Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 what are symtoms of a problem with a ivc my husband had one placed in lower belly area on 19th of dec. to help with blood clots in both legs that formed while in hospital from brain injury , he has been home 1 week and started to complain of a funny pain in lower belly , they did not tell me what signs to look for if something happened to the ivc he seems to have a small area in his lower belly that feels like a small round ball . im not sure if i should take to er or just watch to see ? ### REPLY: Hi welcome to  forum.  Thanks for choosing . Forum.  Your husband got an I.V.C filter fitted in inferior venacava to prevent thrombus from his legs to enter into the heart, to prevent any thrombi embolism.  Now he is having funny pain lower belly. That feels like a small round ball.  There are so many side effects some common are 1. Fracture of IOC, or perforation into duodenum.  Now it appears that none of these is the case. It may be the thrombus lodged in the IOC and causing obstruction to the flow of blood.Don't worry it could be a psychological feeling also.  What ever may be the cause any abnormal feeling should be reported to the concerned doctor. So immediately report to your doctor about this.  Wishing for a quick and complete remission from the complaint.  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 am taking Akt4 ftom 1 month.....since then my hair fall has incresed tremendously.....every time I comb or wash my hair a thick bunch of hair vomes out even on touching....in a month it has become 1/5.....I ALSO TAKE ELTROXIN 100 FROM 7 YRS...I AM 32 YRS OLD... ### REPLY: Hello, You seem to have Halogen Effluvium. A systemic illness like tuberculosis is a common cause of increased hair shedding due to shifting in hair growth cycle from growing phase(managed) to shedding phase (halogen).  Appropriate treatment with anti-tuberculosis medications would help by restoring this shift as tuberculosis resolves. I suggest you to also take an oral biotin supplement e.g. tab Reviles for a few months. Hope I have answered your query. Let me know if I can assist you further. Take care . , Dermatologist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a mole chkd out 3 wks ago & the doctor wants to remove it but he told me not to worry but I m worried sick I m 16 wks pregnant and I lost 3 lbs since they told me this. I m worried that it s something that won t beable to get cured! Also last wk i went to the dr for a groin lymph node that seemed swollen and she told me that it was bc i shave there and not to worry... but again I am! ### REPLY: Hello! I can totally understand how it feels to find something not normal when you're pregnant, especially knowing that now your baby is dependent on you too. Please donor worry and take care of your health and diet. Both the mole and the lymph node in the groin can very well be explained simply. The mole may have shown some minor change in size or color (which may rarely happen during pregnancy); hence your dermatologist wants to get it removed and examined, but if he is not insisting on it to get it done immediately, I'm sure it is not something very serious and urgent. As regards the groin lymph node, any minor trauma to lower limb including a small bump or a scratch or a small boil may make it large enough to be felt. If your doctor has found no other specific focus of infection on examination, we can safely wait and watch; most likely it will regress on its own in a couple of weeks. Wishing you a happy and worry-free pregnancy. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 1 of my very close has the following problem. i will explain as far he has told me. spines c5,c6 to c7 or c8 has been detected problem. Doctor said that an disc has been moved. more over the doctor has said that go for physiotheraphy and at the same time continue with some medicine he has prescribed mean time let us ask an neuro specialist advice for nerves problem. could u explain me what his actual problem is ### REPLY: Tithe spine is the bone in mid-line of back.  It is not single bone - many pieces stacked on each other.  In between pieces, there is disc. If disc becomes weak, bone may slip.  The spinal cord is inside the spine. Nerves go out between the pieces. So slip may press the cord or the nerve.  The nerve may become weak. Pressure on cord can cause paralysis. So you have to see nerve specialist - to prevent or treat. 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! I dont know if this is neccessarily a health question, but I am singing a solo for my high school choir performance this sunday, and at least 500 people will be there. Although I have done this many times before, I have never done it in front of this many people, and I get extremely shaky, my breathing becomes shallow and I get horrible stomach butterflies, which can really affect my singing in a negative way. Is there any beverage or food that I could take before my performance that would force me to not be shaky or have butterflies? ### REPLY: Hey dear not to worry about your performance it will be the best of your life. There is no such beverage or food that can increase your confidence unless and until you build it up in your own mind. Your own mind is the best solution for the problem. First you think as if you are singing in a lonely space with full of greenery everywhere & nobody other than birds & trees to hear you. Once you will pick up the grip & people front of you will start to respond you in positive manner you will automatically gain the confidence.Don't think that you are short of breath you are the best. Else you can have a proper psychological counselling session. One more thing you can do is you can just have fresh lime water just 30 minutes before your performance & you won't face any problem. (placebo effect) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 severe burining pain on my right abdomen which spreads upwards and also at the right back area. when i went to see the doctor i was told to do urine test ant blood test. after the test it was found out that i had pus in my urine ++++++, the test for syphlis was also reactive but a have never had something like sores or any other syptoms of primary and secondary syphlis. what is the relationship between pus cells in the urine, pain at my right side and syphlis. ### REPLY: Hi. Thanks for your query and an elucidated history. The relationship between the pus cells, pain on the right side of abdomen which spreads upwards and also at the right back and syphilis.First, the presence of so many pus cells in the urine with the symptoms you have indicates that you are suffering from Pyelonephritis of the right Kidney. Meaning there is infection of the Kidney with an active infection producing pus. This is the reason you are getting the pain spreading up on the right side of abdomen and back. You should undergo further tests : First you have to send the sample of Urine for culture and sensitivity before starting the antibiotic therapy to get appropriate results. Blood for Raised WBC, sugar, and blood culture and sensitivity. Ultrasonography. Get admitted. Intravenous fluids and antibiotics. Repeat the test for Syphilis, It may be negative. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was diagonose with hemochromatosis. He is 24yrs old. We had a blood test done and it was at 430. What is your recommendation on what he needs to do? We have cut back on his Red meat intake and no shellfish e.g. (beef, lamp, and clams). He is also starting to work out 2-3times a week. Is there anything else? and what is the cure for this? ### REPLY: Hi, Welcome to  ! The information provided is inadequate. I presume that the number 430 indicates his serum ferritin level. You have not mentioned his transferring saturation and his liver function test report.Also, whether genetic testing has been done. If genetic testing has been done and more in favor of hemochromotosis and if his liver enzymes are normal, then therapeutic phlebotomy should be done (a form of treatment where blood is let out). If the liver enzymes are high a liver biopsy has to be done for further evaluation to assess the damage to liver. The treatment essentially consists of routine therapeutic phlebotomy and if end stage liver disease has developed, then liver transplantation should be done. