Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 a 47 yrs old female. these days i notice  my skin of  my hands becoming dark like patches hereand there.also my face looks dull and dark circles aroun eyes.in the forehead region also some dark patches found.i am not taking any medicine for anything.can you pls make it clear why this is happening and suggest me some remedy or ointment.regards ### REPLY: **1. Get yourself examined with relevant investigation, because appropriate treatment demands accurate diagnosis and diagnosis needs physician consultation. [In best Interest it will be wise to see a Dermatologist for proper evaluation and management and/ or with hormonal disturbances]2. Stay away from the sun during peak hours [11 AM to 4 PM] or ensure a good sunscreen applied on the area to limit damages. Wash your face with Began and Luke warm water after coming from outside ( the best natural bleaching agent), removing excess sebum and dead skin cells, and acts as a deep cleanser.3. Potato acts as a very good bleaching agent, this would lighten the marks.4. Take two spoonfuls of gram flour, add a pinch of turmeric, few .  Apply this pack regularly and you will notice  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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. ....im 33yrs n am married I have been trying to get pregnant for 3yrs nw. My de said I should take fertomid 50 after my menstrual after that I should take pregnancy test it was negative.... Plz Dr help my menstrual cycle its changes all the timelake nw I started 25,11,2017 its end 27,112017 wen shod I start having sex plz help ### REPLY: First your menstrual cycles should be regulated. Induction after regulation only will help u in conception. U can take hormonal plus from 5th day for regulation. U should continue this for Atlas 3 months for your cycles to be regulated. During your regulation treatment u cannot get pregnant. Once regulated u can be induced with Fatimid 50.It's good to have sex between 14th to 21st day of your cycles ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Back in October of last year, I had inflamed hemroids, lots of bleeding out. About one month ago I started to have hard BM with bleeding from the rectum. My blood pressure has been up as well as my pulse rate. I have slight dizziness. What do I do? ### REPLY: Hello, I understand your concern and would explain that the high blood pressure values and heart rate values could be related to the pain.  Coming to this point, I recommend consulting with a surgeon for a physical exam and trying to treat your hemorrhoids.  Some blood lab tests are also necessary (complete blood count, PCR, ESR for inflammation).  Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mom  is 85, had Lap cholecystectomy done Monday the15th, and was admitted to ICU from Post OP due to Tachy, Hypertensive, then became hypotensive and is now presenting slurred speech, hallucinations, and very confused. She is in a rural hospital I would like her transferred to a bigger facility where there are specialist to evaluate her current status. What do you thing is happening. ### REPLY: HelloThanks for writing to ChatDoctorYour mother is probably suffering from postoperative delirium which is very common among old age patients. She needs psychiatric consultation. Anti psychotics like haloperidol and chlorpromazine as well as the second-generation antipsychotics olanzapine and risperidone are equally effective.However, other causes like hypoxia should also be evaluated. CT Scan of brain should also be done to confirm other possibilities. Hope I have answered your query. 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 sister s age is 23.Her weight is 64.For the last 10 years she has been suffering from a typical sort of pain in her left foot.The pain triggers when she strains her foot by over walking or by walking on an uneven road or even by keeping her leg in one position for a very long time.The pain remains for 10 to 15 days.It is unbearable.She is unable to stand,walk ,move the leg,touch the area of pain.XRay shows everything is fine.Reports show deficiency of vitamin D,even after taking injections for vitamin D there is no relief .There is no swelling.PLz help. ### REPLY: Hello, Your sister may be suffering from plantar fasciitis or chronic foot strain, this commonly occurs due to improper footwear or overuse. I would suggest her to wear a soft cushioned footwear (Or tho sole). Hot fomentation daily once when she gets up and once before going to bed. She can keep both her foot immersed in lukewarm water for 20 minutes. For pain relief she can apply any topical pain relieving gel or balm (diclofenac gel). Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am only 37 years old have been taking lovenox and coumadin due to a blood clot that formed in my leg. my doctor believed it was because of a fibroid. I have since had an hysterectomy and was  just recently taken off lovenox. I am now experiencing rumbling and bubbling in both legs. Is this possibly a new blood clot trying to form? ### REPLY: Hello welcome to  Thanks for your query. Since you had been given Lovenox and Coumadin, most probably you would have had deep vein thrombosis. It is perfect that they had stopped anticoagulants after surgery to prevent internal hemorrhage. Now it is advisable to take a Doppler study of the lower limbs and further continue the treatment. And to treat this problem medically or surgically will be evaluated on further investigations and physical examination. Consult vascular surgeon and take further suggestion swish you a good healthThank 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: good morning doctor, my brother ,he is around 24 years working in software company for the past 11/2 year.In the starting 3 months of the job he suffered from back pain alot. he consulted nearby doctor he gave some medicines for temporary relief. now ChatDoctore to hyd and he has done all the x-rays and respective tests for back pain, fromthat all test and MRI scan finally doctor said that the problem is L5S1 disc is enlarged and that pressure is on the spinal nerve roots and also he has pain in the right leg, doctor preferred to go root canal treatment surgery something. Doctor is there any furthur treatment for this problem to avoid surgery.Please tell me doctor ### REPLY: Hello, your brother is having early lumbar spondylosis with radiculopathy that is the intervertebral disc is pressing on his nerves which is causing the pain. There is a chance for conservative management also that is with tablets, injections and physiotherapy he can improve, and he should do back strengthening exercises which he has to continue and maintain correct posture while working on computer and avoid using laptop and take a break every 1/2 hr of sitting in the same position. So please consult a neurologist and physiotherapist who will guide and i don't think there is need of surgery immediately. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: yes i have been diagnosed with PVCs, they have given me a beta blocker and said it was not life threatning. but when i have them i feel like they are taking my last breath and after they have passed i am very very tired and fatigued. could it be something else wrong? ### REPLY: Hi welcome to . I understand your query and concern.PVC scan be treated effectively in many cases. Mostly they are benign. All organic causes have to be ruled out by the following protocol. 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. . Reduce the intake of fatty and fried food. One pomegranate a day will help to keep your heart at good pace without clot formation. Avoid coffee and tea and alcohol by all means. Consult a Cardiologist for further expert management. Post your further queries if any. