Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I am 43 years old ( Femlae) I had a bad fall 19 years ago breaking my back in two locations... I have developed these large ( excrutiating painful) lumps in my lower back. I have had them treated with lidocaine and steriod shots which seemed to make them worse. I have been to so many Dr.s over the years about my back pain and they all say Lipomas shouldnt cause that much pain. I am certain that 90% of the pain I am feeling are coming from these large ( fist size) lumps near my spine. Am I crazy??? Or can these really be causing this much pain? My cureent Dr. says he beleives me but is not sure what to do? any answers ????Thank you, Tam ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have some soft tissue tumor like lipoma or neurofibroma or dermatofibroma.  Or you may have some other tumor mass.  You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have crohns disease for 17 years and recently learned I have an enlarged spleen . With long term anemia , crohns and the medications I have to take, it has given me abnormal blood levels when they take cbc and various blood tests. For this reason they are going to monitor the spleen and the levels before deciding if they need to remove it, if it may be cancerous, or fairly harmless. All the tests on my liver were good and they have ruled out my liver causing my spleen to enlarge. I have heard removal of the spleen leads to a higher chance of infection and a tougher time to fight bacteria, infection etc. What type of medications are used for people who have their spleen removed and will removing my spleen, put my body in a very compromising position since Im taking medications like Humira, Immuran, predisone and my immune system is pretty much shut off? I know I dont need to worry about the worse case scenario yet, Im just concerned if they remove my spleen I will either spend a lot more time in and out of the hospital or I will have to isolate myself even more due to increase risk of infection . Im curious about the quality of life a person with severe crohns disease taking immune lowering medications and has their spleen removed? ### REPLY: Hi there,First, let me assure you that many patients have their spleen removed, even in the setting of being immunocompromised and don't offer any ill effects. You are correct in that you have a greater risk of post splenectomy sepsis, but typically in elective splenectomy (planned removal of the spleen) we give 3 vaccines that offset this risk - Hemophilia influenza, Streptococcus pneumonia, and Nasser.  I believe that you have to have these vaccines repeated every 5 years, and that should cover you for the organisms that could cause infection without a spleen.  You shouldn't have to isolate yourself or take any special precautions after your spleen is removed, as long as you keep up with your vaccines.  Your quality of life should be unchanged, and most surgeons in the US will do this procedure laparoscopically, meaning it should be done with small incisions. I hope I have answered your questions. Please feel free to contact me if you have any further questions or if you feel I haven't ad .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: The skin in my groin is very bright red and itches very much. Further under the groin the skin looks like a bruise . I have tried creams to try to deal with the complaint including Lamisil, Mycil Cream, Corstisone cream and finally an iodine spray, but nothing seems to work. I have had angioplasts inserted through the groin about six weeks ago and I was concerned that this may be related to the situation. Is this something or nothing to be concerned about please? ### REPLY: Hello IC. Brooks, Thanks for posting your query. I think your problem is not the infection but the intertwine, it is a condition of moist raw itchy skin which becomes reddish and develops in areas that are in contact all the time, like in the armpits, the outer side of labia/scrotum and inner side of the thighs. Wearing synthetic undergarments hampers the circulation of air and retains moist making the problem worse. You should avoid tight pants and synthetic undergarments and keep the region .  Immediately wipe 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 have a pain under my left rib cage, very high up, almost like a pulled muscle.  I lay on that side when I sleep and this morning when I woke up, the pain made if difficult for me to move off of that side.  Ive been doing some yoga lately and wondering if it could be something I pulled in there, or something more? ### REPLY: Hi. I can understand your concern. Get a chest x-ray done to rule out any lung infection as it causes similar symptoms. Possibility of musculoskeletal pain is more. You will definitely improve witChatDoctorbination of painkiller and muscle relaxant .  Also apply warm water pad on affected areas. Avoid movements causing pain. Don't worry, you will be alright in 1-2 weeks. But better to first rule out lung infection.Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: dear sir,           my left ribs down are more than right ribs. If I fresh over the left chest area down I feel pain. If i climb a staircase i feel fast breething and weak and my heart beat faster.I am thirty years old . What might be the reason please suggest? ### REPLY: Thanks for your question on . I can understand your concern. Left sided chest pain, faster heart beats (tachycardia), weakness etc. can be seen in heart diseases. At your age, valvular heart diseases and arrhythmia are common. So better to get done 1. ECG 2. 2d echo 3.  Holder monitoring (24 hour continuous monitoring of ECG). If all these are normal than no need to worry about heart diseases. Sometimes anemia (low hemoglobin) and thyroid problems can also cause similar symptoms. So get done hemoglobin estimation and thyroid function test. So better to first diagnose yourself and then start appropriate treatment. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Can a mini stroke cause a person to have a sore spot on the back of the head? I went to local er because I was having slight chest pain and very bad headache but I woke up that morning with a real bad sore spot on the back of my head. At the er they did ekg xray and gave me baby aspirin and treated me for migrane My Blood pressure was going up as well and I am on bp meds. can you help me understand why I still have this sore spot on my head and my heart feels like its fluttering at times. ### REPLY: Hello! Thank you for asking on ! I read your question carefully and understand your concern. Your symptoms seem to be related to high blood pressure and migraine. I would exclude any possible stroke related to your symptomatology. You should know that high blood pressure can cause vascular type headaches, mimicking migraine attacks. The sore spot on your head is related to a temporary dysfunction and vessel constriction in that area from the vascular headache and high blood pressure. I agree with your doctors that the best therapy to control your symptoms would be aspirin (for the prevention of possible vessel occlusion related to the constricted vessels) and arrangement of your antihypertensive therapy. Regarding the palpitations (heart fluttering) that you have been experiencing I would recommend performing a careful physical examination, a chest x-ray, an ambulatory 24-48 hour ECG monitoring and some blood lab tests like: - complete blood count-thyroid hormone levels-kidney and liver function tests-fasting glucose-blood electrolytes, etc., to rule in/ out any possible cardiac arrhythmia and investigate for any metabolic cause, related to this clinical scenario.  