Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: for the past few months, a sore spot has come & gone on the bottom side of my tongue. More recently, I had a head cold with congestion & phlegm in my throat. The cold is gone now but I still have some mucus towards the back of my tongue & throat area. my tongue swells up & throat is sore. also topside of tongue feels raw & burns. Do you have any ideas as to what might be causing this? ### REPLY: Hi. Thanks for the query. I have gone through your query and can understand your concerns. As per your complaint you are suffering from RECURRENT AUTHORS ULCER which is causing you the eruption of a small sore spot under the tongue. Burning sensation of tongue is due to inflammation of the tooth leading to Glossies. It can be caused due to a number of reasons like Stress, Nutritional Deficiency [Iron, Vitamin B12 and Folic acid], hormonal changes, acid reflux, tongue trauma due to some sharp teeth or tongue biting habit, excessive intake of sour and citrus foods, uncontrolled diabetes and other immunocompromised conditions etc... You need to consult an Oral Physician or a general dentist in this regard to get evaluated and treated. For authors ulcer you can do warm saline garglesGargles with 1:1 solution of Ben . . Apply numbing gel over the sore for relief from pain especially during eating. Take a multivitamin tablet for a period of 15 days. Avoid spicy, sour and acidic foods. In case if still the condition does not subside the physician can prescribe you to take a Steroid course as it is the ultimate treatment in case if nothing else works. 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: I have an infection in my foot that has been diagnosed as cellulitis. I actually have a hole in my foot that will probably need skin graphs. I ve been given iv antibiotics as well as oral antibiotics. I also have one on my arm that has actually burst and is draining right now. In addition to that, there is a redness around this boil like wound that is hot and seems to be moving up my arm. I was told at the hospital that I could get more of these until the infection gets out of my body. I am currently soaking my foot in an antiseptic solution, putting antibiotic ointment on both wounds, covering with gauze pads. I am suppose to go to a wound clinic for followup care. Do I need to go to the er with this redness going up my arm? ### REPLY: Hello, Welcome to , In case of cellulitis infection spread to the subcutaneous (under skin) tissues as well. I think instead of debating on what caused the boil or bite and made way for the entry of the bacteria it is important to treat fast. I would suggest you to take some lab investigations like CBC, blood culture, routine urine examination and culture of the wound discharge. Furthermore, I suggest you to take oral antibiotics first for at least 2 to 3 weeks to contain the spread of cellulitis. You need anti-inflammatory like Ibuprofen up to 600 mg per dose two to three doses a day. If the symptoms are still persisting, you may have to make an appointment with your surgeon. 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: Last month I had a molar pulled and had deep pocket cleaning on my teeth.  My lymph nodes are still slightly swollen..which causes my tongue to swell.  My tongue has white patches on the back and large red bumps.  There is also a sore on both sides of my tongue.  Just now when I gargled, I spit up some blood.  My peridontist says things look okay.  Whats going on???? ### REPLY: HiT hank you for your query with , As such with the symptoms and signs you have mentioned it looks like you have a periodontal disease. Coming to your second issue lumps in the floor of mouth or back of tongue might be lymph node enlargement due to infection need a complete thorough check up with radiographic examination, and also you need full antibiotic coverage. Please stop if you have any adverse habits like smoking or chewing if tobacco. Hope this answers 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: HI I AM GEORGIA WICKETT AND I have been ahaving some chest pain I think I also have asma and I am not sure which it is though I am fealing better as I wright this still have some tighting in my chest but not so mych I thinkI am ok now I do not seam to nave any pain thank you for your help ### REPLY: Hi, thank you for asking . Going through your presentation, one may still need to ask you some few questions like the précised location of the chest pain, the frequency and duration of the pain, if it is accompanied by breathlessness and cough, etc. Asthma occurs periodically and is characterized by difficulty in breathing and cough. I would advise you see a doctor if the pain is still disturbing you or if possible you try to through more light on what is happening to you. We would be delighted to give you satisfactory answers. I hope that helps wish you well ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: every once in a while in he morning i see blood in my spit after brushing my teeth.  gums do not appear to be inflamed.  was just at the dentist and gums are healthy? i feel fine..healthy etc.  what could it be and what kind of doctor should i go to for this. ### REPLY: Hello, Welcome Thanks for consulting , I have gone through your query, as you have bleeding gums while brushing don't worry it can be due to dirty teeth, Due to periodontal problem bleeding while brushing occurs.  Do warm saline gargle two - three times a day.  Do brushing twice daily. Do chlorhexidine mouthwash twice daily. Consult dentist and go for ORAL Prophylaxis. Hope this will help you. Wishing you good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have just seen a catalog offer for a product called Slim Ice 906090. This two products which supposedly work together - a reduction body gel and firming body spray to slim down body and reduce cellulite within 30 minutes - could this possibly work? ### REPLY: Hi, This is fake to advertise. Do not trust on such products which claim to reduce cellulite in a few minutes. How can be possible... reduction of cellulite in 30 minutes? This is a bogus thing... never go for such fake things. Just consult the doctor for obesity and get proper advice. You may consult the nutritionist to change your diet. And also go to a gym for exercise and yoga. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, about a week ago I had gay interaction with a man. Basically I gave him unprotected oral and he gave me unprotected oral and spit on the head of my penis. I then engaged in protected receptive anal sex. During the anal sex I spit on the condon and gave him oral on the condom for lube and then proceeded with anal sex. About 10 years ago I had random small pimple like bumps on my lower stomach that would come and go and found out my female mate had HPV. I never got tested because we were unprotected and I figured I had it. Two days after my gay encounter my penis burnEd slightly and itched . penis and scroutum seem slightly swollen and wrinkled but no pain during g urination no discharge and no bumps as of yet just red patch on my penis head. When I use anti fungal cream symptoms seem to scale back including swelling. My question is what could I have contracted and could the encounter just have triggered my HPV. The symptoms feel slightly the same. ### REPLY: Thanks for asking in  forum Unprotected anal/oral/vaginal intercourse can cause infection. There are a lot of organisms which can cause infection in this kind of situation depending upon the status of your partner.  So, swelling and red patches on your penis may be due to infection called balanoposthitis. Hence, visit a doctor for examination and further investigations for Sexually transmitted diseases.  All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive had bad balance problems for 5 weeks, my mri came back normal. Ive got a loud hissing sound in my ears. none of the vertigo medicines are working ive had serc bethahistine, cinnarizine and several others.My neck has been sore/stiff as well and ive had vommiting for five days in the middle of all this but this has stopped at present. I dont know what else to do ive been to the gp but they do not know what is causing this. I wish i could stop the dizziness/ lightheadedness.e ### REPLY: Hello! Welcome on ! Your symptoms could be related to chronic degeneration of the cervical spine (also called cervical spondylarthrosis). A bulging cervical disc can not be excluded either. Coming to this point, I would recommend consulting with your doctor for some other tests: - a cervical spine X-ray study- PCR, sedimentation rate for inflammation cervical spine CT scan or MRI would give more information on the above-mentioned disorders. You should discuss with your doctor on the above issues. 