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had an mri which showed a piece of a disc has broken off and is pushing against the nerves to my right leg. Dr. mentioned L1 L2 area. I have had intense pain when standing, straigtening the leg or walking and now I have numbness in the leg as well. This began 30 days ago. Is there a chance this would resolve on its own or is surgery the only option? ### REPLY: Hi, Thank you for posting your query. Based on the MRI findings, the problem seems to be severe, and the chance of improvement without surgery is less. However, in most cases, one has to give a chance for conservative management. This includes rest, physiotherapy and neuropathic pain medications such as pregabalin. If the above measure fail, then, surgery can be considered. Best wishes, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been seeing my doctor for 14 weeks now, it started with a red hot pain in my left temple, i was put on steroids for temporial arteritus, i am 43 and always suffered headaches, however this is a major pain in my temple and i hav a vein that is on show about 2 inches in length down the side of my head, i ended up in hospital with severe pains in my left side, they took blood tests and said my levels are normal, so no temporial, i was told 2 come off the steroids. However i have been in major pain, and things are now worse than ever. Other doctors say icauld have trigiminal neuralgia , as the burning spreads over my forhead, scalp, now my nose and mouth are also burning!! I have had an mri scan , results say no tumor , temporial looked normal, but i am still taking steroids, am now down 2 four a day, i hav read that the steroids would interfere with results? I am now waiting 2 see a rymatolagist, but i am getting worse by the day. the doctor does not know whats wrong with me!! I now have burning in my left hand and neck, i cannot walk a distance, as i feel so week, inside my head feels dizzy, and echoing, i am taking antenalol 25mg, as my blood pressure has gone up, with all the pain, prednisolone now 4 a day from 8, gabapentin 3 per day, morphine 5mg patches, and oramorphine when needed, paracetamol 8 per day, i also hav thrush and ulcers in my mouth. now iv been given clonazapan once per day, and now i hav infection and been put on penicillin 8 per day, also dispersible asprin. My main worry now is all my veins are very bluein my wrists and hands, some itch and burn, and the burning on my head where the vein is, never goes away. I need 2 know why im getting worse, i am not goin out now and im constantly in pain, plz HELP? ### REPLY: Dear sir, symptomatology seems to be between 2 differential diagnosis temporal arteritides and trigeminal neuralgia both excluded by Cerebral MRI. My advice is to remove XXXX and start XXXX a day starting from XXXX a day. Anyway other blood test has to be done to make the diagnosis. I would strongly recommend Angled test, because the only disease which has such diffuse symptoms is Lupus. Wishing you all the best hopping that my advice will be helpful to determinate the 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: My daugther got a silver crown placed on her teeth about 2 1/2 months ago and the gum area around the crown is still bleeding when I brush or floss around it. What could be causing this? The dentist did put a bigger size crown on her tooth because her tooth was an in-between size. ### REPLY: Hello, Thanks for consulting , Read your query, as your daughter had crown placement on tooth this continuous bleeding can be due periodontal problem due to deposition of food there is periodontal pocket formation. For this I will suggest you to consult periodontist and go for examination of tooth and Investigations Iowa X-ray of tooth if there is pocket formation then you should go for Curettage. Hope this will help you. 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 have PCOS and ttc.  My dr had me take clomid and progetrone at the same time (first time taking clomid) after I had 2 days of light brown spotting.  2 days after I finished the clomid I had 2 positive opt tests 2 days in a row.  The next day I had an inconclusive hpt. So I waited a couple days finished the progetrone, which usually makes me start my peroid the very next day and took another hpt; it was negative. Fastforward 2 weeks, I still havent gotten my peroid, my breasts are swollen and nipples tender and I have become extremely sensitive to smells. I took another hpt today and it was negative, could my ChatDoctor be too low to read on a hpt? ### REPLY: Hello, thanks for using  I have read your query with a lot of concern. The first thing I find is a little ambiguity as to why your hit were positive and two weeks later negative. It most likely scenario is that the hit gave false positive results. Normally, pregnancy test becomes positive at two weeks after fertilization i.e. about the time the next menses was about to start, and the first symptom thus is absent of menses in most cases. If truly, the tests were positive, then you might have been pregnant long before you even started taking the .  However, this is also ambiguous because it requires averagely three weeks for the test to become negative after termination of pregnancy. If you recently became pregnant and it's less than 4 weeks(you have not yet missed your period), the hit will be negative. Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was lifting a wight bar the other day, and felt a pop in my wrist. It hurt at the time it happened but not too bad shortly after that. That night I woke up several times from pain in my wrist. The pain is on the pinky side of my wrist. I have some swelling and a lot of tenderness near that bump at the base of my wrist. It also hurts pretty bad to turn my arm or pick up anything. Is this just a bad sprain, or something else? ### REPLY: Hello, It looks from your details that you may have a sprain of collateral ligament of medial side of wrist. You should do following to have relief in this:- Do cold fomentation over it for at least 3 days after injury.- Apply an ace bandage over it, starting from hand towards the wrist.- Take a good analgesic like Advil, aspirin or ibuprofen.- Give rest to affected hand. Do all this for at least 5-7 days. Even after that if you have any problem then it will be better to have an X-ray of affected part and consult to your doctor. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, Im 27 year old. During my childhood I used to eat slate pencil a lot however  later on I stopped. But now I feel like eating again. Now that Im also planning for pregnancy, would my slate eating habit make any bad effect on this and Im also trying to avoid this craving during my pregnancy. ### REPLY: Hello and welcome to . Thanks for your query. I understand that you are distressed due to the symptoms that you have mentioned. Eating non-edible objects such as slate pencil is called Pica. There could be a number of causes for this symptom and one of the most common causes is anemia. So, I would advise you to have a proper medical evaluation, including a hemoglobin test, in order to establish the cause of your pica. Moreover, since you are planning for pregnancy, it is important to detect if you are anemic, so that appropriate treatment can be initiated at the earliest. 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: hi doctor i find out in 2001 dat i have hepatit b infection i went to the liver clinic for 3 year i dint have no liver probleme and the doctor tol me i whose good he said the infection whose very lo.ee but juin 2013 my primary doctor tol me i still have the infection in my body is thad possible ?   my blood test whose hep a ab,igm negative,  hep a ab,total positive, hbsag positive   . ### REPLY: Respected Sir/ Thanks for your query. I am afraid some of your words are not clear. However, Bag positivity means that you still have hepatitis B virus infection. It may be possible that after treatment the level of infection and activity of virus had gone down to low levels as suggested by your other doctor. This might have come-up again. It would be best to consult a hepatologist (specialist in liver diseases) to get a clearer picture and start treatment, if it is warranted. SincerelySukhvinder ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am having an occasional shooting pain at the back of my left armpit three inches below the beginning of the upper arm (about even with nipple).  It hurts when I rub the skin of my armpit with my arm and seems to be in the skin, not the underlying tissue.  There is also a slight numbness in the same area. ### REPLY: Armpit or underarm pain can be caused by a number of things that include pinched nerve, pregnancy, cancer, swollen armpits and lymph nodes, muscle twitch, breastfeeding, waxing, cystic pimple, cancer, among other causes. But in your case there may be-Brachial plexus nerve injuries - Shooting pain Pinched nerves especially brachial plexus from stretching, pressure or trauma can lead to this problem. This is often accompanied by numbness and tingling feeling and pain that resemble electric pulses.  