Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 dont know what to do. I have crazy mood swings, I will be happy and the smallest insignificant thing will upset me and make me feel depressed. I am confident and happy and fun one day then sad self conciouse and depressed the next for no reason. I have a lot of trouble focusing and I really need to do something about this. It was pointed out by my boyfriend who suggested I talk to someone about it but unfortunately I cant afford it. Its affecting my life and I cant continue like this. ### REPLY: HI, thanks for using  Mental health is just as important as physical health and one generally influences the other. Depression is a common mental illness that can have a significant impact on a persons' life. It is associated with sadness, loss of interest in activities, difficulty concentrating, feelings of guilt, fatigue, change in sleep or eating habits. It would be best to be assessed by someone, if possible, treatment involves the use of medication and counselling. The time frame of the medications vary but in general they are used for at least 6 to 12 months. I hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am a healthy 20 y old female who has been getting dizzy walking up/down stairs, standing up or sitting down, and even just sitting here. My heart rate goes up alot when I do these things too. I drink enough water and eat enough food. What is wrong with me? (I also am very pale alot so it might be anemia...?) ### REPLY: Welcome at  I have gone through your query and being your physician I completely understand your health concerns.  For how long you're suffering from it? Any other associated problem like diabetes or hypertension? Any goiter or neck swelling? Have you done your thyroid function tests? What is your HE? What is your heart rate?  If I am your attending physician I will definitely get your FBC ECG and thyroid function tests. I will rule out the ATRIAL FIBRILLATION first, before labeling any pathology. Anemia does cause rise in heart rate, but you need to be examined by your doctor for proper management.  Meanwhile, stay calm Get well soon Hope your query is adequately ad .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my boyfriend has a past with kidney stones, he had surgery a few years ago and they removed stones. for the past few days the pain from his kidney has been unbearable and he doesnt have insurance so he is affraid to go to the doctor just yet he wants to wait untill he cant handle it anymore, he said hes almost positive that his tube is closed shut, he is swelling on his left side lower back, and in alot of pain, can you tell me what i need to do with him please this is a huge emergency and if i can get you to confirm that this is serious and he needs to go to the emergency room asap. so please help ### REPLY: Hi and welcome to .  As a Urologist, i can understand your anxiety. You should rush your boyfriend to the ER. He's most likely having a stone problem. This can be confirmed after examination and doing following tests :1. Urine routine and culture.2. Blood routine, creatinine,RBS, uric acid, and platelets.3.plain CLUB scan. If stone is seen, then a ACTIVE is needed. After seeing the reports, an expert advise can be given. You can get my expert opinion, by sending a direct question in my name. .  Manga. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have severe back pain. At work I was hit on the head with a 500lb backhoe bucket. I think my pain is caused from that. I recently got an MRI and it staes the following findings: the visualized images of the abdomen and pelvis are unremarkable. the conus terminates at L1-L2. There is no loss of vertebral body height, Alignment is maintained. No marrow signal abnormality. There is very mild degenerative disc desiccation at L3-L4. there is no evidence of disc bulge. No central spinal canal or neural foraminal stenosis. what does this mean? ### REPLY: Thank you for the question. Your MRI r/o any spinal abnormality directly. It is possible that at the time of the impact you may have abnormal crouched or fallen down with sudden contraction of back muscles causing some muscle injury/sprain or pull along with other soft tissues around spine. You may stop bending/lifting heavy objects for a few days and take adequate bed rest to ease the muscles. Do fomentation and take Ibuprofen 600 mg twice a day after meals along with chloaxazone 500 mg twice for 5 days ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: MY HUSBAND AGE IS 31.HE IS HAVING SEISURE DISORDER IT WAS STARTED AT 27 YRS.6MONTH INTERVAL PERIOD ONLY FITS CAME . HE IS TAKING TAB.FRIZUM 10 MG AND TAB. EPILEX CHRONO MY QESTION. LIFE LONG CONTINU FOR THIS TAB! .WHAT CAN I DO FOR STOP THE FITS PROBLEM! ### REPLY: Hello, I cannot answer your question because I don't have sufficient information about his specific epileptic disorder. You must speak to the doctor about the REASON he is having such problems.  Sometimes it is possible to retire the medications if he has been seizure-free for a period of at least 2-3 years.  It doesn't sound like this is happening.  Stopping the fits means your doctor should be able to tell you EITHER the underlying cause to his episodes OR the doctor needs to find another combination or another DOSING regimen of medications that can control his episodes.  Also, you can help your husband by making sure he is well HY .  You should also make sure with the pharmacist that your husband is not taking any other medications or EATING certain foods or beverages that can NEGATE the effects of his medications to control the seizures. 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: Goodmorning, Iam using EcosprinAV 75 since one year now recent days while going for walking or after comming from walking iam getting my left Knee is paining, This is while walking i don t feel anypain but sitting time only i suffer. Kindly advice. Regards, Naushad ### REPLY: Hello, 1. What's your age2. What is your job profile3. Are you diabetic or hypersensitive4? Are you suffering from any other chronic illness5? Do you have pain in any other joints6? Do you have morning stiffness7? Do you sustain an injury on the same knee As you are taking Esprit I can assume that you are either older age or middle age? The most common cause of knee pain at this age is osteoarthritis. So pls follow these: Get the X-ray of knee done in standing position. Avoid sitting crossed legged, use knee cap, give hot fomentation, use calcium and vitamin D supplements, avoid painkillers as much as possible, take paracetamol if necessary. 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: yes they say i have bad bronchitis and im wheezing alot mostly on exhale and cant lie down was on prednisone and antibiotic not much better also have ventolin inhaler, they think im just tired and need sleep they gave me tussin with codein which works great for the cough and ambien for sleep, well did that and slept for three hours and the wheezing woke me up , any suggestions ### REPLY: Hello Welcome to . BY your description seems you have infective exacerbation of bronchitis. You need to take a short course of oral steroids like prednisolone in tapering doses starting from 30 mg once daily and decreasing by 10 mg every three days. Since you have already been on antibiotics there is no need for antibiotics now. But most important thing here is your inhaler which is not sufficient. Ventolin is an inhaler which will provide only symptomatic relief. It will not help to stop the inflammation within. It is like talking paracetamol for fever. I suggest you take a steroid inhaler on a regular basis like a forecourt inhaler 2 puffs twice a day AMF Ventolin as required. This will curb the infection within and aid in faster recovery. You cannot be on oral steroids every time you wheeze. Please do the above-mentioned, and you will do exceptionally well. Wishing you good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 34, 54kg and I know that I have 2 2cm gallstones. I have been trying to control the symptoms with diet. At the moment I dont have any pain, just nausea and feel very lighheaded. I can understand why food would make me nasueous, but what causes the lightheadedness? ### REPLY: Hello Thanks for writing to ChatDoctorYou are suffering from large gall bladder calculus and treatment of choice is laparoscopic cholecystectomy(surgical removal of gall bladder).Nowadays, laproscopic method is widely used and recovery is very fast in this procedure. You shouldn't delay operation, gall bladder may get obstructed and infected any time, and it may cause emergency, So it is better to get rid of calculus. Get well soon. Hope I have answered your question. 