Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 good morning Doc.i just want to ask what is the best medicine can you recommend for the cyst in my breast. But i have already a mammogram and breast ultrasound result. My doctor said that it is benied, but sometimes i feel aching when im tired and stress. Im hoping for your feedback regarding this.Thank you.CarisaEmail Add:  YYYY@YYYY ### REPLY: Hi! Welcome to ! In most cases, a benign breast cyst needs no treatment unless it is particularly large or painful. If your breast pain is not related to your menstrual cycle, you can take simple painkillers, such as paracetamol or ibuprofen. Danazol is a medication that can be used to treat pain associated with benign fibrotic breast disease but Canal has to be monitored. If your lump is large, growing or is causing other symptoms, you may need surgery to remove it. Hope this helps! Take care! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi,Doc ,I am Debendra from Bhubanesar,I checked my blood my SGPT -ALT is 56,and SGOT (AST) is 44 ,I got Typhoid O and 1:40 postive,I am suffering from gas and indigestion problem since a month.Is the SGPT and SGOT test normal? Kindly suggest what to do. ### REPLY: Hi. Thanks for your query. Noted the history and understood your concerns. Gas and indigestion can be due to many reasons. Widal test for typhoid in the range of 1:40 is negative. Intestinal infection can cause liver problems to raise a bit of the liver enzymes like GOT and SGPT which will get reverted to normal or correct treatment. I would advise you the following in such a situation:Get the stool test done for three consecutive days. Other blood test like thyroid functions. Repeat liver functions. Ultrasonography of the abdomen. A course of an antibiotic, metronidazole and probiotics helps a lot in some cases, you need a valid prescription for such medications from your Family Doctor. Use boiled and cooled water and eat only homemade fresh foods. Take banana, curds and activated charcoal to hasten the recovery. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I had a lumbar puncture two days ago to check my pressure because I am having a loud whooshing pulsating noise in my ears and headaches. My pressure was high. It was 28. Dr tried to remove fluid to relieve pressure but couldn t because it hurt too badly. It hurt in the butt area towards bottom of tailbone like someone was poking or shocking it and pain down my right leg. For the past two days I have had extreme pain down lower back and right leg making it difficult to sit, stand or bend. Just the smallest movement of bending my head to kiss my baby sends the extreme pain to my lower back. I am also experiencing extremely fatigue. It is very hard to even hold my eyes open. Is this a normal reaction to the lumbar puncture and the attempt to remove fluid ? ### REPLY: Brief Answer:Fatigue and pain is a normal reaction to lumbar puncture. Detailed Answer:Hello, Thank you for using . I understand your concern. After the lumbar puncture, you may feel pain or tenderness in your lower back. The pain might radiate down the back of your legs. In most cases, the pain will ease after a few days, and it can be treated with painkillers, such as paracetamol. Fatigue, does fit with performing of the procedure. You may develop a headache, nausea, fatigue afterward due to a leak of fluid into nearby tissues. A pain-relieving medication that contains acetaminophen can help you reduce headache too. Try to rest and don't participate in strenuous activities. Regarding the results of the cerebrospinal fluid taken by lumbar puncture, is important to evaluate his appearance, WBC count, Glucose level, Protein level, beside the opening pressure (that in your case is elevated), in way to be focused into a possible diagnosis. It can be considered additional tests such as CSF culture, depending on clinical findings. Hope this is helpful. Let me know if you need more clarifications. Otherwise, please close and rate the answer. Kind  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had a hysterectomy last Monday for a large fast growing complex cyst. They took her ovaries, uterous, cervix and appendix. They said it went well 3 hours and that it looked good. Frozen section was inconclusive. Her final pathology is expect 10-14 days after surgery (last Monday). How often do inconclusives like this turn out cancerous and why do the final results take so long? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have complex endometrial hyperplasia.  With atypical chances of cancer are 64%. If no atypical then chances of cancer are lower.  Histopathological report on specimen is the final report.  It takes time because of long processing time.  Moreover, if they want IOC study then it will take extra time.  On an average it takes 6 to 8 days Food report. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: want to ask few more questions , as due to my masturbation habit , my penis gets very smaller , shrinker , and looser in normal stage , and while masturbating my ejaculationcomes out very quickly , and it also didn t give me much pleasure while doing in hand , so i want to get harder and longer and pleasurable erections b y hand now or while marriage life or BY HAND JOB, OF ANY WOMEN , it doen t feel me much pleasure , though iam massaging 1 ounce sesame oil with 2-3 drops of mustard oil by mixing and massaging , in my penis now , as iam thinkingt it might create any damage OF TISSUE/NERVES FOR EARLIER MASTURBATION , SO HOW CAN I COME BACK WITH IT, WHAT RE THE DRUGS OR HOMETREATMENT I SHOULD TAKE TO GAIN MY POWER AND LONGER AND HARDER PENIS FOR CONTINUING LONGER PERIOD OF TIME(AS I COULDN T DISCUS IT WITH MY FAMILY) , ,,,,,,,PLEASE REPLY ACCORDINGLY.(IAM FROM INDIA , PLEASE ADVICE ME DRUGS IF REQUIRED OF GENERALLY LOW COST SO THAT ANYONE CAN BEAR THE EXPENSES). ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much because your problem is not that peculiar. So many young people do suffer from this type of thinking and apprehension and anxiety. Masturbation is not a sin, and it cannot reduce the length of penis and masturbation cannot make you tired. In fact, size of penis cannot determine sex life satisfaction. Even a two-inch penis can satisfy any lady. Your current trouble of premature ejaculation is mainly due to psychological disorder, here negative thinking. Tiredness and other weakness are all in your thoughts. Divert your energy and thoughts to more productive or creative things such as education and career or sports. You might need psychotherapy and other cognitive behavioral therapies. I can help you through telephone. Please do contact me through customer care of www.ChatDoctor .com for a telephonic consultation session. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi Dr, I was diagonized for typhoid fever was admitted in hospital for 5 days. I got discharged on 04-07-12. I felt I am fine. But from 29-07-12 I am feeling I have fever again. Doc advised me to have normal veg food. I was having veg food all these days ### REPLY: HelloSign such long duration of fever (low grade fever), even after the treatment for typhoid fever may be due to these possibilities, these include:1 Tuberculosis, diagnosis can be confirmed by blood examination for CBC, ESR & x RAY chest and tuberculin PCR.2 Jaundice is another common cause of such fever. Get in blood examination for HBase for A B C & E. However, there are so many other reasons of such type of fever, as cancer, anemia. I recommend you please consult a physician and get his opinion (2nd) because this is long duration fever. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi i receantly quite a job that was making me sick had blood in my pool and recently got back my chest exray and i have obstructive pulmonary disease and am going for a castonoghfy when i was working i constantly complained about the gas fumes could this be the cause of my illnesses and how can i test for it doctors keep telling me there are no test ### REPLY: Thanks for your question on . Yes, you are right. Chronic inhalation of chemical fumes can lead to chronic obstructive pulmonary disease (COPD). And if you are smoker chances of COPD are more. So gas fumes can cause COPD. The cornerstone of COPD diagnosis is PFT (Pulmonary Function Test). It will not only diagnose COPD, But also tells you about severity of the disease. And treatment of COPD is according to the severity of the disease. So better to consult pulmonologist first and discuss all these, get done PFT and start treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good evening, I have a daughter who just had her first baby 6 months ago. The baby is using a pacifier. My daughter and her husband have 5 dogs and 3 cats so there floors are dusty. In addition they live in Tucson, Az. Every time the baby drops the pacifier from her mouth, they insist that it is fine to put it right back into the baby s mouth w/o washing it off. My granddaughter seems to have a constant cold and I am concerned that it is related to always placing a pacifier that is not as clean as it should be in her mouth. They claim their Dr. said it was alright to place It in the baby s mouth after being on the floor as this will build up immunities. I worked 23 years in a state health department and we never utilized that idea with with our new mothers in parenting classes. I not sure they have discussed with their Dr. that the house has 8 animals in it. What do you suggest I do in this situation. I m thinking of accompanying my daughter and the baby to her next Pediatric appointment and inquiring about this situation. They may have not shared with the Doctor the number of animals in the house which causes a great deal of dust and dirt. Am I correct that it is very unsanitary to keep reintroducing a soiled pacifier back in the baby s mouth and this could lead to health problems for the baby. Thank you in advanced for your thoughts. Edna Vajda ### REPLY: Using pacifier is not recommended by any pediatrician nowadays. Because it is the medium or source of infections to the kid. Having pets in home is also not recommended because its fur or hairs might trigger asthmatic attacks and toxoplasmosis infection in child . . What ever the doctor said was worn. I don't agree with his words. Better consult any pediatrician for opinion. Getting immunity by using soiled pacifier is a myth. don't allow you kids to have pacifier in mouth, it is dangerous. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Sir, I have one lumps or may be boil on skin of scrotum. for last 4 year i have and there size is some thing like half of vegetable pee. in this there is no pain. just like a piece of hard dead muscles. There is no irritation also. Initially when it grow that time i pressed it and i find no pain and in that i see some black colour thing come out. after that it increase and now it is fixed. But my worries is nearby the lump i find 2 new very small lumps also. same as first one. Please tell me what is this and why it happen to me. and how to cure it. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have sebaceous cyst.  Multiple sebaceous cysts are common on scrotal skin.  You should go for examination and if needed go for biopsy.  Surgical excision is the treatment of choice. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I have a small lump which feels a little like gristle but spongy feel in my left ear I noticed this just over a year ago. It hasn t grown in size it doesn t hurt its just noticeably different from my inside right ear. I keep poking and prodding thinking it may be a blocked spot. ### REPLY: Hello and welcome to , Painless lump in left ear could be due to a soft tissue swelling. A clinical assessment is required to know the exact site of the lesion and its relation to other structures. If the lesion is not clinically fixed to underlying structures, it can be surgically excised followed by histopathological examination. You need to consult an ENT specialist for clinical assessment and further management. Thanks and 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 slipped mopping the floor and my left leg got strained.  I didnt fall or break anything.  I might have heard a pop at the top of the leg.  The back of my L leg from top to knee hurts.  Hard to bend, hard to go up stairs, and really difficult getting up from sitting.  Most comfortable to walk without putting left leg toward the lead; have to catch it up with the right leg. Muscle strain? How to treat? ### REPLY: Hello, I have studied your case. As per your history there is possibility of soft tissue injury in knee. Most commonly meniscus injury occurs may be associated collateral ligament injury. You may need to do MRI knee to see for any functional defect. As per your symptoms you need to do physiotherapy and knee exercises to improve range of motion. Rest and ice fomentation along with supportive brace will help to reduce locking episode and pain. Small meniscus tear can be managed conservatively with physiotherapy with USG and TENS. Large meniscus injury can be managed by arthroscopic repair. Another possibility of patellar ligament tightness which can be evaluated clinically. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: sir,i m 32/m/india.i m obase.wt 95 kg ht 175cms.having a male baby aged 6 months.i m suffering from dermatitis herpitoformis last 2.5 yrs & having no reliefe with different treatments.recently i m having multiple boils in my scalp.with antibiotics i got reliefe.gone through routin test...total count is higher which is 12.6 serum alkaline phosphate is higher,i.e.164.s.triglicerides,cholestrole all r bit higher then normal.urine is clear.in ct head having frontal maxillary spenoid sinusitis bilat.the biggest worry is cardiomegally in x-ray chest.s.alkaline is increased due to cardiomegally?or dermatitis?or early arthritis?or some amylodisis?please give me direction to follow.i hate to excercise.i love gambling.i daily play i.e.gamble.love to get excited.but last few weeks i noticed i get very nervous & feel palpitation while gambling.i m heavy smoker.i drink casually. ### REPLY: Hi, Your raised alkaline phosphatase is most likely because of your recent pregnancy. This enzyme grossly raises during pregnancy and may remain elevated for a year or more after delivery. So your level is high most probably for this reason.  Other causes of elevated ALP are liver diseases or bone disease which is unlikely in your case. It's not related to cardiomegaly, or arthritis, or amyloses. 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: respected Dr.,       I wanted to ask that what are the recent trends in hematological malignanciens. i wanted to go for summer research and for that i wanted to know that. i read few articles on google. but if you get time thn please tell me something about that. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Treatment of hematological malignancy depends on type of malignancy.  Most definitive treatment in most of the cases is bone marrow transplantation.  Chemotherapy and molecular therapy are the other options.  Many newer .  But that all depends on type of leukemia. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had a cough and congestion for 3 days.  I woke up this morning at 4 am feeling like someone was sitting on my chest and finding it hard to breath.  There is an uneasy feeling in my chest; which I thought was indigestion, but now I am not sure that is it.  Any idea what may be going on? ### REPLY: Thanks for your question on . I can understand your concern. Cough, congestion and Heaviness in chest are commonly seen with bronchitis and lung infection. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x-ray and PFT (Pulmonary Function Test). Chest x-ray is needed to rule out lung infection.PFT is must for the diagnosis of bronchitis. You are many need antibiotics and inhaled bronchodilators (formoterol or albuterol).Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello Doctor, am Michael, 37yrs, l want to know why am having this symptom immediate after sex, (1)serious sneeze and am while sneezing that will be a kind of movement of something down my abdominal to my chest and once this thing get to my chest then the second symptom will started which is running of nose (3) my stomach will big as if have over feeding myself (4) can l call it internal heat of the body or high temperature and the temperature go higher each time l want to have sex (5) burning during urination and after urination (6) sometimes my pelvic heavy (7)quick ejaculation . and each time l take the following drug l feel relive, chloramphenicol 250mg, ciprofloxacin 500mg, and phenoxymethylepencillin 250mg or if l take full malaria treatment am total free of all this symptom but any day l have sex whether with condom or without condom. please help me what can l do? ### REPLY: YOU ARE HAVING EXERCISE INDUCED ALLERGIES IN INITIAL STAGES THE ALLERGIES ARE HIDDEN AND THEY ONLY EXPRESS THEMSELVES AS SYMPTOMS WHEN YOU DO EXERCISE IN ANY FORM LIKE FAST RUNNING SEX AND OTHER HARD EXERCISESDONRT TAKE ANTIBIOTICSONLY TAKE ANTI ALLERGIST ALLERGY STATE FIND OUT HIDDEN ALLERGIES AND CAN TREAT TEXTILE YOU GET INVESTIGATED TAKE TAB ALLEGRA 120 MGM 1 HR BEFORE DOING SEX AND APPLY NOEOSPORIN H EYE OINTMENT IN NOSE BD REGULARLY TILL YOU START RX ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 led below my knee is red, swollen, warm to touch and the skin is shiny. I haven t been on a plane or long car drive. I ve had a history of dvt. My leg is as described in addition it is throbbing while I m sitting I my recliner and really hurts when I stand. ### REPLY: Hello, I have studied your case. Your symptoms suggest possibility of Deep vein thrombosis. Ultrasonography/color Doppler leg will help to rule pathology leading to pain and swelling like deep vein thrombosis. I will advise you to do MRI spine to see for any nerve compression. Consulting your doctor infection /cellulitis can be ruled out; antibiotic can be started according to examination. If required you may need to do blood investigation for prognosis and recovery. I will advise checking your it B12 and it D3 level. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: As of a few months ago my daughter has been complaining of a tight feeling in her chest ... it would come and go. We did take her to get a chest x-ray and nothing was found. The doctor thought it might be a small allergic type reaction to her eating too much tomato based foods (i.e. spaghetti sauce etc..). I recently came across an article about the dangerous side effects of Gardasil (papillomavirus vaccine) and tightness in chest is a rare symptom that was listed. I am greatly concerned now that it could be what is happening. Her first shot was given on 5/5/2010 and the second shot on 9/14/2011. Should I be concerned at this point 3yrs later? Is it related? ### REPLY: Thanks for your question on . I can understand your concern. The reaction mentioned for the vaccine are only acute, so vaccine is unlikely the cause for her symptoms after 3 years. Chest tightness as described by you is commonly seen in asthma. Since her chest x-ray is normal, no need to worry about lung infection. Possibility of asthma is more in her case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT is needed for the diagnosis of asthma. It will also tell you about severity of the disease and treatment of asthma is based on severity only. She will be better with inhaled bronchodilators and inhaled corticosteroid (ICS). Don't worry, she will be alright. Hope I have solved your query. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my name is Kevin and yesterday about 5pm I had a white stool. I the previous weeks I have been seeing a family doctor and a Rhuemotogist for a high CK. Either my skin is itching from dry skin or something else. Can you answer some needed questions because all the doctors are out till the first of the year. ### REPLY: HIT hank for asking to ChatDoctorI really appreciate your concern looking to the given history here your main concern would be itching problem your other medical history that you gave here are not correlated with each other and that might not be the reason of itching bit this could be hypersensitivity reaction and this can be best treated with" Tab Levocetrizine 10 mg three times in day" hope this information helps you, take care and have nice day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am awaiting a GP appointment to interpret the following MRI scan results, but would appreciate a translation/interpretation if possible; encephalomalacia anteriorly in the inferior aspect of both frontal lobes adjacent to the midline with resultant expansion of the overlying csf space and some high signal change in the underlying subcortial white matter. there is no mass effect or evidence of restricted diffusion. appearance elsewhere are unremarkable. presumably these are a sequelae of the previous head injury and results of bilateral frontal contusions. The previous head injury referred to was over 40yrs ago and has had no impact (that I am aware of! lol) on my mental or physical functioning. ### REPLY: Hi, Thanks for writing in. You might be one of the lucky few who had a serious head injury at a younger age and have recovered without any residual symptoms. Encephalomalacia means softening of the brain. This happens when there is injury to the brain and absent blood supply and consequently resulting in loss of brain matter and cerebrospinal fluid occupies the area after the shrinkage of that part of the brain. Since it has happened more than 40 years ago, and you might have been much younger at that time, the brain circuits that were damaged were realigned, and your affected brain was compensated for its loss in functions. At a young age the brain learns to cope up with its limitations in a better way. This is called neuroplasticity. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment. Therefore, you have been normal throughout your life. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 cervical rib. A few years back My left hand fingers were numb but after some exercises it was Ok. Now I have occasional pinky finger tremble ( two or three times a day for about a minute or less) but no numbness or pain. Is it due to again Cervical rib or PD ( Parkinson disease) I am 61 healthy without any Blood Pressure , Or Diabetes problem and absolutely no history of PD in family. I am very active , nice sleep at night , no sleepy sensation in the morning , no urinary inconsistency etc. ### REPLY: Hi, Actually it may be a case of Trigger finger, ulnar nerve pathology, ganglion, cyst, also this happens with overuse I suggest MRI for proper evaluation. I don't think it is related to your old injury due to absence of numbness and pain. Please click THANK YOU and consider a 5-star rating with some positive feedback if the information was helpful. Hope the above information helps you. Any further clarifications feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my mother is 70 years old and had backache for 30 years , in last few days she has severe backache and she is unable to walk , she cant lift her feet , pain is radiating to groins . what can be the cause ? is this a case of nerve compression or some joint problem or what , she is taking brufen tablets so no pain while at rest but cant walk coz of pain ### REPLY: Hi, Thank you for posting your query. There are two likely causes for your mothers symptoms: 1. Arthritis of hip joints- it is common in older people. X-ray of the hips can help in diagnosing this condition. 2. Lumbar disc disease witChatDoctorpression of the nerves at back-this can lead to pain and weakness of legs.  An additional condition to exclude is osteoporosis- weakness of bones-which is again common in old age. An evaluation by a neurologist/orthopedic could be useful in sorting the problem out and planning the treatment. Best wishes, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father has stone in his gall bladder. what is the right treatment for this ### REPLY: You have not mentioned his age. Size of the stone, number of sons in the gall bladder, other medical condition like diabetes, high cholesterol level are all factors to be considered when we plan the treatment.in general, patients with multiple stones, single large stone, diabetes and those who had complications due to stone are candidates for removal of gall bladder. Medical treatment can be done in selected patients but not for large stones. Removal of the gall bladder is done without making large opening in abdomen. The procedure of choice is Laparoscopic cholecystectomy which has become the gold standard, and it is a common procedure ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive got a viral infection and Ive already had the full amount of paracetamol allowed within a 24 hr period today. My ears are still murderously painful & I still feel feverish even though I took the last dose an hour ago - is there anything else I can take? ### REPLY: Hi. Thanks for the query. It seems like ear pain and fever are due to acute infection in ear, and it seems like a bacterial infection and less probably to be viral. I would suggest you to consult an Otolaryngologies and get evaluated and a thorough clinical evaluation and Endoscopic examination can help in diagnosis and treatment can be planned accordingly. You will be advised to take antibiotics like Augmenting, anti-inflammatory painkillers like Ibuprofen, Tylenol for reducing fever and along with it putting antibiotic ear .