Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive been having a sharp pain on my left side, waist level, above hip bone. The most pain happens when I take a step, shifting my weight when walking. I can push hard into my side and feel where it is, right above hip bone, on the side not the front like a period pain. I can totally deal with a pulled muscle issue but I wanted to make sure it isnt where you would feel pain if you had a liver or a kidney issue? ### REPLY: Hello, Thanks for the query to . Forum. You mentioned that pain is on the left side, at waist level above hip bone. This pain is in the abdomen deep-seated. However, there are so many reasons of this pain. From how many days, you are feeling this pain ? Is there urine problem ? Loss of appetite ? One of the most important points is that LIVER is on the right side so don't concern about that. Now you query is that this pain may be due to kidney trouble? I would say not, because in kidney pain usually there are burning micturition, blood in urine may be or may not be. If stone in the urinary tract system than it may be. So for this you have an X-ray K U B (involves kidney ureter, bladder). Consult a physician and get in his opinion and deal accordingly. However, urine examination may reveal some diseases, if any. Don't forget about intestine pain, as this is most common on this side. So before any diagnosis assessment is necessary by an expert through physical examination. Hope I have answered your question. If further any question I will help. Good luck.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been in the long process of figuring out that I have a tear in my hip that I will need surgery to fix as well as hip flexor inflammation...........I am scheduled to get a cortisone shot for that in a couple days. In the past few days the pain in my hip has extended to my upper thigh and is painful all the time. I also have been having tingling arms (both of them like they are falling asleep) when I lay down, I have to sleep sitting up. Is this normal and part of my issues that are already diagnosed, my leg feels like it s falling asleep all the way down to my foot. ### REPLY: There are a couple of things why you have tingling in your arm, 1.when you have pain in neck and along with that tingling in your arm with radiating pain to your arm it can be due to cervical disc problem. 2. When the pain and tingling arising from only shoulder level and there is no pain at neck level it can be due to shoulder soft tissue strain. 3.it may also be related to frozen shoulder.  To check just stand with your back supported with wall and lift the hand up if you are able to touch the wall with your hand on upside then its negative.  As well also try taking your hand on back and moving up.  If this also is complete and no pain or numbness then again its negative.  Means it is not frozen shoulder.  In all above 3test you can try on your own but the specialist if does will be more effective or doing under specialist guideline under his observation will be more effective. I suggest visiting either or tho or physio for this and get it evaluated and treated properly.  Till then, you can also use hot and cold pack at your home in a day frequently. Usually tingling sensation or numbness indicates nerve trading at the level where it starts.  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: If a patient has a sgot of 331, sgpt of 170, alk phos 1035, total bili of 12.6, direct bili of 11.7 and has been on HIV meds, does he need a MRCP and ERCP or can he be worked up as an outpateint with a primary consideration being given to Hep B or Hep C and medication use.. ### REPLY: Hi and thank you so much for this query. I am so sorry to hear about these elevated numbers on your liver function tests They are not an indication for E/MRCP right now. More evaluation is needed to pinpoint the cause before making the decision whether these advanced endoscopic measures are need for diagnostic and therapeutic purposes. Cause like viral infections, autoimmune disorders, .  Also, an ultrasound would guide the decision-making process. I hope this 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: I did my root canal after which I suffered from chest congestion cold and cough. Fever comes and goes. I have been taking anitibiotics roxid 150 for 5 days. now the cough has gone but cold still exist and slightly fever is there.... need to know is this the side effect of the root canal.. and is it serious. ### REPLY: Hi. Thanks for the query. Well, chest congestion, cough and cold is due to viral infection of the respiratory tract. Whereas tooth infection is bacterial in nature. So it can be con-incidental that you have got cold and chest congestion after root canal treatment, however you might be exposed to someone who is already infected causing infection. Do not worry as the viral infection generally resolves once the virus completes its cycle in human body. As of now you can start with supportive treatment to relieve the symptoms like:-Take a combination of decongestant like Phenylephrine, Bucolic like Aerosol and anti-allergic Levocetrizine and another combination of Acetaminophen and Ibuprofen-Take cough expectorant containing Gueifenesin and cough suppressant containing Dextromethorphan.-Chew a vitamin C pellet daily.-Do steam inhalations.-Avoid spicy and chilled foods.-Sip on warm water throughout the day-Do warm compresses over chest. Hopefully the symptoms will resolve within a week and if it worsens consult a General Physician and get evaluated. Hope this helps. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I already have AS and 4 degenerated disk in my back. I had a cluster of bumps show up on my arm about a month ago and the doctor said it was a Fungal infection. Here lately the last 3 weeks or so I have been very tired like falling a sleep during the day and feeling give out. My throat was hurting a couple of days now my neck is hurting so bad I can t move it. Are any of these symptoms worth going to my doctor? Had a low grade fever a couple of days. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Yes you should visit to the nearby doctors. Fungal infections and feeling dizziness can be a symptom of the nervous system involvement of fungal infections. Fungal infections should be treated with the fluconazole. Completed treatment is necessary. Fungal infections are common in diabetics and in HIV positive persons. So in my advice you should also test this to condition in nearby laboratory. Please maintain good local hygiene where fungal infection occurred. This will help cure the infections at earliest. As you are feeling dizzy avoid the work which requires concentration. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i am 13 years old, and I have been a very healthy girl up until this week. In the past few days I haven t been able to stand up with out getting dizzy. Today at school, I had my head down on my desk and all of a sudden I could feel everything spinning. (but my eyes were closed) Then I tried to listen to my teacher and the noise was all jumbled up. When I ate lunch, I wanted to throw up, but I kept it down. I have stabbing pains in my upper stomach every so often. And every time I exhale, my rib cage seems to feel like it is getting pulled on very harshly. I got up from my seat and I fell and almost passed out, but just barely stayed awake. All my senses went away, but just for a couple seconds. Every time I get up and walk from class to class, my friends have to hold me up so I don t fall again. There is a lot more, but this has been the worst. My family can not afford going to to Hospital or anything. There are way too many other doctor bills from me pulling my Achilles tendon , and then forming tendonitis in it as well. Oh, one more big thing; I haven t been able to talk at all this past week because even saying a few words makes me become out of breath . Help? ### REPLY: Hi, thanks for query, you immediately needs medical attention. You seem to have some problem that needs to be diagnosed. The complaints are many and confusion so physical examination by doctor is must. I can understand your social and financial problem, but it is better to take medical treatment at present, if neglected this can lead to more problems and at that time you will be forced to spend too much. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had a colonoscopy and endoscopy last week and just found out i have h.pylori. I am very anemic and have been for 30yrs. My Dr. wants me to take antibiotics which I have many allergies to and also my sister passed away last year from c-diff. I really do not want to take the meds. Please advise. Clarithromycin 500mg, Omeprazole 20mg, Metronidazole 500mg. Thank you,Marie 53yrs old ### REPLY: Hello. The only effective treatment for h.pylori is called triple therapy (omeprazole + two antibiotics). The most widely used regimen is omeprazole + amoxicillin + azithromycin. In patients allergic to amoxicillin, is replaced by metronidazole. Mentioned antibiotics are not related to c.difficile, even Metronidazole is used to treat infection by c.difficile. I wish you good health.(If the answer has helped you, please indicate 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 have been struggling from a back injury from work for over a year! Just yesterday they did their second MRI & EMG NCV treating! Today I am usually a level 4 never 0 anyways. Out of no-where I went to a level 10? My low back is throbbing but my private area & down my legs and feet I have numbness & shooting pains and tingling only in private area and down legs. My low back flat out hurts??? Should I go to the ER? Incidental note of Bilateral cysts at S1-S2/S2-S3... Not on Doctor at Kaiser would ever discuss the cysts nor show me my MRI onMonitor until my new Doctor and for second opinion. He is not in and I am scared? Why are doctors so uneducated about the truth and reality and that Tarlov s cysts are a RARE DISEASE? ### REPLY: Hi, thanks for the brief history of you. If you have severe pain going to ER is always a good option. Since you have taken an MRI, NCV and EMG one should be able to come to a conclusion close by if any nerve is getting trapped in the area. Since you mentioned even you have bilateral cysts at Sq-S2 and S2-S3 levels it is hard to do instantly anything to get the pain lower. But you should try out a physical therapist where I am wondering why you have been not advised yet. Since the pain is more along with tingling and numbness getting the help from a physical therapist should work for you. The therapist might use therapeutic ultrasound and TENS to help you get ease of pain. Since its invasive and works on pain gate theory as well you should find some relief. I have seen a couple of case and advised the same, the pain level has instantly come to a point where the disability of the functional movement had come to ability of functional movements. I recommend you to look for a physical therapist and seek some help from there. Once the pain levels come down strengthening the core and hip muscles will surely help you. With the grace of God I wish you a speedy recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I am now 21 weeks one day pegnant according to my last period. My last period was may 14th 2014. The issue is im not sure who the father of my child is. I had sex with another man on the 17th of may while I was still on my period. But I had an appointment on the 12th of sept and the fetus was measuring at 17 weeks and one day so that keeps me on track for getting pregnant after my period ended, I always have regular periods on the same date every month. my question is what are the chances that I got pregnant while I was on my period. ### REPLY: Hi welcome to the  If cycle is regular and if sexual intercourse done during period time than pregnancy unlikely as it is safe period for intercourse and no ovulation occurs in that period But if you have issue regarding father of child than it is legal issue and for that confirmation molecular methods should be done like PCR.... Hope your concern solved Take care Consult gynecologist for examination and further discussion regarding 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: Hi. I ve been having intense pain in my tooth . My cheek is swollen, I haven t slept in 2 nights, upset stomach , and I feel weak. I have no insurance at all, as far as dental goes. Debating on going to the ER tomorrow morning, beccause at this point I m in tears I hurt so bad. Is this an abscessed tooth? And if so can they help me until I can find an afordable dentist? Thank you. ### REPLY: Hi, Thanks for asking the query, Pain in the tooth and cheek swelling indicates severe tooth infection and abscess formation. There is spread of infection to the adjoining periodontal tissues leading to periodontal abscess. If not treated in time it may lead to further spread of infection to the adjacent tissues. I would advise you to get a complete clinical evaluation done . Take an x-ray . At home take saline water gargles 3-4 times a day. Use 0.2% of chlorhexidine mouthwash gargles twice daily. Take tab flemiclav625 mg TDS , tab Flagyl 400 mg TDS, tab colonel TDS. Hope this helps out, Regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I got my wisdom teeth extracted about ten days ago and have been trying to rinse with the syringe. The bottom right socket is extremely deep, the entire syringe doesnt fill it. I can see bits of food stuck in there and possibly one large particle that wont dislodge. Im really worried because inside the socket looks almost like barnacles on a ship. What should I do? ### REPLY: Thanks for your query, I have gone through your query. The socket will be open till it get healed completely by formation of a granulation tissue. Nothing to be panic, It's common to have food lodgment. Do thorough rinsing of you mouth soon after eating anything. Even after rinsing your mouth if the debris still remains in the socket consult an oral maxillofacial surgeon or a dentist and get the socket irrigated with saline. Do it on alternative days for a week. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a 3month old daughter that has developed an hemangioma on her her adjacent to her fontanel. I am worried whether it should be removed or left alone. I am also wondering what type of Dr. I should take her to have hemangioma accessed. I have already taken her to one surgeon and he seemed to be very radical in his ways and suggested immediate remove w general anesthesia etc. However, I asked a pathologist (a professor of mine-in dental school) and his suggestion was to leave it and will regress w time. Do you have any suggestions?? ### REPLY: DONOR DO ANYTHING for a small hematoma. Except a cosmetic problem it doesn't cause any problem and MAY NOT reduce on its own. You can do following1) leave it alone till 2 to 3 yrs age2) one can use Steroid cream or inject steroid which will RETRACT the size of hemangioma3Laser treatment can be considered after 4 to 5 years age DONOR WORRY it's just a cosmetic issue and better not touch at 3 months age ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a week (maybe a week in a half) ago I went to my doctor thinking I had bronchitis. (I m asthmatic and get it often) so she gave me biaxin to fight it. Unfortunately the biaxin didn t work and I ended up going to a walk in, due to my doctor being on vacation, and he told me to take my inhalers (pulmacort and the blue one). A few days ago, however; what feels like the back of my right lung started to hurt when I breathed deeply and today during work it hurt even more while I was lifting. Now I can barely lift anything and walking/moving is a chore. Both breathing and lifting hurts. I drive a standard and could barely shift gears on the way home due to the pain ### REPLY: Hi thanks for asking question. You seem to have worsened your asthma attack with viral or bacterial infection that lead to bronchospasm. First if it found severe asthma as breathlessness even with mild exertion take nebulization with levosalbutamol and budesonide res pule. It will relieve bronchospasm to some extent, and you feel better. Then regularly maintain on foretell metered dose inhaler. Take your chest x-ray if consolidation present then antibiotic given. Complete blood examination also done. Eucalyptus with steam inhalation useful. Garlic is good in your case. Onion having anti-inflammatory action so helpful. Wish you good health. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was lifting a chair out of the back of my truck and had my lower back make this popping sensation I felt pop about 2 or 3 times. I am in a pretty good amount of pain now with not being ableto bend forward much at all or lean to the side. Also not able to lift or pickup anything ### REPLY: HiT hank you for asking ChatDoctorI have gone through your query. In your condition an intervertebral disc bulge of lumbosacral spine or a strain/sprain can be suspected. A physical examination with an orthopedic can give clue for that and an X-ray followed by MRI if required can confirm it. For such cases in my patients I advise NSAIDs like Diclofenac muscle relaxants like thiocolchicoside and neurotrophic . I also advise them to have a rest of 4 to 5 days. I send them for physiotherapy along with this. Lumbar supporting belt also will be helpful for some. Hope this may help you. Let me know if you have any further query. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doc well let start from last year, I lost my mom she had a massive heart attack and ever since in and out of work I feel really drained, I thought it would go away but it seems to get worse my symptoms now are I keep getting shortness of breath and nearly fainted twice in work ive had diarehoea a lot of times headaches and over this weekend I literally felt so weak I couldnt move off the sofa, then just after that I started getting the shivers really bad and felt really bad, but to be honest I dont think ive got over the death of my mom at all, we were so close and the death was a big surprise and shock ### REPLY: Hello am sorry about your mothers' death. The symptoms you are having as easy navigability, shortness of breath, fainting episodes, headaches etc. are most likely due to normal grief reaction. But such symptoms are considered normal for about 6 months only, if symptoms persist beyond 6 moths then they may result in development of depression. Somatic symptoms are common in depression. As symptoms are causing dysfunction in your social and personal life I would advise you to consult a Psychiatrist for opinion. 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 extremely bad back pains which is making my arms quite sore too. It s been very hard to get out of bed the last couple of days and the pain is getting so intense that it wakes me up and I can t get back to sleep. It gets worse when I sit upright and it cause loss of feeling in my legs when the pains at its worse. I m 23 years old and it s been this way for three days after I had an accident at work hitting my back. Can any body tell me what the problem may be? ### REPLY: Dear patient It seems you have met with serious accident to your back and your symptoms suggest significant trauma to your back. Back pain even with rest and increases with sitting indicates vertebral trauma and either compression or fracture. Kindly get yourself investigated for radiograph of lumbosacral spine anteroposterior and lateral views. I would also like to advise MRI of spine to rule out disc problem. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 dull pain in the centre of my chest which is worse when i lie down or move about. it also pulsates with my heart beat and when my heart gives a big thud (beat) it hurts more, feel like there is a thump n my throat and chest, i had this about 5 yrs ago and tests came back with nothing. i have had it over 24 hrs now, could it been indigestion ? ### REPLY: Hi, This looks like a gastritis and reflux disease. Still one ECG just to rule out heart disease, if you have any risk factors like elder, smoking, high BP, or cholesterol, then avoid fatty, oily and high calorie diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Eat lots of green leafy vegetables, fruits, fish once or twice a week, and avoid meat. Also, avoid smoking and alcohol if any. You can get prescribed tab Pantoprazole before breakfast once a day for 2 weeks. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello, i was electrocuted january 17 by a 120v generator. I was hospitalized and had muscle damage as a result. I am having heart "flutters" the last few days (periodically), should I get this checked out? My heart was perfectly fine after many tests, could I be experiencing after effects? ### REPLY: Hello, Yes its possible that it could be an after effect. Possibility of cardiac arrhythmias like atrial fibrillation is there. So you need to get it confirmed, for that you'll ECG during you are having symptoms. If ECG could be done during fluttering period then only it will show some abnormalities. Otherwise, you'll need 24 hr holder monitoring. Hope this helps you and get back if you have any doubts. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir,im 29 years, my penis was itching,a white paste like thing was coming,its smells so worst its not sperm,red patches occur,fore skin of penis got cracked,i usually wash my penis with soap twice a day while taking bath,i used itch guard ointment but its not working,i masturbate every day,im virgin,no sex till now to get infections,plz kindly help me and suggest me a good ointment, thank u sir, ### REPLY: Hi welcome to  forum.  It appears that you have blood sugar, means that you may be a diabetic. Or there may be a urinary tract infection. If you have a contact at least once, it may be the gonorrhea.  I advise you to consult a physician for diagnosis and treatment.  Take more of green leafy vegetables, pulses, sprouts, and protein rich foods to have a good resistance against such diseases.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have recently had a stroke and was diagniased with an atrial afib. I was put on warfarin for a week and then taken off it as it was deemed too risky as i also have a history of nose bleeds. Today I have an inr of 1.3. What does this mean? Do i need to see my gp? ### REPLY: Hello, Thanks for using . I have gone through your query. Basically atrial fibrillation needs control of heart rate and anticoagulants. You INR of 1.3 is a bit on lower side as far as your case is concerned.First you must establish cause of nasal bleed. If there is any local cause, it should be tackled by an ENT surgeon. If it was due to prolonged INR due to warfarin You should restart warfarin with a lower dose and maintain INR around 2.0.for heart rate control you may need beta blockers, my best wishes .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My seven year old son has pain around his belly button and right side of abdomen . He has no fever , not throwing up, and no loss of appetite . But his pain number is a 5-6, on a scale of 1-10. It hurts when I press on it, when he moves, or coughs, and he says it hurts a little when he urinates. ### REPLY: Welcome to , Your son symptoms are suggestive of appendicitis but lack of fever/vomiting can create confusion, but appendicitis can sometimes present without fever, so it is better to get it ruled out by a USG and a urine test which will rule out a ureteric colic and thus can give a more precise diagnosis. Anyways the best way is to get him seen by a surgeon as early as possible.  I hope your queries have been answered well. Have a healthy life. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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, we r planning for a child, my period is due from 28th , till now i have not got my periods , i have being using susten 200 vaginally from 18th , last night i checked through pregnncy check whicChatDoctore negative, pls advice, i am 31 yrs old 54 kgs, no medical histroy ### REPLY: Hi I think you should wait for one more week and repeat the test if periods don't come. If test is negative then you will have to take medicines to get your periods after consulting a doctor. You can try some medicines for ovulation and can track your ovulation and try naturally for 6 months. After that you can go for GUI. Just do a thyroid profile and prolactin levels and a semen analysis of your husband. Hope I have answered your question. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my hand is swollen and reddish as i used veet on my hand yesterday it is paining what should i do ### REPLY: Hi! Jovial, Welcome To  forum, It seems you have developed an irritant reaction to MEET. You can use a topical steroid in combination with an antibiotic cream over the lesion. Also take an anti-allergic tablet daily for few days till the lesions subsides completely. If the swelling doesn't go with this then consult a dermatologist who can prescribe you with oral steroids. Regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an abdominoplasty 9 days ago and was feeling quite well up till last night. I have some pain around the right side where drain tubes were and its a bit like a burning sensation. I am swollen just above the incision line right across my stomache and am not sure if it is fluid or not. I just dont feel that well today and my stomache was quite sore when trying to sleep last night. I dont see my surgeon until Monday so just wont to know if I should be concerned Thanks ### REPLY: Hi. Thanks for your query. Noted the history of Abdominoplasty 9 days ago, now have burning pain around the right side where the . There may be a Serbia or mild infection causing the symptoms. Watch if you have fever, nausea or bloating. If no present, nothing much to worry. Take the medicines as advised by your Doctor. If there is any problem you can visit the ER and get checked:Blood for CBC. Ultrasonography to see if there is collection;Aspiration if required and get the dosages of antibiotic and anti-inflammatory medicines till you see your Surgeon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My ferretin level is 252 and my ggt is 350 all other liver function test are currently in normal range. I have never smoked and drink approx. 3 glasses of wine a month sometimes none. Previous liver studies were just slightly elevated. Was taken off of Crestor (5mgm everyother day) two months ago. Aloso often have muscle aches and joint paint and intermittent muscle cramps. Do I need to be concerned? Thank You. ### REPLY: Hi thanks for asking question. Serum ferritin indicate iron storage ... Which is increased in your case.... According to history provided by you here hemochromatosis has to be ruled out.... It can affect liver...so liver enzymes might be increased .... Close follow up of patient needed... If needed liver biopsy could be useful for its diagnosis.....Meanwhile, take law fatty diet with more fruits and green leafy vegetables..... Take care.... .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been extremely exhausted the past two weeks. totally out of my routine. I dont have any cold symptoms but i have a had a tight chest for about a week now and it hurts to breathe in deep just yesterday i woke up with the same feeling in my chest but i have a pain right behind my rib cage on the left side. i am dizzy and nauseas and sometimes feel like whatever i swallow is stuck at the back of my throat ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of HERD (gastroesophageal reflux disease) is more. HERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of burning, nausea, chest pain, chest tightness etc. So better to follow these steps for symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Avoid stress and tension. 4. Take proton pump inhibitor like pantoprazole. 5. Quit smoking and Alcohol if you have these habits. 6. Keep 2-3 pillows under head in the bed to prevent reflux. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 5 year old daughter recently fainted at school after wAtching a diabetes video. This is the third time she has fainted. The first time was after watching her sister get her flu shot, who was screaming and crying, and before that she watched my mom fall and hurt her finger. She remembers everything that happens and comes to quickly. She had an ekg done and everything was well. Today, she kept getting chills randomly and saying her chest hurt but then it would go away. Do you think it s anxiety? What can I do to help her? ### REPLY: Hi, welcome to . I have read your questions in detail, I know that you are very concerned about this. Three episodes of fainting which has also led to injury once could be absence seizure or anxiety episodes. In absence seizure, the child has starring look and child usually falls on ground or sits idle without talking, the child doesn't remember anything about the episode. In my opinion, a EEG and MRI brain should be done to rule out seizure. Till then try to calm the child. I hope this has helped you. Take care. Regards - .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have recently noticed a ridge on the top of my 9 year old daughters head that wasnt there before, she complains that it hurts when she runs ( can feeling it bouncing and hurting). Wondering what it could be.She is otherwise healthy, no colds, sore throat, or fever. ### REPLY: HI, Dear,Thanks for the inquisitive query to .1-I studied your query in depth.2-In my opinion, the ridge on top of your daughters head -indicates -Cranio-syn-ostosis, 3-Please show it to the pediatric doctor and keep a watch on the -Skull Circumferrence-and mental development and school progress of the child under doctors observation.4-Hope this would solve your query and worry about your 9 yr old daughter.5-Wellcome for more queries to me On .6-Thnks once again for your inquisitive query. Have a 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: My husband and I have just had a very bad chest infection which seems to have faded over the last 8-10 days however, we have now botChatDoctore out in small red spots that a very itchy. They came up over the last day or two. I also had some vomiting as the chest infection started which lasted 24 hours. We have both had chicken pox years ago but a work colleagues children had it about 3-4 weeks ago - could we have it? ### REPLY: Hello, Thanks for the query. You both should see your doctor who can confirm if it is Chicken pox or other skin rash problem. Does any of you get sharp pain anywhere ? To answer your question, Chicken pox can happen in anyone witChatDoctorpromised immunity. Also, there might be simultaneous bacterial infection too. Treatment is generally symptomatic but if your doctor confirms it as Chicken pox, he might do some test to find the cause AND he can advise vaccine. Hope you get better soon! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having severe pain in between in shoulder blades radiating to left armpit and down left arm and under left breast.  My chest xrays were not helpful and I am scheduled for a MRI in one week.  The pain is unbearable.  what could be the problem? ### REPLY: Dear friend to diagnose your problem it needs more history from you. By the way, you are planning for the MRI then it will rule out the underlying cause. After that treatment will be more specific. But temporarily you can take analgesic like ibuprofen or for severe pain take combination of diclofenac+paracetamol+chlorzoxazon/serratiopeptidase for pain relief. Hope this answer will be helpful to you. For more queries please don't hesitate to ask. Get well soon dear friend ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 taking carbimazole for a week now and I developed joint pains and right lower quadrant pain,lumbar pain and gum sore which are relieved by an ibuprofen. I was terrible last Friday,then today these symptoms eased out because I stopped the medicine but continue ibuprofen. I still can feel a nagging pain on my right lower abdol but sometimes I get light headed and with chills and paleness. Im thinking not to ignore these because ibuprofen could have just decreased symptoms of pain, but I needed much more attention than that? Is it time to go to e/r or w8 for my gp on Monday. ### REPLY: Hi. Carbimazole is known to cause reactions like you have mentioned. It can affect the bone marrow and cause the reduced production of white cells, which in turn can cause many of the problems you have mentioned. IT is good that you have already stopped Cabimazole. I would advise you to stop Ibuprofen too unless has been advised by your Physician, as this may potentiate the side effects of reaction. I would also advise you to visit the ER immediately, get investigated particularly for hematology in detail, get appropriate treatment started fast. Also needed is an ultrasonography to find the cause of abdominal and lumbar pains. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Diagnosed with NASH 1 1/2 years ago when first diagnosed with Hemochromatosis. Enzyme levels back to normal as is the size of my liver. Current ferritin level is 6. High blood pressure discovered a month ago and dr. has me on 12.5mg of HCTZ a day. Will this caused any damage to my liver? 48 yr. old male 6ft. 263 lbs. ### REPLY: Thanks for posting your concern on ! I appreciate your concern for the high BP and high Ferritin levels. Hy . 5 mg/day) is used to treat mild hypertension, and it seems your BP is well controlled with this dose. HCTZ is unlikely to cause liver damage, however patients with severe liver disease or cirrhosis are very susceptible to thiazide-induced electrolyte disturbances (hypokalemic hypochloremic alkalosis) which can cause hepatic coma. Hemochromatosis is a hereditary disorder in which excess of iron is stored in the tissues of major organs, especially liver, pancreas, heart and testes. Serum ferritin measures the amount of iron stored in the body. For adults, the ideal range is 50-150 NG/ml. Over a period of years, the stored iron can severely damage many organs, leading to organ failure and chronic diseases such as cirrhosis, diabetes and heart failure. Regular removal of blood (phlebotomy) can be done every 8 weeks. Serum ferritin  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 work for the Commonwealth games in Glasgow .. I do house keeping and I used my hands to pick up rubbish from a bin that was in a athletics room!, I had noticed little green and white tubes and empty rapers .. I ain t a 100% sure if I had accidentally prick myself with a needle or not but am 8 weeks pregnant and quite scared that it was a needle or not!, what should I do .. Thanks ### REPLY: Cellophane You for contacting . Whenever you encounter such thing then always wash hand with antiseptic solution immediately. Chances of infection are less if there is a small prick like you had. You need to keep extra precaution now. Always use hand gloves while picking trash. Also do inform your gynecology doctor about this on your next visit. Report to hospital immediately if:> Any unusual symptom appears.> You observe any change in skin color at the site of injury. Hope I have answered your query. If you have any further questions I will be happy to help. If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health & healthy baby!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 doc says I may have MS.  I was on 5 different mess for seizures and movement disorder and got permenent movement disorder called a word with t u r e t t e s  I am on disability.  Been 22 years or so.  When 13 had severe horse accident, coma 3 was then to relearn read write  etc yes I have lots tingling numbness, most the stuff listed on and off. I do have a caregiver live in . Just wonder, neurologists are last I want to see but here I am.  Does any of this make sense 4 ms   ...if I get on treadmill or still bike my body can shut down fast can not move no ability at times . A gym did call once 911 amb. Came and not allowed to be any gym ### REPLY: I read your question carefully, and I understand your concern. The diagnosis of MS is made by symptoms and signs coupled with MRI. Since you don't mention to have had any MRI lately we are left only with the tingling and movement disorder (which is a little unclear). Tingling can be a manifestation of MS but so can it be a manifestation of many brain lesions. In your case given your history with the accident, the coma and subsequent seizures it is to be assumed that a brain lesion has happened due to the accident, and it has left a damaged area which could well justify the symptoms. So to conclude I would consider it far more likely the symptoms to be due to the brain injury rather than you having a whole new neurological condition (frankly what are the chances of that on top of what you already have). In order to completely exclude MS an MRI can be scheduled. I hope to have been of 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: Sir, I am getting or I believe that I am suffering from psychological erectile dysfunction because when I be with a lady I could not get strong erection but when I am doing masturbation, my erection is strong. kindly suggest me or prescribe medicine to get strong erection with the female. ### REPLY: HelloThanks for query. Your problem of Erectile Dysfunction is due to what is called as Performance anxiety. Following measure will help you to boost up your confidence and getting good erection.1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc3)Take anti oxidants like Almonds 5-6 every day.4) Avoid alcohol and smoking. Taking Sildenafil (Viagra)as on demand will help to get good hard sustainable erection and to have enjoyable sex. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 23 weeks pregnant. Last night she experienced intense discomfort in her elbow joint, wrist, and armpit of one arm. It was so uncomfortable she couldn t sleep. No other symptoms but scratchy throat. Any idea what would cause this pain? Would a warm cloth help ease it for her if it happens again. The wrist & elbow pain are better, but the armpit discomfort continues. ### REPLY: Hi. Armpit discomfort could be due to a hormonal fluctuation resulting from pregnancy, as the lymph nodes leading to the breast lie in the armpit region. There is nothing much we can do about that, and I am sure it will subside soon. And yes, you can use a warm pack or compress over the region. As for the scratchy throat, if she develops a fever along with that then please report to her doctor. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son is 4 1/2 years old and complained of itching around his ankles. I noticed a welt like rash on both ankles and a few spots on his torso. Within an hour it has spread to his hands and more areas on his torso. He has had a cough for 2 days and fever for past day. Can you tell me what this might be? ### REPLY: Hi... Thank you for consulting in . Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. 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: SIR MY MOTHER IS HAVING A KNEE PAIN FROM LAST 4 MONTHS ..SHE CANT EVEN WALK PROPERLY !! WE HAVE CONSULTED MANY DOCTORS ,THEY HAVE GIVEN LONG LIST OF MEDICINES BUT NO USE OF THEM !! WHAT TO DO ?? I NEED YOUR HELP ?? SOME DOCTORS SAYS THAT SHE WILL BE FINE AND SOME SAYS THAT THERE WILL BE A OPERATION OF KNEE !! I NEED UR HELP THAT WAHT SHOULD WE DO ?? ### REPLY: Hello, As history directs my thoughts towards the Osteoarthritis of the knee for your Mother.  I can understand the pain is high and there is difficulty in walking. I will help you with some therapy part, and you can try this which should yield good results. Try taking help from a physiotherapist who can help your mother with physiotherapy management of the knee.  The knee treatment includes - a therapeutic ultrasound for reducing the joint inflammation, TENS therapy - for reducing pain, knee braces, exercises - static hamstring, static qua .  With the above-mentioned therapy of knee, your mother should find the change in the overall muscle strength of the lower limbs and will help improve their pain and walking. Hope I have answered your query. Let me know if I can assist you further. Jay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 30 years old. 6 2 200lbs I ve been having chest pains on the left center heart feels like it skips I get kinda dizzy short of breath I m an active man still doing back flips and running with kids and dogs as well as exercising I do smoke half pack a day and drink heavy once a wk my pulse is 107 I sweat like crazy at night ### REPLY: Thanks for your question on . In my opinion you should get done investigation s to rule out cardiac and pulmonary causes. So get done ECG and 2D ECHO to rule out cardiac cause. Get done Chest c ray and PFT (Pulmonary Function Test) to rule out pulmonary causes. Your heart rate is very high. Ideally OT should be less than 90. Smoking and .  