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 of 27 years age is having left hip joint pain and the MRI suggest fluid presence. blood test of TB gold indicates positive and the reading is .8 instead of .3,many blood test are done related and their result is normal except ESR which is 28 and CRP QUANTITATIVE SERUM  test show 17.3 .Chest x-ray is clear but she is advised to go for CT scan for chest. Confused and whom to consult for correct diognestic for start of TB treatment. pl advise.ibrao ### REPLY: Thanks for your question on . I can understand your concern. Your daughter is having septic arthritis of hip joint with collection of fluid (synovial effusion). Most common cause for this is tuberculosis. Her TB gold test is also positive with high CRP (C Reactive Protein) and ESR (erythrocyte sedimentation rate). All these favor TB more. But confirmation should be done by aspiration of synovial fluid from hip joint and send it for ADA (adenosine Deaminate) level. ADA is marker of tb infection fluid. So if ADA of fluid is also high, better to start anti TB .  So consult orthopedic doctor and discuss synovial fluid aspiration. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sister is experiencing seveere head ached and back pain. Last night she was in the energency room all day with the doctors giving her IV s because along wuth the head aches she was vomiting and experiencing diarhhea. She is suppose to have a spinal tap done on Thursday because of the swelling of her ocular nerve. I am concerned about her constant headaches and the fact that the doctors are looking at the spinal fluid from the test. The MRI of her brain showed no tumors and the CAT scan or what ever est they did today showed no irregularities of her heart since her heart rate was elevated today. Could my sister be experiencing early signs of spinal menegitis and if the doctors are doing a spinal tap want they be looking for bacteria in the fluid. More importantly shouldn t they place a rush on this test because I know spinal menegitis can be lethal and if gone untreated a patient could succumb with in a 24 hour spand of time. ### REPLY: One of the most worrisome differential diagnosis of headache with fever is meningitis. You did not mention fever, but if she has fever or any signs of infection in her blood analysis (leukocytosis, high CRP) and there is no other origin found (normal chest X-ray, normal urinalysis) a spinal tap is definitely indicated to rule our meningitis or encephalitis. To a .  The tap can be deferred for a few hours, if that is not the case. Headache is also a common nonspecific symptom with accompanies a GI-infection, which does seem more likely from what you told me. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 m Rajiv from Digboi age 25 i have stone problem for the past 1 years at first i have 3 stones so i under went doctor advice and they treated with kmac syrup and cystone table for 2 months then later i get cured . Before 3 months i scanned in that they told me now in that 3 stones 2 were gone away and now 2 were still present in right side of the kidney .But from last month onwards i feel pinching in the right side of my stomach. pls give me some suggestion . ### REPLY: helloThanks for query. Based on your statement it seems that you have two stones in your Rt kidney. You have not mentioned size of the stones. If the stones are smaller than 8 mm and non obstructing in nature you can expect them to pass out through urine spontaneously. Following measures will help to pass them out 1) . This helps to dilate the ureter and there by help to move the stone down without pain 3) Take Tab  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was c section in jan 2012 after that i have problem in my stitches my GP said you have incisional  hernia.my baby is very small how long i leave this hernia without surgery . some time i feel pain at that place i have gas problem also plz sir give me suggestion what can i do please. ### REPLY: Hi, If I were your treating Doctor for this case of an incisional hernia, I would come up with following notes:1. Avoid gaining weight and over- .  Take caution not to get infected or frictions in the area3. Take some abdominal band / strap in the region so that the hernia does not enlarge!4. Avoid straining / some abdominal movements (consult physiotherapist for demonstration!)  And do other muscle strengthening exercises5. Do follow the swelling preferably with serial USG or by noting its size! Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. 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: On and off for the last couple of months, around my ankle feels bruised. This is not the ankle itself and there is not an actual bruise. Location is above the inside ankle and about an inch across the foot. I can feel this with palpation and upon rotation of foot. ### REPLY: Welcome to  I have gone through your query and understand your concern. It may be due to infection. Treatment of it is analgesic such as ibuprofen and antibiotics. You are advised to consult Orthopedic for it. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you. Wishing you a good health. 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, may I answer your health queries right now ?  Please type your query here...Im getting tugging cramping feelings in my lower back and abdomen. Felt it in my vagina also. Started bleeding today but for a month I thought I was pregnant because when I suck my stomach in its uncomforatable. Like its got something in it. What is this? ### REPLY: Bellflower abdominal pain may be due to May cause like pelvic pathology, genito-urinary causes, colitis etc. It is important to examine uterus and adnexa. You need clinical correlation and investigations like routine hologram, random blood sugar, liver function test, renal function test, urine RE/ME and ultrasound of abdomen. Ultrasound of abdomen can exclude many possibilities. Proper treatment depend upon findings. 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: I have been experiencing chest pain in the center of my chest that runs from the front to my back. I am a female in my mid 50s moderately active and 10-12 lbs overweight. These pains have occurred 3 times in the last week and generally have gone away in under 5 minutes. Tonights pain is lasting longer. The pain occurs after eating. Is this something that is serious? I do not feel faint or nauseous. ### REPLY: Thanks for your question on . I can understand your concern. Central chest pain after eating is commonly seen with gastritis. So follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. Avoid junk food. 2. Avoid large meals, instead take frequent small meals.3. Take pantoprazole tablet on empty stomach twice daily.4. Lose weight. Quit smoking and alcohol if you have these habits.5. Go for walking after meals.Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: ALLERGY - Respiratory . Hello, my uncle (65 yrs) has been having sinusitis for the past 30 years. About 6 months ago, he had a new consisting with a bit of cough + phlegm building on his throat . So far, the meds that my uncle was prescribed until now wereAerius / Telfast / Clarinese / Xyzal. Recently, he was given ampules for own injections (daily) just in case his allergy got worse. The doctor that prescribed didn t want to let us know the meds ingredients. So far, after getting the injections, my uncle s allergy was getting better. But we re curious WHY the doctor didn t want tell us about the meds. Our question, is there such thing as INJECTION medicine intended for allergy purpose? Also.. recently, my uncle was prescribed with another meds -- Singulair, on top of those meds above + the injection meds. Please advise. ### REPLY: Hi welcome to . Yes there is an emergency injection that can be taken subcutaneously in an emergency and is sometimes handed over to patients for use in an emergency. Rest of your medications are for asthma and allergy. His doctor has probably not told him details of the injection because it may unnecessarily create anxiety if he reads about it. I am sure his doctor would have told him how to use the injection and what to expect. If he is a specialist, I am sure he knows what he is doing, and you must trust him. 