Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 severe pain in my hands and arms first i was diagnosed with carpotonal then tenolitisis had the carpotonal surgery on the right hand but is still in pain. hsve had 2cortisone shots in the same hand my dr. is puzzle has have blood tests done as well.4 different drs from hand surgery to orthopedic. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have severe pain in the hands and arms. Well there can be many reasons for symptoms you mention in query like cervical spondylosis, cervical radiculopathy, nerve compression, or symptoms or angina. I would suggest you to consult orthopedic surgeon for proper examination. Sometimes the symptoms can occur due to post surgery complication or side effects of certain . Doctor may order CT scan or MRI along with nerve conduction test. Doctor may prescribe nerve supplement muscle relaxant along with anti-inflammatory and physical therapy along with particular stretching exercises. You can also keep your arm and hand in hot water tub with Epsom salt for 15 minutest daily. Doctor may also refer you to cardiologist in case of cardiac problem. For now eat healthy and take ibuprofen or acetaminophen for pain. If you are experiencing dizziness, shortness of breath or weakness along with numbness and tingling in legs then you should go to emergency. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has had cramping in his jaw since late this afternoon and after eating ice the left jaw area is now very swollen. He said his left hand started cramping first. He did a ton of yard work yesterday (hand cramps). Too late for urgent care yet not serious enough for the E.R. Any ideas? He is 6 1 and 175lbs. He does suffer from leg cramps. ### REPLY: Hello, I can understand your concern. There can be two possibilities in your husbands physical condition. First is, he might be having some heart problem which may cause pain in left arm and jaw. You might not feel it serious enough for now, but it may increase in intensity and may cause emergency later. Thus, it is better to get it checked once by a cardiologist by an ECG. In absence of heart problem, the hand cramps and jaw pain will be different entities to treat and just a co-incidence that they started together. I would advise you to gen at an appointment of a dentist to check for presence of an infected tooth and abscess related to it. If that is the case, then after getting treatment of that infected tooth by root canal treatment or extraction depending on the extent of infection, your husband will be pain-free. The hand pain might be related to the muscle fatigue due to yard work and can be relieved by taking muscle relaxant medicines like Dan-MR (Paracetamol 500 mg + Diclofenac Sodium 50 mg + Chlorzoxazone 250 mg) twice a day for 5 days. In addition to that, compression heat and local application with Diclofenac Gel (Voting) will help. I hope this information helps you. Thank you for choosing . Let me know if you have follow-up questions. Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been advised to get my wisdom teeth removed  since the age 25 .I am now almost 50 and am having slight pain in the lower left wisdom tooth amd also the upper left .I bite my inner cheek often if I dont eat with care. Do I have to extract my W teeth ? I am 5 feet 3 inches 145 pounds and I take Levothyroxine 88 mcg /day.I also took vit D prescription medication for three months and now I have a good vit D result. ### REPLY: Thanks for your query, I have gone through your query. The cheek bite could be because of abnormal position of the wisdom tooth in the arch. The wisdom tooth can be removed if it is troubling, since it is a non-functional tooth. Consult an oral maxillofacial surgeon and get the tooth removed under local anesthesia. You can take a course of antibiotics like penicillin 500 mg TID for three days(if you are not allergic)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: female 37 58 140 pounds.  I have had ongoing gas and bloating, uncontrollable belching for 4 years.  I have done an endoscopy and I am fine.  My dad died 5 years ago of colon cancer.  I think it would be a good idea to go for a colonoscopy.  Over the last 4 days I have had liquied diareha for 3days, bloating, uncontrollable burping and belching, loss of appetite..what should I do? ### REPLY: Hi and welcome to . These aren't usual symptoms of colon cancer or any colon disorder. It sounds like upper gastrointestinal disorder, stomach(HERD, gastritis), duodenum or gallbladder(stones). It is usually recommended to do colonoscopy after 50 age because in younger colon cancer is uncommon. But if you want to be sure you can do it, maybe some diverticulosis, polyp or inflammatory bowel disease may be discovered. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a crown placed about 3 weeks ago after having a root canal. Before the crown was placed, I advised to the dentist that I still had pain there. He took an x-ray and said he saw nothing and everything was fine. I still have a lot of pain when i drink something hot or cold and the gum where my crown is feels itchy and irritated. What should I do? ### REPLY: Hi. Thanks for the query. I have gone through your query and can understand your concerns. As per your complaint it looks like either the Infection in the tooth has not yet subsided or there is any missed root canal that is left from being cleaned and filled and is causing the presence of the pain symptoms. I would suggest you to consult an Endodontist and get evaluated and a thorough clinical evaluation and x-rays from different angles has to be taken to rule extra canals or Infection. In case if any canal is missing then location the same and filling it up will resolve the symptoms. In case of Infection a course of antibiotics like Augmenting and anti-inflammatory painkillers like Ibuprofen can help but if still pain persist then Re- Root Canal Treatment or extraction can be advised. Hope this information helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi...... i got dissolving stitches on my inner lip 2 days ago because they took out some growth. now there is suome white stuff on it......... what is it and should i be worried??????? and how can i also get the swelling to down????????? thanks. busted lip girl ### REPLY: Thanks for your query, I have gone through your query. The white stuff on the area where the stitches have been put is nothing but a soft tissue slough. Nothing to be panic, it is common after surgery. The other possible cause can be food debris over the stitches. Do saline gargling and keep the area clean. Rinse your mouth thoroughly soon after eating anything. Regarding the swelling, it will be there for another one day, because the damaged lymphatics will take 24-48hrs of time to recover so nothing to worry. You can take analgesic with anti-inflammatory .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: what are the chances of getting Genu recurvatum all right. my one month old daughter is having this,her legs have been plastered for three weeks. Is surgery the best option? And at wat age we should go for surgery if the problem remains the same and not corrected by the current treatment? ### REPLY: Genus recurvatum is a deformity in the knee joint, so that the knee bends backwards. In this deformity, excessive extension occurs in the tibiofemoral joint. The most important factors of knee stability include:Ligaments of the knee: The knee joint is stabilized by four main ligaments:Anterior cruciate ligament (ACL). The ACL has an important role in stabilization of knee extension movement by preventing the knee from hyperextending. Posterior cruciate ligament (PCL)Medial collateral ligament (MCL)Lateral collateral ligament (LCL)Joint capsule or articular capsule (especially posterior knee capsule)Qua . Treatment will depend on the cause of genus recurvatum. Causes The following factors may be involved in causing this deformity:Inherent laxity of the knee ligamentsWeakness of biceps femoris muscleInstability of the knee joint due to ligaments and joint capsule injuriesInappropriate alignment of the tibia and femurMalunion of the bones around the kneeWeakness in the hip extensor musclesGastrocnemius muscle weakness (in standing position)Connective tissue disorders. In these disorders, there are excessive joint mobility (joint hypermobility) problems. These disorders include:Marian syn ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Latest CT Scan says : Borderline hepatomegaly. Mild to moderate hepatic steatosis. I ve been having so many problems, fluid retention, dizziness, blood flow problems, chest pain, etc , reoccurring infection w kidneys or behind liver or something, Levaquin knocks it out , but 3 or 4 days after stopping levaquin, symptoms start back. What would be the next move for me to make? I am so sick but I haven t gotten any where with anyone. The only cardiology exam left that we haven t looked at is heart Cath. I m very not well, but no one has been able to give me much to go on. Please help in any way that you can. Jacob ### REPLY: Hello, There is no specific symptom for Hepatic Stenosis in initial stage. But some people may have malaise and fatigue. Symptoms are predominantly seen in advanced stages where they may have ASCIIs and jaundice.  