Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have a pain under my rib cage on the left hand side, this is a dull pain most days, other times its so bad I cant move, they have checked out my gallbladder and liver, and tell me that i have polyps in my gallbladder and some cysts on my liver, and they have done an upper GI that showed no issues with my stomach.  I also have lots of gas   can you tell me what else I should be checking with ### REPLY: Hi, Welcome to  forum.  Your liver and gallbladder might be having cysts and polyps, but you didn't have pain there. So they can be looked after afterwards.  The reason for pain in the left rib cage may be the pain of the pancreas, spleen, stomach, colon, kidney, ureter, etc. I advise you to consult a surgeon for diagnosis and treatment.  Take more of green leafy vegetables, pulses, sprouts, and protein rich foods to hasten the recovery.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi im using pills,and everytime im taking it and after i finished tking it on the 3rd day may period starts,but dis month i dont have may period,actually im 6 days delayed after finishing may pills and im so worried about it so this afternoon i tried to use pregnancy test and im shock that it turned positive...is that possible to happen..even i dont mis any pill ### REPLY: Hello Good Evening, Yes pregnancy can possible despite the pills because it is not 100% effective.1-2 % failure rate is there. But from now onward, you should keep watch on your period and repeat urine pregnancy test after 1 week. If UPT will be positive then you can go for USG to see gestational sac and then only you will get confirmation about your pregnancy. But meanwhile periods also can be started with some unusual delay. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Daughter has large quarter size bruise for a weak now with white center pea size lump. Shes say she fell on the wooden swing outside, but shes 5yrs old. Is this common in a typical bruise? Or should I be worried about spider bit? Found a spider in home the other day. Thanks you! ### REPLY: Hi... Thank you for consulting in . Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have what i would describe as a swollen bump with no head i guess on the inside of my left butt cheek close to my anus. it has been hurting the last three days i cant stand without it hurt cant sit without it hurting wakes me up in my sleep as well.what could it be ### REPLY: Hi.based from your description, it could be any of the following: a hemorrhoid, anal polyp, an abscess formation, fistula-in-ano, or a fissure. It is best if you consult with your doctor for medical and physical examination of the lesion. Diagnostics such as photocopy and rectal examination will also be done. Management (medical and/or surgical) will be directed accordingly. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. Im in college and it s finals week. I just took adderal for the first time ever. I took it Tuesday dec. 10th at 10am and now, 1:53am on Wednesday the 11th my tongue feels swollen, theres swelling below my adams apple and when I swallow it kind of hurts.i still have my tonsils and about a year ago I had a really bad case of tonsillitis. Is this an allergic reaction? Or something else? ### REPLY: Hi and thank you so much for this query. I am so sorry to hear about these symptoms after taking Adderall. These symptoms are very unlikely to be related to a side effect of this .  I will suggest that you get this looked into and treated accordingly and don't just ascribe it to possible side effects. Please, I understand the reasons for taking Adderall, but it never makes it a god idea. That is a substance of abuse and doesn't settle good. It can make you prone to future substance abuse. II hope you find the above information helpful. Thank you so much for using our services, and please feel free to request for clarifications or ask for more information if need be. I wish you the best of health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I AM FACING MENTAL PROBLEM SINCE 5 YRS. MY PROBLE IS UNSECURITY, FEARFUL THOUGHTS,PANIC ANXITY AND HIGH SEXUAL THOUGHT TO OVERCOME FROM THIS PROBLEM.TAKING MEDICINES .PL. SUGGEST HOW TO OVERCOME FROM THIS PROBLEMS WITHOUT MEDICINES? I AM DOING SUDARSHANKRIYA, LISTNING BRAHMAHA KUMARIES PROGREM DAILY FOR 30 MIN.ALSO READING BOOKS ON THIS PROBLEM, I AM CONFUSED WHETHER TO DO ART OF LIVING OR ONLY WALKING OR OM SHANTI OR HAPPY THOUGHT OR MANSHAKTI OR REKI OR HIPNOTHEROPATHY OR ANY OTHER PATHY.PL GIVE CONSULTATION. ### REPLY: Degree understand your concerns went through your description. I suggest you not to worry too much. Please understand that psychiatry / psychology is a deep health science. Prolonged treatment may be necessary.  Proper assessment is required to have proper diagnosis and treatment. Please consult a psychologist for psychometric assessment and advise on further treatment methodology.  Yoga, meditation and psychotherapy are proven to assist the recovery procedure. But they cannot cure you if used alone. You must also work with your psychiatrist so that he can help you. Getting anxious about your mental conditions aggregate symptoms and those meditation methods cannot help you in that case. If you need more of my help in this regard, please post a direct query on this portal. I am happy to help you. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctors, ive heard of a "human embryo" vaccine for dog bite. can i have this vaccine instead of usual antirabbies (5shots) for my relative? am i correct with that information. please enhance me with what vaccine is needed. will appreciate your response. thank you! ### REPLY: Hello, Welcome to , There are different type of anti rabies vaccines like human diploid cell culture vaccine (HDCV), purified very cell rabies vaccine (PVRV) and purifies chick embryo cell vaccine (PCEC) which are available in the market. All these vaccines are equally effective, and you need to take all the five shots of vaccine with any of the above-mentioned vaccine. If you give any of this vaccine as per the WHO schedule it is going to protect against development of rabies. 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 whitish "cheesy" sticky staff on penis after having sex with my wife which never use to happen before. The staff does not smell nor she has not complained of any pain in her vagina. Does this mean that she has been sleeping around and this is the result of dried sperm from someone else? ### REPLY: Hello No, it can't beat sperms doesn't stay in vaginas for any longer after the exits not a store house for semen either need not doubt in your wife, this could be due infection of urogenital tract like candida or other fungal or bacterial infectionApart from infection, it can be physiological secretion of vagina are times you need not worry In my opinion you should consult your doctor preferably a gynecologist for per vaginal examination and a battery of tests like vaginal swab culture and urine cultureMeanwhile Use condom during sex and maintain good hygieneThanks and regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear sir my 3 year old daughter has been diagnosed for typhoid fever . Doctor has prescribed P-250 and ofloxacin syrup, and in case the fever is above 102 F, then meftal P.are these medicines sufficient for speedy recovery? Also kindly advise fooding pattern during these days as she is unwilling to eat anything. ### REPLY: Hi... the gold standard for diagnosing is blood culture and the bug should be growing in the culture. I hope this is how the diagnosis was confirmed in your kids case.1. Metal contains Metonymic acid which is a NSAID. It carries the risk of gastritis and renal problems in the long run. Please do not use Metal.2. Rather than Ofloxacin I would have preferred Definite as oral treatment option of antibiotic.3. Regarding feeding, no specific dietary restrictions, but better to avoid spicy food. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am HLA B27+ patient. I am having stiffness on my back and neck. I have been advised by my Rheumatologist to take the below medicines: Microcid 1 - 1 - 1 Sazo 1000mg 1 - 0 - 1 Foli Track - 15 Mg once a week Please let me know whether the above medicines may have any side effects. Thanks ### REPLY: Hi, Based on the history you seem to be suffering from an inflammatory condition called ankylosing spondylitis for which your doctor has prescribed the treatment. Generally, these .  