And cause cardiac and pulmonary causes. So consult your doctor and discuss these. Please quit smoking 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 yeast infection and bought the monistat 3 day. I was unable to insert the tube due to swelling. Once I pushed the tube in blood squirted out and it was dark red. What caused the blood? I tried the second day to insert and again unable so I did not persue. ### REPLY: Hello, THX to contact us. If I am your treating doctor I would like to advice you that how can you come to know that you have yeast infection in the vagina, have you undergone any test? Because I never heard that yeast infection will cause this much sever infection. It requires visual examination to say something more. I advice you to carry out the grams staining and culture sensitivity from the lesion. Also take the .  If you have anything else to ask please contact me. Than.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor, I am having Autoimmune pancreatitis . I am under treatment now since 2 months. I am taking creaon 0000mg 6 tabs a day and omnacortil 40 mg/ day and got tappered to 5 mg/ day. Now i am going to stop steriod in another 3 days. My recent CT Abdomen shows good improvement in pancreas , gall bladder , bile duct etc. I got my stent also removed from bile duct. I got my eyes affected because of steriod and now I have CSR and lattices in both eyes for which no treatment taken. Dr said they can review after stopping steriod. Is there any chances of AIP relapsing? what is the treatment for me now? ### REPLY: Hi Seaman, CSR, usually has a good prognosis. 90% of cases after with .  For your faster relief, you may be prescribed low dose of Aspirin. Slight impairment of vision, specially night vision and color blindness can persist. If your eye condition do not improve, you may have to undergo laser surgery for the eyes. Relapse of Autoimmune pancreatitis can occur in 20-30% cases, which may require prolonged course of corticosteroid. Chances of relapses are more if there is an involvement of extrahepatic or intrahepatic bile duct. One thing to remember is that in case you have to start again the steroid, your doctor must closely monitor the doses and blood levels of the steroid, because it is directly related to your chances of CIS. Wish you good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 11 yr old son had glandular fever over a yr ago.He was admitted for a wk with having a swollan spleen.After all this time his glands are always sweeling up,often.He has had numerous blood test and his white cell count is always low.He has been complianing of been dizzy,and has just had papitions and difficulty breathing,which wore off after having a warm bath.Is there anything to worry about. ### REPLY: Hello, Thanks for the query to . Forum. Usually glandular fever is not present in humans, but when present have the following symptoms, acute localized supportive infection, pulmonary infection, hence patients feel discomfort in breathing. Septicemia (high fever). Later this acute stage develop into ( turn) chronic as in your child. So symptoms in chronic cases are, Pus in lymph nodes so there is dilatation, fever (low grade), malaise, prostration, dizziness Evidence of B Malta(causative organism) dissemination may include, lymph node enlargement, liver enlargement, SPLEEN enlargement. Liver & spleen abscess. Get relief having warm because of malaise, prostration and chills(mild degree). Ceftazidime, Eminem are the .  Hope I have an answered your question. If further any question I will help. 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 iam 27 yrs old. recently married past 8 months. Doc said I have Poly cysts and prescribed Deviry  10mg to be taken for 5 days twice daily. after 6 weeks of my period. Will that tablet  help me to concieve  . plz suggest me what to do for I want to be preganant ### REPLY: Hi, thanks for writing. Intercourse in and around fertile period helps in getting pregnant. Devilry is a progesterone tablet which helps in getting periods. Until 1 year of unprotected intercourse if you don't conceive, it is called infertility. Get follicular study from day 11 on alternate day till follicle size reaches 20 mm which is the time of ovulation. Timed intercourse during this time helps in pregnancy. Hope I have answered your query. 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: what are the causes of inhomogeneos opacity in lower zone oh both lungs. thirty eight years ago, i had suffered from bronchitis, pneumonia or right lung and pleurisy on left lung. but since then have not suffered lung desease except common colds. a recent chest x-ray showed the above said observation. please advise. ### REPLY: Hello, In homogenous, opacities in both lower lobes of lung is seen with:1. Bilateral lung infection (Pneumonia)2. Pulmonary fibrosis3. Bronchiectesis4. BOOK (bronchiolitis obliterate organizing pneumonia)So, it is better to consult pulmonologist and get done clinical examination and high resolution CT scan (HRCT) for the diagnosis. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Yes! Can you help me? I never had this before but for about six months now I have been coughing up a whole lot of flame and now I have wheezing in my chest. I am now afraid to lay down become every time I do I feel shortness of breath. What is wrong with me? ### REPLY: Respected user, HiT hanks for using .come have evaluated your query thoroughly.* There lies different conditions responsible as - Conditions of lungs as pneumonia, tumor, infection, others - Pleura related - effusion, inflammations - Bronchi alveolar spasms from allergy, noxious substances' inhalation adverse effects of smoking , others - Rib conditions as fracture , inflammations - Cardiac lesions - congestive cardiomyopathy, valvular problems , atherosclerosis of coronary vessels.  - Systemic or pulmonary hypertension.  - Stress or anxiety induced. Hope this clears your query. Welcome for further guidance. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Sir, We would like to know your opinion on below mentioned case of my sister Name: Ms Pooja Jadhav Age:14 She had complaint of Back Pain and doctor advised us for sonography and DTPA RENOGRAM AND SCAN. The Details regarding the reports is as follows: Sonography reports shows that the size of Right Kidney is enlarged: 16 x 7.7 cm, Left Kidney :9.5 x 4.7 cm Echotexture : Gross Hydronephrosis with paper thin cortex for Right Kidney and for left kidney it is normal CMD: Lost in right kidney , Left kidney it is Maintained. Renal Calculi: None (both) Ureter: Undilated (both) Ureteric Calculi: None (both) And DTPA RENOGRAM shows results as follows: QUANTITATIVE DATA: A) Cortical function at 2 min 1. Left Kidney: 65.64% 2. Right Kidney : 34.36% B) Retention at 30 minutes: 1. Left Kidney: 27% 2. Right Kidney: 100% Comments: Left Kidney shows normal perfusion , compensatory cortical function and normal excretion . Right Kidney shows reduced perfusion, residual cortical function and is obstructive in nature. We request you to please go through the details provided and advised us suitably. Please let us know if there is any medicine which can cure this problem also any alternative way to surgery. Hope to hear positive reply soon from you end. You may contact us on +91 0000 and +91 0000. With regards, Anjali Misal Mumbai ### REPLY: Hello, You mention the sister has symptoms of back pain. The ultrasonogram has shown that the right kidney is grossly enlarged (normal 9-11 cm, but 16 cm in her case). The DTPA genogram shows an obstructed .  In a symptomatic patient it is always better to go for surgical treatment. Unfortunately there is no medical treatment for this condition. It can be explained in a simple mechanical example where in the out flow pipeline is blocked and there is enlarged kidney as a result of the pressure built up. If you can remove the blockade then it will help at this stage especially because the relative function of the kidney despite being HY ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor,I am 28 years old, i got marrried 5 months back. Recently i have been diagnosed with tb and also my periods are not regular, it come only for 1 day with very less bleeding. Can you pls guide me how fertile am I and when should we plan a baby?Regards - Parminder ### REPLY: Hello Par minder, Since you have been diagnosed with TB, first job is to complete the Anti-TB .  