Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 want to ask you is it necessary to women also got discharged for conceiving ? Nd plz tell me some pills for conceiving faster i have one baby but its now about 4 years dat i am unable to conceive wht instruction we follow during sex if we want to conceive a baby girl ? ### REPLY: Hi, Thanks for the query. To increase the possibility of pregnancy, you have to track the ovulation and have to plan unprotected intercourse around that time. Ovulation can be tracked by physiological methods like cervical mucus method or by ovulation kit etc. For more details : http://srsree.blogspot.com/2013/10/ovulation.htmlHaving male or female baby is chromosomal dependent and cannot be judged preconceptionally. If you do not succeed with ovulation kit, once consult gynecologist and get evaluated. Go for ovulation induction and follicular study. This will increase the possibility of pregnancy. Start taking folic acid supplementation from downwards. 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 name is Jayasimha and my newly born baby ( 4 days old) is having albinism. Can you please let me know if there are any treatements available in the early stages itself. Also, do let me know if there are any hospitals available in bangalore for the same. Regards, Jayasimha ### REPLY: Thanks for asking I have gone through your question. Your 4 days baby is having albinism. (are you sure for diagnosis? Because albinism is a genetic disorder, treatment is limited. But getting proper eye care and monitoring skin for signs of abnormalities are especially important to your children health. Your child will most likely need to wear prescription lenses, and he or she should receive annual eye exams by an ophthalmologist. Although surgery is rarely part of treatment for albinism, your ophthalmologist may recommend surgery on optical muscles to minimize nystagmus. Surgery to correct strabismus may make the condition less noticeable, but it won't improve vision. Dermatologist should conduct an annual assessment of your children skin to screen for skin cancer or lesions that can lead to cancer. Adults with albinism need annual eye and skin exams throughout their lives. Hope i able to answer your query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have nasal drainage and congestion at times, the drainage is clear for the most part. I also have a cough, which is deep at times. Can you please tell me what it might be? I was thinking sinus infection or just a cold. I am 14 weeks pregnant, so I am unsure of what I can take, or if the doctor can prescribe me anything that can help.Thank you! Amanda ### REPLY: Hi, Thanks for the query. I understand your concern. Nasal congestion & flow is mostly due to exposure to cold, allergens(dust, fumes,mold, fabric,fragrances, scents,cosmetics), low resistance viral or bacterial infection. You should try to avoid exposure to allergens, improve nutrition to gain resistance. Vapor inhalation helps.  When the secretions are thick. Antibiotics are needed.you have already passed first three months. So now you can consult your doctor take pregnancy friendly medicines for treatment.  Consultation of ENT specialist if needed.  Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello i have a sister who lives in africa she had her son 3 years back byc-section and was put on alot of drips without havin a catheter 2 drain herurine out, she slipped into a coma and ws later drained alot of urine but nowshe complains of severe stomach ache. she has done 2 operations done to find outwhats causing the stomach ache but they cannot deal with this, please help me ### REPLY: Hi! Good evening. I am , a general surgeon answering your query. This is a situation where one might not be able to opine on the problem unless all the papers having information on the intraoperative findings during each surgery done are available. Therefore, I would suggest you to send all the findings with reports to arrive at a tentative cause of your sisters abdominal pain, although a personal physical examination would also be needed to arrive at a conclusion. Thanks for choosing  to clear doubts on your health problems. I wish your sister an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have found a lump in my labia that was painful, but now is just like a lump with no sensation at all.  It is about as large as the end of my thumb.  As 3 members of my family (2 sisters with breast cancer and a brother with brain cancer) have had cancer( 1 sister died...breast cancer-went to bone cancer-went to cervical cancer, sister in remission from breast cancer,-brother in treatment for brain cancer), I am worried. I have no insurance.Can you help relieve my concerns? ### REPLY: Hi ! Good morning. I am  answering your query. From the description by you about the lump, it seems more like a Bartholdi cyst (a benign cyst) which got inflamed initially causing the pain, and now it is just persisting as a cyst after the inflammation subsided. However, the exact situation could be known after a physical examination of the lesion by a general surgeon/gynecologist. With your family history which can not be ignored, I would suggest you take an appointment with the doctor, or show yourself in a government hospital as the case may be. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. Wishing you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, i want to now if it is safe to take an injection to avoid pregnancy for over an year ### REPLY: HI, thanks for using  You may be referring to the demo proverb injection. Yes, this can be safely used for a year, some persons use it for longer. Many women who use this form of contraception would notice that they may experience reduced or no menstrual bleeding during this time. There may be some episodes of breakthrough bleeding which is occasional spotting, but this tends to resolve as the medication is continued. When you decide you wish to conceive you can discontinue the medications and your cycles would return. 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: YES PLEASE...  I AM 50...  AND RECENTLY EXPERIECING A SOFTER ERRECTION WHEN INVOLVED WITH MY WOMAN...  AND LOWER SPERM.    I AM PRETTY PHYSICALLY ACTIVE FOR MY WORK.  I HAVE A SERVICES BUISNESS IN FLORIDA.   I EXCERCISE A COUPLE TIMES A WEEK....  I EAT PRETTY WELL...  I WATCH MY SATURATED INTAKE..  DO YOU HAVE ANY IDEAS..  WHY. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Problem in erection and low semen volume may be due to many reasons. Any kind of illness, mental stress, or other disease can lead to problem in erection. You should consult your doctor once if problem persistent.  . Low semen volume is not a cause of big worry. Just be relaxed. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother has had significant weight loss, (about 5-10%) in 3 months, is nauseated, especially in the morning, and is fatigued. She is 71 years old and has never been sick and has never had depression. She is a non-smoker and a non-drinker. She has a hgb of 162. currently her c-reactive protein is normal. She describes her stools to be dark but not black. She also has a uti, which is being treated. She had an abd ultrasound 2 years ago because of symptoms of lower abd discomfort but they saw nothing.  She is to have a colonoscopy and and gastroscopy as well as another ultra sound and possibly a CT of the abd. ### REPLY: Hello, As per your statement your mother is C/O1) Nausea in the morning2) Loss of weight3) Fatique4) Dark colored motional investigations done - Hub and C-reactive proteins are normal - So we can't expect any major inflammatory disease.USG abdomen done 2 years back was normalize is waiting for gastrostomy and colonoscopy and repeat USG abdomen and possibly a CT abdomen. First you must arrive at a probable diagnosis and then investigation should be as per the probability. You have not mentioned whether she is having DM/HT/HD. Even a UTI can produce all the symptoms you have mentionedProbable Diagnosis. Do a urinalysis - Macro, Micro and culture and sensitivity a motion examination - Macro, Micro, RBC and culture and sensitivity. If RBC is present - it may be GI Bleeder the above you can come to a conclusion - what investigation is needed further.Accordingly, you do the investigation and treat her - instead of subjecting her to the cumbersome unwanted investigation. She will get alright - because I don't expect any major problem. Best wishes ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am experiencing sciatica.  