However, the following side effects may occur:Microchip can cause dyspepsia, indigestion, diarrhea, stomach ulcer or bleeding, headache, and allergic reactionsSazo can cause stomach upset, headache, vomiting, decreased sperm count, allergic reactions, hemolytic anemia, and liver dysfunctionFolic Track is prescribed to treat anemia due to folic acid deficiency caused by the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Molar extracted last night week and the blood clot formed properly and turned white. My dentist said it was normal. After a week the blood clot is now bigger and splitting in half. Half of it is hanging off and doesn t hurt but it awkward and uncomfortable. Will it fall off on it s own or will it be hanging there until the rest of the clot is ready to come out? ### REPLY: HelloWelcome to ChatDoctorI would like to tell you that after getting extraction blood clot is seen at initial stage & later it is replaced by granulation tissue. This takes around 1 week. This process takes time & is normal sequel of healing. You need to rinse your mouth with Betadine gargles twice a day. Take medicines as prescribed by your dentist. Consult your dentist for further query. 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: hi. i have a lower left twitching in the eye for the past month or more.its really worrying me also i have not been sleeping alot lately as i seem to wake up in a shock with my heart pumping fast.i have had an anxiety attack not long ago and dont know if it is stress as i think alot and have a job with high expectations.i have taking a rescue remedy but i cant carry on like this.doctor can you please give me a potential problem? thanks ### REPLY: Hello Welcome to  Twitching of eye may be part of anxiety. You had symptoms of anxiety and recently developed restlessness with pumping heart. It was also episode of anxiety attack. There is possibility of either Generalized anxiety disorder or Panic disorder. Please visit a good psychiatrist for proper evaluation.  Treatment options are -Medicines as SSRI, SARI, Benzodiazepines etc. Psychological treatment as Behavior therapy, relaxation exercises etc. 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: brest fed is not enough so i am giving farex formula to my baby 5 month old but she is not gaining weight iam giving 60ml for 2 hrs once. she is not awake in night time what shold i do for this iam worry about my baby weight. born weight is 2450 kg anf now 5 kg ### REPLY: Hello.  I just read through your question. I understand your frustration with the feeding of your baby. Furthermore, I want to reassure you, however, that the weight that you report is not abnormal. We expect babies to double their birth weight in the first four to five months of life. The numbers you report indicate that your babies birth weight has doubled. Typically, we recommend beginning baby foods at this time in a babies life. Adding baby foods can potentially have a positive effect on your babies weight. I recommend consulting with your doctor about your babies diet. However, I again reassure you that the weights that you report are 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: My toddler has extremely swollen upper gums coming almost over front teeth, some bleeding and oozing, ulcer like sores over lips and tongue, bad breath, temperature, and total refusal to let me brush his teeth. This is a scam and you should be ashamed. Either you are able to provide advice for free, or you need to provide a disclaimer on the FRONT of any website that there is a cost involved. You are just trying to get email addresses so that you can send rubbish through. I will remove myself from any email list and I insist that you remove me now. ### REPLY: Thanks for your query, I have gone through your query. The swollen gums associated ulcers and bleeding can be because of the gum infection secondary to herpes virus infection(herpetic gingivostomatitis). Nothing to be panic, consult an oral physician and get it evaluated. Meanwhile, you can take topical anesthetic and analgesic like lidocaine and choline salicylate. Do saline gargling. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor, my father just undergo CABG bypass surgery. After stay in the hospital for 2 weeks(after surgery), he discharged from the hospital. A few days at home, i noticed both of my fathers leg are swollen and sometimes he complaining shortness of breath, but if he coughing he felt relief. Is this normal for after CABG? should i send back him to hospital? Please help me. Thank you. ### REPLY: Hello, I have gone through your query. Thanks for using . I presume that he had leg veins used to graft her heart arteries. In that case swollen legs are common and needs just elevation of limb while sitting and while sleeping. His shortness of breath improving after coughing suggests that he may have secretion collected in lungs and needs good chest physiotherapy, My 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: Yes.  I have a strange feeling that comes and goes in my chest.  I thought I was getting a cold but I have had no other symptoms.  The feeling is in the center of my chest and is not painful or tight.  Its almost like im breathing in metal? I dont know if that makes sense? ### REPLY: Hi thanks for contacting  Noted you have metal like smell and felling cold.... You also might have felt some hotness inside.... So it could be simple sub acute viral infection. In that mediators released can lead inflammation and increase temperature. So treat it symptomatically. Take more water. Salt water gargles.... Take phenylephrine like antihistamines . .... Take care.Don't worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I had a coronary stent put in 18 months ago. I am on plavix, metoporal, hydrchloriazide, crestor,. I normally take antibiodics before a dental session. I had a tattoo done 7 days ago and didnt even think about the antibiodics. Have I placed myself in danger? Should I contact my heart doctor and get antibiodiotics now ### REPLY: Hello and welcome, As per the details you have produced, its not clear which part of teeth you got the tattoo done. If the tattoo involves within the enamel of teeth, nothing to worry, as the chance of infection is very less. If the tattoo is placed too deep, you should take antibiotic cover as it can cause infective endocarditis. Please do mention your medical history whenever you are getting any treatment done. I would suggest you to visit your dentist soon and get details regarding this. Please do maintain good oral hygiene. Brush your teeth twice daily. As the chance of gingivitis is severe in your case, please lead a healthy lifestyle. 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 keep making miss takes when talking. Like when I m trying to say a word but the wrong sound comes out and sometimes I even say the wrong word but its right in my head but I don t notice I have done it. Even my young children have corrected me which makes me worry more. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. These speech slurs / not uttering the right word at the right time even though it is in the brain is due to stress or strain. Mind body coordination is essential. Speech is actually performed with the help of vocal cords and is physical or body related. If body is tired, stressed, desired kind of activity is always jeopardized. Worry about this worry also gives additional worry. For now learn to ignore the problem. Along with it, learn to relax. If you are a teacher, take rest in between sessions and don't over strain vocal cords. Don't worry. Your problem should be cleared just by this method. Hope this answers your query. If you need more of my help on this regard, please post a direct query. Please provide every detail as possible. I shall teach some tailor made psychotherapy techniques which should be of immense help.  I am always available to clear your doubts. 