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My daughter has just been to the dentist with tooth ache. The dentist says her tooth is loose and X-ray shows a shadow in the tooth but the dentist said there were no holes visible. She has an urgent opg tomorrow and has to see specialist dentist the day after. Any ideas what this is? Its her permanent tooth! ### REPLY: Thanks for your query, I have gone through your query. The pain in the tooth could be because of tooth infection or gum infection. The tooth can become loose secondary to bone loss or any cyst or benign tumor. Consult an oral physician and get the OPG done to rule out the above said causes. If it is a tooth infection get it treated by root canal treatment. If it is gum infection get your teeth cleaned once. If it is a cyst or tumor you need to get it removed surgically.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: my tooth enamel got broken, i know i wont grow again, but is there a way to repair it? ### REPLY: HI, Yes you are right that enamel won't grow at all. But there are a number of ways to repair it.1 if it is a very minute chip off, reshaping of tooth might help you.2 if it is small chip off, it can be repair witChatDoctorposite restoration.3 if it is a big lesion, you can go for crown or laminates of that particular tooth. sometimes it looks like that only enamel has broken, but dentin is also involved. So, my advice is to visit your dentist and as per diagnosis go for proper and advised treatment. Thanks, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 14 day old baby woke up this morning with a lot of red bumps all over his face, his ear lobe is swollen on both sides. He has been crying non-stop and is very irritable; he is a very calm baby and usually does not cry much at all. I think this could be an allergic reaction , it is very much like the allergies I have myself. Is this a reason to bring him to the emergency? or what can I do to treat him at home? ### REPLY: Hi, Thanks for writing in. From the history given above, it definitely looks like allergy. You should apply first detail lotion to your babies body. If that is not available, apply at least moisturizer till you get medical help. You need to consult pediatrician to get medicines prescribed like antihistamines syrup like cetirizine or Atari. Meantime try to find out cause for allergy as new soap or oil or cloth. Continue breastfeeding and keep him HY . I hope I have answered your query. In case of doubt, revert. 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 had a lung infection eight months ago, had been on antibiotics a sinus infection at the same time and had taken an antibiotic for that also . I am still coughing up green flem hugely . could this be a type of cancer ? I have been back to my doctor but have been told there is no infection . ### REPLY: Hi and welcome to . Thanks for the query. Cancer is the last thing to think of. It sounds to me more like COPD or emphysema especially if you smoke. Also, it can be some other lung disease, but cancer is not usually manifested with these symptoms. You can also have some chronic bacterial inflammation. So I suggest doing lung ventilation test and more detailed microbiologic testing. 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: My lymphatic system shut down about 6 yrs ago. I have a lot of pain and swelling. Saw a dermatologist last week and she did skin biopsy on my wrist and inner thigh- suspects cancer. I had mascetomy in 1999. Is lymphono cancer one of my symptons. I dont have anything to help fight infections. Could these signs be lymphono cancer?Im scared because since having breast cancer I have not had any energy, stay tired all the time. Any info. would be appreciated. ### REPLY: Hi and welcome to , thank you for your query. It may be lymphoma, but it has to be confirmed by biopsy. You didn't mention what exactly this previous biopsy showed. If this is just skin cancer then I don't think this is related to your risk of lymphoma. So your lack of energy probably isn't sign of new cancer.it can be signed of various other diseases. Lymphomas can be also ruled out by certain blood tests and sternal function. Wish you good health. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi! im 52 years old male and a smoker for 30 years, it seems like my collar bone has some sort of hard lump, like the bone poked out but no pain, is this might be related to lung cancer or c.a.d (coronary artery disease). please help, thank you so much ### REPLY: Welcome to  .1. Lung cancer is one of the cause for the mass at the collar bone.2. Or any bony lesion arising from the collar bone itself.3. An x-ray chest / picogram initially to evaluate the lesion.4.depending on the involvement CT could be suggested.5. Yes even arteries cause lump, but they are not so hard. (an ultrasound will help in case of soft masses)6. However, get an appointment and see your doctor and do needful investigations. Anything to ask ? Do not hesitate. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor, Last few days (4/5 days) I feel head dizzy, I could not think anything properly, Basically I feel, my back side of head has been zam. My blood pressure is normal. Age 34 yrs, Male and I was passing a serious brain stress in 20 days due to illness and death of my mother. Please suggest me, what can i do. ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. These could be a manifestation of depression. You will need some benzodiazepine and SSRI medications like Escitalopram or mirtazapine to help with your problems. Some psychotherapy will also help. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, I keep going back to the doctor with pain around lower abadom, told her I have a cough and fells like I have something in my throat. Has sent me for vaginal swab, nothing came up so says wait a few more moths, if come back I will do blood tests. I am tired,anxious  and irritable for about 6 months, this is not like me. I had bleeding a few years ago like a normal period,only a week off inbetween for 3 months. Just brushing me of like I am imaging it, I am not like that, don,t like having to go. ### REPLY: Hello! I just read your concerns.  If I was you treating physician, for your abdominal pain, I will request an imaging -- transvaginal ultrasound or a CT scan, especially you had a history of bleeding before.  For your cough, I will thoroughly need to check on your throat for any signs of infection, if no infection is seen, will request for a chest x-ray.  I believe you have 2 different problems unrelated to each other.  I hope you'll be able to get well soon.  Good Day! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi there I have have had pain in my pelvis for a few months it seems to be getting worse and I am very stressed alot of the time have on going back pain from a crooked spine, a few weeks ago I had a bladder infection wich I got medication for , but still been having a sharp pain between my pelvis bone ### REPLY: Hello, Thanks for writing to us. I suggest you to follow the below-mentioned measures to reduce your back pain-- Usually 1-2 days of bed rest will calm severe back pain. Do not stay off your feet for longer, though.- Avoid lifting weights as it imparts more strain on your back-Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting as it will worsen the intervertebral disc problems. If you want to bend forwards, do it with your hips and knees flexed.- Use a lumbosacral back support to stabilize your spinal muscles and to provide support for your spinal column.- After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. The main aim of exercise is to encourage mobility, reduce muscle spasm, prevent further deterioration in the muscles and speed recovery.- You should maintain an optimum body weight to decrease the strain on your vertebral column causing more degeneration and arthritic changes.