I order for the following tests in such cases to identify the cause.  1. Liver function test 2. Fasting lipids (usually raised) 3. Fasting glucose 4. Full blood count 5. Ceruloplasmin 6. Anti-Nuclear antibodies studies. Treatment depends on the cause. If you consume alcohol it is best to quit alcohol now.  Diet containing plenty of vegetables and fruits is a must. Avoid deep-fried and fat rich foods. You also need to start exercise to shed extra weight.  Hope I have answered your query. Let me know if I can assist you further. Take care .  Rammstein, General Surgeon ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 very desperate for a job and had unprotected sex with a guy who promised me a job on the 7th of March 2014, I took morning after pills on the 8th March, first day of my last period was on 16 March (of which I was convinced the pill worked). I then had unprotected sex again (after my period) with my boyfriend several times but don t recall the dates (somewhere from March 10) . I found out I was pregnant on the 10th of April and went for an ultrasound on the 30th of April, my Doc said I am 7wks 5dys preg. How accurate could that be as I believed at the back of my mind that I am between 5-6wks pregnant. Could it be possible that the pill didn t work? I m scared and confused that it might not be my boyfriends. Please help. I am losing my mind and can t seem to not stress about this mess I put myself in. I also have one more concern please, my period was normal as it lasted for 4-5days, *sigh* my boyfriend and my mother know about the pregnancy as we (my boyfriend and I) were pretty much planning to have a child together but the ultrasound dates just really gave me a huge slap on my face. The ultrasound based on the measurement of the embryo showed that my due date is on December 12, 2014 (my doctor didn t ask me when my last period was) I am also a bit confused about two other things as well - the first one being when I use the due date calculator by sonogram (reverse calculation) it says that I conceived on March 21, (how long does it take to conceive after sex) then the second calculation based on my first day of LMP which was March 16, shows that conception date was March 30. Am I chasing empty pavements or none of this changes anything? I had a miscarriage last year and really wanted a baby but not that of a man I don t even love. ### REPLY: Degree understand your concerns went through your details. Sperm life within moist vagina is up to 48 hours. If sperm cell could not find a way into the ovum, within this 48 hours, the sperm cell dies. Sonogram shows the growth of the embryo, and it could be possible that the embryo had grown a bit faster than usual. That happens in many cases. The tentative delivery date is calculated based on the general arithmetic and assumption, but there are techniques like this too. I don't think you have anything to worry about the current scenario. Doctor said 7 weeks and your calculation is 6 weeks. The matter of 7 to 10 days tolerance is normal. Note that almost all pregnant women give birth at least a week or more before the tentative delivery date. Don't worry. You may talk to your doctor in detail. Don't be shy and afraid to talk to your doctor and clarify your doubts. Take care. If you still need my assistance in this regard, please use this link. http://goo.gl/aYW2pR. Please remember to describe the whole problem with full detail. 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: my 13 year old is very healthy but recently he has been complainnig of chest pain, pressure in his chest, hard time breathing, and numbness of the left arm and hand he had an ekg done and the results were abnormal we still have to see a cardiologist but what can this be or mean? ### REPLY: Hello! Thank you for asking on  ! I would like to directly review his ECG, if you can upload it for a more professional opinion. At his age, coronary artery disease would be really exceptional. Anyway, every ECG finding should be evaluated in correlation with the clinical symptoms and cardiac enzyme levels. I would also recommend performing a cardiac ultrasound and an exercise cardiac stress test, especially in case of abnormal cardiac enzymes. A chest X-ray study coupled with pulmonary function tests is also necessary to exclude a possible lung disorder. Hope you will find this answer helpful! Wishing all the best,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, I want to ask you about my sister. When she was small she use to tear the clothes with blade or scissor. She also tried commiting suicide once. NOw she is 30 years old. She is married. Her family is very good. Family members are nice however sometimes she gets lot of irritated or angry by small things. When she is angry she talk rubbish, avoid food and water for 2-3 days. She behave like this only when she is angry otherwise she is the best person I have ever seen. This time she was damn angry and when she opened the door, I saw she again tear or cut her new dresses and her husbands shirts. Doctor, do she need any treatment or this situation is fine when anyone is angry. please advise. ### REPLY: From your description, it is very clear that she has psychic disorder from childhood itself It could be her personality. Irritability, behavioral disorder, depressive episodes and may be destructive behavior. You need to consult a psychologist / psychiatrist for proper diagnosis and treatment. She can be cured or her problems with medicines and psychotherapy and meditation techniques. Wish her speedy recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 51 yo female - I have severe leg pain upon waking. I can t move my right leg or hip and have to massage the top of my thigh for minutes just to force my leg to hang over the side of the bed. My left leg is fine. I cannot get out of bed quickly and cannot walk with my right leg without a walker or cane. In 1-2 hours the pain often subsides, with just severe pain at the top of my right thigh and hip. I also have a rash with pustules that look like chicken pox behind my right knee. Rheumatology ran every blood test imaginable and all looks good. ### REPLY: Hello, When did the pain start? Where does it radiate? Have you hurt that leg before? Do you have other signs like: tingling sensation, numbness? Is it constant? Do you feel a blockage in the knee or hip in the morning that lasts 20 minutes? Does rest make it better? I suggest you to visit an orthopedic to see if you have problems with the coxofemoral region or the knee. You may need to do a lumbar x-ray or a knee x-ray. But first better visit an orthopedic. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, i have problem with my foreskin swell and red stains, besides everything there is a loop (like a ring made of rope) skin growing on the edge of the foreskin which creates the pressure on my glans while it is enlarged during intercourse. it is painful. Sometimes this this ring is coming off the foreskin and then a new ring is growing again. I don t know what it could be. My family practitioner said it could come from my wife, but she has no symptoms. I practically don t hav3 sexual life since it happened. ### REPLY: Thanks for asking in  forum In short: Most probably you are suffering for balanoposthitis(infection of foreskin and glans)Explanation: If you were able to retract your foreskin previously and having difficulty now, then your infection of foreskin and glans with adhesion may be causing this. As you told that there are red stains on foreskin, this is a probability.  Usually after balanoposthitis foreskin becomes tight like a ring due to inflammation and scarring. So, If are able to retract foreskin then do it daily with point clobetasol(3-4 days) and if you get relief then ok otherwise you have to go for circumcision.  