But exact diagnosis is made on basis of investigation or examination. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 baby boy,5 months old bone with posterir urethral valve and surgery done on 14 june.still under follow up.what r the risk facters that i should worry about... will my baby go for renal trasplant. we r living in doha.please give me some advice ### REPLY: Hi, The most common delayed complication is restenosis during followup, although only some develops that. You need not worry about transplantation now-he had undergone surgery without delay, relieving obstruction and hence allowing kidneys to function normally. Just keep him under regular followup to detect any stenosis without delay. Also report to doctor if he develops fever & crying on micturition, suggesting urine infection that needs early treatment with antibiotics. Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir, i am suffering with severe allergy on my both legs. itching is very high and red impressions.  The problem is occuring when hot climate and sweating is more.  The problem is occuring only on both legs.  please suggest some remedy. Regards, A.R. Srinivasa Rao YYYY@YYYY ### REPLY: Hello A.R. Srinivasan Ran, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. Were I treating you, I would prescribe you an antihistamine like cetirizine/fexofenadine/HY . 2. Please avoid scratching at the itching areas as scratching will aggravate itching. I would suggest you to apply a lotion like calamine to the itchy areas.3. In addition to above, personally I would suggest you to avoid wearing tight-fitting or woolen clothes. Loose-fitting, cotton clothes will be the best option in my opinion.4. Please avoid activities that cause excessive sweating. Please avoid hot, spicy foods for a few days. These may help. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you a quick recovery and the best of the health. 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: My heart does one very hard beat occasionally and slows down a bit when this happens. It happens intermittently - sometimes as frequently as every 6 beats or so - sometimes 30 to 40 beats between occurrences. It is most noticeable when lying down. Has been going on for about a month. Is it anything I should worry about or get checked out? ### REPLY: Hello, I passed carefully through your question and would explain that your symptoms could be related to a possible cardiac arrhythmia. Anxiety cannot be excluded either.  For this reason, I would recommend consulting with your attending physician for a physical exam and some tests (a resting ECG, complete blood count for anemia, thyroid hormone levels and blood electrolytes for possible imbalance).  A prolonged ECG Holder monitoring would help investigate for possible cardiac arrhythmia. You should discuss with your doctor on the above tests.  In the meantime, I recommend reducing caffeine intake and straining physical activity.  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: Good Morning, I was wondering if you could help point me in the direction i need. My partner and i are planning to have a baby, We have found a doner since we are a gay couple. We know the Doner on a personal level but we want to do this very cautiously. Do you know where I can find any informantion on this. We have spoke with our GYN and PCP I would like to make sure we take all percautions so i want information like what tests we should have our doner take and what not. Think you can help? ### REPLY: Hi, Donors needs to be screened for multiple infections such as HIV, Bag, HCV, V . If I had been your treating Doctor. Would like to do all basic tests of Donor to rule out sexual transmitted diseases, basic routine tests such as TSH, complete blood count, Liver and Kidney function test, Clinical examination to rule out heart problem, respiratory problem, blood pressure measurement. Other part is done sonogram to check ovarian volume and astral follicles. It is preferable to get AMH anti mullein hormone test done done ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello my name is javier i am 24 about 170 give or take. as far as i know im healthy except for this cold .when i was younger my mom said that the doctors told her  i was supposed to have asthma but it never developed but i disagree, to this day i still have breathing problems. anyway my question was is it possible to cough so hard that you have aneurysm, or damage a blood vessel? ### REPLY: Hi welcome to ... You are having chronic cough and cold problem... For rule out asthma or COPD like case investigate with Spirometry that is pulmonary function test .... If asthma present in spirometry than treatment for that started .... If on auscultation bronchoconstriction present than palmetto like bronchodilator given.... Excess cough can lead damage to blood vessel and hemoptysis can occur ... But it usually not leads aneurysm... If troublesome . ... Take care So investigate with spirometry and chest x-ray after consulting pulmonologist ... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: The inside of my left foot started hurting 2 days ago. I don t remember injuring it. There is a sharp pain when I move it after putting weight on it, as well as when I put pressure on the ball of my foot. It doesn t look like it is very swollen or bruised. ### REPLY: Hi, There are many reasons for the pain in your foot. Like improper footwear, fungal infection, nail bed injury gout. You need to get thoroughly examined by a physician. You can take Ibuprofen for time being, but remember it won't help in treating the condition, will just provide you a temporary pain relief. Till then take care and rest well. Hope I have answered your query. Let me know if I can assist you further.   ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: They have done two head MRI s and found some white matter in the 2nd one. They are sending me to the brain trauma unit in TX. They also had a spinal tap done and it showed high level of protein. During the last week I have noticed my legs feeling numb. Can you help me. ### REPLY: Hi, as you mentioned the symptoms of numbness you need to be little slow in first getting what the cause is. as the medical fraternity is trying to figure out the cause. Also, The CNS has two kinds of tissue: gray matter and white matter, Grey matter, which has a pinkish-grey color in the living brain, contains the cell bodies, den .  White matter is made of axons connecting different parts of gray matter to each other. Now as you said the spinal tap test is done you need to wait and see the reports. The numbness can also be because of the lumbar spine issue. Which has to be ruled out. An MRI will put the insight to the matter. Most of the time, we have to wait for any other symptoms to arise, as most symptoms are self limiting and are not a major cause. So rather getting panic you should just stay calm.Also, you can perform regular meditation and breathing exercises with general physical exercise as it will keep you out of stress and tension. With the grace of God I wish you a speedy recoveryRegardsJay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir I hv dust and smoke alerge form 7 yr  but its nt asthma    iam using  tis medicine  from 2 yr wen I feel  hard to breath   ill take it  but   oly in winters ill get tis problem  in summer so..... plz giv some suggestions   iam suffering much from tis but wen I take tis ill bcm free ### REPLY: Hello, Thank you for asking at . I went through your history and would like to know more about you like - a. what is your age? b. how frequent are your symptoms? c. What are your nose symptoms, what are your throat symptoms and what are your chest symptoms (breathing difficulty etc.) d. What are the medications you use? e. Do you have any other medical conditions? f. Do you take any other medicines frequently? Above details are necessary to help you better. However, at present, I would like to make suggestions for you from your given information as follows:1. I usually prescribe my such patients regular montelukast and levocetirizine. I also prescribe them albuterol inhaler to be used on as-and-when-needed basis.2. Furthermore, I would suggest you allergy testing for common air-borne allergens such as house dust mites, molds, insect proteins, pollen and pet dander (if you have pet). It will help you identify the substances causing allergies to you as well as to know the measures to avoid them.3. Based on allergy testing report, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which gradually works on immune system to improve allergy symptoms over a long period.4. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution as much as possible.5. Regular breathing exercise and a healthy diet rich in vitamins & minerals also would help you to improve your lung capacity and immunity respectively over a long duration. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you 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: I am get sharp pain in the left side when iam talking long breath. I under high stress for the past 4 months . When i get Sad, Cry my troat chokes and i get sharp chest pain on the left side. Please let me know what it might be. Iam 33 years old and i have 4 year old kid ### REPLY: Hello dearWelcome to .come have gone through your concern in depth.* Suggestions for your better recovery- . - Avoid stress, anxiety with deep breathing exercises, YOGA.- Regular walking in fresh air.- Avoid smoking or alcohol if using.- Tab. Tylenol (500) mg 3 times a day after meals.- Be extra careful while lifting weight or other strenuous household work.- Consult later doctor if required. Wishing you fine health ahead. 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 had some type of novocaine for fillings, the first filling done on upper right, 2 days later tremendous pain in my teeth on left side, asked the dentist, he didnt have a clue, a week later filled cavity on lower right, same occurrence,(on left side) a week later cavity on upper left, 2 days later extreme pain, mostly in bottom left, every tooth was like nerves on fire, now the teeth on upper left hurting, but not as much, but face swelling much more.  pain is intense. Thank you for any information, also my throat on left side seemed too close, have been feeling nauseous, but i think from pain. ### REPLY: Thanks for your query, I have gone through your query. The pain on the left upper and lower teeth can be because of the decay involving the pulp and the periapical area. Consult an oral physician and get a radiograph of the teeth where you have pain. If there is any infection in the root tip of these teeth, then get them treated with RCT and crown. If I am your treating doctor, I would have suggested you to take a course of antibiotics like amoxicillin 500 mg and metronidazole 400 mg TID for 5 days (if you are not allergic) till we confirm the diagnosis. 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: hi doctor my semen analysis is : volume 2 ml color normal liquification time 10 min count 45 mil per min motility 50%: sluggish 25% 15 active movement 5% very good active movement in linear direction forward 5% circular movement and no direct forward pus cell 14 before 5 month my wife get pregnant but pregnancy end with missed abortion my semen analysis with normal limits or what? ### REPLY: HelloThanks for your query. Your semen analysis is well within normal limits. Your wife remain pregnant but unfortunately resulted in to miscarriage, Please note that there is no relation between quality of sperms and the miscarriage. The miscarriage is due to some Hormonal imbalance during pregnancy. Please consult some Gynecologist for proper evaluation and assessment before the pregnancy and after she conceives so that she can be given hormonal support to continue the pregnancy, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor,Recently, i have started feeling sleepy and sometime runs tired easily. i have treated malaria fever in the last 3 weeks with coaterm (aletermineter and numerfantrin). at work i feel easily sleepry, please help me for recommendationmy age is 34,height is about 1.73M and weight about 79-80KG, Medical history - My father has high Blood Pressure but is been managed ### REPLY: Hello, Welcome to ChatDoctorI understand your concerns. You are suffering from post fever tiredness and fatigue. It takes 2 -3 weeks for you to get rid of these symptoms. As you had fever 3 weeks back, it would have decreased your bodies immunity, and it takes about 3 weeks after fever to boost up the immunity. So, i would suggest you 1. To take good rest and sound sleep2. Eat lots of fruits and vegetables which are rich in vitamins3. Eat . Hope I have answered your query. Thank you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mom has mild right paracentral bulges are seen at c4- c5 and c5 -c6 levels, mildly impinging the anterior subarachnoid space .any thing seriousmild posterocentral bulge of c3- c4 and mild diffuse of c6 -c7 disc is seen whole spine screening sequence shows mild sacttereddisc bulges in the thoracolumbar spine, ### REPLY: Hi, Welcome to  .com I am . Mariano Into Bruno Mascaras. I have gone through your query with diligence and would like you to know that I am here to help you. We can not decide based on Imaging Findings alone need to look at the Motor Power Sensation Reflexes before deciding whether this para central bulge needs treatment or not Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in  at http://bit.ly/ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my child is 2 years old and she likes to eat dirt and rocks, what can i do? ### REPLY: Hi, Thank you for the query. This pattern of eating or habit of eating dirt and rocks is medically termed as PICA which is a disorder in which usually child .  It occurs due to loss of certain nutrients such as iron deficiency anemia, zinc deficiency. I suggest you to see your children pediatrician to rule out presence of any calcium deficiency which usually initiates the child to eat dirt or soil or rock. Hope this information helps 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: hi sir iam having a sciatica problem and lumber spine problem for this pain i had taken a electro homeopathy treatment in that doctor had given me a electric shock on my left leg main nerve for 3 times and the pain is gone for few days only after that it came again i had taken  lot of pills but no cure now my doctor suggest me duzella 30 mg so how much its useful for me pls suggest me some good medicine iam fearing tht any side affects will come because my marriage is thier in a month and iam having high uric acid 9.0 ### REPLY: **1. Since the symptoms again came back after taking conservative treatment, thus check with X-ray LS-spine, MRI for any nerve impingement or narrowing [which might be the cause of sciatic pain], thus consider orthopedic surgeon opinion.PS. if there is shooting pain along one leg, initially you may require pelvic traction, epidural injections, geography studies.2. Since you have been diagnosed with the said problem, thus in Ayurveda we treat/manage the disease on the line of Gridhrasi PS. Della [duloxetine] is an antidepressant/antianxiety .  You can incorporate following prophylactic aspect also:. Sleep on hard bed/mattress. Wear heavy shoes and warm socks. Massage of olive oil is beneficial PS. Acupuncture has been approved by the U.S. FDA as a treatment for back pain, and the National Institutes of Health has recognized acupuncture as effective in relieving back pain, including sciatica. Take 4 SF holy basil juice 4 SF ginger juice 4 SF honey and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi,my daughter is 4yrs old and havind severe fever (38-40c)and is reducing after paracetamol intake,thn again she feels cold and after 1-2hrs fever is raising up,with running nose,decreased urination,it started on saturday last week,an dit was constipation at first,but now its diarrhoea ### REPLY: Hi Thanks for writing to . From your description your child seems to be suffering from Gastroenteritis which is mostly viral. And seems to be deny . Is there blood in motions? Kindly give fever medicine as required and give 1 glass of ORS after each loose motion. But if she hadn't passes urine well, she needs to be seen by pediatrician. Thanks. In case you have more query I am happy to answer else rate this answer and close the discussion. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor,I am aged 43 years and has a history of high triglycerides and Cholesterol levels, had pancreatitis few times and takes Lipanthyil 200M.  For last one month i did not take Lipanthyl and recently checked my lipid profile; the results: Triglycerides-575, Cholesterol-301, HDLC-30 LDL-115 and VLDL-38.  Also the AST-63 and ALT was-14.  