If you have been diagnosed with TB in lungs, damage to uterus is not very significant. But can't always predict. Extrapulmonary TB - can damage Uterus. Your reduced flow may be due to the stress of heavy infection & may be normal once cleared. TB in uterus usually affects inner lining, reducing the thickness, blood supply. Ovaries are spared. As soon as ATT is over, meet an infertility specialist & plan a pregnancy. If the inner lining of uterus is damaged, it is irreversible. You can get pregnant only by IVF- Surrogate the best ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HEllo Dr. my name is Muneer. I consulted so many dermatologists but in vain. Some say my pigmentation is due to excessive exposure to sun. Some say they are ephilids. I have read about the freckles and ephilids. there in duration increases in summer and decreases in winter, but i feel no change in summer as well as winter. please provide me the proper advice and remedy. ### REPLY: Hello, Thanks for writing your query to us. Freckles are clusters of concentrated melanin which are often visible in fair skin people. It is genetic in origin. Formation of freckles is triggered by sunlight. So it is not related to weather. It is basically the exposure to sunlight that means exposure to UV B light that activates the melanocytes to increase melanin production which makes freckles darker & make them more visible. 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: Dear Sir I am 28 years old and do not able to masturbate. Whenever i try to masturbate , i do not make it to the end & leave inbetween. I usually have a night fall in 10-12 days. I want to know that is it curable & also how much time will it take to completely get normal ?? So , plz. help me out as i am getting married this year. Regards Rajiv Kapoor ### REPLY: Hello, The need for your night fall is because you are unable to ejaculate while masturbation. When you masturbate, semen and sperm is produced. You are not ejaculating, so the semen is still present inside your body. Some may be absorbed by body, but the rest come out through night fall. It is common and nothing to worry. Therefore, I suggest consulting a psychologist for counseling. Take care. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been diagnosed with an enlarged aorta (also have high blood pressure and high cholesterol). I have read about supplements of vitamin D and omega 3 but see very different dosages suggested. How much per day is recommended of each for someone with my condition? ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion. You should know that cholesterol target levels depends on some factors like your age and other associated rich factors like hypertension, diabetes, smoking and hereditary history of high cholesterol levels. Normal cholesterol level should be below 180 mg / DL and for LDL col below130 mg / DL in normal people. If you have tried a dietary modification and didn't have good results than its necessary to start medical treatment.Omega-3 are supplements that helps but the best anti lipid class are statins like atorvastatin, rosuvastatin, simvastatin etc. For aortic dilatation its necessary to know its dimension and valvular situation. If there is a slight dilatation than you just need to control your blood pressure rigorously and make regular cardiac echo. If the dilatation is sever, then it might need surgery. Hope I was helpful. Best regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just found a lump in my neck. I been getting pain from my ear down to my shoulder and now when I lift my arm, a vein pops up and it as a lump on it. Its sort of round and sits on the vein. Im 48, 5ft 1 and weigh between 69 & 71 kilo. I been getting headache for about 6 weeks or longer. Very tired and weak sometimes I have a sore throat and a runny nose, like I got a allergy. Sometimes when I get up to do something I start sweating. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have sore throat, runny nose pain in ear, headache and lump in neck. All can be seen in upper respiratory tract infection. Your lump may be enlarged lymph node due to reactive hyperplasia of lymph node due to infection. You should take a course of antibiotics like azithromycin or levofloxacin. For runny nose and headache you can take .  These all are prescription based medicine so consult your doctor and take treatment accordingly. If lump doesn't respond to treatment then biopsy diagnosis is advisable. Hope I have answered your question, if you have any doubts then contact me at 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 a problem and its about the increase of size of the prostate gland. It is 38mm x 50mm x 38mm or 38 g in size. According to the Abdomenal Ultrasound I had the "prevoid urine volume" is 550 ml and "postvoid urine volume" is 150 ml.Please help out. Is there any way that the size can be reduced or I will have to go for surgery..? What are the health risks related to this problem? ### REPLY: Hello, You can be prescribed tamsulosin medicine to relieve urinary symptoms due to prostate enlargement. Meanwhile, you have to investigate with PSA estimation in serum as well for further work up. If PSA fall within range than you can start finasteride as well for reducing prostate size. If medicine working than no need for surgery. I suggest you consult urologist for detailed evaluation. 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: Im a diabetic whom seem to always have a yeast infection. But for a year now Ive been wiping away brown, spec, like particles. All my doctors are saying this is part of the yeast. But what will it take to make this go away. All the other symptoms of the yeast are cured but the brown particles. One of my doctors thought it may have been skin. But I know better. This is not skin falling from my privacy when I wipe myself. Can someone ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. No it will not look like yeast infection. Yeast infection never causes brown discharge. It causes curry white discharge. Skin can be brown. So it is either the skin falling down or it is hemorrhage which is getting brown. I advise you to do Grams staining from the discharge if it is yeast than the report will say Grams positive yeast cells is seen. You can than take the treatment accordingly. I advise you to maintain good hygiene as it is equally important in preventing the infection. I will be happy to answer your further concern on bit.ly/ . Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have pain in my testicles with redness, and a feeling of tightness, and occasionally burning and tenderness in the tip of the penis. This happened once before about six months ago but went away on its own. This may be unrelated, but I also experience tingling and slightly chapped lips both times this occured. I have been to the clinic twice for urine tests to treat a bladder infection and also std tests, came back negative so I don`t know what to do next. ### REPLY: Hello need proper clinical examination and routine investigations. Investigations include routine hologram, random blood sugar, ultrasound and color Doppler of scrotum, urine RE/ME. Your symptoms may be due to many causes like epididymo-orchitis, UTI etc. Ultrasound of scrotum is important due to redness and tightness. It can assess many conditions in testis. Proper treatment depend upon findings. You may need to take antibiotics. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, my son 2 and half years old weight 12 kg was suffering from fever since last 2-3 days... crocin was not affecting much thus our doctor replaced the same with 6ml combiflam every 4-6hrs... now fever has subside but he has developed some skin rashes all over body. please advise ### REPLY: Hello. Thanks for writing to us at ChatDoctorRash that has appeared after the fever has subsided could be either a" . Anthem Suit, caused by Human Herpes Virus type 6 (HHV Type 6), classically presents with rash that makes its appearance, the day after fever subsides. Fever is high grade. The rash in Anthem suit subsides in another 2 -3 days, without any complications. If I was the treating doctor I would have asked you to apply a topical soothing lotion e.g. calamine lotion, twice daily. You may add an OTC oral antihistamine e.g. cetirizine spy once daily. 