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: Last year I had an ultrasound and was told that I had 2 Epiymal (?) cysts on my right testicle. and it had caused a slightly swollen lymph node. I was told not to worry unless it caused pain. It has been over a year and while not painful, it does cause a heavy sensation ion my right side groin and a sense of tightness in my lower abdomen. Should I be concerned, I have no other health issues associated with this. ### REPLY: HelloThanks for query. You have sensation of heaviness in groin on Rt side and detected to have two small Epididymis Cysts. The Epididymis cyst is a benign cyst and does not require any active treatment unless it gives rise to pain or there is sudden increase in size of the cyst. Mild discomfort that you have can be managed with painkillers as and when necessary. Do not worry and just keep a close watch on the cysts as regards increase in size. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello....I am 42yo, white male, good shape, 6ft tall, 195....I was hit in the head with an errant baseball last Thursday. No real issues afterward except for a headache. However the knot on the side of my head still hurts quite a bit.  No blurry vision, no dizziness. Any cause for concern? ### REPLY: Good day, and thank you for being with  !!! For any head trauma, we suggest getting a plain CT scan of the head just to be sure there is no blood formation inside the skull which in turn may cause compression of the brain. There are cases where in patients are asymptomatic for two to three weeks only to find out that the blood inside has been accumulating until the brain reached its threshold and there was sudden loss of consciousness. I would suggest getting a plain CT scan to be safe and sure. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ? Please type your query here...for about 5 months now i have little bumps that itch badly when i stratch turn to sore and is hard to heal feel moving sensation under skin bump turn to sore leaves dark spot when healed looks terrible i am on a very strick fruit and veggie diet lots of water no health problems i am 64 black female very active @ tennis, basketball, rollerskating, exercing daily help ### REPLY: Hi, Dear,Thanks for the query to . I studied your query in depth. I feel concerned about it. Dear don't worry much about these little bumps. In my opinion, you are suffering from-furuncles-with sores due to scratching.  You need not worry as you are a active lady with good health. I would advise surgeons consultation, as you had not given more info on its location, but the 5 myths period with sores after scratching indicates furuncles-boils of the skin. Hope this would resolve your query. Welcome again for more queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: it happened while i was wearing my clothes in hurry bcos was to go smwhere.due to hurry i not wear my brief, and put on pants. but when i was zipping up, my penis was strucked badly in the zipper.it was horrible.in panic i zip down suddenly, but it torn the skin of my penis.it bleed also, but not much.it became swollen nd more painful. it took about 2 weeks to lessen the pain nd swelling.but still i have pain in my penis specially if i get a hard on. and also there is big white mark on the penis head nd below it. i cannot wear brief bcos its feel burning if brief rubs on it. so i keep my penis wrapped in a soft handkerchief nd wear only pants without brief. i am worried much.what to do? will it remain like this forever.i cant tell it to anyone else.i am a shy boy..also i fear of marrying now. plz help me ### REPLY: HelloThanks for query. You have sustained accidental injury to penile skin being trapped in Zipper and have a wound over glans penis and penile skin. Following plan will help you in complete healing of the injured skin 1) Wash your genital with microbial solution like Betadine 2) Apply optical antibiotic like Newsprint or Tobramycin over guns and injured skin 3) Cover the pens with sterile cause cloth and wrap sterile bandage around it to prevent it from getting contaminated with cloths .4) take antibiotic like Doxycycline and Anti-inflammatory medication like Diclofenac twice daily to prevent infection. Please note that Penile skin has tremendous potential for complete healing hence there is nothing to be worried about it. With this treatment it is bound to get healed up completely within 2 weeks. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 sharp pain in my back right arm and right jaw.went to er.had EKG and blood work. one test was elevated,hd ct san to rule out blood clot in lungs Now im having chest pains along wit other symtoms. They said im fine. Im 46 with history of bo sides of family. wth strokes ad uncle w/quadruple bi-pass. Can I still be haing heart probems even though tests were negative? ### REPLY: Thanks for your question on . I can understand your concern. Yes, it is possible to have heart diseases despite normal ECG report. You are also having strong family history of heart diseases. So we should definitely get done few more tests to rule out heart diseases in your case. So consult doctor and get done 1. Blood pressure monitoring 2. Repeat ECG 3. 2d echo 4. Stress test (trade mill test) 5. Coronary angiography (if required). If all these are normal then no need to worry about heart diseases. But if any of the above tests show anything then start cardiac supportive .  Don't worry, you will be alright. 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 full thyroductemy done for papilary carcinoma a year ago and there is a regular checkup every six months and every thing is normal, I take a dose of 200mg eltroxin every morning Pan 40 once a day and gemcal twice a day regularly. If I dont take Pan 40 once I get hyper acidity problem, Now for the few months I am facing problem of Piles, hyper acidity and rough tounge. please advice me what is the problem and how to correct it ### REPLY: Hi, Long term acidity problems or gastritis can occur due Helicobacter pylori infection. It is a bacterium which can grow in the acidic environment of gastric area and cause inflammation, ulcers. This bacterial infection can be controlled by multi- .  Urea breath test and antibodies in blood can help in diagnosing the condition. Gastric endoscopy may also be required. Take care. Hope I have answered your question. 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: Grandson chewers his shirt & also very rarely walks mostly runs in the house. Can never remember what he ate from 1 day ago . He is very academic excels in school .. he also sticks his tongue out a lot to the point that he gets a rash around his mouth .. very well manned & loving .. my son took custody of him when he was 4 as his mother was not responsible etc she is the daughter of my sons wife from 1 st marriage . He use to cry a lot & has scares on his tongue from biting from crying . My daughter in law says these issues are just quirks I don t think so . Hope to hear from you .Thank you , Victoria Rawlins ### REPLY: Hi Victoria RawlinsAfter going through your query I understand your concern about your Grandson. I would like to tell you that it can be cold sore/ herpes labials that generally infect child .  You can ease his discomfort by - Applying ice or warm washcloth - give him chilled smoothies to keep him Hydrated - don't give acidic food, it can irritate the cold foresee a Pediatrician if it doesn't go within 10 days. Hopefully this has answered your query. Kind Regards  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i got 2 blockages to my  heart they are 20 to 30 percent last few weeks i had tightness in my chest and i been having trouble sleeping .last week i was plie white in my face family worry about me .any way had heavyness and tightness in my chest off and on had a sharp pain last saturday with it almost call 911 took one of my nerve pills went away some .it comes back now and then could it be from the blockages or a heart problem ### REPLY: Hellothanks for posting here. Since yoke angiogram shows 20-30% disease, the pain in the chest or tightness does not seem to be heart related. Blockages take time to increase and won't increase from 30 to 80 in few months. So don't worry about a heart issue. Since you said you are on nerve pills, the symptoms may be due to the anxiety. So the treatment is anxiety relief for which you are already on medications. Along with medications, diet, lifestyle modifications, exercise, yoga ANF meditation all can help in preventing further progression of your minor blocks in the heart and also decrease your anxiety. Wishing you good health. 