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 for a year now , my cheeks inside the mouth like peeling off skin also feels a litle inflamated and vains are now noticesable on both sides were the vains are visable i have a small lump of meat that i can feel,wich I never had before this year period .my tounge also gets red on the tip and grows, like geografic toung then gets to normal al this going on for a year straight . the roof of my mouth feels scratchy also. my head doctor gave me amoxycilin 500s once but nothing . i also get a bad allergy (red)all over my body itchy, dont know if its related to this but it doesnt go away neither. ### REPLY: Hi, Thanks for asking the query, Swollen inflamed cheek can be because of allergic reactions, vitamin deficiencies, inflammation of the lymph nodes, parotid gland, underlying dental infections, presence of cysts and tumors. Geographic tongue occurs due to immunological causes or nutritional deficiencies. I would suggest you to visit to an Oral and Maxillofacial Surgeon and get the checkup done. Take an x-ray if needed. Take multivitamin tablets. Avoid eating of hot and spicy foodstuffs. Maintain a good oral hygiene and use antiseptic mouthwash gargles twice daily. Hope this helps out. Regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear sir Recently I discovered that I have ependymoma,and my neurological doctor described me 5 cortisone injections but after the third one I have a sever left kedny pain just when I lay down and in the same time I had herpes over my penis since 10 years ago but It was treated but now I saw it again with great amount over the penis again. So please inform me if it is because the cortisne injection. ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Recurrence of herpes over the penis shaft is because of cortisone injection. Pain in abdomen may be because of the cortisone injection. But it is required to be investigated. Cortisone is the steroid which causes immunosuppression. Initially it cures the infections like herpes but later grows with much higher intensity. So in my advice if the cortisone injection is not necessary to take than you can avoid it, or you can take it for short period of time and then you can avoid taking it. Alternatively you can keep some time gap in between the . 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: My daughter has gone through an eating disorder a year ago she has since gained her wait back her last period was Nov. 21 and we are waiting for the next period.  Her doctor said she has a heart murmur, I am wondering if this is because she does not have a regular cycle, she is 15 years old. Thank you ### REPLY: Thanks for your question on . I can understand your concern. No, heart murmur is not associated with irregular menstrual cycle. Her irregular menstrual cycle is mostly due to hormonal imbalance. So consult gynecologist for this. Heart murmur is commonly seen with congenital heart diseases and arrhythmia. Both these are common interests young age group. So better to consult cardiologist and get done ECG, 2d echo and Holder monitoring (24 hour continuous monitoring of ECG) to find out the cause for heart murmur. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Every once in a while I get a pain, sharp growing in intensity, intermittent, on my lower right abdomen. It can be so intense it causes me to double over. The pain is localized. The pain happens on and off for a while then disappears, usually for a day or two. Then it might occur again a month or so later. It is happening right now to me. I am 58, Female, post menopausal, diabetic.  I am experiencing flatulence at this time also.  Should I seek medical attention? ### REPLY: Bellflower abdominal pain may be due to many reasons like pelvic pathology, genitourinary causes, musculoskeletal causes etc. You need proper clinical examination and routine investigations. Investigations include routine hologram, renal function test, urine RE/ME, ultrasound of abdomen. Ultrasound of abdomen is important in diagnosis and treatment. Proper treatment depend upon findings. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: What causes burning in your body. It may start on the top of my foot, in my arm, on my face through out my body. I do take blood pressure medicine. It has really made me feel sick. I have had headaches and just not feeling very well. It happens and I can just start feeling in run through out my body. ### REPLY: Howell come to ChatDoctorI really appreciate your concern, such burning sensation could be due to some endocrine disease and another one is functional conditions, first thing you need to ruled out the endocrine dysfunction, some time may be due to some vitamin deficiency, before the complaint being diagnosed or differentiated better try some multivitamin tablet and try to be away form stress, hope this information helps, 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: im 46 years old ... since the past 3-5 years , i have been facing the problem of getting secretion from the upper side of head ... i am experiencing weight loss of approx 7 kilos , sore throat and tonsilitis frequently ... doctor , ENT specialist advised me levocetrizine dihydrochloride and montelukast sodium tablets ... azelastine hydrochloride and fluticasone propionate nasal spray .... i am afraid if im developing tubercular meningitis ...my mother recovered from TB meningitis 3 years ago ..... please help with your valuable advice .. ### REPLY: Dear Rajesh, Getting treatment for your current symptoms from an ENT specialist is different matter but for your weight loss of 7 kg, you must see a good physician. The physician will rule out many conditions which cause weight loss in a person who is not trying weight management intentionally. Common conditions being diabetes, hyperthyroidism, HIV infection leading to AIDS, TB, hypocortisolism, chronic diarrhea which deprives the body of nutrition from the eaten food etc. Certainly your family history of TBM will help them take decision by having look at you whether you also need to be tested for any kind of TB as it is also one of the causes for weight loss. He/she will also see if the discharge is treated appropriately or not. So see the doctor and ask what all investigations are necessary. Wish you 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: sir my child suffering in gall bladder stone since 2 years ,it found in 15 days back after diegonised the size of the stone is 7mmx6mm and 6mmto4mm in gall bladder,so many dr adivace to take a remedies not foe surgery plz advice me he is 8 old son. ### REPLY: Hi, Thank you for asking question on . Oral Ursodeoxycholicacid for period of 2 years may dissolve the gall stones. But the may recur after stopping the treatment. Obstruction of bile ducts by gall stones may be relieved by ERS following ERCP (endoscopic procedure) or Lithography to break stones into small particles so that they will be excreted in feces. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care . V. Subrahmanyam MD;Disassociate professor of pediatrics ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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,WILL START WITH MY COUSINS QUERY..HE IS 48 YRS OLD,SLIGHTLY OVERWEIGHT,ALWAYS DIETIN....HIS LIVER ENZYMES ARE SLIGHTLY ELEVATED..SGOT AND SGPT..IN 40S AND T.BIL..1.4..CLINICALLY NORMAL..WAS ON FLUCONAZOLE FOR A W=FEW WEEKS..ALSO ON A HIGH PROTEIN DIET.APART FROM THE DRUGS..CAN HIGH PROTEIN DIETS CAUSE ELEVATED ENZYMES?? ### REPLY: Hi welcome to the  Normally protein consumption doesn't lead elevated liver enzymes... But if high protein diet consumed regularly along with supplement product for few months than can lead elevated liver enzymes. He is overweight, hence fatty liver or NASH condition might responsible here. Slight elevation like around 40 as per history not significant More than twofold increase need investigation work up... Temporary viral infections, few . . -Serum cholesterol estimation -USG abdomen Take care Consult physician for examination with keeping all this in mind ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Husband and I are experiencing the same thing. During breakfast, all the sudden we experience a tingling feeling around the face, our ears get hot and then it looks as if we are getting a sunburn on the face. Elbows get hot as well as knees. We are dairy and gluten free. It seems to happen during (unknown) stress. ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. During stress some of these problems are reported. Some even with high intensity. Apprehension could also be another problem. Preoccupation about the change during breakfast, can bring on the symptoms. Mind has that capacity. You should also take account of the weather. The ears get hot when weather changes suddenly and if there is a heat .  Check. In any case, don't worry. Learn to ignore the signs and it shall vanish. For more psychotherapy techniques, You can post a direct question to me in this website. Include every detail as much as you can. I shall prescribe some psychotherapy techniques to control your condition. I am sure that the techniques should be a success. 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 been told I have atrial fibrillation. i have pulse136 heart rate and my blood presure this time 104/60.. i am 77. they have me on metoprolol 50 mg and diltiazem hcl 300mg. Also ramipril 5mg simvastatin 20mg , 1 aspirin 325 , terazosin. It seem the medication isn t working. What are suggestions This condiion only happened with in the last two months. I was allways had blood pressure 130 /80. And normal ekg reading. thank you appricate your imput. ### REPLY: Hi welcome to . I understand your query and concern. Atrial fibrillation is known to cause fluctuations in blood pressure. You are currently placed on right kind of . I advise you to have a baseline 2 dimensional echocardiography, ECG and lipid profile to assess the basic cardiac reserve of your heart. Restrict the intake of salt to less than 6g/day. Regular physical exercise in the form of brisk walk for 20 min a day for 5 days a week is pretty useful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, recently my girlfriend developed a rash on her lower arm where the elbow connects and the rash in less than three days has spread to her entire chest, left and right arms, and neck. She has taken every medicine such as Benydrl, etc. Recently she scratched a bit too hard and it started giving out this clear discharge and she cannot stop itching. ### REPLY: Hi, It seems that your girlfriend would be having contact irritant or allergic dermatitis. There may be some cause. House dust, house dust mite, soap,cosmetics, fume,pollutants, grass,clothes.etc. may be the cause. Give her antihistamines like levocetirizine, and steroids in tampering dose. Tell her to apply mild steroid with antibiotic cream. You take her to consult dermatologist. I hope you got my answer. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My son was hit in the shin in a footbal game roughly 6 months ago. There was significant bruising and it was sore to the touch but no pain in weight bearing or lateral movement situations. He played 1 more month of football and is now playing basketball. The soreness has lessened but continues. There is now a growing soft lump in the area that is increasingly sore. What is the next step-specialist, primary care ### REPLY: Hi, Dear Good Evening, I went through your query and understood your concern. I my opinion--Cause and Treatment-on the data given from you is as follows-a-That lump of your son-is - infected hematoma of the shin-leg with cellulitis and needs to be shown to an ER Surgeon. Treatment-Surgeon would advise following treatment-Consult an ER primary doctor or Surgeon to treat this.a-Anti-inflammatory painkillers for 5 daysb-Cold Compresses with Ice packs.c-Antibiotics to control infective cellulitis.d-If no response and lump increases -Surgical . Hope this would resolve the lump issue of shin of the legs. This would help you to plan treatment with your doctor who would treat it accordingly. Hope this resolves your query. Wish you fast recovery. Wellcome for more further queries in this regard. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi Im a chef and have been over the last 8 years, I deal with a heavy work load, long hours and alot of stress, but this has never been a problem and I have thrived off this for years, but in recent I am really struggling to keep up and always feel exhausted and have the shakes for most of the day ### REPLY: Hello and welcome to . Thanks for your query. I understand that you are quite distressed by your recent problems. Feeling exhausted and having shakes could be due to a variety of causes. Psychological problems such as depression, anxiety, etc. could be possible causes. Medical problems like hypoglycemia, anemia, other nutritional deficiencies, etc. also have to be considered. So, the first step in management of this problem is to have a proper evaluation. Only if the correct cause is identified, then further treatment can be planned. So, I would advise you to consult a doctor in your place for a detailed evaluation and further treatment. Wish you 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: Hello Dr, My HSG report says I have Bilateral distal tubal block and the scan report says Bilateral polycystic ovaries . I m 30 years old and trying for a baby for around an year(Since from my marriage, Jan 2010). My husband is not having any problem and for me the Uterus and cervics are normal. I m adviced to go for a Laproscopic surgery which will treat for both the problems. Is it good to go for laproscopy? Will it completely cure the problem? What are the risks in it? Is there any alternative treatment for this? Please advice me. ### REPLY: Hi Welcome to  With bilateral tubal block you have 2 options.1) to go for laparoscopic surgery and 2) to go directly for IVF. Both the treatments have their own positives and negatives. With laparoscopy, as said by .  Even at good hands chances of tubal pregnancy are quite high after treatment. Positives are it is less expensive than IVF for sure, minimally invasive, and it can treat other associated problems if found during operation. If you are lucky you'll get pregnant after laparoscopy. IVF is expensive, but it is the treatment of choice in patients with bilateral tubal block. It gives very good success rates. First get your hormonal evaluation like FSH, LH,Estrogen, prolactin and TSH done to rule out other associated factors which may also contribute to infertility. 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: From August of 2011 to December of 2011, I lost 20 lbs, going from 125 to 105. In December of 2011 I started noticing extreme bloating and severe fullness after eating as if my food was not digesting, which would last the entire day and get worse as I ate more food throughout the day, only feeling better with long fasting(15+ hours). This has lasted until now. The past couple months, I ve had an endoscopy , a gastric emptying test, a small bowel barium x-ray , a upper right quadrant ultrasound, and a HIDA scan with CCK. All were normal except the HIDA scan. My gallbladder never appeared after 4 hours and they never injected the CCK. My GI doctor told me this may be what is causing at least some of my symptoms. I went to see a surgeon, who told me that my symptoms appear to be inconsistent with what he said were the only 2 reasons for results like mine, inflammation, and a gall stone blocking the duct(I asked about sludge and he said sludge usually shows up on an ultrasound). He said if that were the case, I would be in severe pain where my gallbladder is located. I am really looking for answers. All of my tests have come back normal except for the HIDA, and the surgeon doesn t seem to believe it. I am really worried and am looking for any information I can find. Although I am not a doctor, I ve read that gallbladder problems can FEEL as if your food is not digesting(although clinically I KNOW mine is digesting), and bloating and an unusual feeling of fullness can occur. I have also read that rapid weight loss can contribute to gallbladder issues. I guess what I m asking is, out of all these tests one comes back abnormal and the surgeon is not willing to accept it as abnormal, so MUST you feel severe pain as the doctor said for a test to come back the way mine did? And do my other symptoms(fullness, bloating) fit at all with my abnormal HIDA scan result? ### REPLY: Hello! Thank you for the query. You have the right to insist that this is gallbladder only if you do suffer from symptoms like: upper right abdomen pain radiating to the back, nausea and vomiting, pain after a meal especially when it is fatty or spicy food. Otherwise, there is no reason for gallbladder removing. Looking into the tests you have had performed, I cannot see colonoscopy and abdominal CT. Weight lost and bloating can be a symptom of colon cancer. Colonoscopy is very important in ruling it out. Abdominal CT with oral contrast is another test which should be done to visualize pancreas. Regular ultrasound won't tell anything about its condition. You should also have some blood tests: amylase, lipase, urine amylase, CEA, CA 19.9, CA-125. Stool tests should be also performed. Only if really all other reasons of your pain will be ruled out, and you do suffer from symptoms located in the upper right abdomen, you may ask a surgeon for laparoscopic gallbladder removal.  Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,I have applied clotrimazole 1% cream to a blister on my daughters toe.  The blister itches and is slightly painful to the touch.  The itching leads me to believe it might be caused by a fungal infection.  After two days of using the cream (twice a day) she has a small, hard bump on the side of her foot.  We have not applied any cream in that area of her foot.  Could it be related to the medicine ( a side effect)?  She is 7 years old.  Thank you for your help. ### REPLY: Hi, I can understand your concern for itchy and painful blister on the toe of your daughter. There can be multiple possibilities of the blister, and it requires a close physical examination to diagnose the exact entity of the problem. In my view correlating with the facts you have provided it appears to be simple bacterial infection called as impetigo so do not worry about any serious possibility in the same. I suggest you to meet a dermatologist to for proper antibiotic therapy. In between you should wash the area properly and apply an antibiotic cream such as mupirocin or funding. 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: I have started taking Mirtazapine about 3 weeks ago on a low dose of 15mg, after 8-9 days I had to go on 30mg and since I have NOT slept well at all It seems like I have to readjust myself constantly in the night, leaving me feeling like I haven t slept at all, this is making me stress out and I have a Horrible Tension headache in the lower right side of my head behind my ear that hasn t gone away for three days... Anyone else dealing with that? I am calling the DR tomorrow to make an appointment.. ### REPLY: Hello sarah11976 Mirtazapine is a good antidepressant, it has a unique effect on sleep. Also called as paradoxical effect, it causes increased sleep at low doses like at 15 mg but at higher doses it has no effect on sleep. So increase in dose from 15 to 30 resulted in paradoxical insomnia. Kindly visit your psychiatrist and ask for addition of some hypnotic like Benzodiazepine as clonazepam, or collided for some time. Thanks, take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hiMy partner has a lump on the bottom of his jaw and over the last two months or so it has grown to the size of a golf ball. He is in alot of pain. We dont have much money atal and have no idea what to do. We are flying to Perth on sunday and dont know whether we should as it grew in size when we flew a few weeks back. Can you help with any advise atal?We think it might be an abscess? ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have growing lump on jaw which is painful as well is mainly because of presence of infection in circumscribed area. Infection keeps on increasing in size and not finding any way to leave so forming abscess there and leading to facial space infection. I would suggest you to visit dentist once and get it examined and go for IOWA of particular tooth and root canal treatment of that particular tooth. Take antibiotic to suppress infection in that area. It would not grow in size in just few days, but you have to get it treated as early as possible. Maintain basic oral hygiene. Do warm saline rinses. Hope your concern has been resolved. Get Well Soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HI. .my girlfriend had taken an I pill within 4 hours .later on she also had taken little homeopathy medicine to get the periods sooner since she had planed vacation holidays ...she also ate papaya and all..The periods date was 30 of the month ...she usually gets on time. ..its two days late now. ..pls guide .. ### REPLY: Hi there,I-pills are very effective especially if taken within 72 hours of unprotected sexual intercourse. So it would make the risk of pregnancy very, very low. I do not know the safety or efficacy of homeopathy or their ability to advance the periods. Also, they can interact with the I-pill and may affect its function. This would depend on which pill she has taken. Papaya and all... will not help you to prevent pregnancy and there is no scientific evidence that they prevent pregnancy or cause an abortion. But I am sure you will hear a lot of people vouch for its efficacy. I-pill itself can delay the period, and she needs to do a urine pregnancy test after 3 weeks of taking the I-pill to rule out pregnancy. Its best that she takes guidance from a doctor rather than take pills herself to regulate her periods. Hope this helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: When I wake up, my heart normally beats unusually fast, and I get short of breath. I get dizzy when I stand or sit up, and am normally weak to the point where I dont want to move. Other times, I cant even feel it beating. Im 16. I used to be a cross country runner and sprinter. Im always tired, but I can never ever sleep. Ive been diagnosed with Severe Depression, Anemia, ADD, and Insomnia, but they still cant figure it out. Any theories? ### REPLY: Hello, Thanks for choosing  for posting your query. You have given a very detailed description of your problem and I understand that you have diagnosed with lot many illnesses and you being treated for the same too. Anaemia and Hypotension can lead to this kind of problems. Hypotension (less blood pressure), especially postural can be due to the . Hypothyroidism could be a problem related to all the symptoms that you have stated, and the same can be confirmed by doing a thyroid assay (TSH levels). Depression could also be a plausible diagnosis. You can try changing the anti-depressant as there are many types of antidepressants available in the market. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: It is about my daughter. She is 30 years old. she recently experienced what the doctor called a vassal vagal. Her blood pressure spikes for no apparent reason for short periods of time. When she goes to bed she feels like her heart is fluttering. Side note my brother had two major heart attacks at age 46. My Grandfather on my Dad s side died of a heart attack and my Grandmother on Dad s side had a pace maker. My grandfather on Mom s side had heart disease. what can I say or do to get my daughter to go to a specialist? ### REPLY: Howell come to ChatDoctorI really appreciate your concern, vasovagal syncope cant be itself because there are many apparent reasons behind this and without that it may not be vasovagal attack and this need to be ruled out and this is only possible when patient clinically examined and history elicited, but this is self limiting because this is malaise mediated which directly related with vagus nerve, vasovagal attack causes low blood and not high blood pressure, your sister may not be having any cardiac disease, still it is advisable to get done cardiac evaluation test, in short this is nothing to worry, take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband was told he is in 3rd stage congestive heart failure 3 years ago now the new stress shows bottom of the heart has damage and is not working,he already has lost the back of the heart from a previous heart attack.He now has the water retention again and the leg cramps he had before the last heart attack.How much more can we expect? He already hsa a pacemaker/difublator in plaec can I trust that to save him? ### REPLY: Hisorry to hear about your husband prognosis of every patient is different, golden rule of medical science is that there is no rules remain hopeful the role of the defibrillator is to shock the heart when rhythm of heart is disturbed but as CHF is in stage 3, It's not always possible for the defibrillator to revert the rhythm back if ejection fraction of his heart is less than 20%, prognosis is poor water retention should immediately be treated by diuretics, muscle cramp is because of the electrolyte disbalance (serum electrolytes should be monitored every alternate day ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my sister in law suffering from a haemagioma in brain. doctor suggested to tale levetiracetam (epilive 500). two time in a daywhen she takes drug she feels lazy, always sleeping, weakness , so she never took both the dose in a day. Is this normal or some thing wrong? age 32gender female ### REPLY: Hematomas typically are not removable.  