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: Hi I have two health questions....1. until about 2 weeks ago i was straight but then i started thinking what if im a lesbian now im young and Ive always love guys but I keep over thinking it...2. How do i stop myself from over thinking the little things in life. For example if I feel like Im gonna throw up my brain will think about it so much it will convince me that i will throw up!HELP!!!1 ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. These are called obsessive thoughts. Brain (mind) is made for its own functions and its duty is to think. Therefore, you cannot stop it from thinking. But you definitely can control the way it thinks by diverting its attention to more demanding things. Creative thinking should help brain diverting. If you try to forcefully overcome obsessive thoughts, it will come back sometimes and disturb you more vehemently. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. 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 pain on right side of body on and around rib cage...I feel small nodules or soft bumps/lumps on the ribs. I am nauseated, but no vomitiing or temp.... have sweats, chills, .....this pain is mostly debilitating in the am....till mid afternoon. Please help. ### REPLY: Hello, I read carefully your query and understand your concern. The sweat and chills are commonly related to a viral infection. The bumps can be caused by enlarged lymph nodes due to the presence of an infection in the system. I suggest using anti-inflammatory medications such as Acetaminophen to relieve the inflammation. I also recommend doing a complete blood count for further evaluation. Hope my answer was helpful. If you have further queries feel free to contact me again. 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: my son who is now 26 was diagnosed with depression/anxiety about six years ago. He was given antidepressants and saw a psychologist . He felt neither were particularly helpful He since then has been unemployed and for several years was extremely isolated and struggled through a lot of confusion insomnia and mental discomfort including guilt and anxiety for not feeling he was able to cope with the outside world. He now attends fortnightly meetups for the socially anxious and shy and occasionally attends another social group . He has not been able to find work but volunteers weekly at an aged care facility where he trains elderly in gaming technology. All of these appeared to be signs of recovery. Recently his depression has flared up and from what I read , he has all the symptoms of agitated depression (along with possibly other mood disorders). I ve read this should be treated very differently to other kinds of depression. He has resisted help for a long time but has been feeling desperate enough lately to try other kinds of therapy. Do you know of anyone specializing in the treatment of agitated (mixed states ) depression? Any advice is welcome ### REPLY: Hi, Welcome to  forum.  As you describe he is capable, and going in the right way. But I also advise him to take some medication, advised by the doctors.  He should take care of his general health as well.If something is wrong, he may attribute it to the mental health. When ever he gets some health problem, he should get advise by the physician.  He should have some money in hand, and you can have some supervision over it.  I advise him to practice, yoga,meditation, and some earning procedures, like internal decoration, internal gardening, or vegetable gardening.  You don't explain all this, let him read the reply, by him self, if he is convinced, it is well and good.  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: hi, iam 27yrs old, completed our 4th yr of marriage. iam diagnosed with PCOS , ihv been taking treatment for almost 2 yrs. its been 1 1/2yrs of consultation with my present doc who is treating me. I along with my husband have got all the test done. my husband is completely fit, touchwood. we had tried alot for concieving but till now no luck. i dont get menses without taking medicine. in my 1st stage of treatment i was taking TARANA then in the 2nd stage i took laterol , pregnistar, premosa, duphaston , folic acid . and for ovulation i was prescribed pregnyl 5000. can anyone of u plss advice me was this the best treatment or what is the reason for me not concieving. thank you ### REPLY: Hi welcome to ChatDoctorForum. forces many people are getting treatment and getting pregnancy. It is not successful means there must be some other factors inhibiting ovulation like anemia hypothyroidism diabetes or some other causes. I advise you both partners to consult a fertility clinic for tests including semen analysis. Besides, I advise both of you some diet recommendations as eat more of green leafy vegetables pulses sprouts fruits and juices to build up blood picture and for general wellbeing. Wishing for a beautiful baby 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 believe that my daughter is suffering from anorexia. She has developed this condition where she constantly swallows and expels tiny burps. Is this part of anorexia or could it be something else. Also, she was born with Corrective Transposition with Pulmonary atresia ### REPLY: Hi...it would have been better if you had mentioned the age of your kid. By what you quote I do not feel that it is anorexia. I feel that she is doing it by habit, and it is habit disorder. The best way to manage this is by tender loving care and get her out of the habit. If not it could also be due to attention seeking behavior in which case it is better to ignore it. If nothing is working I suggest you get in touch with a clinical psychologist. 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 25 year old nephew has been in a medically induced coma following a tbi one week ago. They have reduced his sedation and he has been moving and twitching but also recipes when his aural temperature is taken and when his eyes are exposed to light (he has patches on them due to trauma). Are these signs that he is becoming aware or are they just reflex movements? ### REPLY: Hello! Thank you for asking on ! Regarding your concern, I would explain that these movements may be just reflexes, related to different stimuli (light, electrolyte changes, etc.). Anyway, a careful neurological examination (the brain stem reflexes, reaction to the pain or sound) are necessary to give a more adequate answer to your question. You should discuss with his attending physician on these issues. Hope to have been 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: My doctor could not explain why my MRI film shows calcium deposit covering my tail bone. It is an MRI of August 2013. I was surprise that my chiropractors (several) and my physical medicine doctor could not see it and diagnosed it until I went looking for a second opinion yesterday with a new doctor. The reason I saw him is to find out if he could treat me with the lower pain back that had become chronic, regardless sessions over sessions of chiropractic and physical therapy . could you please let me know the cause of my calcification? the treatment? or any way to stop the progress of it? I jumped to the conclusion that I had pain caused by this calcification. What is your opinion? ### REPLY: Hi welcome to ChatDoctorI have gone through your query regarding calcium deposits in your tailbone. Dear you have not mentioned your age which can help determine the right diagnosis and treatment. Why your doctor and Cairo could not read the MRI film because it is a field of a specialist. So advance forward to know the cause, remove and solve the problem. A hormonal disorder causes calcium from the bones to move into the blood stream. A variety of calcium buildup is harmless and may be