It has been persistent for over 6 weeks and is getting worse.  I can no longer sit for any period of time nor drive a car.What is the prognosis for most people? Is it episodic or is this the new normal.  What treatments are recommended? ### REPLY: I read your question carefully, and I am sorry about the persisting pain you are in. In 80% of the patients the sciatica pain does subside gradually over the course of the weeks. It may be recurring though, that is a possibility if there are chronic changes on your spine which with aging are not likely to disappear. If the pain has not subsided for 6 weeks though imaging evaluation is needed to see the degree and site of nerve compression. If disk compression by degenerative changes is confirmed then initial step remains physical therapy and painkillers, if those remain ineffective local injections of steroids and analgesics are tried. Last resort is surgery. I hope to have been of help. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: good afternoon sir...my complexion is dusky...could u prescribe me a cream to get fair skin ### REPLY: Hi!, Welcome To  forum, If your complexion is genetically dark and even your rest of the body part is as dark as face then you may not have a good result. But if not, so then you should go for CHEMICAL PEELS from an experienced dermatologist. One requires multiple sittings at 2 wk intervals. It save and effective. Along with this you should also apply creams like glycolic acid or retinoid cream at night.It's mandatory to use a SUN SCREEN daily three times.Sunscreen itself would help you a lot. For maintaining your self you can use comic acid cream daily later.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 was having stiff neck and neck pain from last two months. The pain is nearly gone now but I am getting tingling or slight numbness at the back of my head just above the place where cervical nervers start. My c-6 and c-7 are nearly clubbed together ( it is by birth as per my doctor). Any idea what si the reason for this? ### REPLY: Hi I am . .  In my opinion it is a sort of perineal cysts that are asymptomatic and may be found at birth , fall, overexertion or heavy lifting on your back or neck.  Usually they are asymptomatic and may resolve simultaneously or treated symptomatically by painkillers like Advil 400 mg when needed, hot massaging with topical gels, physiotherapy and some B12 vitamin supplementation will be effective for now.  For my patients I may suggest MRI and CT spine for proper evaluation and management. Please click THANK YOU and a 5-star rating with some positive feedback if the information was helpful. Hope the above information helps you, Any further clarifications feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had sex two days ago while on antibiotics and birth control I used a condom too but it skipped down about an inch I was wondering if I could get pregnant and if I should take plan b ? Also I started antibiotics and birth control on the same day, does antibiotics actually effect birth control ? ### REPLY: Hi, Thanks for the query. Sometimes antibiotics can affect the function of birth control pills by disturbing their metabolism. But if you used the contraceptive pills as per the guidelines the possibility of pregnancy is less. For more details : http://srsree.blogspot.com/2013/11/general-guidelines-of-using-combined. tells, you used condom also, if there was no ejaculation, there is less possibility for pregnancy. So, continue to pills and wait till your expected date of with .  Possibly you will get with ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I seem to feel better now. But was in a lot of pain and considered going to hospital. I am a 41 female. Yesterday and today I have had really bad upper tummy lower chest pain .. No reflux.. Yesterday I feel bloated before the pain ..I kept burping lots today and yesterday. It seem to last about 4 hrs about 1/2 hr after having brunch which I was late having both days 1 pm ish . 2 x Grain toast yesterday with peanut butter and jam , today 4x toast . 2 with jam and 2 cheese and tomatoes . It was tight cramp sore pain that would Make me breath shallow and hard to talk because of the pain .. When I laid down I felt better . I seemed to keep burping heeps over the few hours.Im a bit scared to have dinner or breakfast as worries it might set me off again . Get the odd cold chill . I will go take my temp soon .Wonder if it was Gaul stones, IBS, really bad indigestion . I think I will try and book to see dr in the next few days .. Cheer megan ### REPLY: Hi. Thanks for your query and an elucidated history. Noted your history of pain in the upper abdomen and lower chest, so much severe that it made you breathe shallow and hard to talk. Lasted for 4 hours after brunch with grain toast with peanut butter with jam. Since the whole grains toast has gluten and the peanut butter may not be suitable causing you the problems, There may be gluten allergy or subacute intestinal obstruction causing all such problems, I would advise in such a condition the following:X-ray of the abdomen in standing position. UltrasonographyClinical evaluation and further investigations to have a proper diagnosis and treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My wife has complained about a tightening in her chest causing coughing systems, asthma like, and also slight pains in her chest. We went to a Cardiologist and they didn t seem to think it was too serious but I m worried about her. What could this be? ### REPLY: Thanks for your question on . I can understand your concern. Tightness in chest with coughing is mostly seen in asthma and bronchitis. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x-ray and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of asthma and bronchitis. It will also tell you about severity of the disease. And treatment is based on severity only. She may need inhaled bronchodilators and inhaled corticosteroid (ICS). If all these investigations are normal than sometimes, stress and anxiety can also cause similar symptoms. So ask her to avoid stress and tension if she has. Don't worry, she will be alright. First rule out Pulmonary causes. Hope I have solved your query. Wishing good health to your wife. 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 2 weeks out from having open heart surgery to repair an aortic aneurysm. My first appt. is Monday, but I am curious about this puffiness above my collarbone. I m also having pain only in my collarbone area which I know it will take time to heal from my sternotomy, but the only pain I have is in my collarbone area. I guess I am wondering if this is normal or what else might be causing the pain. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have symptoms of puffiness and pain above the collarbone which seems to be due to acid reflux disease or gastrointestinal reflux disease (HERD) due to which upper sphincter of esophagus allow the acidic content of stomach to come upwards in esophagus, which causes throat irritation and pressure in throat and collarbones. It can also occur due to muscle strain or due to cardiac problem. Consult cardiologist for diagnosis if there is any heart related problem. I would suggest you to avoid spicy and heavy meal, avoid late night eating, eat at least 1- 1.5 hours before going to bed and take frequent and small meals. You should consult gastroenterologist for proper examination. Doctor may order endoscopy test, ambulatory probe tests and X-ray of digestive system. Doctor may prescribe antacids such as genus to neutralize acid, H₂ blocker such as sanitizing to prevent acid production and proton pump inhibitor omeprazole. You should keep your head elevated while sleeping keep clove in mouth to suppress cough and do warm saline gargles. Hope your concern has been resolved. Get Well Soon. Best wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am experiencing a burning sensation from my spine across my waist to my belly button on my right side only. Major bloating, major discomfort laying down. This burning is inside my skin. No evidence of rash or sores. This has been going on for aprox. one week.ricksmiss ### REPLY: Hello! Welcome on ! Regarding your concern, I would explain that your symptoms could be related to a nerve pain or a spinal cord disorder (including inflammation or myelitis). For this reason, I would recommend consulting with a neurologist for a careful physical exam. A spinal cord MRI may be needed to exclude the above-mentioned possible causes. Hope you will find this answer helpful! Kind regards,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my mother age 70, is having pain and breathing difficulty in the chest since the last two days. She also feels numbness in the legs and this morning, she acted as if she was mentally ill. Please let me what else could be happening with her besides the heart problem. ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of heart related diseases is more in your mothers case. Besides heart diseases, lung diseases like lung infection and bronchitis can also cause similar symptoms. So consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x-ray 3. PUT (pulmonary function test). Chest x-ray is needed to rule out lung infection. PFT is must for the diagnosis of bronchitis. She may need antibiotics, inhaled bronchodilator and inhaled corticosteroids (ICS) on the basis of these reports. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. 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 son had to have 12 biopsies of his prostate to check for any cancer.  He is 47 yrs. old.  This was done about one month ago.  Now he says his semen is watery and would like to know the reason.  He was found benign.  What is causing the watery semen? ### REPLY: Hello, Watery semen may be due to low sperm count or due to block in spermatic cord or due to frequent ejaculation etc. Until examination is done it is difficult to say what it is. Get it done semen analysis, get done ultrasound scrotum to know the block. If symptoms not improved please consult with your physician he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have hyperaeration bilaterally with flattening of the hemidiaphragms , I am 61 yr old.  I am only taking xopenex hfa .  What else should I be taking for this problem?  I keep feeling like some one is sqeezing me on the lower part of my ribs.  I have been to the doctors many times for this and nothing has changed in the trweatment which I am getting. ### REPLY: Thanks for your question on . I can understand your concern. I have gone through the x-ray report you have mentioned. This kind of x-ray report is suggestive of chronic bronchitis (COPD). And you are taking only exposed (levoalbuterol) for this. You are not taking proper treatment this is the reason for persistent symptoms. Ideally treatment of COPD should be guided on severity and severity is known by PFT (pulmonary function test). So consult pulmonologist and get done clinical examination of respiratory system and PFT (pulmonary function test). PFT will tell you about severity of the disease and treatment is based on severity only. You will improve with long acting inhaled bronchodilator (formoterol or albuterol) and inhaled corticosteroids (ICS) (budesonide or fluticasone). 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: i am 29, female. i have had a guilt for the past 6 months, after that i lost control over myself, had panic attacks, pin pricks over my arms, face and even palpitations, no sleep at night and in a confused state of mind. i consulted a doc.. he has put me anti depressants Veniz XR 37.5 about 10 days back and i felt normal in 4 days. now increasing the dosage to 75mg, Serenace and Zapiz 0.25. I want to know what will be the side effects of these? will i ever be able to get off these medications? and why do i feel scared, anxious, and feel like crying a lot. i cant stop my negative thinking too. what do i do? what is wrong with me? ### REPLY: From the symptoms that you are facing at the moment it does look like you are suffering from depression. In most cases the patents has symptoms of Anxiety and Panic attacks intermittently along with sleep problems due to excessive negative thinking. The symptoms that you are facing is due to excessive stress that you are facing in your life or sometimes its genetically programmed to do so. This part is not under out control and hence you should not feel bad about it. There are neurotransmitters in the brains(chemicals) which regulate the daily function they have decreased hence the medication to put thing right by correction of the chemicals, one may be kept on these medications for about 6 months to a year depending on the progress which shall be decided by the consulting psychiatrist. The medication are always started in low dose and slowly increased to see for any side effects it may have and the dose at which you may respond. These tablets will definitely help you to get better but if you do face side effects like nausea, .  In case you do you can always discuss with your doctor. These tablets do take time to work and to improve your condition may take 2-3 weeks time. If you got a good response in a short time then these tablets are well suited for you.  About the negative thoughts they will fade away automatically during the course of treatment and with counseling ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 wife is being diagnosed with Obstetric cholestasis by our gynaecologist in Cape Town. She is 39 weeks pregnant, beginning 40th week tomorrow.My questions are:1. is there any information you may be able to share re longitudinal research on the risks, there is so little research on OC on the web and we are trying to gauge the risk my wife is in (and so much would like a natural non induced birth). Obviously we wont rely on your research or in any way disseminate any info you may send us. 2. my wifes bile results are 19 (norm on our test was stated as 0 - 10) (her S-ALT score is 53 (norm range given as 10 - 32) and her S-AST is 40 (norm range 10 - 32). Is 19 a high risk bile acid level?Any views you may have would be greatly appreciated.Many thanksCharles ### REPLY: Hi there,Obstetric homeostasis At term (40 weeks) with bile acids of 19 should be induced for delivery. There is no point waiting for labor to start, as every day more is an added risk for further rise in bile acid levels and may affect the baby. The problem of Obstetric homeostasis is it can cause sudden death in a full term baby as the bile salt can cause problem with the heart rhythm of the baby. And at 40 weeks the baby is fit to survive, so delivery should be induced immediately. The risk though less than 1 in 100 is still very important to make note as the baby is absolutely normal and has reached 40 weeks and to be affected by bile salts at this stage would be tragic.Also, the risk of passing meconium during labor or inter is higher and also is the chance of operative delivery (cesarean or forceps) in women with Obstetric homeostasis.  The risk of bleeding after birth in mother is also slightly higher and kept in mind. Vitamin K oral should be given to mother after 36 weeks. The liver function tests should be repeated 10 days after delivery as it takes that much time to get back to normal.Also, the risk of repeat obstetric homeostasis in next pregnancy is very common up to 90% and should be informed to the doctor early in next pregnancy. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a 4 year old. I noticed lumps under her skin on her stomach when she raised her arms and stretched the skin. When i felt the bumps they were on a vein and she said it hurt. When i noticed the raised skin it looked like something was just under the surface. Any ideas? ### REPLY: Hi, Dear,Thanks for the query to . I studied your problem in depth and I understood your concerns. Causes for lump below nipples in abdomen-Cause is related with undisclosed supernumerary Polynesia in few cases and is a congenital anomaly. So they are undisclosed breast tissues. So please consult ER Surgeon and GAEC. This advice is based on the facts from the history you give and needs further clinical check. So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to  and be comfortable to resolve your health issues. Welcome for any more query in this regard to . Write good resume and Click thanks if you feel satisfied with my advice. Have a Good Day. . N. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 did 100 squats for my thigh muscles in a hurry,,,,& know its been 4 days i cannot fold my legs i thing the muscles are not yet relaxed,,its paining when i try to fold my legs i had 1 voveron painkiller yesterday & 1 hifenac mr day b4 yesterday wat medicine do u prescribe?plzz plzz help ### REPLY: Hello, Pain may be due to qua .  Over-exercise will lead to muscle fatigue and accumulation Of waste products of metabolism responsible for pain.  Take rest and avoid squats for a week. Take tab Ibuprofen thrice a day.  Local application of ice packs and limb elevation will help.  If a not relieved visit to orthopedic surgeon is recommended.  Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 15 month old son has a staph infection in his groin area.  It started out looking like a boil, since he has been taking antibiotics the redness has gone away.  Now there is a hardened oval area under where the boil was.  It doesnt appear to be getting smaller.  Could this be something more serious?  How do I treat it? ### REPLY: Dear I can understand your concern. I would like to inform you that some induration that is hardened area may persistent at site of infection. It will slowly go away. There is no need of any medicine for that, and it should not be any matter of worry.Don't press over that repeatedly. It may cause reinfection to that site and swelling can increase as well. Hope this will help you. If you have any other concerns please feel free to message me. Thanks for contacting . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 9 years old has been suffering fever, headache since last Wednesday. I used P-500 syrup @ 5ml. (his Body weight 28 kg) as given by child specialist. But when he takes this medicine he has tendency for vomiting. I  actually dropped this medicine because I have seen some small spots in his body and thought to be measles. But my doctor told me that he was given vaccination, so he wanted to see my son and instructed me to use P-500 as it will work for headaches. What is opinion in this regard. ### REPLY: Hi, Since your young man is vomiting, he is not able to keep anything down.  This includes medicine. I have done some investigation and discovered that P-500 does not come in suppository form.  I would recommend that you obtain acetaminophen suppositories to replace the oral medicine.  Should the suppository be soft, then place it in the refrigerator (NOT freezer) for 30 minutes before administering.  Place a small amount of Vaseline on the end to be inserted. Push with a finger (using a disposable glove) until all the suppositories is within his rectum.  Take your finger out and hold his buttocks together for a couple of minutes. His dose should be 320-400 mg by rectum every 4-6 hours. If he needs this med.  For more than2-3 days, he ought to be seen by his pediatrician. Sometimes if you give him nothing by mouth for 6-8 hours you allow time for his stomach to settle down.  Then, if there has been no vomiting, begin with a few teaspoons of crushed ice.  Repeat in another hour. Next offer 2-3 oz of apple or pear juice.  Then you can advance fluids as he desires. When he says he is hungry, let him eat anything he wishes. Hope I have answered your query. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have sudden brownish spots in the center of my chest down my sternum area. I experienced discoloration like this during my first pregnancy. I have taken a hpt and got a negative result. I am getting bloating above my pelvic area and I had my period (however lighter than usual). I am also experiencing modd swings alog with fatigue and nausea occasionally. What could be the cause of this? ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you're all symptoms including brown spot near sternum are more suggestive of hormonal imbalance. So better to consult gynecologist and get done hormone levels. You may need hormone pills to regulate hormones. Once your hormones are normalized, 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: I was recently diagnosed with herpes complex 2, I have severe vaginal irritation that will not go away its like an open wound. I have been taking Valacyclovir for 2 and a half months. Is an outbreak known to last this long? I m beginning to think this is something else. What are the symptons for uterus cancer? ### REPLY: Hi and welcome to . Thanks for the query. Cancer is the last thing to think of and these are not sign of any female cancer. This is probably herpes and herpes infections are usually refracted and bothering and easily treatable in some people. You should continue with val acyclovir. Outbreaks can last even longer, and it is hard to predict how long. Uterine cancer is usually seen in postmenopausal women, it goes with pelvic pain, prolonged and excessive vaginal bleeding. You should do testing for other STDs. Wish you 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: hi, im 31yrs old. im 56 and slim. in the last week iv had problems with sharp pains in my chest. Also i get very dizzy and in the last few days im beginning to lose the feeling in my arms and legs. I went to the doctor and i was told it stress and was given painkillers for the pains, she also told me i had a kidney infection and it would go away with drinking juice. however i went back to her yesterday as the numbing in my arms and legs are getting worse. No examination was done and she still hasent done blood tests. I dont get the impression shes listening to me. Is it stress? ### REPLY: Respected user, thanks for using .come have evaluated your query thoroughly.* There are various reasons - low hemoglobin (anemia) - respiratory infection - underlying Pyrex development manifesting as systemic symptoms - vitamins, minerals deficiency - stress - inadequate rest - others * Need thorough clinical examination, basic laboratory tests and x-ray chest to find out the exact cause and manage accordingly. Hope this clears your query. Welcome for any query in the future. 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: pain for last two day after I urinate, not during.  lower abdominal pain on the left side and some back pain. No fever and as of tonight am having blood and mucus after urinating.  About 4-5 months ago had a kidneystone.  I am 47 and female.  And there is no chance that I am pregnant. ### REPLY: Hello! I read carefully your query. The way you describe it seems to be urinary tract infection that might be due to kidney stone. Your symptoms:back pain, lower abdominal pain, pain after urinating, blood and mucus after urinating, fit perfectly with this diagnose. You need to do a urine test and an abdominal ultrasound to confirm the diagnosis. I suggest consulting a physician and get the tests done in order to take the right treatment. It is important to do this because for this infection you need to take antibiotics, so the infection will not affect the kidney. You also need to . This will increase the urine production and will help with infection. You can take Ibuprofen and Tuscan to relief your pain. Hope my answer has helped. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi I am 32 yrs, married for 6 yrs.for first 2 yrs used emergency pills for around 5 -6 times total. Then we planned for conception,but fruitless.we tried to evaluate.hormone profile,thyroid profile was normal but i was found to have thallessemia minor.my periods are regular of 28 days cycle. Recently we consulted a gynaecologist. my USG done on day 7showed b/l small follicles,so i was prescribed tab fertomid till day 11.on day 11 usg revealed 3 and 2 growing follicles on either side.on day 13 usg showed 3 mature follicles on rt and 1 growing follicles on left.I was given inj ChatDoctor 10000iu on day 13 and was asked to be in contact with husband .my husbands sperm count was around 65 million. even wit this we could not conceive. what should i do further. ### REPLY: Hi, I guess your concern is about medications for getting conceive. First I want to say that relax as there are many medications and methods for getting pregnancy. One of them is ovulation induction which is already started by your treating gynecologist. In this method .  