The treatment therefore, of LEVETIRACETAM (Brand name KENDRA in the US) is used for seizure control which can occur with these types of lesions due to their bleeding.  Her response and behavior is due to the medication and her doctors may need to adjust dosing or check what other medications are being given to her at the same time to decide if there is a .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: iam 20 aged andmy balls are hnging alot i.e, lower than my pennisand my skin also wont come backand iam spelling sperms in the nights sleep ( 3 times a week)and my pennis shape is like bananaand inner skin itches, white particles are acumulating  help me for coming out of these!!!!!!!!!! ### REPLY: Degree understand your concerns went through your description. I suggest you not to worry much. Your balls are hanging because your skin there tend to loosen and tighten according to so many physical and atmospheric conditions. Nothing to worry. Your foreskin may be operated for clear skin movement and for better sexual life. Night spilling of sperm is normal at your age. Penis shape is like banana for almost every one, and it is good for intercourse. You should keep your private area clean as an immediate treatment to itching. You are just 20, and you are worrying about your sexual life. Please keep yourself engaged in your career and education. Sexual life is secondary. You will learn it in due course. You might need psychological counseling., I am more than happy to provide telephone psychological counseling through . Contact me through customer care, www.ChatDoctor .com. 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: My husband has had an ongoing problem for longer than 4 years. Every 3-6 months his upper lip will swell like a balloon and he says he gets a "coppery taste" from it. I was thinking maybe he is allergic to parabens, sulfates, or some other chemical that is widely used in hygiene products. Is any of that a possibility? If not, what could the problem be? ### REPLY: Hi dear, At the outset, all your husband complaints are suggestive of acquired angioedema, it usually caused by allergy. The skin of the face, normally around the mouth, and the mucosa of the mouth and/or throat, as well as the tongue, swell up over the period of minutes to hours. In my opinion, avoidance of allergen and use of antihistamines like Tab.cetirizine can prevent future attacks.please let me know if my advice helpful to you in any way. Best wishes. 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: yes i went to the emergency room on the 10th and my blood pressure was 153/102 then they gave me a shot n checked it again it was 130 somthing 107 then they gave me a blood pressure pill and it went down.my question is how can i get it to go down.i took my atenolol 50 mg this morning.and it started after that.should i go back to the ER? or any suggestions please thnk u ### REPLY: Hello Welcome to  Atenolol is a very reliable BP medication and 50 mg is quite a good dose. Please take you atenolol daily. It will help get the BP under control. You do not need to worry about slightly higher BP levels up to 150/90. If the BP remains persistently higher despite taking atenolol regularly for more than one month, then you must be started on two BP medications. Pelase check your BP once in two days in resting period at different times of the day and maintain a log book. Please revert after a month with the readings. Wishing you good healthRegards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 name is chad I have a broken wisdom tooth and have had no problems with it I just noticed on the outside of my jaw in line with the broken tooth there is a hard kinda lump that runs down and under my jaw its tender when I push on it hard but not painful in any other way there is no paid. When I eat or put pressure on the tooth I am just wondering what this could be and if I should think of it as a life threat ### REPLY: Hello there, Thanks for writing your query, According to your history I can suspect your broken wisdom tooth has undergone bacterial infection due to food lodgment or improper oral hygiene. The infection has gone worse, and you have developed a periodontal abscess due to spread of infection to the underlying tissues.  The hard lump under the jaw is nothing but the spread of infection to the jaw bone. You need to get an x-ray done the affected area to confirm the presence of infection, approach a dentist for the treatment.  I would suggest you to start with an antibiotic and analgesic course consulting your dentist, which helps in subsiding the swelling and relives pain.  I hope this helps, 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: whether a person with BP can donate a kidney. on what frequency does the authorization committee meets at hyderabad and who will be the members of the committee? Whether the status of approval of committee will be uploaded online like in other states e.g. TN, Assam, etc ### REPLY: Regarding BP, BP of 130/80 without medication or 140/90 with single medication is acceptable provided other parameters are normal like sugar Renal and cardiac function. But my sincere advice is don't push him as a donor if he has uncontrolled BP as he may face complications in the future. Regarding authorization committee, you should consult local authorities. Best of luck. If you have any questions Fe free to contact. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mother in law has just had ERCP procedure to remove a stent and left ove stones and returned home. She has come out in a pink red rash which she has had before and was treated with iv anti histermine. She doesnt want to eat or drink and has had 2 anti histermine tablets is there anymore we can do. ### REPLY: Hello, Thank you for asking at . I went through your mothers-in-law history and would like to make suggestions for her as follows:1. As she has already taken 2 antihistamines, please consult a doctor before taking further dose of antihistamine.2. I would suggest her to take tablet montelukast.3. I would also suggest her to apply calamine lotion over the area with rash.4. Furthermore, I would suggest her not to scratch the itchy area as it would aggravate itching. Hope above suggestions will be helpful to her. Should you have any further query, please feel free to ask at . Wish your mother-in-law the best of the health ahead. Thank you & 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: Yes i have a question for my boyfriend. He has adhd and needs help fast. He just had an episode today and it scared me bad because i have epilypse. I Just Dont know what to do. He doesnt have a job or insurance to cover the cost of a doctors visit. Is there anyway i can get him help? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. The best treatment for ADHD starts with awareness. Your boyfriend should be aware of his condition and you and his family members should also be aware of it. Erratic behavior pattern is normal with ADHD. Second step in treatment is psychologist / psychiatrist intervention. Please consult psychologist / psychiatrist for treatment. 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: Hi, Three fingers on my left hand (thumb, middle and ring) are extremely dry, leathery looking and also painful. This is going on for about three months. I was advised by a doctor to use AmLactin cream but I do not have much luck. Please, help! Thanks. ### REPLY: Hello. Thanks for writing to us at  This condition is due to extreme .  