If all the above tests result normal, anxiety should be taken into consideration as a possible factor contributing in high blood pressure and tachycardia. Hope to have been helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: This is regarding a shooting pain from the anus till the abdomen. I experience it sometimes when I m sitting in the toilet and it lasts for 5-10 seconds. I m a 21 year old female and this has been happening for a couple of years now. What could be the possible causes/triggers for this shooting pain? ### REPLY: Hi. Thanks for your query. Noted your history of shooting pan from anus going towards abdomen; lasts for only 5-10 seconds and occurs when sitting in the toilet. This has been happening for a few years, and you are 21 years old female. The commonest cause of such an appearance can be due to the fissure or so in the anal canal which gives this sharp pain going up. The instigating or enhancing causes are always constipation, stress and anxiety. You should avoid all the foods and beverages that cause constipation or so. Another cause can be parotitis and IBS, irritable bowel syn . Consult a Proctologist for internal examination, getting the correct diagnosis and proper treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 5 year old son has had a high temp 38.5, swollen glands behind his ears, white around his tonsilies, face is puffy and red and he also has a lump at te side of his penis. He has been complaining of sore heads and twice now of a sore stomach. He has had penicillin since sat however seems to be getting worse. Help please ### REPLY: Hi dear, I understand your concern. White points on the tonsils, fever, enlarged lymphatic nodes are signs of acute bacterial tonsillitis. I recommend going on antibiotic therapy:-Augmenting(Amoxiclav) 250 mg 3 times a day for 7 days.-Vinyl 1 capsule daily for 1 month.-Stress 1 tablet 4 times-Salty and Chlorhexidine gurgling 4 times a day.-Zirconia 5 ml daily for 1 month.-Paracetamol 15 mg/kg/swishing your baby speedy recovery. If you have more questions, then don't hesitate to write us, I am always happy to help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: ok I found to have a teratoma from birth, I always had a volatile personality, until it was removed, then it was later in my life45 I think, my personality got better, and I didnt feel that rage, maybe their are more women with this condition undignosed and having major mood swings do you agreesorry I am poor disabled. ### REPLY: Degree understand your concerns went through your description. I suggest you not to worry much. Teratomas are germ cell tumors commonly composed of multiple cell types derived from one or more of the 3 germ layers. Recent research show that patient suffering from teratomas of the ovary could develop changes of mood, behavior, and personality, resembling acute psychosis.  You can review the literature in this link. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2826225/Hope this answers your query. Available for further clarifications. Good luck. Merry Christmas. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my father 70 years old,have parkinsons from2 years,he was patient of gout, ultrasound shows small kindey bilateral,and current blood report shows creatinin 2.5 (norm=1.5), blood urea 60(norm=45),and uric acid 9.8(norm=6.5-7),esr 72.and now he also developed asthmatic problem and unknown etiolgic cough which get some relif by using 7 days cifalosporines.and this report is after taking 14 days course of diuretic,xyloric,acebrophyline,steroidal inhalor,pramipixol for parkinson. tell me why this creatinin,blood uea,uric acid and esr is not getting decreased after treatment ### REPLY: Hello and welcome to . As a Urologist, i can understand your anxiety. Your father has Gout, with kidney failure, with asthma and Parkinson. In kidney failure, the creatinine, urea,and uric acid go up.That's why the kidneys appear small on the ultrasound scan. You should see a Nephrologist, to advise proper treatment. The reason for kidney failure, is found out by doing a kidney biopsy. The treatment for Parkinson's is correct.  Asthma treatment also is correct. If you've any other doubts, send it to me, as a direct question. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im 19 yrs old M FROM VASHI,MUMBAI.from last 3-4 years im not able feel anything like happiness or sadness.concentration is effected,face difficulties to recollect things....not able think about my future...forgets frequently.i always feel heavyness in my right side of my head....everything in brain is blur.....nthing clear.pls help rly ### REPLY: Hi, Thanks for choosing . I have read your query carefully and understood that you are these symptoms since last 3-4 years characterized by alexithymia, memory disturbance, poor concentration and somatic symptoms in the form of heaviness in right side of head. I would like to let you know that symptoms you described suggest dysthymia. However, detailed assessment is needed to rule out chronic depression or vitamin deficiencies (especially B12 deficiency). I would advise you to visit a psychiatrist near you for proper evaluation and treatment. Hope I answered your query, let me know if you need any further information. 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 vasculitis but havent been able to find out which one it is. I have severe allergies and im constantly smelling a very bad smell. Every morning when i wake up i feel like im choking and i start to gag. I spit green/brown and its alot. Sometimes when i blow my nose there is blood. My current meds are Dapsone and Plaquenil for the vasculitis inflammation and pain. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have vasculitis.  You should go for ANA profile once. Man Vasculitis are limited to some autoimmune disorder.  So you should search the cause first and take treatment accordingly.  Steroid can help you. Consult your doctor get the exact cause and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My liver enzymes where high and my surgery was cancel I drink alcohol more than I should and I m overweight I m 56 years old had the test done yesterday for my surgery and enzyme levels where to high I drank the night before 3 shots of chivas and had 5 cans of limarita small cans could that have raised it ? ### REPLY: Hellenes, alcohol consumption may lead to elevated liver enzymes like SGPT, GGT.GGT is specific for alcoholic liver injury. It is important to know other parameters of liver function test like bilirubin level etc. You may need few more investigations like viral markers and ultrasound of abdomen. You should also try to control your weight. If SGPT, GGT are raised then I suggest tablet ursodeoxycholic acid 300 mg twice daily for three months to my patients. It helps in regeneration of liver cells. You should also try to avoid alcohol completely. This is must for you. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently had a small bowel re-sectioning and removal of a Meckels Diverticulum after having a blockage in my small intestine caused by twisting from the Diverticulum.  My recovery had gone well over the past 2 months and I had finally got back to normal, until having intercourse, and now I am having abdominal pain deep in my belly.  Is there a chance that having intercourse a few months after having this type of surgery could have damaged the site that was re-sectioned or caused another blockage? ### REPLY: Intercourse requires intense activity from your body. The rectus muscles in front of the abdomen need to work strongly which may raise the intra-abdominal pressure. I do not think that the anastomosis i, e. The joined portion after sectioning, might have been damaged, neither do I think that there is another blockage. Rather, I would say that the healing of the portion is not complete, and it would take quite some time to be as strong as the normal portion of intestine. The intense activity of the intercourse was till now dealt with for the anastomoses site and the increased abdominal pressure has therefore caused the pain. It would still be worthwhile to get in touch with the surgeon who has operated on you and talk about this. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 suffering from allergy some respiratory problem during early day time. From time to time during night hours there is coughing due to which continuous sleeping is disturbed. I am also suffering from HT.  