Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 mild proteus mirabilis bacteria in my urine culture. Per ob gyne physical chk up, she said i also hve bacteria in vagina so it could be why i have the urine culture results n presctibed me suppository.Im confused if i do hve uti or another infection. If i do hve uti will the suppository help me . Or is it ineffective and i should tke oral? Im pregnnt 5 th month. Also have yeast for a month alredy due to an antibiotic which is why i am afraid to tke again ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. In my opinion you should repeat the urine culture and sensitivity testing. As you have vaginal bacterial infection it is likely that Proteus Mirabilis in culture is because of contamination. If you find same organism again in urine we can say you have urinary tract infection. Please continue your previous medications as per doctors advice. . Please maintain the local hygiene it helps clear infection fast. I will be happy to answer your further concern, you can ask me on bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with right side varicocele by ultrasound by my family doctor. He is referring me to a urologist for treatment. I am 43 years old & had a vasectomy about 7 years ago.What should I expect??Should I be concerned about other underline health issues? ### REPLY: Hi greetings Since you have undergone vasectomy and not planning fertility again varicocele can be ignored unless it is very severe causing pain or any other issues. Normally we see varicocele in some men, and it should not be tackled unless the sperm parameters are affected. So in your case I won't be interfering. A check-up with urologist can be done to rule out associated issues. Hope my answer helps you. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there I have been taking the combined contraceptive pill and two days before I was due to stop them for my pill free week I had the runs just after I had took the pill, I also had the runs half hour later and about three hours after that. I was worried so didnt have my pill free week and continued to take the next pack. I now am due for my pill free week in several days, I have noticed my boobs have been quite sore I have had sex regularly whilst I have been on the pill the last five weeks. Do u think I could be pregnant that the pill lost its effectiveness because of the runs? ### REPLY: Hi, Thanks for the query. Usually diarrhea won't affect the efficacy of the pills. But vomiting immediately after intake of pill can affect the efficacy. As you took two packs of pills without break, that may be the reason for delayed periods. If there is any history of missing the pill, there is possibility of pregnancy. So if you want, go for pregnancy test once. If the test comes negative, possibly you will get with .  If you do not get with ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 25 yrs and im trying to concieve. I had urine test on 38 th day . which was negative. after which i took 4 regestrone tablets 2 days 2 times per day.i still didt get my period is there any chance of pregnancy. 5 months back i had irregular cycle that time my doctor said i ve cycst. after which for four months i had normal cycle. but this month i ve same irregular period. so give me clear suggestion for getting pregnant as early as possible ### REPLY: Hi, I think you should take some medicines for growth of your eggs and also track the follicles by ultrasound. You can know about your ovulation days and then can be in contact with your husband around the ovulation time.  This time you have taken progesterone for 2 days only. It is not enough. Take it for 5 days at least and then wait for 1 to 2 weeks. If they don't come, you may need other medicines to get your periods. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 am elackia.i have a long story of mine .. Now i have lots of problems in family, studies, next future plans.. My question s am not having hope that there problem ll have an end point. Am not moving freely with other, i wish to be alone.. Am not frank to any one.. Can i have some counselling plz ### REPLY: Hi, From history it seems that you might be having Anxiety neurosis associated with Depression. Develop strong will power and self-confidence. You require few counselings with Psychologist and you will be alright. Always remember that in life there is always struggle and unwanted circumstances. Face with strong courage and with patience. Try to mix with your friends and share joy and happy moments with them. Go for entertainment and sports in the evening. Listen music and go for movies often. Ok 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: Have been to the urgent care center twice this week for light headedness,chest pain and sharp pain in my rib cage area...ive came close to passing out and am very afraid bc the symptoms are getting worse and no one seems to get to the root cause...been put on anti inflammatory medicine...not helping...very concerned about possibly having blood clots in lungs ### REPLY: Hello rearward welcome to .come have evaluated your query thoroughly.* This does not seem to be only due to blood clots in the lungs, there may be so many issues for the same.* The condition must be revealed in some tests either x-ray chest, pulmonary function test, CT scan or else.* Recommended to consult with all details of the reports as scanned attachment. Hope this will help you for sure. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My grand-daughter was born w/osteogenisis imperfecta. Her father has it. waiting to hear which type from genetic tests. i heard pamidronate is in clinical trials to use for treatment. ive done hundreds of searches. cant locate ANY information. She is 2 months old. already had fx femur, fx humerous. HELP? thx Laurie YYYY@YYYY . ### REPLY: Hi, I am so sorry for your granddaughter but I always say early diagnosis and prevention always the best for such cases. Some say it has no cure but nowadays development of many researches that says maintaining a healthy lifestyle by exercising and avoiding smoking can help prevent fractures. Treatment may include care of broken bones, pain medication, physical therapy, braces or wheelchairs, and surgery. A type of surgery that puts metal rods through long bones may be done to strengthen them. Tentative evidence supports the use of medications of the bisphosphonate type. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 60 year old male, who as a result of some SOB with increased exercise had a echo cardiogram. Results not seen but told over phone are thickened septum wall, but no thickending in ventricular wall. Referral to a cardiologist. What can I expect in way of dx and treatment?Thanks ### REPLY: Dear Sir, Thickening of septum can be caused by blood pressure fluctuations, if there is a tendency of high blood pressure. But you shouldn't worry. If there is thickening only in septum, and the other walls have normal thickness, it means that disease is not advanced and can be treated and prevented further thickening of other walls. In case of mild thickening, it is not dangerous, only if there is significant thickening, it can be caused by significant disease. Hope I could help nourishing you good health In case of further questions don't hesitate to ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i forgot to take my bp med yesterday but remembered just before i went to bed so i took it, then again when i woke up this morning, this evening i was very dizzy, very tired and by pulse rate was lower than usual bp was good though, is this because i took med dose to close together? or should i be worried its something more? ### REPLY: Hellothanks for posting here. Looks like you are on beta blocker medications for blood pressure control. Beta blockers have an additional effect of lowering the heart rate asking with lowering blood pressure.  So since you took two doses in short intervals that's why you had slow heart rate and symptoms. You may skip your routine evening dose and start again from the next morning. Beta blockers are very beneficial for blood pressure and also have a protecting effect from a cardiac event. So please continue taking them. In case you have similar symptoms you can skip one dose and then continue there forth. If these symptoms persist then you must see your doctor. As of now there is nothing to worry. 