This is a cumulative condition that is further exacerbated by wet work, soaps, detergents etc. and therefore also known as chronic cumulative irritant contact dermatitis. Individuals engaged in a lot of wet work e.g. housewives and food handlers are prone to develop this condition. The condition is more common in topics; those who already have an underlying  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 38 year old woman 5 foot 112 pounds I have had pain in my upper left side under my underarm and pressure in my chest every day and have had it for two months if I eat it gets worse I have had ekg s and a treadmill stress test they all came back fine I do have high cholesterol and I am on cholesterol medication but when I take it it makes my chest hurt in a different way , what do you think it could be its driving me crazy ### REPLY: Dear-thanks for using our system, I read your question with care and will give you my medical advice. You might be experiencing chest pain from digestive tract or non-cardiac origin. The fact that you already had a negative treadmill stress test goes against cardiac. I understand that you have risk factors for coronary artery disease, but test was negative. Statins are the most used medication for cholesterol treatment, and they can cause muscle pain that can be what you are suffering. I would consult with your doctor to consider holding the medication for few weeks to see if you have an improvement. Increase the exercise and improve the diet for a better cholesterol. You should see the results in 4-5 months. I hope that my advice has been 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: I have a sinusities problem..meaning that I caught with bad sneezing very frequently. I am 38 years old and the problem persists from last 6-7 years. It was not so frequent earlier but from last 1 year I have to take Levocet tablet daily. Please suggest what should I do. I want to avoid taking tablet. My weight is 63 KG and height is 5 ft. ### REPLY: There r many causes for sinusitis. It can be caused by deviated nasal septum, infection, dust and pollen allergy, due to sleeping habits and many more. Pls describe the symptoms and your gender too.  Also mention whether you are taking any medicines for hypertension. Steam inhalation with menthol or eucalyptus or inhalation of smoke of Turmeric wick dipped in ghee can give very good results as it expels the phlegm accumulated in the paranasal sinuses. Internally taking quasi juice 1tsp+ honey 1tsp + ginger juice 1/2tsp + black pepper 1 pinch twice a day in empty stomach gives good results. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello I have been trying to get pregnant for the past 2 years but I havent been successful  ( I already have 2 daughters) but i been told that due to me having blood clots while in my period every month is the reason i cant get pregnant.  Is that true if so what can i do? I really want another baby. By the way Im 38 years old.Thank you ### REPLY: Hi, Thanks for writing in to us. At age 38 years, the number of viable eggs in a woman significantly decreases with increasing age. The reason of not getting pregnant due to blood clots in your periods is not right. If you have two daughters already, you do not have any structural abnormality in yourself. Please try to have intercourse with your partner around the date of ovulation, one day before ovulation and for four dates after that regularly. Keeping your age in mind, I would suggest you to consult a fetal medicine clinic and discuss the information on issues with child .  Some screening tests may become necessary to be done once you get pregnant to confirm that the unborn baby is normal in all respects. Hope this helps ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m a 23 yr old healthy female. I was in a severe car accident four weeks ago. My first mri showed mild spinal stenosis in my t6-7 my symptoms have been worsening every day along with having new symptoms. Two days ago I had another mri done at the er and it says I have moderate to severe spinal stenosis in t6-7 along with degeneration in my c3-4-5-6 and t11-12. I can t take this pain anymore, left arm goes numb and tingling down to my fingers, severe radiating back pain , rapid heart beat, the most awkward sensation that raps around my rib cage, a feeling as if there is an elephants sitting on my chest and mid back, my right leg also gets pins and needles feeling along with severe muscle spasms in right leg and arm. and now I m even experiencing bladder incontinenc e. I know my body and pain threshold but i can t handle it anymore, I even take a steady regimen of ibprofen everyday ### REPLY: Hello. Thanks for writing to us. I can understand your concern. Due to the accident, the spinal stenosis is causing the compression of the spinal cord which is responsible for your symptoms. You need to consider the surgical treatment for your problem. An early intervention will be most helpful. Please consult a spine surgeon for the treatment. I hope this information has been both informative and helpful for 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,am having stomach cramps like someone who is on her periods but nothing, its so painful, its happened like this for the last three months, i was given femiplan injection on 21st sep 2012, please advise my email is  YYYY@YYYY  sorry cant afford to pay online at the moment please ### REPLY: Hello! Thank you for the query. Stomach cramps can indicate bowels obstruction. Especially when lasting for so long. Due to some intestine narrowing or lump, the stool can not get through the intestine what gives cramps. These cramps are the symptom of intestine trying to force the stool through the obstruction. So if your abdomen is also bloated, you have nausea, vomiting, constipation, diarrhea please visit your doctor as soon as possible. Abdominal X-ray should be done at first. If you are over 50, colonoscopy is necessary. Hope this will help. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi , i want an advise. My dad fell in the bathroom on 30th Nov 2012 and was hospitalized . he was diagnosed for Brain Hemorrhage and right side weakness. we performed EVD extra ventricular drain to drain the excess fluid . according to the doc my dad was not stable enough for a shunt . he was in the hospital for 36 days and the docs requested to take him home . now he has been discharged he is awake but no movement as such .. can you advise what treatment should we go for ### REPLY: Hi, Thank you for posting your q Urey. At this stage, your dad requires regular exercises under the guidance of a physiotherapist. He should be made to sit, stand and walk with support. He would also benefit from cognitive stimulation. Family members should talk to him, tell him about various events in the family, etc. He should be also made to listen to songs, Bajans, etc. In addition, you should take care of his food and nutrition, with the help of a dietician. Best wishes, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 2 year old nephew gets these large lumps in different spots of his body. Theyre mostly on his scalp, and they appear on his arms, legs and he recently got one on his feet. Do you know what this could be? I dont know if it matters, but he has the sickle cell anemia trait. ### REPLY: Hi, dairy have gone through your question. I can understand your concern.  He may have multiple lipomatous or neurofibromatosis.  It has no relation with sickle cell trait.  He should go for fine needle aspiration cytology or biopsy of one lump.  Then he 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: My daughter had a low grade fever and with the fever she had this rash that looked like a sunburn.  Under her arm, neck, part of her upper chest, lower side (just the right side) and also her private area.  The rash is itchy and seems to be fading in some areas but getting stronger in other areas.  We just took her temperature before sending her off to bed and her temp is normal.  She just had a little sore throat, not much of one so Im sure it is not strep or scarlet fever.....been through that enough to be able to rule out.  