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: I HAVE NORMAL SPERM COUNT AND ITS VIABILTY IS NORMAL BUT MY WIFE HAS PROBLEM IN UTERUS.HER 7 KG. FIBROID WAS REMOVED IN A MAJOR OPERATION OF UTERUS IN 2007.AS PER DOCTORS REPORT MY WIFE IS UNABLE TO CONCEIVE.BUT I WANT MY OWN CHILD.PLEASE PROVIDE ME THE SOLUTION OF THIS PROBLEM. ### REPLY: Hi, I understand your concern.  If your wife has a normal menstrual cycle (with normal hormonal pattern & only tubes are damaged, You can think of GUI / Test tube baby . Using your wives uterus... but... Arrogation is the way left for you in case your wife is unable to conceive Its sort of renting some other ladies uterus for the fetal development. Here GUI using your semen would help.  Please consult a fertility specialist for detailed advice.  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 had severe pain in my upper back for about the past 5 days now. I can hardly move my neck in any direction. Its very difficult to lift my arms, or lift any weight, also hard to bend down at all. Almost everything makes it worse. I cant stand for more than 15-20 minutes without having to sit down, and I cant sit up right in a chair for more than 30 minutes before I have to move. Any movement makes it worse. It hurts my back just to even take a deep breathe. The only test I have had is an X-ray and it showed nothing, but there has to be something wrong because I can hardly change and bathe myself let alone do the daily demands. What should I do? ### REPLY: Hi, The symptoms that you are experiencing are caused due to cervical myelopathy. However, a thorough neurological examination is required. The cure for the weakness and stiffness depends on the causative factor. Here I would first suggest you to get an MRI scan of the cervical spine immediately after consulting with a physician. In case the MRI shows a protruding disc impinging on the nerves you would need immediate cervical discectomy and fusion. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Extreme lower back pain (by tail bone) shooting down legs especially hurts in my shin area. Sitting and laying don t seem to relieve the pain. It s waking me up at night, literally had no sleep this week. I ve been taking cataflam , mobic, advil , and alieve but get no relief. Fell down my parents stairs twice in the last year, once while pregnant. Any ideas on what could be causing this and how to get pain relief without burning a hole in my stomach from all the NSAIDS and steroids the doctor has been giving me. ### REPLY: Hello. Thanks for using this forum on . The pain radiating from your spine towards your leg can be due to various reasons. This could include trauma to the spinal vertebrae or spinal column leading to disc herniation causing compression of the nerve.  Other reason can be muscle strain involving the muscles supporting the spinal vertebrae. Firstly you should consider getting an MRI scan done for your spinal vertebrae after full assessment by your doctor to rule out the above conditions. Avoid too many movements such as excessive flexion or extension. Talk with a physiotherapist after a diagnosis is made for proper exercise regime. Feel free for further queries. 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 dont know whats wrong feeling preety scared had have multiple symptoms for a month and a half , it started with the flu or virus i had gotten from niece, managed to get over that but had gotten swimmers ear went into drs,and got ear drops, within that time i had a hurtful pop or snap in back of neck. it only hurted at the time but then after a day or two started feeling numb and swollen in back of right side head to base of spine , didnt have much feeling there either, few days had past and started getting this buning cold sensation on arms and chest i still get but not as much, shortness of breath chest pressure legs felt numb and tingling arms also got numb from time to time, pins and needles feeling in body, and then last night felt a shock and vibration in head neck and top of shoulders, woke up with little shocks or tingly arms/legs feels like a bug crawling up legs and arms. cant sleep very well... please help ### REPLY: Welcome to Ask a doctor service. I have reviewed your query and here is my advice. An ear infection can easily spread to brain and in your case signs of meningitis are present. Vibrations, tingling, Numbness all are may due to affected corticospinal tract. I suggest you to go to a general physician as soon as possible because clinical examination is necessary. Hope I have answered your query, let me know if I can assist you further. Stay healthy ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir / Madam,Iam from hyderabad, My wife she is 31 yrs of age, 2.5 yrs back we got married. After 2.5yrs of marriage we consulted to Gynologist and done testing. She is having Thyroid and  after scanning,it analysed that one of her kidney is at her front right side by  birth, we had done kidney test also, it was normal only. but she is having swelling in her feet and back pain. her weight is 74Kg now.Kindly suggest & updateRegards,Lino Cherian YYYY@YYYY  YYYY@YYYY ### REPLY: Hi Lino and welcome to .  As a Urologist, i can understand your anxiety.There's nothing to worry about the swelling over feet or the kidney position. After treatment of thyroid problem, the swelling should gradually reduce. Most likely, it should be a hypothyroidism problem, common in females. A kidney seen in abnormal position since birth, is not an alarming situation. Most of them are functioning well. That can be confirmed on a ACTIVE scan. If you've any infertility problem, you can send a direct question to me. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had abdominal tuberculosis from past one year.and i had taken full course of the T.B treatment for 1 year. bt after 1 year it is found that abdominal T.B is now treated but my ultra sound reports shows 3 reasons to which doctor says that this a tuburculoma in liver ....now what is that and what treatment i have to take for this....? can you plz suggest? ### REPLY: Hi and welcome to ChatDoctor.it depends on how big and how fast is growing this tuberculous. Also is it symptomatic or not. Usually tuberculosis in liver may be resistant to medical therapy and only surgical resection may be enough for treatment, but this all evaluated and if there is size progression, pain of fever then you should consider surgery and postoperative antituberculotic treatment. Wish you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, for 10months now I ve had bad tailbone pain whenever I was sitting or worse from sitting to standing. After a month I went to dr and had ct scan done which showed bony erosion 4th & 5th sacral segements with anterior cortex soft tissue thickening my doctor followed up with a bone scan but that was fine so nothing else was done, it has now been 8-9months now and the pain is extreme. My feet often go dumb when I am able to sit, and my bowel movements are thinning. Pain is now radiating both up and down and feels like my whole pelvis is aching. I am a 30 year old dance teacher. No falls. 1 child. 1 operation of full hysterectomy with ovary removal during labour complications plus blood transfusions. Currently take 1mg oestridiol ( HRT) daily. I have a mri booked for next week, I am in a lot of pain though and considering going to hospital, should I be concerned or not? ### REPLY: Dear user, don't worry of if it is nothing but lumbar spondylosis. You just take inferential and ultrasonic therapy for 20 - 25 days. With some regular back muscle strengthening exercises you will improve. But you need to correct your sitting posture, as it may be the cause of pain in back. Sit straight always don't bend forward while sitting, avoid lifting heavy objects for few days. Wear LS belt. Within a month your pain will reduce. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi im a male 25 years old , My case is a little complicated as I think that my practice of masturbation and my psychological frustration has caused me some kind of nervous harm. i have many symptoms and events that make me believe i have some kind of a nervous problem first when i finished masturbation i feel some heartburn and a significant increase in sensitivity in the right side of my face especially when do my effort to get the orgasm Then, I realized the right side of my face become much more sensitive in the social situations especially when i meet a person who make me nervous and i feel a strong muscle strain arround my right eye. Besides of this i have a little social phobia and it s not a big problem because it s under controle but the real problem is i can t control my facial expressions for example when i still in the home alone i feel my face relax with a little bit of muscle strain in the right side of my face but when i go out and meet people i feel the muscle strain increase so high and always in the right side and i can see the people and even my freinds fear me because i look so angry in my face expression and they think im a bad guy. searching the cause of the inconscinous anger i remembered that Two years ago, I ordered a period of frustration and resentment and one night while I was asleep I felt something strange like a dream where I would strongly angry and misled repeat words quickly and hysterical and I felt like I d lose my mind and repeat the command again after around a year, but lessand of the time and I m wondering if it could be an explosion not aware of the pent-up anger and caused damage in the brain? help me please i m loosing my freinds because of this and even they girls run away from and i know because they are more sensitive to the facial expressions ### REPLY: Held Dearth about masturbation is prevalent in age section of population Let me tell you from sexual maturity point of you masturbation is a normal sexual activity in males during development and even after that. Large majority of people do it ;believe me ; both married and unmarried .and lead total normal sexual and physical life It causes no harm to nerves or to any part of body including sexual part penis etc. Those who have myths or wrong notion and guilt about masturbation they get symptoms as you are getting My advice is take masturbation as normal sexual activity and get over the guilt about it. A psychiatrist; psychologist or sexual counselor will help you out. Please consult any one of they will be back to normal .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I am Farha 35 yr old lady and married since 11 yrs but having no child. Presently i have consulted a gynecologist and started IUI treatment, I am on Menogon75 injections for four days starting from yesterday but . suddenly i started spotting blood today after I had my first injection yesterday . Its eighth day of my periods and its quite unusual for me to feel spotting I never in my life had this spotting coming on my eighth day of periods. Is it due to Menogon? Is is safe and should I continue further taking Menogon for three more days?? Please reply ### REPLY: Hi, Menogen contains Genotropin hormone, and it works by facilitating the maturation of follicles in the ovaries which contains the eggs. This helps treat female infertility due to improper egg production (an ovulation). Spotting may occur with the .  Continue the injection and check your estradiol and LH levels to check for ovulation. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, Since 2010 iv been having a rash which itches like nothing and causes for swelling all over my body. Sometimes my face swells so much that i look a complete different person, my fingers would also swell at times. It is extremely itchy and i cannot stop itching. It lasts for about an hour and then completely dissapears leaving no clue of the rash. Please let me know what this is. Thank you ### REPLY: Hello dear, From your description, as the rash appears and disappears, this could be the result of an allergic reaction. In all cases of allergic reactions, we need to find out the allergen (the causative agent). My advice would be to monitor the food you consume, try to think back and remember what you ate or came in contact with on the days you experienced the rash. Allergens range from food products (fish, etc.), clothes (cotton, silk, etc.), seasonal (more often in autumn and spring), insect bites, accessories (deodorants, perfumes, henna, etc.) , medication, and many more. Think back and see if there were common items you consumed or came in contact with when the rash occurred. Try to change your bedsheets often, and install grills or meshes for your windows. Protective lotions like calamine lotion, could help in providing a barrier between you and the contact allergen (if external). Finding the allergen and avoiding it can help you prevent the rasChatDoctorpletely. Also, I would advise you carry an anti-histamine .  Hope this information has helped you. Wishing you the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi docmy 3 yr daughter had a fever to rule out dengue her doc advise us to do ultrasound in that she was diagnosed with mild hepatospeenomegaly. her hb was 9  and has microcytic hypochromic anaemia with neutrophilia. she is 11kg and 91cm . she has very low immunity and fall sick every 15 days or so . she has also mild ricket trouble. her appetide is very less its very difficult to feed her but likes to take milk.she also have a severe broncities/asthma trouble and we are giving her singulair 4mg.pls asvise me what to do with her so that her immunity can increase. ### REPLY: Thanks for your question on . I can understand your concern. Hepatosplenomegaly and anemia in child .  Possibility of malnutrition, malabsorption, thalassemia, sickle cell anemia etc. is more. And in a this immunity is low. So better to get done reports to rule out above-mentioned causes. Continue singular fir asthma. Singular is safe for long term use in pediatric patients. Give her green leafy vegetables, fruits rich in vitamin C (orange, grapes, strawberries etc.), high protein diet (pulses, protein powder) etc. for good immunity. Do her vaccination timely. 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: Hi, my 9 year old son has a WBC of 3100 and ANC of 1100  steadily going down within the past month.  He has a persistent rash on his face and itches alot.  We have since seen a hematologist who did a CBC and told us that those numbers are good considering his ethnicity without doing further testing.  Should I get a second opinion or is this normal? ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. If you have persistent .  Check your platelets count also.  You may have some viral infection.  If not cured within few days then you should go for bone marrow examination. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I m a 22 yr old male. I have had blood and blood chunks in my semen for as long as I can remember (about 8 years). I have never had pain. It is normal colored for only about a week at a time and this happens about once every 4 months. I don t really want to go in and get checked right away because I m not in any pain or discomfort. Since this is an abnormality that has always been present, I was hoping you could recommend any medication for me to start?? Thanks ### REPLY: Degree understand your concerns went through your details. Seeing blood in the semen can make a man anxious. Fortunately, it doesn't always signal a major medical problem. For men younger than 40 with no related symptoms and no risk factors for underlying medical conditions, blood in semen usually disappears on its own. In your case, you are 22, and you are frequently witnessing the problem. I suggest you not to oversee this and consult a urologist for further investigation and treatment. 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. 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: Have had a cold the past few says. Drainage in the throat. Lots of blowing my nose. This morning after I woke up, I blew my nose. It was stuffed, so I blew it kind of hard. Well, my left ear popped. Pain happened next. A few minutes later, the pain decreased, but now I am afraid that I hurt that ear. I am afraid that if I sneeze or blow my nose again, it will hurt more or cause damage. What should I do? I took an ibrupropen. What should I be experiencing if real damage occurred? ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, in my opinion you are mostly having severe cold. It is mostly viral infection. Ibuprofen is good for anti-inflammatory action. But you need antihistamine .  No need to worry about ear damage. It will clear once your cold is improving. Also start steam inhalation 5-6 times a day. This will help you in stuffed nose. Also  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello dr. i have a two months baby suffering from boil like skin disease especially in her back. they raise, break with pus and leave black spot scars. she has been gien ampiclox syrup by doctors. they go though few come back. wht is the cause and treatment. thanks. ### REPLY: Hi.... a 2-month-old baby getting recurrent boils means she is getting it out of bacterial infection. This is called recurrent pyoderma - this is not normal at this age. Rather than just treating the boils with antibiotic every time we should evaluate and investigate the kid for immunodeficiency. I suggest that you consult your pediatrician regarding this with this tip and proceed further with evaluation for immunodeficiency. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi I am girish suffering from bronchitis for 5 years its becoming hell being suffered by this disease whenever season changed. please tell any permanent solution to get rid of. I have to nubilize  myself when got breathlessness. please suggest something effective. ### REPLY: Hello, Welcome to , Bronchitis is a condition in which mucus membrane of the bronchial tube will becomes inflamed which results in narrowing of the airways in the lungs resulting in cough and breathlessness. Treatment of bronchitis includes 1. Plenty of rest2. . Avoiding smoke and fumes4. Bronchodilator cough syrup.5. Oral steroids to reduce inflammation.6. Supplementary oxygen may be necessary. The aforementioned measures help to improve the condition and makes you comfortable. 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 back hi, At the end of last summer, my nack started to be a little bit pain ful at soe spots. i first thought that it was in reason of the work i was doing but now it keeps getting worse. plus its now all over my back starting at my head and going all the way down. every where in my back, craks every day. some times i walk diferently. where should i go and what should i do? ### REPLY: Hi, I need to know following answers from you to guide you the best as1. What's your age?2. What's your occupation?3. Are you doing a long hour standing job?4. Do you feel morning stiffness, fever, weakness?5. Is there any family history of same? What you need to do is, get these investigations done first:1. Him with ESR2. CRP3. X-ray dorsal lumbar spine app and lateral views in flexion and extension4. MRI dorsolumbar spine with a screening of the whole spine5. HLA B276. ANTICCP. Follow these to relieve your pain1. Take rest2. Avoid bending, weight lifting.3. Use a hard bed to sleep4. Give hot fomentation5. Take any good muscle relaxant such as thiocolchicoside6. Take physiotherapy sessions. 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 had a bruise on the tops of both my feet for about 12 years. They never completely go away, but they do grow, shrink and change in size. One doctor said that for whatever reason my blood vessels seem to be leaking and rupturing. For the first time ever, these "bruises" are coming up my legs. as far as i can remember there was no trama. they dont hurt to touch, my toes do go numb often and they are always cold. i also have lots of "growing pains" in my hands wrist and lower legs and feet. blood test showed that all my platlets and major orgens and blood counts were normal, as well as a spinal lumbar MRI. I am slightly anemic, and my thyroid jumps from under to over active, never too dramatic though and my meds are adjusted right away. what could this be. what should i make sure my doctor checks for? ### REPLY: Hello and welcome to , I am of the opinion that you should consult a surgeon for clinical assessment of the bruises on feet. A Doppler ultrasound of the lower limb vessels will help to determine the status of blood vessels of lower limbs. If there is any abnormality of lower limb vessels it will show up on Doppler ultrasound. Numbness and cold sensation on the feet are also suggestive of vascular problem in lower limb. There is a possibility that arterial supply to lower limb is compromised which is responsible for numbness. Rupture and abnormality of veins could be the cause of bruising of feet and legs. Your history suggests that you are suffering from thyroid disorder. Medications are required to prevent the swings from hypothyroidism to hypothyroidism. Complete hologram is required to know the extent of anemia and type of anemia. Thus, consult your primary healthcare provider for hematological investigations. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is almost 4 years old and since birth has had a lump n hair patch on her lower back right next to her spine. She been sick allot lately with a bad cough for three weeks now she also been complaining of that lump hurting her when I press on it . What should I do? Should I be concerned ### REPLY: Hi ! Good morning. I am  answering your query. I would advise you not to press or fiddle with the lump on the back of your daughter, and would like to refer her to a general surgeon to rule out any connectivity of the swelling to the spinal canal/cord of her. Once any connection to the spinal column is ruled out, the pain on the lump could be due to inflammation due to friction or infection, and the general surgeon might consider getting it removed and send it for a histopathology test. In case investigations show that it is connected with the spinal column, a neurosurgeon might be called in by the general surgeon for opinion and further management. Till then, you could continue her treatment for the cough and cold. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a very swolen ball where the hard plate meets the soft plate. It is very sore because i play with it with my tongue but cant help it. When i play with it it becomes soft and taste like something is seeping out of it. And it hurts really bad. I am just getting over a cold or somethin that lasted 3 days but made me caugh really bad. But the swelling just showed up this morning. Should i be worried. Just live with it.......or......can i pop it???? Thanks Dj ### REPLY: Thanks for your query, I have gone through your query. The swelling could be a muscle that is cystic lesion of salivary gland. Or it could be an abscess secondary to tooth infection. Consult an oral physician and take a radiograph of the tooth and confirm the diagnosis. If it is a muscle get it surgically enucleated. If it is an abscess get the affected tooth canal treated or extracted. You can take a course of antibiotics after consulting the physician. 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: I have a round open sore on my penis shaft about the size of a pencil top eraser. It is painful when bumped. It also scabs and then when the scab comes off it looks sort of whitish. The sore is slightly raised around the edges but otherwise basically flat.I visited my doctor and he tested for a host of stds. All results were negative. He is suggesting that I may need to see a specialist. Meanwhile, I have been applying a triple antiobiotic ointment to encourage healing, but this does not seem to be helping any. The sore has existed for about a week now with no real healing.I will go see a specialist as suggested, but just to put my mind at ease, is there any idea what this may be? ### REPLY: HelloThanks for query. You have ulcer over shaft of your penis since one week. You have not mentioned sexual history in your query.whether it occurred after unprotected sex ? You need to consult sexual disease specialist and get swab test and culture of a scrapping from the base of the ulcer to establish diagnosis. You need to take broad spectrum antibiotic like Cefuroxime along with anti-inflammatory . Ensure to wash your genitals with warm water twice daily. Ensure to avoid sexual encounters till it heals up completely. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 85 YO mother is suffering wrist pain and the doctor has asked her to take Aleve 2x2 daily. She continues to suffer because she believes she cannot lay down if she takes it. She lays down 60 % of her waking hours. Should I try and convince her to take it anyway. She also takes Tylenol 3 for other issues. ### REPLY: Hi thanks for asking question. The alive is the naproxen containing analgesic... For pain this . . But search for cause of wrist pain should be done... Does she have any history of trauma.?? With advancing age because of estrogen secretion decreased bone becomes weak and lead osteoporosis like changes.x-ray of local part done...X-ray also detect if synovitis or arthritis related changes if present... Calcium tablet can be given to her. If condition advancing is needed bisphosphonate group of  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 40 yr old black male. No smoking, drinking, drugs etc. My PSA score is 0.87 and my digital rectal exam is negative for cancer, but I am having an issue with blood clots in my urine and semen. Even with negative test results, is it possible I may still have cancer or BPH? ### REPLY: Hi, If you have a prostate problem then on per rectal examination usually prostate palpable. As PSA is within limit chance of cancer less. But you need to investigate further with semen culture, urine routine microscopic examination, and USG scan. It will help in rule out any infection or cancerous growth if present.  Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son was diagnosed with dengue 2 days ago. Today will be his 5th day of high fever. This is his second time getting dengue. My concern is that his platelet count has dropped to 26000 even before his fever has subsided.  I am worried about what will happen to his platelet count when his fever eventually subsides. Should I be concernedand what should I do? ### REPLY: Hello, I have gone through your query and understand your concern. His Platelet count will eventually increase when he recovers from dengue infection. If the platelet count . Thus, nothing to worry about this. Have you confirmed the dengue fever with NS1 antigen.NS1 Positive?because Egg may be positive in previously infected cases.Thus, if NS1 is negative, Please do the investigations for any platelet disorder. Give plenty of water. Give him healthy foods. Hope this helps. Please write back for further queries. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI,Suffer from severe sharp pain in my @@ left stomach at around the height of my belly button. It hurts more severe when tensing or breathing in deeply.I have a hard time standing straight as the sharp pain hurts even then. The pain does not come in intervals, it is pretty much constant. I do not have fever, have been drinking and eating enough.I would appreciate any help. ### REPLY: Hi and thanks for the query, Other parameters are required for the complete evaluation of this pain. Causes could range from acute gastritis, gastroesophageal reflux, gastroenteritis, and gall bladder disease or liver disease. The intensity, duration, irradiation, aggravating and relieving factors, associated symptoms like fever, vomiting, cough, family history, medical and . Suspicion of peptic ulcer disease or gastroesophageal reflux might require a microscopy. An abdominal ultrasound could be required at some point in time. A stool examination, liver function tests could ask as shall be guided by a clinical examination. I suggest you book an appointment with an internist or gastroenterologist for a proper examination and appropriate care. Thanks and best regards, Luchuo, MD. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have pus coming from my gums on my top left side and it fall down on my tongue along with a substance that feels like sand.  Ending is a paste like substance on my tongue that keep my tongue burning and my mouth dry email  YYYY@YYYY ### REPLY: Hi! Welcome to . I read your query. Is this pus in only limited part of gums as you mentioned or is it generalized? Do you notice any cavity in tooth near pus area? If there is, this pus can be due to dental infection, for which you need to visit a dentist. If there is no cavity, then this pus can be due to gum disease. Is the tooth in that area mobile, calculus deposit or gum receding? You need to visit a dentist. Get an x-ray done if required. In case of gum disease, you will be given an antibiotic course. If there is not much bone loss and tooth firm, scaling and curettage will help in removing infection. Maintain good oral hygiene. Do warm saline rinses. Use chlorhexidine mouthwash twice a day. Massage gums using gum paint. Take healthy diet and multivitamins. Have regular oral prophylaxis. This requires good and sustained oral care. Hope the answer helps you. 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: Sir,I am suffering from Hep.B since 2006...My immunity level has been deteriorated before i started Ayurvedic Medicines.Digestion is better now.And,I tested myself on Hep.B screening test.And the result is 250 as compared to the reference range of <.05..What should I do next? ### REPLY: Hello there, I am . See there is no any treatment for hep-b. 10 % people get symptoms of hep-b, less than 5 % have severe infection, 3-4 % become carrier. So, after 2-3 year you are still positiver than you are a carrier. So carrier state remains lifelong in case of hep-b. Very rare cases become negative from carrier state. So you need to prevent others from infection from you. All your family member should get vaccinated. And you also get vaccine because it is somewhat preventive from long term manifestation. Hope I have given appropriate guidance to you. If you have any query you can consult me anytime. Give me star rating, helpful vote & thank you according to your satisfaction level. Thanking 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: Pulsating lump above temple, noticeable vein around it, no sign of bruising. What could it be? Hello, I just noticed a lump formed just above my left temple and is pulsating. The vein next ... head while sleeping as there is no sign of bruising or tenderness. .. ### REPLY: Hi, I could not understand your question completely. But, it seems like it could be an AV malformation. Do let me know answers to these questions, so I can advise you completely.1. Has it been since a long time since the lump has been there? 2. What is your age?3. Is there any different color or extra pink or red color over the lump? You will need to see a Doctor who can examine you and probably order an Ultrasound or Doppler test to rule out an Arteriovenous malformation. If that is there then we can discuss the treatment. It is nothing to worry about, but you should get it examined. Do let me know how it goes and let me know the answers to the above. You can contact me directly by leaving a direct question or Specialist question. Take care, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a curiosity question. I just had a CT scan and was told I have nodules in my lungs. Is there an easy explanation as to what that means? I just had PE s in both lungs which are now dissolved. No mention of nodules were made prior to the current CT. WOndering what causes them. t ### REPLY: Thanks for your question on . Since you had pulmonary embolism with new developing nodules on CT thorax, we need to rule out following possibilities.1. Connective tissue diseases (CTD)2. Malignancy3. Tuberculosis4. Acidosis. So better to consult pulmonologist and get done bronchoscopy and BAD (Bronchoalveolar Lavage) analysis to rule out above-mentioned causes. If everything is normal then get done repeat scan after 6 months to see whether nodules are increasing, static or decreasing in size. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive lately been having a problem. People around me always think Im upset about something. That I always have an attitude. When I dont. I feel fine. But the people around me just judge me on the face Im making. Even though I never intend for this. What do I call this? Can I get help? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much.  People around you, if they are your well-wishers, could be right on this regard. They could be worried with your behavior, and so they are trying to warn you. You should accept the warning sign and do what is necessary. Talk to your friends and find the wrong side of your behavior. Understand it and try to change for better. If need be, please consult a psychologist. Work with him for a positive change. 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: my husband is experiencing spells in which he is unable to move his right hand. He has a lightheaded sensation prior to these eposides and they last between 15 seconds - 10 minutes. He is on Dilantin and we are wondering if it is not working? He was at an ER yesterday and his MRI and dilantin levels were confirmed as fine? ### REPLY: Hi, Thanks for writing in. It can indicate that your husband might be having a type of partial seizures. Since MRI brain is normal therefore a serious condition in the brain is ruled out. Dilation can take some time to work, and the response might take few days to show improvement. It is required that he consults a neurologist or an epilepsy clinic for a complete assessment and further investigations like electroencephalogram and a detailed medical history. Should he be taking any medications then these must be discussed in details to know if he is symptoms are related to other medical conditions and medications? Anti-epileptics usually take 15 days for any visible improvements in most patients. 