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 had knee replacement one year ago..the alignment has never felt right. Me knee feels heavy and though I have exceptional range of motion, I have to almost work to swing the leg to walk. The kneecap always feels tight as though someone is holding it and trying to pull it off.My foot is not straight when I walk, it is pointed outward. I now have extreme pain in my hip. What do you think this is. My right knee was replaced prior to this one by the same surgeon, but with a different implant. It is a work of art. ### REPLY: Hi. The knee may be taking time to adjust to the hip replacement, granted it has been almost a year. Sometimes it may never feel the same way it did prior to surgery, and if at all the complaints persist we also go ahead and redo the whole surgery on request by the patient. But you can still go for an MRI of the hip and knee joint, so your doctor can decide what can be done to help you. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a 2d echo, exercise stress test and 24 hour halter monitor on ..I had nuclear stress tes today and there was a shadow on the front part of heart the cardiologist recommends a heart cath concerned it might be blockage and I might need a stent what is the likely hood this is what is going on ### REPLY: Hello! Thank you for asking on ! Regarding your concern, I would like to explain that your doctor is right to recommend you a coronary angiography, as the nuclear cardiac imagine test is a reliable exam to confirm any possible myocardial ischemia. The level of coronary stenosis and therapeutic options to pursue, remain to be clarified by coronary angiography. So, my advice is to follow your doctor recommendations. 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: I twisted my ankle yesterday and until now the pain has been severe. The pain has gotten remarkable better but there is still pain there. The swelling has got slightly worse, bruising has come up and my toes/foot keep getting numb and tingly. Is this normal? ### REPLY: Hello, The tingling and numbness are due to the compression of tiny nerves by the swelling.  Try applying cold compress or ice.  If it gets worse you would need to take medicines that would resolve the swelling or may need to immobilize and rest the ankle. Do get back to me if you have further queries. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 5 year old daughter has had a cough, runny nose, congestion, sneezing and red itchy eyes for about 3 weeks. She s on singular, Flonase, and Allegra. Nothing is helping and im so frustrated with the whole situation. I don t know know what to do to get rid of these symptoms so she can feel better ### REPLY: Hello, Thank you for asking at . I went through your daughters history and would like to make suggestions for her as follows:1. At present, I would agree with montelukast (singular), Flonase (intranasal corticosteroid spray) and Allegra (fexofenadine - antihistamine).2. As these are not helping her symptoms, I would suggest her to add saline nasal sprays frequently during day to wash nose cavity, which will reduce her symptoms.3. I would also suggest her to wash her eyes with clean water to reduce eye symptoms.4. If she has any of chest congestion, wheezing (whistling sound), breathlessness, fast breathing, I would suggest getting her chest examined by a pediatrician. If she has wheezing, she may require nebulization with . 5. Please give her adequate rest, plenty of oral fluids during day (to maintain HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hii i was due to give birth on the 5th of april but still no sign went to hospial and they told me i was 3 to 4 cm in slow labour then woke up this morning and there was a wet patch on my bed and water in my knickers is this my waters broke or what do i do please help got some tummy ache too ### REPLY: Hi there, Yes you are in labor now, once the bag of water situated around the baby ruptures, labor is imminent, and you should go to the hospital immediately. The tummy ache is going to increase as the labor progresses, and it is likely that you will deliver soon. So please get to a hospital immediately, as sometimes after rupture of membranes the baby may require monitoring and labor progress rapidly. It is common to not be in labor on the due date and 90% of women deliver within 10 days after the due date. Do do not worry and get to a hospital. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have recently found a painful lump between my anus and vagina.. It is under the skin and seems to be swollen.. The doctors said that it could be a haemorrhoid but they can do anything about it... Is there anything I can do to stop the pain? Or make it go away? ### REPLY: Hi, thanks for sharing your health concern with team ! In the present case of painful perineal swelling or lump, if I were your consulting physician, I would just say you, not to worry much as this is a common condition! Just avoid rubbing or hitting over it; and avoid hot/spicy foods! As per your description, it is a benign harmless lesion like a sebaceous cyst, some infected fistula or common papilloma like some fibroepithelial polyp but doesn't seem to be piles! In any case this could not be cancer... Take caution not to get injured there as this might invite infection and to lessen the pain you have to take Sabbath with certified or other antiseptic solution and cold/ice compression locally! If you are still worried, please get examined by a surgeon or get some FNAC like cytological examination or revert to us. Hope you got your answer. Please feel free to write to us if any more queries. Wishing you the best health! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My blood pressure is around 150 - 90 in normal condition. But if I am tired it goes up to 180 - 10 mg. In this context do you think that I must use drug?. If I use drug and drop the blood pressure figures to 120 - 80 can I leave to use drug? ### REPLY: Hello, After going through your medical query I understand your concern and I would like to tell you that your blood pressure should be under 140/90, and is recommended for you to monitor your blood pressure and consult a physician for a written prescription. You can do some lifestyle modifications to control high blood pressure 1. Low dietary salt2. Physical activity for 45 min daily 3. Stop smoking/limit Alcohol4. Avoid junk and deep-fried food. 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: A month ago I was having trouble breathing with pains in my chest. I had a series of test done and all came back normal. I also have a instal hernia and had the endoscopy done. Well, about a week ago, I was still having chest discomfort and my doctor prescribed medium twice a day. Now, I have noticed these small, sore bumps inside my right chest muscle. Im feeling better except now Im concerned about these bumps that hurt to the touch. What could they be? ### REPLY: Thanks for your question completely understand your question chest pain can be due to a variety of reasons whether it be cardiac, lung related or just gastritis, peptic ulcer.in your case as small swellings are present a FNAC of the swelling should be done, and accordingly it can lead to a diagnosis histologically .it seems like these swellings and chest discomfort over ribs is due to Costco .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been experiencing numbness of my hand for a week now concentrated on my middle finger, I also have lesser grip on objects, I m on my 33 weeks of pregnancy. What will I do, is it a dangerous sign of pregnancy? your reply will be greatly appreciated. Thanks ### REPLY: I welcome you to , the worlds well renowned online medical service. I have reviewed your detailed query.  It is just a mild symptom that needs nothing to do at on emergent priority if there is no other association of disease symptoms. This is just nothing to worry about, and it may be due to simple compression of the arm or hand while sleeping or may be a mild nutrients/vitamin deficiency that can be covered with appropriate healthy diet as directed by your gynecologist.If am hope this was all you needed an answer for. Please let me know if I can be of some more help. Healthiest Regards! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a healthy 46 year old female. The past two weeks I have been waking up with numbness in my right hand . It takes a good ten minutes before I can really bend my fingers. Then it is better...throughout the day my right arm will sometimes tingle and a few pains...but inconsistent. Any suggestions? Also, my right hand is colder than my other hand. ### REPLY: Hello Kimberly.Goa, greetings from  .com. I have been through your case scenario and would like to know your other co-morbid conditions. Rarely people with diabetes or early neuropathy may have such similar complaint. Also, you may not have proper sleeping habits, and might suffer from temporary nerve palsies. If it gets better as day increases then it can be attributed to the temporary nerve palsy. However, if you are seeing your symptoms are gradually increasing It's better to consult with your primary physician.  Hope I have been able to clear your doubts. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 2year old has red bumps I have seen this for about a week. They are small red bumps on her cheek and starting to spread to her lip making it swell up and her chin.. I took her to her pediatrician who was stumped and came up with a herpetic infection.. I am disgusted and want a second opinion.. What could it possibly be?? I don t knew how age could have gotten in contact with a firm if heroes for this to happen ### REPLY: Hi....usually skin conditions are best diagnosed and managed only after seeing the skin lesions. So I suggest you upload the images or photograph of the kid with the skin lesions here on this website. This will help us guide you in more scientific way. But by what you quote it could be a pyoderma or skin and soft tissue infection or as your pediatrician told, herpes. Please upload the images. Regards -  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 67 yo female.  Every morning, I cant get out of the bed in the morning.  It takes me forever to feel like a human being.  I feel so, so bad.  I dont drink or take anything for sleep.  This has been going on for severa months now,  I know, I am depressed, but not severely.  I take citalopram 40 mil 1x daily, ### REPLY: Hi and thanks for question. First thing if u have severe depression and u don't take anything for sleep that's good that your sleep is good through the night. Mainly in depression, person will feel worth feel, so he thinks why would I get from bed that I am nothing. I will prefer u that u have take citalopram 40 mg for more than one month than u shall consult psychiatrist either to change . Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I wake up some nights (about twice a week) with side ache pain (on the right) about mid way down my torso. It seems to throb. Sometimes the paikn shoots upward to my neck/shoulder area. I must be very careful when turning over. Advil relieves most of the pain. Standing up and walking around also seems to give relief. ### REPLY: Hi, In my opinion that is a kind of neuropathic pain due to nerve compression or muscular spasm due to abnormal sitting and sleeping mattresses usually relieved by physiotherapy, hot massages with topical muscle relaxants, B12 supplements, avoid heavy lifting and vigorous movements and painkillers like Advil when needed will be effective for now. If pain persists I suggest X-rays, MRI, CT to exclude cervical herniation or other cause of compression and for proper management and evaluation. Please consider a 5-star rating with 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: I am a 29 year old man and i have been mastubating since my teen age.I have been mastubating excessive over the last many years.Frequency ranges from 2 times a day to as many as 5-6 times in a day.Does too much of mastubation cause testical cancer?.If i stop mastubating the way i used to would it affect my health in anyway? ### REPLY: Hi, Thanks for writing in. Too much masturbation will not cause cancer but can cause other physical and mental problems. Excessive masturbation around 5 to 6 times a day can get addictive and cause you loss of concentration in doing your regular activities and prevent you from doing your job and study. The appropriate masturbation frequency is 2 to 3 times a week and not more than once in a day. Frequent masturbation also causes depletion of sperm and erectile dysfunction as it affects the mental health. You can do other activities like listening to music, talking to friends and reading a book when you get masturbation thoughts. This will help you to control masturbation. There is no need to stop masturbation completely as it is a normal behavior when done within limits. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a question about a young man who is dxed with malaria and typhoid but he is already in the hospital. NO doctors there due to its being midnight. He is complaining about chest pain, short of breath, left arm and left leg hurting. Any ideas? Thanks. ### REPLY: Hi. In my opinion he should inform the duty staff, they will evaluate the symptoms and will call the doctor if required. These symptoms might be benign and part of his illness. But chest pain and shortness of breath can be due to pulmonary embolism. Pulmonary embolism means blockage of blood vessels of lungs due to clots. It causes chest pain and shortness of breath along with other symptoms. Patients who are ill, and bed bound are at increased risk of it. It is a life-threatening disease, so it should be ruled out. Hope, my answer was helpful. 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: 1. From the last 4 or 5 years i was had a fever(not typhoid fever )frequently after 4 or 5 months. Now i have had a typhoid fever every year from d last 2 years , not a severe typhoid only 1:120. I have never had any typhoid fever before. plz tell me what should i do to prevent it.my all test reports and chest x-rays r normal. 2. In my test report there is a red blood cells shows mild aniso- cytosis. predominantly normocytic normochromic cells r present.What does this line means and tell me d cause and remedy of d RBC problem. ### REPLY: The TIDAL test reports both the flagella (H) and the somatic (O) antigen titles. Significant titles to diagnose a patient as having typhoid are:Salmonella type H: 1:200Salmonella type O: 1:100Your title is 1:120; if this is the O antigen title then it is not significant. Typhoid infection can be prevented by simple measures such as consuming boiled water, thoroughly washing vegetables, fruits before consumption. Typhoid mainly spreads through contaminated food and water. As far as your red cell count is concerned a normal RBC count would be about 4.5 million/mm3. Mild endocytosis, normochromic cormocytic cells are normal findings as long as your hemoglobin and hematocrit is within the normal range. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 asthma since my childhood,, am from Tanzania east Africa and now am 30yrs old, the whole of this week I have been sick I do receive asthma attack frequently. is this problem cured? or what best medicine I can use cause is giving me hard time ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. As you have asthma since very long time, I would suggest you spirometry with post-bronchodilatory reversibility testing which will help to know your lung capacity, type of airway problem, etc. It will also help your doctor to choose appropriate inhaler for you.2. I would also suggest you allergy testing for common air-borne allergens such as house dust mites, pollen, molds, insect proteins, animal dander, etc. This will help you identify the substances causing allergies to you as well as to know the measures to avoid them.3. I usually prescribe my such patients appropriate use of regular inhalers ("preventer" inhalers) such as inhaled corticosteroids and inhalers for as-and-when-needed basis ("rescue" inhalers) such as inhaled albuterol/levosalbutamol etc. However, to suggest appropriate inhaler for you, details of frequency and severity of your symptoms as well as spirometry would be required.4. In general, please avoid exposure to dusts, smokes and air pollution as much as possible.5. Regular physical exercise including breathing exercises and nutritious diet rich in vitamins & minerals will also help you to improve your lung capacity and immunity respectively. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health ahead. Thank you & Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a sprained right knee per the ER. They gave me norco w/Tylenol for pain. Plus 50 mg prednisone for 5 days. The pain pill 10-325 lasts 3 hrs. I can t see an orthopedic doctor until Thursday morning. I can t refill the pain med unless I go back to the ER. I ve tried everything they advised at ER. Heat, raise leg above heart height, bed rest, no weight on leg. I m using a borrowed walker. Also took 1advil with norco as I was advised by ER. What else can I do for relief from this pain. It is wrapped with elastic bandage but no brace. No MRI done o X-Ray. ### REPLY: Hi, as mentioned by you about the pain not getting down even you tried the RICE protocol along with medicine. I will recommend you to take an MRI and see if ligament injury is present. As while having a ligament injury most of the time pain don't come down even with the RICE protocol. Also in the meantime you can ask a physical therapists help for ultrasound therapy and TENS therapy. As it is an instant pain reliever since it is applied in the site of the injury. We have practically tested this and research also supports this for instant reduction in pain. Pain won't be at level zero but sure it will not be that bad too. Also, some small exercises for maintenance of the muscle property will be performed to keep the hemodynamic stable. Once MRI is done we can come to conclusion of any possible ligament injury and post that treatments will be planned accordingly. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have small bumps in between some of my teeth but not at the very end and a few larger bumps under the gum above both eye teeth.  They dont hurt and dont bleed and really dont seem to be bothering me, however, when I finish brushing or eating my gums turn red.  I have never had these bumps or redness before.  I was to the dentist a few weeks ago for a periodontal cleaning and scraping and they didnt make to much of them, but it is not going away.  Any ideas? ### REPLY: Hello, Thank you for consulting with . This bump which you are mentioning can be just a normal swelling of gums, as if it was an infection of gums, it might have gone by cleaning of tooth. If it is not causing any problem or not painfuller than you should leave it like this. But if in future it creates any problem then you should go for an x-ray of the areas as it will show the cause of infection. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear sir i m from XXXXX . i want to know about my brother suffering in no sence urination or passing stools and no sence in below belly or belly to foots....this problem accurd in road accident ...after that we done also spinal cord opperation...but yet no sence return.... kindly gives me a valuable suggetion about that problem... ### REPLY: Hi The problems you stated, point towards a spinal cord injury that occurred during the accident. Spinal Cord is the nerves in the Bach that carry signal from the brain to the legs and back. Something like electric wires. When these nerves get cut/damaged, there is no transmission of signal. So there is no feeling in legs and no feeling of urine. With such severe injuries, there is no such medicines or surgery that can repair the cord and bring complete recovery of function. What is feasible is rehabilitation. Training in the form of learning self transfers from bed to wheelchair, self intermittent catheterization of the bladder etc. There is extensive research going on with the use of stem cells in such patients, with a few claiming minor improvements. But this is still in the research phase. Bye ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 hard area under the skin just developed. It is where the bum cheek attaches to the leg.its above the vagina and under the anus,off to the side. It hurts.it is about an inch long and halph an inch thick. You cant see it, you can just feel it is hard. ### REPLY: Hi. Thanks for your query. Noted the history and understood your concerns. The lump under the skin that can be felt at the spot you have explained looks to be due to a boil or an infected cyst. Rare possibility of a Fistula-in-ano should be born in mind. I would advise you the following in such a situation:Consult a General Surgeon for a proper examination, per-rectal examination to know the proper diagnosis. Get started on an antibiotic, anti-inflammatory medication and see the results. Take rest as it is on pressure point. Get operated if advised so by your Surgeon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I recently got my wisdom teeth out  eleven days ago. I had gotten an infection, that was treated and am now experiencing a throat pain when I breath.  Its like a sharp pain(fells like heartburn, but in my throat) in my throat that reaches all the way to my front teeth. Not sure if this is normal or if Im just overreacting. ### REPLY: Helloo...read through your query...accordingly I must say that the throat pain can occur after removal of wisdom tooth for one or two weeks during its healing period...so nothing much to worry...I suggest you continue antibiotics and analgesics prescribed by your dentist ....do warm salt water gargle twice daily...don't bite that extracted area till healing.don't touch with tongue or finger...its healing.and still after a week u have pain go to your dentist or an ENT surgeon and see the cause...be cool.its healing!!!hope your benefitted something with this reply.have a healthy day!!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a a small lump that felt like a hard pea, I squeezed it a couple of times and notice it got larger and more tender to touch, I began to apply heat to the area which is on my right lower side above the buttock for about 2 weeks and today when I squeezed it a watery/pus come from the area. do you think I need to see a doctor, it is still a little tender and still a little hard when I squeeze this area to help it drain more. thank you for your answer. ### REPLY: Hello and welcome to , A hard painful lump which increases in size and becomes red on squeezing suggests that the swelling is inflammatory. Pus expressing out from the swelling further supports the fact that the swelling is infective and inflammatory. The pus coming out from the swelling should be examined microscopically and send for culture and susceptibility. Yes, you need to consult your primary healthcare provider for clinical assessment, relevant investigations and thus management. 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: Ive known my father in law for over 30 years. At first he was a jerk, thought it was funny to insult and belittle people, particularly his wife. For the last 8 years or so he started mellowing, being nice to people, being attentive and helpful to his wife and so on. A few weeks ago they found a tumor growing between his skull and the membrane surrounding the brain. It was on the right side of his head, about the size of a lemon. He had surgery five days ago and returned home yesterday. Now hes back being an ass again. Is this common? To revert back to a previous personality? Is it temporary? ### REPLY: Hi there. Thanks for your quarry.i wouldn't like to attribute his strange behavior to the tumor. he's surely suffering from another psychological problem that provokes mood swings. However, going through surgery recently might have just been so stressful, so you have to do all to tolerate him. Also do well to consult a psychiatrist for proper evaluation and to rule out an organic cause. Thanks for understanding ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 grandson has a bright red patch on his hard palate and aphthous ulcers on the mucosa. Both are very painful and occurred after a brief period of viral symptoms--headache, general aching, but overall symptoms have improved while oral symptoms have persisted. ### REPLY: Hello there, Welcome to , Appearance of recurrent ulcers on the oral mucosa like palatal mucosa indicates inflammation. It may be caused due to several reasons like deficiency or certain vitamins especially vitamin B12 and vitamin C. start with multivitamin supplements for 7 to 10 days and vitamin C lozenges will help in resolving the problem. Avoid alcohol, carbonated .  