Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: The patient is 66 years old female, not very dynamic, not a BP patient, no sugar complaint. This test was discontinued in the I stage it self as she reached maximum level. Can I know what that indicates? She was taken for this test because she complained of chest pain, not lowered by isosorbitrate, but better by antacids. She is not a know cardiac patient ### REPLY: Hi, This is . Person who does not exercise regularly or has poor exercise tolerance can't walk on TMT for long & their heart rate increase to the target heart rate range in the first stage only & than the test has to be stopped. I don't think it's good for a >60yr old for a TMT. I'll recommend for a better test called Dobutamine Stress Echo where heart rate is increased by medicine. I hope I answered your queryThanksTake care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is having dry cough since long time, tried different medicine, steaming , gargle but nothing is working. Had her blood test done and everything seems to be okay. She is 8 years 8 months now.Have consulted 3 different doctors and nothing seems working. What shall I do now? ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. Chronic .  Chronic lung infection2. Bronchial Asthma3. Bronchitis. So consult pulmonologist and get done1. Clinical examination of respiratory system. 2. Chest x-ray. 3. PUT (pulmonary function test). Chest x-ray is needed to rule out lung infection. PFT is needed to rule out asthma and bronchitis. She may need inhaled bronchodilators. Don't worry, she will be alright. First diagnose her and then start appropriate treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a small marble sized lump on the top right gums of my mouth where it meets the cheek. Its very sore to touch on the outside and on the inside. Its making it hard for me to chew anything on that side. Do you have any idea of what it may be or what I could do to ease the pain associated with it? ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint it seems more like a dental abscess in case if the tooth is decayed over which the lump is present. It can occur due to infection reaching below the root tips of the tooth leading to pus formation. In case of tooth is not infected other causes can be gum infection leading to gum or Periodontal abscess. I would suggest you to consult an Oral Physician and get evaluated, and he can do a thorough clinical evaluation and investigations like X-ray if needed. On case of Dental Abscess either Root Canal Treatment or extraction of tooth can help. In case of Periodontal abscess or gum abscess Scaling, curettage and antibiotics will relieve. As of now you can take anti-inflammatory painkillers like Ibuprofen and apply a numbing gel over it for relief. Do warm saline gargles. Thanks and regards. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For about a week my lymph node on my right side of my neck has been swollen (enough that it s visible without even feeling it) and my neck and back are sore, immulating flu like symptoms. However, I have only had a low grade fever and no pain in my throat or ears. I am so tired all the time and feel extremely weak. Just in the past couple days there is pain when I take deep breaths. Does this sound like mono? I m not sure since my throat is not sore at all. What would you recommend? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Yes it is looking like a mono infection. But there is no need to worry as mono infection is self limiting in most of the patients. Simple symptomatic treatment and preventive antibiotics is sufficient to cure the infections. Only some patient will develop in to the chronic mono infections and will be difficult to treat unless we visit to the chronic fatigue specialist. You can maintain good hygiene and eat great food. This is all what is necessary to cure your infection. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I don t feel like going to talk to my school counselor and I don t feel like talking to a friend about this, so I decided to talk to you. (a stranger) Lately I haven t had the energy to do anything, my dorm room is filthy, and I absolutely hate waking up in the mornings. I feel like a failure in school and like I am living in my friend s shadow... I don t know if I am depressed or not, but I feel like I shouldn t be because I am the one to help people and make them feel better about themselves, even when I can t do the same for me. I don t know how to ask for help, and I may not need help, but I feel dead inside. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. I sincerely suggest that you are victim of your own negative thinking. You cannot term your current state of mind as clinical depression. Rather, this is just disappointment. Disappointment which arises out of unforeseen life events do bring such symptoms like sadness, irritation, anger, lethargy, lack of interest, lack of appetite etc. Please understand this fact and make sure to introspect. Talking to your friends, outdoor activities and being creative should give you relief. Find the reason for your disappointment and consult a psychologist if need be. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 42 yr old that had a lump pop up on my collar bone area about 2 yrs ago.  I was sent for a x-ray and it showed a BB.  Much to my surprise I had no idea and my family (parents) claim the same.  In the past 2 yrs I have had multiple test for chronic fatigue.  My fatigue has always been blamed on Thalassemia and Epstein Bar Virus.  I just feel something is being overlooked and tired of feeling tired!!  Could this BB be pressing on anything important??  Its a lump that has gotten bigger in the past 3 months for some reason.  Can it cause poison in your body?  I have no idea how long its been there honestly!  I am assuming childhood. ### REPLY: Welcome to . 1. The history suggest me the possible cause could be enlarged lymph node.2. The chronic systemic problems you have can cause this enlargement of the lymph node. The next possible cause will be lipoma (fat containing lesion).3. For confirmation an ultrasound examination will help - which will assess the nature of the lump its source and extensions can be known.4. If it's solid mass an FNAC - fine needle aspiration cytology can help to identify the nature of cells responsible for this cause.5. Sugget to get an appointment and get examined and request for scan. Good luck. Hope I have answered your query.Anything to ask do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter (5yrs old) was prescribed Azythromycin (300mg / 100mg per 5ml) last week Friday and we were instructed to start it on Saturday if her fever continued. We started on Saturday with a 1 1/2 tsp dose with continued 3/4 tsp doses. We are now on day three of taking the medication with no relief in her fever. I have been treating with OTC Children s Advil for the fever. I am wondering how long it should take for the fever to disappear? She was tested for the flu and this was negative. Are we dealing with a virus and I just have to let it run its course? ### REPLY: Hi.regarding your query, of fever still persists after documentation of the temperature for three days it is better to do a blood total count just to make sure it is a viral infection or bacterial. If associated with any other symptoms like cough, sore throat, vomiting, abdominal pain, symptomatic treatment would be apt with an antipyretic like paracetamol that should have been taken along with the antibiotic plus an antacid. Do not worry. :) hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I got my wisdom teeth out about close to a month ago just today my right bottom one swelled up and hurt so badly all of a sudden all this pus erupted from it , it was gross but I kept the said pocket open with a q-tip until it had drained out then I rinsed with salt water was that the right thing to do? ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have mentioned that you have undergone extraction of wisdom tooth month ago now you feel like pus from right lower tooth, don't worry it can be due to periodontal problem may be due to formation of Periodontal abscess For this you should visit dentist and go for investigations done and if problem is of periodontal abscess then go for Scaling and Curettage, As you asked for warm salt gargle yes you can do warm saline gargle two - three times a day Consult dentist as early as possible Hope this will help you.  