- At times, spinal steroid injections and Facet blocks will help in alleviating the lower back pain. I personally feel that your symptoms will improve with the above measures, and you can go well with all your regular activities of daily living. Hope this helps you. You can consult me again directly through my profile http://www.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: Hello i have just found out that i am pregnant 3 days ago. My period was due yesterday and today i have started experiencing some cramping in the lower left side of my stomach. Is this normal? Also I have been told that i should go and see my gp and have my proestogen levels checked, is this right? If so what test do they do?Thanks ### REPLY: Hi, You should get B-ChatDoctor levels in blood checked and repeated after 48 hours to see if there is a doubling in their levels. Pain on one side, with a positive pregnancy, could mean ectopic pregnancy, which needs to be ruled out. Progesterone levels can tell if the pregnancy is viable or likely to fail, depending on their levels, with 25 micrograms taken as a cut off. Do see a Gynecologist and get  checked. Hope this Helps. Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: im so confuse of what i really felt specially in my left body from my head to toe ive been into a lot of medical tests and it turns out negative,im suffering from panic attack as what i have read its symptoms i feel the same way i have a lot of fears right now i dont want to go to the mall,crowded area,even in churceh i dont want to take buses all i want is to stay in the house coz im afraid im going to have an attack outside,please do help me im very scared as if im going to die, or having a heart attack or maybe some of my nerves in my brains will burst please i need a help. ### REPLY: Hello........ Thanks for your query. Panic disorder frequently coexists with agoraphobia i.e. characterized by anxiety symptoms associated with closed spaces or crowded places. I would suggest you undergo a psychiatric evaluation to rule out the above disorders in addition to other anxiety disorders.  I would like to reassure you that they are not life-threatening conditions. The treatment include antianxiety .  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: Using my outstretched right arm and exerting pressure (e.g. pushing something away, or turning a screw) is painful. I know I have insufficiency of the rotator cuff and a torn supra spinatus. I do shoulder exercises. But it is getting less comfortable with age (almost 80). Plus, I play the violin which I have to limit practice time not to make it worse. I am grateful for any hints how to strengthen and stabilize the arm more. Barbara. ### REPLY: Hi, I must first congratulate you on your active life and ability to be the finest violinist, at your age, despite the discomfort. You have not specified where exactly you have pain, I would presume that the pain is in the shoulder. Since you are doing exercises for shoulder the only thing I can add is a local injection in the shoulder, either steroid or PRP. 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: Sir i have a running nose and I am sneezing continuously. My doctor has given me decongestant tablet for 3 days and told me that I might have a sinus infection. After 3 days I still have pain behind my eyes though the sneezing has reduced. I used to have this problem frequently but this is the first time doctors told me that it might be sunus infection. Now the doctor has given me Azithral 500 and Montair LC with Nimutab. Should I take this or consult an ENT specialist? Thank you. ### REPLY: Thanks for query on . Pain behind eyes with sneezing usually occurs in sinusitis. You can take azithromycin, montair LC, continue it. You have to taken said like paracetamol 650 mg. twice a day for pain according to me. Ask you doctor about it then start. It will subside within 5 to 7 days. Steam inhalation will be helpful. If it persists then go for complete eye check up. Keep in touch with your doctor. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 got sebeceous many cysts all over scrotum(small as hardly 1mm in size but large in numbers abt100-200). i have already undergone surgery for the same. yet new cysts are coming. which cream can i apply on scrotum dat will break cysts but wont harm skin & my sex ability as well? ### REPLY: Hi, Multiple sebaceous cysts over the scrotum is a rare condition but should be promptly treated if infected to avoid complications that can be harmful to your in the future. Best is to consult a surgeon who can examine you and confirm the diagnosis. Once confirmed, a carefully planned surgery must be done to remove the cysts and then probably reconstruct the scrotum using skin flap surgery. Applying cream may not always help and if ignored then you might end with a potentially life-threatening condition which can lead to infections and gangrene of the scrotum. With the latest surgical techniques complete treatment is possible. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 fell down two stairs a week ago. I have a bruised tailbone, waiting on MRI to check further on something that showed up on xray. I have bad heaviness that wraps around my back, hip to hip, now starting to go around to the front. lumbar xray done. showed something. severe cramping type pain when lying down when I try to move or raise up. on flexeril, Mobic, Tylenol for pain. can t stay on my feet but very limited time. have been very week; getting a little stronger, but can t do much. it was a very hard fall that bruised my back below the waist to the tailbone, small bruises, and my upper back hit the wall. what could I have done? the lst dr. said the exray showed something smashed or mashed in my spine ### REPLY: Hi, as you mentioned your history of fall and symptoms, it appears to me there could be chances of the soft tissue Injury in the intervertebral disc space, the second chance could be the listless of the spine which is common. But in 99% of the cases the recovery is achieved by the combination of conservative treatment and physical therapy. So let the report come first as it will assist further. With the grace of God I wish you a good health ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sat level was 41 most recently a month ago. Was due to re test. seven days ago, got severe diarrhea that has lasted seven days. No consistency, almost like water. And it has been beige in color, never seen this before. Saw a physicians assistant that seemed to think I had stomach flu. No fever. But I did not rest, I am attorney with very busy schedule and two toddlers so he seemed to think it was stress related possibly as well. I ve had stress, I do not manifest it this way. Anxiety is how I manifest stress. I have taken anti depressant all my life now on wellbutrin and 10 years was on effexxor as well as a host of other add ons. Do i need to rush to the ER for possible bile duct abstraction?w ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. As you know anxiety and stress, I am not explaining them in detail. These are mental disorders and not diseases. These are mental conditions rather, manifested itself out of wrong perceptions and stimuli. Numerous researchers and researches emphasize again and again on the fact that mental disorders cannot be cured only with the help of psychiatric medicines. You need to alter your lifestyle to suit the requirement, change your thinking patters and maintain positive body metabolism. Psychotherapy techniques, yoga, meditation etc. should help you achieve these requirements. A trained psychologist / psychotherapist can help you in this aspect. If you still need my help, please describe the whole problem in detail and post a direct question to me. I shall definitely help you with psychotherapy techniques to overcome your problems. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: When straightening up after bending over for a couple minutes I had a sharp pain in my back.  Now I cannot straighten my back and have trouble walking because of the pain.  The only way to relieve the pain so far has been to lay down in the fetal position.  