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 ve been experiencing extreme pain in the tailbone area. I have swelling at the top of the butt crack, sort of in an upside down u-shape, that is extremely tender and warm to the touch. I ve tried icing it but doesnt help. I have bruised my tailbone before but this pain is much more excruciating, occuring even when there is no pressure on the area (i.e. Standing, laying on stomach). I am a young male and really want to find a way to cure this without seeing a doctor because i dont have insurance. Is there any way i can? ### REPLY: Tail bone fracture takes times to heal. But here do you have taken x-rays? And checked that it is tail bone fracture only. If yes then all right. If not then take an x-ray and get it checked with orthopedic. Since you are telling you have pain even when you sleep on your stomach I think you have also injured your lower back. So a specialist consultation is must. Here I must suggest thinking on early rehabilitation then the money part because the more you delay. Your recovery time will also be delay and so that there will be a loss of effective working hours for you. You can also use the ring fusion comes like tube with hollow from center so that when you sit on it. It will not give pressure on your tail bone. I must suggest based on the injury there is physiotherapy treatment is also available so visit once and check on treatment therapy with exercise program for your problematize care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor,I am 26 years old Hyderabad based. On July 14th, I got my periods after 1 & half months, induced by 20 tablets of Regestrone tablet, advised by my doctor. I got all my hormonal blood test reports done. They were in normal range. Then I was advised FSH, my size was small. I was given tablets Devisy and Fertyl. In august month scan, first day egg was small, then they grew, then I was given Lupride Injection, it got better, then Pubergen 10000 then again Lupride, though my eggs size was good, it got released too. I was advised to match with husband. I am currently on Duphaston for 10 days and hope & wait that I conceived. What I do NOT understand is that are these medicines absolutely normal/essential? As we have not been really trying for long, hardly once or twice, we have had unsafe sex, no record/consideration of cycle etc. So why I am under Infertility medication, without a confirmed infertility (as per internet information  about these meds)? It is really scary at times, please help. ### REPLY: Hi, Thanks for writing to . I personally advice my patients to try minimum for 1 year to conceive only if she has 28 days regular menstrual cycle with normal 3 to 5 days bleeding. After that I investigate. In your case since you need to induce your menstrual cycles there could be problem in ovulation. I wish you conceive this time. If you couldn't then I advise to get a follicular study. This gives information about your ovulation pattern and time. If you are ovulating normally then no need to take all these hormones and try for 6 months. If you are not ovulating normally then you should take these hormones. All hormones which you are taking have there side effects like weakness, leg pain etc. But if you get severe side effect like abdomen distension or breathlessness you should inform your doctor and stop medication. But these side effects are rare, and it is safe to take them. Hope I have been helpfulRegards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor i am 67 years old for the last week i have started sudden pain on my lower right back, which moves to my testicle (right one) i have done the ultrasound for any kidney problem, but its clear, i also done Urine RE and blood tests all are clear, with the pain i have also noticed constipation than i have eaten medicen for costipation relief and when it went off my pain also went off. after 2 days now it again started my lower back right side and than some times in my testicle and some time lower abdomen ### REPLY: HI Well come to ChatDoctorI really appreciate your concern, the most common case of lower back pain which radiates to testes would be renal stone, if this is not being detected in ultrasonography then better to get done the plain x-ray of kidney ureter and bladder, till then pain can be managed with "Tab Diclofenac 50 mg sustain release once in day" Tab Acetaminophen with Dicyclomine" three times in day, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 25 yrs old female. I had delivered a child 6 months ago and one month before delivery I had lost my job. The treatment at home is worst , My Mother In Law is creating problem day by day , even relation with my husband is ruining. She is giving a mental torture by taunting and saying ill words for my Late parents who are no more in this world. Also she abuses my sisters who are more than parents for me. She speaks ill about my character with others on phone and indirectly speaks ill and curses me. I am so much fed up that I feel to kill her or kill myself. Tell me what to do. She is not the kind of person to speak or discuss with as she is the worst person I have seen on earth I have tried all the means to convince her but she is never satisfied and I am getting mentally disturbed. Help me out. ### REPLY: Dear Friend, Welcome to  Forum.  Most of the mother-in-law - Daughter in law relations are somewhat like this.  It is because both of them are possessive. Mother-in-law possessive about her son and Daughter in law about her husband. Hence, there is a conflict.  These things have to be dealt very diplomatically.  Contact me for more information or guidance Wish you Good Reproductive & Sexual Health With Warm  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 would like to start taking saw palmetto to help me ease my prostate problems but I am already taking warfarin & I understand it may clash. Just wondered, is it simply just not advisable to take saw palmetto whilst on warfarin because it is dangerous, or could I take it as long as I have my INR regularly checked? ### REPLY: Hi, It may be taken with close monitoring of INR. Although there is no documented evidence of any harmful interactions between the herb saw palmetto and warfarin however if you wish to take the herb then INR should be monitored, and it should be kept within the normal range. If you experience any bruising, bleeding from the nose or in the urine you must stop taking the herb and inform your doctor. 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 am a hospice nurse. I currently am treating a resident with end stage ETOH liver disease he has drank 25 oz of Vodka daily for thirty years. Recently he has lost consciousness twice , some SOB, N& V, he is hpotensive. H was just tapped two days ago, withdrawing 5 liters. Are his bouts of syncope caused by ETOH? ### REPLY: Hi thanks for asking question. This patient can have hepatic encephalopathy. Measure his ammonia level. Maintain his airway. If needed intubation done. For providing nutrition nasogastric tube intubation done. For reducing ammonia production Aureomycin or rifaximine like antibiotic or lactulose needed. Diuretic can be given to decrease swelling.TIPS or liver transplantation might be needed after consulting doctor. 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: hey friends i am a 18 years old girl pls tell me how to remove hairs from my private parts? is their any product for that? pls tell somthing affordable?? ### REPLY: Hi...dear Havana., Thanks for choosing ., Dont remove You’re hairs on genital area..., Bcoz during shaving, it will cut follicles of Hair buds (More.,prominent in genital regions...) produce irritation and infection., So hairs should be trim with trimmer only..., ok., If coming to Hair removal side...any cream will give irritation ..., and produce IRRITANT DERMATITIS., So don't use those creams., Keep that part always . . Clotrimazole)., and hygienic ok...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: Im a 59 year old female who two-three times a year experiences allergic reactions for no apparent reasons.  They have occurred while sleeping, walking in either cold or warm conditions, or just sitting.   My doctor has claimed I have a conditional known as a heat induced anaphylactic reaction.  So far I have not experienced difficulty breathing during a reaction, but my body becomes covered with hives and my face will swell.  