Wishing you good health Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have lipomass spreading in my arms legs and belly. At night if my arms are pressed under the head or my chest the whole arm gets numb and I cannot sleep. Also, my shortest fingers of both hand feel numb all the time because of these lipomass. I am really worried. ### REPLY: Hi, Thanks for writing in. It is important to know if you are having multiple lipomas or neurofibromas. Lipomas are pure fat containing tumors and are soft to touch. On clinical examination they slip under the skin. Neurofibromas are nerve related tumors and appear at many placers all over the body. Since they are related to nerves, these tumors can get painful. It will help to do ultrasound scan on the swellings which have now become painful and to know their nature. Please consult a surgeon and get clinically examined to make diagnosis. A needle testing called FNAC might be required to study the cells in the swelling. Some neurofibromas trap the nerves and then this causes pain. Severe pain requires the neurofibroma to be removed and the pressure over the nerve released by doing a surgery. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a small node on the right side of my neck , my neck pains me a lot expecially where there is this small node( linfonode) i always fell to straigthen it for relief, i dont know which is the course but the right side of my face have swallow a bit more than the left side, i have pain around the right ear and the right jow, the right eye keeps on buffering everytime and it usually burns inside , it seems that it is going to esplode. i have got another node infront of the hole of the right ear where i usually have the pains , i actually fell the vein that passes around my right ear head pumping more strongly than the left one , infact i usually have to massage that part to make it better infact because the vein there is soo superficial i cant put on glasses because everytime i put on glasses the contact with the glasses makes every pain double including had headeache and imposibility to concentrate on anything, my head becomes like its in fire . i have also linfonode front down the hip where i have also always had pains , infact i fell pains when i walk , i have problems remembling things, i use to bleed from the nose , i alway bleed in the morning when i wash my mouth, my teeth are very strong but i always bleed my gums sometimes i even bleed my gums when i just suck them , i hope u can have a sujection ### REPLY: HI. First go for a proper physical examination by a Doctor to see the lymph nodes, liver, spleen and all. Secondly go for the through blood tests and other investigations as might be advised by you doctor as per physical findings. Your part is to tell a proper history and not to jump to conclusions as it looks a bit complicated problem/s. There looks to be a problem with your TM joint. Vasculature problem and may be trigeminal neuralgia.... Please go for a proper diagnosis and then only a possible treatment is possible. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 23. 53. 115. Right now I am taking prenatals(not pregnant), remeron for insomnia and Zoloft for anxiety. I did not take them last night. And woke up around 6. Went to the bathroom, peed a little but had a hard time peeing. Then when I went back to lay down my heart starting racing, my chest got warm and my body was all tingly. My family does have a history Narcolepsy and anxiety and depressions. I had an episode about a month ago about 6 hours after I got the HPV shot. My heart was racing, my vision was getting black and fuzzy, hard time breathing and this tingly and warm feeling was from head to toe. I hope this helps... ### REPLY: Respected user, thanks for using .come have evaluated your query thoroughly.* This is definitely due to psychological manifestation of underlying anxiety disorder.* My suggestions for you - Daily allow 1 hr for meditations, deep breathing exercises, YOGA - 30 minutes regular walking in fresh air - Manage to have regular sound sleep of 8 hrs - Plenty of liquids, balanced nutritious diet-Avoid smoking, alcohol-Avoid stress, anxiety - Keep BP, blood sugar under control Hope this clears your query. Welcome for further assistance. 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 mother(63) was detected for high blood sugar 8 years ago. She immediately took to strict dietary controls and maintained it in the range <140 (post parendial). She also started taking medication for the same since last three years. Six months ago, she started having problem of pain in shoulder joint(left initially then both). Physiotherapy was suggested by a doctor but it was not successful. Then one month back she went to another doctor who gave the following medication:cinnarizine, medrol, myoril and buta proxyvon. She got releived from the pain but a week ago she started having swelling in face and legs alongwith vomiting sensation. We immediately stopped the medication and went for the tests. Sugar levels were 90, 110 wnile Serum creatinine 1.5. Now the swelling has returned to almost normal, but vomiting sensation still persists. yesterdays resullts show blood sugar, 140, 240 and S creatinine 1.5. I want to know whther the creatinine level will decrease automatically or we nee ### REPLY: Hello and welcome to .  As a Urologist, i can understand your concern. Your diabetes may lead to nephropathy, which increases creatinine. This can't decrease automatically, but follow certain safety measures, like :1. Keep blood sugars in control.  Check FBS,HbA1C,and PP2BS.2. Urine routine and ACR.3. Check blood routine, creatinine,platelets, uric acid, LFT and electrolytes4. Ultrasound-KUB, with residual urine. Restrict salt intake and exercise daily for about half hour. According to reports, advise to prevent rise in creatinine, can be given. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son has gotten the chicken pox just this morning. We took him to the doctor and so we found out. But i have not gotten the chicken pox yet and neither has my husband or 2 other kids. I am 39 years old and my son is 10. My other 2 children are 13, and 9. What should i do, because i can`t leave my son alone. He needs to be looked after, and i haven`t got chicken pox before but i know its a much higher risk. Please help. Thanks,Lisa. ### REPLY: Thanks for contacting  with your medical questions am sorry to hear that your son has chicken pox and that the rest of the family is now exposed. The chicken pox virus is extremely contagious and at this time the entire family has been exposed and if they never had chicken pox will probably get it. For the child .  For the adults it could be more serious. It is possible though that you and your husband had chicken pox when you were child ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 do no thave a cold or any cold symptoms, but since last night out of the blue i started this dry, hacking cough. Today, I coughed so hard it felt like someone punched me in my chest and hurt pretty badly. Now, it hurts very badly even with the smallest cough and I can feel pressure on my chest constantly. What could this be? ### REPLY: Thanks for your question on . I can understand your concern. Sudden onset coughing with chest pain and pressure are seen commonly with lung infection or bronchitis. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x-ray and PFT (Pulmonary Function Test). If all these are normal then no need to worry much. Take levocetrizine and paracetamol twice daily. Do warm water gargles 5-6 times a day.  .  You will mostly improve with all these in 2-3 days. 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 lumps inside under my tong on jaw line I need lower dentures but cant be fitted for them because of the bumps I have tried many dentists but no one can fit me properly. do I really have to have bone surgery to remove the  lumps?  Im  a diabetic is it wise to do this or do I go with out teeth im  only 60 yrs ### REPLY: Thanks for your query, I have gone through your query. The bony lumps have to be removed, if you want to go for a denture. Because the bony lumps will interfere with path of removal and insertion of the denture. That might result in injury to the tissues. If you are diabetic, get the RBS and HBA1C done, if it is under normal limits get it surgically corrected. Nothing to worry, it is a simple procedure. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I am very sad now becos for the last 2 years i hav been trying to be a father but last time exactly on 3rd Nov 2011 my semen analysis was done and the result showed as below Motility- Rapid progrssive-00%, Slow progressive-40%, Non Progressive 20% Immotile-40% and Normal forms 2% Is there any case of infertility? Can I improve the motility? If Yes, How? Please help me giving an answer. I m 31 years old and was very much tensed over the last five years cause of stress from job. But the last 3 three years it is fine.(that means not that much tensed I am) thank you ### REPLY: Hellowelcome to  the semen parameters suggest - low motility and normal count 2% only There are medications which you can try like coenzyme Q, vitamin E and other antioxidants for a period of 3 months and recheck you sperm test it will be worthwhile meeting a urologist and getting a check done to look for any other problem present and getting a treatment for the same Hope to have answered your query .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I started producing alot more sliva about 3 months ago. I dont know WHY it started? I have never had this problem before. It is worse during the time I try to fall asleep. I t seems to be worse when I crunch my left / lower teeth together also. The problem has gotten worse over the past week! ### REPLY: Hi Dear, Welcome to . Understanding your concern. According to symptoms mention in the query the excess saliva production occur due to a condition called BRUISE means clenching of teeth specially while sleeping. There can be many reasons for bruise, but the most common reasons are stress, anxiety and temporomandibular problems (TMJ)You should consult dentist for proper examination. Doctor will take history and may order X-ray or CT scan to find out the exact cause. If the problem is due to stress and anxiety the doctor will give your mouth guard and may prescribe muscle relaxant (orthodox MR) and medicine like scopolamine for reducing the quantity of saliva. Doctor also ask you to reduce your stress. If the problem is related to TMJ the doctor will refer you to oral surgeon for proper treatment. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have stage 4 mestastatic cancer, I have been having my back tattooed when I am not on scheme, I have recently got pleural effusion and have been given time off from chemo to give my body a rest. Is it safe to continue with my back tattoo with the pleural effussion Thanks Karen ### REPLY: Thanks for your question on . In my opinion tattoo has nothing to with pleural effusion. Tattoo is on skin and can not produce pleural effusion. In my opinion you are having malignant pleural effusion due to spread from your primary cancer. Pleural involvement is common in many cancers and thus can produce malignant effusion. So get done pleural fluid aspiration and check it for malignant cells and infection. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 nasopharyngeal cancer. He has had chemo and radiation treatment and an operation removing a 7cm gland. he went for more chemo, but his body rejected the chemo. the doctors advised mroe radiation as he still a gland under his arm.After the first chemo and radiation treatment - he had another scan and this was clear in the nasopharynx area. His blood is low and he is feeling tired all the time. Why did the chemo not work the second time and is more radiation the answer? ### REPLY: Hi, Thanks for writing in. Cancer is a difficult condition to treat, and it is not possible to predict the outcome before giving treatment. The usual treatment is surgery, chemotherapy and radiation therapy. Surgery is done for early cancers and that is why the doctors removed a 7 cm tumor. This is followed by single or combination chemotherapy and radiation therapy. Chemotherapy might not work because the cells are resistant to the particular medicine. If first line of medicine does not work then the second line of chemotherapy is given. If there is still no response then radiation therapy is increased in dose. The second chemotherapy probably did not work due to aggressive nature of the cancer and is rarely seen. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i want to get pregnant after an abortion in jan this year.even after having unproctected sex for past 3 months i could not concieve.i get my periods regularly and last month i had bled dark brown bloodclots juz for a day .i had consultated a gyanee she said to wait for 3 months , ### REPLY: Hi, I have gone through your question and understand your concerns. Infertility is said to occur when one fails to conceive after one year of successful unprotected intercourse. Moreover, since you have conceived once, so it is appropriate for you to wait for at least three months before undergoing any infertility investigations and management. Chances to conceive in each menstrual cycle is only 20-25 %, therefore do not take stress and try for natural conception for at least next3-4 months. Hope you found the answer helpful. 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: i am 38 years old lady, married since 2004, height 5.2", weight 70 kg, i delivered my 3rd baby an year ago, 4 months after this delivery i have had hair fall problem can i use epivite? will it be effective? how much time will it take to grow my hair again? i myself dont have any medical history except this that i have migrane but for this i donot take any medicene but only pain killer, my mother is diebetic and BP patient, i am much worried about my hair as i have only a few layers left on my scalp please reply ### REPLY: Hello and welcome to ChatDoctorRegarding your hair fall, it is normal after pregnancy and childbirth, since you don't have any other medical condition. Your hair will take a while to grow well, as the hair growth slows as you age as well. You can start on a supplement like Bootee or Collinear. Do check if your hemoglobin and iron levels are back to normal after delivery or if you need Iron supplements. Take the capsules daily for at least 3 months. Apply Recite or tress go solution to the scalp at night. Use Anaphase shampoo regularly. Take care of your diet and rest well. These measures will help your hair growth but will take a couple of months to show results. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been battling Erectile Dysfunction for years. I have tried Viagra, Cialis and Levitra some time they work some times they don t. they all are very expensive. I had been prescribed Axiron (testosterone) for low T. I was given a sample by my urologist. I tried to get another container and it was rejected by my insurance. Axiron is $1000.00 a month for a 30 day supply. I recently research the Boston Medical Group who claim they have medication that is better than Viagra, Cialis or Levitra and their medication has 98 percent success rate. What can I do about my ED problem? all of the medication prescription for ED is expensive. Should I try acupuncture or herbs. what do you suggest. ### REPLY: , FOR ERECTION TO OCCUR YOU MUST HAVE GOOD HORMONE, GOOD NERVES, BLOOD VESSELS AND SEXUAL AROUSAL. So it is a combination of physical and psychological issues. Even anxiety can worsen erectile dysfunction. Any underlying diseases such as diabetes, heart disease, low testosterone can cause erectile dysfunction. In my opinion the cause for your erectile dysfunction has to be identified and treated for full recovery.anion is a testosterone replacement . Viagra calls and Levitt increases the blood flow to the penis in response to sexual stimulation now a day there are vibrators which stimulate the penis and increases blood flow to the penis which can be tried by you. Hope this explains with 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 a 29 yr old female with hx of Lyme disease 2 years ago. 2 days ago after eating asparagus for the first time I broke out in a rash under my arms on my thighs. I was put on a steriod pack. I know have joint pain in knees, tingling and numbness in arms and chest pain Could I have Lyme again. I did remove a tick 3 to 4 weeks ago from my leg. ### REPLY: Hi, After reading your history it appears that you urticaria or hives. This is common problem, and we see so many of cases in normal population. So do not worry about it. There are so many of the aggravating factor and in yourself including day to day factors of environment. You can take loratadine or levocetrizine or fexofenadine daily. You can apply calamine lotion over the affected area. Stay away from hot and humid climate and wear cotton clothes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Severe neck pain for 4 weeks. Orthopedist read MRI findings. Results, supposedly could be 1. Disc space infection or 2. spinal cord tumor. I was referred to a spinal cord specialist. Will he be able to confirm which it is? Are there any other tests that will result in a definitive answer. ### REPLY: Hi, It will not be hard to determine the difference between a MASS LESION or an infection since there are several diagnostic studies such as PET SCAN, ULTRASOUND, and finally FINE NEEDLE BIOPSY that can all help differentiate between those 2 entities. Also, blood tests can help when looking at high white blood cells and/or the presence of fever etc. 