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 mother is experiencing pain on her right lower abdomen. It started with some churning and then the pain got worse and spread to her right thigh. She is in so much pain she is rolling all over the floor. I gave her some Diclofenac (prescribed for her rheumatoid arthritis) and Omeprazole. The diclofenac helped to reduce the pain but only slightly. ### REPLY: Hi. Thanks for your query and an elucidated history. From the history provided by you, I would think of a right sided ureteric colic. The stone in the ureter causes severe pain, sufficient to roll over, and can be referred to the upper thigh region. Another least possible reason can be ovarian, appendicular problem. Ultrasonography and relevant blood and urine test may help. I think she needs injectable form of antispasmodic like Tuscan or so. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently my friend has had really sharp pains in his chest on the left side. He sometimes get these sharp pains in the middle of the night that wake him up out of sleep. He has had these symptoms this last week but other that he usually has chest pains all the time off and only recently has his chest swollen on the left side and he has also told me that it feels like the pain has kind of started to spread to his whole chest. What do you think he should do? Im really worried. ### REPLY: Hello I need to know more about the symptoms, like precipitating factors, factors that increase pain etc. Mostly it's a gastritis and reflux disease. Do you also have upper abdominal pain, nausea, bloating, burping, increase in pain on food, sour water feeling in throat or chest burning, if yes it further supports the diagnosis? You should avoid fatty, oily and high calorie diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any.  You can get prescribed tab Pan DSR 40 mg before breakfast once a day for 2 weeks.  Secondly does this pain increase on applying pressure over the area, if yes it could be Costco .  Does this pain increase on deep breathing and coughing etc. if yes it a pain arising from lining of lungs and needs NSAIDs treatment and evaluation. Hope this helps you and get back if you and get back if you have any other doubts. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 diagnosed with acute pericarditis about three weeks,and i am currently on colchicine and aspirin . I appear quite stable but do experience occasional chest discomfort. Can i know the usual duration of therapy and also if i can engage in sexual activity. ### REPLY: Hello! Thank you for asking on ! I understand your concern and would like to explain that therapy duration, when we are facing with acute pericarditis depends on: (1) need for symptomatic relief (treatment of persistent disturbing and restraining pain); (2) treatment of pericardial effusion (avoiding such way the risk for cardiac function compromise), (3) treatment of potential obvious etiological factors (for example, a thyroid disorder, any possible infections, inflammations, etc.). Regarding your actual therapy, I would explain that colchicine duration will depend on the actual clinical and echocardiography results of treatment (that is, if fluid accumulation is disappeared and bothering pain has almost faded, then it would be recommended a change of colchicine to any anti-inflammatory .  Colchicine has the potential to show dangerous side effects (hematological, digestive, etc.). So I would recommend a safer option. I recommend you to talk with your doctor about that issue.  Regarding sexual intercourse, you are free to that, but only if your pain is not limiting. Hope to have been helpful to you. Greetings!  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, this morning while standing in line to get lunch my stomach starting hurting all of the sudden then starting seeing black spots all around me, felt like i was gonna pass out, i ran to the bathroom and ended up vomiting. I ve been weak ever since and can barely walk, and my stomach hasn t stopped hurting. i can feel everything spinning around me even when laying down, also been shaky all day. should i be concerned? should i head to the ER? ### REPLY: Hi! Good afternoon. I am  answering your query. Yes, if I were your family physician, I would definitely advise you to report to the ER of your nearest hospital where a physical examination along with the related investigations could be done to rule out any kind of intro abdominal pathology requiring urgent treatment. Till that you might go for an anti-emetic and an antispasmodic for a symptomatic relief only. I hope this helps in solving your problem. In case of any doubt please do not hesitate to ask again. Thanks for using  portal for your health related queries. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i 51/f taking odimont-LC since one year.I used to take one doze daily sometimes when not relived then i increased the doze to two or three.Now i got a problem in legs and joints --- like swelling in joints and thigh adding to this also starting eching .. kindly tell if is is steroid and also tell me about the symptons that i m suffering from?? ### REPLY: Hello, The symptoms in the joints are probably related arthritis. I suggest checking the rheumatoid factor level for further evaluation. Meanwhile, I suggest using anti-inflammatory medications such as Ibuprofen 400 mg three times a day. I also recommend using cold compresses for local application and gentle stretching exercises. 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: Last summer and fall I had instances when I was working outside in the yard I felt strong pulsations at the base of my neck ( in the back of my neck), accompanied by shortness of breath. I rested, then worked some more, then rested, etc until the shortness of breath subsided (15 minutes?). The one in the fall was a month or so later and was not as strong so I just kept working through it by slowing down the pace of my work.A month ago, after a stress test, the cardiologist did a cath and put two stents in one of my heart arteries( I had one put in ten years ago and apparently it was getting clogged). He said I did not have a heart attack but explain the pulsations at the base of my neck accompanied by shortness of breath.  I hope someone can explain this to me. Maybe I should see a neurologist? Im one who believes in checking things out so problems can be caught and treated early. Looking forward to your answer. ### REPLY: Thanks for your question on . I can understand your situation and problem. By your history and description, in my opinion you are having acute left ventricular failure. It is common in cardiac patients. It is due to poor ejection fraction (EF).  Because of this pimping function of heart is reduced. So in rest body is comfortable, so cardiac demand is less. But when body is under physical stress, cardiac demand increases, and this can not be meet by failing left ventricle. So heart rate is increased. Your neck pulsations are mostly due to this. Failing heart causes fluid retention. And fluid accumulate in lungs and can cause Pulmonary edema. This gives breathlessness on exertion. So this is not heart attack, this is acute left ventricular failure which is causing you neck palpitations and breathlessness. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor, I am 23 years old. I am in great physical shape, but my diet could be better. I have occasional high blood pressure , but my eyes are always vasocontricted. Lately, the left side of my brain has been giving me some weird tingling feeling. During these times, i find it hard to concentrate. Im worried i may be experiencing small stroke . My ekg is normal. Im just freaking out cause I don t know what it is ### REPLY: Hi friend, Welcome to  High blood pressure at this young age needs aggressive investigation and management. If it is occasional - causes like Pheochromocytoma may have to be investigated. No curable cause should be missed. Association with other symptoms again point to the need for further assessment and assistance. You should see an Internist / earlier, the better Take tarnishing speedy recovery God bless 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 was rushed to the hospital with blood in his urine  cat scan showed no kidney stone  today he was rushed back with suvere back pain which he was given pain med for and seemed to pass   he was told it may have been a blood clote  that passed through again cat scan showed no kidney stone.  