Once the follicles becomes dominant then in  5000-10000iu given for follicle rupture. After that couples are advised to do contacts for many times. This cycles usually repeated for maximum 6 times. With number of cycles there are chances of getting pregnancy increases. With the above information you can try out my suggestions:1. RELAX.EVERY PROBLEM HAVE SOLUTION. There are chances.2. Try to do coitus during fertile period (it's a time from 10th to 16th day of cycle), during this period chances of getting pregnant is high.3. If you are in hurry then visit to nearby infertility specialist. He /she can help you. I hope the above information is useful, informative and helpful for you. Let me know if I can assist you further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I get cramps on top of my left forearm and hand and it causes my hand and fingers to draw up and it hurts. It mainly does this when I bend my arm. I ve been told that I have a slight pinch in a nerve in my neck. Could this be a cause? I don t think so. ### REPLY: Hi there. It may sound difficult to believe it, but the nerves which supply your forearms and hand, start at the level of spinal cord and on their way towards the forearm and hand regions which they supply, the course of these nerves pass through difference facial and muscular planes that can make them susceptible to entrapment naturopathies. It's a group of conditions where a nerve gets compressed between a muscle and a bone, or between the fibers of a muscle that it pierces or passes through. Also, the compression can happen when the nerves are travelling around a blood vessel which can mechanically put pressure on them. Usually patients who would be having such a problem present with a dull aching pain over the arm and forearm. If it is not too severe and does not cause any neurological deficits then conservative management with Pregabalin and vitamin B complex tablets, activity modifications and physiotherapy can be started which will provide relief. Avoid the activities which exaggerate your problem. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have recently changed pill to microgynon 30. I have noticed that I have two lumps of hair missing in my head the size of 3cm length and width being the largest. I also suffer with stress and anxiety. What could be the reason for this? It is not something serious is it? ### REPLY: Hi, As per your query you have symptoms of lumps of hair missing in the head which could be due to fungal infection, stress, hormonal fluctuations, improper hygiene and due to nutritional deficiency. Need not worry. I would suggest you make sure about complete nourishment of scalp and maintain proper hygiene of your scalp. Consult a dermatologist for proper examination and go for required testing done and then start treatment. The doctor may also prescribe supplements containing biotin, Acetylcysteine, copper as active ingredients. You can use finasteride preparations as well.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I randomly get a flutter in the middle of my chest.  It almost feels like a fish flipped flopped inside me.  The flutter is not accompanied by any pain, but I do feel it takes by breath away.  I have had numerous EGKs done and they have are been normal.  The flutter, could that be a muscle that is just spasaming? ### REPLY: Thanks for your question on . I can understand your concern. No need to worry about cardiac diseases because your multiple ECG s are normal. Possibility of involuntary muscular contractions is more in your case. Common causes for this are low calcium and magnesium level. So get done serum calcium and magnesium level. If deficiency than you need supplements. If both are normal than sometimes stress and anxiety can also cause fluttering sensation in chest. So avoid stress and tension. Be relax and calm. Don't worry, you will be alright. First rule out calcium and magnesium deficiency. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello I am a 45 year old woman with type diabetes, high cholesterol and a slightly elevated high blood pressure.  For the past month and a half every time I go up stairs or go up a hill or force after something heavy my heart feels like its going to pop out of my chest giving me extreme pain and tightens my throat.  I sweat alot and my blood pressure gets higher than it usually is. Also, my heart tends to skip a beat (which ordinarily happens in all) but I get chest pain on the left side and out of breath.  Today, I drank a slush (which gives brain freeze) but my chest hurt sooo badly I had to stop drinking and eating for a few minutes and the pain was strong and constant until it went away after maybe 5 to 7 minutes.  What is happening? I went to see a doctor 3 weeks ago and has given me a blood test for thyroid problems but I have no results yet.  Should I be concerned? ### REPLY: Thanks for your question on . I can understand your concern. Your chest pain after .  But your chest pain and breathing difficulty on exertion (climbing stairs), popping of heart etc. are more suggestive of heart diseases. So better to consult cardiologist and get done 1. Blood pressure monitoring 2. ECG 3. 2d echo 4. Stress test. Possibility of heart failure or coronary artery disease (CAD) is more in your case. You will need cardiac supportive  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 astma and take alubertol and advair daily. I have been short of breath for the last week and a half. I cant catch my breath doing simple things. My blood pressure has been high and my pulse. Highest BP today 142/91 and pulse 112. I know the albuterol can make your heart beat fast. what about the advair? I have been on both for years. I use my albuterol daily. ### REPLY: Hello, Thanks for the query to . Forum. I would come up with these possibilities for such type of breathlessness, This includes.1 Cor pulmonale, diagnosis can be confirmed by X-ray chest and M R I. As you mentioned that you are having asthma from many years, so this is very common feature in old asthmatic case that their asthma turned into cor pulmonale.2 Congestive cardiac (heart) failure i.e. C H F, diagnosis can be confirmed by physical examination as well as treadmill test. E K G & echo will find out the exact nature of disease. As you mentioned that you are also having high B P, so chance of C H F can not be rule out.3 As albuterol is a potent bronchodilator and not effective. While adverse (fluticasone +albuterol) is also steroid and bronchodilator. Both . In my opinion consult a cardiologist and get his opinion. Good luck.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a noticable white line starting from under the cheek pad of my left cheek, crossing my nose above the nostrils and carrying onto my right cheek, following the same line as my left cheek (think of a cat face mask)! Make-up doesn t disguise it very effectivlely. ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have symptoms of noticeable white line across the face which can occur due to causes such as stress, hormonal changes, side effect of certain medicines or sun exposure. It could be due to underlying systemic pathology. Need not worry. I would suggest you to :-- Avoid excessive exposure to sunlight and keep your skin covered.- Wash your face with face wash containing benzoyl peroxide. It is very effective for acne.- Apply atelier acid containing cream, which is very effective for acne as well as dark spots.- Exfoliate your skin once a week for white lines. Consult dermatologist for proper examination. Doctor may prescribe antibiotics course, isotretinoin or other steroid containing creams. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am in such pain. My neck very.stiff and painful. My right lower kidney area has a sharp stabbing pain when I breath deep. Even my butt cheeks hurt when I sit down.as well as my.calf muscles. I only have a slight cough non productive. I only have.a low.grade fever 99.6 I have taken a percocet 5/325 without any relief. There is no pain with urination. ### REPLY: Hello, I would explain that your symptoms seem to be related to a viral infection. For this reason, I recommend taking ibuprofen or acetaminophen three times daily. If this situation persists, I recommend consulting with your attending physician for a physical exam and some blood lab tests (complete blood count, PCR, ESR, blood electrolytes). Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I recently had a wisdom tooth removed and was informed of all the risks e.g. nerve damage etc.. It has now been a week and although am feeling well, there is a sensation I feel on my tongue that is similar to that which you get when you burn it. I haven t eated anything that could burn my tongue and am a bit concerned as it has been this way for a about 3 days now! This irritation seems to be on the same side as that which had the wisdom tooth removed. Any help would be much appreciated! thanks ### REPLY: Hi and welcome to , Nerve damage post extraction is a rare condition unless the extraction of wisdom tooth is traumatic. Numb sensation in the tongue or paresthesia is caused due to damage to lingual nerve due to traumatic removal of the tooth. In your case I suspect, damage to the peripheral nerve branches during extraction may have developed this loss of sensation which is temporary. Nothing to worry about as these nerve fibers regenerate with time, so you can wait for another week or two, if the symptoms persists after that please consult your dentist.I hope I answered your query, get well soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had chest pain and pain in my shoulders for close to 3 months now. I have had a colonosopy and endoscopy and both were ok. I had a ekg and ecocardio gram and it was ok. I have never smoked, but when I put my symptoms in on some internet sites, it says I could have everything from broncitus to lung cancer. My gp is convinced that it is anxiety. Im not. If it was anxiety, would that make my chest and shoulders hurt all the time? ### REPLY: Hello, The chest pain can be related to anxiety. Another possible cause can be rheumatoid arthritis. I suggest checking the rheumatoid blood level for further evaluation.  Meanwhile, I suggest using anti-inflammatory medications such as Acetaminophen to relieve the pain. I also suggest using magnesium supplements for muscle relaxation. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I woke up with a pain under by left breast,that hurts when i take a deep breath. I had a massage this weekend on Saturday, and she did lot of work on my back, particularly my upper left shoulder area. Is there any connection? Some say it may be related to exercise but I did not go to they gym tho weekend,so I worry that a it can be something more serious. I am a 60 year old woman and healthy weight, no medications. ### REPLY: To check the seriousness of your problem just stretch your hand out stretch for the same side keeping hand above shoulder level and if it does not pain then don't worry.  But if you feel tenderness more over the beast region even after 2 days than I suggest visiting your gynecologist doctor once.  And exercise or massage on back can not cause this kind of pain. But do check once with cardiologist too if there is a breathing difficulty or pain in chest deep. Hope you have got your answer.  Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 35 years old male, i ve been facing itching problem from last 6 months, Before the itching starts I feel acidity very badly. i ve been to several doctors so far nobody have had able to diagnosis my problem, i have done my full body test and all of them were normal. To get temporarily relief I am having one tablet everyday (cetirizine hydrochloride) which keeps whole body in normal and had a feeling of 100% relief, but it will last only for 24 hours. my symptoms are below I feel acidity issue and the itching starts through out my chest and arms with red rashes. ### REPLY: You are having generalized pruritic. There are many causes of generalized pruritic. But in your case, no cause is still found. All investigations are within normal limits as you said. If no reason, then it is idiopathic or psychological origin. You avoid stress, anxiety and worry. Keep the body moist. No soap. Cotton clothes should be wore. Take good sleep. Apply moderate potency steroid daily at night and good moisturizer after bath... Take HY . . I hope you will improve. . Ok ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 HEAVY HEAD CAUSING LACK OF CONCENTRATION ITS BEEN EVERY DAY SINCE 8MONTHS AGO I GOT A HEAD MRI BLOOD TESTS ALL NORMAL I FEEL GOOD ONLY WHEN I HAVE ALCOHOL I GOT TESTED VNG TEST I HAVE A DEFICIT IN RIGHT VESTIBULAR TOOK BETACERC DIDN T WORK I DONNO WUT TO DO ITS GETS REAL SEVERE AROUND 2 PM EVREYDAY ### REPLY: Hi, Welcome to  .com I am . Mariano Into Bruno Mascaras, and I am here to help you. I have read your question with care and understand your concerns.  You have heaviness in head with lack of concentration even if your MRI and Blood Results are normal if you have 1. Heart Problems 2. Lung Problems 3. Low BP 4. High BP Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. Best Wishes for Speedy Recovery Let me know if I can assist you further. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been suffering from really bad lower back pain, like I never have before, for the last 2-3 months. as far as I can tell the ONLY thing I did was start using simvastatin at about the same time. My lower back, left and right just below my ribs and a littler higher off my hips feels like glass ready to break. I deal with it but serveral times a day the pain make me whinise. I havee an appointment with my doctor friday. I am 66 and have been in great health all my life, 6 2 215lbs and drink red wine 4-5 days a week..2-3 glasses per night. ### REPLY: Hi, Welcome to  forum.  As you describe it appears to be the arthritis of the spine, stenosis, or deformity of the spine, also may be due to the urinary tract infection or the stone in the ureter.  I advise you to consult an orthopedic surgeon for diagnosis and treatment.  You may need to have a C.T. scan for confirmation.  I usually prescribe to my patient with such symptoms neurotrophic injections for 10 consecutive days, and then periodically, calcium supplements, and painkillers.  Avoid taking potato, other tubers, tomato,egg, chicken, and and seafoods.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a feeling of salt while gulping and a feeling of blisters on the edge of my right side of my tongue .This has been for over a month now.I get a very bad smell from my mouth which irritates me further.I had checked with a dentist to which he said its not a dental problem and also i drink over 3 litres of water a day.I need to know the reason to which such a problem can occur. ### REPLY: Hello there... There are various reasons for that... Please mention your age? ... Since you have already got yourself examined from a dental surgeon the other reason could be from the upper respiratory tract... Salty discharge could happen if you have upper respiratory tract infections. Post nasal discharge that runs down through your hypopharynx would taste salty...and you would appreciate it more when you lie in the supine position . Person with chronic sinusitis would also have bad breadth from their mouth... If the dental examination has ruled out your problem visit an ENT for further evaluation or visit an Oral and Maxillofacial Surgeon for further 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 Mother is claim she is having sever abdominal pain . She is 46 and has had a hysterectomy , Furthermore, She has a bad back this limiting her ability to get ideal exercise she is 5 11 140lbs so she is in good shape. But I am concerned about her lack of being able to get out and do things as cause a kidney stone or cause some other type of problem. ### REPLY: Hi, thank you for your query hysterectomy can be done either microscopically or abdominal or vaginally.laparoscopic hysterectomies have lesser postop pain compared to the other two methods. Hence during post op period experiencing pain is common. Recovery from open abdominal hysterectomy usually takes 6-8 weeks. Recovery time will be quicker for other methods. Bleeding along with pain can also be expected in this time for few days. I can suggest few simple tips to reduce pain and any complications.1. During the first two to three weeks, rest and avoid lifting.2. Slowly increase your activities. Begin with light chores and short walks. 3. Depending on your job, you may be able to return to work.4.to promote healing, eat a diet rich in fruits and vegetables .5. Try to avoid constipation by: Eating high-fiber foods, . Using stool softeners if needed7. Ask your doctor when you can use tampons.8.ask about Keel exercises. By  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 on Hospice with Ovarian and Kidney cancer...since mid april they have  prescribed remeron (generic name is mirazapin 25 mg. One table taken late at night allows me deep sleep  until nearly noon each day.  