What may be the problem? ### REPLY: After going through your query I came to know that you are probably suffering from lumbar disc prolapse. It can be confirmed by MRI scan. There are two treatment options. First option is rest in position of relief(generally lateral position with both knee bend), neurotopics such as mecobalamin and analgesics (Diclofenac three times a day after meals is effective). Sometimes strong analgesic(such as tramadol three times a day after meals) is required. Omeprazole before meals prevent acidity caused by analgesics. Second option is go for surgical operation(Discectomy).  You can discuss with your treating Doctor about it. I do hope that you have found something helpful, and I will be glad to answer any further 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: I have a small, red growth on my upper left gum that bleeds when I brush my teeth. I went to the dentist, and they removed it, but it has since grown back. I have a follow up appointment in a few days because they said if it grows back I need to go to hospital, which is concerning me, what could it be? ### REPLY: Thanks for your query, I have gone through your query. The red growth on the gums that bleeds on brushing could be because of a myogenic granuloma or gingival or pulp polyp. Consult an oral physician and get it evaluated. Since you are giving history of previous treatment and its recurrence, consult an oral maxillofacial surgeon and get it surgically removed and send the specimen for histopathological examination to confirm the diagnosis. If it is a myogenic granuloma or gingival polyp, it can be treated surgically. If it is a pulp polyp, then the tooth has to be treated followed by excision of the growth. 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: A Dr told me I have high oxalate levels in my blood causeing kidney stones.......i have recently had gastric bypass.....im sure thats the reason because I DONT TAKE MY VITAMINS AND CALCIUM RIGHT!  What other problems could this create or should i expect......im trying to take my meds better now. ### REPLY: HAI, High level oxalate indicates you are taking high oxalate containing foods. Vitamins and calcium will not help in reducing the oxalate level in blood. Poor intake of water will lead to increase in oxalate content in blood. Oxalate crystals may produce stone. Kidney stone will give you pain in the back depend upon the stone formation in the respective kidney. It will be a radiating pain, to the down pelvis. Urinary infection, urinary tract obstruction, burning sensation while passing urine, blood in urine can be experienced. Thank you hope I answered your query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My gastroengerologist has referred me for surgery to repair paraesophogeal hernia.  He indicated an urgency because of the possibility of vomitting in my lungs and suphocating.  I was kind of in shock during the interview and I wasnt able to ask how that would be even possible -- do you know? ### REPLY: Hi. Para esophageal hernia can cause varied symptoms. One of them may be gastroesophageal reflux disease meaning the stomach contents, particularly the acid comes up in the esophagus causing burning, difficulty or painful swallowing and so. It would have beneficial for me to know your symptoms, why the investigations were done to diagnose this in the first place. The possibility of vomiting in the lung casing suffocation is very remote. So urgency is not required on this ground. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello! my daughter is 3+ yrs old. she is good on all activities but she is thin. she can not eat all at one go, she eats on regular interval. She is thin and her wweight is also less, currently her weight is 11kgs.. So I like to know how can I increase her weight and immune system well.Thank you,Bhavesh Vora ### REPLY: Hi Read your questioner daughter is under weight According to u your daughter eat at regular interval For weight gain u have to give her all types of food And also pulses and cereals U have to give her chelcerol sachet (one sachet on every week for 10 weeks)Also give her protein powder if not taking pulses in food Give food regular intervals but healthy food not biscuits or refers and other junk food Give daily morning Paley(spinach) soup which contains iron Also give her weather fruits and vegetable. If not gaining at properly then consult pediatrician and ask him/her for diary chart for your daughter ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have had 2 blood tests done one on 10/15 ( ChatDoctor Beta at 829) another test done on 10/17 (ChatDoctor Beta at 896) I also had a ultrasound done on 10/18/12 and per the measurements i am 5 weeks and 2 days and they saw a gestational sac and the endometrium measuring at 12mm. Just by looking at my levels do you think everything could work out?? My doctor requested I have the shot right after the second blood test to terminate and I requested the ultrasound then saw the sac, and had another round of blood work. Please give me your honest opinion. Thanks. ### REPLY: Hello madam, I am not happy with the beta  rise in two days. It should have risen more and nearly doubled in a viable intrauterine pregnancy. I would also like to know whether you have got any pain, because then we have to be more cautious to rule out an ectopic pregnancy. (a sac in the uterus can also be seen in ectopic pregnancy, called a pseudo-gestational sac). I would advise you to repeat the transvaginal ultrasound after two weeks, if you don't have any symptoms of pain or bleeding in the meantime, before going for a termination.  Good luck ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: At what level of creatinine will dialysis be recommended. Patient is 66yrs with hypertension and history of mild stroke. Creatnine level was 1.7 in Nov 2011 and is 1.9 now. also will daily ecosprin usage adversely affect the kidneys further? thanks, ### REPLY: Hi, I appreciate your concern for kidney health. Let me inform you that one should not base the decision to do dialysis solely on the creatinine levels. One should take into consideration clinical condition, any other coexisting disease, blood levels of other substances as well. Having said that, what some of us roughly follow is a creatinine level of around 8 for deciding it. Any does beyond 75 mg of esprit has a potential to adversely affect the kidneys. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m 27 years old Married, I have Asthenospermia as per the following test result for my seminal fluid analysis: Volum: 1.4mL pH:8.5 Total Concentration: 58M/mL Total CountL 81 M/ej MORPHOLOGY: Normal: 70% Abnormal: 30% MOTILITY a.Rapid progressive: 0% b.Slow progressive: 20% c. Non progressive: 30% d.Non-Motile: 50% Liquefaction time : 1 Hour Color: Cream Consistency: Normal WBC/hpf: 0-2 RBC/hpf:1-3 Sperm agglutination: Negative What are causes the Asthenospermia? Would you please advise according to the above test result what is solution for me to do in order to have children? Your earliest reply in same matter shall be highly apprecaited. Thanks Mohamud ### REPLY: Hi Welcome to  Your semen analysis report appears to be normal other than low motility (asthenospermia). According to WHO, Motility (progressive+non-progressive) should be >40% out of which progressive motility should be at least 32%. In your case progressive motility is on lower side. There are many factors which may impair sperm motility like environmental (heat, Pollution,pesticides), Lifestyle (smoking, alcohol, obesity, poor diet, stress etc.), infections and few others. Though pus cells are within normal limits in your semen report, still get a semen culture done to rule out infections. Taking antioxidants will help. Consult a fertility specialist or urologist. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I have had  very bad back pain in my lower left back which goes into my buttock for over 2 weeks.  I saw my doctor two weeks ago, who thought it was chronic back strain.  I have been very careful since, moving around, but sitting down and standing for short periods is painful. I have dull period like pains in my stomach although not due a period for another 10 days or so.  