considered a normal part of aging. However, calcification can disrupt organ function and affect blood vessels. Longstanding kidney failure and excessive intake of vitamin D, which results in excessive absorption of calcium from the intestines, can also lead to this type of calcification. According to the specialists, about 99 percent of calcium in the body is transported to teeth and bones. The remaining 1 percent is in the blood, muscles, fluid outside the cells, and other body tissues. This 1 percent can add up and cause problems over time. For your info, our faulty food habits and derailed lifestyle also is responsible for low immunity and cause of sufferings. I would like to suggest you to modify your lifestyle and food habits. Include essential nutrient and antioxidants in proper proportion according to a qualified dietitian and regular exercise, walk, yoga - Bhujangasan Sheratan, Back being postures , Panama- Deep Breathing exercises - Inhale deep - Hold 2sec - Exhale deep-Hold 2 sec. Kapalbhati, Aguilar, Anglo Film are also life giver postures to be done under a qualified trainer. A spoon of turmeric powder in a cup of hot cows milk is good to alley pain and inflammation also Homeopathic Arica 30 /thrice / in half cup of water/ for 2-3 days day very effective in pains. Only a doctor can determine whether your if case warrants any other. Treatment. Hope this helps solve your query.Don't hesitate to get back if you have any other doubt. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 female a 53. In the last few months i have suffered a couple of memory loss incidents and it has happened again today. I have a dull headache and everything seems to have a perculiar metallic smell including food. I have been stressed at work lately and wondered if that had anything to do with it. Up until these incidents i have been perfectly healthy and am not overweight. ### REPLY: Hi, First, you should do some investigations such as:measuring blood pressure and doing lipid profile in the blood. If you had hypertension, you should receive medical treatment, decrease salt and fat intake, besides do an ECG and an ECHO on your heart. The dose of oral contraceptive pills or a hormonal replacement therapy should be adjusted. The disorder of memory with peculiar smell sensation could mean that you need to take vitamin B complex, so you should take vitamin B complex once per day after meals and Benfotiamine 40 mg twice per day after meals to. Finally, you should avoid smoking and .  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I had an abortion a month ago. I keep having this upper back/ neck pain . it comes and go. I visited 3 different doctors all them said it s stress and tension but sometimes the pain is so terrible it makes me cry, but also sometimes its gone for hours... it s really normal or do I have a real problem? maybe it s not connect it to abortion, maybe it s something else? ### REPLY: Hi there, Sorry to hear that you are in a lot of pain. I don't think the neck and back pain are connected to the abortion. Also, you have visited 3 different doctors; who have evaluated and examined you. So, please be reassured. It is quite possible that it is related to posture, or it could also be an orthopedic complaint. Try the following measures; and still if you feel there is no improvement, visit an orthopedic and get yourself evaluated.1. Apply a thin film of voting gel on the affected area. 20 minutes later apply hot fomentation/ heat application. This might bring you some relief.2.  . 3. Maintain good posture.4. Sleep in a proper position. Invest in a good pillow, like Temper etc. While sleeping, if you lie on your side, keep your hips and knees flexed and place a pillow between your thighs and knees. If you normally lie on your back, place a pillow under your knees.5. Sign up for yoga classes if you have a good yoga instructor in your area. Deep breathing and Relaxation techniques will also help.6. If the pain is quite bad, then an over the counter analgesic like broken might help. Hope you feel better soon.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am 35 years old man in recent ultrasound i have coarse liver and i am also hepatitis c patient since 2011. my Lfts are of 120-130 range. kindly tell me how much my liver have been affected at this stage and what should i do.i have not yet treated me with inetrfiron. ### REPLY: Hi I can understand your concern... Noted you have hepatitis c chronic infection. Here our aim is to prevent complications like cirrhosis and portal hypertension. If you have chronic active disease decided by HCV RNA then Antiviral . . Take more fruits with low fatty and less fried food.... Avoid alcohol as it is toxic to hepatocytes. Daily in morning take grinned spinach leaves and carrot juice ... Take one tsp licorice with honey... Cheese, butter, pizza, meat avoided.... In dinner include vegetable soup also. Yoghurt also useful... Take low salt diet... If ascites develop contact doc immediately. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 and just had my last 2 wisdom teeth removed a week and a half ago..I feel sinus pressure and my ear has been hurting on and off. There is still a small hole on the side where my tooth was removed, but has been checked and Ive been assured everything looks fine. Still not fully recovered though and am wondering what needs to be done. ### REPLY: Hello, Healing will take longer than this time frame. A small hole is not a concern unless there is inflammation in the socket. Consider having the socket rechecked since you report sinus discomfort. Sometimes the socket area needs to be cleaned out and antibiotics may be considered. You may have a sinus condition or ear infection that is a separate concern if the socket looks fine again. With assurance that all looks fine, you may still experience some discomfort with healing. Make sure you continue to rinse well and prevent anything from getting lodged in the hole. Take some anti-inflammatory medication, practice good hygiene and be gentle with your diet. Thank you for your inquiry. I hope you feel better soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i m black female i was using petogen for 13 years now i stop, there is any chances to get pregnant quickly my age is 28 years my waight is 90kg height is 6.5 i dont have any medical history what can i use to clean the petogen as soon as possible ### REPLY: Hi, if you stop it suddenly there is sudden partial or complete loss of vision, or if there is a sudden onset of proposes, diplopia or migraine. If examination reveals papilloma or retinal lesions, medication should be discontinued.  Progestins had been reported to precipitate attacks of porphyria. Where r u living? I suggest you to take panchakarma an ayurvedic treatment which act as detoxification treatment, which also helps to reduce your weight. Contact me on . benade@gmail.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 6 year old daughter has a hole in what looks like her gums between her 1st molar and the tooth in front of it. She says its not sore or uncomfortable at all. She has her 1st (yes shes never been to the dentist because she is so scared she wont even let the doctor examine her mouth) check up on Feb 19. Im cleaning the hole out 2x a day with a pick, is that ok? Why does she have the hole? And do I need to take her to the dentist sooner?Thank you! ### REPLY: Hi. Welcome to . I read your query. You mentioned the age of your daughter 6 yrs. The first permanent molars are newly erupted at this time. So the surrounding gums may be loose. Also, chances are she might have loather adjacent primary tooth recently which left the space. If the hole is not painful or leaking, just observe it for 2-3 days. It will start closing. Maintain good oral hygiene. Brushing twice a day, rinsing properly after eating. Pay attention that no food is left sticking in that area. Give healthy diet. If it persists or show symptoms, show her to dentist for further check up. Hope the answer helps you. 