FBS-97 and Uric acid: 3.7  For the last two weeks i have started taking Lipanthyl (one time) and Legalon (two times daily). When i was a baby i was diagnosed with enlarged liver.   Please advise as to why my triglycerides shoots very high (before i started lipanthyl, it was 3000+)  is this problem from my liver.. Kind regards,Sam. ### REPLY: Hi welcome to  ... Your history regarding gall stone and alcohol, medication should be taken... If you have alcohol habit than pancreatitis can occur by it... High cholesterol is predisposing factor for fatty liver and so liver enzymes can be high... Here for high triglycerides continue using . . Regular exercise and low fat diet useful... Fruits taken more.... Lemon juice, avocados, Indian gooseberry, spinach are good for liver Take care Advise : Gastroenterologist consultation for examination.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 25 years old male...i have been diagnose with asthma 3 days before...i was suffering from violent dry coughing especially in early morning hours.chest pain,vomiting due to stressed coughing..and i am allergic to dust and climate change...i am a assistant director in movies ..can i spend my rest of life normally or i have to take medicines whole life..also suggest me what all diet and things i should include or exclude..i am a smoker too since 6 years ### REPLY: Hello.First, my sincere advice is to quit smoking, if necessary, seek professional help also. Smoking harms the lungs and not only worsens asthma but also reduces efficacy of some asthma medications. This will be one of the most important step for you for a better lung health. Apart from this, with proper understanding and correct use of asthma medications, you will be able to live a normal life, including exercises, sports & adventures. So please do not worry. Depending on the severity of asthma, you may have to take daily regular medicines or intermittent medicines on as & when needed basis. With passage of time, you & your physician will be able to decide minimum dosage of medications to control the asthma. Unless you are particularly allergic to some foods, you may not have too much food restrictions. I would suggest minimizing cold foods (cold water, cold .  Otherwise, please try to have balanced & nutritious diet rich in vitamins & minerals. I would also suggest you regular exercise, breathing exercises, yoga & Panama. Control stress with relaxation & meditation (stress may trigger an asthma attack). Hope this was helpful to you. Wish you the best of the health. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, My name is mark. I am 25 years old, I am a web developer. From my childhood i was very good in studies even when i not study well i still do very good in exams. It was till about 16 years of age. After that I understand that i need to achieve something in my life so i decided to work hard on my studies and became a very good software engineer. But don t know now i started showing bad results in exams while i study day night and work hard. In this way i completed my degree 3 years ago it was recession period and i not able to find good job. So i started with small one and i got success and open my own software company. But i don t know now i have to work hard to get my company to top. I am not able to focus on my work. I continuously play games and watch movies on my notebook instead of doing my work. While i know i am doing wrong, but i can t help it my mind just stop working and force me to these stuff. Please help me what is wrong.... I also want to tell you my family history and about my personal life may be it helps. My father was from a joint family. He get married to my mother and they live together with my grand father, and my father s other brother and sisters. My father is the oldest one in all. But no body respect him because i also found he is bit lazy and don t know much family relationship. My father s brother and sisters hate my mother while my mother do all good for them. So after facing much torture from them my parent get separated. My parents love me a lot and upto 10 years of age of mine they try to provide me everything i wanted. But after that i realize financial state of my family is not good at all. So i started saving money. From my childhood i keep having long discussion fights with my mother, but i love and respect her from my heart . I am not much good looking, so i keep distance from girls from i was a child. From about 12 years of age I mostly like to be in my room. I don t like to go out, may be i afraid from getting disrespected or ignored by other, as i don t like this. Now I am living a life just equal to prisoner always in my room in-front of my notebook, in this way i have lost my company. Have worked on 2 of my own websites, which developed taking very long time and much of time i wasted in playing video games and watching movies. Please i want to know why i do wrong while i know i am doing wrong and why i keep myself in my room only don t want or afraid of being out. Is this a mental disorder or something else. Please suggest how can i get rid of it....... Please help me. Best Regards, Mark ### REPLY: Hello and welcome to . Thanks for your query. Your symptoms could be indicative of a mood disorder. However, you need a detailed psychological assessment to make a definitive diagnosis. I would advise you to consult a psychiatrist for a detailed evaluation and further treatment.  Then there are effective treatment options available - in the form of medication or counselling / psychotherapy which will help him overcome your problems. 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: Hi I have recently found out that my prolactin is high, I have bad headaches, sometimes a ringing in my left ear, I am cold and exhausted. When the prolactin is high, how common is it to have a swelling in the brain especially if my mother suffered this when she was around my age 25-30? ### REPLY: Hello, High prolactin levels may indicate that there is a brain tumor (mostly benign) or pituitary adenoid. A brain MRI and blood tests for other hormones produced by the pituitary gland and visual field examination are necessary for a correct diagnosis. Heredity may play a role in such cases. Discuss with your Doctor for these issues. Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I WAS SKIN TESTED FOR ALLERGIES IN JAN 2014. I AM ALLERGIC TO DUST, DUST MITES,CATS,RAG WEED,GRASSES. I CLEANED THE HOUSE VERY WEEL, SPRAYED FOR DUST MITES. I WAS GOING FOR ALLERGY SHOTS BUT CAN NOT AFFORD TO GO ANYMORE AS I HAVE NO HEALTH COVERAGE AND AM SELF PAY, IT WAS COSTING ME $180.00 A MONTH FOR SHOTS 2X A WEEK. ANY ADVICE TO ALLEVATE THE SYSMTOMS OF VERY STUFFY NOSE, ITCHY EYES AND SNEEZING. I USE AFRIN BUT THAT ONLY HELPS FOR A FEW HOURS. I LIVE IN NORTH EAST OHIO, FEMALE 53YRS OLD. GOOD HEALH. ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. I can understand that you can not afford allergy shots at present. So I would suggest you intranasal corticosteroid spray (methadone or fluticasone) for at least 14 days as at present your symptoms are severe.2. I would also suggest you to take regular montelukast and levocetirizine for longer periods such as 3 to 6 months. You may need them to take lifelong if allergy continues to be a problem.3. As you are allergic to dust, dust mites, cats, rag weed and grasses, I would suggest you as follows for allergen avoidance:a. Remove carpets and curtains from your home, especially bedrooms (for dust mite).b. Wash your mattress covers, pillow covers, bedsheets, etc. in hot water (around 55 C) every week (for dust mite).c. Prefer cleaning with vacuum or wet mopping over . d. Avoid humidity inside home, if possible, please allow sunlight and ensure good ventilation to reduce humidity inside rooms and to washout allergens (for dust mite).e. Please do not have a cat inside home (for cat).f. For ragweed and grasses, if their pollination seasons are known, please avoid moving into high pollination areas during those particular seasons and cover your nose with mask if going outside.4. In general, I would also suggest you to avoid exposure to dusts, smokes and air pollution as much as possible.5. If you have nose obstruction, I would suggest you simple measures like steam inhalation and nose irrigation with saline which may help. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you 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: Hi doctor. Just want to ask. My penis started to itch and present allergy like symptom almost 2 weeks ago. It became puffy. The left part of my lip(mouth) felt tingly. After 3 days, my penis started to have black spots. One is a big circle and there were lesions on the glans and foreskin. It turned from itchy to painful. My left lip also had a small crack that s why it is also painful. Please help. ### REPLY: Hello,Itchy penis and black spots on foreskin makes me suspect that probably you are having candida posits which is more common in diabetics, whereas recurrent bacterial infections are also common if one's blood sugar levels is raised. I would suggest that you take a course of an oral antibiotic (penicillin or cephalosporin group e.g. Amoxicillin or CEA . An OTC antifungal cream e.g. clotrimazole cream, can be applied twice daily on the cracked foreskin. An oral antifungal e.g. fluconazole 150 mg single dose would also take care of the candida posits.Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have been having uper thigh/lowser abdomen pain for about 24 hours now. It is getting slightly worse over time. I really would like to know what this aching in this area could be. I have read about it and it looks like it could be a possible groin strain. can u please help me? ### REPLY: Bellflower abdominal pain may be due to many reasons like pelvic pathology, genitourinary pathology, colitis,musculoskeletal reasons like sprain etc. You need clinical correlation and investigations like routine hologram, random blood sugar, liver function test, renal function test, urine RE/ME and ultrasound of abdomen. Ultrasound is important in your case. Proper treatment depend upon findings. Get well soon. Take Care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 58 years old and am presently suffering from Calcium oxalate kidney stone (which is in the lower ureter ) for which I am taking medicines, however I often suffer from severe pain in the leg which goes after I take a calcium tablet. I was taking Shelcal 500, however I understand that taking calcium tablets can increase the risk of forming more stones. Would like to know what needs to be done since I need to have calcium supplements for my leg paim as well. Please help, I live in Mumbai (India), am 58 years, Female and have suffered from kidney stones (calcium oxalate) once in 1986 and after that now. ### REPLY: Hi, Thanks for writing in. I would like to tell you that in people with calcium oxalate stones, calcium restriction is NOT NECESSARY. To prevent further stones, I would recommend the following steps:a.  .  You should be consuming at least 3-4 liters of water in a day.b. Limit the amount of protein you are consuming: You should be having a total 2 servings of milk and milk products + fish/poultry/meat/legumes to 140 g per day. [Approximately, 1 deck of cards = 84 g] c. Limit Foods High in Oxalate like nuts, soda, carrots, beets, cauliflower, carrots.d. Limit your sodium and vitamin C intake. Avoid adding salt, pickles, papas, chutneys, I do not think that the pain in your leg is related to the deficiency of calcium. It needs an independent evaluation. You can continue taking Shell 500 as a calcium supplement would be recommended in post menopausal women. 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: last night i was drunked .I was also vomiting suddenly i had a severe pain in my lower abdomen n when i peed i had blood in it and after peeing blood was still coming out plz note that that i have pain on and off in my lower abdomen for the past 2 weeks n i was drunked for ghe first time i hope u will help i am really worried ...!! ### REPLY: Hello! Thank you for the query. Most likely you are suffering from urinary tract infection. Blood in urine, lower abdominal pain, burning while urinating, frequent urinating are typical symptoms of such infection. You may also have back pain and fever. I suggest you to consult your doctor and have abdominal ultrasound and urinalysis first. In case of an infection, antibiotic should be prescribed. You should also increase mineral water intake and start cranberries supplementation. 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: Aloha from Hawaii:I just heard back from my doctor who ordered an MRI the other night.  His diagnosis is L5, S1 disc protrusion.  I am wondering if there is a medicine of choice for this pain until I can get more physical therapy, etc.  I tried vicodin, tramadol and now he put me on Lyrica.  Someone also spoke of Cymbalta (sp?) ### REPLY: Hi, You are diagnosed to have L5 S1 disc prolapse, and you have severe neuralgic pain because of it. Lyrica dose to be increased for relief from neuralgia. Cymbalta contains duloxetine which is a selective serotonin and norepinephrine reuptake inhibitor which when used reduces neuralgic pain, dose range from 20 mg to maximum 60 mg daily. If symptoms still persists you should consult neurosurgeon, for epidural steroids. 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: 25 yrs old male 57 260lb. i have been having some pain and discomfort in my upper and lower left side of my abdomen and it irritates my colon at times. I do not have a bloody stool or tarry stool. What could it be?....also for the past couple of nights my right leg has been feeling a little numb in the middle i wake up because of it. my feet look a little swollen and a little bruised but when i feel it i have no pain what could it be??? ### REPLY: Hello Welcome the , Brief.you may need colonoscopy and rheumatoid factor level. Detail...since large colon symptoms with swelling of joints (ankle or knee) could be because of rheumatoid disease. It can also be only irritable bowl syn . . My opinion would be got colonoscopy done and discuss with gastroenterologist and rheumatologist for evaluation of your symptoms. You may further ask regarding reports without any hesitation. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pain/ache in my lower back, right hand side and a pain/ache around the same place in my lower abdomen, right hand side. The pain feels the same in my back as in my abdomen.  It is more like a throbbing ache than a definite pain. It is intermittent and comes and goes and can last for up to 2 - 3 days.  I am 49 and had a Marina coil fitted a few years ago as I had period problems.  I havent had a period for about a year but not sure if this is the coil or my age!! Any ideas what the pain/ache could be? ### REPLY: HiT hank you for asking . I have gone through your query. Your problem can be due to pelvic inflammatory disease. Women with intrauterine device are more prone to get this. If you had any unprotected sex, that also is significant for this. A gynecologic examination including bimanual examination and ultrasound will be needed to rule out the condition. If there are such problems then antibiotics will be needed and intrauterine device should be removed also. Hope this may help you. Let me know if you have any further queries. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have a silly question yesterday i was out side riding an atv in tall grass later the day i came home approx 5 hours later i find a tick on my penile foreskin i removed it an now the skin has a small bump an red an itches really bad what is wrong ive never had a tick itch ### REPLY: Thanks for contacting ChatDoctorI am sorry to hear that you found a tick and the area that you found the tick is now swelling and red. When you removed the tick it is possible the tick released some of its body juices into your skin. I would recommend using a small dose of HY .  