I have noticed over the last few months that my back gets painful for a couple of days before my period, which goes after a few days, but this pain isnt going away! ### REPLY: Hi, thanks for writing to . Back pain occurring a few days before menstrual periods is considered as normal which usually results due to pelvic congestion during that time. In your case, back pain which is persisting and radiating into the gluteal region might be possibly due to Sacroiliac joint strain or some issues in the Lower Lumbar spine. A detailed clinical examination and appropriate investigations like X-rays of the L.S.spine & S.I.joints or an MRI scan will help in establishing the correct diagnosis. The treatment depends upon the diagnosed condition. I suggest you to consult an orthopedic surgeon for further management. Hope this information is helpful. Good day ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have constant pain in my head and have been diagnosed with POSTHERPETIC Neuralgia. I am taking Lyrica which doesn t help at all. I rub Capsasin into my hair and it just burns. Is there anything else I can do to stop the pain. It is unbearable. Thank you. ### REPLY: Hi Dear, Understanding your concern. Postherpetic neuralgia is a complication of shingles, which is caused by the chickenpox virus. If you experience persistent pain due to postherpetic Neuralgia you should consult neurologist for proper examination. Post-herpetic neuralgia is easy to diagnose based on your symptoms and medical history. Doctor may prescribe lidocaine patches, anticonvulsant gabapentin like Neurontin other than lyrics and in case of severe pain doctor may also prescribe stronger painkiller like tramadol. For now, you can apply anesthetic cream for relief from pain and itchiness. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, gor the past 2 nights I ve been experiencing a dull pain on my ribs on my left side just under my armpit. Activity doesn t seem to bother it but it is tender to the touch and is uncomfortable to lay on my side or even rest my arm against it. Any ideas? ### REPLY: Hello, I have studied your case and I think that you might be having pain and selling on rib due to some injury which you might not notice. sometimes it can be due to chest infection also. A severe cough can also cause such muscle strain. I would recommend you to get a chest x-ray and see if there is any hair line fracture in the bone. Also, some time there can be muscle pull. All you need is rest and pain killers and violin gel local application with hot water fomentation.  I hope this answer will be useful for you. Let me know if there is any other followup questions. 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: Wondering what is causing my lung pain. Background: Worsens both with activity/movement, and whilst lying down. Sitting still provides relief. Seems related to my menstrual cycle - over past year it is worst either during, or just before, menstruation. I ve been checked for heart issues - tests came up clear. Also had CT for chest to check for clots, came up clear. I have existing conditions: recurring stage 4 endometriosis in bowel and reproductive organs, PCOS and ongoing joint pain. ### REPLY: Thanks for your question on . In my opinion you are having anxiety related chest symptoms mostly. Since your all cardiac and pulmonary tests are normal, no need to worry about major organic disease. It is anxiety mostly. You are also having endometriosis and PCs (poly cystic ovarian disease). Both these diseases are associated with stress and anxiety. So I advise you to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life. And work out solution for the same. You may require anxiolytic . So avoid stress and tension. Be relax and calm. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 wondering if when head extended can you manually push the C-5 C6 vertebrae forward a small amount? I have felt a round bump for about six months and it feels like it moves with the vertebrae. Does the faucet on the vertebrae feel more spongy then the vertebrae itself? I just have a dull ache no pain. ### REPLY: Hi, I personally recommend you ask your neurosurgeon for some imaging like CT, MRI, x-rays on your cervical spine for a more précised diagnosis it could be asymptomatic, and could cause some pain attacks.  It also could be some kind of cyst, or SC lipoma, even cervical herniation may cause some bulging. For now, I recommend some physiotherapy with topical muscle relaxants or even yoga is effective. Advil tab, and Acetaminophen tab will be more than enough. Hope the above information helps you. Any further clarifications feel free to ask. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Several years ago my father was diagonosed with prostate cancer with a PSA level of 28. With medication the medical people got it down to 9. At the present time, my father is 85 in a nursing home. This week the family requested another PSA count. The results came back today from the lab and it was 495. What does this mean for our father. Thank You ### REPLY: Hi, Thanks for writing in.PSA is prostate specific antigen. It is a substance that is secreted in larger amounts should a patient have cancer of prostate. It can also be secreted in conditions like infections of the prostate gland in elderly men. A single PSA level is not very reliable but follow-up levels are important. As your father has regularly got PSA analysis done therefore it will help to know the duration between the tests. The normal level of PSA in less than 4. However, 495 appears to be a highly inflated figure, and it will help to know if his test is erroneously showing high levels or if he has an infection or active disease leading to this value. If required the pleasing repeat the test once again. Please do not worry. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Iam having teeth ache problem..........now doctor has advised to take novaclox - lb....after 1.5 days my pain is not decresing . After taking food , its getting very painfull. Once i used cold water pain will decrease....... for small duration.Still how many days need for pain control ### REPLY: Thanks for your query. I have gone through your query. The pain you are describing is a characteristic feature of pulpits. So the Inovalon will not help much. The teeth have to be treated immediately by RCT. Once the treatment is started pain will come down. You can start with Inovalon and analgesic like diclofenac 50 mg BID. This will reduce the pain when you take medicines and will be effective for 4-5hours. So consult an endodontist and get it treated immediately. I hope my answer will help you. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I was diagnosed with Astrocytoma grade 2 in January 2014 via biopsy, then had 98% removed April 2014. Since then I have had two seizures while not on any medication, I am now on Keppra 500 mg twice a day. I have had several doctors (3 here in Tennessee  and 2 in Illinois) tell me my life expectancy is 4 years and pneumonia would be the cause of my death. I guess my question is, how true is that? January will be 4 years, should I start planning my funeral?  Any homeopathic approach to my condition would be greatly appreciated. Also, I have had a lot of people ask If I smoke Marijuana or use CBD. I do not smoke Marijuana and know nothing about CBD. ### REPLY: Thanks for contacting with your health concern1. Grade II astrocyte [diffuse astrocyte] are slow growing brain tumor, but recurrence is possible even after treatment and since they are diffuse which means it does not have well-defined edges which make it difficult to remove completely [consult a Neurosurgeon for the second opinion]2. The average survival time after surgery is 6-8 years. More than 40% of people live more than 10 years.3. Cannabidiol [CBD] oil is a natural, non-psychotropic concentrate extracted from hemp and although is used in the treatment of astrocyte since it is not an approved/accepted treatment thus if you want to use it your attending Physician must be told about the same. [you may also look for CBD liquid/capsules/tincture/Gum]4. As this type of tumor can change quickly from grade II to grade III [malignant form] thus remain under constant supervision, observation and guidance of Neurosurgeon and for any alternative approach kindly let him know to prevent any .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 39 yrs old female, 52, weight 138 lbs. My blood pressure is 145/70. I have been having difficulty breathing lately and/or having difficulty getting that full breath unless I take a reallydeep breath. We are curently liviing with the in laws and its been a stressful situation. What exercise and diet should I do in order to get a normal blood pressure. More Cardio/walking? Please advise. ### REPLY: Respected user, hi I evaluated your query thoroughly.