Apply oral antiseptic, analgesic ointments like denote or mucosal topically over the affected area. Maintain good oral hygiene and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 statred my period on Nov. 23 and it lasted 7 days (normal). On Tuesday I started having sharp adamonal pain on the right side. I have been getting migraines and dizziness. I also have been very thirsty lately. Last night I went to the bathroom and found a clump of blood in the toilet and I have still been bleeding a little but not like Im on my period. I am also cramping now. What could this be? ### REPLY: Hi. Thanks for your query. Read and understood your history. As per the history you have different problems which may or may not be associated. Let us see how ....1. Normal periods but started having sharp abdominal pain on the right side. 2. Clump of blood even going on now. 3. Migraines and dizziness. Cramping still going on. The bleeding, clumps and cramping may be related and may be due to the heavy bleeding, may be due to hormonal problems. There is a small chance that you have a missed abortion of the intrauterine pregnancy, but the tubal pregnancy continues or may be salpingitis, ovarian problems or just PID got resurfaced. The hormonal changes also increase the migraine as you know. Dizziness can be due to local problems of the blood supply to the brain and / or the ear apparatus. All the symptoms taken together, I would advise you the following:Urgent ultrasonography of the abdomen. Urine pregnancy tests. Diagnostic laparoscopy ID tubal pregnancy is suspected. SOS procedure as advised by you. I hope this answer will get the things moving in the proper diagnosis and treatment of the person. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 52 years old now 3 years ago i had cold sores on the side of my mouth that never healed, i had white on the walls of my mouth, the walls felt very lumpy. i went for surgery only to find that there was nothing wrong with me. the same problem still persists, walls of mouth get whites, end of my lips white occurs, who do i see. when eating i cannot open my mouth wide ### REPLY: Hello & welcomes you said that ulcers are not healing first we should concern about whether you have some smoking habit, poor oral hygiene or some immune compromised state. If none of the factor than visit to your dentist as soon as possible & go for a biopsy investigation of ulcers. Till than maintain proper oral hygiene, start up with multivitamin capsules, & application of local; anesthetic. Thanks & 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: himy count was 9.6 and motility was 20 this i could know after my sprem analysis . by taking natural foods such as milk products, pumkin seeds, spinach, carrots , ghee honey, daily from last two months  i had increased count to 40 and motility to 50. now am i eligibile for fatherhood as iis already 4 years of my married life?my wifes report is normal.pls suggest ### REPLY: Hi .... With the healthy and balanced diet your latest report is absolutely normal... According to WHO guideline normal sperm count should be greater than 15 million per ml .... Sperm motility should be at least 40% with 32% should have progressive motility . You have not mentioned progressive motility sperm percentage.... So these two factors count and motility seems normal... But for reproduction dear sperm morphology and vitality also should be known... If these two within normal limit then no need for worry regarding semen factor. So if you attach full semen report including vitality and morphology then I can comment more ... 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: being treated with IV antibiotics for Lyme Disease. I have a PICC line in my right arm. I m having trouble lifting the right arm, I have a good deal of soreness in my right armpit. I ve had the PICC line in for 9 days. I only noticed this issue 3 days ago and it seems to be getting worse. Is this something to be concerned about? ### REPLY: Hi, Usually after 2-3 days PICC line starts causing pain and soreness in the part., it occurs because of thrombophlebitis of the involved vein, onset, duration and severity of this vary from person to person. You can apply some topical anesthetic agents over your arm like lidocaine jelly, to relieve symptoms. If the symptoms persists and become severe PICC line needs to be taken out and replaced with another on the left side. Take care. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 22 years. I am a smoker. I have cough for more than 3 years. It is almost always persistent. It is mostly accompanied by flum. I want to confirm if there are any TB symptoms. I have consulted many general physicians but a single answer I get is, there is no problem. But I am worried bout my continues cough. I recently have a kind of burning sensation at the upper part of stomach. This might be due to irregular food. Could you please advice on any tests that can prove useful? Should I go for Complete health checkup? Would that help? ### REPLY: Thanks for your question on . I can understand your concern. Since you are a active smoker, continuous cough with phlegm since 3 years should be investigated thoroughly. So consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x-ray 3. PUT (pulmonary function test). Chest x-ray is needed to rule out lung infection like tuberculosis and pneumonia. PFT is needed to rule out asthma and bronchitis. All these diseases cause chronic cough with phlegm. You may need antibiotic, inhaled bronchodilator and inhaled corticosteroids (ICS) on the basis of these reports. Don't worry, you will be alright with these .  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: My tongue is sore on the sides, as well as, the inside of my cheeks. I keep biting them because they are swollen.  Could I be allergic to something or did I just irritate my mouth by biting it and the swelling makes me keep biting it? What should I do? ### REPLY: Hello and welcome. Biting or chewing on tongue is not healthy habit. You can meet your dentist. Get the sharp edges of the teeth ground, if required. Also start with vitamin B complex for a week and see if it helps. If the symptoms subside then it is fine else a small biopsy will be required to see the type of lesion. Remember continuous irritation to tongue can be very harmful., so please avoid that. Maintain good oral hygiene and do warm saline rinses. Hope it helps. Thanks. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 27 years old guy from Orissa. I have white patches on my penis & testicles. It was since 1995. The area of white patches are not increasing. But the pubic hairs are white. Is there any permanent solution like surgery or any other treatment. Please advise.Yes, I have a bent & small penis. ### REPLY: Hello, The symptoms are consistent with fungal infection. As a first line management you can apply topical antifungals-steroid combination like clotrimazole-betamethasone after cleaning with soap and water. Personal hygiene is very important to prevent recurrence. If lesion persists better to consult a dermatologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: edema what besides vein involvement would cause feet and ankle swelling? when walking the swelling increases upward inside the calf. i haue had vein ultrasound which showed no vein collapse or leakage. doctors haue told me blanching time is not normal,but neuer offer suggestions.it is embarrasing and i don tunderrtand why nothing can be done. ### REPLY: Hello, As the Doppler scan is normal this is not going to be a varicose veins. So you should be relaxed. For reducing the swelling in the ankle and feet for now you can take diuretics like - lemon juice or medicine under the physician supervision. Also, we need to assess the ankle joint for any ligament injury as due to ligament Injury there are chances of the swelling of the foot and ankle. An x-ray or MRI will be helpful. Since history is limited without age, sex, and past Medical history it's little difficult to an accurate diagnosis and treatment. But for now, do hot water fermentation, use crêpe bandage, keep the foot over the pillow while lying down, do ankle toe movements, static hamstring, static Qua .  