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 finished chemo for breast cancer (taxotere) 4 weeks ago and have had 5 lots of radiotherapy this week. Yesterday around mid day I started having severe pain in my abdomen,my ribs downwards ie not my stomache. My temperature rose to 38.7 yesterday evening and I started shaking. I took paracetamol and temp went down after 2  hours. Today I still have the pain and my abdomen is bloated. Paracetamol does not take the pain away. ### REPLY: Hi. Radiotherapies for Breast Cancer and the medicines for cancer like Texture itself causes all the symptoms as its complications. This is because to tissue Necrosis and its attendant side effects. Paracetamol alone can not help in such cases. This will settle with time, as the bodies resistance power and Healing power picks up. On a safer side it is better to take an antibiotic as you had raised temperature. There can be a close cavity infection, Take an X-ray of the chest and Ultrasonography of the abdomen to rule out underlying causes. You may take tramadol or Ibuprofen for pain relief if needed ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 hbs ag report is asfollows; please guide me what steps to take further anti HBc-Total(serum/CMIA):reactive(14.83) antiHBs(serum/CMIA): Nonreactive(0.00) anti HBe(serum/CMIA);reacrtive(0.02) HBsAg(serum/CMIA):Reactive (more than250) HBeAg(serum/CMIA):Non reactive(.0237) anti Hc-IgM(serum/CMIA):negative HDV-Total As to Hepatitis DeltaVirus(serum(:Negative)please help me and let me know the actual position ### REPLY: Good morning I am sorry to hear about your diseaseYour disease could indicate that you may be in inactive carrier stage. But before saying, so I would like to know your age and sex, LFT reports, HBO DNA levels. If everything is normal and DNA is at low level I am not worried about your hepatitis B and I would rather observe you with periodic tests (every 6 months to 12 months) as were done for you previously Hepatitis B is an infection which need not be treated in all stages. Indication for treatment will be persistently high liver enzymes, jaundice I would suggest a family screening of HBS AG and vaccination of all of them who are negative and evaluation of them who all turn to be positive. This is important because this infection is transmitted commonly by mother to child transmission during birth or person to person transmission like unprotected sexual exposure Hope this would answer your question would be happy to answer your future queriesWish you a speedy recovery ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi.My 3 year old has a hard lump just above her right ear. I noticed that couple weeks ago and got freaked out. I asked my husband and he said that it s probably just her skull growing and not to worry about. Is this even true? I asked my daughter if it s hurting and she would say no. She s been acting normal, but I m here worried. Should I even worry? Please help. ### REPLY: Hi Dear, Welcome to . UNDERSTANDING YOUR CONCERN. As per your query hard lump above ear in your daughter suggests mainly a Desmond cyst, with a possible intracranial extension. It could be sebaceous cyst as well which is non infected due to which no pain is there. You need to show it to a surgeon for a physical examination and a skull X-ray. That lump and the skin can be removed in a single sitting only simultaneously, and they are mostly unrelated to each other, unless the lump turns out to be a lymph node. So it is advisable to get a needle biopsy of the lump prior to its excision, as it will help in planning the excision. Need not worry about it. You should start a course of antibiotics like Amoxicillin 500 mg thrice daily and some anti-inflammatory . Hope your concern has been resolved. Get Well Soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hey, I needed contraception and have tried about 4 different pills throughout the course of my relationship (currently a year and a half) all with negative side affects. I had to cease taking them for my own well being and when seeking a new method of contraception despite wanting to avoid hormones my doctor convinced me to try Implanon. I had it in for 3 weeks before my mood deteriorated to the point where I no longer wanted to live. I had it out a week a go and still feel incredibly emotionally unstable. I was just wondering how long will it be until my mood returns to normal? ### REPLY: Hello, and I hope I can help you today. Hormonal birth control methods like the pill and the Implant get out of your system very quickly, usually within days of discontinuing them.  So I am a bit concerned that your mood symptoms may be due to depression or another mood disorder and not be a side effect of your contraceptive.  There are many factors involved in mood problems that have nothing to do with your hormones.  You should consult with your primary physician as your emotional problems may need medical treatment if you feel so bad that you do not feel like you want to live. The IOC, or intrauterine contraceptive, also called the IUD is a non-hormonal method of birth control that can be placed in your doctor's office that is actually the most widely used birth control method in the world.  IUD's are widely available and safe, and I suggest if you desire future contraception that could be a method that you can consider. However, I really believe that your mental health symptoms may be due to other factors and if you continue to feel emotionally labile or depressed you really should see your general physician or a mental health provider. I hope this information was helpful and that you feel better soon. Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve had an unusual pain in my right mid-lower back region that I attributed to a disc problem. The pain is more prevalent when I go to bed. I have much pain turning over in bed. The pain has not relented for the last 2 days, despite taking a celebrex and a muscle relaxer. Some occur to me today this may not be a disc problem but a kidney problem. ### REPLY: Back pain is a common symptom in middle and older age population. There are various pain producing structures in the lower back. Although I do not know know your age, the fact that the pain is more while turning in bed indicates a spinal instability pain pattern. Although pain in lower back can occur due to pathology in other organs called referred pain, its usually in a small percentage of patients. I would suggest you to consult a specialist for evaluation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hey i went to my boyfriends house one week ago and stayed there two days , i forgot my toothbrush so i didnt brush my teeth 2 days straight, we ate a lot of different things, some of them hot and then i noticed the gums in the inner top right side of my mouth seemed like they peeled off and they were red, i bought a mouth wash and the problem cleared up in a couple of days, but im still thinking about it. could it be an indication of something serious ### REPLY: HelloWelcome to ChatDoctorI would advise you that never skip brushing even a single day because that's awful & will lead to many new problems like gingivitis. All foodstuff get accumulated & lead to discoloration of teeth. When that biofilm will be calcified it will lead to calculus formation that will be difficult to removed. Also use sugar-free chewing gums like orbit. Regarding your problem skin peeling in inner mouth it might be due to taking some oily stuff. It will resolve on its own, just . Consult your dentist for further treatment. Take Disregards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 face used to be lighter than my hands but over rhe years my face has gotten darker than my hands about a shade or two. I walk home from school everyday in the hot Arizona sun so I think that may be one of the reasons why. What can I do to avoid getting any darker and lightening what the sun has already made dark? ### REPLY: Hello, I can understand your concern for the dark skin and remedies to lighten the skin tone. After analyzing your query I can make out that you have sun tanning of the affected areas. I suggest you to do the best of the sun protection to get the earliest relief. You can use good broad spectrum sunscreen to be used for 2-3 times daily. Eat best of diet with a lot of fruits and green vegetables on daily basis. Do not try to use any skin lightening agent as self application. I suggest you to reduce your weight if on higher side. In your kind of cases I generally prescribe skin lightening agents such as comic acid or albumin to be applied at nighttime. You can meet a dermatologist to get further guidance regarding the treatment for dark skin color. All the best. ### END