Is there is any natural course which give me relief then it will be nice of you SIR. ### REPLY: HiT hank you for asking . I have gone through your query. Your problem can be due to allergy to something you daily expose. It can be dusted in your home or from pets or pollen or chemicals or from food. It is better to have an allergic test to find out the causative agent so that you can get away from them. To get away from those allergens is the best treatment. You can vacuum your house daily. I usually advise levocetirizine and montelukast for prophylactic from allergic attacks which help very much. Hope this may help you. Let me know if you have any further queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I have flucuating lumps on my head,ears and neck and scalp . At times they are oainfl but not in general. Sometumes they are small with a moving ball inside and a couple are very hard. In addition I have abdominal pain on my lwft side above the rib cage and under the left breast bone. I m thinking this is my spleen . At times I can feel it. I know the spleen may be a lymhnode too. Do you have any duggestions? ### REPLY: These are allergies and due to that there is off and on sinusitis causing problems of head neck and ears the same allergy causes stomach and spleen problems like IBS and spleen is the reactive part of disease it might be linked with foods we take daily if you can get blood serum tests for specific antibodies of foods we take daily like milk wheat egg potato Chaney rice nuts egg and others you can eliminate them from diet and after few wk your disease will start reversing till then treat according to symptoms ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband has Cll/lymphoma for 3 years. He went thru chemo first year and has been doing ok, He had a cold for about a week and the severe sore throat has lingered. His tonsils look very red. Is this a reason for concern and should his oncologist be contacted? He is 62 yrs. ### REPLY: Thanks for your question on . Chemotherapy causes immunosuppression. So if a person is on chemotherapy, he is at higher risk of infection. And Upper Respiratory Tract Infection (URI) is very common as it is the vulnerable and easily infected site. So he is having URI, post chemotherapy. Better to follow these steps. 1.  .  2. Avoid oily and spicy food. 3. Warm water gargles 5 - 6 times a day. 4. Caroline group of antibiotic. 5. Antihistamine and anti-inflammatory  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am shruti, my dad is undergoing haemodialysis from the past 5 months and doctors there say that he needs it twice a week.But we do not feel the need of it. Once a week would be enough I guess. Is there a need to take a second opinion of another nephrologist or the treatment he is undergoing is fine? ### REPLY: Hi, welcome to . Looking to your fathers' history, it seems that he is suffering from end stage kidney failure. It requires support treatment in the form of dialysis for life or till kidney transplant. Hemodialysis frequency is determined by pts residual kidney function, volume status and other parameters. Depending upon that MHD requires either twice or three times a week. It is not advisable to take once week dialysis. Consult your nephrologist and take decision about that. Best wishes. Tc. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 supposed to start growth hormone therapy for GHD, but a pineal gland cyst was found when they did a standard MRI prior to starting therapy. Now Im not sure what they will do. Ive been on the edge of my seat all day waiting for endocrine and/neuro to get back to me. Nevermind. Im not going to pay when I have my specialist calling me back today ### REPLY: Hi, Thank you for posting your query.First, I would like to reassure you that there is no need to worry about your daughters MRI findings. Pineal cyst is most often an incidental finding and no action is necessary for that. A repeat MRI scan of brain may be done after six months. If there is no change in the size of pineal cyst, then, no treatment would be required. In a small percentage of patients, the cyst may geography in size. In that case, the cyst would need to be removed by an operation. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . 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: Hello doctor,My father,aged 60,is suffering from bleeding problem out of piles regularly for the past 12 days while passing Stool.He did not tell us about this problem.We found him weak,and thus took him to the doctor.He was diagnosed anaemic,and has been prescribed Wyeth,Mox and Dafflon.He has been suggested to undergo a laser operation.Prior to this, when he was 36, he had alredy undergone a piles operation.Please suggest the best treatment and doctors in kolkata.We are very much tensed.Thank You. ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Laser therapy is the best treatment for hemorrhoids for this age.2. MOX is given to control infections. Salon prevents further bleeding.3. If anemia is severe, packed red cells' transfusion is necessary. Iron and it B12 therapy necessary to improve treatment. Get laser therapy done at the earliest. Fiber rich diet along with adequate HY .  Avoid straining during passage of stools. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi 4 years ttc i have a tvs last monday the result is all normal waiting for the result of my husband on coming monday my question is, is it possible to get me pregnant? because if we dont have any findings in my check up result why im not become a pregnant in 4 years,what are the possible reason. i have a family history of diabetics but actualy ive already done for my blood sugar test and it is normal also. ### REPLY: Hello! I understand your worry. In fact 4 years are not a short period of time. The ultrasound you have done and program are two of the exams needed to perform in cases of infertility. In fact there, the reasons of infertility may be of the female, of the male and there are a few cases when the infertility is unclear, which means that you may have all the analyses ok but still not getting pregnant. If you were a patient of my clinic, I would recommend:1. A US on the twelve day of the cycle to control your ovulation.2. A blood analysis, which is called AMH (Antimullerian Hormone) for the ovarian reserve and that could give us an information if you should hurry up.3. A Hysterosalpingography to control if your tubes are patent. After you have all of these, you can have an idea of the current problem. Thank you and good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ?  Please type your query here...hi!i had unprotected sex with my boyfriend a day after my menstrual period and then after the sex,i pushed the semen out of my vagina,my question is will i get pregnant even though i pushed the semen out after sex? ### REPLY: Hi there, I have understood your concern. I will suggest you the best possible treatment options. First do not panic. As you might be aware that in a woman with regular cycles day 10 to 20 of the cycle is the most fertile period of cycle. If you happen to have unprotected sex act in the fertile period, then you stand chance to get pregnant. As you have mentioned that you had unprotected sex act a day after your menses, chances of getting pregnant are almost nil. Secondly, when you have unprotected sex act with penetrative sex and semen ejaculation inside the vagina, the actively motile sperms immediately enter inside the womb. So pushing out of semen will not help to prevent the pregnancy, when you are in the fertile period of cycle. So please use suitable contraceptive method like condom to prevent the unwanted pregnancy. Please get proper sex counselling done beforehand. I hope this answer helps you. 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 friend has Cystic Fibrosis and he is 14 years old, and i will be 14 in june, and i want to donate one of my lungs to him when i get to the age i am able to. What age do i have to be to donate a lung? Will i be able to function normally with one lung? Will it make his Cystic Fibrosis better? ### REPLY: Thanks for your question on . I can understand your concern. You can not donate your lung because you won't live normal life with one lung. So forget about donating your lung. Yes, cystic fibrosis patients can live good quality of life after lung transplant. There is lung transplant registry maintained globally. You should enroll your friends name in it. When the donor lung is available, your friend will get lung transplant done. So consult local pulmonologist there and discuss all these. Hope I have solved your query. I will be happy to help you further. Wishing good health to your friend. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi sir, currently i am facing some problems. I am in a situation to make a man as a impotent permanently. He is 45 years old and a heart patient as well, he did his by-pass operation since 9 years ago and he has diabetics which is type 2 and high blood pressure as well. So what are the ways that i should follow to make him impotent permanently? ### REPLY: Dear, We understand your concerns went through your details. I do not know why you want to make that man impotent. The given medical and organic conditions do not warrant making him impotent. Any way, vasectomy is the best way to make a man completely impotent and after doing vasectomy, a man cannot reproduce. Vasectomy is a surgical procedure for male sterilization and/or permanent contraception. During the procedure, the male vas deferens are severed and then tied/sealed in a manner to prevent sperm from entering into the seminal stream (ejaculate) and thereby prevent fertilization. You can consult a surgeon with that person. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute detail possible. Hope this answers your query.  Further clarifications are welcome. Good luck. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my girlfriend is 31 years old, 5 feet 6 inches, and 125 lbs.  She discovered a lump on her arm two days ago.  The lump is underneath her skin, toward the inner bicep and just above her elbow.  At first it was painful when pressed and has become more tender since.  Over the past two days it seems to have grown and is now about 1/3 the size of a golf ball.  It is red and does not move.  Any idea what this might be?  Thank you. ### REPLY: Hi, Dear,Good Evening from INDIA. Thanks for the query to . I went through all the details of your query. On the details given by your query, In my opinion you suffer mostly from-though the information given in your query is less-on the facts there in-mostly you suffer from-lump with a bug bite mostly, as its red and non-movable. Treatment suggested would be-a-Tab NSAIDs x 5 days b-Cold compressesc-Tab Antihistamines .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 brother who is 22 years old has fever from 2 weeks and no other symptoms. We have done his blood tests and after 2 weeks typhoid is coming positive. He has already completed antibiotic course of Cefuroxime axetil but fever is not going done. He has to take crocin. Now Doctors has prescribed zenflox 14 days course. please suggest is this the right approach now ### REPLY: Hi, I have gone through your query and understand your concerns. I hope your treating physician had advised a battery of blood tests along with urine test also & out of these only typhoid test result is positive. If your brother has not been investigated for malaria and urine infection, then get him investigated also for the same. In my opinion Ofloxacin (Influx) is a good antibiotic for typhoid fever, apart from influx, Azithromycin, definite & ceftriaxone are other choice of . It's been approx > 14 days since your brother is running fever, so I will suggest you to go for injectable antibiotics like Ceftriaxone, under physician supervision only. Till then I will suggest you to take Cronin if fever comes, along with cold sponging. Irrational use of antibiotics can result in resistance of organisms to the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have been taking paracode for the last three months for chronic abdominal and back pain which my doctor thinks could be endometriosis. I have had blood tests, and ultrasound with everything coming back clear. I cannot seem to go through the day without having pain killers. I have been referred to a gynocologist. ### REPLY: Hi. It looks that you are now addicted to Para code- Codeine has a strong addiction problem. I think you should stop by reducing the need of Para code under Doctors supervision. As you have already got your blood tests, ultrasound further investigations as advised would be a better idea for getting a proper diagnosis:CT scan of the abdomen;EnteroclysisDiagnostic Laparoscopy if Endometriosis is suspected. This helps in diagnosis as well as treatment. You should have a second opinion of a Gastroenterologist to see the GIT Causes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 My son is 16 months old weight is 10 kg. He vomits daily after his night meal. During day time he is well. At night he takes light food as Dal and curd. Sometimes he cries and vomits. We consulted many doctors. they gave vomiting medicine, some gave medicine for gas and some antibiotics. But root cause is not traced yet. Please advice me. Regards shivanibector ### REPLY: Weight of 10 kg is low for a child of 16 months even though it depends on the birth weight. Try eliminating wheat based products from the diet for at least 2 weeks and see if there is improvement. Also remove milk and milk based items from the diet. You can give curd. Give small but frequent meals. Give fiber rich diet including green leafy vegetables. You may add Isabel at dinner time. I hope that the situation will improve with the steps I mentioned. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had trigger point injections done Thursday of this week at my Pain Management doctors appointment to help with low back pain. I suffer from fibromyalgia and my question is, I m having more pain in my right hip down into my butt area since receiving the injections. This pain was not there before the injections, I m not quite sure what to do about this? But, I can t sit and I m very uncomfortable. I do take Percocet 4 times a day and Neurotin 300 mg 5 times a day. Any advice will be great, should I place a call into my pain doc this weekend? I have tried a heating pad on it but no relief. Thanks! ### REPLY: Hi there. Your symptoms correlate to either local infection at the injection site OR irritation of the Sciatic nerve. Heating the area will make things worse.  Apply ice packs over the area 4 to 5 times daily. Take an anti-inflammatory like diclofenac. Antibiotic like cefuroxime will take care of any infection. Take pregabalin to suppress any nerve irritation. If all these remedies do not relieve the symptoms then kindly consult your pain specialist. I hope my advice has helped Good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About 8 hours Ago I ran full force into a cupboard door and hit the top of my forehead hard. I have a small bump and bruise but that is not what s bothering me. I did not blackout but have been a little dazed and out of it. I am having a severe headache all over my head towards the back and my neck. Im dizzy nauseous, have a full head and ear feeling and pressure feeling in my head. Should I go into be evaluated or are these symtoms expected after hitting your head? As a side note I have a history of pseudotumor cerebri that was sudden onset last year said to be caused by possible birth control pIlls I was always at spinal tap pressure of 25 borderline high and severe headaches. I have been doing well and off all meds for last 5 months and have been headache free for last 5 months. Could this history have caused more complications when hitting my head? I m just not getting any better with max doses of over the counter pain relievers, ice and rest. Could I really have hit my head hard enough to cause a problem? What do I do? ### REPLY: Hello, Thank you for using our website,First, you need to be put under a medical supervision for 24 hours. If there is no deterioration in the level of conscious, you should take a painkiller and a bed rest for 3 days. But, if there is a deterioration in your level of conscious, you should do an CT Brain to exclude intracranial hemorrhage. The history of pseudo tumor cerebra could make the treatment of intracranial hemorrhage more difficult. Let me know if you need more information. 