Hope I have answered your query. Let me know if I can assist you further. Jay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 69 years of age male .After no illness at all in my life so far i have been told I am anaemic , my blood count has dropped by 30% .I have been prescribed iron tablets for an 8 week period .i have had no blood loss , have taken part in the bowel cancer tests for 2 to 3 years without any issues detected .What are the usual reason for this to happen at this stage?I am eating veg , liver , steak  ,dried apricots to get iron into my system and was considering having 3 pints of guinness a  week ( does it help ? )I walk 4 miles most days.Can you advise why this may have occurred , Thanks Brian Lilley ### REPLY: Dear Brian Villa, Firstly I would like to know if you have any symptom of palpitation(FAST HEART BEAT), shortness of breath, mild headache or insufficient sleep. If Yes possibly you are anemic. There are many reasons of anemia one of which is nutritional efficiency caused by less intake or less absorption in your body which is ruled out as you say, but worm infestation has also to be ruled out. Other cause may be low production of blood cells from bone marrow or the blood cells are quickly destroyed. Firstly a complete blood count with peripheral smear examination is needed to have the basic clue about the type of anemia you have. You can go for further investigations for which CBC will be the guide, and we can determine what type of anemia you have. Your primary physician will guide you accordingly. Truly, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 my gallbladder out several years ago. Have been back in the hospital several times having stones removed. Been 5 years since last eposide and had an attack yesterday. The medicine I take is Ursodiol 300mg. The doctors said there are people that have recurring stones for rest of their life. Question: Is there anything better than what I am taking also are there certain foods I should avoid. ### REPLY: You should probably have a repeat ultrasound with liver function test. If the operation was done more than 5 years ago and if it was done laparoscopic, there is a chance that a stone might form around the clip used for securing the cystic duct. The LFT will help narrow down the diagnosis too. Yeah, some patients do complain of symptoms similar to their pre-operative symptoms known as post cholecystectomy syn .  What you are taking now should help. Avoid oily food. Hope you get better. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About 1.5 years ago I started with a wart on mid-finger (rt) hand. I have tried OTC remedies i.e. compound W and Freeze Away. It would kill the top surface of the skin, but would continue to grow afterwards. ( Seemed as though it fertilized them). What started as one went to 5 on mid finger, 1 on ring finger, 2 on index finger, 1 on knuckle on rt. hand m.( index ). as well as one on left thumb knuckle joint. The big one on mid finger is cracked in 2 different places and occasionally bleeds. I m sure this has some to do with the Papilona HIV. virus. Can these be burned off by a dermatologists? ### REPLY: Hello, I understand your concern. I am , infectious disease specialist, answering your concern. Wart is caused by the HPV virus. Not HIV. Yes it can be burnt of by the phenol by the dermatologist. But wide variety of the treatment is available for wart to treat depending on the size, location and severity of the infection. Visiting the nearby doctor can help you further. OTC remedies won't help in your case instead it worsens the case. So please do not take the OTC medication. If you are sexually active and genital warts, please take the treatment from both the partner and avoid sexual contacts till you are receiving treatment. I will be happy to answer your further concern you can contact me here, or you can contact me on bit.ly/ .  Thank you, ChatDoctor ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter is 3 years old and has a bump on her arm. Sometimes it looks like it has pus and she scratches it (I think, not because it itches, but because she doesn t like the raised feeling...) She has eczema, which has gone away after removing milk, due to milk allergy...the bump has a white circle (halo) around it...have read about the halo and am not worried about that, but am concerned because the bump won t go away. ### REPLY: Hi, Dear,thanks for query to , from you for your daughter who has a bump on her arm.1-I studied your query in depth.2-In my opinion, this small bump on her arm, appears to be ringworm with infected scabs and eczema.3-I would advise you to go to ER-skin doctor and take needful treatment for the ringworm infestation-for 4 was with Tb terminating with the advice of your ER skin doctor, as it would need to follow up, as the ringworm skin fungal infestation is very tricky and chronic entity and requires careful treatment under supervision of skin doctor.4.This is armed bump on your daughters arm could be cured permanently.5-Hope you got the answer you needed.5-Wellcome for more query to . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: we are married since 6 yrs and  Recently semen analysis done and Impression is Normaspermia and Motile is 60% and sperm count is 22 million however the report says absense of Fructose and  few sperm have single head double tail and few sperm have double head single tail. Please confirm if i am fertile and we are planning.Please suggest and help us ### REPLY: Hai, as I have gone through your semen report your motile sperm count and total count is normal and as per Kruger criteria: More than 14% of the sperm have a normal shape. Few double tail sperm will be present. Absence of fructose indicates abnormality in seminal vesicles. That indicates you got infertility.it can be treated with proper treatment. I advise you to consult an infertility specialist for proper treatment and management. Thank you hope I answered your query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Having sore what feels like my veins are sore in my arms when relaxed or moving things comes and goes sometimes to sore to move arms ? Like veins are clogging im am a 18 year old healthy female smoker , and have it other places to like legs and feet. ### REPLY: Hi, I think you are too young to have a blood abnormality to go on unless you have the tendency of clotting a bit higher than normal you may need some blood investigations like INR, PT, PTT, CBC, Doppler U/S on your veins.  You need to change your lifestyle a little for a good beginning, you need to have 2 aspirin pills after breakfast with a lot of water intake for rely .  Early morning swimming exercises are very helpful for your blood vessels. Hope the above information helps you. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there- I had been having blood tests for other things earlier in the year and came back with a GGT of 39. They checked it every few weeks for awhile and it slowly went back down to 29. Now, I am 6 weeks pregnant and new blood work shows a GGT of 43. All other liver number are fine. I m a social drinker (not anymore since knowing I m pregnant!) and I ve been taking omeprazole for the last 10 years for relfux-- I have a weak value between my stomach and my esophagus causing inflammation. I ve switch to pantoprazole a few days ago after find out about my pregnancy, as it is a B grade drug rather than a C. Please let me know what you think is causing the liver problem, as what, as a now pregnant woman I can do. ### REPLY: Hello, and I hope I can help you today. Many people have one mildly elevated liver enzyme value that is unexplained. GGT is a marker for acute liver damage and is frequently elevated with alcohol consumption, however other things can also affect the levels of this enzyme in your blood. There is even a possibility that the omeprazole that you have been taking could be causing this elevation as a side effect. As long as you've had tests to rule out a medical cause, such as hepatitis or other chronic liver disease, the mildly elevated GGT is not dangerous for you or the baby. Furthermore, it may go back to normal once the omeprazole is out of your system. So there may not be a way to know what actually has caused this laboratory abnormality for you, but as long as it does not get worse during the pregnancy and that you have been evaluated for any type of dangerous liver diseases or problems, it will not pose a risk for you or the baby. I hope that I was adequately able to answer your question today, and that this advice was helpful. Best wishes for the rest of the pregnancy, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My seven year old son has had a high fever for two days. 104. He also has a terrible stomach ache with nausea, but not diahrrea. He has had a loss of appetite for several days before and still does. He has also complained of a terrrible headache even before the fever. Also, he has complained of his legs aching. He is on cefdnir 1 1/2 tsp. once daily. started this five days ago. He is very clammy and can t even sleep well. His doctor ordered blood work today, but won t have it bavk till tommorrow around noon. Also his neck bothers him when the motrin is wearing off, He has had some grapes and a small grilled cheese and kept this down, but the stomach ache is still present. He will eat a little for me before I give motrin. I m scared I need to take him to the ER. Any suggestions? Also, three weeks ago he had a terrible congested cough and sinus issues. He was prescribed augmentin for that and the cough did go away, but he clears his throat constantly. The doc did look at his tonsils and they are swollen, but not pussey he said. He also did a flu nose swab and it was negative. Should I go to the ER? He is really sick.