my question what if any are the interactions between red yeast rice he has been on for 2 yrs with  wararin sod 4 mg which he was just put on for afib ### REPLY: Hi! Welcome to ! Red yeast rice is made by fermenting a type of yeast called Monarchs purposes over red rice and used both as a food and medicine. Since, your husband has been consuming red yeast rice for the last 2 years, and recently he was started on Warfarin 4 mg for his atrial fibrillation. The persistent bleeding that occurred is due to the interaction between the red yeast rice and warfarin. Red yeast rice is known to increase the bleeding in patients who are receiving warfarin. Your husband must undergo the following lab tests PT and INR then he must consult his doctor to see the change in the dose or use of other . Regards! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doc i m 29 male unmarried guy, im having no sex drive for the last 3 mnths ,i m in the habit of mastrubation fr last 12 yrs n doing it regularly, i had this problem few yrs back also fr like 6 mnths but thn i did kegel exercise n gt my erec ltion back ,again suffering frm this problem .i m havung some erection while doin kegels , it has improved ed lil bit but still hav no sex drive .pls guide me ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Masturbation is not a sin and not an unhealthy matter. Everyone masturbates. Even animals masturbate. That is quite natural. From the description you gave, I conclude that you have just some sort of anxiety about unhealthiness of masturbation, and that could be reason for your erectile dysfunction. Exercising is good and exercising cannot cause erectile dysfunction. But anxiety about it can. Therefore, stop worrying about exercise and masturbation. Just live life as it comes. Don't worry about what will happen next, because nobody can predict that. You might need psychological counseling and or psychotherapy. Please visit http://psychocure.webs.com for behavior modification, mental health assistance, Cognitive Behavior Therapy and other psychotherapies. 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: ok i have all my wisdom teeth my teeth are tight, uncomfortable, and painful.my top two wisdom teeth are really rotten.im pretty sure a have an infection or gum disease.my jaw comes out of place and i grind my teeth so are all kina loose.i need help asap but i dont have enogh money bad credit and no cosigner.what should i do this problem really controls my life. ### REPLY: Hi, Thanks for posting the query, I would like to tell you that wisdom tooth is the last tooth to er rut in the oral cavity and is often tilted in position or impacted this region is difficult to clean, so there is often food accumulation leading to inflammation, pain, swelling, Peritonitis, I would suggest you to get the tooth examined by an Oral Surgeon get an OPG radiograph done and plan for its removal... Take care! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi - I have two problems which I m not sure are related - I have had disc fusion in my cerivical spine - 4 years ago - all ok. Recently had pain in my left bicep, near my elbow travelling up into my shoulder and neck which makes it difficult for me to drive. The second problem is that my hands stiffen up over night and in the morning I am unable to make a fist with them. the stiffness wears off over the day, but I do have some weakness in my hands, particularly my right one - making it difficult to use tin-openers, etc ### REPLY: Hi, Thank you for posting your query. Your problems seem to be inter-related and most likely, they are connected to the cervical spine problem. If there is a pinched nerve in the neck, it could lead to pain in the arm, associated with numbness, stiffness and weakness. Please discuss this with your doctor, as certain medications such as pregabalin and physiotherapy would help you a lot. Please get back if you require any additional information. Best wishes, . Ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have suffered back pain for the past 10 years, I had surgery, but made no difference, I have had root blocks, epidurals and facet injection.  I now have severe back pain with tingling and spiky feeling from my sole of my foot to my knee, with back leg pain as well. ### REPLY: Hellowelcome to ChatDoctorthe pain in your back is due to DISC PROLAPSE although you haunt mentioned your MRI REPORTS and the pain which is going lower down in your leg is due to a condition called as SCIATICA...sciatic is a nerve which supplies lower limb and its compression or stretching is what that causes pain in the back side of thigh n in legs....I would like to warn you that TAKING TOO MUCH AND FREQUENT EPIDURAL INJECTIONS/ROOT BLOCKS CAN DETERIORATE YOUR CONDITION AND WILL CAUSE MORE HARM Than BENEFIT....injections and blocks are for temporary relief only and should be taken occasionally in situations of acute emergency like when you are scheduled for some unavoidable business trip or family function etc....the best way to go in your case will be to STRENGTHEN YOUR BACK MUSCLES BECAUSE It's THE CONSTANT MUSCLE SPASM WHICH IS THE MAIN CULPRIT FOR CAUSING CONTINUOUS SEVERE PAIN...STRENGTHENING THE BACK MUSCLES WILL PREVENT MUSCLE SPASMS AND IT WILL AUTOMATICALLY IN TURN KEEP U FREE FROM FREQUENT PAIN... For the strengthening of your lower back muscles you need to visit a PHYSIOTHERAPIST who will guide you and teach you which specific spinal exercises you should do, and then you include those exercise in your daily routine to have LONG TERM BENEFITS...off course having epidural injections is an EASY TO GET AND INSTANT SOLUTION FOR RELIEF FROM PAIN BUT ONLY FOR A SHORT TIME and DOING EXERCISES DAILY IS A SLOW AND TEDIOUS PROCESS BUT THE BENEFITS WILL BE FOR LOOKING TERM, i hope you got my point...remember that story we use to read in our primary school ?? " SLOW AND STEADY WINS THE RACE" !!!!regardsChatDoctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: one months before my wife has suffered weakness & pain in left side upper stomach. On consulting MS Surgen he has suggested liver blood test. on test it is been observed that her sgpt level has raisen to 1480 & sgot 74.so doctor told that sonography has to be done. on songraphy  it is mentioned that Mild hepatomegaly is seen. liver shows alterted echotexture.no focal lesion is seen.Itrahepatis venous and biliary radicalls are normal.the portal vein is normal.also report concludes that mild hepatomegaly with diffuse liver parenchymal disease. Now after 18 days preoper rest & treatment now her sgpt level is 53  & sgot 33 which is normal.Now our doctor says everything is ok & recomnded sonography after 3 months.also hepatitis A.B,C,E tests found to be negative.Pls sugest us what to do next?  Patient Name:Saritha S ShanbhagAge:31height:162cmweight:70kg ### REPLY: Hi thanks for contacting .... Noted you had hepatomegaly with elevated liver enzymes... But now your enzymes value lowering down....so you are improving... You could have viral hepatitis that is resolved now... Your viral markers negative, so it could be by temporary cytomegalovirus or infectious mononucleosis virus infection.... You could have simple fatty liver like condition also...Meanwhile, for few days continue with low fat diet.... Green leafy veg and fruits more. One tsp licorice with honey can be taken... Less oil in cooking ... Avoid alcohol.... Repeat sonography test after few weeks...with liver enzymes .... It will be normal.... If still liver enzymes high . ... Hope your concern solved.... 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 take lisinopril for high bp, 10mg.. and digoxin .25mg for my heart rate.. as of now and most of the day my heart rate has mee up to 120 and my bp so far hit as high as 170 can i take the lisinorril again? and does xanax work for bringing down the heart rate and bp? ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain you and give my opinion. You should know that when we treat hypertension our goal is to keep mean blood pressure values below 140 / 90 Amiga person might have high frequency and blood pressure value during emotional and physicals trees so It's mandatory to judge on mean values. So, if you have mean value that exceeds 140 / 90 mmHg than it is possible to rise the dosage of lisinopril up to 20 mg. Xanax is an antidepressant . It might help to lower your frequency or blood pressure if you are an emotional type, meaning that your values are strongly related to emotions, stress. In this cases' Xanax might help. If not, you can add to your therapy another medication that lower your frequency, but you have to discuss this with your doctor according to your heart function. Hope I was helpful. Best regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: This is the fifth week since i got a severe bang on my shin its not broken the bruising from the back of my leg is gone but i still have a lump on my shin its very painful touch and hot and if i put my foot on the ground for any time it swells my leg and my foot. please help me. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have hematoma formation due to trauma.  You should go for x-ray to rule out minor bone injury.  Furthermore, you should take anti-inflammatory plus analgesic .  Choral forte can help you to reduce edema. 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 am currently unable to sleep as due to severe back pain and bloating i cannot get comfortable.on top of that the noise of wind in my belly is constant and upset lik bubbles popping all the time without me actually letting off gas.the back pain is agonising anf on top of that i have been going to the toilet constantly.also the trapped wind is making me feel like i want to vomit ### REPLY: Hi ! Good morning. I am  answering your query. I have gone through your history. Furthermore, I would like to know a few details from you: 1) Your dietary habits, that is if you eat frequently from outside, and if you go frequently for fast foods. By the time you send all the information to me, I would suggest a few things which you can do:1) Go for a morning walk and regular exercise within your tolerance limits.2) Take a high roughage diet and plenty of liquids.3) Avoid eating from outside if you do as intestinal infections might creep in resulting in your symptoms.4) Get your routine stool test done for ova and cyst.5) Get yourself examined clinically by your family physician to rule out any intra-abdominal pathology.6) Till then you could go for an antispasmodic . 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: does smoking affect hepatitis b patient  my age is 20 yrs old,100 kg,im having hepatitis form past several years just few days back i consulted a dr he suggested me for some test the results are not yet out but i just want to know wether smoking injurous for me as im a hepatitis b patient ### REPLY: Hi. Since smoking affects lungs primarily, it is more dangerous to smoke longer time. With time, hepatitis b can progress and problems appears more and more. Also, being overweight gives some extra "bonuses" to bad health status. I know it is not easy to change life habits, but even small step is a step. Reduce smoking and better food without fats and grill and alcohol, and your liver, and you will be happier. 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: 1.What is the side effect of oligocare? 2. What is the required dose per day? 3. How long can it be used to have an effective result? And also, can a person that doesn t have a low sperm count use oligocare and what could have been the effects if it is used by such? ### REPLY: 1. side effects are Very few-vomiting, gastric upset, diarrhea, headache etc. and are rare and mild.2. Dose- 2 tablets daily3. Duration 3 months because sperm production needs 3 months.4. Utility- whether it is effective in improving sperm count or not is not clearly known. In some men it works and in some men it fails. Its unpredictable. But even ugh it dies nit work, even with zero sperm count we can treat patients and give hi baby. Pls read- ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 22year old boy ,,i am suffering from elevated liver enzymes sgot , sgpt . my current state of these enzymes are 104 and 138 respectively..i had a sono grapy lastweek ,mild hepatomegaly was also diagnosed in sonography...and my sgot and sgpt lies between 110 to 90 and 160 to 140 respectively fro last 4months... sir plz give a correct advise for curing this...hope for positive ans soon....... my imail id is YYYY@YYYY ### REPLY: Hi, Thanks for posting your query. There may be viral hepatitis in you. I am not sure if you have got your Bag test done. If not, please get it done.  The values of GOT and SGPT are not significant unless they are increased to more than threefold the normal range.  However, there is mild hepatomegaly too. Get a complete liver function test done and urine routine as well. The treatment will depend on the underlying cause. Hope this helps.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there for the past 2 years ive had pain and bloating on my right side of abdomen . Sometimes even burning down to my pelvis and under right rib. My doc referred me for kidney scan and all was normal she says its constipation . But last few months ive noticed my stomach swelling on right side.Im now 4 months pregnant and it seems to be worse . I am waiting to see a specialist. Im that worried i even caused myself to have panic attacks. my stomach doesnt hurt when doc presses it and no lumps just swollen.. Please help as im really worried!! ### REPLY: Hi, thanks for query. You should have gone ultrasound of whole abdomen. There are chances of stones in the gall bladder which can lead to this kind of problem. As you are pregnant please go for whole abdomen scan. Take light diet and avoid fasting or overeating. Take frequent and small meals. Talk to your gynecologist about this. Avoid maize products and have more of vegetable soups and juices. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have copd and am planning a trip tomorrow. I seem to be getting a cold which always exacerbates my copd. How can I lower high co2 levels in my blood quickly? I was hospitalized last year because of hipercapnia but just don t want to cancel my trip. I live at 7,000 feet sea level and will be going to sea level. ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Going down to sea level would improve the oxygenation.2. The cold will definitely exacerbate, you can try bronchodilator along with antihistamines like cetirizine to reduce cold.3. Steam inhalation will also help in reducing mucus in the airway. Not to worry. Oxygen will improve as you go to sea level. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 some kind of bug started off like sinus infection(bloody mucus) this blood cleared up head plugged up with mucus that went to chest now sputum is white and thick at time cough hard- eyes itch and have discharge around by lashes sneezing a lot chest feels tight ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. In my opinion you should be investigated for autoimmune disease. The symptoms you have mentioned is exactly matching with the autoimmune disease. Proper diagnosis in terms of what autoimmune condition is exactly is must in terms of treatment. For relief purpose you can take the low dose steroid under your doctors' guidance. But remember that it will be taken only when required. There is also possibility of allergic reaction in you. I advise you can also look for possible allergen in you. I will be happy to answer your further concern, you can ask me on bit.ly/ .  Thank you. ChatDoctorInfectious diseases specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I HAVE A SHARP STABBING SEVERE CHEST PAIN THAT COMES AND GOES, IT LITERALLY MAKES ME STOP EVERYTHING IM DOING AND ITS VERY SCARY. ITS ON MY LEFT SIDE UPPER AREA. I HAD MULPITAL CLOTS IN MY LEFT LUNG AND I NOW TAKE 15 MG OF COUMADIN DAILY. I WENT TO SEE CARDIOLIGIST AND HE DID A D DIAMER TEST AND THE RESULTS WERE GOOD NO CLOTTING FIBERS, BUT THE PAIN IN MY CHEST IS STILL HERE. I WAS DIAGNOSED WITH PROTEIN S DEFIENCY WHEN THEY FOUND THE CLOTS 8 MONTHS AGO. I AM REALLY SCARED AND WHOULD APPRECIATE ANY ANSWERS. MY DEAREST RESPECT FOR THE DOCS HELPING PEOPLE WHO NEED THEM MAY GOD BLESS! ### REPLY: Thanks for your question on . I can understand your concern. You are having protein S deficiency. It is hypercoagulable state. Intravascular clotting is common in this condition. So clotting and obstruction in the coronary arteries is also common. And this can cause sharp, stabbing, left sided chest pain. So better to get done 1. ECG 2. 2d echo 3. Stress test (trade mill test) 4. Coronary Angiography if required. If all these are normal then no need to worry much. Musculoskeletal pain can cause similar symptoms. So avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise. Take painkiller and muscle relaxant .  