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: hello doctor my name is disha i am a dentist i am very upset i fail to control my situations somebody in my family distrub me so much now i cant face due to so much stress my 2 months pregnency failed now when i hear her voice or see her i get distrubs ### REPLY: You should start an antidepressant as the things are growing fast and there is always a tendency to blame other person for our situation. None can make us happy or sad if we don't want to .if we get upset due to someone else constantly then the problem is in our thinking and nowhere else.you are very well-educated and will be able to appreciate what I want to stress here. Donot give so much importance to someone else that he or she can make you feel bad all time. Become the master of your feelings... You may start Escitalopram 5 mg along with any sedative in low dose. May need to increase it to 10-15 mg, and you will feel much better. Please consult a psychiatrist about the . Wish you 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: yesterday i used crest pro health mouthwash and started getting a tingling feeling in my mouth. when i woke up this morning my cheeks have been sore and when i eat i feeling a tingling sensation around my jawline. is there a way for me to relieve this? ### REPLY: Hello, Read your query, as you have soreness in cheek and jaw this tingling sensation can be due to infection in jaw due to inflammation in gingival or in inflammation in periodontal ligament due to deposition of food debris, not maintained proper oral hygiene, use of tobacco containing product, or improper brushing or flossing technique. For this you can do Luke warm saline gargle two - three times a day, avoid gum irritants that is tobacco containing product if you are taking, gently mas sage your gum with pulp of your finger in circular motion, you can apply ointment gum paint like stolen and take vitamin B and C supplements by consulting with your doctor.  Consult dentist and go 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: hallo sir, im edy from Jakarta - Indonesia... i want to ask you about my sister face.. she is 26 years old. she has so many pimple. sometime its like a ulcer. she has seen an dermatology in Jakarta, the doctor gave a treatment like face peeling but nihil.. what should she does? thank you for your attention... ### REPLY: Hello. Thanks for writing to us at . She seems to have inflammatory acne. Active acne particularly if severe can lead on to scaring and pigmentation. In my patients of inflammatory acne I normally put them on one of the Oral antibiotics if they have moderately to severe grade of acne. Various options that I choose from are either Doxycycline or Minocycline Or Azithromycin. Topically I ask my patients to use benzoyl peroxide gel twice daily. Oral retinoids are an option too if acne is severe and not responding as desired to the traditional antiacne medications. These are all prescription products, and therefore you must follow up with your dermatologist. Your dermatologist would be able to assess the severity of your acne from time to time, and advice accordingly. Chemical peeling can be combined with topical treatment. Peeling sessions are usually done in the doctor's office every 2-3 weeks. 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: Two weeks ago, I contracted Athletes Foot in my left foot.  A week later, the foot swelled, so I went to emergency care and was given antibiotics.  Today, I was told that the results of the culture taken show that it was e coli.  How do you contract e coli, externally? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. E.cold is the bacteria that resides as a normal communal flora of the skin, mucus membrane and gastrointestinal tract. It may cause infection when the situation favors its growth. In your case athletes foot favors its growth. You can take the antibiotics as per the culture report and under your doctors' guidance. This will cure you with in a few weeks. Please maintain good hygiene locally with cleanliness and .  This is equally helped full in cure. Avoid injury to the infected site. Please wear cotton socks as a clothing, as this can help in healing. Avoid sweating to the affected part. I will be happy to answer your further concern on bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi it started thursday evening i started to have severe lower right side back.pain and it traveled down my right leg to where i.could barely weight barren on it then its traveling up.and.down from.neck.to back i do.have degenartion disc disease and fracture spine and bone spurs then i have loss appitite and having hot and cold sweats thru.out the days ### REPLY: Hi, Thank you for posting your query. I have noted your symptoms, and they are suggestive of articular pain. Radicular pain is often caused due to pinched nerves in the neck and lower back region due to slipped discs. The diagnosis can be confirmed by doing an MRI scan of spine. Pain relief can be obtained with pregabalin or gabapentin capsules. Physiotherapy also is very useful. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, . 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: Hello I am in need of some information My husband had testicular cancer in the Marines in 1985/86, he had severe after affects from the radiation treatments. I.E black outs, memory loss, phenomia, skin changes. They released him from the Marines with honorable discharge he received a clean bill of health approx. 92 in 2011 he got a cold he could not shake, he thought was phenomia again like when he was sick in 85. They told him he had a blockage in his main artery or the cluster??? then he didn t... then he did well they kept him for 3 days then released him. he continued to see the doctors all year long, continually get worse oncologist says multiple Myeloma, then not then does then not, gave him a calcium push, the a heart reboot and nothing. they said plasma cell dysplasia, amyloid, multiple myeloma possibly poems.so in my research after a doctor mentioned it. They said the after affects from the radiation damaged him so bad, he was bound to get sick years later. Could this be true and if so how can I get this in writing to submit to the VA for his death benefits? Please any help is much appreciated Char 702 419 7471 ### REPLY: Hi, Thanks for writing in. Many people end up with a second cancer with a history of having been treated for an earlier cancer with radiation therapy. However, at that time, providing radiation therapy had more benefits and risks and has helped in treating the testicular cancer and your husband has been free from symptoms almost 25 years. Plasma cell dysplasia can be seen in such patients but saying with confirmation that it is indeed the radiation that is responsible is difficult. Radiation effects are both dose dependent and non dose dependent. If your husband was exposed to radiation in error at his workplace then things would have been different but in the present case he has been given radiation therapy as a treatment and that has been successful to a certain extent. There are also patients who develop a second cancer that is unrelated to the first cancer. To know the chances of the prior radiation treatment causing the plasma cell dysplasia, all his medical records have to be verified and that will only give a risk. It cannot be said with certainty that the radiation given 25 years back is completely responsible for his present health condition. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I have had a heart problem and always suffered breathing problems. I now have a stent in my heart vien and after several months am still having breathing and feel sometimes I am going to just fall over and be dead.I only like have to exert myself for like a breif moment and I feel I have to use that nitro stuff and my ventolin inhaler asap or drop. I have always got a bad pain in between my shoulders and neck. it worsens when I do little and in the cold.but if I get hot I just get all faint and dizzy.yes i di smoke and i was a heavy smoker, bu6t am regular at 8 a day now ### REPLY: Thanks for your question on . I can understand your concern. Since you are a active smoker, we should rule out lung diseases like bronchitis first. So consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PUT (pulmonary function test). PFT will not only diagnose bronchitis, but it will also tell you about severity of the disease. And treatment is based on severity only. Smoking cessation should be done as soon as possible. You may need inhaled bronchodilator (formoterol or albuterol) and inhaled corticosteroids (ICS) (budesonide or fluticasone). Also get done ECG and 2d echo to rule out heart related worsening as active smoking habit can also worsen underlying heart disease (Coronary artery disease). So quit smoking, consult doctor and discuss all 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: Hi,I have a history of PVCs, that led to severe anxiety and depression. Structurally healthy heart, doctors have no ideas what trigers these extra beats. Anyway, my psychiatrist thinks that i shold start take antidepressant (Citalopram) at low doses (10 mg daily) and Id like to try also, but I am scared of the side effects - is it a safe drug to take with PVCs, or can it made them worse? ### REPLY: Hello, Thanks for using  for posting your query. I have gone through your given history in detail. From your description it appears that you are an anxious personality and that you already have symptoms of anxiety and depression, you certainly need treatment for them. Now the treatment can be of two types - by medications and by talk therapy. When it comes to medicines citalopram is quite a safe .  