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 need to find closest psychiatrist to florence, wi who accepts humana medicare and new patients.  I mostly need medication management as I am on several medications for severe panic disorder, depression and PTSD  Have seen same psychiatrist for 17 years who found a perfect combination of medications but move from colorado. ### REPLY: HI, thanks for using  You can consider asking your previous psychiatrist for a referral. He or she may know of another doctor in your area that will be able to treat you. If this is not an option then you can use one of the web based doctor directories to locate a doctor in your area. This would include sites such as WebMD physician directory, findable, findadoctor, Healthgrades. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi! My daughter s been prescribed a 5ml does of amoxicillin, and I gave her some. I left for a little while, and my son forgot and gave her another dose. She is six years old. Is this seriously dangerous as a one off? I have her a glass of water afterwards to maybe dilute the effects. ### REPLY: Hello, But let me tell you that there is nothing to worry as 5 ml Amoxicillin for a six-year kid is lower than normal dose so if she has been given 10 ml at a time, it's okay and nothing serious will happen, I assure you. But, yes you have to follow the dose advised by the doctor, so please take care and give her the dose prescribed by her doctor. Anyway, don't worry she will be fine. 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 11 year old son has woken up violently vomiting 4 of the past 5 nights.  He does not have a fever nor is he sick acting or feeling.  He wakes up and comes down stairs in a panic and vomits.  I have read online it could be some form of epilepsy.  Any suggestions! ### REPLY: Welcome to the ChatDoctorI have gone through your question and understand your concern. The symptoms can occur due to gastritis associated with overnight fasting, or it may be a form of juvenile myoclonic epilepsy. The hallmark characteristics of juvenile myoclonic epilepsy are the presence of myoclonic jerks that occur on awakening from sleep either in the morning or from a nap. They are typically described as shock-like, irregular and arrhythmic movements of both arms. Sometimes these movements are restricted only to the fingers making the patient or individual look clumsy or prone to .  They are precipitated by alcohol intake, stress and sleep deprivation. If you feel that the episodes are associated with above-mentioned symptoms, then an electroencephalogram (EEG) will be useful to detect any occult epilepsy. Else, you may start antacids for him to relieve gastric acidity which might be the cause of these episodes of vomiting. Hopefully this will help you. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have toenail fungus and have heard that treatment with pills can damage your liver. I won t take anything that has that kind of serious side effect. But in looking up - the 5 best toenail fungus treatments website Only one of those was noted to have liver damage problems. The others said no side effects eg Zetaclear which is both a topical liquid and an oral spray. can you shed any light on this? What is the likelihood of Liver damage from toenail fungus treatments? Do all treatments have that possibility?? Thanks very much, Jim ### REPLY: Hi, Thanks for writing in to . I understand your problem and will try my best to help you out. Zetaclear is a homeopatChatDoctoredication consisting of zeta clear oral spray-arsenic and sulfur and heavy metals and lotion contains various oils. The safety of heavy metals is an issue of concern. I suggest kindly consult a dermatologist. They shall first diagnose the disease by taking scrapings from the toe to identify the fungus and then prescribe oral medications like terminating tablets for six to 12 weeks for best results along with medicated nail enamel protectors containing ciclopirox. Hope this answered your query. Get well soon. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: So yesterday every time I would breathe in or move it would hurt right under my sternum,and today it was not so bad, but today I was just sitting and if felt like someone hit me under the collarbone and it made my whole body jruked and it only hurt for a second. So what is wrong and do I need to go see a doctor? ### REPLY: Hi, Dear,Thanks for your query to . Dear I read your query and reviewed it with context to your query facts. I understood your health concerns and feel Concerned about them. Based on the facts of your query, you seem to suffer from-Acute MI(Myocardial infarct)? Hepatitis ? Pancreatitis? Acute Duodenitis. These possibilities need to be kept in mind besides other which cause similar complaints under the sternum. Pre-cordial Catch Syn .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have just turned 50 ..8 days ago. I noticed when brushing my teeth a black spot about the size of a normal button. Maybe a bit smaller. It is black in color and there is no swelllling or pain. Just appeared just like that. I do not drink or smoke and workout daily. Try to maintain a healthy diet . However i have this annoying cough lately. I am scheduled to see my dentist on the 28th aug. I am very nervous about this spot which is located right near my back molar on the roof of my moth. Very dark in color...black even. Please tell me this is not cancerous. ### REPLY: Hallowelcome to ChatDoctorThanks for the concern.It's nice to read that you are leading a quite healthy lifestyle. Sir we usually see this kind of patches in associated with long term tobacco use, can be chewable/smoking.as you are a non-smoker don't worry. It can be melanin pigmentation or some kind of metallic reaction patch, which can be diagnosed only after seeing it clinically. So it's better to consult your dentist for the opinion and treatment. 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 between 15 and 16 weeks pregnant and went to the ER for intermediate chest pains and tightness. The d-dimer blood test came back positive, slightly elevated. I did not want to undergo a CT scan with contrast but the doctor urged me to get it done to rule out a PE. We argued for awhile before I consented due to the risk of a blood clot In the lung. He assured me the baby would be fine and that the exposure to radiation is about the same as a cross country flight. He also stated the contrast does not pass the placenta. Research online has lead me to panic....I cannot verify his statements. The CT scan revealed that I do not have a clot in the lung. Can you please shed some light on this? Thank you. ### REPLY: Hi, CT scan of chest is not in the area of pregnant uterus to cause direct harm by the rays and the contrast does not cross the placenta. There is a very minimal 1/185000 chance of increase risk of cancer to the child, which I feel is very small compared to the need of the CT. As when we suspect pulmonary embolism in pregnancy a proper diagnosis by CT could be life-saving for mother and fetus. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi have been twice to my local Dr. I have been ill since February with viral illness also he called it a viral lung infection. Now I am experiencing sporadic low grade fever that is accompanied by upper to middle aches and soreness in my back. Whenever I experience the back symptoms a fever follows. I am experiencing the sweats, and also am extremely tired and sleep at least 10-11 hours a day. Is there any recommendation you can give me to get rid of this once and for all. Dr. did prescribe z-pac not much of a help, but did somewhat elevate symptoms. Thank you for any advice. Debra ### REPLY: Hello dear, thanks for your question on . I can understand your situation and problem. In my opinion, we should first rule of bronchitis In your case because recurrent viral infection can cause post infectious bronchitis. So better to consult pulmonologist and get done1. Clinical examination of respiratory system. 2. PUT (pulmonary function test).PFT will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need inhaled bronchodilators and antihistamine .  Also get done adult respiratory vaccination with influenza vaccine to prevent recurrent viral infection. ### END