Any insight would be much appreciated. ### REPLY: Hi, Welcome to health care magic, There can be plenty of causes for allergic hives or urticaria like . Generally urticaria disappears after few minutes without any treatment if it persists then you may require further treatment with antihistamines like cetirizine or steroids and mast cell stabilizers. So, if you are suffering from this then first thing you don't have to worry. In the majority of cases, It subsides by itself, or you may take antihistamines like Ben ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I recently noticed a knot on my forehead that was not there before. It s been there for about 2 days and is about the size of an egg in width and sticks out about half an inch. It hurts when you put pressure on it but has no discoloration. I don t remember hitting my head at all. Please help. ### REPLY: Hello, thank you for your question. As I understand you have grown a lump for 2 day with size of an egg, without redness of the skin or discoloration, painful to palpation. If you were my patient I would suggest getting an appointment with general surgeon for physical examination and probably ultrasonography. It is most probably soft tissue infection that needs to be .  It also can be some benign tumor like lipoma or atheroma cyst. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 addicted to opiates for over 2 years now (following a full term pregnancy that ended witChatDoctorplications, I lost my son yet retained the placenta and was rushed into an emergency d&c ) I felt like I needed to add that medical history, that emotional trauma has been too much to handle without the self medicating. I now suffer from severe abdominal pain , and a wide variety of inconsistant bowel charictaristics. I just passed lime green, slimey, very fowl smelling feces. Recently, I have seen clay colored, black tar like, marblely, hard to pass, blood mixed inside, white mucous, well, you get the idea. Colon cancer runs in my family. The pain is becoming more than I can medicate away on my own, I do not know what is wrong with me or what I should do but I fear that if I do not seek help soon I will have autopsy results instead of a treatment plan. Please help me. Thank you for listening. -H.M.L ### REPLY: Hello! Your symptoms associated are significant for acute pancreatic inflammation. And morphine intake doesn't help as morphine can sometimes cause this disease. Your symptoms may be also caused by severe constipation caused by morphine as well. It can also make your gallbladder overfilled as it caused gallbladder muscle spasmed. I suggest you to have abdomen ultrasound and blood tests, liver enzymes tests and pancreatic enzymes test as well. You cannot get rid of acute pancreatitis by yourself as it is very urgent state and needs immediate medical attention. 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 6 1/2 years old having sever wheezing now ...iam giving him budicort and levolin combination...today morning 10am once 4 pm once but still controlled anything....infact he is suffering a lot..one of our child specialist asked us to give levolin back to back ( 2 levolin at 9pm to controle severity) given but still he is in the same condtion again 11pm budicort and levolin combination given....now also he still not free with his breath that whistling  sound able to outsiders..what to do? let me know how much time gap should be there for budicort levolin combination...will it safe for him nubulizing with these medicine...please help me  I will be waiting for the answer thanku. ### REPLY: Hi welcome to ChatDoctori am concerned about you child as your son is having wheeze which is not reduced inspire of giving leveling and decor nebulization, I would like to suggest use of oral steroids at the dose of 1 mg/kg body weight and if he is having any fever use of antibiotics such as azithromycin can give along with this leveling zebu;station thrice daily. If not subsided you can give Dublin nebulization(leveling+ipratropium)hope my answer is useful ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 swollen lump on the inside of my left butt cheek next to my anus. It is internal, no surfsce penatration. If I apply pressure or squeeze it, clear redish liquid comes out. Not sure what to do at this point. Have been taking Amoxicillin that I had left over. ### REPLY: Welcome to  .1. It seems like a bacterial infection causing abscess formation with sinus / external opening.2. They are colonial sinus whicChatDoctores from the hair follicle and make a communication to rectum / bowel and externally opening. 3. I would suggest getting an ultrasound scan of the lesion done to see the nature and content of the lesion, and its extension.4. A course of antibiotic or incision and . 5. Get an appointment meant and see your doctor as soon as you can, as there are complications in this issue. Hope it helps you. Wish you a good health. Anything to ask ? Do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My left shoulder started hurting a little while ago. It is getting more painful by the minute. I am concerned about possible connection with such pain and the heart. I heard once that if a particular are hurts, it can be a symptom of a heart attack but i cant remember which arm ### REPLY: Hi, thank-you for providing the brief history of you As the pain is located only at the shoulder joints I feel it is more of a muscular issue. Also, for a safety case Cardiac assessment can be done. Post which is the cardiac assessment is negative than you may have to undergo physical therapy for further management Physical therapy includes - therapeutic ultrasound therapy, TENS therapy and exercises In my clinical practice most cases respond well to physical therapy Regards 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 had blood work done 2-28-14. The doctor talked to me about several things but never about the GFR score. It was 80. The printout says that is stage 2 and indicates kidney damage. The GFR score on this printout is rather hard to notice; I never noticed it until today. Do you think my doctor may have overlooked it and I should ask her about it or should I ignore it. ### REPLY: Hi, welcome to ChatDoctorKidney damage defines according to GFR. But, without implication on health of patient or if it is not associated with other abnormality suggestive of kidney disease, if GFR is> 60 then it is not considered as kidney damage. Check basic urine report, BP, S.potassium and sonography. With these reports, we can rule out kidney damage. You can then consult your doctor, or you can get back to me also with reports. I think this would be helpful to you. Best wishes. TC. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, i am 28 weeks pregnant and have had this pain that shoots from the top of my breast on the left side through to my back and i have to breath slowly for about 10minutes and then it goes it has happened before maybe twice, am i having heart spasame? what is it also my doctor wants to test me for systolic murmur il have that at the end of the month, other than that i have had no problems so far alh. ### REPLY: Thanks for your question on . I can understand your concern. Possibility of musculoskeletal pain is more likely. But better to get done ECG and 2d echo to rule out heart diseases. If these tests are normal then no need to worry about heart diseases. Avoid movements causing pain. Avoid heavyweight lifting and strenuous exercise. Avoid sudden jerky movements. Apply warm water pad on affected areas. Wear rib belt to prevent mobilization of ribs. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father is suffering from dry cough since past 1 month.He is 64 years old weighing 70 kg ,he is heart patient.8 years back he was hospitalised due to cardiac arrest, One and half years back he was again hospitalised since water got accumlated in his lungs.Doctor now suggested dry cough is due to allergy.He is on antibiotic since past one month.his condition improves but after 2 days same symtomsis seen.Please guide me whether to continue with antibiotic. ### REPLY: Hello, thanks for using . I had gone through all the data you have posted. As you father was a cardiac patient and h/o pulmonary edema (water in lungs) he might be on ACE inhibitor (Angiotensin converts enzyme) which can cause persistent .  Allergic cough starting at 64 yrs and persisting for 1 month is rare. We need more details like CBP report or chest x-ray if it was done. Take tab. Montelukast +fexofenidine 1-0-0 for 3 days and spy. Corex 2 tsp two times a day. If cough persists, discuss with your doctor and try to change ACE inhibitor to ARB. 