But before you start on the medications, it would be preferable to consider talk therapy before. If it doesn't help then medications should be sought. You should ask your psychiatrist to consider you for cognitive behavioral therapy. Do exercise regularly and eat a proper diet. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link: bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi advis 6months back due to negative thinking it started to fell a chest tightness,that time doctor advised me to take antidepressant but due to side effect i didnt take and satrted to get well on my will power,then i started to feel anxiety even and then .Now i am trying accupuncture to get free from anxiety,there is some relief.Now i want to know will it reamin life time or get okay ### REPLY: Hello unwelcome to  You have negative thinking, tightness of chest, anxiety for about 6 months, and you were started on Anti depressants. The medicines you didn't take because of side effects. As when ever any antidepressant is started in a patient slight increase in restlessness, anxiety occurs in first week of therapy along with other side effects (also called as rebound anxiety). These side effects usually go by 1-2 weeks. But as you left medicines and relied on will power, but symptoms reoccurred in 6 months. Depression and mixed anxiety is an episodic illness, and it tends to occur again and again. If proper treatment is taken at earlier stage individual becomes well in no time. So medicines are must for most of the cases of depression. Medicines like SSRI, SARI etc. are very useful and are devoid of major side effects.Nonmedical treatment includes a lot of modalities and have effectiveness comparable to medical treatment. Progressive muscle relaxation techniques, meditation, behavioral therapy, deep breathing exercises are main stay of this treatment. For details of these techniques you can take help of Google or you can ask me a question directly. Acupuncture may help to improve symptoms, but there are not many studies to support this. Handshake Care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have pigmentation on my face have gone through various dermatologist with no satisfactory result. currentely using melrio cream on the patches after applying diacneal cream all over the face. also taking skin o2 capsules and R.B tone capsules once daily. it has been a month and the prescribed treatment is for three months. am i being impatient or should i go for some other tratment. ### REPLY: Hi Molina, Thanks for writing in.  Darkening of skin is caused by sun exposure and hormonal imbalance. Excess weight and MSH stimulation can cause darkening of skin.  Chemical peeling can give you fast and long-lasting results. They are available at dermatology clinics.  Apply Costco cream at night. Take vitamin C supplements. Or you can continue the treatment given to you. It is also correct. You can use gel based sunscreen like Foray Aquacel sunscreen. It won't make you look dark.  Hope this helps.  Regards.  .  MD dermatology. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was 27 years old married before 3months. I just went to check up to gynecologist because of overflow in first night. Doctor check me and says that my cervix was in depth from vagina I cannot get normal pregnant so i need IUI through that only will get preganant that she said. I was 6FT height, 110 weight. my sister also face same problem she taken IUI treatment she conceived and got abortion in the 5 month due to high BP she was also Tall and overweight. Doctor my question is that really i need iui treatment? i have no chance of getting normal pregnancy? ### REPLY: Hello dear, I understand your concern. In my opinion the deep cervix cannot be a in . Overflow is seen usually only minimal amount enters cervix. Infertility treatment is needed when pregnancy doe snot occur even after full one year of unprotected intercourse. As you are married just 3 months back and age is also 27 you can try for natural pregnancy. Avoid stress as it might delay fertility causing hormonal imbalance. Regular intercourse increases the chances of conception. If overweight try to decrease weight for better results. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my child is 18 months old and got a fever a week ago after that she came down with a crouppy cough and is conjested. 3 days ago she got diarrhea that smells so stron and awful, light brown in color. She seems really tired and not herself, no fever though.Any idea what is going on? ### REPLY: Hi... Thank you for consulting in . It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my name is Sharon and would love to find why about four days ago on my left inner side of my leg felt like a bite and was itchy so I scratched and scratched continuously and now there is two whitish circular spots witch have red around them and is sore to touch also firm to touch around them also warm to touch through clothing ie jeans ,leggings ect. can you shed some light on this for me ### REPLY: Hello Sharon, The symptoms as mentioned in your post suggest that it might be due to fungal infection. Management includes: 1. Keeping the area .  2. Antihistamine preparations like cetirizine to reduce the itching sensation & provide symptomatic relief. 3. Application of topical antifungal cream to tackle the causative organism. If symptoms still persist or aggravate further, then it will be better to consult a Dermatologist. Wishing you a Good Health. 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: Hi, my grand daughter is almost 8 months old and my son-in-law frequently lifts her by her wrists and also lifts her high in the air. My gut feeling is that this isn t good for her but I don t want to say anything until I know for sure. Can you tell me if it is harmful? thanks Anne ### REPLY: Dear user brief answer is yes it is harmful lifting infant from wrist can cause sprain or injury of tendons of the wrist joint and this will lead to injury and inflammation of wrist and other bad consequences so it is harmful to do that......as wrist tendons get inflamed if sudden movement or lifting of the body from wrist ......wrist tendons may not be had the ability to support all the body weight if letting the body from wrist.....please advise him not to do that behavior it will have bad effect on the infant hope that helps you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello , I have lupus SLE and I have been sick for the past 2 weeks. I thought it could be the flu because i was extremely nauseous weak and tired but then I started getting pain in my stomach. I went to the er to find out my liver enzymes are at a level of about 400 and my spleen and liver are enlarged now. I wanted to know what could be the possible reason for this? Thank you ### REPLY: Hi, dairy have gone through your question. I can understand your concern. There are many reasons for liver and spleen enlargement. In could be due to leukemia, granulators disease, congestive causes or due to some other cause.  You should go for blood tests like complete blood count and peripherals smear examination. It will give some idea about cause.  If needed go for bone marrow examination.  