I have incredibly complex but pleasant dreams, no complaints there, but am I supposed to be on this  med forever...is it too strong perhaps? ### REPLY: Hi, Remeron contains mirtazapine which is an antidepressant with sedating properties. If used only to induce sleep. The usual dosage is 7.5 to 15 mg at bedtime, but you mention that you are taking 25 mg per day. In my opinion, you should discuss with your doctor regarding a dose reduction as you are sleeping till noon daily. You do not need to be on this forever and neither is it habit-forming. Best wishes. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 50 years old and my height is 5 feet 2 inches and I weigh 182 pounds. I have not had any previous problems with high blood pressure. However three days ago I woke up dizzy and not feeling myself kinda like a druggie feeling. I went today to get checked out and my blood pressure was 137 over 96 laying down and standing up. The doctor prescribed blood pressure medincine at the lowest dosage. I had a doctor check me out about 9 days ago and I had a reading of 125 over 85 what happen with in 6 days ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Your blood pressure is normal after medicine.  Slight variation in blood pressure is common within same day.  Even intro observer variation is also there. So no need to worry.  It's not fluctuating too much.  Continue with your medicine and go for regular checking of blood pressure.  Take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a hard round something in between my butt cheeks near the top, not next to the anus. Sometimes it is so bad it pains no matter what I do. I assumed it is a boil because it is not next to the anus and doesn t look or sound like a hemorrhoid according to my research. It itches something terrible. I cannot afford a dr visit and am hoping you can help me figure out what it is. I have been putting Hemorrhoid Cream on it, which helps it get smaller, but then it grows again. It is under the skin and sometimes has a dark color. It is very hard. Thanks for any suggestions or help you can provide. ### REPLY: Hi, Good Morning. I am . S.CUTS -super-specialist- From India-attending your health query to  virtual-online Clinic--I studied your query in-depth and Understood your concerns.-In my opinion -Treatment would be-a-Consult a Surgeon ideally.It's mostly an -acute on Chronic Boil/fur uncle -of hair follicle or ? Pilonidal cyst by its position.b- I would advise -Mayflower spine-sacro-coccyxial area/USG /?if need be MRI to fix the cause of the lump?codon put Hemorrhoid cream -as it may complicate further.d-Excision biopsy of the Colonial cyst / or Chronic boil after antibiotic cover will resolve your issue.Don't worry at all.In the meanwhile I would advise-a- Tb NSADb-Antibiotics, which would receive the pain and discomfort you have.-Wish you early recovery. Wellcome for any question if it worries you still. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: 23 yrs old, male , i cannot use any of the cosmetic  face wash or even a cream on my face as i usually end up getting pimples with them and skin gets kind of "dirty" with them ( i don"t know how to explain it better) , the only thing which seems working is salicylic acid facewash but it seems it cannot completly clean the skin. the best thing which works is when i used to be on anti allergic medicine( cetrizine) but since i stopped it skin reverted to being pimple prone.i also have raised liver enzymes but heptologist have ruled it as "insignificant" ### REPLY: Hi, your skin is oily, so you get acne frequently. You feel face dirty, as the skin is seborrhea, i.e. excessively oily. Salicylic acid and glycolic acid containing face wash will work better. All dirty remnants and oil will be removed. And chances of acne development will be reduced. Avoid stress, anxiety, excessive exercise. Take good sleep. Avoid milk, ghee and excessive oily food. Avoid exposure to sun. Be calm and cool. Along with this, take cap minocycline 50 mg once a day on empty stomach in morning for about three months. Apply clindamycin gel at night on lesions... Ok. You will be alright ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I have itchy and painful rashes on the lower side of the buttocks & little in front between the joints, scrating makes blood come out of it slightly and it pains after that. I have applied tenovate M since a month but they disappear partially and reappear. Please suggest some non side effect treatment for these.. ### REPLY: Hello, Welcome to the ChatDoctorBrief. First rule out the cause of rashesDetailed answer... Since rashes can be because of many reasons,e.g. allergy, . But from your history it seems that you are getting rashes mostly on extensor regions, for which I doubt about psoriasis (an autoimmune disease). My opinion would be got checked by dermatologist, otherwise you can use ointment pander, ointment with 1percent corticosteroid. And discuss further. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had pain in groin for 8 months .Painkillers help, but tests ;blood,ultrasound x.ray urine and physical exam have found nothing . Symptoms to me sugest inguianal hernia  but doctor disagrees .I am  a 55 year old male whose symptoms started and continue with lifting ,bending sitting and even walking. ### REPLY: Hi, Dear,Thanks for your query to . Dear I read your query and reviewed it with context to your query facts. I understood your health concerns and feel Concerned about them. Based on the facts of your query, you seem to suffer from-Upper thigh Muscle Cramps ? Or Could be Early hernia in transition. Or Post-strain Fibromyalgias. It could be from strains public movements / or strain in adductors originating from pubic bone. Just keep a watch if no relief is achieved after in.escort at the tender muscle spots. Hope this would help you to solve your health issues in the best way possible. Welcome for any further query in this regard. Good Day!! . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son was on Dilantin for seizures for from the ages of about 4 thru 16.  At about 13 yrs of age, the pharmacist told me that it drew the calcium out of his bones and for him to take a supplement. Needless to say he would not take supplements (also had trouble getting him to stay on the meds).  He is now 34 and his teeth are falling apart.  Is there anything other than eating calcium rich foods and taking a supplement that he can do?  Does he need to get his blood checked? ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Get serum calcium level checked along with a bone mineral density test.2. Dilation is known to cause calcium depletion due to reduced absorption. However, the calcium gets replaced from bones resulting in normal serum calcium levels but weak bones.3. If the tests are abnormal, calcium supplement is essential. If absorption is problematic, slow calcium infusion needs to be given. Overtime, it would improve. Study could also demonstrate, if there is any associated degenerative skeletal diseases. Test reports necessary for further opinion. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: After about 5 days from getting my front tooth removed, a hole has opened up at the surgery location. I dont know how deep it goes, but  have an implanted bone that was put it to replace my infected bone. I dont know if maybe the stitches came loose or what, I am just hoping that this doesnt complicate my dental process. Any information you could possible give me? or maybe some advice/personal experience? ### REPLY: Hi, Thanks for asking the query, According to your clinical history I suppose that your infected bone is removed and replaced with an implanted bone, don't worry it will take some time to heal usually up to 2-4 months. You just maintain a very good oral hygiene in the region, the sutures are to be removed after a week of time. You just follow the post surgery instructions given to you. Maintain a very good oral hygiene. Take lukewarm saline and antiseptic mouthwash rinses. Avoid eating of hot and spicy foodstuffs. Avoid smoking and alcohol consumption. Hope this helps out, Regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having abdominal pain, fatty bowel movements and nausea for about a month now and had similar issues last year around the same time. I had many tests done last year and nothing was conclusive. The morning is the worst. I wake up at almost the same time everyday - between 3 and 5 am - with pain and get some relief when I go to the bathroom. The doctor thinks I have the stomach flu and the stress is a factor. I did some research and Pancreatitis fits my symptoms. My Triglycerides arent high (152) but my LDL is 181. Also my WBC has been a little elevated for several years (14.1). My doctor started me on Lovastatin for my high cholesterol, but it caused my stomach symptoms to be worse, so she said to stop taking it. Im not sure what to do and fear that no one takes me seriously because I suffer from OCD which exaggerates the symptoms at times. Could it be Pancreatitis? ### REPLY: HI. Thanks for an elucidated history and I have understood your problems well. Very true that the symptoms of abdominal pain, nausea and fatty stools can fit into a clinical diagnosis of pancreatitis. The other factors which can be contributory are: Backache at the place where the pancreas is. Jaundice in some cases, pain is always in an upper abdomen and deep-rooted. There may not be fever. The other probable causes can be IBS, stress, gastroenteritis, gastrointestinal cancer and so on. I would advise you the following:MRCP and ERCP can really help in a diagnosis. Liver function tests. Blood amylase and lipase for pancreatitis Blood sugar, urea, creatinine, electrolytes and so on. Stool examination - indication of pancreatitis Eminence the diagnosis is made it becomes easy to manage a case. It is good that your Lovastatin is stopped as it was causing a problem. Take Fat free diet, multivitamins, Pancreatic enzyme supplements. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: from roxicodone 15 mg to fentanyl patch 50 mg my doctor recently put me on fentanyl patch 50 mcg/hr after taking roxicodone 15 mg for ablout a year but the patch is making me sick trwoing up,stomach pain,very sleepy,left arm felt asleep lots of tingling and dry pain is this safe?? ### REPLY: Hello, Any opiate often causes stomach sickness: opiates affect gut motility and cause constipation. Opiates cause gall bladder spasm, opiates directly cause nausea, opiates cause sleepiness even to the point of fatal overdose, opiate with .  Cannot say in your particular case, and there are many reasons how opiates affect gastrointestinal action and/or nausea. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Im 4 weeks away from my due date... Im pregnant!And I have been occasionally masturbating but when I do I make sure not to be too rough. But after I orgasm I realize I bleed. At first its small blood clots n then its just light red blood. Could this be harmfull?? ### REPLY: Hallow Dear, Neither masturbation nor sexual intercourse is harmful during pregnancy if specifically not contraindicated. Deep insertion of penis or dildo is to be avoided to safeguard the pregnancy from irritating the uterus. The bleeding you are having after masturbation suggests:1. Deep insertion of dildo or2. Some trauma inside the vagina. To avoid any risk of infection, better report to your Obstetrician. If you are more than 36 weeks now, I would advise you to refrain from the masturbation now. Hope this helps you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I went to A & E at 3am this morning with what started as itchy hands and feet, then body & face went bright red , then I started swelling up,  I had all these symptoms a couple of months ago but thought it was something Id eaten, however this time my tongue, mouth & lips also swelled , the common factor in both cases was omeprazole which my Partner has prescribed and which I took on both occasions. Why did I react to this when I have never had any previous allergies. ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concern. As per your complaint the symptoms of itchy hands and feet along with redness or flushing of face and swelling or hives along with allergic angioedema seems to be due to Allergic reaction as such symptoms are the most common presentation of allergic reaction or anaphylaxis. In case if on both occasions when the symptoms appeared you have taken Omeprazole the symptoms seems to be due to allergic reaction to Omeprazole that is a Proton Pump Inhibitor. I would suggest you to consult an Allergist and get evaluated, and he can do a thorough clinical evaluation and also advise allergic tests like LAST test, Patch test, food challenge test to rule out the exact cause of the problem and treat you accordingly. As of now you can take anti allergic like Allegra or Ben . . The best way to prevent an allergic attack is to avoid exposure to allergen and in case if it is something that you come in contact with frequently you can be advised Immunotherapy to reduce the severity of allergy symptoms. Hope this information helps. Thanks and regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, how are you Doctor? Q: I am a 50 year old person who is weighs about 295 pounds, once diagnosed with lyme back in the year 2001, and always out of breath, however, I become very tired in all my muscles even when I chew.. I always feel like I have active Lyme, even though I took the medication when I first acquired the disease..I also feel very week around my lower hip joints when having to have a bowel movement. My bowel movements are all so sudden, and most times liquid..I try to be very active in a day, however, this problem is slowing me down every day..What can I ad more to say? what would be you suggestion? I appreciate your input to my problem..Robert Scialpi New Paltz NY ### REPLY: Hello, Welcome, and thanks for sharing your concern I went through your query, Approximately 10 to 20% of patients (particularly those who were diagnosed later), who received appropriate antibiotic treatment, may have persistent or recurrent symptoms and are considered to have Post-treatment Lyme Disease Syn .  The treatment of these symptoms is dependent on individual areas as they are not due to the infection but due to effect of the infection on the body, and this depends on the site of symptoms, you may need steroids in controlled doses to control the aftereffects, and some symptomatic treatment, our aim is to help the body come out of this after effect. I hope my advice would have been useful, in decision-making regarding your treatment, still if you have any clarifications or doubts feel free to contact back. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have a question. Occasionally after I masturbate at night I get a slight itch after I ve ejaculated. It used to be in the shaft of the penis, but lately it has been at the tip. This only happens when I masturbate at night and the itch doesn t last very long. I don t have any other discharge or a burning sensation when I pee. What could it be? ### REPLY: HiT hank you for asking . I have gone through your query. Your problem is most likely due to fungal infection or irritation. In such case I advise ointments witChatDoctorbination of antifungal like fluconazole or terminating with corticosteroid quinolone. You should also avoid soaps for cleaning penis as it may irritate more. You can use warm water or saline for that. Hope this may help you. Let me know if you have any further queries. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband and I have had a stomach virus, vomiting and diarrhea. Our daughter just gave birth today to twins, 5 lbs and 5 lbs 8 oz.  My question is when would it be safe for us to visit?  We do not want to spread the illness.  I have not vomited, etc in approx. 36 hours. ### REPLY: Hello Madam, Welcome to . I have gone through your query and I understand your concern.First, I want to congratulate you for your nephews. Regarding your question, stomach virus is contagious, but it is spread through close contact with infected people, such as by sharing food or eating utensils, and by touching contaminated surfaces and objects. I would recommend you to wash your hands often with soap and water and use hand sanitizer is the most effective way to stop the spread of these viruses to others. It would be safe to visit the newborns if you follow carefully my recommendations. Hope I answered to your question. For further questions feel free to ask again. Kind  ### END