Any ideas? ### REPLY: Hello! I really appreciate your concern. These symptoms could be due chickenpox. If child with similar symptom comes to my clinic I would ask for chickenpox vaccination or previous episode of chickenpox. If the child is not vaccinated or did nit have previous episode of chickenpox it is more likely that she is having chickenpox. Treatment of chickenpox is symptomatic only because it is mostly a self limiting disease. Hope my answer has solved your query. Take Care. Thank you. Best Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 4 year old daughter has red swelling on both ears. I know it s not a spider bite or sunburn. I am perplexed by it because it is getting bigger. It doesn t seem to cause her too much pain or itching. I took her to her ped but he had no clue what it is was and didn t set her up with a referral to a different dr. ### REPLY: A few things that might cause this : most commonly allergy causes a bilateral ear swelling and redness, its mostly due to the contact with chemical material like soap, creams, makeup, sunscreen or even a shampoo .try to limit the use of these chemicals until you decides what is the one that make her allergic.another possibility is ear-piercing if its recent, can cause bilateral Jericho .  I hope this was 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: I have a quick question. Last year, I struggled with self-harm for a brief period, but stopped on my own never having sought help. Then, last weekend, I did it again. I dont plan on doing it again and feel I can stop on my own. Should I still seek help? ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. Though the question seems simple, there is supposed to be more to it. Every behavior has its reasons. If you behave in such a way that you harm yourself, even just once, why? I need an answer to the above question. Generally self harming behavior comes out of anger and frustration. Both these emotional outbursts can go out of hand. Then another question comes forth. What was your emotional state when you tried to harm you in both those occasions? Please, You can post a direct question to me in this website. Include every detail as much as you can. I shall prescribe some psychotherapy techniques to control your condition. I am sure that the techniques should be a success. 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: my mother 77 years old is a chronic asthmatic patient. Almost every month she gets asthma attacks in which she is coughing almost non stop.Every time she is given antibiotics.This time she again had the attack of coughthe doctor has given her antibiotic and defcort 24 for three days bd. I want to know is that the right way to keep her asthma attacks in control?She daily takes doulin nebulizer.and other puffs but still gets cough attacks .She has no vision due to Glucoma hence life is very difficult.Mere going for a bath makes her breathless. ### REPLY: Hello dear, Asthma is caused due to bronchoconstriction (obstruction of smaller airway passages) which is indicative of Hyper-responsiveness of air passages. Management consists of:1. Stalin+ Aeroflot inhaler-provide symptomatic relief by causing bronchodilator (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs)So, it can be used whenever there is an acute attack.2. Montelukast preparations- used as a maintenance therapy to relieve symptoms of asthma.3. Antihistamines like Cetirizine & Anti-tussive can also be used to provide symptomatic relief.4. Need for anti bionics arise if there is a secondary infection. But this should be taken only under the guidance of your Physician.5. Steam inhalation & deep breathing exercises.6. Maintain adequate HY . 7. Protection from exposure to cold, dust or other allergens. If symptoms still persist, kindly consult a Pulmonologist for complete clinical examination including Pulmonary Function Tests. Wishing her a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with a throat cancer on april 2012 (left vocal chord). I received a laser surgery and I am in process of receiving a radiation therapy (28 cessions which I completed 20 cession so far). I still have a dry throat and very difficult to swallow . My question is considering my cancer was in stage one how long will it take to recover my voice and how will I know if the concer is completely gone. Thank you ### REPLY: Hi, a Stage I throat cancer (vocal cord) is usually treated with a single modality, be it surgery or radiation. You have undergone laser excision for that & then there should be some reason for your doctor to ask for radiation. Maybe the margins came out as positive. Otherwise, voice usually starts recovering around 6-8 weeks post the completion of radiation, but the quantum of recovery can be explained by the operating surgeon depending upon how much he/she has excised. 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 question I got hit with a refrigerator it hit me hard and at the same time it scrape down so I fell like a hard lump where it hit me, so I went with my doctor and he said he felt something hard but that he didn t feel a lump but he still send me to get ultrasound just to make shure it wasn t nothing bad, so he got the results and everything was normal , but I have two months already since I had that accident and I have been feeling like a tingling or needles sensation something like that in my nipple and its been every day and ill day , you think I should get worried cause I m scared but like everything was normal at the ultrasound what do think it could be thanks. ### REPLY: Hi, Thanks for query to My  virtual Clinic. I studied all details of your query. I understood your health concerns about tingling in your nipple after hit in the head. Cause of tingling in your nipple after hit in the head-After reviewing your query facts, In my opinion these 2 complaints are not related to each other. If any relation, it's the anxiety from correlating these 2 complaints. Reasons for this opinion is -that the lump after the head hit was confirmed as normal after USG study of that lump and 2 months have passed normally. Probable reason for tingling in the breast needs to be ruled out for which I would suggest Second Opinion from Surgeon, who would physically check the nipple part and would treat it accordingly. Still if you feel obsessed, I would suggest CT Skull and opinion from Neurosurgeon. I think you should not worry till the CT studies are done. Wait with a cool head and act according to above suggestions. Hope this reply would help you in resolving this complex query and anxiety with it.Don't forget to hit thanks and write excellent review comments to help needy visitors at . Welcome for any further query in this regard. . N.M.S. Genl- CUTS. Senior Surgical Specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: HIIam a diabetic patient under insulin injection therapy. I have severe dental pain. my dentist gave me antibiotics and painkillers but i still suffer. The dentist advise to extract the tooth.Can i go for extraction even my glucose level is 355 and i couldnt get it down? and if i go for extraction what are the risks in that?Thanks alot ### REPLY: Thanks for your query, I have gone through your query. If the glucose level is 355 it's not an ideal condition to go ahead with extraction. The complications associated with uncontrolled blood glucose level includes delayed wound healing, infection of the bone, spread of infection. it's better to get an HbA1C level if it is normal then you can go for extraction. But still it's better to bring the glucose level to normal and then go for extraction. Consult your physician and adjust the dose of antidiabetic .  I hope my answer will help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have started having pain in my feet (for about 3 months now) it gets so severe that I can hardly walk when I first stand up, it gets better after I move around, but this happens every time I stand up. I also cannot seem to get enough rest, no matter how much sleep I get, I am always exhausted. I am a 47 year old male ### REPLY: Hello and Welcome to  Forum! If you are 47 years old, Did you get your BP and Sugar levels checked, Common cause for pain in the feet at this age could be It D deficiency, or increased uric acid levels in blood and even High Sugar levels. I would suggest you to take the following Blood tests:FBS, PUBS, Serum Uric Acid, Serum Creatinine, Serum It Dafter the evaluation of these we can be able to come to a final diagnosis, since you are complaining of the foot pain being more after you first stand up it seems like a circulatory problem, when it gets better after the blood flow resumes normally to your feet when u walk around, and also the exhaustion you're facing seems to have come from defective metabolism where your body slows down in detoxification process and even when u r at rest your body doesn't get enough rest making you feel exhausted, So you need to detoxify your liver with Beetroots, carrots n spinach or green leafy vegetables, green tea, avoid sugar n artificial sweeteners, diet sodas, carbonated . Hope this helps! 