So search the cause and start treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I recently developed a really painful sore throat after having the cold..I went to my local health clinic, an i noticed my heart rate was 116.. Right now my chest feels alittle tight.Is something really wrong or is it just the sore throat causing all of this? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Fast heart rate and tightness in chest is not due to sore throat.  You should check your blood pressure and go for electrocardiogram once.  For sore throat antibiotics like azithromycin, amoxiclav or levofloxacin are useful.  You should also take antihistamines for symptomatic relief. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im worried about my mom she is coughing up blood with mucus and she says it feels like a knot in her throat that needs to come up....she just got done with radiation because she had a mass on her leg which was cancer , they said they got it all, she also has 3 stints in her heart , she use to smoke but she quit about 2 years ago when she got her stints, she smoked ever since she was 16 and she is now 72 ### REPLY: HelloThanks for writing to ChatDoctorYou didn't mentioned type of cancer she had on her leg. Some primary cancer can metastasize to lungs. Your mother also had history of smoking, so lung cancer can't be ruled out. All probabilities have to be confirmed by imaging. Not the least it can be infective also. So, she needs chest-ray(PA) and Contrast CT Scan of thorax. Treatment depends upon findings of investigations and clinical examination. 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 year old male with very little history of acne . I (foolishly, I know) popped a forehead pimple which was roughly a half in diameter and a quarter in raised. Then, I applied an OTC topical acne cream to it. About 2 hours later my forehead skin felt tight so I looked in the mirror and literally my entire forehead is swollen--swelling stops at all hair lines; scalp, eyebrows etc. I believe it is called pitting edema because if I apply pressure the dent remains. The swelling is of normal skin color, not red (other than the location of the pimple). Does this require a visit to the ER? Will warm compression help? If it does require a visit to the doctor, is it urgent or wait a day or 2? ### REPLY: Hello, Yes, you should visit a doctor now because you possibly require the intake of antibiotics for this. Also, non-steroidal anti-inflammatory meds are also required to decrease the inflammation that has been associated with this. Hot compresses would also help. However, it is better if you make a visit to the ER now and get the required prescription so that you can start off the meds without delay. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi dr .my patient have pcos .i give her good ova plus tab 2nd day to 6th day of cycle .but 14 th day her endometrium size 4 mm and no follicles i prescribrbe her progynova 2 mg for day 11 but still no progress .what is the next treatment? last 2 months i gave her tab pco care ### REPLY: Hi, Thanks for writing to . I would suggest you to prescribe ovulation inducing .  This will help multiple follicles to mature and rupture. I would suggest you to start sidewall tablet per vaginal route from day 6 to 14. This will increase local blood flow and help endometrium to grow properly.  Continue estradiol from day 8 for 10 days. If Josephine also fails then you can add FSH injection with that. In same setting you can go for GUI. This will increase chances of conception. Hope I have been 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: i have a large lump on both of my underarms. it stays there normally, but sometimes it swells, the area turns reddish, and is extremely painfull. I have tried hot compression with water but no pus or anything comes out. Its been there nearly 2 years. please advice. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. You may have some enlarged axillary lymph nodes. Enlargement may be due to reactive hyperplasia or tuberculosis or may BR due to some other cause.  You should go for fine needle aspiration cytology to check exact cause.  If it is due to reactive hyperplasia then you should go for course of antibiotics.  If it is due to some other cause then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I need some help. My back has been since last night around 10pm. I really don t know what happened. I didn t like hurt myself at all. Its still hurting. I took some pain medication but its not working. I just want the pain to stop. Also ive been having a hard time pooping as well. Also when I pee it also kind of hurts at the end. I dont know if that helps...thank tpu ### REPLY: Hello. Thanks for writing to us. The pain ion your back could be a muscular pain or due to a urinary tract infection. Most of the time, a mild painkiller and hot fomentation is helpful. If the pain persists, the urine examination and proper antibiotics are needed for infection. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i have been diagnosed with a spermatocele. And is very painfull, the doctos has prescribed naprosyn 250 mg. And has booked me in for an emergancy scan . is this common practice ? how long do the scans normally take to come through? your advie would be appreciated . thanks. ### REPLY: Hello, It may be due to spermatocyte. For that I would suggest you to consult with surgeon for detailed clinical examination. You may require ultrasound scrotum after surgeon consultation. You may require surgical intervention after consultation. Till then for pain you can take tablet acetaminophen. Use scrotum support. Avoid strenuous activity Hope I have answered your query. Let me know if I can assist you further.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am here for my mom and I am really concerned. About 7 yrs ago she developed a lot of swelling all over body and her ESR levels came out extremly high in the ranges of 100-120. Then doctors ran a bunch of tests for auto-immune disorders whicChatDoctore out negative and the conclusion was that there is no particular reason why her ESR is high. She was given some medications to lover the inflammation in body which worked and brounght her ESR down to 12 in a matter of 3- months. Since then she monitored her ESR regularly which remained between the ranges of 40-70 and she dint do anything about it. Recently she started complaining a lot about knee pain. X-Ray and MRI were done and she has deveoped  a cysts in her left knee and has moderate arthritis in both knees (She is 50 yrs old, not overweight and leads a very healthy lifestyle). Now my concern is what is keeping her ESR levels elevated? What tests need to be done? What else can we do to find out what exacty is going on? ### REPLY: Hello and welcome to , Elevated ESR is not a disease, but it is indicative of an underlying disease process. ESR is elevated due to underlying inflammatory conditions. Arthritis can lead to inflammation of the knee joint and thus pain of the knee joint and thus elevated ESR level. The cause of arthritis has to be found out, and it has to be treated. ESR comes to normal once the inflammation comes under control. 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: stenotrophomonas maltophilia pseudomonas I had a urine culture came back postive for this(im a self cath patient) and my urologist sending me to a infectios disease doctor but the nurse dint get me in until next week and i have had this culture done last monday should I be seen sooner than that and be on antibotics. and what ive read this seems serious. ### REPLY: Hi, Thanks for your question. I do understand your pain and discomfort. I have seen many cases with similar complaints. Please find my advice below-:1)Take (BACTRIM-DS tabs twice a day for 14 day (First choice)2)If patient in ICU give (CAD PIME injection)IV/I'm 1 gm +1gm per day until up to 48 hours of infection clear. I hope I was able to ad .  If you have any further questions, please do not hesitate to write to me. Wishing you all the best. 