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 name is Kelli Jo...Last July I was involved in a (hit & run) accident. I was struck by a truck motorist and broke my left tibia. Underwent surgery receiving a metal plate with 8 screws. About a month after surgery my right ankle started to swell. Surgeon encouraged me to see primary physician. I did, and because I did not have health insurance at the time, and my doctor did not believe it was accident related, returned to work and waited 8 months until I received insurance to. go in and get tested. The first test I was given was a Doppler ultrasound, blood & urine samples. What came back under UA Micro Panel: positive for Leuk sm1. (i was told thyroid problems..my thyroid has to work xtra hard to work). My doctor s nurse contacted me with the results and scheduled a phone meeting with my doctor. Unfortunately, I woke up late and missed the meeting. Called the clinic right away to reschedule but not able to get in until 6/23. I m upset because...I m tired of suffering. I ve gone back to work after my accident but have had to work on my feet all day with swollen ankles. I have swelling in both feet, but more so in my right ankle. By the end of the day from work I can t even walk. It so bad. I travel to and from work by bus and have to walk to and from bus stops. I ve missed some work because of it too. (more lately). I ve been having a lot of charley horse cramps in my legs. They re more like ATTACKS. So brutal and so hard to subside. Last night I was awaken at 3:00am..started with 1 in my right back of the upper leg, then got another one same area in my left leg. (So had the both together). They re so bad I think I wake up the whole apt. complex...crying with agony and pain. I m mentally & physically exhausted having to go through this. I m depressed. I do take depression medicine celexa and have been for many years. (with the exception having no medical, went off it cold turkey for 8 months). I ve dealt with this long enough and I m tired of it affecting my job performance wise and absenteeism. I ve told my doctor about this and I have followed everything she s recommended to help while I m working..(compression socks, extra breaks putting my feet up, anti inflammatory pills). My doctor is on vacation now. Even though I missed the phone meeting..could t she of recommended something in the meantime? I don t want to lose my job over this. But I m afraid I may be getting close. I ve been at my employment for 4 years. I do housekeeping & laundry for a nursing home facility. I am 48 yrs old. will be 49 in August. Please can you provide some suggestions.. Thank you. (sorry about the note length). I APOLOGIZE I THOUGHT THIS WAS FREE ADVICE. I DON T HAVE A CREDIT CARD. THANK YOU ANYWAYS. I APPRECIATE YOU READING THIS. I LL FIGURE SOMETHING ELSE OUT. (i hope). ### REPLY: Don't worry. .this swelling is common after fracture fixation and prolonged period of immobilization of the joint. Do full laboratory investigation(CBC.liver and kidney enzymes. Blood sugar. Serum uric acid). Do X-Ray on your leg and your swollen ankle. Don't hang your leg down. Always keep them produce your physical activity and reduce mental stress as it may exaggerate the pain. Be sure you Will practice your work as before ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 knot in between my rib cage tha size of a quarter feels like a cists it doesnt hurt or nothing but i noticed i have bad breath now also has been there 6 months or better jus curious to what it might be an are the two possibly linked? im 42 afro-american female 5 2 an weigh 131 ibs i am anemic but my hemoglobin has been good for months dont have any medical issues i am prone to bv though have had it a lot in the past ### REPLY: Hi.based from your description, it could possibly be a cyst (sebaceous or gelatinous type), a fibrous (fibrous tissue formation) or a lipoma (a fatty tissue deposit). And no, your bad breath is not related to the lesion in your chest area. It is best if you consult with a doctor, preferably a general surgeon, for clinical evaluation. Management (medical and/or surgical) will be directed accordingly. A good oral hygiene is also encouraged. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mum 56 years old woman and kidney donor 5 years ago suffering with fever and body pains.not eating or showing intrest to eat anything as taste is not there i think.taking little fruit and may be drinking glucon d water.local doctor has given some medicines and she tells some kind of pressure pain in stomach.i am unable to understand what to do any suggestions please ### REPLY: HelloThanks for query. Your mother has donated her kidney 5 years back and now getting pain in abdomen fever etc. In view of she's having only one renal unit(Kidney) she needs to be investigated to rule out an infection(UTI) or stone formation. Please consult qualified Urologist for clinical assessment and get following basic test done to confirm the diagnosis .1) Urine Culture 2) Mammogram 3) Renal function tests 4) Ultrasound Scanning of abdomen and pelvis.In the meanwhile give her antibiotics like Ciprofloxacin along with H₂ receptor antagonist Pantoprazole twice daily. Ensure she .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had numbness in my right hand for about a month or so. It comes and goes and usually comes when I am using that hand or the opposite when I am sleeping it goes so numb that it keeps me awake and is actually quite painful. I have seen my doctor and he thinks it is related to arthritis that I have but no other place that is irate by my arthritis is affected. ### REPLY: Hithanks for writing to  .you seem to suffer from carpal tunnel syn .  it's a condition in which a major nerve supplying the thumb, index middle and part of ring finger gets compressed at the wrist level. Please do the following1. Use wrist splints, especially while sleeping2. Avoid bending your wrists too much3.avoid keeping your wrists under your head while sleeping4. Give rest to your wrists, avoid typing too much on your computer or mobile phone.5. Apply ice packs4-5 times a day6.use a mild analgesic like acetaminophen it will take 3-4 weeks for complete recovery. Hope I have answered your query 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: HiI have symptoms and want to confirm if it is a yeast overgrowthMy symptoms include sinus pressure, ears that dont hurt but feel clogged and I feel a warm sensation like fluid in my ears. My tongue is white and sometimes is inflamed and burns or stings, I am starting to get rashes on my neck around my ears and neck, I also have swollen gland under my ear on my jaw. ### REPLY: Hi. Welcome to  . I have gone through your query and can understand. As per your complaint sinus pressure can be due to sinus infection which is commonly due to bacterial infection in the sinuses while can also be secondary to viral cold and cough. Clogging in ears and feeling of fluid inside the ears seems to be due to ear infection secondary to sinus infection. White coating on tongue can be due to yeast infection causing thrush and is probably due to reduced resistance as you have other infections. The rashes can be due to either fungal infection, but chances are less and more probably be due to some allergic reaction. I would however suggest you to consult an Otolaryngologies and get evaluated, and he can advise you to get a PNS VIEW x-ray done to rule out for problem in the sinuses as well as do an endoscopic examination to look for ear infection. Thrush can be diagnosed with its typical appearance of cheesy white patches. In case of infection in sinuses and ear you can be advised to take antibiotics oral as well as ear .  Saline nasal irrigation, steam inhalation and decongestants like phenylephrine oral as well as nasal  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had tailbone pain for well over 12 months. I have seen a physio, I have taken anti inflammatory tablets, I sit on a cushioned ring. The last week or so I have been in so much pain that now it throbs when Im laying in bed and standing also (not just sitting). It also hurts just standing.  I work in a classroom so I am up and down off chairs during the day and in the evenings Im also on computer lots as Im completing university also. Any more help would be appreciated. ### REPLY: Hello, I have studied your case. For resistant coccydynia[tail bone pain] sacral local block injection may be helpful. Phototherapy [local injection] may also work for sacral pain. Consult your doctor for injection. Physiotherapy like ultrasound and inferential therapy will give relief. I will advise checking your it B12 and it D3 level. Continue site bath and use of ring cushion. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. 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 had upper wisdom extraction yesterday. Did the 24 hour rule. Felt like there was a scab, thought that was the blood clot. After eating yogurt, put water in my mouth and lightly shook my head to swish water.  