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: yes thank you i went recently to er and they said i had high sedmintation rate platelets and she said 4 times before but they did not tell me  the last time just this time and cat scan was clear and they said i should fo;;ow up i am concerned  can u help ease my anxietys ### REPLY: High sedimentation rates may be caused by autoimmune diseases, such as systemic lupus erythematous or rheumatoid arthritis. Cancer, such as lymphoma or multiple myeloma. Chronic kidney disease. Infection, such as pneumonia, pelvic inflammatory disease, or appendicitis. Inflammation of joints (such as polymyalgia rheumatic) and blood vessels (such as giant cell arthritis) can also high ESR. 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 had an inner ear canal infection that I have meds for but I have also been experiencing forgetfullness and when im talking I stop and say what was I talking about. Im only 20, I usualy never foget stuff or cant concentrate like that. I usually just think about 1 topic at a time when im telling someone something. And Im forgetting my friends name or if Ive meet someone before or what ive done that day. Also im very tired, not sleeping as much, headaches, slurred speech and feeling sick. Whats wrong with me? ### REPLY: Hello, Your symptoms could be related to psychological stress. Anyway, considering your past medical history, I would recommend consulting with a neurologist for a physical exam and performing a brain MRI in order to exclude a possible brain infection, related to the inner ear infection. It is also necessary checking thyroid hormone levels for possible imbalance. Hope I have answered your query. Let me know if I can assist you further. Take care  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor,I am Amit from Bangalore, I have hair loss problem and started became bald from front. How do i cure it ? How do I regrow my hair ? I heard of Tara Homeo Clinic, any idea about them ? Also the product like Livon Hair Gain or Mintop which one can help me ? ### REPLY: Hello Amit, Thank you for posting on . I appreciate your concern regarding hair fall. Hair fall is usually ascribed to multiple factors like diet and nutrition, hormones, stress, cosmetic products etc. From your description, it seems you might be having Male pattern hair loss or An .  If I were your dermatologist/trichologist, I would like to take through history including family history, history of recent major trauma/illness/stress/medications etc., and recommend some basic investigations like CBC, blood sugar, Thyroid function test. I would suggest you a course of oral tablets containing biotin and other essential vitamins and minerals for minimum 3-6 months. Also, would put you on solution containing 10% minoxidil once a day and a hair serum containing peptides for hair growth at night.(Q era etc.). Finasteride (Final) can be used in selected patients after thorough counselling and checking your liver function. Finasteride, inhibits metabolism of testosterone at hair root level. It sometime leads to embarrassing side effects like impotency, decrease in semen volume but which are totally reversible on stopping the  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i am 21 and have had shooting pains from my testicles to what feels like as far as my chest since i was mid 19 i have had this checked by a doctor when i was 19 and he said it was due to anxiety and stress so i thought nothing of it but now it seems to of worsened and i am starting to feel dizzy and on my right testicle it has created a small lump on one side and become swolen on the other i am now worried about this as it does not feel normal could you please let me know if you have heard of this before ?? ### REPLY: HelloThanks for your query, based on the facts that you have posted it appears that you have swelling in both the testicles. This could be due to infection of the Epididymis (Epididymitis).However, this needs to be confirmed by clinical examination by a qualified General Surgeon and ultrasound scanning of the scrotum. You need to take broad spectrum antibiotic like Čeferin along with anti-inflammatory . Further treatment will be decided by him and depends on 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: I am a chemo patient currently on topotecan. Last night I took a dose of miralax and I have not felt we ll all day. Slight chest discomfort and some anxiety. Also a low grade fever this evening which I gave most evenings anyway. Also have significant gas. Had a diverticulitis attack about a month, no current abdominal pain. Could I be allergic to miralax? ### REPLY: Hello dear, thanks for your question on . In my opinion you are having mostly HERD (gastroesophageal reflux disease). You are on chemotherapy and these .  Anxiety is the added factor for worsening of HERD. And your symptoms like chest discomfort, nausea, gaseous feeling etc. are suggestive of HERD more. So better to follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid stress and tension. 3. Avoid large meals, instead take frequent small meals. 4. Start Proton pump inhibitors. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in bed to prevent reflux. Don't worry, you will be alright. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr.  we are blessed that we have succeeded in our first  ICSI with beautifull angel baby girl. 2 years later, we have undergone to the second  ICSI ....This time after embryo transfer my wife is not  experiencing any pregnancy symptoms......please advise.Mali ### REPLY: Dear Mr. Mali, There are mainly four types of symptoms a woman gets in the early phase of her pregnancy. The symptoms of early pregnancy - in first three months are:1. Missing a period : This she must be having2. Nausea and vomiting : Some women do not get this symptom at all. Nothing abnormal not anything to worry about it. 3. Frequency of urination: Woman may not notice it. 4. Breast Changes - Woman starts feeling them after 6 weeks of pregnancy. * Engorgement and tenderness* Brownish discoloration of nipples and areola. This happens in first pregnancy and is permanent change.* Increasing the size of areola* Clear secretions from nipple on squeezing which of these symptoms she is not having? You should have mentioned. I hope you have got the answer for 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: My husband has dissy spells, somtimes on waking. Today he was gardening and had a sudden attack of dissiness, nausia and vomiting. He says he feels as though he is sea sick. He also complained of a sudden sharp pain in left back of neck. He had open heart surgery in 2004 to replace a bicusbet ascending aortic valve and a portion of damaged aorta. (please excuse spelling). These spells have been more frequent the last two weeks. We saw a new doctor today and he is going to fit him with a heart monitor on Friday. I am worried, could he be having small strokes? Or trouble with blook clotting? ### REPLY: Hi, I am . The Symptoms you have described 1. Sudden attack of dizziness, 2. Nausea and 3. Vomiting. 4. feels as though he is sea sick. Indicate a problem in Posterior Fossa of Brain (mostly decreased blood circulation or rarely a space occupying lesion) The sudden sharp pain in left back of neck can be due to Conditions Associated with the above I would suggest you to visit a Neurosurgeon immediately and get evaluated If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 expereincing a alot of pain on my back right side in kidney area, have diahrea. I hurt my lower back 2 days ago but that had seemed to get better but now this is much higher and on just the 1 side. Should I go to emergency room? Hard to sit, lay or stand. Thank you, Mark ### REPLY: Hi, Thanks for writing in. The diarrhea is probably due to a stomach flu or bowel infection and unrelated to your fall two days back. Please . The back pain after the fall is from muscle spasm. After your fall the muscles in the back got injured. These release pain causing substances due to muscle injury a day after your fall. Therefore, the pain seemed to get better on the first day and then was severe the following day. This will improve in 3 to 5 days and avoidance of heavy physical activity is suggested. Please apply pain relief ointment. Please do not worry. ### END