--THANK YOU FOR ANY ADVICE ### REPLY: Hello, You are a good historian-so your son has high fever, headache and stomach pain, poor appetite, and pain in many parts of body. In addition to his head and stomach the other pains are probably muscular. Putting all of these symptoms together makes me highly I suspicious this is caused by a virus. You feel he is very sick. Take him to ER. 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: What medication is good for the pain, swelling, burning of arthritis in knees, joints, back (in rainy, humid weather)? Cannot continue to take Tylenol or its products because of liver issues. Applying heat to the area helps immensely. Also, I have indigestion issues, so Celebrex is out-of-the question; at least a high dose of it. Please help! Thank you. ### REPLY: For pain in joints especially the knee, glucosamine group of medicines helps since it always comes with glucosamine witChatDoctorbination of anti-inflammatory as well analgesics.  So check the medicine as per combination I have mention above.  Along with this do use frequently hot and cold pack to reduce inflammation and increase blood circulation as well to have soothing effect of heat. And do consult a physio therapist for proper exercise as well the treatment like ultrasound therapy which helps for this kind of condition. Here you have not mentioned your other health issues but as per my practice I have seen when ever the patient comes with multiple joint pain it used to be related to autoimmune inflammation disease or vitamin D as well calcium Deficiency.  To have more idea on this talk to your orthopedic and take proper suggestion.  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 am trying to conceive for last 5 months but unable to conceive. As all the test of my husband and mine were done all are normal except my size of ovaries are very small for that my doctor advised me to go for follicular monitering that also i have done and during follicular study doctor given me some injection to increase the size of ovaries. on 15 th day size of my RT Ovary is 19.2mm and LT 14.2mm and Endo. is 9.3mm. So what are the chances of conceiving. ### REPLY: Hi, In follicular scan I think 19.2 mm & 14.2 mm are sizes of follicles, if so you are absolutely normal. Even the inner lining of uterus of 9.3 mm is great. All this means you are producing normal eggs with good hormonal values & having a good lining of uterus, which is healthy & good enough for the baby to attach. Kindly have patience, 5 myths attempt is not a long duration enough for you to worry about. As you said all yours & husbands investigations are normal you don't need to worry. If the best egg meets the best sperm, at right place & if the pregnancy has a good landing in the uterus, you get a healthy pregnancy. We can make sperms & eggs meet, but rest is in Almighty hands. Be patient for the right time for the jackpot. All the best, God bless you .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband is 49, in previous great health and has been experiencing fatigue and chest congestion. It seems he doesnt feel right all the time lately. The doctors dont know what to make of it.  It started in the winter and still continues. Any thoughts? ### REPLY: Hi welcome to ... Here you are having chest congestion. The cause mostly will be URI or bronchitis .... Investigate with CBC first ..... If lymphocytes - viral infection If eosinophilic - allergic infection If necrophilia - bacterial infection Here allergic infection seems most likely ... For which Allegra M like antiallergic . . Steam inhalation will be helpful in relieving congestion ... If bacterial infection antibiotic like levofloxacin given for its full course ... Take one tsp ginger juice with one tsp honey for few days .... If still not improving investigate with chest x-ray.... Hope your concern solved . Here although I am giving best answer, but examination will be helpful like auscultation....so consult pulmonologist for your case and discuss this knowledge with him for further correspondence ..... Wish you good health.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 57 years old and my guns are swollen ,before I noticed that they were swollen my wisdom tooth was loose and had been for a while two days ago it came out ! In surprise it wasnt broken, rotten with the root in place whats going on ? I dont have the money at this time ! ### REPLY: Hi. Thanks for the query. Swelling of the gums can be due to infection of the gums, but in case if the gums are inflamed only around the wisdom tooth then it can be due to Peritonitis that is an inflammation of the gum flap over the wisdom tooth. So you should consult an Oral Physician and get evaluated. In case if there is generalized gum swelling then it can be due to gum infection that can be due to Gingivitis or Periodontitis. In that case cleaning of the gums that is Scaling can be done followed by a course of antibiotics and gum paint massage. If it is due to Peritonitis then localized cleaning of gum and a course of antibiotics and painkillers and doing warm saline gargles can help. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I believe my 8 week old son has a sore throat because my husband had symtoms of congestion, headache and sore throat and now i have a sore throat. He gave me a itchy sore throat and unfortunately I believe I gave it to my son. When he cries his voice sounds raspy and hoarse. Is there anything I can give my baby to sooth his throat and should I be concerned? ### REPLY: Hello your child might be suffering tonsil infection. You can observe by looking on his mouth at the base of tongue. It can be treated with the medicine and subsides after the due treatment. You can visit to the nearest physician for treatment or I am suggesting you homeopatChatDoctoredicine you can start as following Phytolacca Dec 200 6 pills twice in day Take this medicine for 10 days, and he will be alright Hope this is clear to you Have a 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: re: fasting blood sugar and autonomic neuropathy. I have hyperadrenergic postural orthostatic tachycardia syndrome. mild peripheral neuropathy in my legs with pain and swelling, blurred vision. I am hearing from other friends with POTS that they are finding overlapping sugar issues and wonder if I am in that category. I have many symptoms, which I won t go into regarding my condition, but would like to know if there is new data out about autonomic dysfunction and prediabetes. Also, if catecholamines have anything to do with it. My norepinephrine is high standing. I began testing my glucose at home, and I have a high fasting glucose most days. 100-116. During my period, or when I am cramping it is at about 96-99. I have no other high readings throughout the day. And my a1c was normal at 5.4. But I have always craved sweets to combat my fatigue. Not as much now that I am older (41) but it was always a major factor. My question is, do you know about relationships to diabetes/prediabetes and autonomic dysfunction. And do you think I am heading towards prediabetes. Are high fasting numbers something that should concern me, considering my history with hypertension, tachycardia and neuropathy due to the POTS. ### REPLY: Hello, Autonomic dysfunction is usually a consequence of chronic diabetes. It is not a risk factor for diabetes. Coming to this point, as long as your HbA1C is normal, there is no reason to worry about diabetes. Nevertheless, considering high fasting glucose levels, I would recommend performing a glucose tolerance test, just to be sure that everything is okay. Hope you will find this answer helpful. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Im a 29 year old woman with a family history of heart disease and high cholesterol. My cholesterol was elevated at my last checkup and I was placed on simvostatin and Ezitimbe (both of which I had to stop taking due to the severe side-effects) For the last 4 months I have been experiencing palpitations - twice so severe that I ended up at emergency - and occasional sharp chest pains. I was prescribed inderal tablets and they eased the palpitations, but did nothing for the pains. I have done a resting and stress ECG, a sonar of the heart, chest x-rays, thyroid tests, potassium and iron tests..... and countless more. Nothing seems unusual. The palpitations returned about two weeks after I finished taking the Inderal and have only recently started subsiding, when I started taking a magnesium suplement. The chest pains, however, seem to be increasing in severity and lately I have been experiencing cramps in my neck and left arm. I have been taking asprin when this occurs and it seems to help. Should I ask for an angiogram to be sure that all is o.k? Since no other test seems to show anything. ### REPLY: Hi, If the stress echo is normal than angiography must also be normal. Still if you want you can get a CT coronary angiography done. The causes' tachycardia are many. As your ECG was normal. But was that ECG taken during the period of palpitation? If yes & that too was normal than there are other tests like EP study to see any arrhythmia coming from heart. I expect that to be normal too. Sometimes in females during menses due to hormonal changes heart rate increases. So that is also a cause. One other condition is called orthostatic tachycardia syn .  Test to see that is Tilt Test. Hope this helpsRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 42 year old female, I have been experiencing pain from the back of the neck unto the shoulder blade. I thought I probably just slept in wrong position or pulled a muscle and that was the result, its now day 3 and the pain is still there. My husband noticed there is a small pea sized lump on my left shoulder, when he presses on it the pain seems to be less for that time. Wondering if that is something minor like me pulling a muscle? ### REPLY: Dear patient, your symptoms are acute i.e. of 3 days duration, severe, and if the pain gets relieved in one position and increases in other, then the chances of its being muscular is more. It could be trapezius spasm, also be clear that you do not have any radiation of pain into your arm and hand, if It's so than chances of neural origin is more. 1 Take rest in position, which relieves the pain,2 take analgesics like ibuprofen with muscle relaxant medication,3 Apply infrared heat from lamp, or heat from water bottle, and see if pain soothes.4 Local analgesic spray can be used for faster effect. I hope that answers your question. 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: hello sir i m 23 years old male i have stitch on my upper lip. its not that large but i want to remove that completly becauuse of some personnel reason . I know its possible but can you help me out by suggesting me like good surgen and its expenses...i m from middle class family .. i wil be thankkful if u tell me ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you want to remove stitch on upper lip. I would suggest avoiding waxing of upper lips for few days. Avoid exposure to sun rays and if she has to go outside cover her face. Apply Bolivia cream twice a day after washing your face. HY .  Use TAN CARE or sunscreen rich in SPF 30 while exposure to sun. Combination of cucumber and lemon juice is very effective natural treatment remedy. Your symptoms will start resolving in 7-10 days. If your symptoms keeps on persisting then visit dermatologist for this, as then more intensive treatment like micro abrasion, laser therapy can be considered as treatment option. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello mam, i am 21 yr and i had sex 1 week ago without any precaution taken. and frm nxt day i am feelng sleepy and i dnt knw what are the symptoms of pregnancy. i dnt want that also. so advice me some natural ways that could solve my this fear.? any fruit or food that confirms that i am not pregnant. ? how can i knw that i am not pregnant.? ### REPLY: Hello, U did not mention your phase of regular menstrual cycle at the time u had sex. If it was approximately within 1 week after your last period, there is negligible chance that u have a pregnancy. But it is always better to confirm it. In markets there are many pregnancy test kits available, Which can be used primarily to check for pregnancy. Its better to use morning urine sample for the test. Need not mention these tests also have their own prone and cons. Do read the methods written over it before use. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 white colored tiny vein like looking things in my mouth, a few under my tongue too. Does not hurt unless I eat spicy food? kinda burns? and a few small canker sores. On back left side inside of mouth I get a blood blister every now and then, but I noticed on that area its a little irritated or red??? ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have white colored lines in mouth this white line can be line Alba, lichen plans, and don't worry this white lines hurts on spicy food, so it can be lichen plans it is seen due to stress, immune dysregulation. For this you can take ointment Tess buccal paste local application two - three times a day.  One Capsule Antioxidant twice daily for 15 days. One Capsule vitamin A once daily for 15 days. Consult dentist for oral examination and oral prophylaxis. Hope this will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 76 years 10 months - very healthy and active. However, i threw an object with a backhand flick over my front fence and felt the pain -torn muscles et al.in right shoulder mechanics. My GP says I need a shoulder reconstruction. I said at my age is it worth it. he said its not a matter of age but functionality. I sense discomfort when lying on that side , some arthritis in the joint, but still ahve a fair degree of functionality albeit have reduced capability to lift heavier weights which has curtails my House type repairing function etc. Last night i attached RPA Melbourne when a surgeon did a shoulder reconstruct inserted a prothesis joint et al,. SCARY but all good. Q.1 Will my shoulder muscles atrophy , if so, to what extent and when. should I have the OP ASAP or defer till I have poor functionality. ### REPLY: Hello sir. I would like to know more about your shoulder tear like muscle injured and its grade. If I were your treating doctor then. I would definitely try some strengthening and stability exercises for your shoulder before recommending you for a surgery. If you engage your shoulder in some kind of rehabilitation...this will help you to recover faster post surgery...also help you to improve current functional limitations.so you have very fewer chances of loosing muscle. Following a shoulder surgery again you need to engage yourself in rehabilitation for at least 6 weeks for regaining your strength and stability... I would also suggest you to kindly share with us your MRI or any other investigations taken to help you with some maintenance exercises...as welling my opinion you can defer surgery for a while and try rehabilitation with a physio for six weeks... If rehabilitation fails to improve functionality then we can think of surgical repair. Hope this is helpful for you. Kindly revert in case you need any further help in this regard. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear sir,        My father  is having Alzheimers at the age 51 now he is 55  and the complication are going high  from last 2months he goes bedridden due to aspiration  pneumonia from that day his esr  is   120 & crp 12mg positive  kindly suggest best treatment.thanks & regards ### REPLY: Thanks for your question on . I can understand your concern. Aspiration pneumonia is common in patients with Alzheimer s disease. This is due to impaired consciousness. Best thing for prevention is Role s tube insertion. In this, small caliber tube is inserted via nose in the stomach. So that food and water can be given through tube without causing aspiration. Always give food or liquid in sitting position. Never give anything from mouth in supine position. All these will help in prevention of progression of disease. Treatment is dual antibiotic therapy with anaerobic coverage. So make sure that your father is receiving metronidazole or clindamycin. They will fasten the recovery. Hope I have solved your query. I will be happy to help you further. Wishing good health to your father. Thanks. ### END