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: 9 month old has run fever of up to 104 for 4 days. The fever broke yesterday and now rectal temp has been all over the place, from 97-98.6. The 97 scares me. Isn t that too low? I should also mention that there was no known cause found for fever. WBC was high. Over 20,000. ### REPLY: Hello. I just read through your question. It is very reassuring that the temperature came down. The reading of 97 is nothing to be concerned about. The white blood cell count of 20,000 indicates that there was an infection, but based on the resolution of the high fever, appears to be a harmless virus. It would be worth considering with your pediatrician doing a repeat blood count to make sure it normalized. In any case, however, the illness is resolving. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pain under my right breast and the only time it hurts is when I eat and drink. I have been on a lot of medicine because I have misplaced cartilage in my chest. Could the medicine be caught in my esophogas? If that could be the case what do I do to get it out of there? ### REPLY: Thanks for your question on . I can understand your situation and problem. In my opinion you are having HERD (gastroesophageal reflux disease) mostly. Right sided pain after eating is seen in HERD. And the . It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. So try to follow these steps for better symptomatic relief.1. Avoid stress and anxiety.2. Avoid hot and spicy food.3. Avoid large meals, instead take frequent small meals.4. Start proton pump inhibitor.5. Go for walk after meals.6. Avoid unnecessary use of painkillers. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m on my 4th pace maker, had 2 infections & 3 lead problems.The last one was put in on 1/10/17 & they had to go back in on 1/24/17 because a lead came loose. The incision open up on 3/3/17, they put on a sulphur anti for 19 days. It did heal & the cultures came back ( no growth). I now have a severe itch & a rash in that area. Could there be a festering bacteria in there? What should I do? ### REPLY: HIT hank for asking to ChatDoctorYour query will be highly appreciated, I can understand your concern, rash at the site of wound indicates the allergic condition most of the time it is the autoimmune disorders plays the role, and it may not be the bacteria if not subsided within a couple of days. Persistence rash, may not be due to allergic condition, but it could be due to soft tissue inflammatory condition, it is the tissue injuries, fungal infection may the cause then. Clinical examination will clear the picture, in my opinion just keep the area very much clean with antiseptic or broad spectrum wound cleaning solution. Hope this information helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother has a history of depressed hemoglobin/hematocrit levels following severe UTI.  The first time occurred when she was hospitalized about seven years ago.  It was treated with Procrit, which was very effective. I shared this information with her current doctor, who is skeptical.  I tried to find supporting evidence online (I have seen it before, but that was some time ago). She was hospitalized a week ago with UTI, and although levels improved to >9, >27 during the week,her current levels are hemoglobin<8, hematocrit <25. Do you have any information? ### REPLY: HiT hanks for posting your query.  There is no relationship between UTI and low Hemoglobin. I think her hemoglobin was being checked when she used to get admitted to hospital.  So we need to find out what is causing her low hemoglobin. I usually suspect either iron deficiency or chronic blood loss. Chronic blood usually happens in the form of blood loss in motions.  I advise you get these tests done and revert :Peripheral smear for blood picture, stool for occult blood, Iron profile, TSH. Any clarification feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a persistent cough for years. I have been diagnosed with asthma, but have heard that heartburn can also cause coughing. I have some minor heartburn symptoms and am wondering which is the best and least intense otc to use to see if this is the reason for my cough ### REPLY: Hello. I have read your message. I think I can help you. Yes, as you have correctly surmised, heartburn can cause chronic cough. This is definitely a possibility. There are however the following factors that go against that being a possibility in your case-1. You have been examined by a doctor-chest auscultation with stethoscope yields typical sounds heard in asthma, not heartburn.2. I assume, though details are missing in your query, that you may have been prescribed inhalers and tablets that help you. This is unlikely to be beneficial with heartburn.3. Other possible symptoms like breathlessness are typical to asthma, not really heartburn. Since the details are not conclusively mentioned in your query, I cannot inform the actual possibility to you. However, I have tried to make it simple and easy to understand so that you can . Tab Pantoprazole 40 mg once a day half hour before breakfast may help you with your heartburn. Feel free to contact me for further suggestions if there is any point you need to clarify. Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a series of unfortunate events over the past 9 years. I have been stable out of necessity, but I am now starting to have increased anxiety that is interfering with my life. My family history frightens any use of anti-anxiety drugs. I need help and don t know where to begin. I don t know if I am normal with never ending duress or if I am mentally ill. ### REPLY: Degree understand your concerns went through your details. YOU HAVE BEEN STABLE OUT OF NECESSITY FOR 9 YEARS !!. Amazing. This fact in itself is a confidence building measure for yourself as well as the therapist. Please understand what is anxiety. Anxiety always happen to someone who once was very courageous. Went against conventional diktats. Therefore, that is not a punishment, but a review. You need to go through literature regarding anxiety. Those will teach you how you need to ignore anxiety, because it is not a disease. You, too, need psychotherapy methods to streamline your life and thinking. Please consult a psychologist. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 type2 diabetes. My blood work just came back and A1C is 12 has been high for awhile on metformin 1000 mg 2 x a day and trajenta 5mg. My doctor tested c-peptide and it was .87 and he says my body is not producing much insuline. Last A1C was 13. Should I go see and Endorse or just take lantus like my Md of over 10 years suggest? ### REPLY: Hello, I understand your hesitancy to go on insulin. It is a natural very normal concern to question a major move such as this. Most certainly if there is any question about a plan of care; seek out a second opinion from a specialist. I do not think your personal physician would take offense at this. I cannot express an opinion on this matter without seeing all of your labs and health history, however, I noted that a c-peptide test was done and that was low indicating to your doctor that you needed the insulin. One thing I would be concerned with is whether you received any type of medical/nutritional advice on controlling blood sugar with diet, exercise and lifestyle. Such interventions can reduce need for medication. Regardless, the blood sugar needs to be controlled to prevent cardiovascular and neurological complications without delay. If you decide on obtaining a second opinion, I would do so without hesitation as time is of importance. If indeed your body is not producing insulin, then you will need insulin injections. If it is a matter of insulin resistance, this may be a different situation where perhaps insulin may be used until other lifestyle modifications are made such as losing weight if overweight, et cetera. 