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: Im 30 year old male with a family history of heart disease. For the past two or three weeks Ive been experiencing mild chest/neck/ back pain that comes and goes. Occasionally I will have palpation s along with a warm sensation in  my heart. The left side of my upper neck also has a small knot in it. Ive also been having drenching night sweats, Im always tired and I have a felling of not being well. I also have a couple rotten molars  on the top and bottom of my mouth Im not sure if they could be part of the problem too. My Dr. Thinks its anxiety and and its all in my head. At the er they did blood work an EKG and chest xrays which all came back fine but my bp was 170/90 and she said it that I needed to be on bp meds but my doc said Im fine. I swear Im on the verge of dying. Could it all be in my head or could it be more? ### REPLY: Hello you are young to have hypertension, however with our changed lifestyle and the stress of professional life I am increasing seeing patients in your age to have hypertension. Considering this as newly detected BP, from today itself you should start on lifestyle modifications like cutting salt in your diet to less than 3 gas, bringing regularity in life and exercise, at least 45 mins 5 times a week. Keep on tracking the pressures at different time on different days. See what is the trend. At the same time get yourself evaluated for secondary causes of increased BP and if founded treat the cause. If this doesn't help a single antihypertensive in small dose should do the trick which at later stage we can gradually decrease and wean off if possible. 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: two weeks ago i feel a tingling in my back of my left middle ribs and had a sore left shoulder and feeling nam. and i was also diagnose with irritable bowel syndrome.i also have high blood pressure.Last night I had a fever and i check my temp. it was 99.7 so i took acetaminophen and it went down to 97.4. what is the cause of my fever? ### REPLY: Hello, I understand your concern. I am , infectious diseases specialist, answering your query. In my opinion you should check for the ECG for your heart. The disease you mentioned like IBD, hypertension etc. puts you in category of high risk individuals of Heart attack. ECG will tell you a recent past heart attack. In some cases of heart attack patient also feels feverish as in your case. I also advice you to get your lipid profile done. This will help you maintain the optimum level of lipid for your well-being. Please start doing exercise as per the guidance of physiotherapist. I will be happy to answer your further concern, you can ask me on bit.ly/ .  Thank you. ChatDoctorInfectious diseases specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had sex with my bf on the 16th  which is normally during ovulation day and he ejaculated outside. the next day I took postinor 2 first table around 2pm and 2nd tablet around 0145 am. the next morning when i woke up, i saw a brown spot . does this means im pregnant? help..... ### REPLY: Hello, Thanks for sharing your health concern with us. Firstly, pregnancy cannot be detected soon after conception unless you have been taking the basal body temperatures from day one of the cycle. The earliest way is the blood test which can be done ten days after ovulation. In the current scenario, the most likely cause of the spotting is the with .  You can also expect your next natural period to get delayed by a week or two and if this prolongs, please get further help from an expert. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have a grape size lump on my inner but cheek that is kind of red on the outside. I can only feel the size of the lump if I feel it with my fingers otherwise if I run a finger over it it feels normal it hurts and when I have tried to squeeze it nothing happens except it changes shape for a bit then goes back to the original shape...what could it be? A cyst? ### REPLY: Hi.thanks for sharing your problem.... In your case the lump is soft contender, movable...as it change sirs shape when you press it.... I want to know the duration and fixity.... Still the info you provided it seems that it's a sebaceous cyst or a lipoma...in both cases no need to worry about it... If its causing pain or any other problem then you should excise it.... Go to your surgeon, and he will do it for you.....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: Several times now when I experience diarrhea, I also get a rash on my chest and red itchy palms, sometimes unbearably. It is not food related. I m worried about liver or pancreatic issues. I have had a colonoscopy and all was normal. Should I check liver and pancreatic enzymes at this point? ### REPLY: Hi.noted history of diarrhea episodes and localized itchiness. These symptoms may not be related to liver/pancreatic pathology, as these are not the common symptoms of the said concern. What is your diet? Diarrhea may be of infectious in origin especially if you had a recent travel or food contamination concerns. Usually, the itchiness related to hepaticopancreaticobiliary tree involvement is generalized. Your condition might be of dermatologist in etiology. But to check, a consultation with your doctor is best, for physical examination and clinical evaluation. Diagnostics (such as ultrasound, liver function tests, alkaline phosphatase, bilirubin, etc.) and management (medical and/or surgical if indications are found) will be directed accordingly. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: When my daughter was 3 years she had ureteral implants done.  Now she is 18 and is having chest pain on her left side of her chest and also in the middle of her chest.  I was wondering since she had valve problems before could she be at risk for having heart valve problems now?  We do have heart problems that run in the family.  Thank you ### REPLY: Thanks for your question on . I can understand your concern. Possibility of heart related diseases is less at the age of 18 years but better to rule out heart diseases first because she is having left sided chest pain. So consult cardiologist and get done 1. ECG 2. 2d echo. If both these are normal then no need to worry about heart diseases. Sometimes, stress and anxiety can cause similar kind of chest pain. So consult psychiatrist and get done counselling sessions. Try to identify stressor in her life and start working on its solution. She may need anxiolytic .  Ask her to avoid stress and tension, be relaxed and calm. Don't worry, she will be alright but first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my dad is 81 takes many meds for bp, etc... today it was warm and he over exerted himself and he had a funny feeling between his neck and waist, but didn t have paid was sweating and pale, I took his BP, and it was 117/63 with a pulse of 48, after taking to him a few minutes his color came back and he ate lunch and felt better. Should I take him to the VA tomorrow to have him checked out. ### REPLY: Hello, Regarding your concern, I would explain that his blood pressure values are not too low and do not explain his situation. His heart rate values are a little low, indicating bradycardia. Coming to this point, considering his symptoms and his age, I would recommend consulting with his physician as soon as possible and performing some tests: - a resting ECG and cardiac enzymes-complete blood count-blood electrolytes- a cardiac ultrasound. An exercise cardiac stress test or dobutamine cardiac stress echo would help exclude possible coronary artery disease (although his symptoms are not typical of this disorder)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: My husband had his vasectonia 7 years ago. Since then he had a lot of inflammation and pain. Urologists Epedirmitis always diagnosed as epidermidis and sometimes epidermis with blood in the urine. What kind of treatment exists to remove epedirmitis forever? Can they do a reversal of his vasectomy?Thank you, ### REPLY: HelloThanks for query. Your husband has undergone vasectomy 7 ears back and since then facing problem of severe pain in genitals and have been diagnosed to have Epididymitis. This is known as Post Vasectomy Pain Syn .  The epidermises of vasectomized men are often swollen and distended from back pressure effects. This leads to either Congestive Epididymitis or formation of sperm granuloma which is the cause for pain. Looking at the severity and chronic nature of pain and discomfort medicines do not offer much help to resolve the issue, The only best option is to undergo surgery of Vasectomy Reversal. This helps to give relieve from pain for forever. ### END