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: dear sir, I had taken AKT-4 for 2 months for treating intestine Ulcers. Now i am having r-cinex 750mg. it will give any side effects..how i vl cope up this situation bcoz my SGPT & SGOT already increased upto 60 Also my Liver is mildly Enlarge in Ultrasound. please reply me soon.. What will I do? Regards, Kishore Kushwaha Mob: 0000 ### REPLY: Hi and welcome to . Thank you for your query. I am , I understand your concerns and I will try to help you as much as I can. Usually liver enlargement may indicate some types of hepatitis or fatty liver diseases and in most cases it doesn't require any specific treatment.  If this is caused by diet, obesity and diabetes then dietary and lifestyle changes will be beneficial in every case. Alcohol and viral hepatitis are the most common causes and in this case medical evaluation is required. Also, if there is infectious disease or biliary duct disorders then you need to do some tests to rule out more serious issues which require specific medical treatment. You need to check your viral markers and do liver biopsy if necessary. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am getting burning and tingling sensation on my right thigh . if I seat on chair, the that burning and tingling spread through out legs and gets aggravated. and getting pain on hip area of right foot and gets buttock pain sometimes when sits on chair. ### REPLY: Hello this burning and tingling sensation is mainly due to the irritation on spinal nerve roots .as you sit the intradermal pressure increases and put pressure on the nerve roots.  These nerve roots carry sensation so burning and tingling sensation aggravates at that time. I will advise you to start spinal extension strengthening exercises such a pelvic bridging exercises followed by flexion abdominal strengthening exercises . As your spine muscles will get strengthen your problem will be solved.  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: Dear Doctor My youngest sister was diagnosed with metastatic myaloma cancer on 2 October 2010and had chemotheraphy and now has a tumor on the brain that is being treated with radiation.  How successfull is this treatment. And what is the changes of recovery. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. She has metastatic lesion in brain.  Chemotherapy is not helpful in brain lesion. So she should require radiation treatment to control brain tumor.  This treatment is palliative treatment only.  It will not cure the disease. Ultimate prognosis is poor. Life expectancy is not good. Sorry to say but it is fact. Consult your oncologist and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my name is jared 16 years old and I have 2 problems 1 is tht my balls r hanging extremely low like all the time and 2nd everytime I ejaculate my semen is light green? I no its suppose to b white cuz I learned it n health class I just hope I dont hve cancer....plz answer ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. I advise you should do semen analysis. Which include microscopic examination and chemical examination. If you receive report stating that abnormal malignant cells are seen than its malignancy. I think color of your semen becomes normal after some times. Till that time you can take Doxycycline 100 mg two times a day. Please take it under your doctors' guidance. Please . Cancer van be associated with variety of symptoms like cathexis, loss of weight etc. I will be happy to answer your further concern on bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,My mother is suffering from dengue fever. Her platelet count had dropped to 20000. After platelet transfusion it went up to 41000 but has again dropped to 33000. She is vomiting and passing loose motions. Her age is 71. We are really worried. What is the best treatment. ### REPLY: Hi there. The platelet level is really low, and your mom is elderly - I strongly recommend that you immediately take her to the nearest hospital for treatment. You need to understand that there is no cure for dengue infection - treatment given at the hospital is supportive through rely .  Should platelet levels dip too low -platelets may be transfused to prevent internal bleeding. It is very necessary that you take your Mother to hospital ASAP. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor. i am thinking to use melacare forte cream so before i go for it i wanna know your suggestion and views of melacare forte cream. i heard from some of my friends that melacare forte cream just take out a layer of skin by which its look fairer n while we stop using it our faces becomes dark then ever before ..... thanks a lot ..... ### REPLY: Hi, Delaware forte cream is a known lightening agent. It is one of the triple combinations that is widely used by dermatologists all over. It is a good and effective agent if used under medical supervision. Using sucChatDoctorbinations as OVER THE COUNTER .  Yes, there is no doubt that it does improve the skin tone when used. It is used by dermatologists for various hyperpigmented skin conditions. But I would recommend you not to use it without prior assessment and recommendation by a skin specialist. One of the known problems with such medications is that it can cause hyperpigmentation, if not used properly and as advised by a dermatologist. Such medications have to be used only for a limited period of time. Excessive use can cause problems. Also, these are too used only at nighttime. Hope I have answered your query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my 7 yr old has painful lumps on his feet, on the side below his little toe and on the bridge. They appear bruised tonight although they have been there for months now. His ankle bone looks swollen too. What can we do please, he is in a lot of pain. ### REPLY: Thanks for your question on . I can understand your sons situation and problem. Painful, multiple lumps on lower limb can be due to 1. Staphylococcal infection (cellulitis) 2. Allergic skin lesions 3. Connective tissue disease (CTD). So better to consult dermatologist and get done clinical examination and blood investigations like ANA level, hemoglobin estimation, total ABCs, serum IGE level etc. to rule out above-mentioned possible causes. First diagnose himself and then start appropriate treatment. Hope I have solved your query. Wishing good health to your son. 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 a 29 year old, diagnosed with PCOS, and have irregular menses.Been trying to conceive and carried out an IUI procedure recently after a basl temperature drop- sign of Ovulation.Usually when i take Primolut,it induces bleeding.But my Doc prescribed it for Day 16-25 of period.Is it safe even after IUI procedure @ day 14? ### REPLY: Hallow Dear, If you are a case of PCs, you should not go for GUI empirically. Just do not go by temperature changes in the Basal Body Temperature Chart; some other relevant information is important and required before attempting any Artificial Reproduction Technique like GUI. In patients with regular menstrual cycle, day of ovulation is 14 days before the expected menstrual cycle. However, since you are a PCs case, your menses must be irregular. Hence, better not rely on day 14 of the cycle. I would advise you to go for ultrasonography ovulation monitoring. It will help following way: 1. It will precisely detect the day of ovulation when you can go for Intrauterine Insemination (GUI). 2. Furthermore, it will inform us about the size of the follicle when it ruptured to release the egg. Follicles of size between 18 mm to 21 mm release the healthiest eggs having good chances of successful pregnancy. 3. If the eggs are not getting released naturally (which is characteristic of PCs), your Gynecologist can plan induction of ovulation by some medicines like Camphene citrate or HMG/ combination and then plan GUI accordingly. Maybe you might require Metformin or MYO Inositol as an adjuvant therapy. 4. Ultrasonography will inform us about the development of the uterine cavity lining (endometrium). Endometrium of thickness between 9 mm to 14 mm is most conducive for implantation of fertilized egg. If the endometrium is thin, your GUI may go waste. Hence, please submit yourself for ovulation monitoring from by Ultrasonography day 9 of the cycle and then plan for GUI. Please do not take Primal pills for regularizing the menses; they may interfere with the egg release. Ovulation induction medicines will regularize your menses along with the induction of ovulation. Please report to some Infertility Consultant. I hope you got the message.