If the area becomes more inflamed I recommend you seek medical attention. Hope I answered your question. Please feel free to contact us again for you medical concerns and 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 am having pain when I urinate, but different from last infection in that it hurts only at the end of the stream. My urine is cloudy and smells different. I also have been having pain in my right flank off and on for 6 months. I had bladder infection, successfully treated with antibiotics 6 months ago. I had ultra sound on right abdomen that shows fatty liver. I am 60 lbs overweight, but have been exercising and have lost 3 inches of belly measurement in the last 3 months. ### REPLY: Hello findings suggests deposition of fat within liver cells(fatty liver). Fatty liver may be due to many reasons like hepatitis, obesity,alcoholism, metabolic disorder, . It may be due to obesity in your case. You may need few more investigations like routine hologram, random blood sugar, lipid profile, liver function test, urine RE/ME. You may need to change food habit and lifestyle. You should avoid saturated fat and go for brisk walk regularly. Take a lot of fruits and vegetables in your diet. Avoid alcohol if you take it. Try to further reduce your weight. Get well soon. Take Care ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have allergic rhinitis and asthma . doctors give me to use a inheler name seretide and a nosol spray name beconase aqueous nasal spray to use everyday . i am using it everyday. asthma is no more causing problem. but i am suffering allergic rhinitis. my eyes and nose are itching, eyes look like red eyes, it is hard to breath . water dicharge from eyes and nose. what i do ??? ### REPLY: Hi Cousin, Kindly don't worry as it will take some time for the symptoms to subside and depends on the weather also. Get yourself examined by a ENT Specialist, so that he may examine you and Prescribe medications.  Stick to your treatment plan and go for regular follow up. Follow these home remedies: 1.) Stay indoors2.) Use an Air conditioner at home3.) wear a face mask when you move out4.) Remove pets if you have any from home5.) exercise regularly for a hour6.) eat healthy nutritious balanced diet which should include fresh fruits and green leafy vegetables. Wish you Good Health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: SIR, I AM B.K. SHARAN, 68 YEAR OLD IN JAN MY SGOT LABEL IS 23 ONLY, BUT ON 26 MARCH  MY REPORT CONFIRM MY SGOT-192, SGPT-334, GAMMA- GLUTAMYL-92.5, ANTI HCV IgG/IgM NEGATIVE,HEPATITIS B IS NEGATIVE, I AM 35 YEAR OLD DIABETIC, CURRENT HBAIC IS 6.01,HAEMOGLO-9.7, TOT CHOLESTROL IS 136. TG LABAL IS 269, PLS SUGGEST ### REPLY: Thank you for posting query.It's also advice to get an abdominal ultrasound and also give your medication history (if any)> certain medication are hematologic.advice:abstinence from "Alcohol and .  - use lemon juice (lemonade) once in a day-walk 30 to 40 minutes every day.- or swimming is alternative to walking-NO sports and NO jogging-"recheck liver enzymes after 6 to 8 weeks".if any further questions, feel free to ask. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health. Regards, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my name is karthiga age -25 years i have subserous fibroid which was identified this year jan . now i am under going follicular study 12 day - rt ovarian follicle -1.7 * 1.6mm endometrial thickness 9mm . i am very afried hwether i will get postive result this month  or do i have ay problem ### REPLY: Hi, thanks for writing. Get a follicular study repeated on every alternate day till follicle size reaches 20 mm. This is the time it is likely to ovulate, and you should have intercourse to achieve pregnancy. Post ovulation get a scan done to see signs of ovulation. Take progesterone for 10 days in the post ovulatory period for 10 days. In the next period if you are too anxious to conceive, you can take ovulation induction .  Hope I have answered your query. Feel free to ask any doubts through http://doctor.ChatDoctor .com/doctors/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had 4 wisdom teeth surgically removed 17 days ago. After 6 days had to go back due to dry socked. had them filled with packing then 5 days l.ater removed.  While the packing was in there was no pain. The pain has been pack for a week now as well I have developed over the last week alot of bright green weird tasting phlem in the back of my throat that comes from my nose. the pain goes from my jaw on the right side around my eye to my temple, back of the head and in the ear. I have taken all meds they gave me, and still have been on 2 extra strength tylenol every 4 hrs to keep away the pain. I have tried on 2 seperate days to not take any pills but cant make it past 2pm. I am worried that taking stuff for 2 weeks is too long. I am 44 years old. ### REPLY: Hello, Thanks for consulting , Read your query, as you have undergone extraction of wisdom tooth now you have pain don't be worried so much in surgical extraction there is pain and takes time in healing, for this pain you can take dispensable Paracetamol tablet for pain, Follow all post-operative instruction given by your dentist, take proper course of antibiotics, Take soft diet. If your pain continues then consult dentist and go for examination of extraction socket. Hope this will help you. 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: Hi, I hurt my wrist by hitting it on the railing really hard when I ran into it. It s right under my thumb but lower by sort of on my wrist. It s bruised and there s swelling. It s also very tender and hurts to touch. It s on my left hand on the left side, not on the bone that sticks up. What should I do? Is it just bruised? ### REPLY: Dear patient You have got significant trauma to your left hand and possibility of fracture cannot be ruled out.  I would advise X-ray of left hand anteroposterior and oblique views to rule out bony abnormalities. Visit radiology center nearby you and get it done. Meanwhile, start tab diclofenac plus serratiopeptodase combination twice a day for pain relief. Apply ice packs on bruise to reduce pain and swelling.  You need to consult expert orthopedic surgeon with report.  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: How long does it take for Stage 4 bile duct cancer to spread to the brain ? ### REPLY: Hi Sal. Thanks for Posting your query. Stage 4 Bile Duct cancer means that it's already spread outside the primary site. Most of these spread occurs through blood stream. It's difficult to tell in exact time frame, how long it would take to spread to brain. However, the closest answer would be that it can take a few weeks if not being treated. Hope this answers your query. Thanks and Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi thanks for your time my question is what is best for breakthrough pain i am taking 145mg methadone in two daily split oses it does help but i get bad electric shocks down back and front of my right leg and my knee is real sore too as is my big toe and on thge outside of my foot it is sort of pins and needles and my bum goes to sleep but atm its the burning and the shocks that are killing me i believe i dislocated l4,l5 facet joints and think i may also have nerve root involvement i am miserable ### REPLY: Hi, Welcome to  forum.  As you describe it appears to be the neuralgia, may be secondary to the hypertension, diabetes, anemia, deficiency of vitamins, or calcium. The other cause may be the pressure on the nerves of the leg.  I advise you to consult a neurologist for diagnosis and treatment.  I usually prescribe to my patient with such symptoms neurotrophic injections for 10 consecutive days, and then periodically. Calcium supplements, and painkillers.  Avoid taking potato, other tubers, tomato, egg, chicken, and seafoods.  Wishing for a quick and complete recovery. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 16 year old son has fever (39.8 degree celsius) this afternoon around 5:45 PM so 1 tab Paracetamol 500 mg was given to him per orem. Fever was monitored and went down to 38.2. By 8pm, his fever went up to 39.4 so another tablet of Paracetamol was given. Its 9:30 PM  but his fever has not subsided. Should I bring him to the ER already? ### REPLY: Hello dear, Thank you for your contact to . I read and understand your concern. I am  answering your concern. Yes, if the facility of immediate treatment is available than you can go for the treatment immediately. You can do the laboratory testing of blood for the malaria, typhoid, dengue. Also get tested for urine microscopic examination. This will give you catch about the possible pathogen. Till that time I advise you to take the paracetamol to cover the fever. Please . Please check for any serious sign like high fever, unconscious less and hemorrhage. If this happens than you can immediately transfer to the hospital. I will be happy to answer your further concern on bit.ly/ ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Doctor,I usually have sex every 20 days but my husband doesn`t want me to get pregnant and neither does he like to use Condoms, so he asks me to have contraceptive after the night we had sex. I had been practising this almost a year.I want you to tell me whether this would lead me to some serious or long term side effect? ### REPLY: Welcome to , You have been using Emergency contraceptive pill after having sex. Emergency pill are to be used only occasionally as a back-up method to prevent pregnancy as they have higher does of hormones which have side effects such as altered menstrual cycle, vaginal bleeding, vomiting, stomach pain, breast tenderness etc. As you have sex once in 20 days, a condom is the best contraceptive for you. If still your husband is not agreeing to a condom then you can take regular Oral contraceptive pills which have to be taken regularly. Hope that answers your question.  .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Q : i hve problems in balancing, when i walk it seems as if i will fall- people say i m drunked !! i cant run, my body is slowed down- i write also very slow now, i cant close my eyes while standing- i will fal, i surfed web for it and think i m suffering from parkinson.. ### REPLY: Hello Thank you for trusting  Dear your description of symptoms like sensory ataxia, cerebellar ataxia and Parkinsonism.  If you say Parkinsonism there should be four Cardinal features like tremor, rigidity, bradykinesia, loss of balance. But you have loss of balance and slowing of movement. There is a possibility of Parkinsonism with sensory ataxia. Please consult your doctor he will examine and treat you accordingly. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 having severe hair loss. I am 31 and was just diagnosed with Pulmonary Hypertension, mixed connective tissue disease and on on several medications. I have been on them for over six months to a year and the hair loss started about 2 months ago. ### REPLY: Howell come to ChatDoctorI really appreciate your concern, as long as the hair fall is concern age and gender is very important which are not given here, here the hair fall may not be due to the medicines but may be due to age and gender related, in either case of gender Minoxidil 5% solution can be used, apply this at least twice in day on scalp (Better advise could have been given in case of given information about age and gender) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 creatiine level pretty high but he has his usual morning walks, does his routine work , has appetite, he is on medication he has type II diabetes & hyper tension does he require dialysis now he does not want to go for dialysis is it advisable to go for transplantation Please advise. His creatine is nearly 8 ### REPLY: Hi, Creatine level which you have mentioned is high, Usually in our patient we keep both the options open, Dialysis need more compliance, sometimes patient don't will to do dialysis now and then, Transplant is always better, with modern technique rejection rates has gone low, and survival rate has increased up to 10 yrs, But problem with it is matching the donor, So considering all the thing and good counselling with a nephrologist you can make a decision, to go for dialysis or transplant. Hope this information helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, my son had a stage 3 brain tumor on the left side 8 years ago....removed successfully except for losses in his abilities,however, he had surgery on his lip a few months ago and now this lump ( size of a tennis ball) under his R arm they are calling possible Melanoma. They are ( considering) taking it out........he is so worried that they might even take his arm off. His wife tries to console him ( and herself) that it is just the lump. His appointment is for next Thursday. Please help me understand...... ### REPLY: Hi, Thank you for posting your query. I can understand the personal and physical disabilities your son is going through at this stage. He needs all possible care and compassion to deal with this. The exact nature of the lump in the arm can only be ascertained after the surgery, when we receive the biopsy report. If it comes as melanoma, then, it would be considered as a more advanced stage disease than stage 3. However, if it is something unrelated to the melanoma, then, it would be good news. Best wishes, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been experiencing various strage symptoms this past month. I was put on flecanide 50 last Dec. And propanolol 40 to take with it to prevent arrythmias. I have had lone afib a few times a year for a few hrs and have had all the work ups done with normal results. I also have had svt on a d off all my life with no problems except inconvenience. So they tried to ablate it in Dec and it was not successful. So that is why I am on flecanide and propanolol. This has worked well until last month. I has a routine d&c for what they thought was a polyp and turned out to be nothing. During the procedure my heart rate went down to 30 and they gave me robinal. A week after that I was started on protocol for a cholesterol of 278. My cholesterol has always been ok before that.  7 days later and 10 days after the d&c I began experiencing lightheadedness and a bp of 90/60 and a pulse in the 40s. I went to the hospital and was kept overnight on tele. All was ok hr in 40s-50s. Had normal echo in am and sent home.  I hadnt taken propanolol  since the night in hospital and began to experience pounding heart rate headache shakiness and over all terrible. Cardiologist said it was beta blocker withdrawal. They put me on half dose, back on flecanide,off protocol, and did stress echo and 24 hr halter and said it may have been vago vasel related. I went back to the gun for post op f/u and c/o lower and cramps. Found to have vaginal infection, on abs now.  What bothers me is that I am still having these strange lightheaded moments and I dont know why. Everything seems to check  out ok. It is not like fainting or dizziness. My pulse and bp is ok except that my pulse does get somewhat faint during it.  Sometimes I get a cold feeling on the side of my head with and lingering after it.  I am normally very very healthy and I dont know what is happening with me. Is there something I can do to find an answer? I am  62 and a little overweight. Thankyou ### REPLY: DEAR OVERTHINKS FOR CONSULTING AT ChatDoctorI UNDERSTAND YOUR CONCERN. BUT FROM YOUR HISTORY THAT YOU PROVIDED PAST HISTORY OF LONE AD AND PSV WITH FAILURE OF ABLATION THERAPY POINTS THAT YOU HAVE THESE DIZZINESS SYMPTOMS ARE A PART OF CARDIAC SYNCOPE LIKE FEATURESTHOUGH YOU HAVE NO LOSS OF CONSCIOUSNESS It's PROBABLY BECAUSE OF UNDERLYING CARDIAC ARRHYTHMIA I SUGGEST YOU TO GO FOR A 24HR HOLDER MONITORING GET A ECHOCARDIOGRAPHY DONECONSULT A CARDIOLOGIST SO THAT YOU CAN BE PUT ON A PROPHYLACTIC INTRACARDIAC DEFIBRILLATOR THAT CAN PREVENT FURTHER RISK OF ARRYTHMIAHOPE I HAVE ANSWERED YOUR QUESTION. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Sir, My mother is 52 year old, last march 2011 she had  a operation of uterus in dehradun, and the doctor removed uterus. now she had still pain in stomach, while the Ultrasound and X-ray KUV reports are fine. what should i do please suggest me and we did the thyroid test in which her STH is high may be due to that fat is incresing especially in her stomach. she is taking the tablet for thyroid but the fat is not in control. We are not able to find out the reason of the pain.I would really thankful  if you please suggest me the test which i should go, or the specialist of this field RegardsPavan ### REPLY: Hi Pagan, Welcome to . If USG and pub X-ray are normal then pain could be due to postoperative adhesions. For that you need to show to a laparoscopic surgeon for a diagnostic laparoscopy and adhesinolysis if adhesions are found. But before that her thyroid has to get normal. And for that you need to repeat the TSH levels every two months to adjust the dose. Hope I have been helpful. 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 just read my medical records to find that I have stage 2 CKD. I am suffering from multi-level spinal conditions with pain and wondered why my primary care physician did not make me aware. I found out by accident . Is stage 2 something that my doctor is not concerned with? ### REPLY: Hello and welcome to . As a Urologist, i can understand your concern.CKD is a term used to denote, level of kidney function. Stages are defined from 1-5. Stage 1 CKD, is mildly reduced kidney function. So you've slightly reduced kidney function. These are measured by blood test called creatinine, and urine albumin test. By stage 3-4, one is referred to a Nephrologist, for further treatment. If you've any other doubt, you can send them as a direct question to me. .  Manga. ### END