Apply warm water pad on affected areas. Don't worry, you will be alright, but first rule out heart diseases. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: helo i got a lump on my forehead its not painful, i have had this for my than 7 yrs now. An ENT specialist said i got sinus and think i have had them for more than 7years. I turned down the advise for surgical correction. In January this year,i realised that eggs were contributing to my sinus problem. I stopped taking them since then and there is a change for the better. My questions are 1)how can i deal with this lump, i am worried that it might cancerous since my sinuses are not completely, i could still be reacting to other types of food. Can i have a list foods and other conditions that are known to trigger sinuses so i can go on a try and error session with that. many thanks ### REPLY: Hello welcome to  You didn't mention in the query about the lump,,,whether it is freely mobile or just attached to the skin like a swelling in the forehead. Eggs have very nutritive value,it contains more protein, also contain It B12 which is essential for neurological development.you can take eggs no problem. Eating eggs is unrelated to your problem. There is no dietary restriction to a sinus problem(if assumed it a sinus problem)consult radiologist and have your CT of paranasal sinuses(PNS)it will reveal what is the hidden problem. Then show it to your ENT specialist and get suggestionsThank 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 was decorating the christmas tree, fell off a chair and banged my elbow on a hard wood floor. Now I have a spot about the size of a nickel that will deliver instant shooting pain if I lean on it just there. Will it heal up after a while?  I am 56 and male and sort of a skinny guy. ### REPLY: Hi, In my opinion if no fissures or any inability of movements of your joint actions' flexion, extension, rotation, supination properly with icing it for the first 48 hrs, massaging with topical gels and NSAIDs painkillers would not take more than a week if not I recommend slabbing and elevating by an arm sling, x-rays, CT for proper evaluation. Please consider some positive feedback if the information was helpful. Hope the above information helps you, Any further clarifications feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I started getting sores on my right foot and there s one in particular that won t heal. In fact, it keeps getting bigger and it continues to leak. I ve tried putting antibiotic cream, cleaning it, putting bandaids on it but it s only gotten worse. What s wrong with my foot and how can I get the sore to heal? Thanks! ### REPLY: Thanks for posting your query to . First I want to know how did you develop this sore ? Is it because of any injury or develop spontaneously ? Is there any history of diabetes or hypertension ? As these associated condition make the healing difficult. I suggest you to consult a general surgeon for .  I also suggest you to send discharge from your wound for culture and sensitivity testing to know bacterial cause of infection and its treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having dizzy spells. I feel light headed, feels like room is moving especially when I am laying on my right side. I feel like I am going to pass out at times. I feel some chest tightness and my heart feels like it s racing at times. I am also noticing a metallic taste in my mouth. ### REPLY: Thanks for your question on . In my opinion you need some investigations.1. ECG and 2D Echo to rule out to rule out cardiac causes.2. CBC to rule out anemia.3. S.TSH to rule out thyroid disease. If all of the above are normal than your symptoms are mostly related to stress and anxiety. So consult psychiatrist and get done counselling sessions. Avoid stress and anxiety.  Start anxiolytic if needed. They are safe and not habit-forming. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I have a history of renal problems. I had a stint put in when I was a toddler and had what I think was called a bilateral implant done at the same time. that was roughly 26 years ago and since my surgery I have had frequent utis bladder and kidney infections the most recent was three weeks ago and it got bad fast so I got myself back into a urilogist. The day after I saw her I started passing fleshy white chunks sometimes bloody in my urin and. I have sharp pain through my right side from my hip to my rib cage after I urinate. I had an ultrasound today and have been soar from the tech pushing on my left kidney and am now peeing blood. Should I wait to hear from my uroligist or go in? ### REPLY: HelloThanks for query. Based on the history that you have posted It seems that you had Bilateral Mexico Ureteric Re flux (OUR) since birth and was operated in childhood and bilateral rampant was done. Since then, you are getting repeated episodes of UTI frequently. The present symptoms rare due to UTI, Please get your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to. Please take broad spectrum antibiotics like Definite along with urinary antiseptic like Nitrofurantoin twice daily and urine alkalizer thrice daily. Later on switch on to appropriate antibiotics as per culture report. Get the prescription of medicines from your family Physician. Ensure to . To keep your urine dilute This will help to control dysuria. Please note that you need to take long term prophylactic antibiotic like Norfloxacin or Nitrofurantoin twice daily to prevent getting UTI. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 anxiety and the past few says have had anxiety all day and a nauseous detached feeling..a feeling of my familiar spaces feeling different to me..I have been on Zoloft for about 10 years and haven t has this feeling for a really long time..what could cause this..is it anxiety? ### REPLY: Anxiety may cause this feeling of detachment from surrounding. Such feelings of unfamiliarity with surroundings are also seen in other conditions (such as migraine, with use of recreational . In my practice, I often see these in patients of panic disorder and sometimes in migraines; treatment of these conditions gives relief from this symptom too. Zoloft is not likely to be the cause for this feeling. In my opinion, you should continue Zoloft and report the symptom, along with any other complaints you may have, to your doctor during your next appointment. I hope this answers your question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,i have a grandmother,she is 80s of age ,she was operated just this year.She a colon a cancer and the doctors remove some part of her intestine to prevent the spread of cancer.She pooh on her belly and not from her anus.bec. the Dr. here in Phils.cut the connection of it. My grandmother lose her appetite and she is now confine.The Doctor said she have a knot intestines.Is it possible?How they will solve the problem?Thank you from a Pharmacy Grad. apple. ### REPLY: Hi, Thanks for writing in. Your grandmother might have got a colon surgery and permanent colostomy done. It will help to provide her with nutritious food including proteins and fluids. Please know what foods are her favorite and she might take that. Loss of appetite is common in patients fighting cancer. Is it important to know if she is taking chemotherapy to control cancer. This also causes weight loss and difficulty in eating. At her age she should be given a daily 1800 kcal diet mostly containing fluids and fresh juices which are easy to ingest and can be given regularly in small amounts. Please ask her if there is pain which is making her uncomfortable and give her pain relief. 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 went to the er because I had anallergic reaction.when the nurse put the iv in my hand she missed.now my hand is black and blue and it feels like im getting shocked everytime I move it or shake someones hand..it hurts extrmely bad and I would like to know whats wrong with my hand ### REPLY: Hello, The discoloration is due to bleeding and should resolve on its own, but you can use some warm compresses to help speed up the process. They sometimes touch a nerve when they insert the needle and this can be responsible for the shock like feeling. That too will resolve but can take a few weeks, there is nothing you can do to speed up that process. Sorry this happened. Use some warm compresses and take ibuprofen if you are very uncomfortable. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor,i used to get , every  afternoon, for the past 10 days, certain symptoms like  sudden dry mouth and sudden weakness, numbness with slight pain in my right arm & right legs which lasted for about 10  minutes . I consulted a local neurologist & he suspected carotid artery block & prescribed Rousastatin   10 mg once a day and strocit plus  one tab per day  for 10 days . and now 4 days over but my symptoms seem to persist , rather increase. Kindly suggest what i can do. Thank you ### REPLY: Hi, Welcome to  .com I am . Mariano Into Bruno Mascaras. I have gone through your query with diligence and would like you to know that I am here to help you. Based on your narration, you need to undergo 1. MRI Brain Plain and Contrast 2. DSA of Four Vessels can plan the further course of action based on the results of these tests only Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in  at http://bit.ly/ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For about 4 years now I ve had a hard lump about 2 inches above my knee cap. If my knee cap is 12 then the lump is at about 1. Any kind of strenuous activity causes minor swelling but severe pain. It s about the size of a golf ball. Taking ibuprofen helps to make it tolerable, and I m on a prescription 1000 mg (2x500mg ibuprofen pills) and with that only makes it tolerable. Lately the pain has gotten worse. About a year after I noticed it I went and got x-rays done and they told me it didn t show up so nothing was wrong with the bone. I don t have insurance just yet so I m looking for something I can do to help manage the pain a little better. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern.  You have lump in your thigh. X-ray doesn't show any connection to bone. So it must be of soft tissue origin.  It may be arisen from muscle or fat or nerve.  You should go for fine needle aspiration cytology.  It will give you exact diagnosis whether it is benign or malignant and from where it arises. Then you should take treatment accordingly.  Till that you can take analgesic to receive pain according to your doctors' advice. 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: hello,       i had blood in my urine and was given two lots of antibiotics from my gp. as he diagnosed me with a kidney infection.i have finished my antibiotics well over two weeks ago now. since then i still urinating a lot and i have pain before i need to go. no burning. i feeling very tired and thirsty and keep going hot and cold ### REPLY: Hi, You are still having pain during micturition. So persistent urinary tract infection could be possibility. I suggest you investigate with urine routine microscopic examination and urine culture report to guide you further.  According to the culture report antibiotic course prescribed. Maintain HY .  Avoid excess spicy foods' intake.  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: Dear Doctor, This is Savitha from India. From past few months my mind is not in my control.. Last June I came to know that my Husband was talked with a Lady on a daily basis(only one time after 11.30 pm and his duty over at that time). Once i saw her number i asked him that who is this and he told me that it is a sales man.. After few months again i saw that number and called and came to know that that was a lady. Then I asked to my husband about her and he told me that she is a Cancer Patient and she dont have anyone so she asked to my Hubby to call her daily. After that I called her and she told me that she is a cancer patient and she dont have one Kidney too and she loved my husband and my husband also loved her but my husband never express his love to her.. My husband thrown his old sim card and told me that he never loved anybody except me and he dont want to talk anybody without my permission. After few days I became a mental patient and treated by a Doctor. Unfortunately we couldnt complete my treatment and the Doctor suggested me Opripol, Zosert and Anxozap Tablets. 2014 August 25 i tried to commit to suicide with Anxozap tablets.. I have two beautiful kids and I always thinking about my husband and that lady, Doctor. Still I cant sleep well, eat well and I often crying in the night. I know that my husband will not cheat me but i couldnt control myself. I still asking him about that lady . Sometimes I am thinking that I want to kill her and you know doctor she is not a patient and she is a fraud and she want to talk with my husband so she lied him that she is a cancer patient. I know all these things but i cant forget her words. I want to die doctor.Please help me please ### REPLY: Dear SavithaWe understand your concerns went through your details. Let me be very clear in my approach. Nobody can help you die except god. You suspected your husband with such a venom and because of that you had to be diagnosed mental patient. Why would you like to do so? You have never sawed your husband with that girl. You just suspect and suspect. I don't see any reason or proof of the relationship between your husband and that girl. He lied to you, I can understand. There are so many occasions in a family relationship, where lies are common. Can you say for sure that you never lied to your husband? Your husband clearly told you he does not have any relationship with that girl, and he promised to love you and you only. You did not believe him and instead believed circumstances. In family relationship, you should learn to believe your husband rather than circumstances. Then family life becomes peaceful. The best option you have now is to consult a psychologist for several counseling sessions. Take care. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a petuitary sac tumour removed in April, 2014. Doctors put me on Solupred, Eltroxin and Crestor... I gained 20 kg over 5 months. I jut tappered off Solupred, how can i lose the weight gained? I feel heavy and tired most of the time.. I eat a lot of snacks, don t drink or smoke ### REPLY: Thanks for your question on . I can understand your concern. Pituitary gland is the master gland in the body which control all hormones in the body. So hormonal imbalance is likely in your case. So you need to take Elton (thyroid hormone supplement) life long. You are advised creator mostly due to obesity. To control obesity, you need to follow strict diet, avoid snacks and exercise regimen. Ford this better to consult dietician. Avoid stress and tension. Avoid oily and fatty food. Avoid large meals, instead take frequent small meals. Eat high fiber diet like green vegetables, fruits etc. Do regular aerobic exercise like running, cycling, swimming etc. Don't worry, you will be alright. You're willing definitely lose weight. 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 Doctor.. I my 33years old and recently I got fever on 19-Aug-14 so i went to clinic which is near to my home, after treating for two days till fever is not coming down. So i had blood test for typhoid and following are the results. Doctor looking at report said i got typhoid and need to go course of antibiotics for few days. I realized this doctor trying to deceive me so approached other doctor with the report and i was confirmed that i do not have typhoid and even i am feeling good just after two days of fever. Test results salmonella Typhi O 1:160 salmonella Typhi H 1:160 salmonella Para Typhi AH Less than 1:80 salmonella Para Typhi BH Less than 1:80 So does it mean i have Typhoid? what is the normal range for each of this? ### REPLY: Llo, I understand your concern. I am , infectious diseases specialist, answering your query. In my opinion you should test yourself for typhoon test. It is more specific test than tidal test. As you had taken short course of antibiotic chances of Negative tidal test increases. I suggest you to do stool and blood culture for salmonella type followed by sensitivity testing. Once you complete your treatment according to the sensitivity report in completed course you will be treated completely will be happy to answer your further concern, you can ask me on bit.ly/ .  