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 age is 27. i am suffering from sever pcod&over weight.since 10year. i took so many medicines by doctor recommend.  but it still its not cure. so,that i cannot consive also.and i took so many test thats all ok .so,please tell some remidi to get pregnancy. ### REPLY: Hello dairy understand your concerns is very complex disease and difficult to treat in some cases. It causes hormonal imbalance, insulin resistance, infertility issue. I would suggest taking treatment under the advice of the authorized gynecologist. Following medicine will help you:Progesterone pill: in second half of the period to regularize the periodMetformin: to induce ovulation and decrease insulin resistanceClomiphene citrate: first 4-5 days of the cycle to induce ovulation and help in conceivingSpironolactone and FSH analogue can be used. In unresponsive case surgical process like ovarian .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 going on holiday on friday and i am unable to see a doctor as there are no appointments before then. I noticed a few weeks ago that my right nipple was itchy it then became dry, itchy, cracked and sore. I tried to use moisturiser but this did not get rid of it. A bit worried because it is only on one nipple. Do you know if there is anything i can do or buy from the chemist to get rid of it? thanks ### REPLY: Hello, Thank you for posting on . It seems you are suffering from Tina corporal, a kind of fungal infection. I would suggest you to consult your dermatologist for proper management of the condition. I usually recommend proper course of oral antifungal .  You can additionally use antifungal dusting powder containing ketoconazole during daytime and a soap containing ketoconazole for rinsing of affected areas. Take oral antihistamines for itching as required. Maintain hygiene over those areas and avoid wearing tight undergarments. Hope your queries are resolved and wish you best of health. Kindly spare some time to rate my answer and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor, Baby is 3 month old. Birth weight 2.9kg. Weight at 10 weeks is 4.6kg. Gaining average of 700gms. She had loose motions and rash (chaffed skin) at anus since 12 days of birth. Her urine & stool are acidic. Last month her stool pH was 6.0, reducing substance - absent. We started giving her homeopathy medicine (on consulting doctor) since 2 weeks. Rash seems to get better. She is on nutritional supplement for last 3 weeks. Got her urine & stool tested again now. Stool pH is at 4.5. Reducing substance -present. Urine is acidic. She is exclusively on breastfeeding. Is she lactose intolerant? Can breastfeeding be continued? Or supplement feed be given? Please advice on a solution for acidity control & anal ulcer/rash. How to proceed further.. ### REPLY: Welcome to the ChatDoctorBrief... It could be metabolic disorder (galactosemia) or zinc deficiency. Detailed answer. As I have gone through your children history. It seems that she might be having galactosemia in which child can not tolerate breastfeed, and have positive reducing substances. Lactose intolerance occur if child is having cows milk. So it is less likely that she is having lactose intolerance. Other cause can be zinc deficiency, which can also cause these symptoms. My suggestion would be if she is having only rashes and loose motion then make sure she is getting zinc supplement and if she gets other symptoms like jaundice, lethargy, hypoglycemia (get her blood sugar test done) and discuss with allopathic pediatrician further. Hopefully my answer will be helpful. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: For over a Month now the middle of my back on the right side will just get tight all of a sudden and feel like a tens unit going off,I can just be standing and it will start hurting in the center right side of my Back and travel downwards,no matter what I am doing it has come on all day every day for over a month,I had chest xrays last nov when I had a bloodclot in my left lung so i dont think its my lung ### REPLY: Thanks for your question on . Yes, this can be due to blood clot in lung. This condition is known as Pulmonary embolism (PE). And if not treated properly, can lead to pulmonary infarction. And this infarcted area can cause pleuritic type of chest pain and tightness. So better to consult pulmonologist and get done1. CT pulmonary angiography2. V-Q (Ventilation Perfusion) scan. These will be helpful in rule out pulmonary infarction. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 17 years old i am a male 4 weeks ago i had my appendix removed while the surgery they saw an umbilical hernia and repaired they told me it was tiny now i can feel this bulge under my belly button and i have this numb pain that i cant tell if its in my belly button or my penis its really weird it feels sharp and numb it feels better when i sit down and take my mind off of it but it is stopping me from going to work because im afraid of damaging myself further my quest is, is it normal to have this pain this long after my surgery and should there be a bulge any help is welcomed thanks ### REPLY: Hello, It is not usual to have a bulge under your umbilicus after 4 weeks and that too specially it was not there before your surgery. However since you have no other signs of inflammation, it could just be a wound hematoma which could resolve in a few weeks. Your numb pain is mostly related to neuropraxia/paresis of T10 nerve supplying the umbilical region. This also produces referred pain to the penis. I would suggest you get a followup with the operating surgeon in this regard. 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: My sister has elevated Liver Enzymes and Elevated Bilirubin levels with Stomach pain, Vomiting and diarrhea for the last two weeks. Normal abdominal ultrasound. Only medications she is taking currently are Gabapentin and Zofran which is supposed to stop the vomiting , but isnt. What comes to mind? ### REPLY: Hello, She should rule out viral hepatitis by viral marker investigation like anti HAD estimation, Bag estimation, Anti HCV estimation, Anti HE E antibody estimation etc. You can revert with reports once done. Meanwhile, take care not to eat high fatty foods and sugar cane juice should be taken more. Apple juice also beneficial.  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 a dark circular black spot that looks like a bruise on my inner thigh. It is tender and about the size of a half dollar. It appeared about a week ago and I am concerned. I have been getting phantom bruises for some time now but never this dark and circular. What could this be? ### REPLY: Hello, It can be caused by skin infection called Tina Courts, visit ER, get physically examined. You may need antifungals (Fluconazole) since you complain of getting such black spots every now & then. You can apply steroid containing creams, like Pander, Qua .  Dark circular black spots can be due pigmentation, chafing makes skin thin, itchy & discolored, make sure that your inner thighs do not rub against each other while walking or doing exercises, it may cause a bruise. If you are obese take control of your diet & reduce weight. Take care of your hygiene, avoid use of harsh soaps, wear cotton clothes. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am a 64 yr old woman about to undergo a mastectomy.While undergoing various other tests they discovered stones in my gall bladder.However there is no pain.The doctor has suggested removing the gall bladder via laparoscopy since I would already be undergoing the breast removal surgery.Should I go ahead or since theres no pain leave it as it is.Thank you! ### REPLY: Hi and welcome to . It would be advisable to remove gallbladder if general anesthesia will be already performed. This would prevent any future difficulties due to gallbladder stones and procedure is routine today with negligible risk of complications. Of course, this is all up to you, but as I said there is more benefit than costs and I agree with your doctors about it. Thanks for the query. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir i have typhidot, i did test for it, the result of the tests were weakly reactive/ weakly positive, then i used 3 courses for it but still i am not feeling fine, sir i used ciprofloxacine gemifloxacine and levofloxacine tablets for its treatment but my condition is still worst, please guide me and tell me some good treatment, thanks. ### REPLY: Hello, I understand your concern. I am , Infectious diseases specialists, responding to you. I suggest you to do a stool and blood culture test to detect Salmonella type causative agent of typhoid fever. Sometimes it is found that they are resistant to prescribed .  So as you have sensitivity report in hand. I suggest taking antibiotics accordingly. Your infection will be cured once you take antibiotics as per the report. Please do consult the doctor before you take the treatment. I will be glad to answer your further query. Thank you for your contact to . Wish you the best health. Thank you, ChatDoctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my daughter just went to her dentist and I was told she had to have 2 back teeth pulled and 6 caps. She is only four years old. I knew it wasnt god when I brought her in. She has experienced no pain what so ever. I know it was my fault from lack of care but it is my job to make her feel the most comfortable as possible. Her molar on her right side is bothering her gums because it is infected and is starting to puss. She was prescribed amoxicillin. They scheduled four separate appointments to do the dental work. The appointments seem fairly close together. I dont believe it is enough time for her to recover before going back. I had asked for her to be put to sleep when the teeth were pulled and the dentist told me she recommended her to be on laughing gas because she was very cooperative. So my question to you is, how long does it take a four year old to recover from teeth being pulled and caps? Also, do you think the teeth should be pulled? Do you think I should demand her to be put to sleep? ### REPLY: Hello, thank you for consulting with . As you are mentioning that your daughter molar teeth are infected, and even there is pus discharge, then you should get them removed as these are milk teeth not permanent and if you will leave them they will infect the erupting permanent tooth also. These capping which the dentist has mentioned will maintain the space for permanent teeth, so they are necessary. It will take only 1 to 2 days in recovery from pain otherwise she will be ok after surgery only. So please do not take tension and believe on the dentist. Hope it will help you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I developed fever and chills with some body aches three days ago. I have been taking Cipro 500 mgs. twice daily since Thursday evening. I continue to have episodes for sweating and developed a dry hacking cough two days ago. Heaviness in the chest and basically fever fatigued and letharagic with a runny nose. I have also been taking Flu and Cold. One year ago I received a pacemaker, have Tyoe 2 Diabetes. I did receive a Pneumonia and Flu injection at that time. I was wondering if I might have Pneumonia. I feeling like I am having trouble moving in air. ### REPLY: Thanks for your question on . In my opinion you should get done blood report (CBC) and chest x-ray to rule OIT infection in the lungs. Possibility of lung infection is more because1. Fever with chills and . 2. You are diabetic, so chances of infection are more.3. Your flu vaccine is a year ago, so coverage is over. So you are quite prone to lung infection, so we have to rule out this first. If chest x-ray is normal than malaria should be rule out as fever with chills is there. So better to consult doctor and discuss all these. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i am a boy of 23 year.i have a very big problem that i have suffering from excess wet dream.i have lost my  weight,semen,strenthand memory.i have consulted many docters and specialists .but i could get any permanent solution for it .please guess me ,what is the proper causes of nightfall or wet dream.and please give me solution for it.thanks ### 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-High testosterone activity(High Blood levels of testosterone), with Excessive desire without any option for natural outlet for ejaculation in males, is the cause of Wet . Lack of knowledge, fantasies about sex acts and excessive involvement may cause this in and around puberty years. Besides this, GI diseases with Gases and Hyper-urination / increased frequency of urine, may cause these wet  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Jessica. I have been experiencing sever low back hip pain for a week. It s getting worsse. Hard to walk. My neuro called yesterday with my blood results. Eerything was good, but high potassium. I went to y family doc tyoday, and was told i Have a bladder infection? Sounds to me more like kidney stones?? ### REPLY: helloThanks for query. Severe low back pain without any positive neurological findings is most likely to be due to presence of stone either in kidney or Ureter. Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvis3) Serum electrolytes Further treatment will depend upon result of these tests and final diagnosis. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: during a basketball game 3 weeks ago my son took a knee to his thigh, it is still very sore and he was kneeling today and it gave out on him and he can barely walk on it now, there is no bruising. should I have him apply ice or heat or should I have him looked at? ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have bruise on thigh post an accident due to rupture of blood vessels secondary to trauma, and it is leading to accumulation of blood in the soft tissues and causing bruising and hematoma formation. I would suggest you to do cool compresses over the swollen and bruised areas, take anti-inflammatory painkiller like Ibuprofen, apply analgesic gel to relieve pain, elevate your leg while lying down. If condition doesn't get better than consult general surgeon for proper examination. Doctor may .  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: Hi. I am just wondering what caused me to have my tongue to feel tasteless when eating. I think that one of the reasons is that I stuffed toothbrush with toothpaste (mint flavor) for to long as I got distracted by watching the television. Is it possible? And how long will it take for it to go away? It has been more than 20 hours after brushing my teeth yesterday night. ### REPLY: Hello, Thanks for posting your query. The tasteless feeling is due to the prolonged use or contact of toothpaste material on your tongue resulting in numbness. I would suggest you to rinse your mouth thoroughly using warm saline. Use chlorhexidine mouth rinse to gargle. Floss your tongue using tongue scrapers. Usually such numbness lasts for 24 hours only. Please be careful while brushing your teeth, and only a pea-sized amount of toothpaste is usually used for brushing your teeth. . If symptoms persists, please do visit your dentist and get a thorough evaluation done. Also, intake of spicy, salty food has to be limited. 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 43 years old with four children. I eat healthy and exercise and am at a low weight. I recently started feeling extremely tired and felt like there was a lump in my throat . My brother is 32 years old and last year his thyroid was removed. It was cancerous. I am going for a thyroid sonogram tomm. I have accepted the fact I most likely have to have my thyroid removed but I am nervous because some of my glands are swollen. Supraclavicular and one in the back of my neck are swollen. Does this mean if it is cancer-it has spread and this will be much worse? ### REPLY: Thyroid cancer is not run in families except in some syn .  First you should go for investigations, it should include FNAC from the swellings. The prognosis for most of the thyroid cancers is good so not to worry too much. And also the gland swollen means not always cancer. The infection in the throat can cause the glands' enlargement. So you should go for investigations and depend on the results, further treatment can be taken. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 having an allergic reation to something but I dont no where to start to figure out whats wrong. I start having very itchy hands followd by a rash that covers my whole body. Then I start vomiting and having severe diarreha and passing out, this usually last a fews days then it is gone. Each time it has happened it just so happens i have eat wheat noodle or wheat bun ### REPLY: HI, thanks for using  Allergic reactions can involve the skin and other areas of the body including the stomach and intestines (the vomiting, diarrhea). You may want to consider allergy tests to find out exactly what is causing the reaction. This can be in the form of skin prick tests or a blood test. Once the exact cause is determined then you can eliminate or reduce your exposure. 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: My Daughter was in Urgent Care yesterday. She was seen for Naseau, vomitting, Lower Back Pain, very overall fatigue in body. Low grade fever. Blood work was done. High White Cell Count, Elevated Red Cell Count, TSH Low. Today she is worse. Extreme Lower Back Pain, progress up back into neck. Fever 100.3 Vomitting. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern.  She may have some infection.  It leads to high WBC count.  It also leads to cause and vomiting.  Vomiting leads to deny .  You should go for ultrasound abdomen. You need a course of antibiotics. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am taking methadone 30mg 2x a day. I have cervical dystonia and get botox every three months. The botox does not work anymore and have two herniated discs in my neck. I just got my last botox 3 weeks ago. Can t get comfortable in bed at all - even sitting in a recliner. Also have pain in both feet and left leg. The leg is a different color as I broke my left ankle in 3 places in 2005 and then fell and broke left tibia platue followed by a total knee replacement in 2011 at New England Baptist Hospital in Boston, MA. I am in great pain and don t know what to do. Can you help me as I have been to the pain center at Brigham Womens Hospital and recently had a lidocaine fusion which didn t help. ### REPLY: Hello, I have studied your case. Due to compression of this nerve root there is tingling numbness in your leg and arm and pain. For these symptoms analgesic and neurotrophic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. If nerve compression becomes severe later on then surgical decompression will give permanent relief. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m a 47 female with a history of anxiety. However, I am a firm believer that my anxiety is a reaction from the pain I expierience and not the other way around. I went to my Cardiologist last December and he performed, Echo, EKG, Blood Test, Ultrasound, and even checked my Carotid Artieries (for stroke)... All negative Today I have been expieriencing the following discomfort: pain in and around the collarbone (both sides), pain in and around both shoulderblades, tightness in front of upper chest, pain under my chin. Any suggestions? I also take an aspirin every morning... is that more harmful than helpful? ### REPLY: Hello, As I understand that this pain is muscular as most of the systemic reports have turned out to be negative.  I will advise doing hot water fermentation to the neck and throat muscles along with upper back muscles. This will help the muscles to get relaxed.  Also, due to the tightness of the muscles of the respiratory system, the accessory muscles, sternocleidomastoid there will be trouble in the throat and jaw region.  Hot water fermentation will help reduce the pain by relaxing the muscles.  Also, do some simple stretching of the muscles of the throat. Post this, do stability exercise for the neck muscles and shoulder muscles. This will help reduce the joint compression and relieve the pain.  The Trapezius muscle looks spasm and with hot water fermentation and gentle kneading massage, it will be helped. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have mild to moderate pain in the upper right quadrant of my chest that goes through to my back when I lie down. It usually lasts several minutes and goes away if I shift positions. When I return to lying on my back, sometimes the pain returns and sometimes it does not. I was at the drs. about a month ago for a persistent cough and blood work was for the most part good. A chest x-ray was done and the result overall lungs appeared fairly clear, but report reads in part, There appears to be an area of scarring. A subtle density projects along the anterior margin of the first right rib. ### REPLY: Hello, Mostly the pain in the supine position is due to: 1. Gastritis.2. Pancreatitis.3. Pleural effusion (which is ruled out by X-ray chest)4. Any fluid collection in peritoneum.5. Rarely its cardiac pain. Some investigations to rule out the possibilities 1. Ultrasound of abdomen2. Cardiac markers and 2D echo.3. CT scan of chest & abdomen is the last option for the same. 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: For the past two days my heart has hurt really bad. When I lay on my left side it hurts a lot worse then if I am sitting up or standing. When i take a deep breath in, it hurts as i exhale. When I feel my heart with my hand, it feels like its beating very fast, although i never really payed attention to the speed of my heart. I ve also been very tired lately, more tired than I ever have been before. ### REPLY: Hello, I passed carefully through your question and would explain that your symptoms do not seem to be related to the heart, but to local musculoskeletal inflammation. You should know that the heart lays really deep in the chest, and you can not touch it or even hurt it by deep breathing or laying on the left side.  For this reason, I would recommend performing a chest X-ray study and some blood lab tests (complete blood count, PCR, ESR for inflammation).  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 two very painful lumps that reappear very often but this time slightly lower than my armpit i would like advice on what i can take for the pain ? i also get the same around my groin and creases along my upper thighs.im 27 years old female weight 10 and a half stones. i have searched for the excat same symptoms and have self diagnosed Hidradentis Suppurativa, is surgery a possibilty? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have enlarged lymph node in axillary areas and groin.  It can be due to reactive hyperplasia, tuberculosis or lymphoma. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question,, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, I had a pea sized lump on my collar bone that wasn t painful but movable. suddenly it seemed to scab and surface and looks black...I tried to pop it but it looks like a black ball under the skin and there was no way I could ve. What is this? Should I get it looked at? ### REPLY: Hi! This is a common clinical problem in the patients visiting my office day-to-day; therefore many people would be happy and benefited to read your post; thanks! I must explain the possibility in this case as follows:lump on collar bone: lipoma, lymph nodes, neurofibroma, hematoma, cyst, abscess, lymphangioma. Painless lump : all possibilities as above mobile lump: as above except abscess oozing lump: cyst, abscess, lymphangiomalump turned black: recent hemorrhage; therefore a benign cyst only! Only a simple needle biopsy could confirm that this is nothing but a sebaceous cyst; therefore see a surgeon for confirmation and excision which is the best therapy for it!regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had cancer in the stomach, stronger cut it out. this was a year and a half ago. I have a quarter of a stomach. Went out to eat yesterday knowing I cant eat that much but did anyway, went to a buffet, stomach cramped so bad I through up bile all night, was that because I had to much food in my stomach, ### REPLY: Hi, Thanks for writing in. You might have had an early stage of stomach cancer and therefore recommended surgery as a treatment. It is not clear if to also received chemotherapy or radiation as a treatment. As you might be aware, your stomach volume has been reduced after surgery and this requires you tho have small light meals throughout the day to be taken at frequent intervals. The symptoms you experienced are due to dumping syn .  