindly revert in case you need any further help in this regard... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter was taken to ER with severe pain in the kidney area. While there she was told no stones and no infection. However, the UA RBC test shows 20-30 A. The ultra sound and CAT scan showed moderate right hydronephrosis and visualized proximal ureter is dilated. She also shows multiple phleboliths. They gave her some vicodin and an antibiotic and sent her home. That was last Thursday. She is still in severe pain and when she urinates it is not a steady stream......can you advise? ### REPLY: HelloThanks for query. Your daughter has severe pain in kidney area and ultrasound scanning and CT revealed HY . This is suggestive of presence of obstruction of the ureter in middle portion of ureter. In the majority of cases it is due to the impacted stone in the ureter. This can be confirmed by doing radiological tests called Intro Venous Paleography.(MVP). Consult Urologist for evaluation and get the I.V.P done under his supervision. You need to confirm that her creatinine levels are normal before going for I.V.P. Further treatment will be decided by him and will depend upon the results of test, position of stone and degree of obstruction. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 experienced gallbladder attacks off and on for the past couple years. So far the have been infrequent and until recently was not seen by a doctor for them. The last attack I experienced went on for many hours longer than usual, so I was seen by an urgent care physician. Unfortunately, I was not able to get in for an ultrasound until 3 1/2 days after the onset of the attack. I am still experiencing some pain 5 days later, but not as severe. The report shows that everything is normal except 2 large (1.7 cm) mobile gallstones present. Is it possible that there were further issues at the time of the attack that would not be visible on this ultrasound? What is the common treatment for this type of situation? Also, note that I am on the pill and suffer with IBS. I understand that these are risk factors for gallbladder disease. ### REPLY: Hi.noted history of gallstone disease. Frequency of attacks are apparent in your case. It is not an emergent situation, but urgency must be there in terms of management. It is best if you consult with a doctor, preferably a general surgeon, for physical examination and clinical evaluation. Other diagnostics (such as blood count, liver function tests, etc.) and management (cholecystectomy or surgical removal of the gallbladder is the definite treatment) will be directed accordingly. Low fat low salt diet is also recommended. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here.my daughter regularly uses asthalin respules bcoz of cold and cough and 2 years before heart surgery was done so i wanna know that there is any side effect of regularly using respules ### REPLY: Hello. Thank you for asking at . Common side effects of Stalin (Albuterol) are increased heart rate, sometimes irregular heart rate, feeling of heart beats (palpitation), tremors especially in hands, "shaky feeling" in the body, reduced blood potassium levels (leading to fatigue and muscle cramps), irritation or . As she has had a heart surgery, personally I would prefer levosalbutamol over albuterol for her. Levosalbutamol has almost similar actions as albuterol (Stalin) but less heart-related side effects such as rapid/irregular heart beats. Please discuss this matter with her treating doctor. Hope above answer will be helpful to your daughter. Wish her the best of the health. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doc,post delivery after a c-section on 29jan 2010 iv got periods during 8th mth of my son,since then my periods were regular ,,,last period was on jan 19 2011,,,,since then i din get periods yet,iv got both urine n blood tests done last mth but invain...so gynic gav me primolut-n 5mg thrice for 3dayz,,,till 10dyz no period,so i took duphaston-10mg twice for 5days....till now no periods its almost 10dyz now...wat cud b the rezon 4no menses even after takin so many medicnes 4 withdrawal of bleeding????do i hav still chances for pregnancy???m even on gluco[hage-500 twice daily after meals since december.....b4 my 1st pregnncy i was having pcos,sp was on glycomet-850mg for almost 8mths n mny periods wer regular while i was on it,n by god s grace i even conceived as soon as i joine dmy husband here in riyadh,,,after delivery all my ovaries wer alright der wer no cyst...now in frb i went thru lot of stress as my mom had a new lif,,,cud dat stress b d rezon,,but how long will i ndt get periods dis is 1st time dat even after taking medicnes m not getting my periods,,,,m i pregnant??? or watz d rezon plz help as i want anoder baby as my son is 15mths now ### REPLY: Hi, thanks for query. Pregnancy seems unlikely. As your blood test and urine test are normal there is no reason to worry. Please discuss with your doctor about possibility of thyroid disorder. As you ultrasound is also normal major things are ruled out. Please keep patience and keep regular follow up with your doctor. At times due to some hormonal imbalance and high amount of stress this can happen. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im an 18 year old girl and ive never had sex before the farthest ive gone with a boy is making out and there was absolutely no touching there. never even seen a penis and i had my period two weeks ago for this month. However about two weeks ago on monday i had really bad diahrrea and my abdomen was burning whille i was on the toilet. it was very painful i had diahrrea at least 3 times that night. ever since then ive been constipated but also have had diahrrea intermittely. Im also bloated. normally my stomach is flat and i have a bit of a pouch in my lower abdomen now due to bloating accompanied with cramps . i also feel a little pressure around my hip bones. ill also get burning in my abdomen after i eat or in the morning. it radiates to around my breast bone. please help! ### REPLY: Dear madam,first I would like to tell you that your problem does not seem to be related to your sexual life.Also, the fact that you got your menstrual bleed 2 weeks back should make you reassured. Coming to your abdominal problem....from the history what can be gathered is that you have a gastroenteritis.However, cause for it needs to be evaluated.Hence, I would recommend that you visit your family physician for a basic evaluation and then take a call for there.... All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having pain in my lower abdomen and groin area. The pain is more severe at night. My whole right side of my lower abdomen and right side of pelvic area is swollen. I can t lay down at all, but siting up helps to elevate some pain. I have had total hysterectomy years ago. I have been diagnosed with IC, but it is not the same kind of pain. The pain is around a 8 or 9 thorough out the day. I am active, but right now it hurts to walk, drive, and be touched. The pain is mainly constant but at times go away briefly. ### REPLY: H. With the history of hysterectomy and swelling of the lower abdomen I can think of an obstructed Incisional Hernia as the most probable cause. I would advise you :Stop taking anything orally. Consult a General Surgeon to get a physical examination and Standing x-ray of the abdomen to see for signs of obstruction. Ultrasonography of the abdominal wall and of the abdomen. You may need an urgent surgery if this is obstructed Incisional Hernia. IF not a conservative treatment and further investigations will give an insight about the problem. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 9 month old girl fever has been up to 103 and back down then back up. Went to dr they said its a virus. Came home she napped then woke up with a fever but her hands feet and lips are a little purple. Gave her a bath and she began to shake a lot. She has stopped shaking but still has a fever over 100 with slightly purple hands deer and lips. Any idea? ### REPLY: HI...purplish discoloration and duskiness of lips occurs in high due to peripheral vasoconstriction. If the kid is active otherwise and well when the kid is not having fever, you need not worry. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor i am 24y old married women. 9months back I got pregnancy. In 3rd month I got bleeding and then abortion . From their onwards I got periods irregularly one month it comes 20days and another month 30days and this month I will get periods in 16days. I consult my doctor and she prefered me to use femilon tabs. Is it is safe. I want to get pregnancy please help me ### REPLY: Hi, You seem to be suffering from post portal hormonal imbalance. This needs to be corrected first to ensure regular ovulation as you do not seem to have any ovulation problems. Felon is an oral contraceptive prescribed in your case to regularize the cycles. After regularizing the cycles, which should be done in a couple of months, treatment for promoting pregnancy will be initiated. You may need induction of ovulation if there is evidence of insufficient ovulation. You can get a complete hormonal profile, sonogram, tubal patency and nutritional supplementation to prepare the system for a good chance of pregnancy. Please get further advice from your doctor. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a hip surgery after an car accident (Feb. 18, 2012) and after a month and half (April 3, 2012) I got DVT in my right leg and then I started taking Warfrain so now I am on blood thinners and keep my INR between 2-3. My question is my right foot had regular swelling although I excercise, swim and have medication on a regular basis. Do I need any medication for swelling or what else I could do? AT present I am in west coast Canada. ### REPLY: Hi The legs have two sets of veins, deep veins and superficial veins (close under the skin), blood goes from the superficial to the deep veins. Clots usually form in the deep veins though they can occur in the superficial veins as well. Whereas the arteries in our bodies have thin muscle our veins do not, and they rely on the contractions of the surrounding muscles to return the blood to the heart. Some persons with a history of DVT can have a complication called post thrombotic syn . Some symptoms of this include: swelling of the leg due to a build up of fluid, varicose veins, heaviness, itching or tingling, discoloration. Initial treatments include leg elevation and the use of compression stocking, in some cases medication can be used. You should speak to your doctor so he or she can assess the swelling and initiate appropriate treatment I hope this helpful to you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a dark spot on my inner thigh and it s been there for about 8 months. There is a lump undernethe the spot. Sometimes it shoots extremely sharp pains up and down my legs. What could the dark spot be? And what cause the pain? The dark spot is about quater size ### REPLY: Hi, thanks for sharing your health concern with team ! In the present case of painful dark thigh swelling or lump, if I were your consulting physician, I would consider two or three possibilities like:1. A neurobibroma or dermatofibroma2. A hematoma with recurrent internal bleeding3. An infected sebaceous cysts per your description, it is a benign harmless lesion like a sebaceous cyst or could be common papilloma like some fibroepithelial polyp! In any case this could not be some serous disease or cancer...! Take caution not to get injured there as this might invite infection! If you are still worried, please get examined by a surgeon or get some FNAC like cytological examination or revert to us. Hope you got your answer. Please feel free to write to us if any more queries. Wishing you the best health! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i use to have a rather dark brown mole on my back beneath my bra, it was only recently i realised the colour had gone completely, its just a redish lump, but today i was in the bath and my back was sore so i went to feel it cause there was something there and its like a rather big raised lump thing and im not sure what to do? can you try give me a diognosis? ### REPLY: Hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. Based from your description, it could be a cyst (a sebaceous or a gelatinous type). These lesions can occur anywhere in the body and have the tendency to recur. It could also be other types of tumor lesions best evaluated clinically. Further diagnostics (such as imaging and tissue diagnosis) and management (medical and surgical) will be directed accordingly. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I I went to dentist 2 days ago,and he worked on a  back molar and replaced a very old filling with a temporary one. The next day I felt a lump behind my ear that hurts to the touch. Please advise? My age is 73; wt: 119 Med history. I have had cataract surgery several years ago, 2 back surgeries, and slight;y elavated blood pressure and cholesrtral ### REPLY: Hello, thank you for consulting with . Just a filling in the molar tooth can not cause this kind of swelling.  But it can be possible that your tooth is infected, and this infection has caused the lymph node which is present behind the ear palpable. For this problem you should visit your dentist again and Tet x-ray done of the tooth as it will show the spread of infection and if necessary go for removal of the tooth. Till then, you should continue with antibiotics. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i undergone pneumonia treatment in hospital for 3 days by taking antibiotics (IV). After discharge i am getting more back pain and chest tighten pain. If I use hifenac-mr it is giving immediate relief, can i continue it, if so please give dosage. i am 36 old and female ### REPLY: Dear patient It seems you have got back stiffness due to rest. Since you were under treatment for pneumonia in hospital you must be on rest which might lead to muscle stiffness and pain. You need physiotherapy with back extension and back strengthening exercises and do hot water fomentation for your back. If you are feeling better with higher Mr you can continue it. Dosage is twice a day for 5 days. All the best ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been prescribed fenibrate 160mg qd after seeing my primary care MD this week.... I am already on Simvastatin 40 mg po qd and Zetia 10 mg po qd and I take 1200mg fish oil daily . I was recently diagnosed with hashimotos disease and my Synthroid dose is 125mcg daily . My lipid panel 6 mo ago had come down and my numbers were in normal range and this week they are elevated and more than they have ever been. (Triglyceride 540, HDL30, and total chol 209) My Tsh is also back to 4.27 while being on the dose of 125mcg of levothyroxine. My question is two-fold....could my lipid panel by off again because of the Hashimotos, and is it safe to take Tricor along with Simvastin and Zetia. Of course I am distressed that my numbers are way out of range (even though I follow a nutricious diet and get some exercise and take my medicine). I am a 55yo female with a strong family hx of high lipids ,,,,,One other thing the Endocrinologist put me on in Sept 2016 was metformin 1000mg for a HgA1C of 6.1 (?? don t know if that was necessary but complied and now wondering if that has something to do with the elevation of the numbers on my lipid panel? Thank you for your time . PS I am an RN and have spent my life working in cardiac care services area so this is a real big concern to me. ### REPLY: Hello, There are many reasons that may alter cholesterol test results. Your test result is likely inaccurate. I advise you to take the test again. The test should be taken at least 1 week after from the current test and the medical decision should be based on both results.  Hashimoto disease is a hyper-functioning of the thyroid gland. High thyroid hormones are known to decrease cholesterol level in Hashimoto disease. But cholesterol level may get increased in under-functioning thyroid gland. Regarding your medications: Simvastatin is a medicine that decreases cholesterol level by inhibiting cholesterol synthesis and has more effect on decreasing LDL levels. Vibrates (Tricorn) decreases TG levels, and Ezetimibe (Zeta) decreases cholesterol absorption from the gut. The combination is more effective than using a single cholesterol medicine but combination Tricorn with Simvastatin may increase muscle pain (myopathy). Metformin has no effect on test results, it was found to decrease cholesterol level.  Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I just got YAZ contraceptive pills from my doctor and she told me to start taking it on my 4th of 5th day of my period (which is today or tomorrow). But lots of websites are telling me to start it either on the first day of my period on on the Sunday after (??). Will it control the start day of my next period? If I want to postpone it can i start taking the pills a bit later? Thank you, ### REPLY: Hi, The time of beginning of YAM is very simple.1. If you start it on the first day of menses, no other contraceptive method is needed and you are protected from pregnancy for the entire cycle.2. If you start it on the first Sunday after the beginning of your period, YAM will not protect you from getting pregnant for the next seven days, and you need additional method like a condom or diaphragm to prevent pregnancy for the next seven days after you