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: last one week I had a severe cough and cold symptoms, throat itching. Not a running nose.  I had my By-pass surgery 18 months ago and Cardiologist advised to not to take any antibiotic. usually I am taking daily BetaloK zok, Ecosprin Noklad. How can reduce my cough and cold symptoms, throat itching. Mohaan-SL ### REPLY: If you had severe cough and cold symptoms then I think you have to take some antibiotics obviously after an expert opinion of your doctor preferably appoint or azithromycin along with diominic-dca or anti-cold for running nose and throat discomfort. For cough, you can take syrup embroils or syrup grilinctus-bm. Take steam inhalation and do hot water gargles to reduce the congestion of your throat. Thank You ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my name is Morgan. im wondering if im a manic. i took the test, and it says i am. also, my sister and almost every one at school dos 2. also, I DONT DREAM, I BERLY SLEEP,SOMETIMES I SEE DANCING LOBSTERS, IM PRETTY SURE THERES A NAKED HOBO FOLLOWING ME, AND IM AFRAID THAT THE HEADLESS HORSEMAN IS GOING TO CHOP MY HEAD OFF WITH AN AXE!!!!!!!!!!!!!!!!!!!! ### REPLY: Hello thanks for asking from ChatDoctorThe symptoms like seeing dancing lobsters are due to hallucinations only. The thinking and fear that someone is following you and will cut your head could be due to delusion. Both these symptoms don't occur normally. But to make the correct diagnosis you should consult a psychiatrist as soon as you can. Medicines like antipsychotics as Olanzapine, Aquitaine, Risperidone etc. are commonly used in psychotic symptoms and help in improvement. Consult a psychiatrist for prescription of these . 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: hello doctor,i am 27 years of age male,i am suffering from one mental problem,really i need your help,i passed my b.tech in 2007,my problem is that from last 3 years i am not able to go out side from my house,not even i stepped out from my home from last 3 years,i just sit in home,i am scared of every thing,24 hours i think that i am going to die,i found best place is my home,i am scared of every thing,i cant ride bike,i cant sit in car,i am very much disturbed,please say me doctor what i must do,how can i reduce my fear,24 hours i a cry seeing my self,i beg u doctor help me,from last 3 years im in home. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. From the description, it is very clear that your problem is social phobia or social anxiety disorder. It is characterized by intense fear in one or more social situations, causing considerable distress and impaired ability to function in at least some parts of daily life. Expert treatment requires for complete cure. Psychiatric treatment along with psychotherapy should cure you. Please do not delay and visit a psychiatrist. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was recently diagnosed with celiac diease. I have had a few days in which shortly after eating a meal my feet and hands will beging to itch so bad it is almost painful. They feel extremely hot and itchy.The itch is so intense that I feel like I will lose mt mind so to speak. But there is no visible rash. The only thing that seems to help a little is time and a cold compress. Can this be a reaction to gluten? ### REPLY: GLUTEN IS ONE PROTEIN IN WHEAT THERE ARE MANY PROTEINS IN HEATED TO GET BLOOD SERUM TESTS FOR SPECIFIC ANTIBODIES FOR WHEAT THING THIS WILL COME POSITIVE AND YOU HAVE TO ELIMINATE COMPLETE WHATEVER IN GLUTEN ALLERGY THERE IS GLUTEN HIDDEN IN MANY MORE SUBSTANCES YOU CAN CHECK ON NET AND COMPLETELY ELIMINATETHESE NEW SYMPTOMS ARE OF ALLERGY SIGNS IF YOU WANT YOU CAN GO FOR IMMUNOTHERAPY AS NEW STUDIES FIND IMMUNOTHERAPY OF FOODS A PROMISING RESULTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 4 year old had to have 2 small fillings placed in his his upper and lower back teeth.  His cheek is so swollen now, in side and out that it looks like someone hit him.  Could this be from biting his cheek whil it was numb, I really dont see bite marks. ### REPLY: Hellooo....read through your query I can say that it can be due to cheek biting can have injured some minor salivary gland causing swollen cheek. Marks won't be there properly...but don't worry.it will heal fast.if he is having pain apply colonel just before food.that's all needed.it will heal by itself.if after few days still swelling u can meet oral surgeon and see the problem.in my view it will heal very fast in few days....hope I have replied to your query....have a healthy day!!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My adult son caught his 3rd finger in a winch rope last Mon. Surgery by hand surgeon on Tues.am and a pin was put in. No pain. Went home Wed. afternoon after I.V. antibiotics. Thurs a.m. did some yard mowing and has been in terrible pain since. Dr. out of town until next week. P.A. sent pain pills & said to come in Tues. & he will X-ray it. Son will not call again as he doesn t think Dr. s are on call anymore. He says he can t do more now but lay on the couch as he is dizzy from the pain pill and has to take it every 4 hrs. or in terrible pain. He has a high pain tolerance as finger didn t hurt him even when he had the accident and sat in the emergency room for hours and didn t have surgery until Tues. Is this proper procedure? ### REPLY: His a surgeon I would expect the pain to get better by the day especially after a fracture fixation or relocation of a finger joint stabilized with a pin. If a doctor is out of town he should make arrangement for a colleague to see his post-operative patients should there be problems. I don't think it is proper procedure, I would advise your son to have his finger looked at even by an emergency physician just to make sure that the finger is still viable(alive) and not infected. Pin must stay in place until a surgeon reviews it. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, recently i came to know that i have pco and my gynecologist prescribed my husband to have a semen analysis. we took the semen sample in a plastic pot bought from a pharmacy. we went to a  reputed hospital in my city which is only 5 min distance from our house. but the doctors there said that the semen should be ejaculated there in the hospital and they rejected to take our sample. i want to know that is there any  legal problem to take the sample bought  from home and why they rejected? ### REPLY: Good day, and thank you for being with  !!! Semen samples should be collected in the hospital premises not due to legal concerns but because of quality and accuracy concerns. We take note of the time when the semen liquefies and how long they stay alive with effective propulsion. This is needed to properly evaluate the sample and for your urologist to be able to have the most accurate data to be interpreted. I am sorry to hear that the hospital that you went to wasn't able to properly explain why an outside sample cannot be allowed. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pnuemonia after several rounds of antibiotics and steroids my breathing is fine but I ve had a feeling of a lump in my lower throat and a cough for several weeks after went to doctor and said my throat felt fine and said it was possibly due to allergies/post nasal. ### REPLY: Hello dear, The symptoms as mentioned in your post suggest that you might be having Allergic tracheo-bronchitis. Examination of the throat using a laryngoscope and X-ray of the chest will be helpful in clinching the diagnosis. Management includes:1. Antihistamine preparations like Allegra & Cough expectorant syrup for symptomatic relief.2. Montelukast preparations- used as a maintenance therapy to relieve symptoms of seasonal allergies.3. A course of antibiotics may be taken to prevent secondary bacterial attack.4. Maintain adequate HY . 