* This relates to the anxiety induced phenomenon.* You require having certain lifestyle modifications as - avoid stress / anxiety with help of meditations, YOGA-deep breathing exercises are the corner stone of the therapy-have regular sound sleep of 8 hours-diet should be containing all necessary ingredients in balance form including carboy . - walking in fresh air for 20 minutes help a lot on daily basis - avoid smoking / alcohol / any abuse substances if using Note that your BP is normal as per your age criteria. Hope this clears your query. Welcome for any further assistance. Thanks for using  .com & giving me an opportunity to assistWishing you fine recovery from the same. Regards dear 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 father age is 67 years old. Last month , he had dedeceted myasthenia gravies . Dr started the medicine myestin 60 , one tab three times a day. My father has 10% relif. Now dr suggest to start a new medicine azoran 50 g. But this have some side effects . Blood test report is _ ACHR ANTIBODIES , ACETYL CHOLINE RECEPTOR ANTIBODIES _ 20.1. Nmol/l please suggest me.what can I do??? ### REPLY: Hello ! Thank you for the question on ! Regarding your concern I would say that his antibodies are really high. The small effect of mystic, is very indicative for a possible progression of the disease. This disease can lead to respiratory insufficiency, causing high morbidity and mortality. So I agree with your doctor to have a more aggressive treatment. We should put into balance the side effects of this .  Another option would be steroids. But they are contraindicated in hypertension, diabetes or gastritis and ulcers. I don't know if your father has any contraindications to oral steroids. I would also recommend a thoracic CT scan for Thomas, or thy mic hyperplasia. This high level of antibody may be related with this disorder. Surgery would be very helpful in that case. Hope to have been helpful! 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 m 45 year old male, suffering from high bp, sugar nd liver enlargement nd hiper thyroid but now days normal i m taking the medicine ( 1)- nebicard h 1 time (2) glimisave m 1 forte 2 times (3) nexcito 10 at night (4) thyroxin 100 mg 1 time morning ### REPLY: Hi. Wel come to , I understand your concern about treatment which you are taking for high B.P., Diabetes, hyper thyroid & liver enlargement. Tab. Medicare H is a very good . p. control & Tab. Eliminate M is also a nice medicine for blood sugar control but subject to that, You should check up your b.p. once or twice in a week & also check up of your blood sugar both--Fasting & p.p.b.s. simultaneously you should also check up of your thyroid by doing laboratory test of---thyroid profile-T3, T4, T.S.H. at regular interval of 3 to 4 months, & also you should do ultrasonography (U.S.G.)  Of whole abdomen to rule out the latest status of liver enlargement. After doing all reports you can share on , So that after studying the status of your health we can recommend even more suitable medicine as well as dose also. Please share following details along with the reports in follow-up discussion to understand your problem in details;1) weight2) b.p. record with 2-3 readings.3) blood sugar reports --- f.b.s., p.p.b.s.4) your eating habits during the 24 hours.5) your type of work.  & any other information which ever you like to share. Please take care, Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctor. 2 days back i realised iam having burnig sensation on my penis foreskin. when i came home from office and checked it was a small cut on the left side foreskin and it was reddish circle on the foreskin. so i immediately applied candid - B and then today when i checked the red circle is not there and the cut is also not visible but i see a whice dry skin circle instead of the red circle. what could it be? ### REPLY: HelloThanks for query. Cracks and reddish foreskin is mostly suggests infection of Foreskin (Prostatitis). Check your blood sugar levels to rule out diabetes as this is one of the first presenting symptom of Diabetes. Take broad spectrum antibiotic like Augmenting twice daily with topical antifungal cream Candid cream for local application. Ensure to wash your genitals with warm water twice daily. It should get cured within a week. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 asthma and coughed so badly feels like i pulled muscle in my ribs. the pain is great. problem is I am not sure if I can take anything for the pain. on abuterol, prednisone , prestiq. also I have a bicuspid arotic valve and acsending anurysym. just want to take something for my pain I am 50 years old and was never sick a day in my life until april 2012 ### REPLY: Hi, Thanks for using the .  Hi for the pain you can take some mild analgesic. For your asthma management you can ask your doctor to start ULTRA (plain montelukast sodium) along with prednisone. Combination ll have better effect and can reduce the dose of steroid gradually(according to Guidelines). This will reduce inflammatory pathways & prevent further damage. You have to continue taking albuterol as and when required. Hope I have answered your query. If you have any further questions I will be happy to help. Thanks get well soon.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m only having sex from behind because my boyfriend prefers it this way(from the ass not the vegina) and I ve heared it causes prostate or hemorrhoid cancer. It s worrying me very much. Ive heared also that the act causes cracks in the lining of the anal straight and so when ejaculation of semen inside the anus, The presence of the cracks lead to some leakage of some sperm into the bloodstream and since the sperm is considered a foreign body to the female body, the body produces antibodies to attack the intruder stranger (the spirm) and so when an intercourse occurs naturally (in the vagina) These antibodies attack sperm ejected into the vagina and cripples if causing infertility for life. This is worrying me very much! Is it true? Please advice ### REPLY: Hi, anal sex may increase chance of HPV infection which has potential to develop cancer. But personal hygiene, no of sexual partners also play a role. Anyway anal cancer has no relation with infertility. What the explanation you are giving has got a theoretical background, but practically chance is negligible. Prostate cancer can not be caused by anal sex. Anal sex may increase chance of prostatitis not cancer. You may consult sexually transmitted disease specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Doctor, I am 32 years old, female, weigh 131 lbs and have a heart mumor.  I get irregular heart palpitations  from time to time and I worry. How can I stop them when i get them?I exercise at a gym at least 3x a week. Today after the exercise, I got the palpitations and felt faint. ### REPLY: Murder in your heart can be because of a valvular malfunction or defect a 2 d echo should be done to find out which valve is involved and to see whether it is a stenotic lesion or regurgitate lesion, there are four types of valves in heart, a 2d echo will show which valve is involved and what is the nature of lesion and its degree whether mild moderate or severe stop doing any exercises till your echo is done, palpitations are because of that lesion only, once we find the defective valve we CN treat it and palpitations will settle down by themselfthanksadviceurgent 2D echo ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ihad or still have bronchitis, have had all the meds prednisone an all ,done with, still use advair spray in mouth, was fine when i got up, at home nurse the dr sends out once a week, said my lungs sound clear, But yet my lungs are burning , an my husband said i sound out of breath what do i do, ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you should get done PFT (Pulmonary Function Test) again. PFT will also tell you about severity of the disease and treatment of bronchitis is based on severity only. You may need additional bronchodilators (inhaled as well as oral). Most common cause for bronchitis is infection. So anti are also important. Other .  So consult pulmonologist and discuss all these. Hope I have solved your query. Wish you good health. Thanks. ### END