start YAM. The pack has 28 pills with 24 active pink pills and 4 inactive pills and the next period usually begins while taking the white pills. Any of the methods can be adopted as per your convenience. You can start to take the pills later if you want to postpone your next period, but you will need to use some other method from now on until 7 days after starting YAM to protect against pregnancy. Hope this was helpful. Have a nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am recovering from the side effects of treatment for esophageal cancer. My recovery has been proceeding nicely, but in recent days I have experienced slimey saliva when I eat. Ordinarily I can clear my mouth and throat within a few minutes, but today this phenomenon has persisted for hours. I am unable to eat and my throat has become quite sore from the effort to expel the slimey substance. (It looks like saliva, but it is thicker and slimier.) What is going on and what can I do? ### REPLY: I believe you have received radiation therapy for your cancer. Radiation often causes a decrease in production and thicker, ropy saliva. Try taking a lot of fluids. Keep sipping water after a few minutes. You might want to try lime juice to stimulate salivary secretions. Also, you can use an artificial salivary substitute if it doesn't help. For the sore throat, try doing warm saline gargles and take honey followed by water to wash it down. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell on my butt, about waist height on a round rusty pipe, it was not sharp, but it bruised me thru my shorts. I saw a little blood on the bruise, will that cause blood poisoning? I ONLY had apple cider vinegar, so I washed it with warm water, will that help? What should I do? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Rusty metals can contain the spores of tetanus bacilli. This can cause a serious tetanus. Though the chance is very minimal because the wound is not closed one it is actually an open one. I advise you to take tetanus toxic injection which will protect you against the tetanus. I suggest you to take the due care of the wound. Please do regular washing and .  You can use Betadine and polypoid ointment over it. I will be happy to answer your further concern on bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi im a 23 year old lady... lately i have been experiencing mild headaches and i thouht it was my sinuses that the other day i got an instant fever but it was bad felt like a hot flush after. today my hands feel weak and a bit shaky. and at time i feel very cold and sometimes when i eat i feel like throwing up. ### REPLY: Hello there, I am .  It may be confined to the sinuses called sinusitis and may also with pharyngitis. Your associated symptoms like fever and headache supportive to that. You need to take decongestant along with any painkiller for 5 days. And along with you take tablet azithromycin or any equivalent antibiotic for 5 days according to your physicians advise. This is look like bacterial infection, so antibiotic is needed. Usually in viral more than one system involvement is seen, which is not here, so it is mostly a bacterial. Take rest and eat healthy diet for few days. Avoid any cooled  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 severe abdominal/intestional pain and cramping all day since I ate some Safeway packaged salad late last night with hard boiled eggs and bacon that was expiring, with some dressing. I also have a headache and overall body ache.  This has been going on for over 12 hours.  What is over the counter recommended treatment.. Thanks, Bobbe ### REPLY: Hi. Thanks for your query. Noted your history of severe abdominal cramps and pains since you had eaten Safeway packaged salad, hard-boiled eggs ad bacon. This has given you gastroenteritis which in turn is causing headache and body ache. Since these are the symptoms suggestive of acute intestinal infection, I would advise you to take the following:Tums and omeprazole, activated charcoal, multivitamins and probiotics. I would advise you the following in addition to the above:An antibiotic and metronidazole and antispasmodic to control pain. Complete the course of 5 days. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 woke up this morning and was washing my hair and felt a knot like bump on the bottom left side of the back of my head. I have been around a lot of sick people at work and then had sick kids last week. I rarely get sick (haven t been in 4 years).I ve been nervous all day, and with any medical symptoms research done online, I ve made myself a nervous wreck. I ve seen everything from a swollen lymph node from an infection or head cold to a tumor to cancer to HIV to cyst, etc.My neck is a little stiff and a bit foggy, I ve a bit tired, but otherwise feel fine. I think I ve got myself stressed to not feeling well more so than actually really not feeling well.Should I get in or see if a head cold develops? I m scared a bit, but not really - as I tend to think it s more a swollen lymph node. I swear it wasn t there Friday and not, as of Sunday morning, I noticed it. If it s a swollen lymph node, how long do they last and am I contagious right now? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some enlarged lymph node due to reactive hyperplasia.  Possibilities of lymphoma or cancer are less likely.  So don't worry much about that.  It may be due to infection in head and neck area.  You are not contagious with lump.  You should take a course of antibiotics.  It will disappear within a week.  If it doesn't respond to treatment then biopsy diagnosis is advisable. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I m a figure skater and I was doing a double toe loop and landed really hard on my left hip, I was able to get up and skate a lap or 2, but it hurt a lot and I got off. Now it s been a day and my hip hurts in the lower area going down to my thigh. It feels tender/tight, and it hurts to walk around, especially up the stairs. There is no visible bruising. At fir to thought it was a hip pointer but it hurts in the wrong area. HELP I need to figure out what s wrong so I can get back to the ice rink to train. ### REPLY: Hithank you for providing the brief history of you. A thorough clinical examination is advised. As you landed on your left hip I suspect it to be strained muscles in the groin area, and you need to take rest for time being as its better to be late than never. Since the muscle is injured the surrounding muscles are acting as a protective mechanism and no allowing freedom of movement in the joint. A natural process of healing will take anywhere between 5-7 days, and you should allow that to happen without aggravating it further. In my clinical practice for pain and inflammation therapeutic ultrasound therapy and TENS therapy for pain helps when patient underwent physical therapy. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Last year we were misdiagnosed with cancer . (multiple melanoma ) he was 2 days away from radiation and then he was told he doesnt have it. They have no idea what he has. The tumor was in his sinus cavity. Recently he has been hurting everytime he goes to the restroom. He drinks on a regular basis. I was just wondering what could be causing this. He doesnt have hemmoroids ### REPLY: Hi jenny, I would like to know whether it is multiple myeloma or malignant melanoma. Both this can occur in sinus cavity. If there is any brain metastasis due to melanoma he can have some behavioral problem depending upon the size and location of the tumor metastasis in brain. If it is myeloma then there is a chance of platelet abnormality which may cause bleeding after passing stools. Whatever it is a biopsy from the lesion in the sinus cavity will rule out cancer. An oncologist consultation is mandatory.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 5 year old daughters front teeth are discoloured, they seem to be going black. She brushes twice a day and uses mouth wash also. She is currently on fer-in-sol, (iron .3ml) per day and my gp says that the dose is so low it wouldnt affect her teeth. Also her breath is quite strong smelling, could they be connected? ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as your child have discoloration of upper front tooth don't worry discoloration is not related to iron supplement you are giving. This discoloration can be due to caries or due to History of injury causing tooth non-vital or due to internal resorption. Consult dentist and go for radiograph X-ray if it is carious or nonvital then go for treatment. Hope this will help you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor,My skin is oily from the beginning, ihad pimples too.. But from 1yr my face is becoming too dry and i am becoming dark also frm 2-3 yrs , i dont know the reasonI am applying moisturizer but aftersome time its drying up asusualSuggestme any home remedies and reason for my dark skin Help me in this regard ### REPLY: HAI, If your in Teenage between 15 and 20 year first don't get fed up because its hormonal change. Follow the below advise to reduce the pimple stake 4- 5 liters of water every day wash your face twice or thrice day. Depends on outside work. Use aloe vera face wash.apply Multan mitt powder mixed with butter milk once in a week.don't take junk foods. Take more leaf vegetables and fruits.u can also take trial juice (Himalaya .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently had an incident of diarrhea for a week. He thought it was a flu bug. He continued having trouble with his stomach and had no appetite. he is 34 and in generally good health. His md ordered some bloodwork which revealed a low potassium level and elevated liver enzymes . He said they normally should be 60 and his were around 130. He still isn t feeling 100%. They did order a ultrasound of liver and more bloodwork. any idea of cause / diagnosis ### REPLY: Hi brackens140,Interpretation of laboratory test can be difficult without having the full report and the actual numbers. However, let me tell you that every time I see elevated potassium together with elevated liver enzymes in a generally healthy person makes me think of a "memorized" blood sample, meaning that the blood sample is not good, since the red blood cells have been broken down giving a wrong laboratory result. This can happen if the blood sample was not appropriately taken, if it was not stored at the correct temperature, if it remained too long in the lab before getting tested, etc. So my suggestion would be to repeat the blood test to confirm or rule out the abnormalities. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 an abortion last year in september and my boyfriend left me to deal with it,he even avoided me after it..whenever I talk I cant knock some sense into his mind,do you think he is going through what Iam going through?Now its like he owes me,I feel like Im going to end up killing him.. ### REPLY: Hi dear, Abortion is a major life changes in you and that's why you anxiety features and after such event it is normal to have such features but as you have such symptoms persist since 1 year you must take treatment. Consult psychiatrist for detail history and mental status examination.is there any other associated symptoms like sleep and appetite disturbance, sadness of mood, loss of interest etc. There are many medications by which you will be all right like SSRI, SARI, benzodiazepine etc.also do meditation, yoga, exercise which also helps you to overcome anxiety. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my nephew is 14 years old , he seems to be mentally handicapped . He is walking , running and eating but he has got no sense of maturity. He developed everything bit late (talking walking etc ) . He did not concentrate in school . He could not start his education also . After birth from his birth till the age of 5-6 years he was bit ok , but afterwards , it seems that his brain is not growing with his age. Now he has stopped talking properly . He is laughing and shouting only . Please help us ### REPLY: HIS understand your concern and positive outlook for your nephew. Mental retardation nowadays called intellectual disability, and it is permanent disability. It is due to lack of proper growth of brain.it is not possible by any mean to grow brain. You have to accept his limitations and support him. Psychological assessment is must identify his IQ and level of adaptation in different area. Need to teach him like a special child. There are many schools in which rehabilitation program will be carried out. Medicines are only helped to control his behavior but not useful to enhance his intellectual power. Consult psychiatrist and take advise. Parental counseling is must. Still have query then feel free to ask. Thank you. Hope for the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: he is 40 years has no problem about money and yet scared to get me pregnant I know he is a shy type. He loves me so much and font want me to break up with him too.we have been dating for 3 years. I asked his brother if there is a reason but he assured me there is none. What can I do please ### REPLY: Hello Tomophobia is fear of getting pregnant in females or fear of childbirth in males. It is seen in a lot of urban couples due to occupational pressure. You have mentioned that there is no money problem. He don't want to get a child and this is causing problem in your personal life. I would advise both of you to consult a Psychiatrist or a marital counselor for expert management. Proper marital counselling will tend to increase his confidence. If condition doesn't improve the there is need to take medicines. Antianxiety medicines will help in early improvement. Thanks, 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: My husband has sinusitis he has green mucus, coughing headaches, and teeth hurt: he gets this once a year and usually has to have three rounds of antibiotics Any suggestions ### REPLY: HI, thanks for using  Based on your description he may need another course of antibiotics. In addition to the antibiotics, he may also need an antihistamine/decongestant combination as well as a topical steroid nasal spray as well.e.g. of topical nasal sprays- Flonase, alone, nasocortAnti histamine/decongestants would be over the counter. He may to take these long term to prevent or reduce the chance of repeated infections 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: hi i just did culture of foreskin and it showed scant growth of staphylococus aureus ...i have history of recurrent boils and white cheesy discharge on entire foresking and glans for 1,5 yr now ...in october culture showed moderate growth of streptococus type b ..what does this means ? should this be treated? ### REPLY: Hi, Welcome to . I understand that you are worried about infection in your genital area. Staphylococcus is normally found in skin as a communal. So infection can be suspected if clinically symptoms of purulent discharge and boils is present. In your case, I suggest you get sensitivity testing done for the Staphylococcus aureus and get appropriate therapy based on the test. Recurrent boils can be caused by MRSA. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have aches on my side especially by lower right abdomen. When i lay down i feel pressure that makes me get up 5x a night andI do actually urinate. But the ache I get is like a ache when you work out and the soreness after wards I get the aches/pain actually now on both of my side, feels like its kinda of getting scrapped ont he sides. I have been to plenty of dr. and they seem not to know the real reason this is happening. ### REPLY: Hi. Thanks for your query and an elucidated history. You have visited plenty of Doctors for the said problems which you described so well. You are getting pain on your sides specially the right and now on both the sides-feeling pressure and actually have to go for urination 5 times in a night - ache is like that of work-out and soreness - like scrapped out the sides-With such a history I can think of the few things only:-Urinary tract infection with a classical reflux into the ureters. I would suggest you the following:-Get the blood tested for CBC, urea, creatinine, sugar.-Urine: routine, microscopy, culture and sensitivity.-Ultrasonography with full urinary bladder and to see if there is a reflux on pressure and to see the post-void urine in the bladder to see the residue/-Actual MVP- intravenous Paleography to see the reflux. The treatment :Antibiotics as per the report of culture and sensitivityUrologists opinion to hold urine for longTreatment of the urinary obstruction at whichever place it shows. I hope this may help you. If required you can go for another / Second Opinion of a Surgical Gastroenterologist to rule out any gastrointestinal cause like colitis. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 friend is in south africa he has skin problem for the last 4 years. at hands ears,some part of the face also. He seems scratch the skin and some white powder like skin comes out leaving somes red rashes.he has been taking medication but not useful.doctor says it is one type soroisis.what medicine he should takepl suggest ### REPLY: Hello. Thanks for writing to us at  Psoriasis presents as red, scaly, itchy patches at various body sites; commonly extensors like knee, elbow, scalp, hands. Facial involvement is less common but may involve the hair line, that may extend on to the adjacent facial skin. Diagnosis of psoriasis is clinical; skin biopsy may be confirmatory in doubtful cases. Psoriasis is a steroid responsive dermatitis and treatment of limited disease includes potent topical steroids e.g. clobetasol propionate clobetasol propionate in cream/point/lotions. Topical vitamin D analogues e, g calcitriol, calcitriol are also among the treatment options. Systemic treatment may be started in those who have widespread Or severe involvement (e.g. pustular psoriasis, erythrodermic psoriasis). Systemic treatment options include methotrexate, cyclosporine, phototherapy etc. Methotrexate sometimes may also be started in those with limited involvement e.g. recalcitrant involvement of hands and feet. Psoriasis is chronic and can recur after seemingly complete cure. Factors that are known to exacerbate psoriasis include .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 married before 8years.I aborted a child in 4th month even though the baby was normal for some personal reasons. after that i have not conceived yet.I have pcod and my husbands count and motility is normal.had done IUI 2 times but i havenot conceived.this month I have gone with 22*22 size of egg and it ruptures in 14th day.from 3rd day of my periods doctor adviced me to take OVAA SHIELD and after the egg ruptured i am taking larigest200 twice a day and folic acid .will i get pregnant atleast this month.should i be in bed rest.pls reply me. ### REPLY: Hi welcome to  forum. Every thing is fine follicle is going to ripe, and you are getting treatment for baby bed and nutrition. The thing is you should have sex for 3 days around the day of ovulation. It should be male above position, and you should be lying straight for some time after sex.  Besides I advise you some diet recommendations as take more of green leafy vegetables, pulses, sprouts, milk, egg, meat, seafoods, fruits, juices, and a lot of .  Wishing for a beautiful baby soon, and thanks for calling. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Imagine a picture of a heart. Well over a few months now I have noticed that I have a small throbbing pain as if someone was taking a small piece of my heart and compressing just that specific area. However sometimes this pain seems to move around in the general left breast area including just above my ribcage?Any possible answers to what is going on in my body as well as possible solutions is appreciated.I am not overweight. I am 31 years old and I off and on swim so I am in relatively good shape. ### REPLY: Hi Thrive read your query and understanding your concern. I would like to tell you, if you are experiencing any breathlessness or chest tightness with this throbbing pain then it can be related heart disease. But heart disease in young age is unlikely until unless you have very strong family history of heart disease. It can be muscle strain or bony pain. You can use tablet Orphan SOS. If doesn't get relief then you can personally consult with an orthopeditian so that he can guide you properly. If you have any family history of cardiac disease then get your ECG and echocardiography done and consult with a cardiologist. Hopefully I answered all your queries. Wish you 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 heavy crushing feeling in my chest back and ribs. Im bringing up quite alot of mucus sometimes like a brown colour sometimes it looks like it has blood in it. And i have awful pain in my left side and under armpit when takin a deep breath. ### REPLY: Thanks for your question on . I can understand your situation and problem. By your history and description, possibility of lower respiratory tract infection (LETI) is more. Chest discomfort with pain and brownish mucus expectoration are common symptoms of LETI - pneumonia. Chest pain on breathing is characteristic feature of pleurisy (inflammation of pleura) and pneumonia is the most common cause for this. So better to get done chest x-ray for the diagnosis of pneumonia. You may need antibiotics, bucolic and expectorant .  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: my father is schedualed for vascular surgery on his right leg on friday and has been on warferin.  his blood is thin, 4.6. he has stopped the medication til the surgery.  would it help thicken his blood to now go ahead and eat green leafy vegetables, grapes, things with vitamin k? ### REPLY: Hello and welcome to , Green leafy vegetables are rich in iron, so consumption of green leafy vegetables will lead to increase in iron content and improve the hemoglobin but will not affect the thickness of blood. Warfarin is stopped before surgery to avoid excessive bleeding during surgery, however, this is only temporary. The . Consumption of green leafy vegetables and fruits is good as it improves hemoglobin levels. Thanks and take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i feel down a on a outdoor wood step and hurt my back area above my butt on the left side. it left a HUGE blackish/purple bruise that is swollen. looks bad. today i have a pinkish color (bloodish) in my urine. should i head in to the dr? anything bad? ### REPLY: hi Hope this msg finds u in good health. I have gone through your complaints and understand your concern. I feel u might have some sort of intro abdominal organ injury.especially the kidney lies exactly under the area u have got hurt.It's definitely to be a .  