5. Also make sure that you are well protected from cold, dust & other allergens. Wishing you a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just delivered twins on 06/26/10. They were 5 weeks and 1 day premature. I had an emergency c-section because I was having liver complications that were making me itch horribly and my blood pressure was high. I was also on blood thinner injections to prevent clots. My doctors office just called me and told me that they forgot to review lab work with me from April saying I was Anemic. Is it possible that being Anemic in such a high risk pregnancy with out treatment could have caused me to have liver problems which forced me to deliver so early? ### REPLY: Hi, The liver problem that you have described seems to be due to increase in bile acids, which is a condition unique to pregnancy. It causes itching without rash and is relieved once delivery occurs. Anemia can cause increased risk of post delivery bleeding, need of blood transfusion during delivery or later, but would not be a reason for liver problems. Twins pregnancies are known to have an increased risk of complications, and also early delivery due to a variety of reasons both maternal and fetal. The high blood pressure, and the itching(obstetric homeostasis) could be the cause. For the anemia, I would advise you to take iron supplements and get your hemoglobin checked again after 1 months time. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have had cervical fusion (C5-C7) with human cadaver bone graft this past December. I have had difficulty breathing through my nose along with more than usual phlegm. A massage therapist recently told me that the surgery I had on my neck and the sinus problems afterwards are very common.Is there anything else that can be done aside from using a nasal spray 2-3 times a day? ### REPLY: Thanks for your question you need to consult a Pulmonologist who can assess by requesting a chest X-ray or an X-ray of sinuses to rule out any other cause steam inhalation 2-4 times per day will help you a lotleukotreine inhibitors like montelukast may be considered depending on your physician if phlegm or nasal secretions are yellow purulent or foul smelling, antibiotics may be needed thanks feel free to ask more questions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Is there a better medication for high blood pressure than Benicar HCT 40mg/12.5mg that does not cause skin sensitivity to the sun? My husband is on this medication and he works out in the sun all day and uses sun screen, but his face, ears and neck are always red when he comes home each day from work. ### REPLY: Hello, botChatDoctorponent s of Benita HCT can cause photosensitivity.  However, in 70-80 of cases HCT is the cause, so just supplementing HCT with another HCT like diuretic with chlorthalidone would do the trick.  If still persistent you can change the .  *note.  Respected mam, as your husband works through the day in the heat, he would be loosing a lot of electrolytes and water on sweat, so a diuretic like HCT is not the best antihypertensive to be given to him, as it will cause undue weakness and may lead to electrolyte imbalance.  Do discuss it with your doctor 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 a patient of h pylori since 5 years but i knw dis now by taking my blood test report dat im having h pylori germ in my stomach having a value of IgG 28.37 U/ml &IgM 1.09 now my question is dis how can i protect my self frm dis desease also by knwing the diet plan of my daily life and also by madicine plz help me ### REPLY: Ok dear as u have a diagnosed case of H. Pylori disease so we will start H.pylori eradication therapy. So all you have to do is start having medications and once it is settled then you can prevent this disease by following simple preventive measures. Medications:1-Tab Azithromycin 500 mg twice daily2-Tab Amoxicillin 1g twice daily3-Cap Omeprazole 20 mg twice daily You have to take medications for 2 weeks. Prevention: This disease can be prevented by following these measures.1-You have to stop taking NSAIDs for pain relief e.g. aspirin, diclofenac, naproxen,fanatic acid. You can take paracetamol for pain relief which is not a NSAID.2-You have to modify your diet i.e. less spicy foods and avoid one large meal. Instead, have three small meals a day. 3-Avoid cigarette smoking as it causes peptic ulcers Thanks, Wishing you best of 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 am very much worried about my mother with recurrence of her kidney stones . My mother is having Blood pressure and diabetis and 2 years back she got gout disease and immediately with a kidney stone and had operated with PCNL immediately after that. She is doing fine for last 1 and half year and now few days ago she got kidney stones in both kidneys which are of 6-8mm size.Because of heavy pain she got operated with ESWL in one kidney 15 days ago and preparing for another kidney ESWL operation in a month later. ### REPLY: Hi, Any person who develops a renal stone has 50% risk of forming stone in the next 10yrs. Your mother is more prone for stone formation because of gout. In this condition she will have high blood level of uric acid which is excreted in the urine in high concentration. This leads to recurrent stone formation. If you have the stone with you, get it analyzed for composition of stone. Few tips for preventing the stones are 1.  .  Low salt diet 3. She can take urinary alkalizing agents like potassium citrate after consulting her doctor 4. Regular ultrasound of abdomen to detect stone formation at its earliest stage.  5. Regular followup with your urologist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my daughter is 3 and a half she has cold flu symptoms runny nose, dry cough which sometimes enfs up being sick after. just checked her temperature and its 38.8 and she has started complaining that her eyes are hurting and also her knees?! Been doctors twice and have just gave her nose drops Im quite worried about the eyes as she has never complained about them. Pls help. ### REPLY: Most often cough and cough in child .  Most often such infections are associated with allergic reactions which can be responsible for runny nose. It may also be associated with increase in temperature and muscle fatigue as in her case. The muscle fatigue is more likely to be the cause of her eye pain as well as her knees hurting. Giving paracetamol should provide relief for both fever and muscle pain. Giving some antiallergic like cetirizine syrup for a few days should help. Also give her steam inhalation. Water in the form of vapor reaches deep into the lungs and helps in diluting the cough and provides relief from  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i was on dupaston for 15 days since my ovulation till 27th oct. my periods were due on 26th oct. wen shud i take the pregnancy test?i m also having periods-like symptoms like pain in abdomen and vagina. i  am desperate to get the pregnancy test done but fear disappointment.thnks ### REPLY: Hi, You are on Duration from ovulation to till 27th date. It contains progesterone and help in implantation and pregnancy. You have to go for urine pregnancy test when your period will delay by more than 7 days from expected period date. Pregnancy test will give false negative result in first 7 days of missed period. I would suggest to wait for period. If period will delay by more than 7 days then go for urine pregnancy test to confirm pregnancy. At this time, you can go for blood  test. It is more accurate and detect pregnancy even during first 7 days of delayed period. Meanwhile, avoid stress, take healthy diet, . Hope this may help you. Contact further if follow up needed. Best regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,my 85 year old dad has been suffering with very sharp abdominal pain,constipation and loss of appetite for a few days,doctor gave him painkillers and laxative but he seems to be getting worse,he is on warfarin and nurse rang to say his blood was 9.5 and not let him  take any warfarin tablets he seems to be getting worse.he never complains so i know he is in pain what can i do.hope you can help ### REPLY: Hello! Thank you for the query. Your dads' hemoglobin 9,5 does not have to be caused by War fin. This medicine makes him more prone to bleeding, but every bleeding has its source. Abdominal pain, constipation, loss of appetite and low hemoglobin level sounds really like a colon cancer. Especially at the age of 85. Hemoglobin level is low because he is probably bleeding from gastrointestinal tract. That is why I suggest your dad to do not wait anymore and have some tests done. Abdominal ultrasound and colonoscopy are strongly advisable. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had unprotected sex the day after my period stopped. I am on birth control but missed a pill this month so I took the morning after pill the morning after we had sex....The guy also claimed he did not cum inside me... What are the chances of me getting pregnant ### REPLY: Hi dear as you people had sex on first day of your periods then there are very, very fewer chances of becoming pregnant as it's the safest period.plus ejaculation has not gone inside that also points that no pregnancy.however if you miss the periods for 7-10 days get the Urinary pregnancy test done and check it.USG is also advisable at that time.hope this will help outranks and regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am recovering from breast cancer where I had a bilateral mastectomy and many lymph nodes removed. I have been on tamoxifen for 6 months now. i have been gaining weight in leaps and bounds. i am back to my weekly exercise routine and the pounds are still piling on. my worry is the tremendous bloating around my stomach. It stays bloated and swelled. Could this be something else besides just weight gain? ### REPLY: Tamoxifen does not cause weight gain. If you are premenopausal or postmenopausal It may be the reason. If you received chemotherapy your ovarian function will be effected leading to weight gain. Normal ovarian function will be back within a year after chemotherapy. Fluid retention and edema can also lead to weight gain. Exercise and avoid concentrated sugar food or fluid. Diet containing moderate fiber also helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, the past few days my chest bone is sorejust left of center of chest. It also hurts when I breath and feels like I am pulling on the area. Kind of like being hit in the chest, and experiencing a feeling when I breath in as sore. My pulse rate the past two months has been over 125 to 136. I am a 52 male who is disabled mainly from DDD, DDJ. My weight is about 180 and do exercise with light weights. My cholestral (?) is 232 as of the past 30 days. My name is Randy Acquistapace (479)250-5650. ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. It looks mostly musculoskeletal pain. But we need to rule out cardiac cause first as you are having many risk factors like1. Age more than 502. High pulse rate (130-150)3. High cholesterol level.4. Left sided chest pain. So get done ECG and 2d echo to rule out cardiac cause. If both are normal than no need to worry much for cardiac cause. Musculoskeletal pain also cause rapid heart rate. So avoid heavyweight lifting, strenuous exercise. Avoid movements causing pain. Avoid bad postures in sleep. Take good painkiller and muscle relaxant. Apply warm water pad on affected site. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is 24 had a baby about 18 months ago at the same time have a very infested gallder removed. they took the baby early. for a while she was ok but for thi last year or more she can not hold anything down. and is away sick. and depression has set in she does not work i need help. ### REPLY: Hi.noted history of depression postpartum and post-cholecystectomy. This can happen to anyone who is sick, someone who underwent surgery and/or pregnancy. The usual blues resolves spontaneously. But if the feeling of being depressed and "sick" is persistent, it is best if you do a followup consult with your doctor, preferably with your surgeon or obstetrician, for clinical evaluation. If needed, psychological/psychiatric consult may be recommended. A talk with a good friend or family can be of help as well. 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 Im married and my husband is diabetic When we always want to make love his pennis doesnt erect that kills me so because I  can see his frustration in his face.my problem is I want to help my husband we are  still young how can I help him with the erection? ### REPLY: What is weight, height, B P. DO not worry. Your husband can take tablet sildenafil (Viagra) 50 mg one hour before sex Normal B P is less than 140/90. Blood sugar less than 120 fasting & less than 200 -2 hours after food. HbA1c less than 7 %. Cholesterol less than 180. Avoid smoking, alcohol,coffee, cola,junk food. Take fresh fruits. Exercise regularly. Cult your doctor, for physical examination. He may order for blood testing, urinalysis,microalbumin. Consult ophthalmologist foe funds examination. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 6 year old grandaughter had an ultrasound today and it showed heterogeneous echotexture of the liver. Her spleen is slightly enlarged also. No signs of lesions but it showed an enlarged lymph node in the porta hepatis 1.5 x 0.7cm. Please explain what heterogeneous echotexture is. She is seeing her GP again on Wednesday to be referred to a Paediatric specialist. ### REPLY: Hello, Sorry to hear about the problem faced by the kid. So far as your question is concerned a bit more information about her history may be needed to reach to a conclusion. However, here in these lines, I shall try to explain some very basic concepts. Normally liver has smooth echo texture (in simple words you can use the word "structure" for echo texture) and heterogeneous echo texture means something wrong is going on that is disturbing the liver structure. Secondarily the kid is having enlarged spleen and portal lymph node. All these findings show that something seriously wrong is going that should not be ignored and dealt as early as possible for better results of the management plan. So the plan here is to get the child to a pediatric physician for thorough evaluation as early as possible and management accordingly. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been having palpations daily, they are short, cause me stress and sometimes come with a sharp quick pain in the upper left chest. my ecg came back showing slighltly overworked but doctor was not concerned, should i be???? i am also prone to ocd and having anxiety over my health ### REPLY: Hi, If your doctor see your ECG and told you not to worry, it means there is nothing serious and you shouldn't worry. I have many patients with palpitations, when they start not to worry about their palpitations, complaints and palpitations disappear gradually. Try to be more in fresh air, eat healthy, walk much, exercise regularly, avoid caffeine, nicotine, and you will feel the difference soon. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my age is 31 and we are planning to have a baby my dr asked for follicular test and i am going through folicullar study. On my 9 th day my rt ov measured 22*19 mm, lt ov measured 9*7 mm and endom thickness was 5.8 mm.. however on my 12th day my rt ov measurd 31*26 and my left ov measured 10*11 and endom thickness is 9.3 . I am worried is it normal in this case ,am i fertile and is the quality of my egg is good and the endom thickness is it good or not please do suggest wt to do ..... ### REPLY: Hi, You have 10*11 follicle size and 9.3 endometrial thickness. Endometrial thickness is sufficient to get conceive. I would suggest going for ovarian follicle study again at 14th day. Follicle size between 18-21 mm release quality and high chance of pregnancy. So if ovarian follicle will not mature and rupture then .  You can also take Metformin, Ova care to become pregnant after complete evaluation. So your endometrial thickness is sufficient, but ovarian follicle is not sufficient to get rupture. Avoid stress, take healthy diet,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir I am 25 Year old..5 year before I suffered from LYMPHO BLASTIC LYPHOMA.. During treatment I suffered from Diabetes..Cancer Disease is ok but now diabetic patient and take insuline... But I Have some sexual problem..my testies will be loose and penis shaft will shorten...and also have pain in lower part ok backbone...my weight is 43 kg.. ### REPLY: Degree understand your concerns went through your details. Please understand there are no chances that your penis shaft to become shorter. They could shrink and seem to be shorter because, body wants it to be. You are tired, worried and anxious. Quite naturally your body also will be tired. When your body understand there is fear, it shuts down other energy consuming activities of the body. Testicle sack will shrink too because of this reaction. Don't worry. Be active. Diabetics can be managed. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Ive been in pain in my abdominal area ,under the beast area down sometimes pains in the back ,dizzy light headed, stabbing pains in the right chest area , hurts to breath , eat , on sunday I could hardly walk ,I cant function as a human being this has been gone on for sometime now ,Im exhausted, my daughter is getting married in july I told my husband im praying to be living by then, My stool is tiny lil pieces & sometimes hard as  rocks, Its hard to breath sometimes ,my stomach swells Ive been to hospitals & they arent helping me, Im begging someone to give me an answer I cant take it anymore I dont have any energy Im constantly in pain anyone their who can help ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  You had pain in the abdomen, under the breast, sometimes down, and back, dizzy, light-headed, stating pain in chest area, hurts to breath and eat, stool is little, or hard. Sometimes it is hard to breath, stomach swells, you doubt whether you can live till your daughters' marriage in July.  First every morning you say that you have no ill health at all. Practice yoga, meditation, reading books of your choice, hearing music, and if interested you can do internal or external, gardening.  Avoid taking spices, junk foods, and oily foods, take more of curd, bland foods, like bread.  I admit that it is gastritis, which is bothering, the rest are apprehension. So I advise you to consult a physician for diagnosis and treatment. You may need to have gastrostomy besides other routine tests for confirmation.  Wishing for a quick and complete recovery.  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: Hello Doctor , I have frequent abdominal pain on the right side of my stomach but I have done the appendicitis operation 9 years ago itself. Im 27 now and have this stomach pain over one year. Last 4 months I feel difficulty to go motion. I smoke 3-4 per day. Im diabetic but I dont drink carbonated water. I dont eat sweet items, I eat spicy sometimes less spicy food. If you prefer me any home remedies to have the loose motion I can try that. Doctor told me my stomach is hard and I have to goto toilet properly but I try its too hard for me. My stomach pain remains all time. ### REPLY: With diabetes at so young age may lead to coronary problems and cerebrovascular events if you smoke even 3-4 cigarettes per day. I advise you to stop smoking at the first. Second for constipation, you may take liquid paraffin for the relief. Initially start with 10-15ml three times a day for a week and then reduce it twice daily for a week and then once at night. Also, you need to follow some dietary instructions as not consuming bakery items, increase in intake of roughage in diet like fruits and cereals and green leafy vegetables.  .  Make a habit to go to toilet whether you have an urge or not and be seated for at least 10-15 minutes. Diabetes cause decrease in the motor function of the intestines and that leads to decrease in the intestinal motility and causes constipation and pain in abdomen. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 blood pressure was 157/102 and the machine started beeping. The PA recommended that I see my PCP. I had a cervical fusion about 13 days ago and was told that after surgery they had difficulty waking me and getting my bp under control. I have never had bp problems before but I have been experiencing a lot of stressors 2 days before my surgery and since. What can I do to lower my bp without medication and could the surgery have contributed to this too? ### REPLY: Hello, Thanks for posting your query on  ...* Brief Answer: surgery as a stress causes high blood pressure readings, diet and lifestyle modification are a good start*Explanation: My opinion is that high blood pressure on many occasions is an indication for control. That happens on many levels. First, be sure that high blood pressure is not secondary to any other diseases as Cushing or renal failure. Then, Diet with low salt and less fat content is crucial. Exercise and other healthy activities are also a mean to control blood pressure. If all that does not help, medications are a must. That is usually decided by your doctor according to your condition and comorbidities. Some . Regular blood pressure monitoring is as important as starting treatment so that we could assess efficacy of the medication we started. I suggest my patients the following : measure blood pressure accurately away of stress or anxiety. The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about other comorbidities and readings before surgery.*Conclusion: I suggest you adhere to good diet and avoid caffeinated  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pain in upper part of the sternum when he lifts arms or holds his head back. He said it is there when doing nothing but sitting but not as bad. It does radiate thru to the same area but in the back. He did pull on a deer out of a truck a few days ago also. He said this has been going on for about 2=3 weeks. Should he be concerned? What can he do to ease the pain? ### REPLY: Hello, As per your history, I think it is a sprain. It is caused because of the pulling of the muscle. I will suggest you to take tablet Higher MR, and tablet Rant ac. Also, apply Diclofenac gel or Voting spray. If symptoms worsen, then do chest x-ray and consult with orthopedic. I will advise you to give some rest to it. Do light activities and do not lift heavy objects. 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: yes i am in several pain at days, i have been to several docotors and everyone says something differnt. i need to get some medicnce to relieve me but cant get the docotrs to prescribe cause they cant see what is wrong with my back .. one says my verbrates are moves and another says everything is fine, also they say i see brusing but then i go back to another docotr and they say nothing there.. i feel like noone is listening to me and i need medicine to control the pain , they act like i am an addict begging all i am asking is to be able to have something so that i can functune day to day wth my activities.. its not like i abuse it i just need some how to come across an docotr who will take me sersiously ### REPLY: I would try to solve your back problem. 1. Get MRI, it is the most sensitive test.  If it is normal, you can be sure that nothing is wrong with your back. 2. Start amytryptalin, this medicine take care of all type of back pain. 3. Start physiotherapy.  Learn back extension exercises, it will strengthen your back muscles. 4. Take MySpace and moral tablet.  These are the best painkillers and muscle relaxant. 5. Back pain is caused by many factors.  Have patience, it will go but slowly. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 started my 7th from 4th of april , day b4 yesterday i got right side abdominal pain continuously, yesterday i have done my routine checkup and 7th month sonography but nothing is found in sonography report but 2day pain is unbearable what should i do, which sort of exercise should i preferred or home remedy Thanks in advance ### REPLY: Hi, thank you for your query.first congrats on your pregnancy. The causes for pain in 7th month include-1. The growing baby puts a lot of pressure on your diaphragm, liver, stomach, and intestines. The additional weight can cause backaches2.another common cause of pain is Round ligament. This is due to normal changes that take place as your body is transformed by pregnancy decrease back strain, make sure 1.to maintain good posture.2. Wear low-heeled shoes3.use a firm mattress when lying down.4.proper nutrition and exercise, to maintain your energy levels and increase your stamina for birth5. Physical activities such as swimming fit well into late pregnancy. Hope these tips helped you, thanking you, wishing you good health ### END