Scab feeling is gone?  There is a red spot at site, but do not know what a clot looks like, or if that little swish dislogged the clot. Should I be worried? ### REPLY: Hi. Thanks for writing to us. No, it does not look like you have lost the blood clot, rather the red spot at the extraction site is blood clot itself. Initially blood clot will appear like a red substance filling the extraction socket. Gradually it will start turning to yellowish and whitish healing tissue that will help in filling up and complete healing of extraction site. So as of now it is appearing to be blood clot. If you have any doubts you can get a clinical examination done by your Dentist. Right now follow the post extraction instructions as advised by your Dentist, avoid forceful spitting, do not suck anything with a straw. Do not smoke, take soft diet and use gentle swishing to clean inside mouth. Hope your query is resolved. 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: Respected Sir,I am from Nepal. My mother has liver cirrhosis. She is 50 years old.and she has the weight of 55. Doctors in Nepal has called it as a result of the long use of drugs. She used to take some psychiatric medicine since 10 years.  Could liver cirrhosis be cured permanently? How much does it cost? There are no hospitals in Nepal for the patient of liver cirrhosis. What can I do? Is CMC vellore is best place to treat? Sir, to whom I have to consult? ### REPLY: Hi I can understand your concern... The cause for cirrhosis many... Here it seems to be by chronic . . Let me know you permeant treatment for cirrhosis is liver transplantation... Here for cirrhosis take low salt diet to avoid edema . If edema present diuretic can be given... Your mother might have portal hypertension also for which beta blocker can be given... Take high protein diet.... Take good food for liver like...../carrot/Indian gooseberry/avocados/spinach /dandelion/grapes, papaya /lemon juice etc..... If immediate liver transplantation not possible TIPS like less invasive procedure might helpful ... You can consult gastroenterologist for your mother condition... Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Sir,I have masterburate from my age of 11 or 12 ..i feel it is one of the biggest mistake of my life.Now i feel very tired and feel there is nothing in my body .Is there any medicine to get rid of it ..please suggest otherwise i will get more weak day after day... ### REPLY: Hi and. Masturbation is very common among adults, no need to feel guilty about this. It is not abnormal and most of the people would have masturbated in their lifetime. Masturbation won't make you weak, it's all in your India you are masturbating very frequently that is almost daily then you have to control this habit. Twice or thrice weekly is acceptable, but there are no strict rule about frequency of masturbation. Here are few tipsAvoid watching porn if you have habit of watchingdont be lonely, try developing some new hobby, Listen music, Play some outdoor games. Eat nutritious foodDivert your concentration to studies or some productive workfare is no such medicine to git rid of this habit. If nothing helps, then don't hesitate to consult a local doctrine again I stress, this it is not the biggest mistake of your life, Don't be guilty about this. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i m 35 year old married woman ..married for 3 yrs..trying for child since 1 yr..i ve regular periods ...i missed periods whenever i ve intercourse during fertile period and i m not pregnant ...this is the second time happening consecutively .. ### REPLY: Hi;welcome to  Since you have not conceived for last one year you need to get yourself as well as your husband investigated. Please consult a Gynecologist to guide you with the investigation required. You are missing the periods because of your anxiousness to have a baby. Please relax ;don't worry you will conceive if all the investigations are normal. Also till then try to have intercourse every alternate day during fertile period and stay in lying down position after intercourse for at least 2 hours. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 41 yo. I have had 2 pe in less than a year. I have no factors that can dictate why. I am also not a smoker, never used birth control, and never had blood cflots in legs or arms. With the last blood clot I had a very high sensitivity to coumadin and ended up in the hospital 3 times getting a blood plasma fusion my hematlogist stated that the coumadin would kill me befor the clot. Three months later I find my self with another blood clot same lung back on coumadin. I am scared. Should I be concerned? ### REPLY: Although you state you have no risk factors for pulmonary embolism, still getting recurrent clots, so you must be tested for few blood defects like Protein C & S deficiencies also. anticoagulation therapies are required for prolonged periods in recurrent Pulmonary embolisms. If the clots in lungs are coming somewhere from the leg veins known as Deep veins thrombosis, then installing Inferior vent naval filters may prevent such clots reaching to the heart and then to the lungs ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 6 year old grandson yesterday developed a large lump on his head about the size of a large grape. It is painful to the touch. He also said his neck hurt to touch and then this morning he has another even larger painful to touch lump on his base of his neck where it was sore yesterday. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern. He may have some reactive lymph node or some benign cyst like lesion or may have some other lesion like tuberculosis or lymphoma.  You should go for fine needle aspiration cytology. It will give you exact idea regarding cause. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: DEAR SIR,MY CHILD GOT SEIZER BEFORE 2YEARS AND GETTING TREATED WITH EPTOIN . DOCTOR RECENTLY INCREASED DOSAGE BECAUSE OF WEIGHT INCREASED.THAT IS 5ML TO 7.5ML.NOW HE IS GETTING BLURRED SPEECH LIKE WA..WA..WA..WATER.IS IT IS A SIDE EFFECT?CAN HE GET CURED?I AM IN MUCH FEAR..HELP ME SIR ### REPLY: Hi, Thanks for writing in. Slurring of speech is a known side effect of phenytoin (which is the .  It is indicative of an overdose.  Please see your physician as soon as possible so that he can modify the dosage. Also, please get the following investigations done: Complete blood count with peripheral smear, Serum phenytoin levels. These symptoms will disappear in a few doses of reducing the dose. 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: I have a two almost 3 year old usually healthy boy. He had a mild case of thrush at 3months old and an ear infection at 11month. He also had bronchitis Feb. this year. Those being his only illnesses, he is complaining of pain in his mouth and lips, and his belly hurting. He has a fever, white patches on his tounge and have spread to his lips over nig. What is this and how do I treat it? ### REPLY: Hello, I can understand your concern. There seems to be one of two possibilities in case of your son. Firstly, it is possible that the child has viral infection which is presenting as low grade fever, white areas in mouth and on lips and pain in stomach. Usually, viral infections heal by itself as the bodies immunity takes over in 7-10 days, and it is not treated by medication. Secondly, there is a chance that the focus of infection is in the stomach. Stomach infections are able to develop ulcers in the mouth that are painful. As the stomach infection will heal, the mouth pain will disappear. Stomach infection might need treatment with antibiotics. In addition, there is also a possibility that the mouth and stomach problem are different and coincidental and mouth problem is associated with another episode of fungal infection. To conclude, I would advise you to visit a pediatrician and periodontist for clinical examination of the child and further investigations, if needed. I hope this information helps you. Thank you for choosing . I wish your son feels better soon. Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had right knee arthroscopy 16 years ago to remove a piece of cartilage. All of a sudden I have been having knee pain for the past several days in the area that the cartilage was removed. The pain is achy but gets sharp as the day goes on with normal activities and taking care of my twin 2 year olds. Should I be worried and see a doctor or is there something that I can do at home. ### REPLY: Pain years after arthroscopic surgery is not uncommon.  