Get an abdominal scan done at d earliest to find out what's wrong. Nothing to worry about. Hope your question has been answered. If u 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: Gud day..im 39 yeras of ages and have 2 kids full time house wife.month of march this year I had my gastroscopy...but before my gastro I had 2 chest x rays done.. the 1st result of x ray is normal..then I have to see gastroentorologist bec im feeling always bloated ..to top it all my doc .suggested me to undergo gastroscopy he ask me to have another x ray and the result is minimal ptb both upper lobes..so I did.the result of gastroscopy is Esophagitis LA grade A diffuse erosive gastropathy incompetent pyloric ringthen he gave 3 combination of antibiotics and other medicine..so I was fine im ok after taking that medicine and then he told me to continue my omeprozole..thpen I stopped my omeprozole for 2 weeks thinking I was ok then..but after 2 weeks some symtoms of gerd came back..I went back to my doc..complaining I had shortness of breath back pain bloated tummy..he ask me again to my third xray and ecg..the result of my x ray is follow upmexamination to study dated 4/7/14 (which is my 2 xray.) Show no significant change in status of minimal fibrotic infiltrates in the left upper lobe.no active parenchymal infiltrates seen in the rest of the lungs fields.what should I do..should I go back to my gastroentorologist..bec he ask my again to have gastroscopy and ct scan.or should I look for a pulmonologist..please help..god bless ### REPLY: Thanks for your question on . In my opinion you should first consult pulmonologist and get done CT Thorax and PFT (Pulmonary Function test).CT Thorax is superior modality than chest x-ray in diagnosis of parenchymal lesions. So by CT we can get more idea upper lobe fibrotic lesion. PFT is needed to rule out bronchitis as HERD can be causative factor for bronchitis. You should also consult gastroenterologist for control of HERD. As HERD and breathing issues are interrelated.  You need to treat both simultaneously for better control. So consult both. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Had Mirena inserted in October, developed an itchy dry flaky patch on my labia...it doesn t spread, doesn t go away, and I have tried anti fungal cream, hydrocortisone, steroid cream...steroid cream reduces it but never goes completely away. What is this? ### REPLY: Hello, Thank you so much for your question. Itchy on labia can be from vaginal discharge from IRENA IUD. Vaginal discharge is abnormal when it occurs with the following symptoms: Itching of the vagina or the area around vagina, redness, pain, or swelling around the vagina, discharge that is foamy, greenish-yellow, or has blood in it, discharge that smells bad, pain when urinating or having sex, pain in the lower part of the belly, fever. Different conditions can cause abnormal vaginal discharge. The most common causes are: An infection in the vagina, cervix or uterus, a reaction to something in the vagina that a woman forgot to take out, such as a tampon or condom, a reaction to a soap or other product that was in the vagina, changes in the body that occur after menopause. You should not treat abnormal vaginal discharge by yourself. Treating yourself can cause your symptoms to get worse. If you have abnormal vaginal discharge, see a doctor so that he or she can figure out the cause. Your doctor will talk with you and do an exam. He or she will also take a sample of your vaginal discharge, and do lab tests on the sample to look for an infection. The treatment will depend on the cause of the abnormal vaginal discharge. For example, different vaginal infections are treated with different medicines. If you have a vaginal infection, your doctor will want to figure out what type of infection you have so that he or she can treat it with the right medicine. If it caused by certain types of infections, your sex partner will also need to see a doctor for treatment. Sometimes you can help prevent abnormal vaginal discharge by using warm water and unscented non-soap cleanser to wash your vulva (the vulva is the area of skin around the outside of the vagina), taking baths in plain warm water, and not using scented bath products, not using sprays or powders on your vagina, not douching (douching is when a woman puts a liquid inside her vagina to rinse it out, not wiping with baby wipes or scented toiler paper after you use the restroom. Hope I have answered your question. Let me know if I can assist you further. Best regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im 21 years old..i have a sgpt level of 141..i have been dieting for the previous weeks prior going to have my blood checked..im been drinking fresh milk and been not drinking alcoholic beverages and smoking ..but why does my sgpt levels are high? my doctor prescribed me with silymarin 3x a day and told me to drink more fluids and fruits and veggies for a week and have my bood checked again..are there any suggestions that you have for me to lower my sgpt level? ### REPLY: SGPT and GOT are signs of liver inflammation. Get tested for viral makers- Bag and anti HCV.  Keep of the good habit of alcohol abstinence and the liver inflammation would subside. If you are overweight you need to lose some weight as well. T. ADÍLIO 300 mg twice daily would help too... donor worry too much about lab values... as long as you are healthy and living a healthy lifestyle, lab values don't mean much. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i was laying in bed lastnight and i had a heart palpatation (which i have had for many years) and then it felt like a big bubble going through my heart. I first thought of blood clot. It was not really painful, just a weird feeling like a bubble of air flowing through my heart and then top left ventrical.. ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, we should first rule out heart diseases in your case because your symptoms are classical of angina pain. So get done ECG, 2d echo and stress test (trade mill test). If all these are normal then no need to worry about heart diseases. Sometimes stress and anxiety can also cause similar symptoms. So consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Avoid stress and tension, be relaxed and calm. Don't worry, you will be alright. First rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END