Also called rapid gastric emptying, dumping syn ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a minor motorcycle wreck and the weight of the bike landed on my knee. It s bruised and sometimes feels crunchy when I move it- as though a tendon is shifting. Also it almost feels numb on the surface. Symptoms have persisted for five days after the wreck without getting much better. Any thoughts? The trauma caused no twisting/straining- only impact. ### REPLY: Hello, I have studied your case. As per your age and history there is possibility of soft tissue injury in knee. Most commonly meniscus injury occurs. As per your symptoms you need to do physiotherapy and knee exercises to improve range of motion. If pain persist then you may need to do MRI again to see for any functional defect. Small meniscus tear can be managed conservatively with physiotherapy with USG and TENS. Meniscus injury can be managed by arthroscopic repair, and same day you can go home. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I was just wondering if you could give me some advice. A month ago I slipped and fell down my steps and I landed on my back on a step. It hurt extremely bad, but shortly after, the pain went away so I thought I was fine. But as the days passed, my back started hurting more and more. Now, it hurts to turn around to look behind me, pick up things, lean forward and it really hurts when I lay down and try to get back up. I know I should have probably went to the hospital. I just figured the pain would disappear. Unfortunately, the pain hasn t gone away. Any suggestions? ### REPLY: Hello Stephanie, Thank you for your post. You are probably having a vertebral column injury or spinal cord injury or just post-traumatic pain (due to pressure on your back muscles and subsequent inflammation). Spinal cord injury is most unlikely because if you have, you should have started developing nervous deficits on your upper or lower extremities depending on level of the lesion on your spinal cord. Cord compression due to vertebral column displacement is another possibility but as I said developing neurological deficits would have been showing as symptoms except of course the injury is very, very mild and also pain will not be the most likely symptom. Vertebral column injury will simply be a small fractured bone of a vertebrae or displacement/dislocation which would present as a pain of progressive intensity as you continue daily activity. The other option is you are having back muscles contusion that should disappear with use of analgesics like as acetaminophen or Tramadol or anti-inflammatory like diclofenac or ibuprofen either orally or local pomade with massaging. In either case, you will probably need to visit a radiologist to run a CT scan or X-ray of the vertebral column to rule out any serious abnormally. 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: Hello.  I am a 55 year old woman.  I am recovering from a flu-like virus where I had feverishness, headache and aches all over my body.  The worst of this lasted about 5 days and I am slowly recovering.  However, I am finding that I am experiencing low mood and an agitated feeling (similar to jangling nerves or butterflies in my stomach) and it is making it difficult for me to fall over to sleep.  Is this a common symptom after having the flu?  I am coping with this quite well as I control my breathing until the feelings pass but it is wearing me down somewhat.  Should I be doing something different? ### REPLY: Hello, Welcome to , These symptoms are common with any viral flu. Most of the viral infections are self limiting, and it will subside by itself. As you are having these symptoms it may also depend on the immune status of the individual. Person having good immune system will cope up early and be alright soon. As your symptoms have lasted for more than five days it will subside gradually. I would suggest you to follow1. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Is there a possibility that a minimal ptb will left no scar at all? I got this minimal ptb 2 weeks ago and im afraid to not work abroad because of this. Because as I have read from the Internet that even it is treated. People with this disease can no longer work abroad. Today I just wish that in my next xray exam there will be no scar on my lungs. ### REPLY: Thanks for your question on . Any lung insult whether TB or pneumonia or trauma can cause healing after treatment. And healing can occur by1. Fibrosis2. Calcification3. Rarely complete resolution. So possibility of scar tissue is high if you have tb infection. But no need to worry about this, for future abroad plan. At present complete the course for your tb. And in future when you apply for visa just consult pulmonologist and get done CT THORAX and Bronchoscopy with BAD (Bronchi Alveolar Lavage) analysis for TB. If both are negative then even with scar tissue you can go abroad. By these tests you can prove yourself for not having active infectious tb. So no need to worry much at present.  Just finish your 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: Hi I have ongoing lower back problems, but currenty suffering severe sciatica on the left side (now at chronic stage as it has been steadily getting worse since March). Results of CT Scans were multilevel lumbar spondylosis with severe spinal stenosis at L4/5 & severe degenerative foraminal narrowing at this level. There is also severe spinal stenosis at L3/4.My GP has prescribed Mobic 15ml capsules with no noticible effect after 2 days. Consulting a Neurosurgeon is out if my affordability.I am 56 y/o, female, not overweight & reasonably fit - though no exercise other than walking for the past 6 weeks.I would like to return to the gym but worried I could cause further damage. Any advice would be most welcome!Regards, Noeleen ### REPLY: Hi, thanks for writing to . As you have multilevel degenerative lumbar disc disease, you are not supposed to do any activity that imparts additional strain on the already damaged structures. The activities that you should avoid in the gym are Lifting of any weights and forward bending movements. If you want to pick up anything from the floor, you should bend forwards with your knees bent. Hope this information is helpful. Good day ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I was fitted for a dental night guard due to bruxism. I have had it re-fitted several times. Since wearing it, there are times where I lock onto the occlusion and am unable to open my mouth in the morning. One dentist told me to stop wearing it as it could damage my jaw, another told me to continue wearing it. It happens about one in every four times i wear it. I have never had a muscle spasm when not using. I almost think unconsciously I am biting harder as I wake up very aware of the clenching and do not notice this when not wearing the nightguard.  Please advise, and thank you kindly for your time!Shanti Z ### REPLY: Thanks for your query, I have gone through your query. The limited mouth opening and pain could be because of the bruise and use of the splints leading to disc displacement in the Temporomandibular joint. If the splints are designed properly and if the thickness is too much and if it is hard splint. Consult an oral physician and get it diagnosed. You can stop using the splints for few days. You can take anti-inflammatory .  Furthermore, you can also take muscle relaxants like chlorzoxazone. Furthermore, you can give hot fomentation over the joints. Do not eat hard things, do not open your mouth too wide. Take soft diet. I hope my answer will help you, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Could long term use of arapax-15 years with no reviews- cause my husband to become a narcissist. He has had depression lately but behind the scenes he is a narcissist- no empathy, anger, unable to apologise etc and all the time has only concern for his outside image. ### REPLY: HiT hanks for using  Antidepressants help to reduce depression and underline anxiety. It never effects on anyone's personality. If your husband has narcissistic trait, that is not due to .  Maybe he has such trait since adolescent which suppressed due to depression and now again he has come to his baseline personality. Second possibility may be manic switch due to antidepressant. Consult a psychiatrist for proper evaluation. Thanks ### END