Surgery often causes scar tissue to form at the location of the surgery and the scar tissue can last for several years.  Scar tissue pain is usually very sharp in nature and very tender to the touch.  It is possible that looking after your twins is causing increased use of muscles around your knee that are putting pressure on that scar tissue.  You might want to try topical Arica cream (I use Article or Trammel), Epson salt soaks, and foam rolling, and if unrelieved see a sports medicine specialist for X-rays to make sure everything is okay. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 burning in both legs seeming to originate at inside of my knees. I fell in September and injured my left knee no apparent tears. Xrays show arthritis in left knee. I also have the beginning of a bulging vein in my left thigh that is tender to touch. I can only sleep flat on my back. Have pain when legs rest on top of each other when trying to sleep on either side. ### REPLY: Hi, Burning sensation in the legs and knees could be due to neural compression of nerves at the spine. You need a thorough examination, and investigations like MRI of the LS spine and thoracic spine, to see if the nerve roots are at fault. The treatment of this condition could be both surgical and non-surgical depending on the findings seen on investigations and examination. I advise for you is to see an expert spine surgeon first, and if he rules out, then a peripheral nerve 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: sir,i am 32,and suffering from heptitis-b (detect on 12/12/2009) and after treatment get negative on april-2010. in hb dna test.with doctor advise i am taking medicine (sebvio-600)since 12/12/2009 till today and doctor advise me that you should stop the medicine after  six month of get negative of HEP-B. pls advise ME WHAT SHOULD I DO. ### REPLY: Hello, Thank you for using . The appropriate time of cessation of hepatitis B treatment with nucleus (t) IDE reverse transcriptase inhibitors (Sergio - Telbivudine), depend on which type of Hepatitis B are you affected. There are two types of hepatitis B, Head positive and Head negative hepatitis. In case you were affected by Head positive hepatitis, it would be ideal that beside the undetectable serum level value of HBV - DNA, would be reached the reconversion into Head neg and then after 6 -12 months you should have stopped the treatment safely. In case you were affected by Head negative hepatitis, the treatment should be safely stopped after at least 2 years with the HBV - DNA remaining undetectable on three separate occasions 6 months apart. Hope this may be helpful for you. Please feel free to contact me for any further information. Thank you,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had a double lung and heart transplant 3 years ago and due to steroids I get swelling and pain in my feet, the appearance is also blue with a constant full ache. Can I get rid of this, I m going on holiday next week and my feet balloon in the air, it s so bad it scares me, Is this normal?? I really worry about. ### REPLY: Welcome to  I have gone through your query and understand your concern. Your swelling can be due to side effects of steroids. So this swelling will reduce after stopping the steroids if you can after consulting your doctor. Second your pain can be due to osteoporosis effect of steroids. You can be benefitted by vitamin D3 and calcium. It will be better to visit Orthopedic for complete treatment of osteoporosis. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you. Wishing you a good health. 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 65years old, taking medicine for BP and Thyroid.Recently,I had weakness,vomiting sensation, cant eat anything sweet because of the vomiting sensation. My Doctor asked for a blood test. Resut is this:  Billirubin Total-1.4, BillirubinDirect-0.6,  SGOT-422,SGPT-477,GGT-97. Doctor suspected Hepptits but when checked for Hepptits Virus there was none. Doctor what is wrong with me? ### REPLY: Hello, Thanks for using . I had gone through data you have posted. Your report shows elevated liver enzymes suggestive of hepatitis. The cause for Hepatitis should be evaluated. Common causes for Hepatitis are viral like Hep B, Hep C, Hep E, Hep A, alcohol induced, acute febrile illness like malaria, dengue, scrub typhus. So we need to go step by step to look at the diagnosis. Kindly consult the nearest general physician or medical gastroenterologist for further evaluation. For now, you can take TAB.ADÍLIO 300 mg 0-0-1. 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: Ankylosing Spondilitis Question I have been in a flare for nearly five months, feeling pain predominantly in my ribs and thoracic spine . It is very debilitating unless I take my voltaren (25mg) x4 per day and Panadol Osteo x6 per day. I am wondering will this flare up ever go away or am I likely to have this pain for much longer yet? ### REPLY: HAI, Thanks for writing in, Ankylosing Spondylitis (AS) flare up can be controlled well with medications but cannot be avoided. You have to take proper medications for AS to avoid the progression of the disease. Seems you are only taking NSAIDs for AS. Discuss with your doctor regarding starting you on Awards like Sulfasalazine. Sometimes acute flare-ups need steroids with/ without dose modification of Awards. You have to take medications for AS regularly as advised for life long to control the disease progression. Physiotherapy is very important to keep your back flexible. Taking NSAIDs for long term might cause gastritis and renal impairment. Take them as per your doctors' advice. Wish you a 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: With all due respect sir/mam, I am 22 years old. I am very sad. From 8 months I am having some dizzy feeling in my head. For 2 months it was just some dizziness. Then I consulted a doctor and he gave me a neck collar. I used it for 2 weeks and found that whenever I move my neck it feels as if neck skin is stretched. And neck feels stiff. And many times when I move my neck a certain cracking sound comes. And one more thing sir. In previous 8 months l have had around 4 episodes of around 5 seconds during night where I got up from bed due to a certain sudden spinning in my head . that is very horrible experience. And I have the feeling that it may always happen again. I have to change my sides during night to averse this spinning attack. Please help me out. ### REPLY: Hi, Thanks for writing in. Moments of dizziness can happen due to decreased blood flow from heart to brain. When it happens, the blood flowing through the vessels from heart to brain might have a reduced flow. These are by the carotid and vertebral arteries on either sides. This is more significant when you are standing upright and doing any moderate to heavy physical activity. You might require a CT scan or MRI scan of the brain. The best way to analyze if the reduced blood flow to the brain is causing your dizziness is by doing a carotid and vertebral arteries Doppler ultrasound. It will show the flow of blood from the heart to the brain and if it is adequate. Clinical examination of inner ear and vestibular system in the ear is also required. It might help to do an Electronystagmography (ENG) or videonystagmography (VNG) done to record abnormal eye movements while the head is placed in different positions or your balance organs are stimulated with water or air. For this you might have to consult the ENT specialist. Dizziness can also occur due to stress related anxiety or overflow of emotions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 prolapsed bladder apparently affecting both bladder and bowel it is causing me a hard time to empty my bladder. My stomache swells and I get back pain. I know it is not an emergency but but what should I do to help with the soreness how long should I wait to be able to see a specialist ### REPLY: Dear friend, I am sorry to know that you are facing problem with urination and bowel movement because of prolapse of bladder. With the help of my clinical knowledge I am telling you as your normal lifestyle is getting hampered because of this, it is time to go for your surgeon for consultation. Because to solve the prolapsed bladder problem you should undergo some clinical and radiological investigation. I sincerely hope under the guidance of your surgeon you will be screened thoroughly for the prolapsed bowel condition .my best wishes for your health in coming days. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor,i am jhansi .My baby boy age is 6 months now,and i have no breast feeding from 3rd month onwards.At present feeding for my baby is Buffalo milk,but he has been suffering from motions.can you please give me suggestion about feeding milk(which one is better ) ### REPLY: Breast milk is the best possible feed for a baby up to 6 months of age. Thereafter, breast milk should be continued along with other semi solids. Cow milk or buffalo milk are produced for the nutritional requirements of their species. Requirements of human babies is different from theirs and hence human breast milk is the best possible feed for a child up to 6 months of age. Most formula milks are cow milk based and hence difficult for the child to digest. It might be the cause of the loose motions your child is getting. If the child is 6 months, milk is now an optional item of the food intake, provided that the nutrients are adequately procured from other food items. So, in case there is no breast milk and the child is 6 months of age, weaning with semi solids needs to be done and basically transitioned over to a mashed version of adult diet low on spices. I would not suggest giving any formula milk of buffalo milk, although some doctors might recommend a low lactose soy based formula. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello - i had sesamoiditis in my right foot. that resulted in rsd chronic regional pain syndrome Lukily my rsd is calming down after 6 month i feel 70 per cent better.However since i wear orthotics - the seaamoid area still hurts.i read its the hardest bone to heal.how much time does these two bones need to heal from demineralization? Some doxtors told me 6 months others 5 years. So i am really lost.Can u please send ur answer to YYYY@YYYY ### REPLY: Hello, As a Sports Medicine doc I am familiar with sesamoid problems. I'm sorry you had to go through all this - RSD is a very painful and debilitating condition. There are several factors that can help with the healing process. Make sure you eat well - a good balanced diet with lots of fruit and vegetables. If you are carrying any extra weight, then certainly losing a few pounds will help. If you carry less weight this means less stress on your feet - including the sesamoids. Make sure you wear well padded shoes - you might want to insert a simple gel insert in your shoes. You can buy these from your local pharmacy. Make sure you put them in both shoes. Try to avoid aggravating the sesamoid area by limiting your walking to no longer than 15 mins at a time. It is very difficult to give you a specific time frame for recovery - everyone is different - and there are many factors to be taken in consideration. I have seen people get better in anything from 1 to 6 months. I hope this helps. Best wishes to you and I hope you continue to improve. A .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I recently got married and trying to have a baby for he ladt 5 months. just got my semen analysis done. The outcome is: Sperm count. 11 million per ml Volume 4.7 ml Total sperm count 52 million Motility 9% Rapid linear motility 0% Morphology 3% normal sperm Please advise if its ok. If not how severe is the problem. If there is a credible treatment and how much hope i can have. Thanks ### REPLY: Hello, Welcome to , I am  Firstly, Sperm count per ml is lower than required (normal is >20million / ml as per WHO1999).  But total sperm count is normal. It's because, as per WHO, normal volume of semen is taken as 2 ml.  But The morphology is quite devastating. Required motility is >25% active motile and total motility is > 50%.  Morphology of the sperm is very bad.  So, over all you have low sperm concentration with low sperm motility and mostly abnormal sperm.  The semen analysis report is not OK.  The problem is very severe.  Consult with an infertility specialist for further investigation and management. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 fell on the steps across her lower back.. She said it was very hard and she couldnt get back up until sister helped her.. She got sick right away. Figured from just eating and the hard crying.. Now she is complaining of off again on again stomach pains.. Any major concerns? She has had a cold for last few days.. ### REPLY: Hi. Thanks for your query about your 5 years old daughter. Noted that she had a fall and now has pain in abdomen. This can be a serious problem and needs MRI of the abdomen to see if there is retro-peritoneal hematoma. If this is so, I may be treated conservatively, but the child has to be admitted and kept under observation. Do not give her anything orally. She may also need Standing X-ray of the abdomen and ultrasonography and also the tests of the blood, urine and stool. The treatment will depend upon the findings. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor My 10 month old is having a severe nappy rash for bout 3 weeks Its gone really badTook her to emergency viewing this morning as her rashes were slightly bleeding Doc recommended temodineJust wan to knoe how good this cream is nd how quickly it can recover ### REPLY: Hello, Timodine cream is effective to cure nappy rash. Nappy rasChatDoctormonly goes away in 2-3 days. Apply Timeline cream(do not use too much cream, little is enough) on the affected part after gently cleaning & .  Do not apply Timeline cream for more than seven days. If it takes more time to heal, get the baby clinically examined. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am suffering from neck pain & headaches , also, I have back problems with L 3,4,&5 discs, I have stomach & B.P problems also, I take prescribed medication for. My Doctor has said that a medication like Prozac may help, he agree s that I am not suffering from depression , but say s that prozac may produce something in my body that may help me, can you tell me what it will produce & how it could help, just the thought of taking anti depressants scares me as I take a lot of medication already, many thanks Jon. ### REPLY: Hello. Thanks for writing to us. Prozac is an antidepressant, but it also helps in maintaining a feeling of general wellness. Taking Prozac will help in reducing the pain perception due to the disc problem that you are having and will help you psychologically. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Mild polyclonal hypergammaglobulinemia i don t understand what this is, i see things about hep c . and i have results from a blood test that say im postive for hep c . never been a drug user, multi partners, never stuck my needle, did have hep b when i was in vietnam ### REPLY: Hi, dear. I have gone through your question. I can understand your concern.  Hepatitis c may occur with hepatitis b. So if you had hepatitis b then there is definite chance of hepatitis c also. Moreover, polyclonal gamaglobulinemia is due to infection and inflammation.  If monoclonal then its due to malignancy. So if it is polyclonal then no need to worried.  Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an accident skiing a week ago and landed hard on my collar bone. Large lump developed over collar bone, very painful, restricted movement in arm, a lot of bruising and swelling which has moved down my chest as the week progressed, I had x-rays on the day of fall which found no broken bones. I just today ( a week later) had a moment where I felt nauseas, nearly fainted and sweated a lot. I sat down, drank water and almost immediately felt better and now feel fine, except y hands are cold. Is this connected to me fall a week ago and is it anything to worry about? thanks ### REPLY: Sorry to hear that you met an accident and an ill effect due to lump formed after accident. If your X-ray shoulder is within normal limit then I suggest local swelling of muscle, which in medical term can be said as inflammation of local area due to injury. This swelling has mass effect whicChatDoctorpress the vital area over neck region which may lead to nauseating feeling and your upper extremity appear cold. I advise you, again do the X-ray of shoulder and USG local part which allow us to correlate the extent of swelling and nearby vulnerable structures.Meanwhile you can performed hot fomention over local region along with painkiller to relief the pain. I advise you meet orthopedic surgeon in person for better understanding. I hope your queries would have clear. Thank you. ### END