Thank you. ChatDoctorInfectious diseases specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my husband has lupus ;and has been treated on several occasions by a gastro dr for rectal bleeding. they usually band a hemroid but with the lupus, he ends up with an infection that makes him very sick.. the bleeding is a lot.. fills the bowl solid red.. is there something that his dr is not looking for that we should ask about.. he has had a colonoscopy on several occasions, and he does take fiber supplements. After apx 2 weeks he is usually anemic and severely fatigued and on two occasions, he has needed a blood transfusion. ..Help ### REPLY: Hi, Thank you for your query. I can understand your concerns. If you are constipated and have hemorrhoids then they can get worse from straining. Vasculitis involving the intestine as often happens in Systemic lupus erythematous (SHE), may cause bleeding from lower gastrointestinal tract. Thrombocytopenia due to SHE may be a recurring problem. If platelet counts are >40,000/L, abnormal bleeding may occur from existing hemorrhoids. Treatment such as HY . 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 just was singing in my vocal class at ECU, I m in musical theatre. I don t usually eat in the morning, so I didn t today. I was just now signing with the group and I started feeling slight nausea that started to persist. I started getting really hot and sweating all over my torso, arms, and head. I felt light headed and possibly like I was going to throw up. I say down for a moment. After only a few minutes I was basically fine. I m in another class now and feel a little light headed and something somewhat in my stomach . What s going on right now? ### REPLY: Hi, Thanks for writing to . Never miss your breakfast. You should cultivate a habit of having something in the morning. You already take a fast of around 12 hrs when you do not eat anything overnight and going on work without having anything is going to cause problems. Prolonged fasting can be responsible for gastritis which could be responsible for various problems you are facing like nausea etc. What is your age? Did you ever have your blood sugar or blood pressure checked up? Please reply in detail so that we can help you better. 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: A few days ago I had very bad sinus pain which went away after a day or two then the following day I developed very swollen lymph nodes and had my temperature checked yesterday by a nurse friend, it was sitting at 35.4oC. My throat isn t sore, although I m unable to talk. I also have a rash on both feet but think that may be due to a new fabric conditioner. Any ideas what might be wrong can t get a doctors appointment for 6 days ### REPLY: Welcome to . I went through the history you have provided here. It seems from the history that you are having sinusitis and swollen lymph node. This indicates infection and enlarged lymph nodes indicate secondary response to the inflammation induced by the infection. I usually treat these conditions with use of antibiotics and anti-inflammatory . Do consult your doctor for examination and prescription 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 woke up this morning with extremely sharp pain in my upper abdomen.The pain sharpens every time I try to take a full breath in i have to hunch over just to make the pain bearable I am also having some vision issues (blurred)nausea & vomiting all started this morning at 10 AM E.S.T. & nothing helps any suggestions would be sincerely appreciated Julia Female 38 years old. ### REPLY: Hi. Read and understood your history. You woke up with sharp pain in the upper abdomen, increasing with deep breathing and also vision problem with nausea and vomiting. This is a serious problem, and you should rush to ER. The most probable reasons as per you history are:-Lower lung or pleura problem like pneumonitis and pleurisy.-or inflammation of the under-surface of the diaphragm by liver, gall bladder, perforated ulcer and so on. You need to be admitted and investigated as per the clinical picture and the further treatment will depend upon the findings. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 both anxiety and asthma. I am in the middle of college finals so I am under extreme stress and have had a full 3 hours of sleep in like 3 nights. And I understand that stress can trigger asthma symptoms...as well as anxiety. Starting last night my chest began feeling tight and feels hard to breathe. I wasn t particularly anxious before this nor did I have other anxiety symptoms, but I had been up for two days straight at this point and was exhausted. I ve taken my anxiety medication and been using my inhaler, but not much relief. I can t tell if I m anxious over having an asthma flare up or if I m having asthma-like symptoms because I m under anxiety and stress. Is this worth going to urgent care for? ### REPLY: Hello there, thank you for writing in your query. Yes, stress can precipitate asthma symptoms. At present, you are suffering from exam anxiety. Anxiety symptoms often present with panic symptoms which can trigger breathing difficulty and ultimately your asthmatic symptoms will worsen. As you are already taking your antianxiety pills, I will suggest you to consult your psychiatrist again and explain your symptoms. You may require some other anxiolytic agent. Meanwhile, you make proper schedule for reading, fixed duration of sleep, do some relaxation and meditation. 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: Two month back my father got a brain stroke due to high bp...while medication and tests performed it was found dat hehas cronic kidney disease too and from last month his cretenine vary in between 3 to 4. Doctr has given aplazaar 2tab trice a day and two days back suggested for espogen 4000 once a week. Hemoglobin is 10.2. Is the medicine ok to avoid dialysis. ### REPLY: Hi, Chronic Kidney Disease (CKD) is due to persistent underlying disease like diabetes, uncontrolled high blood pressure, untreated kidney stones, rarely it may develop as a consequence to AKA (Acute Kidney Injury). In your fathers' case I want to know-1) Presence of Diabetes, Blood pressure, Cholesterol problems if any and treatment taken for it.2) Any habits like smoking, alcohol. Stage of CKD depends on EFR (Glomerular Filtration Rate) it depends upon Age, gender, serum creatinine, weight. Treatment of CKD is to prevent or to slow the process of deterioration of kidney function. It requires-1) Diet with adequate vegetarian proteins.2) Control of Diabetes, blood pressure, cholesterol.3) Avoidance of nephrotoxic food and medicines like pain killers4) Water intake needs to be restricted if there is tendency to retain water.5) Low Potassium intake (avoid intake of fruit and fruit juices, coconut water) in case there is potassium retention in body.6) Maintain calcium, phosphorus, uric acid levels under control.7) Avoid smoking, alcohol. 8) Screening for complication on heart. As you have mentioned your father has got stroke it means he is at increased risk for other vascular events like heart attack (coronary artery disease)Regarding medicines you have mentioned-APLAZAAR: it is a nutritional supplement containing amino acids and other nutrients for kidney that help in containing kidney function but not necessarily it will avoid dialysis. SPOKEN: It contains erythropoietin a hormone needed for hemoglobin formation and is produced by kidney. It is used in CKD because deterioration of kidney function is associated with decreased production of erythropoietin and low hemoglobin. Treatment of CKD is to prevent or to slow the process of deterioration of kidney function. It requires-1) Diet with adequate vegetarian proteins.2) Control of Diabetes, blood pressure, cholesterol.3) Avoidance of nephrotoxic food and medicines like pain killers4) Water intake needs to be restricted if there is tendency to retain water.5) Low Potassium intake (avoid intake of fruit and fruit juices, coconut water) in case there is potassium retention in body.6) Maintain calcium, phosphorus, uric acid levels under control.7) Avoid smoking, alcohol. Need for Hemodialysis depends on on-1) Amount of Urine production daily.2) Serum electrolyte mainly Potassium.3) Serum Creatinine level.4) Arterial Blood Gas (ABG) analysis which denote degree of acid accumulation in blood.5) Signs of water retention like breathing difficulty, swelling over body, puffiness of face. ### END